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A new customised placental weight standard redefines the relationship between maternal obesity and extremes of placental size and is more closely associated with pregnancy complications than an existing population standard
- Jacqueline M. Wallace, Joeleita P. Agard, Graham W. Horgan
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- Journal:
- Journal of Developmental Origins of Health and Disease / Volume 11 / Issue 4 / August 2020
- Published online by Cambridge University Press:
- 07 October 2019, pp. 350-359
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Placental weight is a valuable indicator of its function, predicting both pregnancy outcome and lifelong health. Population-based centile charts of weight-for-gestational-age and parity are useful for identifying extremes of placental weight but fail to consider maternal size. To address this deficit, a multiple regression model was fitted to derive coefficients for predicting normal placental weight using records from healthy pregnancies of nulliparous/multiparous women of differing height and weight (n = 107,170 deliveries, 37–43 weeks gestation). The difference between actual and predicted placental weight generated a z-score/individual centile for the entire cohort including women with pregnancy complications (n = 121,591). The association between maternal BMI and placental weight extremes defined by the new customised versus population-based standard was investigated by logistic regression, as was the association between low placental weight and pregnancy complications. Underweight women had a greater risk of low placental weight [<10thcentile, OR 1.84 (95% CI 1.66, 2.05)] and obese women had a greater risk of high placental weight [>90th centile, OR 1.98 (95% CI 1.88, 2.10)] using a population standard. After customisation, the risk of high placental weight in obese/morbidly obese women was attenuated [OR 1.17 (95% CI 1.09, 1.25)]/no longer significant, while their risk of low placental weight was 59%–129% higher (P < 0.001). The customised placental weight standard was more closely associated with stillbirth, hypertensive disease, placental abruption and neonatal death than the population standard. Our customised placental weight standard reveals higher risk of relative placental growth restriction leading to lower than expected birthweights in obese women, and a stronger association between low placental weight and pregnancy complications generally. Further, it provides an alternative tool for defining placental weight extremes with implications for the placental programming of chronic disease.
Choline supplementation and measures of choline and betaine status: a randomised, controlled trial in postmenopausal women
- Julie M. W. Wallace, Jacqueline M. McCormack, Helene McNulty, Paula M. Walsh, Paula J. Robson, Maxine P. Bonham, Maresa E. Duffy, Mary Ward, Anne M. Molloy, John M. Scott, Per M. Ueland, J. J. Strain
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- Journal:
- British Journal of Nutrition / Volume 108 / Issue 7 / 14 October 2012
- Published online by Cambridge University Press:
- 15 December 2011, pp. 1264-1271
- Print publication:
- 14 October 2012
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Choline is an essential nutrient and can also be obtained by de novo synthesis via an oestrogen responsive pathway. Choline can be oxidised to the methyl donor betaine, with short-term supplementation reported to lower plasma total homocysteine (tHcy); however, the effects of longer-term choline supplementation are less clear. We investigated the effect of choline supplementation on plasma concentrations of free choline, betaine and tHcy and B-vitamin status in postmenopausal women, a group more susceptible to low choline status. We also assessed whether supplementation altered plasma lipid profiles. In this randomised, double-blinded, placebo-controlled study, forty-two healthy postmenopausal women received 1 g choline per d (as choline bitartrate), or an identical placebo supplement with their habitual diet. Fasting blood samples were collected at baseline, week 6 and week 12. Administration of choline increased median choline and betaine concentrations in plasma, with significant effects evident after 6 weeks of supplementation (P < 0·001) and remaining significant at 12 weeks (P < 0·001); no effect was observed on folate status or on plasma lipids. Choline supplementation induced a median (25th, 75th percentile) change in plasma tHcy concentration at week 6 of − 0·9 ( − 1·6, 0·2) μmol, a change which, when compared to that observed in the placebo group 0·6 ( − 0·4, 1·9) μmol, approached statistical significance (P = 0·058). Choline supplementation at a dose of 1 g/d significantly increases the circulating concentration of free choline, and can also significantly increase the concentration of the methyl donor, betaine, thereby potentially enhancing the betaine–homocysteine methyltransferase-mediated remethylation of tHcy. This trial was registered at http://www.controlled-trials.com/ISRCTN82708510.
Adverse metabolic phenotype in low-birth-weight lambs and its modification by postnatal nutrition
- Jacqueline M. Wallace, John S. Milne, Clare L. Adam, Raymond P. Aitken
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- Journal:
- British Journal of Nutrition / Volume 107 / Issue 4 / 28 February 2012
- Published online by Cambridge University Press:
- 05 July 2011, pp. 510-522
- Print publication:
- 28 February 2012
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Both high and low maternal dietary intakes adversely affect fetal nutrient supply in adolescent sheep pregnancies. Aims were: (a) to assess the impact of prenatal nutrition on pregnancy outcome, offspring growth and offspring glucose metabolism and (b) to determine whether the offspring metabolic phenotype could then be altered by modifying postnatal nutrition. Dams carrying a single fetus were offered either an optimal control (C) intake to maintain adiposity throughout pregnancy, undernourished to maintain weight at conception but deplete maternal reserves (UN), or overnourished to promote rapid maternal growth and adiposity (ON). Placental weight and gestation length were reduced in ON dams and lamb birth weights were C>UN>ON (P < 0·001). All offspring were fed ad libitum from weaning to 6 months of age. ON offspring exhibited rapid catch-up growth and had increased fasting glucose and relative glucose intolerance compared with C offspring (P < 0·05). Irrespective of prenatal diet and sex, birth weight correlated negatively with these indices of glucose metabolism. From 7 to 12 months offspring either had continued ad libitum diet (ADLIB; to induce an obesogenic state) or a decreased ration appropriate for normal growth (NORM). At 12 months, the negative relationship between birth weight and indices of glucose metabolism persisted in ADLIB females (for example, fasting glucose, r − 0·632; P < 0·03) but was absent in NORM females and in both male groups. Therefore, low-birth-weight offspring from differentially achieved prenatal malnutrition exhibit an early adverse metabolic phenotype, and this can apparently be ameliorated by postnatal nutrition in females but not in males.
6 - Adaptive maternal, placental and fetal responses to nutritional extremes in the pregnant adolescent: lessons from sheep
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- By Jacqueline M. Wallace, Rowett Research Institute, UK
- Edited by C. G. Nicholas Mascie-Taylor, University of Cambridge, Lyliane Rosetta, Centre National de la Recherche Scientifique (CNRS), Paris
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- Reproduction and Adaptation
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- 16 May 2011
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- 13 January 2011, pp 112-127
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Summary
Introduction
Inadequate fetal nutrient supply and the resulting intrauterine growth restriction (IUGR) and premature delivery continue to cause unacceptably high rates of infant mortality and morbidity throughout the world. Indeed in the relatively affluent UK, recent statistics reveal that the incidence of low birth weight (<2500 g) has increased from 67 per 1000 births in 1989 to 78 per 1000 births in 2006 (Fabian Society, 2006). While these figures may in part reflect both the changing ethnic makeup of UK society and the increased availability of assisted conception procedures and hence multiple births, the trend is worrying as both premature delivery and low birth weight are associated with a lifetime legacy of health issues. For the extremely small and premature baby there is an increased risk of cerebral palsy, autism, visual and aural impairment, and of experiencing developmental problems such as low IQ, poor cognitive function and learning difficulties with their obvious social, ethical and economic costs (Hack & Merkatz, 1995). In addition, there is compelling evidence from a large number of epidemiological studies that low birth weight, even within the normal range, is a major risk factor for the subsequent development of metabolic syndrome and its co-morbidities, particularly when the infant is born into a calorie-rich environment (Barker, 1998, 2006). It is axiomatic that reducing the incidence of low birth weight is a major research priority with the potential to impact immediate survival and lifelong health of the individual.
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Yee, Viktor Yelensky, Yeo Khiok-Khng, Gustav K. K. Yeung, Angela Yiu, Amos Yong, Yong Ting Jin, You Bin, Youhanna Nessim Youssef, Eliana Yunes, Robert Michael Zaller, Valarie H. Ziegler, Barbara Brown Zikmund, Joyce Ann Zimmerman, Aurora Zlotnik, Zhuo Xinping
- Edited by Daniel Patte, Vanderbilt University, Tennessee
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- The Cambridge Dictionary of Christianity
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- 05 August 2012
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- 20 September 2010, pp xi-xliv
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Nutrient partitioning during pregnancy: adverse gestational outcome in overnourished adolescent dams
- Jacqueline M. Wallace
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- Proceedings of the Nutrition Society / Volume 59 / Issue 1 / February 2000
- Published online by Cambridge University Press:
- 28 February 2007, pp. 107-117
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Appropriate nutrient partitioning between the maternal body and gravid uterus is essential for optimum fetal growth and neonatal survival, and in adult sheep nutrient partitioning during pregnancy generally favours the conceptus at the expense of the dam. However, recent studies using an overnourished adolescent sheep model demonstrate that the hierarchy of nutrient partitioning during pregnancy can be dramatically altered in young growing females. Overnourishing the adolescent dams to promote rapid maternal growth throughout pregnancy results in a major restriction in placental mass and leads to a significant decrease in birth weight relative to moderately-fed adolescents of equivalent gynaecological age. High maternal feed intakes are also associated with an increased incidence of non-infectious spontaneous abortion, a reduction in gestation length and colostrum production, and a higher incidence of neonatal mortality. The present paper examines the putative role of a variety of endocrine regulators of nutrient partitioning in this unusual model system, where the dam is overnourished while the stunted placenta restricts nutrient supply to the fetus. The central role of nutritionally-mediated alterations in placental growth and development in setting the subsequent pattern of nutrient partitioning between the maternal body, placenta and fetus is examined, and critical periods of sensitivity to alterations in maternal nutritional status are defined. Finally, the consequences of this form of inappropriate nutrient partitioning on the growth and development of the fetus and neonate are described with particular emphasis on the reproductive axis.
Effect of diet composition on pregnancy outcome in overnourished rapidly growing adolescent sheep
- Jacqueline M. Wallace, John S. Milne, Dale A. Redmer, Raymond P. Aitken
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- Journal:
- British Journal of Nutrition / Volume 96 / Issue 6 / December 2006
- Published online by Cambridge University Press:
- 15 March 2007, pp. 1060-1068
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- December 2006
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When pregnant adolescent sheep are overnourished to promote maternal growth during pregnancy, growth of the placenta is impaired and results in the premature delivery of low birth weight lambs relative to control-fed adolescents of equivalent age. These effects have been achieved by feeding two levels of the same complete diet. The present study evaluated the role of protein in pregnancy outcome in our adolescent sheep paradigm. Adolescent ewes were implanted with single embryos on day 4 post-oestrus. Thereafter ewes were offered ad libitum an isoenergetic diet (11·4 MJ metabolisable energy/kg DM) containing either 12 % (basic, B) or 17 % (extra, E) crude protein. At day 75 of gestation, half the pregnant ewes on each protein level were switched to yield four groups, BB, EE, BE and EB protein. A further optimally nourished control group received a moderate quantity of a ration (14 % crude protein) designed to provide 100 % of the estimated energy and protein requirement of the adolescent sheep according to stage of pregnancy. Pregnancy outcome was determined at term. Feed intakes were independent of protein level in the four groups of ewes fed ad libitum and were higher (P < 0·001) than in the control group throughout. Maternal plasma urea concentrations reflected the current crude protein content of the diet offered and were elevated in the 17 % compared with 12 % protein groups (P < 0·001). Within groups fed ad libitum, maternal plasma insulin, glucose, NEFA and homocysteine concentrations were largely independent of protein level. Gestation length, placental weight, lamb birth weight and initial colostrum yield were reduced (P < 0·05) in all groups fed ad libitum relative to the optimally nourished control group. Similarly, total colostrum IgG, butterfat, lactose and crude protein content at parturition were attenuated in the ad libitum compared with the control groups. However, within ad libitum groups pregnancy outcome parameters were largely unaffected by level or timing of exposure to high protein intakes. The data imply that it is high-energy intakes that are the primary cause of impaired placental development and adverse pregnancy outcome in rapidly growing adolescent sheep.
The effect of overnourishing singleton-bearing adult ewes on nutrient partitioning to the gravid uterus
- Jacqueline M. Wallace, John S. Milne, Raymond P. Aitken
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- Journal:
- British Journal of Nutrition / Volume 94 / Issue 4 / October 2005
- Published online by Cambridge University Press:
- 08 March 2007, pp. 533-539
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- October 2005
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Overnourishing the singleton-bearing adolescent sheep throughout pregnancy promotes maternal tissue synthesis at the expense of the nutrient requirements of the gravid uterus. Consequently, the growth of the placenta is impaired and results in the premature delivery of low-birth-weight lambs relative to moderately fed adolescents of equivalent age. To establish if this phenomenon is unique to the growing animal, singleton pregnancies to a single sire were established by embryo transfer into primiparous adult ewes who had attained the normal mature body size for their genotype. Thereafter ewes were offered a maintenance or a high level of a complete diet throughout gestation. High maternal intakes resulted in elevated maternal insulin, no significant change in growth hormone or glucose, and attenuated progesterone and NEFA concentrations. Live weight gain during the first 93 d of gestation was 48 and 244 g/d, and adiposity score at term was 2·4 and 3·7 in the maintenance and high groups, respectively (P<0·001). In spite of achieving levels of adiposity similar to overnourished adolescents, placental (477 (sem 30) v. 518 (sem 41) g) and fetal (5190 (sem 320) v. 5420 (sem 250) g) weights were equivalent in maintenance and high groups. Gestation length was shorter (P<0·01) and colostrum yield at parturition lower (P<0·05) in high v. maintenance dams. Thus, adult sheep appear to be relatively insensitive to the oversupply of nutrients during pregnancy and have the ability to meet the nutrient requirements for normal conceptus growth in spite of their increased adiposity.
Growth and metabolism of fetal and maternal muscles of adolescent sheep on adequate or high feed intakes: possible role of protein kinase C-α in fetal muscle growth
- Robert M. Palmer, Michael G. Thompson, Chrystel Meallet, Amanda Thom, Raymond P. Aitken, Jacqueline M. Wallace
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- Journal:
- British Journal of Nutrition / Volume 79 / Issue 4 / April 1998
- Published online by Cambridge University Press:
- 09 March 2007, pp. 351-357
- Print publication:
- April 1998
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From days 4–104 of pregnancy, adolescent sheep, weighing 43·7 (SE 0·87)kg were offered a complete diet at two different intakes (approximately 5 or 15 kg/week) designed to meet slightly, or well above, maternal maintenance requirements. The fetal and maternal muscles were taken on day 104 of pregnancy and analysed for total DNA, RNA and protein. Ewes offered a high intake to promote rapid maternal weight gain, weighed more (76·5 (SE 4·5) v. 50·0 (SE 1·7) kg) and had muscles with a greater fresh weight, whilst their fetuses had smaller muscles, than those fed at a lower intake. Plantaris muscle of the ewes fed at the high intake contained more RNA and protein; again the opposite situation was found in the fetal muscle. On the higher maternal intakes, the DNA, RNA and protein contents of the fetal plantaris muscle were less than in fetuses of ewes fed at the lower intake. To investigate the possible mechanisms involved in this decrease in fetal muscle mass, cytosolic and membrane-associated muscle proteins were subjected to Western immunoblotting with antibodies to nine isoforms of protein kinase C (PKC), a family of enzymes known to play an important role in cell growth. Five PKC isoforms (α, ε, θ, μ and ζ) were identified in fetal muscle. One of these, PKC-α, was located predominantly in the cytosolic compartment in the smaller fetuses of the ewes fed at a high plane of nutrition, but was present to a greater extent in the membranes of the more rapidly growing fetuses of the ewes fed at the lower intake. This was the only isoform to demonstrate nutritionally related changes in its subcellular compartmentation suggesting that it may mediate some aspects of the change in fetal growth rate.
The effect of management history on oestrus cyclicity in mule ewes
- Margaret E King, Linda M Mitchell, R P Aitken, Jacqueline M Wallace
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- Journal:
- Proceedings of the British Society of Animal Science / Volume 1995 / March 1995
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- 20 November 2017, p. 94
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- March 1995
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Extensive research has been focused on advancing the breeding season of the ewe but little is known about the duration of the natural breeding season and if this is influenced by previous breeding management. Lambing percentage declines after the winter solstice but it would appear conception rate is maintained or improved (King, 1990). Oestrus cycles also appear to become naturally synchronised at this time giving a compact lambing without the use of teaser rams or exogenous substances. The objective of the present study was to determine the effect of management history on the onset and duration of ovarian activity in the commercially important Mule (Bluefaced Leicester x Blackface/Swaledale) ewe and on ovulation rate measured on three occasions during the natural breeding season.
The effect of management history and time of mating on ovulation and lambing rates in mule ewes
- Linda M Mitchell, Margaret E King, R.P. Aitken, Jacqueline M Wallace
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- Journal:
- Proceedings of the British Society of Animal Science / Volume 1995 / March 1995
- Published online by Cambridge University Press:
- 20 November 2017, p. 95
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- March 1995
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There is increasing interest in the development of later lambing systems for crossbred ewes which more closely match ewe nutritional requirements with herbage growth (Stone, 1988; Mitchell, 1990). It has long been recognised however that at extremes of the natural breeding season fecundity is reduced, a possible consequence of seasonal variations in ovulation rate, fertilisation and/or embryo survival (Hammond, 1944). Daylength is the factor which entrains the endogenous rhythm of reproduction in sheep (Donovan, O’Callaghan, Karsh, Boland and Roche, 1992) and daylength changes per se may be responsible for variations in reproductive response throughout the breeding season. Associated environmental and management factors may also be of importance. The objective of the present study was to determine the effect of management history and month of mating on ovulation and lambing rates in Mule ewes.