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497: Connections between the gut microbiome and gestational diabetes mellitus
Poster Session III
ajog.org
CONCLUSION: In this large study from China, we found that IPIs <18 were associated with increased risk of PTB and SGA, whereas IPIs 60 months were associated with higher risk of PTB and LGA. Our findings may help health authorities and pregnancy care providers in China and elsewhere in the world to devise appropriable plans for a second pregnancy, including the predicted increase of second child births.
496 Effect of interpregnancy interval on adverse birth outcomes in China from 2000 to 2015: a large retrospective cohort study Lifang Zhang1, Songying Shen1, Fanfan Chan1, Jinhua Lu1, Xingxuan Wen1, Weidong Li1, Xiaoyan Xia1, Ping Wang1, Weijian Mo1, Niannian Chen1, Wanqing Xiao1, Shenghui li1, Kin Bong Hubert Lam2, Ben Willem J. Mol3, Huimin Xia1, Xiu Qiu1 1
Guangzhou Women and Children’s Medical Center, Guangzhou Medical University, Guangzhou, China, 2Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom, 3The Robinson Research Institute, School of Pediatrics and Reproductive Health, University of Adelaide, Adelaide, Australia
OBJECTIVE: In 2015, a universal two-child policy was released in
China, which give new opportunity to millions of couples to have a second child. There is lack of data that assessed the effect of interpregnancy interval (IPI) on perinatal outcomes in a Chinese population. We investigated the effects of IPI on adverse birth outcomes in China. STUDY DESIGN: We conducted a retrospective cohort study of 227 352 Chinese women with their first and second delivery between 2000 and 2015. We assessed the relation between the IPI, defined as the time in months between the first delivery date and date of conception of the second pregnancy and preterm birth (PTB) (delivery < 37 weeks), being large for gestational age (LGA) (birth weight > 90th %) and being small for gestational age (SGA) (birth weight <10th %). Propensity score weights were used to balance the distributions of covariates across different IPI groups. RESULTS: We found a J-shape association between the IPI and risk of PTB, and approximate linear associations for LGA and SGA (Figure 1). Compared to women with IPIs of 24-29 months, those with IPIs of <6, 6-11, and 12-17 months had higher risks of PTB and SGA. Women with IPIs of 60-119 months had higher risks of PTB (adjusted odds ratio [aOR] 1.23, 95% confidence interval [CI] 1.081.41) and LGA (aOR 1.23, 95% CI 1.12-1.35). Effects of long IPIs (120 months) on PTB (adjusted OR 1.52, 95% CI 0.64-3.62) and LGA (aOR 1.80, 95% CI 0.89-3.64) were attenuated after propensity score adjustment (Table 2).
497 Connections between the gut microbiome and gestational diabetes mellitus Yong Guo1, Ya-Shu Kuang1, Sheng-Hui Li1, Ming-Yang Yuan1, Jian-Rong He1, Jin-Hua Lu1, Nian-Nian Chen1, Wan-Qing Xiao1, Song-Ying Shen1, Lan Qiu1, Ying-Fang Wu1, Cui-Yue Hu1, Yan-Yan Wu1, Wei-Dong Li1, Qiao-Zhu Chen1, Hong-Wen Deng1,2, Hui-Min Xia1, Xiu Qiu1 1
Guangzhou Women and Children’s Medical Center, Guangzhou Medical University, Guangzhou, China, 2Tulane School of Public Health and Tropic Medicine, New Orleans, LA
Supplement to JANUARY 2017 American Journal of Obstetrics & Gynecology
S293
Poster Session III
ajog.org
OBJECTIVE: The gut microbiome could modulate metabolic health and affect insulin resistance, which may play a role in the observed increase in gestational diabetes mellitus (GDM). The aim of this study was to reveal any relationships between gut microbiome composition and GDM in pregnant women at 24-28 weeks gestation. STUDY DESIGN: Fecal samples were collected from 124 pregnant women (81 non-GDM and 43 GDM) during 24-28 weeks gestation, as part of the Born in Guangzhou Cohort Study, China. The microbiota profiles were assessed by whole-genome shotgun sequencing to analyze microbial diversity at all taxonomic levels. Maternal GDM status was assessed by 2-hour 75-g OGTTs between the 24th and 28th week of gestation. RESULTS: 154,837 genes were identified that displayed significant abundance differences between GDM and non-GDM groups (Mann-Whitney U test, q<0.05). 68% of these genes were clustered into 129 metagenome linkage groups (MLGs). The GDMenriched MLGs of Enterobacteriaceae (K. variicola, E. coli, Enterobacter cloacae and Citrobacter spp.) were closely linked, representing a cooperative promoting function of Enterobacteriaceae to GDM development. When checking the correlations between the MLGs and blood glucoses, several GDM-enriched MLGs, P. distasonis, K. variicola and E. rectale were positively related to the glucose level of OGTT, while the large proportion of control-enriched MLGs were negatively related. Similarly on the analysis of species profiles, Parabacteroides spp., Eggerthella spp. and Megamonas spp. were positively correlated with the glucose level. CONCLUSION: Our study shows novel relationships between gut microbiome composition and GDM. The results suggest that changes of the gut microbiome composition may have the potential in response to increased GDM during pregnancy.
498 Relationship between mode of conception and perinatal outcomes among U.S. women with twin gestations Lynn M. Yee1, Aaron B. Caughey2, William A. Grobman1, Yvonne W. Cheng3 1
Northwestern University Feinberg School of Medicine, Chicago, IL, 2Oregon Health & Science University, Portland, OR, 3California Pacific Medical Center, San Francisco, CA
OBJECTIVE: Although conception via assisted reproductive technology (ART) has been associated with adverse perinatal outcomes, the relationship of ART to maternal and neonatal outcomes of twin gestations is less clear. The aim of this study was to examine maternal and neonatal outcomes of twin pregnancies by whether conception had occurred via ART. STUDY DESIGN: This was a population-based retrospective cohort study of women giving birth to liveborn twins in the U.S. between 2012 and 2014. Women with unknown mode of conception were excluded. Women were categorized as having had or not had ART, defined as procedures in which both egg and sperm are handled in the laboratory. Multivariable logistic regression was utilized to assess
S294 American Journal of Obstetrics & Gynecology Supplement to JANUARY 2017
ajog.org
CONCLUSION: In this large study from China, we found that IPIs <18 were associated with increased risk of PTB and SGA, whereas IPIs 60 months were associated with higher risk of PTB and LGA. Our findings may help health authorities and pregnancy care providers in China and elsewhere in the world to devise appropriable plans for a second pregnancy, including the predicted increase of second child births.
496 Effect of interpregnancy interval on adverse birth outcomes in China from 2000 to 2015: a large retrospective cohort study Lifang Zhang1, Songying Shen1, Fanfan Chan1, Jinhua Lu1, Xingxuan Wen1, Weidong Li1, Xiaoyan Xia1, Ping Wang1, Weijian Mo1, Niannian Chen1, Wanqing Xiao1, Shenghui li1, Kin Bong Hubert Lam2, Ben Willem J. Mol3, Huimin Xia1, Xiu Qiu1 1
Guangzhou Women and Children’s Medical Center, Guangzhou Medical University, Guangzhou, China, 2Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom, 3The Robinson Research Institute, School of Pediatrics and Reproductive Health, University of Adelaide, Adelaide, Australia
OBJECTIVE: In 2015, a universal two-child policy was released in
China, which give new opportunity to millions of couples to have a second child. There is lack of data that assessed the effect of interpregnancy interval (IPI) on perinatal outcomes in a Chinese population. We investigated the effects of IPI on adverse birth outcomes in China. STUDY DESIGN: We conducted a retrospective cohort study of 227 352 Chinese women with their first and second delivery between 2000 and 2015. We assessed the relation between the IPI, defined as the time in months between the first delivery date and date of conception of the second pregnancy and preterm birth (PTB) (delivery < 37 weeks), being large for gestational age (LGA) (birth weight > 90th %) and being small for gestational age (SGA) (birth weight <10th %). Propensity score weights were used to balance the distributions of covariates across different IPI groups. RESULTS: We found a J-shape association between the IPI and risk of PTB, and approximate linear associations for LGA and SGA (Figure 1). Compared to women with IPIs of 24-29 months, those with IPIs of <6, 6-11, and 12-17 months had higher risks of PTB and SGA. Women with IPIs of 60-119 months had higher risks of PTB (adjusted odds ratio [aOR] 1.23, 95% confidence interval [CI] 1.081.41) and LGA (aOR 1.23, 95% CI 1.12-1.35). Effects of long IPIs (120 months) on PTB (adjusted OR 1.52, 95% CI 0.64-3.62) and LGA (aOR 1.80, 95% CI 0.89-3.64) were attenuated after propensity score adjustment (Table 2).
497 Connections between the gut microbiome and gestational diabetes mellitus Yong Guo1, Ya-Shu Kuang1, Sheng-Hui Li1, Ming-Yang Yuan1, Jian-Rong He1, Jin-Hua Lu1, Nian-Nian Chen1, Wan-Qing Xiao1, Song-Ying Shen1, Lan Qiu1, Ying-Fang Wu1, Cui-Yue Hu1, Yan-Yan Wu1, Wei-Dong Li1, Qiao-Zhu Chen1, Hong-Wen Deng1,2, Hui-Min Xia1, Xiu Qiu1 1
Guangzhou Women and Children’s Medical Center, Guangzhou Medical University, Guangzhou, China, 2Tulane School of Public Health and Tropic Medicine, New Orleans, LA
Supplement to JANUARY 2017 American Journal of Obstetrics & Gynecology
S293
Poster Session III
ajog.org
OBJECTIVE: The gut microbiome could modulate metabolic health and affect insulin resistance, which may play a role in the observed increase in gestational diabetes mellitus (GDM). The aim of this study was to reveal any relationships between gut microbiome composition and GDM in pregnant women at 24-28 weeks gestation. STUDY DESIGN: Fecal samples were collected from 124 pregnant women (81 non-GDM and 43 GDM) during 24-28 weeks gestation, as part of the Born in Guangzhou Cohort Study, China. The microbiota profiles were assessed by whole-genome shotgun sequencing to analyze microbial diversity at all taxonomic levels. Maternal GDM status was assessed by 2-hour 75-g OGTTs between the 24th and 28th week of gestation. RESULTS: 154,837 genes were identified that displayed significant abundance differences between GDM and non-GDM groups (Mann-Whitney U test, q<0.05). 68% of these genes were clustered into 129 metagenome linkage groups (MLGs). The GDMenriched MLGs of Enterobacteriaceae (K. variicola, E. coli, Enterobacter cloacae and Citrobacter spp.) were closely linked, representing a cooperative promoting function of Enterobacteriaceae to GDM development. When checking the correlations between the MLGs and blood glucoses, several GDM-enriched MLGs, P. distasonis, K. variicola and E. rectale were positively related to the glucose level of OGTT, while the large proportion of control-enriched MLGs were negatively related. Similarly on the analysis of species profiles, Parabacteroides spp., Eggerthella spp. and Megamonas spp. were positively correlated with the glucose level. CONCLUSION: Our study shows novel relationships between gut microbiome composition and GDM. The results suggest that changes of the gut microbiome composition may have the potential in response to increased GDM during pregnancy.
498 Relationship between mode of conception and perinatal outcomes among U.S. women with twin gestations Lynn M. Yee1, Aaron B. Caughey2, William A. Grobman1, Yvonne W. Cheng3 1
Northwestern University Feinberg School of Medicine, Chicago, IL, 2Oregon Health & Science University, Portland, OR, 3California Pacific Medical Center, San Francisco, CA
OBJECTIVE: Although conception via assisted reproductive technology (ART) has been associated with adverse perinatal outcomes, the relationship of ART to maternal and neonatal outcomes of twin gestations is less clear. The aim of this study was to examine maternal and neonatal outcomes of twin pregnancies by whether conception had occurred via ART. STUDY DESIGN: This was a population-based retrospective cohort study of women giving birth to liveborn twins in the U.S. between 2012 and 2014. Women with unknown mode of conception were excluded. Women were categorized as having had or not had ART, defined as procedures in which both egg and sperm are handled in the laboratory. Multivariable logistic regression was utilized to assess
S294 American Journal of Obstetrics & Gynecology Supplement to JANUARY 2017