title: Neonatal uterine bleeding as a biomarker for reproductive disorders during adolescence: a worldwide call for systematic registration by nurse midwife.
abstract: Neonatal uterine bleeding (NUB) occurs in approximately 5% of newborns and is generally considered to be of little clinical significance. However, the real clinical importance of this condition and its long-term implications remain to be determined. The reason why NUB is rare despite high circulating levels of progesterone can be attributed to a progesterone resistance present in a majority of neonates. Recent work indicates that NUB represents a significant biomarker for events that can occur later-on during adolescence. Indeed, clinical studies have shown that "neonatal menstruation" constitutes a sign of fetal distress during late pregnancy, reflecting a stage of endometrium development that may subsequently have an impact on the reproductive life of the adolescent and the young adult. Via retrograde flow, NUB can cause endometrial stem/progenitor cells to arrive into the pelvic cavity and survive there, dormant underneath the peritoneal surface, until menarche activates them. Indeed, there is both clinical and epidemiological evidence of a link between NUB and adolescent endometriosis. In addition, if progesterone resistance persists till the onset of menarche, in case of an early teen pregnancy, it can result in a disorder of deep placentation. Therefore, we propose that NUB should be carefully recorded so that prospective studies can examine its links with reproductive disorders in adolescence and beyond.
authors.affiliation: a Leuven Institute for Fertility and Embryology , Leuven , Belgium.|b Department of Obstetrics and Gynecology , Catholic University of Leuven , Leuven , Belgium.
authors.forename: Patrick
authors.initials: P
authors.lastname: Puttemans
authors.affiliation: c Department of Gynecology , Obstetrics and Urology, Sapienza, University of Rome , Rome , Italy.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Benagiano
authors.affiliation: d Department of Obstetrics and Gynecology , Monash University , Clayton , Victoria , Australia.
authors.forename: Caroline
authors.initials: C
authors.lastname: Gargett
authors.affiliation: e NICHD, NIH, DHHS, Perinatology Research Branch, Center for Molecular Medicine and Genetics, Wayne State University , Detroit , MI , USA , and.
authors.forename: Roberto
authors.initials: R
authors.lastname: Romero
authors.affiliation: f Shanghai Obstetrics and Gynecology Hospital, Fudan University , Shanghai , China.
authors.forename: Sun-Wei
authors.initials: SW
authors.lastname: Guo
authors.affiliation: a Leuven Institute for Fertility and Embryology , Leuven , Belgium.
authors.forename: Ivo
authors.initials: I
authors.lastname: Brosens
mesh_terms: D000293:Adolescent; D017668:Age of Onset; D015415:Biomarkers; D004715:Endometriosis / Q000209:etiology*; D004717:Endometrium / Q000002:abnormalities / Q000378:metabolism; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D009721:Nurse Midwives; D014591:Uterine Diseases / Q000378:metabolism; D014592:Uterine Hemorrhage / Q000150:complications*
chemical_list: D015415:Biomarkers
keywords: Neonatal uterine bleeding; adolescent pregnancy; deep placentation; endometriosis; progesterone resistance