199: maternal obesity suppresses placental fatty acid uptake in male offspring

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CONCLUSION: Black women had lower levels of triglycerides and fatty acids in the 1st and 2nd trimesters compared to white women, and black women had higher levels of omega-6 fatty acids at 24-28 weeks. Triglycerides and fatty acids are essential for fetal growth and devel- opment, and higher levels of omega-6 fatty acids have been linked to preterm birth. Further investigation is necessary to determine whether these lipid differences contribute to race disparities in preg- nancy outcomes. 198 Prolactin derived vasoinhibins are associated with inflammation in mid-gestation Christy Pearce 1 , Linah Al-Alem 2 , John O’Brien 2 , Kristine Lain 3 , Wendy Hansen 2 , Thomas Curry 2 1 Vanderbilt University, OB/GYN, Nashville, TN, 2 University of Kentucky, OB/GYN, Lexington, KY, 3 Norton Healthcare, Maternal Fetal Medicine, Louisville, KY OBJECTIVE: Prolactin derived vasoinhibins have been implicated in the pathophysiology of preeclampsia and peripartum cardiomyopa- thy via a pro-inflammatory mechanism. We sought to determine the presence and examine the relationship of these prolactin derived va- soinhibins and inflammation in mid-gestation. STUDY DESIGN: Women with a singleton gestation between 16-23 weeks without exclusion for preexisting medical conditions were re- cruited as the study cohort. Women with preeclampsia at 24-42 weeks were recruited as physiologic standards. Serum was tested for C-reac- tive protein with a turbidimetric assay, prolactin with an immunoas- say, and prolactin derived vasoinhibins via immunoprecipitation and Western blot. A sample by which to normalize vasoinhibin expression across different Western blots was selected from one of the recruited preeclamptic standards. Statistical analysis included t-test and corre- lation coefficients. RESULTS: Sixty subjects were recruited at an average of 19.9 1.5 weeks gestation for the study cohort. The mean age was 22.4 3.6 years and mean body mass index (BMI) was 27.9 7.1 kg/m 2 . Most women were primigravidas (n47, 78.3%) and Caucasian (n43, 71.7%). Forty-nine (81.7%) of samples expressed a significant mea- surable optical density of PRL fragment on Western blot. Increasing prolactin derived vasoinhibins and the ratio of vasoinhibins to pro- lactin was associated with increasing C-reactive protein (rho0.3, p0.04 and rho0.3, p0.04). See figure 1. Significant differences in mean C-reactive protein were noted between samples above and be- low the median prolactin derived vasoinhibin optical density (9.78.1 vs. 6.36.1, p0.03) and the median ratio of vasoinhibins to prolactin (9.98.1 vs. 6.26.1, p0.02). CONCLUSION: Prolactin derived vasoinhibins are associated with in- flammation in mid-gestation. Further examination of these prolactin fragments in larger, high risk cohorts may be instructive in the patho- physiology of obstetrical conditions. 199 Maternal obesity suppresses placental fatty acid uptake in male offspring Elizabeth Brass 1 , Kent Thornburg 2 , Perrie O’Tierney 2 1 Oregon Health & Science University, Obstetrics & Gynecology, Portland, OR, 2 Oregon Health & Science University, Heart Research Center, Dept Cardiovascular Medicine, Portland, OR OBJECTIVE: The fetus is dependent on the placenta for its supply of long chain polyunsaturated fatty acids (LCPUFA), which are essential in fetal growth and development. Previous work suggests that mater- nal body mass index is associated with fetal LCPUFA delivery and that males have greater fatty acid requirements than females during devel- opment. We hypothesized that male placental fatty acid uptake would be more sensitive to maternal BMI compared to females. STUDY DESIGN: Women were recruited upon admission to Labor & Delivery for cesarean section (n25). At delivery, placental samples were collected for fatty acid uptake studies using 14C-labeled oleic acid (OA), arachidonic acid, (AA) and docosahexanoic acid (DHA) in placental explants. Uptake was calculated as nmol fatty acid/mg pro- tein at 15 minutes. Results were stratified by fetal sex and maternal first trimester BMI (normal BMI25, obese BMI26). Women with significant co-morbidities were excluded. Dichotomous outcomes were analyzed using 1 way ANOVA followed by Tukey post-hoc test- ing; p0.05 was used to indicate statistical significance. RESULTS: Placental fatty acid uptake of OA and AA in males of obese women was decreased 62% and 60% respectively compared to normal BMI women (p0.001). In females, placental fatty acid uptake was not suppressed in the setting of obesity; OA and AA uptake in normal BMI women was reduced 49% and 48% respectively compared to its male cohort (p0.01). There was no difference in DHA uptake be- tween sex or BMI groups. Fatty acid transporter CD36 and binding protein FABP5 gene expression levels in males mirrored the fatty acid uptake suppression seen in obesity. CONCLUSION: Placentas from males with obese mothers had sup- pressed uptake of unsaturated fatty acids and expression of their transporters, while uptake in females was unaffected by maternal BMI. This data suggest that males born to high BMI mothers may have inadequate LCPUFA acquisition. Males may pay a higher develop- mental price in the setting of maternal obesity. 200 Fetoplacental endothelium demonstrate unique responses to physiologic hypoxemia Emily Su 1 , Hong Xin 1 , Chunfa Jie 2 , Nadareh Jafari 3 , Matthew Dyson 1 , Serdar Bulun 1 1 Northwestern University Feinberg School of Medicine, Obstetrics and Gynecology, Chicago, IL, 2 Northwestern University Feinberg School of Medicine, Surgery/Organ Transplantation, Chicago, IL, 3 Northwestern University Feinberg School of Medicine, Center for Genetic Medicine, Chicago, IL OBJECTIVE: Although physiologic, fetoplacental pO2 is relatively hy- poxemic in comparison to postnatal life, ranging from 12-50 mm Hg (1.5 - 8% O2). In adults, hypoxic conditions have profound effects on endothelial cell function that are often deleterious. We sought to de- Correlation of CRP with prolactin derived vasoinhibin and ratio of prolactin derived vasoinhibin to prolactin Poster Session I Clinical Obstetrics, Epidemiology, Fetus, Medical-Surgical Complications, Neonatology, Physiology/Endocrinology, Prematurity www.AJOG.org S94 American Journal of Obstetrics & Gynecology Supplement to JANUARY 2013

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Page 1: 199: Maternal obesity suppresses placental fatty acid uptake in male offspring

CONCLUSION: Black women had lower levels of triglycerides and fattyacids in the 1st and 2nd trimesters compared to white women, andblack women had higher levels of omega-6 fatty acids at 24-28 weeks.Triglycerides and fatty acids are essential for fetal growth and devel-opment, and higher levels of omega-6 fatty acids have been linked topreterm birth. Further investigation is necessary to determinewhether these lipid differences contribute to race disparities in preg-nancy outcomes.

198 Prolactin derived vasoinhibins are associated withinflammation in mid-gestationChristy Pearce1, Linah Al-Alem2, John O’Brien2, Kristine Lain3,Wendy Hansen2, Thomas Curry2

1Vanderbilt University, OB/GYN, Nashville, TN, 2University of Kentucky,OB/GYN, Lexington, KY, 3Norton Healthcare, Maternal Fetal Medicine,Louisville, KYOBJECTIVE: Prolactin derived vasoinhibins have been implicated inthe pathophysiology of preeclampsia and peripartum cardiomyopa-thy via a pro-inflammatory mechanism. We sought to determine thepresence and examine the relationship of these prolactin derived va-soinhibins and inflammation in mid-gestation.STUDY DESIGN: Women with a singleton gestation between 16-23weeks without exclusion for preexisting medical conditions were re-cruited as the study cohort. Women with preeclampsia at 24-42 weekswere recruited as physiologic standards. Serum was tested for C-reac-tive protein with a turbidimetric assay, prolactin with an immunoas-say, and prolactin derived vasoinhibins via immunoprecipitation andWestern blot. A sample by which to normalize vasoinhibin expressionacross different Western blots was selected from one of the recruitedpreeclamptic standards. Statistical analysis included t-test and corre-lation coefficients.RESULTS: Sixty subjects were recruited at an average of 19.9 � 1.5weeks gestation for the study cohort. The mean age was 22.4 � 3.6years and mean body mass index (BMI) was 27.9 � 7.1 kg/m2. Mostwomen were primigravidas (n�47, 78.3%) and Caucasian (n�43,71.7%). Forty-nine (81.7%) of samples expressed a significant mea-surable optical density of PRL fragment on Western blot. Increasingprolactin derived vasoinhibins and the ratio of vasoinhibins to pro-lactin was associated with increasing C-reactive protein (rho�0.3,p�0.04 and rho�0.3, p�0.04). See figure 1. Significant differences inmean C-reactive protein were noted between samples above and be-low the median prolactin derived vasoinhibin optical density(9.7�8.1 vs. 6.3�6.1, p�0.03) and the median ratio of vasoinhibinsto prolactin (9.9�8.1 vs. 6.2�6.1, p�0.02).CONCLUSION: Prolactin derived vasoinhibins are associated with in-flammation in mid-gestation. Further examination of these prolactinfragments in larger, high risk cohorts may be instructive in the patho-physiology of obstetrical conditions.

199 Maternal obesity suppresses placentalfatty acid uptake in male offspringElizabeth Brass1, Kent Thornburg2, Perrie O’Tierney2

1Oregon Health & Science University, Obstetrics & Gynecology, Portland,OR, 2Oregon Health & Science University, Heart Research Center, DeptCardiovascular Medicine, Portland, OROBJECTIVE: The fetus is dependent on the placenta for its supply oflong chain polyunsaturated fatty acids (LCPUFA), which are essentialin fetal growth and development. Previous work suggests that mater-nal body mass index is associated with fetal LCPUFA delivery and thatmales have greater fatty acid requirements than females during devel-opment. We hypothesized that male placental fatty acid uptake wouldbe more sensitive to maternal BMI compared to females.STUDY DESIGN: Women were recruited upon admission to Labor &Delivery for cesarean section (n�25). At delivery, placental sampleswere collected for fatty acid uptake studies using 14C-labeled oleicacid (OA), arachidonic acid, (AA) and docosahexanoic acid (DHA) inplacental explants. Uptake was calculated as nmol fatty acid/mg pro-tein at 15 minutes. Results were stratified by fetal sex and maternalfirst trimester BMI (normal BMI�25, obese BMI�26). Women withsignificant co-morbidities were excluded. Dichotomous outcomeswere analyzed using 1 way ANOVA followed by Tukey post-hoc test-ing; p�0.05 was used to indicate statistical significance.RESULTS: Placental fatty acid uptake of OA and AA in males of obesewomen was decreased 62% and 60% respectively compared to normalBMI women (p�0.001). In females, placental fatty acid uptake wasnot suppressed in the setting of obesity; OA and AA uptake in normalBMI women was reduced 49% and 48% respectively compared to itsmale cohort (p�0.01). There was no difference in DHA uptake be-tween sex or BMI groups. Fatty acid transporter CD36 and bindingprotein FABP5 gene expression levels in males mirrored the fatty aciduptake suppression seen in obesity.CONCLUSION: Placentas from males with obese mothers had sup-pressed uptake of unsaturated fatty acids and expression of theirtransporters, while uptake in females was unaffected by maternalBMI. This data suggest that males born to high BMI mothers may haveinadequate LCPUFA acquisition. Males may pay a higher develop-mental price in the setting of maternal obesity.

200 Fetoplacental endothelium demonstrate uniqueresponses to physiologic hypoxemiaEmily Su1, Hong Xin1, Chunfa Jie2, Nadareh Jafari3,Matthew Dyson1, Serdar Bulun1

1Northwestern University Feinberg School of Medicine, Obstetrics andGynecology, Chicago, IL, 2Northwestern University Feinberg School ofMedicine, Surgery/Organ Transplantation, Chicago, IL, 3NorthwesternUniversity Feinberg School of Medicine, Center for Genetic Medicine,Chicago, ILOBJECTIVE: Although physiologic, fetoplacental pO2 is relatively hy-poxemic in comparison to postnatal life, ranging from 12-50 mm Hg(1.5 - 8% O2). In adults, hypoxic conditions have profound effects onendothelial cell function that are often deleterious. We sought to de-

Correlation of CRP with prolactin derivedvasoinhibin and ratio of prolactin derivedvasoinhibin to prolactin

Poster Session I Clinical Obstetrics, Epidemiology, Fetus, Medical-Surgical Complications, Neonatology, Physiology/Endocrinology, Prematurity www.AJOG.org

S94 American Journal of Obstetrics & Gynecology Supplement to JANUARY 2013