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287: Maternal folic acid supplementation trends 2009 – 13
Poster Session II
ajog.org Infant adiposity was related to increases in maternal fat-free mass, bone and water. Interventions focussed on restricting maternal fat gain during pregnancy will not limit infant adiposity.
The relationship between maternal parameters and infant adiposity at birth
286 Effect of magnesium sulfate and betamethasone on inflammation and glial differentiation in a preterm labor murine model
Andrew Thagard1, Monica Lutgendorf1, Luckey Reed1, Jessica Slack2, Avedis Kazanjian2, Danielle Ippolito2, Irina Burd3, Peter Napolitano1 1
Madigan Army Medical Center, Maternal Fetal Medicine, Tacoma, WA, Madigan Army Medical Center, Department of Clinical Investigation, Tacoma, WA, 3Johns Hopkins University, Maternal Fetal Medicine, Baltimore, MD 2
OBJECTIVE: Prematurity is associated with fetal neuroinflammation and subsequent neurologic injury. The impact of magnesium sulfate (MgSO4) and betamethasone (BMTZ), commonly employed therapies in the setting of preterm labor, on prematurity-related neurologic morbidity remains incompletely understood. The objective of this study was to identify effects of MgSO4 and BMTZ on markers of inflammation and glial development in offspring of a murine model of preterm birth and perinatal brain injury. STUDY DESIGN: CD1 timed-pregnant mice were randomized to receive an intrauterine injection of 100 mcg of lipopolysaccharide (LPS) or an equivalent volume of phosphate buffered saline (PBS) on gestation day 15. Mice were further randomized to receive MgSO4 (270 mg/kg load dose followed by 27 mg/kg every 20 min for 4h) and/or BMTZ (0.1 mg) 30 min after the injection. Fetal brains were harvested and analyzed for Tlr4, Plp1, Gfap, and Cx3cl1 expression by QPCR. A non-parametric Wilcoxon signed rank test compared to a theoretical value of 1 was utilized for statistical analysis. RESULTS: Considerable heterogeneity in Tlr4 expression was noted among individuals in the LPS-exposed cohort. This expression was reduced in animals treated with combined MgSO4/BMTZ therapy, but was not statistically significant (p>0.05). Plp1, a marker of immature oligodendrocyte expression, was significantly lower in the three treatment cohorts than the positive or negative controls (p<0.05). CONCLUSION: Despite considerable variability consistent with heterogeneity in an outbred animal strain, our study suggests that treatment with BMTZ, MgSO4, or a combination of the 2 drugs may have an impact on early expression of a gene important for white matter development.
287 Maternal folic acid supplementation trends 2009 e 13
Aoife McKeating1, Shona Cawley1, Laura Mullaney1, Maria Farren1, Niamh Daly1, Patrick Maguire1, Sharon Sheehan1, Michael Turner1
1 Coombe Women and Infants University Hospital, UCD Centre for Human Reproduction, Dublin, Ireland
OBJECTIVE: To analyze recent trends in folic acid (FA) supplementation among women booking for prenatal care. STUDY DESIGN: This prospective observational study included all women who delivered an infant 500g between January 1 2009 and December 31 2013. Body Mass Index (BMI) was calculated using early pregnancy weight and height measured at the first prenatal visit. Sociodemographic and clinical details were computerized. Multivariate logistic regression analyses were applied. RESULTS: Of 42,362 women studied, 99.2% (n¼42,042) were suitable for analysis. The mean age was 30.7 years (SD 5.6) and the mean BMI was 25.5 kg/m2 (SD 5.0). Nulliparas accounted for 34.3% (n¼14,381) and 71.1% (n¼29,908) were Irish-born. Overall, 43.9% (n¼18,473) took periconceptional FA, 49.4% (n¼20,782) took postconceptional FA and 6.6% took no FA. However, the number of women taking periconceptional FA, as recommended, decreased from 45.1% in 2009 to 43.1% in 2013 (p¼0.01) (Figure 1). The women most likely to take FA were those who had planned their pregnancy and were >30 years of age, non-obese, Irish-born and employed professionally. The decrease in periconceptional FA rates was among women who were multiparous (65.0% in 2009 to 58.3% in 2013, p<0.001), aged 20 - 29 years (20.6% in 2009 to 18.6% in2013, p¼0.03), Irish-born (80.2% in 2009 to 75.9% in 2013, p<0.001) and semi-skilled (48.4% in 2009 to 32.6% in 2013, p<0.001). We found that 37.6% (n¼2,112) of obese women took preconceptional FA, compared with 46.1% (n¼8,176) of women with a normal BMI (p<0.001). Among those who planned their pregnancy, only 54.5% (n¼1,946) of obese women took preconceptional FA, compared with 63.1% (n¼7,832) of women with a normal BMI (p<0.001). CONCLUSION: The decreasing rate of periconceptional FA supplementation is a concern in light of the recently reported increase in neural tube defects (NTDs) nationally and the fact that FA food fortification remains voluntary and not mandatory in Europe.
Figure 1. Maternal folic acid supplementation 2009-13
Supplement to JANUARY 2015 American Journal of Obstetrics & Gynecology
S155
ajog.org Infant adiposity was related to increases in maternal fat-free mass, bone and water. Interventions focussed on restricting maternal fat gain during pregnancy will not limit infant adiposity.
The relationship between maternal parameters and infant adiposity at birth
286 Effect of magnesium sulfate and betamethasone on inflammation and glial differentiation in a preterm labor murine model
Andrew Thagard1, Monica Lutgendorf1, Luckey Reed1, Jessica Slack2, Avedis Kazanjian2, Danielle Ippolito2, Irina Burd3, Peter Napolitano1 1
Madigan Army Medical Center, Maternal Fetal Medicine, Tacoma, WA, Madigan Army Medical Center, Department of Clinical Investigation, Tacoma, WA, 3Johns Hopkins University, Maternal Fetal Medicine, Baltimore, MD 2
OBJECTIVE: Prematurity is associated with fetal neuroinflammation and subsequent neurologic injury. The impact of magnesium sulfate (MgSO4) and betamethasone (BMTZ), commonly employed therapies in the setting of preterm labor, on prematurity-related neurologic morbidity remains incompletely understood. The objective of this study was to identify effects of MgSO4 and BMTZ on markers of inflammation and glial development in offspring of a murine model of preterm birth and perinatal brain injury. STUDY DESIGN: CD1 timed-pregnant mice were randomized to receive an intrauterine injection of 100 mcg of lipopolysaccharide (LPS) or an equivalent volume of phosphate buffered saline (PBS) on gestation day 15. Mice were further randomized to receive MgSO4 (270 mg/kg load dose followed by 27 mg/kg every 20 min for 4h) and/or BMTZ (0.1 mg) 30 min after the injection. Fetal brains were harvested and analyzed for Tlr4, Plp1, Gfap, and Cx3cl1 expression by QPCR. A non-parametric Wilcoxon signed rank test compared to a theoretical value of 1 was utilized for statistical analysis. RESULTS: Considerable heterogeneity in Tlr4 expression was noted among individuals in the LPS-exposed cohort. This expression was reduced in animals treated with combined MgSO4/BMTZ therapy, but was not statistically significant (p>0.05). Plp1, a marker of immature oligodendrocyte expression, was significantly lower in the three treatment cohorts than the positive or negative controls (p<0.05). CONCLUSION: Despite considerable variability consistent with heterogeneity in an outbred animal strain, our study suggests that treatment with BMTZ, MgSO4, or a combination of the 2 drugs may have an impact on early expression of a gene important for white matter development.
287 Maternal folic acid supplementation trends 2009 e 13
Aoife McKeating1, Shona Cawley1, Laura Mullaney1, Maria Farren1, Niamh Daly1, Patrick Maguire1, Sharon Sheehan1, Michael Turner1
1 Coombe Women and Infants University Hospital, UCD Centre for Human Reproduction, Dublin, Ireland
OBJECTIVE: To analyze recent trends in folic acid (FA) supplementation among women booking for prenatal care. STUDY DESIGN: This prospective observational study included all women who delivered an infant 500g between January 1 2009 and December 31 2013. Body Mass Index (BMI) was calculated using early pregnancy weight and height measured at the first prenatal visit. Sociodemographic and clinical details were computerized. Multivariate logistic regression analyses were applied. RESULTS: Of 42,362 women studied, 99.2% (n¼42,042) were suitable for analysis. The mean age was 30.7 years (SD 5.6) and the mean BMI was 25.5 kg/m2 (SD 5.0). Nulliparas accounted for 34.3% (n¼14,381) and 71.1% (n¼29,908) were Irish-born. Overall, 43.9% (n¼18,473) took periconceptional FA, 49.4% (n¼20,782) took postconceptional FA and 6.6% took no FA. However, the number of women taking periconceptional FA, as recommended, decreased from 45.1% in 2009 to 43.1% in 2013 (p¼0.01) (Figure 1). The women most likely to take FA were those who had planned their pregnancy and were >30 years of age, non-obese, Irish-born and employed professionally. The decrease in periconceptional FA rates was among women who were multiparous (65.0% in 2009 to 58.3% in 2013, p<0.001), aged 20 - 29 years (20.6% in 2009 to 18.6% in2013, p¼0.03), Irish-born (80.2% in 2009 to 75.9% in 2013, p<0.001) and semi-skilled (48.4% in 2009 to 32.6% in 2013, p<0.001). We found that 37.6% (n¼2,112) of obese women took preconceptional FA, compared with 46.1% (n¼8,176) of women with a normal BMI (p<0.001). Among those who planned their pregnancy, only 54.5% (n¼1,946) of obese women took preconceptional FA, compared with 63.1% (n¼7,832) of women with a normal BMI (p<0.001). CONCLUSION: The decreasing rate of periconceptional FA supplementation is a concern in light of the recently reported increase in neural tube defects (NTDs) nationally and the fact that FA food fortification remains voluntary and not mandatory in Europe.
Figure 1. Maternal folic acid supplementation 2009-13
Supplement to JANUARY 2015 American Journal of Obstetrics & Gynecology
S155