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Prenatal interventions for fetal growth restriction in animal models : A systematic review

Valenzuela, Ignacio ; Kinoshita, Mari LU orcid ; van der Merwe, Johannes ; Maršál, Karel LU and Deprest, Jan (2022) In Placenta 126. p.90-113
Abstract

Fetal growth restriction (FGR) in human pregnancy is associated with perinatal mortality, short- and long-term morbidities. No prenatal therapy is currently established despite decades of research. We aimed to review interventions in animal models for prenatal FGR treatment, and to seek the next steps for an effective clinical therapy. We registered our protocol and searched MEDLINE, Embase, and The Cochrane Library with no language restrictions, in accordance with the PRISMA guideline. We included all studies that reported the effects of any prenatal intervention in animal models of induced FGR. From 3257 screened studies, 202 describing 237 interventions were included for the final synthesis. Mice and rats were the most used animals... (More)

Fetal growth restriction (FGR) in human pregnancy is associated with perinatal mortality, short- and long-term morbidities. No prenatal therapy is currently established despite decades of research. We aimed to review interventions in animal models for prenatal FGR treatment, and to seek the next steps for an effective clinical therapy. We registered our protocol and searched MEDLINE, Embase, and The Cochrane Library with no language restrictions, in accordance with the PRISMA guideline. We included all studies that reported the effects of any prenatal intervention in animal models of induced FGR. From 3257 screened studies, 202 describing 237 interventions were included for the final synthesis. Mice and rats were the most used animals (79%) followed by sheep (16%). Antioxidants (23%), followed by vasodilators (18%), nutrients (14%), and immunomodulators (12%) were the most tested therapy. Two-thirds of studies only reported delivery or immediate neonatal outcomes. Adverse effects were rarely reported (11%). Most studies (73%), independent of the intervention, showed a benefit in fetal survival or birthweight. The risk of bias was high, mostly due to the lack of randomization, allocation concealment, and blinding. Future research should aim to describe both short- and long-term outcomes across various organ systems in well-characterized models. Further efforts must be made to reduce selection, performance, and detection bias.

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author
; ; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Animal model, Fetal growth restriction, Pregnancy, Prenatal treatment, Systematic review
in
Placenta
volume
126
pages
24 pages
publisher
W.B. Saunders
external identifiers
  • pmid:35796064
  • scopus:85133237921
ISSN
0143-4004
DOI
10.1016/j.placenta.2022.06.007
language
English
LU publication?
yes
id
1d86b91a-ebc7-41d7-94a9-16b57496f234
date added to LUP
2022-09-07 15:17:07
date last changed
2024-06-13 19:10:20
@article{1d86b91a-ebc7-41d7-94a9-16b57496f234,
  abstract     = {{<p>Fetal growth restriction (FGR) in human pregnancy is associated with perinatal mortality, short- and long-term morbidities. No prenatal therapy is currently established despite decades of research. We aimed to review interventions in animal models for prenatal FGR treatment, and to seek the next steps for an effective clinical therapy. We registered our protocol and searched MEDLINE, Embase, and The Cochrane Library with no language restrictions, in accordance with the PRISMA guideline. We included all studies that reported the effects of any prenatal intervention in animal models of induced FGR. From 3257 screened studies, 202 describing 237 interventions were included for the final synthesis. Mice and rats were the most used animals (79%) followed by sheep (16%). Antioxidants (23%), followed by vasodilators (18%), nutrients (14%), and immunomodulators (12%) were the most tested therapy. Two-thirds of studies only reported delivery or immediate neonatal outcomes. Adverse effects were rarely reported (11%). Most studies (73%), independent of the intervention, showed a benefit in fetal survival or birthweight. The risk of bias was high, mostly due to the lack of randomization, allocation concealment, and blinding. Future research should aim to describe both short- and long-term outcomes across various organ systems in well-characterized models. Further efforts must be made to reduce selection, performance, and detection bias.</p>}},
  author       = {{Valenzuela, Ignacio and Kinoshita, Mari and van der Merwe, Johannes and Maršál, Karel and Deprest, Jan}},
  issn         = {{0143-4004}},
  keywords     = {{Animal model; Fetal growth restriction; Pregnancy; Prenatal treatment; Systematic review}},
  language     = {{eng}},
  pages        = {{90--113}},
  publisher    = {{W.B. Saunders}},
  series       = {{Placenta}},
  title        = {{Prenatal interventions for fetal growth restriction in animal models : A systematic review}},
  url          = {{http://dx.doi.org/10.1016/j.placenta.2022.06.007}},
  doi          = {{10.1016/j.placenta.2022.06.007}},
  volume       = {{126}},
  year         = {{2022}},
}