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PubMed · 9603712

Miscarriage.

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K Griffin. 1998. Miscarriage.. https://pubmed.ncbi.nlm.nih.gov/9603712/

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Spontaneous abortion of normal karyotype embryos in mice and in humans is associated with an increase in uterine T helper (Th) 1 type proinflammatory cytokines, tumour necrosis factor (TNF)-alpha, interferon-gamma and interleukin (IL)-1, and a deficiency of Th2/3 type cytokines, IL-4, IL-10, and transforming growth factor (TGF)-beta2. In mice, Th1 cytokines up-regulate a novel prothrombinase, fgl2, which via thrombin, leads to activation of polymorphonuclear leukocytes that terminate the pregnancy. Here we show that Th1 cytokines up-regulate fgl2 mRNA in fetal trophoblast and secondary decidua of CBA/JxDBA/2 and CBA/JxBALB/c matings, and promote fibrin deposition. This pattern is accompanied by a high rate of abortion. However, the spontaneous abortion rates in abortion-prone CBAxDBA/2 matings and in low abortion rate CBAxBALB/c matings were significantly lower than that expected from the frequency of implantations with high levels of fibrin and fgl2 mRNA(hi). As the glycoprotein OX-2 occurs in the pregnant rat uterus and can deviate cytokine responses to Th2/3, we investigated OX-2 in pregnant CBA/J mice. We found OX-2 mRNA was present at the same sites as fgl2 mRNA, but was reduced in response to Th1 cytokines. Furthermore, anti-OX-2 raised the abortion rate to predicted levels, while recombinant OX-2 dramatically reduced the abortion rate. Fgl2 prothrombinase may provide a mechanism explaining pregnancy loss, and conversely, successful pregnancy may be due in part to OX-2-dependent activation of maternal tolerance mechanisms at the feto-maternal interface.

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The associations of maternal caffeine consumption and nausea with spontaneous abortion.

To examine whether maternal caffeine consumption is associated with the risk of spontaneous abortion, we analyzed data from a population-based prospective study. The study population comprised 575 women delivering singleton livebirths and 75 women who had spontaneous abortions. The subjects were predominantly white, middle-class women enrolled before pregnancy. Study participants were traced to delivery of a liveborn, singleton infant or a spontaneous abortion. Of the 71 women who did not experience nausea, 29.6% had a spontaneous abortion, compared with 7.2% of 514 women who did experience nausea. Maternal caffeine consumption before pregnancy, or in women without nausea, did not increase the risk of spontaneous abortion, whereas maternal caffeine consumption during the first trimester after nausea started might increase risk of spontaneous abortion (risk ratio = 5.4, 95% confidence interval = 2.0-14.6 for caffeine consumption > or = 300 mg per day compared with < 20 mg per day). These results suggest that maternal caffeine consumption during pregnancy may influence fetal viability in women with nausea.

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