Analysis of perinatal and infant outcomes in children born to mothers who were administered cellular technologies during cesarean section

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Abstract

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.

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About the authors

Natalya A. Pekareva

Academician V.I. Kulakov National Medical Research Centre for Obstetrics, Gynecology and Perinatology, Ministry of Health of Russia

Email: n_pekareva@oparina4.ru
ORCID iD: 0000-0002-2710-864X

Dr. Med. Sci., Head of the Scientific Advisory Pediatric Department

Russian Federation, Moscow

Igor I. Baranov

Academician V.I. Kulakov National Medical Research Centre for Obstetrics, Gynecology and Perinatology, Ministry of Health of Russia

Email: i_baranov@oparina4.ru
ORCID iD: 0000-0002-9813-2823

Dr. Med. Sci., Professor, Head of the Department of Scientific and Educational Programs

Russian Federation, Moscow

Denis N. Silachev

Academician V.I. Kulakov National Medical Research Centre for Obstetrics, Gynecology and Perinatology, Ministry of Health of Russia

Email: d_silachev@oparina4.ru
ORCID iD: 0000-0003-0581-9755

Dr. Bio. Sci., Head of the Cell Technologies Laboratory

Russian Federation, Moscow

Evgenia O. Pekareva

Academician V.I. Kulakov National Medical Research Centre for Obstetrics, Gynecology and Perinatology, Ministry of Health of Russia

Email: e_pekareva@oparina4.ru
ORCID iD: 0000-0002-6335-2121

Dr. Med. Sci., Doctor of Ultrasound Diagnostics, Department of Ultrasound and Functional Diagnostics

Russian Federation, Moscow

Ivan M. Pozdnyakov

Novosibirsk City Clinical Perinatal Center

Email: n_pekareva@oparina4.ru
ORCID iD: 0000-0003-0600-3053

Dr. Med. Sci., Professor, Chief Physician

Russian Federation, Novosibirsk

Oleg G. Pekarev

Academician V.I. Kulakov National Medical Research Centre for Obstetrics, Gynecology and Perinatology, Ministry of Health of Russia

Author for correspondence.
Email: o_pekarev@oparina4.ru
ORCID iD: 0000-0001-7122-6830

Dr. Med. Sci., Professor, Deputy Director of the Institute of Obstetrics

Russian Federation, Moscow

References

  1. Майбородин И.В., Якимова Н.В., Матвеева В.А., Пекарев О.Г., Майбородина Е.И., Пекарева Е.О. Ангиогенез в рубце матки крыс после введения аутологичных мезенхимальных стволовых клеток костномозгового происхождения. Бюллетень экспериментальной биологии и медицины. 2010; 150(12): 705-11. [Maiborodin I.V., Yakimova N.V., Matveeva V.A., Pekarev O.G., Maiborodina E.I., Pekareva E.O. Angiogenesis in the uterine rumen of rats after administration of autologous mesenchymal stem cells of bone marrow origin. Bulletin of Experimental Biology and Medicine. 2010; 150(12): 705-11. (in Russian)].
  2. Майбородин И.В., Якимова Н.В., Матвеева В.А., Пекарев О.Г., Майбородина Е.И., Пекарева Е.О., Ткачук О.К. Морфологический анализ результатов введения аутологичных стволовых стромальных клеток костномозгового происхождения в рубец матки крыс. Морфология. 2010; 138(6): 47-55. [Maiborodin I.V., Yakimova N.V., Matveeva V.A., Pekarev O.G., Maiborodina E.I., Pekareva E.O., Tkachuk O.K. Morphological analysis of the results of the introduction of autologous stromal stem cells of bone marrow origin into the rat uterine scar. Morphology. 2010; 138(6): 47-55. (in Russian)].
  3. Майбородин И.В., Оноприенко Н.В., Частикин Г.А. Морфологические изменения тканей матки крыс и возможность самопроизвольных родов в результате введения мультипотентных мезенхимных стромальных клеток на фоне гидрометры. Бюллетень экспериментальной биологии и медицины. 2015; 159(4): 511-6. [Maiborodin I.V., Onoprienko N.V., Chastikin G.A. Morphological changes in the tissues of the uterus of rats and the possibility of spontaneous delivery as a result of the introduction of multipotent mesenchymal stromal cells against the background of a hydrometer. Bulletin of Experimental Biology and Medicine. 2015; 159(4): 511-6. (in Russian)].
  4. Rodrigues M., Yates C.C., Nuschke A., Griffith L., Wells A. The matrikine tenascin-C protects multipotential stromal cells/mesenchymal stem cells from death cytokines such as FasL. Tissue Eng. Part A. 2013; 19(17-18): 1972-83. https://dx.doi.org/10.1089/ten.TEA.2012.0568.
  5. Майбородин И.В., Матвеева В.А., Маслов Р.В., Оноприенко Н.В., Кузнецова И.В., Частикин Г.А., Аникеев А.А. Некоторые реакции регионарных лимфатических узлов крыс после имплантации в дефект костной ткани мультипотентных стромальных клеток, адсорбированных на полигидроксиалканоате. Морфология. 2016; 149(2): 21-6. [Maiborodin I.V., Matveeva V.A., Maslov R.V., Onoprienko N.V., Kuznetsova I.V., Chastikin G.A., Anikeev A.A. Some reactions of rat regional lymph nodes after implantation of multipotent stromal cells adsorbed on a polyhydroxy alkanoate into a bone defect. Morphology. 2016; 149(2): 21-6. (in Russian)].
  6. Майбородин И.В., Морозов В.В., Аникеев А.А., Фигуренко Н.Ф., Маслов Р.В., Частикин Г.А., Матвеева В.А., Майбородина В.И. Макрофагальный ответ у крыс на введение мультипотентных мезенхимальных стромальных клеток в регион хирургической травмы. Новости хирургии. 2017; 25(3): 233-41. [Maiborodin I.V., Morozov V.V., Anikeev A.A., Figurenko N.F., Maslov R.V., Chastikin G.A., Matveeva V.A., Maiborodina V.I. Macrophage reaction to multipotent mesenchymal stromal cells introduction into surgical trauma site in rats. Surgery News. 2017; 25(3): 233-41. (in Russian)]. https:// dx.doi.org/10.18484/2305-0047.2017.3.233.
  7. Yates C.C., Nuschke A., Rodrigues M., Whaley D., Dechant J.J., Taylor D.P. et al. Improved transplanted stem cell survival in a polymer gel supplemented with tenascin C accelerates healing and reduces scarring of murine skin wounds. Cell Transplant. 2017; 26(1): 103-13. https://dx.doi.org/10.3727/096368916X692249.
  8. Takeda Y.S., Xu Q. Neuronal differentiation of human mesenchymal stem cells using exosomes derived from differentiating neuronal cells. PLoS One. 2015; 10(8): e0135111. https://dx.doi.org/10.1371journal.pone.0135111.
  9. Furuta T., Miyaki S., Ishitobi H., Ogura T., Kato Y., Kamei N. et al. Mesenchymal stem cell-derived exosomes promote fracture healing in a mouse model. Stem Cells Transl. Med. 2016; 5(12): 1620-30. https://dx.doi.org/10.5966/ sctm.2015-0285.
  10. Narayanan R., Huang C.C., Ravindran S. Hijacking the cellular mail: exosome mediated differentiation of mesenchymal stem cells. Stem Cells Int. 2016; 2016: 3808674. https://dx.doi.org/10.1155/2016/3808674.
  11. Van der Pol E., Böing A.N., Harrison P., Sturk A., Nieuwland R. Classification, functions, and clinical relevance of extracellular vesicles. Pharmacol. Rev. 2012; 64(3): 676-705. https://dx.doi.org/10.1124/pr.112.005983.
  12. Akers J.C., Gonda D., Kim R., Carter B.S., Chen C.C. Biogenesis of extracellular vesicles (EV): exosomes, microvesicles, retrovirus-like vesicles, and apoptotic bodies. J. Neurooncol. 2013; 113(1): 1-11. https://dx.doi.org/10.1007/ s11060-013-1084-8.
  13. Février B., Raposo G. Exosomes: endosomal-derived vesicles shipping extracellular messages. Curr. Opin. Cell Biol. 2004; 16(4): 415-21. https://dx.doi.org/10.1016/j.ceb.2004.06.003.
  14. Пекарева Е.О., Баранов И.И., Пекарев О.Г. Применение клеточных технологий в экспериментальной и клинической акушерской практике (обзор литературы). Акушерство и гинекология: новости, мнения, обучение. 2022; 10(4): 31-7. [Pekareva E.O., Baranov I.I., Pekarev O.G. Use of cell technologies in experimental and clinical obstetric practice (literature review). Obstetrics and Gynecology: News, Opinions, Training. 2022; 10(4): 31-7. (in Russian)]. https://dx.doi.org/10.33029/2303-9698-2022-10-4-31-37.
  15. Pekarev O.G., Pekareva E.O., Mayborodin I.V., Silachev D.N., Baranov I.I., Pozdnyakov I.M. et al. The potential of extracellular microvesicles of mesenchymal stromal cells in obstetrics. J. Matern. Fetal Neonatal Med. 2022; 35(25): 7523-5. https://dx.doi.org/10.1080/14767058.2021.1951213.
  16. Сухих Г.Т., Пекарева Е.О., Пекарев О.Г., Силачев Д.Н., Майбородин И.В., Баранов И.И., Поздняков И.М., Бушуева Н.С. Возможности родоразрешения пациенток, которым в ходе предшествующего кесарева сечения вводились экстрацеллюлярные микровезикулы мезенхимальных стромальных клеток. Акушерство и гинекология. 2022; 4: 103-14. [Sukhikh G.T., Pekareva E.O., Pekarev O.G., Silachev D.N., Maiborodin I.V., Baranov I.I., Pozdnyakov I.M., Bushueva N.S. Feasibility of delivery in patients receiving mesenchymal stromal cell-derived extracellular microvesicles during the previous caesarean section. Obstetrics and Gynecology. 2022; (4): 103-14. (in Russian)]. https://dx.doi.org/10.18565/aig.2022.4.103-114.
  17. Сухих Г.Т., Пекарев О.Г., Майбородин И.В., Силачев Д.Н., Шевцова Ю.А., Горюнов К.В., Оноприенко Н.В., Майбородина В.И., Галенок Р.В., Новиков А.М., Пекарева Е.О. К вопросу о сохранности экстрацеллюлярных микровезикул мезенхимных стромальных клеток после абдоминального родоразрешения в эксперименте. Клеточные технологии в биологии и медицине. 2020; 1: 3-11. [Sukhikh G.T., Pekarev O.G., Maiborodin I.V., Silachev D.N., Shevtsova Yu.A., Goryunov K.V., Onoprienko N.V., Maiborodina V.I., Galenok R.V., Novikov A.M., Pekareva E.O. On the question of the preservation of extracellular microvesicles of mesenchymal stromal cells after abdominal delivery in the experiment. Cell Technologies in Biology and Medicine. 2020; (1): 3-11. (in Russian)].
  18. Sukhikh G.T., Pekarev О.G., Maiborodin I.V., Silachev D.N., Shevtsova Y.А., Gоrуunоv K.V. et al. Preservation of mesenchymal stem cell-derived extracellu-lar vesicles after abdominal delivery in the experiment. Bull. Exp. Biol. Med. 2020; 169(1): 122-9. https://dx.doi.org/10.1007/s10517-020-04838-1.
  19. Сухих Г.Т., Пекарев О.Г., Пекарева Е.О., Майбородин И.В., Силачев Д.Н., Баранов И.И., Поздняков И.М., Бушуева Н.С., Новиков А.М. Первые результаты клинического применения экстрацеллюлярных микровезикул мезенхимальных стромальных клеток после абдоминального родоразрешения. Акушерство и гинекология. 2021; 1: 52-60. [Sukhikh G.T., Pekarev O.G., Pekareva E.O., Maiborodin I.V., Silachev D.N., Baranov I.I., Pozdnyakov I.M., Bushueva N.S., Novikov A.V. Initial results of clinical application of mesenchymal stromal stem cell-derived extracellular microvesicles after abdominal delivery. Obstetrics and Gynecology. 2021; (1): 52-60. (in Russian)]. https://dx.doi.org/10.18565/aig.2021.1.52-60.
  20. Yu H., Feng H., Zeng H., Wu Y., Zhang Q., Yu J. et al. Exosomes: The emerging mechanisms and potential clinical applications in dermatology. Int. J. Biol. Sci. 2024; 20(5): 1778-95. https://dx.doi.org/10.7150/ijbs.92897.
  21. Пекарева Е.О. Предварительные итоги экспериментального и клинического применения экстрацеллюлярных микровезикул мезенхимальных стромальных клеток после кесарева сечения. Акушерство и гинекология: новости, мнения, обучение. 2021; 9(4): 36-43. [Pekareva E.O. The results of experimental and clinical application of extracellular microvesicles of mesenchymal stromal cells after caesarean section. Obstetrics and Gynecology: News, Opinions, Training. 2021; 9(4): 36-43. (in Russian)]. https:// dx.doi.org/10.33029/2303-9698-2021-9-4-36-43.
  22. Пекарев О.Г., Баранов И.И., Пекарева Е.О., Cилачев Д.Н., Поздняков И.М. Особенности родоразрешения пациенток с рубцом на матке, которым в ходе предшествующего кесарева сечения применялись клеточные технологии Акушерство и гинекология. 2023; 9: 91-7. [Pekarev O.G., Baranov I.I., Pekareva E.O., Silachev D.N., Pozdnyakov I.M. Delivery of patients with a uterine scar who have undergone cell technology in a previous caesarean section. Obstetrics and Gynecology. 2023; (9): 91-7. (in Russian)]. https:// dx.doi.org/10.18565/aig.2023.186.
  23. Silachev D.N., Goryunov K.V., Shpilyuk M.A., Beznoschenko O.S., Morozova N.Y., Kraevaya E.E. et al. Effect of MSCs and MSC-derived extracellular vesicles on human blood coagulation. Cells. 2019; 8(3): 258. https://dx.doi.org/10.3390/cells8030258.
  24. Министерство здравоохранения Российской Федерации. Клинические рекомендации. Роды одноплодные, родоразрешение путем кесарева сечения. М.; 2021. 106с. [Ministry of Health of the Russian Federation. Clinical guidelines. Singleton delivery, cesarean delivery. Moscow; 2021. 106p. (in Russian)].
  25. Министерство здравоохранения Российской Федерации. Клинические рекомендации. Роды одноплодные, самопроизвольное родоразрешение в затылочном предлежании (нормальные роды). М.; 2021. 66с. [Ministry of Health of the Russian Federation. Clinical guidelines. Singleton delivery, spontaneous delivery at the onset (normal delivery). Moscow; 2021. 66p. (in Russian)].
  26. Министерство здравоохранения Российской Федерации. Клинические рекомендации. Послеоперационный рубец на матке, требующий предоставления медицинской помощи матери во время беременности, родов и в послеродовом периоде. M.; 2021. [Ministry of Health of the Russian Federation. Clinical guidelines. Postoperative scar on the uterus, requiring the provision of medical care to the mother during pregnancy, childbirth and in the postoperative period. Moscow; 2021. (in Russian)].
  27. Баиндурашвили А.Г., Чухраева И.Ю. Ультразвуковое исследование тазобедренных суставов в структуре ортопедического скрининга новорожденных (обзор литературы). Травматология и ортопедия России. 2010; 57(3): 171-8. [Baindurashvili A.G., Chukhraeva I.Yu. Ultrasonography of hip joints in structure of newborn orthopedic screening (review). Traumatology and Orthopedics of Russia. 2010; 57(3): 171-8. (in Russian)].
  28. Rigatelli G., Pedon L., Zecchel R., Dell'Avvocata F., Carrozza A., Zennaro M. et al. Long-term outcomes and complications of intracardiac echocardiography-assisted patent foramen ovale closure in 1,000 consecutive patients. J. Interv. Cardiol. 2016; 29(5): 530-8. https://dx.doi.org/10.1111/joic.12325.

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