Analysis of perinatal and infant outcomes in children born to mothers who were administered cellular technologies during cesarean section
Pekareva N.A., Baranov I.I., Silachev D.N., Pekareva E.O., Pozdnyakov I.M., Pekarev O.G.
Objective: To evaluate the course of perinatal and infant periods in children born to mothers who were administered cellular technologies, namely, the injection of exosomes from mesenchymal stromal cells (EMSCs) during cesarean section.
Materials and methods: The course of pregnancy and delivery was evaluated using cellular technologies in 60 pregnant women and women in labor who composed group 1 (main group). Group 2 (comparison group) included 100 patients who did not receive exosome support. The health status of 93 infants was studied, 37 of them were included in group 3 (main group) and were born by spontaneous delivery at term and repeated cesarean section; these infants were born to mothers who were given an injection of 500 μl of EMSCs obtained in the laboratory of cellular technologies at the V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology; EMSCs were injected into the incision area during the previous cesarean section after the uterine incision was closed with a single-row vicryl suture. Group 4 (comparison group) included 56 neonates who were born by spontaneous preterm and term delivery and repeated cesarean section; the neonates were born to mothers who had not received exosome support during the previous cesarean section. The results of the course of pregnancy and second delivery of patients with uterine scar who were/were not administered cellular technologies were evaluated as primary outcomes. The condition of newborns and infants up to one year of age was analyzed as secondary outcomes. The presence/absence of pathology in newborns and infants up to one year of age was determined by neonatologists and pediatricians and analyzed on the basis of medical examinations and data from the medical information system (findings from the Novosibirsk City Clinical Perinatal Center, children’s inpatient clinics, and outpatient records).
Results: The prospective analysis did not reveal any infectious or inflammatory manifestations in patients of group 1, however, the postpartum period of patients in group 2 (comparison group) was complicated by endometritis in 6/100 (6%) cases and lochiometra in 2/100 (2%) cases. The study showed that the success rate of vaginal delivery reached 64.9% (24/37) in patients of group 1 (main group) with prior exosome support, and 21.4% (12/56) in women of group 2 (comparison group). The length and weight of body of all newborns in group 3 (main group) corresponded to the parameters of the preterm gestational age; the infants were born without asphyxia with an Apgar score of 8/9 points. Whereas 4/56 (7.1%) neonates of group 4 (comparison group) were delivered at 34+0–36+1 weeks’ gestation and had an Apgar score of 5/7 points. Congenital pneumonia was diagnosed in 3/56 (5.3%) neonates from group 4 (comparison group), 2/56 (3.57%) infants were diagnosed with patent foramen ovale, which is considered to be normal, and 1/56 (1.78%) newborn had manifestations of hip dysplasia.
Conclusion: The interim prospective analysis found no adverse effect of 500 μl of EMSCs injected during prior cesarean section on subsequent pregnancy, perinatal and infant outcomes.
Authors’ contributions: Pekareva N.A. – collecting and processing the material, writing the article; Baranov I.I., Pozdnyakov I.M. – editing the text; Silachev D.N. – developing the design of the study, editing the text; Pekareva E.O. – statistical processing of the data; Pekarev O.G. – developing the design of the study, writing the text.
Conflicts of interest: Authors declare lack of the possible conflicts of interests.
Funding: The study was conducted without sponsorship.
Ethical Approval: The study was approved by the Ethical Review Board of the Novosibirsk City Clinical Perinatal Center.
Patient Consent for Publication: The patients provided an informed consent for the publication of their data.
Authors' Data Sharing Statement: The data supporting the findings of this study are available on request from the corresponding author after approval from the principal investigator.
For citation: Pekareva N.A., Baranov I.I., Silachev D.N., Pekareva E.O., Pozdnyakov I.M., Pekarev O.G.
Analysis of perinatal and infant outcomes in children born to mothers
who were administered cellular technologies during cesarean section.
Akusherstvo i Ginekologiya/Obstetrics and Gynecology. 2024; (7): 113-120 (in Russian)
https://dx.doi.org/10.18565/aig.2024.102
Keywords
exosomes derived from placental mesenchymal stromal cells
cesarean section
uterine scar
spontaneous vaginal delivery
perinatal and infant periods
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Received 05.04.2024
Accepted 02.07.2024
About the Authors
Natalya A. Pekareva, Dr. Med. Sci., Head of the Scientific Advisory Pediatric Department, Academician V.I. Kulakov, National Medical Research Center for Obstetrics, Gynecology and Perinatology, Ministry of Health of Russia, 117997, Russia, Moscow, Ac. Oparin str., 4, n_pekareva@oparina4.ru, https://orcid.org/0000-0002-2710-864ХIgor I. Baranov, Dr. Med. Sci., Professor, Head of the Department of Scientific and Educational Programs, Academician V.I. Kulakov, National Medical Research Center for Obstetrics, Gynecology and Perinatology, Ministry of Health of Russia, 117997, Russia, Moscow, Ac. Oparin str., 4,
i_baranov@ oparina4.ru, https://orcid.org/0000-0002-9813-2823
Denis N. Silachev, Dr. Bio. Sci., Head of the Cell Technologies Laboratory, Academician V.I. Kulakov, National Medical Research Center for Obstetrics, Gynecology and Perinatology, Ministry of Health of Russia, 117997, Russia, Moscow, Ac. Oparin str., 4, d_silachev@oparina4.ru, https://orcid.org/0000-0003-0581-9755
Evgenia O. Pekareva, Dr. Med. Sci., Doctor of Ultrasound Diagnostics, Department of Ultrasound and Functional Diagnostics, Academician V.I. Kulakov, National Medical Research Center for Obstetrics, Gynecology and Perinatology, Ministry of Health of Russia, 117997, Russia, Moscow, Ac. Oparin str., 4,
e_pekareva@oparina4.ru, https://orcid.org/0000-0002-6335-2121
Ivan M. Pozdnyakov, Dr. Med. Sci., Professor, Chief Physician, Novosibirsk City Clinical Perinatal Center, 630090, Russia, Novosibirsk, A. Lezhen str., 32,
https://orcid.org/0000-0003-0600-3053
Oleg G. Pekarev, Dr. Med. Sci., Professor, Deputy Director of the Institute of Obstetrics, Academician V.I. Kulakov, National Medical Research Center for Obstetrics, Gynecology and Perinatology, Ministry of Health of Russia, 117997, Russia, Moscow, Ac. Oparin str., 4, o_pekarev@oparina4.ru, https://orcid.org/0000-0001-7122-6830
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