253: Single nucleotide polymorphisms and gestational diabetes mellitus: identification of new predictive molecular markers

Poster Session II

Diabetes, Labor, Ultrasound-Imaging

normal screening GCT. Statistical analyses were used t-test, chisquare test, Multiple logistic regression analysis and statistical significance was set at P-value⬍0.05 for all comparisons. RESULTS: Women with a false positive GCT are more likely to be older(32.7⫾4.2 vs 30.8⫾3.8, p⬍0.05) and nulliparous(65.0% vs 55.4%, p⬍0.05). The study group also had a high prepregnancy BMI (23.4⫾2.4 vs 22.1⫾3.4, p⬍0.05), more gestational weight gain(15.7⫾3.2 vs 13.9⫾.1.5, p⬍0.05) and higher birth weight (3351.2⫾556.3 vs 3172.6⫾436.7, p⬍0.05).The maternal and neonatal complications were adjusted for gestational weeks at delivery, BMI, parity, birth weight, cesarean section rate and adjusted odds ratios were obtained.The study group had higher rates of macrosomia (OR 3.65, 95% CI 1.04-12.74), LGA(OR 2.31, 95% CI 1.07-4.95), cesarean section(OR 1.81, 95% CI 1.11-2.95), 5min APGAR⬍7(OR 2.09, 95% CI 1.08-4.02), NICU admission (OR 2.18, 95% CI1.08-4.36). There were no significant differences in the rates of PIH, preterm delivery ⬍37weeks, shoulder dystocia, postpartum hemorrhage, neonatal hypoglycemia, neonatal sepsis. CONCLUSIONS: Women with a false positive GCT are at risk for adverse pregnancy outcomes with GDM. Physicians should attention to false positive GCT women through intensive antenatal care and careful delivery. A large prospective study will necessary to confirm the value of diagnostic criteria of GDM.

253 Single nucleotide polymorphisms and gestational diabetes mellitus: identification of new predictive molecular markers Stefano Brancorsini1, Giuliana Coata1, Arianna Colantonio1, Danilo Piobbico1, Elena Picchiassi1, Michela Centra1, Luana Pennacchi1, Federica Tarquini1, Gian Carlo Di Renzo1 1

University of Perugia, Perugia

OBJECTIVE: Specific Single Nucleotide Polymorphism (SNP) is a pre-

disposing factor for susceptibility to some diseases such as gestational diabetes mellitus (GDM). The latter, defined as carbohydrate intolerance diagnosed for the first time during pregnancy, affects both maternal and fetal health. The aim of this study was to evaluate the association existing between specific SNPs related to type 2 Diabetes Mellitus, and the development of GDM in order to identify new markers useful for its screening and management before and during pregnancy. STUDY DESIGN: Peripheral blood samples were collected from 32 glucose normo-tolerant pregnant women (controls) and 12 pregnant women affected by GDM (cases) at 32 weeks of gestation. Genomic DNA was analyzed by qPCR using specific primers and TaqMan probes for rs4740283 [A/G], rs2021966 [A/G], rs1042522 [C/G] and rs1882095 [C/T] SNPs of RAPGEF1, ENPP1, TP53 and NRF1 genes, respectively. RESULTS: No significant difference of allele distribution for rs4740283 RAPGEF1 polymorphism has been observed between normal pregnant women and patients with GDM. Moreover, the elevated frequency of allele of RAPGEF1 gene with A polymorphism in controls (0,977) and cases (1) invalided the use of this SNP in this study. Homozygous and heterozygous genotypes for rs1042522 TP53 and rs2021966 ENPP1 genes revealed the similar frequency between the studied groups suggesting no significant association with GDM. Concerning the haplotype combination of the two loci of NRF1 gene analyzed, the rs1882095 polymorphism showed a significant result. In fact, homozygosity for allele of NRF1 gene with T polymorphism has been exclusively revealed in controls while it was completely absent in GDM patients. CONCLUSIONS: Among the SNPs analyzed, we highlighted specific homozygosity for NRF1 gene that could have a protective function for the risk of GDM although we did not identify predictive markers related to GDM development. This observation could play an important role to identify pregnant women at low risk of GDM reducing the

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number of women that should be undergone to current clinical screening protocols.

254 Does gestational diabetes impact maternal or cord blood lipids? Glenn Markenson1, Elisabeth Belisle2, Alexander Knee3, Sean Collins4, Prasad Gawade5, Lisa Chasan-Taber6 1 Tufts University School of Medicine/Baystate Medical Center, Springfield, MA, 2Mount Holyoke College, South Hadley, MA, 3Baystate Medical Center Department of Obstetrics and Gynecology, Springfield, MA, 4University of Massachusetts, Worchester Graduate School of Nursing, Worcester, MA, 5 University of Massachusetts, Amherst School of Public Health, Springfield, MA, 6University of Massachusetts Amherst Division of Biostatistics & Epidemiology School of Public Health & Health Sciences, Amherst, MA

OBJECTIVE: Prior studies investigating the impact of lipids during gestation failed to adjust for key confounders such as gestational diabetes (GDM). Our objective was to evaluate the association of GDM with maternal lipids measured during an oral glucose tolerance test (OGTT), after delivery, and in cord blood. STUDY DESIGN: We prospectively enrolled women between 24 to 28 weeks gestation scheduled for a 100 g three hour OGTT as a screening for GDM. Fasting total cholesterol, triglycerides (TG), high and low density lipoprotein (HDL and LDL) were measured at the time of the OGTT, postpartum and in the cord blood. RESULTS: The fasting mean lipids adjusted for maternal age, body mass index (BMI) and gestational age at recruitment were not significantly different between GDM (n⫽42) and non GDM (n⫽54) groups. 49 cord blood samples were available, 22 in the GDM group and 27 in the women without GDM. We conducted a median regression, controlling for gestational age and birth weight. The median cord blood TG among women with GDM was significantly higher than among women without GDM (69 vs. 54 mg/dl, p⫽0.007), and cord blood HDL was lower in women with GDM (30 vs. 41 mg/dl, p⫽ 0.006). For postpartum lipids (GDM⫽19, non-GDM⫽17), we conducted a median regression controlling for maternal age, breast feeding and BMI and stratified results over 4 week intervals. The median lipid levels for each group were not significantly different by GDM status. CONCLUSIONS: Maternal lipids at the time of the OGTT and postpartum are not associated with GDM. However, GDM during pregnancy is associated with increased TG and a decreased HDL level in cord blood. This is important since the children of women with GDM are at high risk for obesity. It is possible that the in-utero influence of GDM on fetal lipid metabolism could impact childhood weight gain. Further studies are required to investigate this association and determine if treatment can be developed during pregnancy which could decrease the risk of obesity in the children of women with GDM.

255 Alterations of calcium (Ca2ⴙ) signaling in human umbilical vein endothelial cells (HUVEC) suggesting a unique vascular adaptation in pre-existing diabetes mellitus (DM) versus gestational diabetes mellitus (GDM) pregnancies Heather Bankowski1, Derek Boeldt2, Fu-Xian Yi2, Ian Bird2, Dinesh Shah2 1

University of Wisconsin, Madison, WI, 2University of WI School of Medicine and Public Health, Madison, WI

OBJECTIVE: Vascular dysfunction in DM may impede vasodilatation characteristic of normal vasculature on the fetal side, thereby resulting in excessive or compromised fetal growth. DM in pregnancy can be categorized as pre-existing DM (DM) and gestational DM (GDM). Previously, we reported that while Ca2⫹ signaling in DM umbilical vein endothelium (UV endo) appears similar to that of normal UV endo, the sustained nitric oxide (NO) response of normal UV endo is blunted in DM UV endo. In this study, we examine whether HUVEC isolated and maintained in culture show Ca2⫹ signaling abnormalities that are specific to DM type. We hypothesize that the difference in

American Journal of Obstetrics & Gynecology Supplement to JANUARY 2011