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obese pregnant women: effects on endothelial and metabolic function
www.AJOG.org
Academic Issues, Antepartum Fetal Assessment, Genetics, Hypertension, Medical-Surgical-Disease
Poster Session V
819 Antenatal depression, altered maternal and neonatal neuroendocrine profiles, and fetal growth patterns Deborah Berman1, Elizabeth Campbell2, Marjorie Treadwell1, Delia Vasquez3, Juan Lopez3, Sheila Marcus3 1 University of Michigan Medical Center, Obstetrics and Gynecology, Division of Maternal-Fetal Medicine, Ann Arbor, MI, 2University of Michigan Medical Center, Obstetrics and Gynecology, Ann Arbor, MI, 3University of Michigan Medical Center, Department of Psychiatry, Ann Arbor, MI
818 Maternal depression and impaired fetal growth Deborah Berman1, Elizabeth Campbell2, Juan Lopez3, Delia Vasquez3, Sheila Marcus3, Marjorie Treadwell1 1 University of Michigan Medical Center, Obstetrics and Gynecology, Division of Maternal-Fetal Medicine, Ann Arbor, MI, 2University of Michigan Medical Center, Department of Obstetrics and Gynecology, Ann Arbor, MI, 3University of Michigan Medical Center, Department of Psychiatry, Ann Arbor, MI
OBJECTIVE: Maternal depression is known to be associated with small for gestational age neonates. We seek to assess whether an association between maternal depression and abnormal fetal growth can be determined by prenatal ultrasound and to define the timing of abnormal fetal growth. STUDY DESIGN: One hundred and thirty eight women receiving prenatal care through the University of Michigan Health System were recruited, including 105 depressed/high risk (HR) and 33 non-depressed /low risk (LR) patients. Depressive symptomatology was assessed using Beck Depression Inventory (BDI) scores at 24, 32, and 37 weeks gestation. Ultrasounds performed at 20, 24,32,and 37 weeks included measurements and corresponding percentiles for biparietal diameter (BPD), head circumference (HC), abdominal circumference (AC), and femur length (FL). RESULTS: Baseline EFW at 20 weeks gestation is similar in both HR and LR groups (p⫽0.833), however the rate of fetal growth between 20 and 37 weeks is significantly decreased in HR versus LR women, using either the calculated EFW or EFW percentiles (p⫽0.02 and p⫽0.01, respectively). Mean EFW was lower in the HR group as compared to the LR at all gestational ages, and approached statistical significance at 32 and 37 wks (p⫽0.05 and p⫽0.06, respectively). When controlling for smoking, the mean EFW in the HR group was significantly lower than LR group at both 32 and 37 wks (p⬍0.05 and p⬍0.01, respectively). Mean AC and FL measurements were significantly lower in HR pregnancies at 37 wks (p⬍0.01 and p⫽0.02, respectively). Head measurements were not different between the HR and LR groups during the third trimester. Although none of the growth parameters were significantly associated with severity of depressive symptomatology as assessed by the BDI, overall growth was decreased with depression. CONCLUSION: Our findings suggest that ultrasound can detect decreased fetal growth patterns in depressed women. Whether impaired growth can be improved by adequate treatment of maternal depression deserves further study.
OBJECTIVE: An association has been identified between maternal depression and adverse neonatal outcomes, including altered growth. Marcus, et al (2011) has previously reported that maternal cortisol and ACTH increase in depressed pregnant women. It has been proposed that these effects may be mediated through the neuroendocrine axis. The aim of our study was to examine the relationship between maternal and neonatal neuroendocrine profiles and fetal growth patterns as determined by prenatal ultrasound. STUDY DESIGN: We designed a prospective case-control study of 138 women receiving prenatal care at University of Michigan Health System, 105 depressed/high risk (HR) and 33 non-depressed/low risk (LR) patients were enrolled. Maternal cortisol and ACTH levels were obtained at 24, 32, and 37 weeks gestation. Neonatal cortisol and ACTH levels were obtained from cord blood. Ultrasounds performed at 24, 32, and 37 weeks included measurements for biparietal diameter (BPD), head circumference (HC), abdominal circumference (AC), femur length (FL), and estimated fetal weight (EFW). RESULTS: Cortisol is higher at all gestational ages in HR as compared to LR women and reaches significance at 37 weeks (p⬍0.05). ACTH is significantly increased in HR women beginning at 32 weeks (p⫽0.02). Neonatal ACTH levels are elevated in offspring of HR as compared to LR mothers (p⬍0.01), while neonatal cortisol levels are not different. Increased maternal cortisol and ACTH in HR women were not associated with decreased estimated fetal weights, and neonatal ACTH and cortisol levels did not correlate with fetal morphometrics (EFW, BPD, HC, AC, FL) (p⫽0.76) CONCLUSION: Antenatal depression is associated with elevated neuroendocrine markers and may contribute to poor neonatal outcomes such as low birth weight. We did not find an association between maternal or infant neuroendocrine status and fetal ultrasound morphometrics. While this suggests that the neuroendocrine system does not mediate fetal growth patterns as measured by fetal biometry, further evaluation of the association between depression, markers, and fetal growth is warranted.
820 L-Arginine-Nitric Oxide (NO) pathway in overweight/obese pregnant women: effects on endothelial and metabolic function Fabio Facchinetti1, Francesca Fontanesi1, Lucrezia Pignatti2, Elisabetta Petrella2, Isabella Neri3 1 Univ. of Modena & Reggio Emilia, Mother-Infant Departement, Modena, Italy, 2Univ. of Modena & Reggio Emilia, Mother-Infant Departement, AOU, via del Pozzo 71, Italy, 3Mother-Infant Dept., Univ. of MO & RE, Mother-Infant Departement, Modena, Italy
OBJECTIVE: Endothelial dysfunction and insulin resistance characterize obese women. Both glucose metabolism and vascular activity are modulated by L-Arg-NO pathway. We aim at evaluating this regulatory system in overweight and obese women in pregnancy. STUDY DESIGN: Eight normal weight (BMI 18.3-24.9) and 14 overweight/obese pregnant women with increased BMI (26.3-45.2) underwent twice (at 9-12th week and at 24-27th week) L-Arginine infusion (30g in 3 hours). Serum assay for glucose, insulin and nitrite/ nitrate (NOx) levels were performed hourly. Endothelial-dependent flow mediated vasodilation (FMD) was evaluated as the percent change of brachial artery diameter in response to increased blood flow shear stress. RESULTS: NOx levels were similar in lean and overweight/obese women at 1st trimester. On the contrary, the difference between
Supplement to JANUARY 2012 American Journal of Obstetrics & Gynecology
S359
Poster Session V
Academic Issues, Antepartum Fetal Assessment, Genetics, Hypertension, Medical-Surgical-Disease
groups became significant at 2nd trimester with L-Arginine induced NOx values less than 1/3 in women with BMI⬎25 after 120 (p⫽0.03) and 180 minutes (p⫽0.05) respect with lean controls. FMD of brachial artery at 2nd trimester was significantly reduced in overweight/ obese (1613%) vs lean (326%, p⫽0.03) women. Fasting insulin levels were significantly higher in overweight/obese (21.38.0 ìUI/ml) vs lean women (12.17.4 ìUI/ml, p⫽0.03). At 1st trimester, L-Arginine significantly reduced insulin levels in both groups whereas at 2nd trimester such effect was attenuated in overweight/obese vs lean women (p⫽0.05). CONCLUSION: L-Arginine-NO pathway is impaired in overweight/ obese women at 2nd trimester and it is associated with a reduction in endothelial-dependent vasodilation. Despite lower NO availability in such patients, insulin decrease was maintained in overweight/obese women. L-Arginine-NO pathway seems more influent on vascular system rather than on metabolic side.
821 A randomized controlled trial comparing a multi-modal intervention and standard obstetrical care for low back and pelvic pain in pregnancy Gilad Gross1, James W. George2, Paul A. Thompson3, D. Michael Nelson4, Clayton Skaggs5 1 Saint Louis University School of Medicine, Obstetrics, Gynecology and Women’s Health, Saint Louis, MO, 2Logan College, Chiropractic, Chesterfield, MO, 3Sanford Research/USD, Methodology and Data Analysis Center, Sioux Falls, SD, 4Washington University School of Medicine in St. Louis, Obstetrics and Gynecology, St. Louis, MO, 5Central Institute of Human Perforemance, Chiropractic, Kirkwood, MO
OBJECTIVE: Musculoskeletal pain in pregnancy is commonly viewed as transient, physiologic and self-limited. Many women report either low back pain (LBP) or pelvic pain (PP) during pregnancy but are rarely formally treated. This study tested the hypothesis that a multimodal approach of manual therapy, exercise, and education for LBP/PP in pregnancy is superior to standard obstetrical care for the reduction of pain, impairment, and disability in the antepartum and postpartum periods. STUDY DESIGN: This is a prospective, randomized, clinical trial that compared standard obstetric care (STOB) to a multi-modal musculoskeletal and obstetric management (MOM). A single masked chiropractor performed a baseline evaluation at enrollment between 24-28 weeks gestation with follow up exams at 33 weeks gestation and 3 months post partum. Subjective questionnaires included the numerical rating scale (NRS), Quebec disability questionnaire (QDQ) and personal pain history (PPH). Objective physical tests included straight leg raise (SLR), posterior pelvic pain provocation (P4), and long dorsal ligament tests (LDLT), which were used to quantify pain, disability and physical function at each assessment. Patients in both the STOB and MOM group received routine obstetrical care. The MOM group also had visits with a chiropractic specialist who provided manual therapy, stabilization exercises, and patient education. RESULTS: STOB (n⫽82) and MOM (n⫽87) groups were demographically similar and baseline evaluation showed no differences in pain, disability, or physical assessments between the two groups. Compared to baseline, patients in the MOM group demonstrated a significant reduction in NRS, QDQ, PPH, and SLR scores at the 33 week visit (all p ⬍ 0.05). STOB patients showed improvement in QDQ alone (p ⬍0.05). The STOB and MOM groups were similar in all parameters studied at the post partum visit. CONCLUSION: A chiropractic approach to musculoskeletal LBP/PP instituted in the late second and early third trimesters of pregnancy benefits patients above and beyond standard obstetrical provider care. Supported by Grant # R18HP07640.
S360
www.AJOG.org
822 The expression of the omega-3 fatty acid receptor, GPR120, is more sensitive to inflammatory cytokines and maternal obesity in male infants than in females Gina Westhoff1, Bernadette Grayson2, David Barker3, Cynthia Morris4, Kent Thornburg3, Perrie O’Tierney3 1 Oregon Health & Science University, Department of Obstetrics and Gynecology, Portland, OR, 2University of Cincinnati, Metabolic Disease Institute, Cincinnati, OH, 3Oregon Health & Science University, Heart Research Center, Portland, OR, 4OHSU, Public Health and Preventative Medicine, Portland, OR
OBJECTIVE: Maternal obesity is associated with a pro-inflammatory intrauterine environment and alterations in fetal metabolism that increase the risk for metabolic diseases later in life. A recently discovered novel G-protein coupled receptor, GPR120, has been shown to decrease inflammation and improve insulin sensitivity after stimulation by omega-3 fatty acids. The presence and role of the GPR120 receptor have not yet been determined in the human placenta. STUDY DESIGN: We studied a cohort of 41 women from Klamath Falls, OR. Demographic information, maternal and umbilical plasma samples, and placental tissue were previously collected. Expression levels of GPR120 mRNA in the placenta were determined by qPCR standardized to -actin expression. Associations between GPR120 expression levels and experimental variables were determined using Spearmans rank correlation coefficient. RESULTS: GPR120 mRNA expression was detected in all placental samples. In males, placental GPR120 expression was negatively associated with maternal obesity (r⫽⫺0.62; p⬍0.05) and placental IL-6 (r⫽⫺0.50; p⬍0.05). In females, placental GPR120 expression was negatively associated with maternal cholesterol (r⫽⫺0.47; p⬍0.05) and maternal LDL (r⫽⫺0.43; p⬍0.05) and positively associated with neonatal total omega-3 levels (r⫽ 0.71, p⬍0.01). CONCLUSION: This study shows that the GPR120 omega-3 fatty acid receptor is present in the human placenta and that its expression is suppressed by two inflammatory indicators, maternal obesity and placental IL-6 in males but not females. In female placentas, GPR120 expression is suppressed by alterations in the maternal lipid profile including cholesterol and LDL. A positive correlation between neonatal total omega-3 levels and placental GPR120 was seen in female infants, but not in males. Our studies show for the first time that placentas from male and female infants express the omega-3 fatty acid receptor, GPR120, and that its expression is regulated by pro-inflammatory conditions in males and by maternal lipid profile in females.
American Journal of Obstetrics & Gynecology Supplement to JANUARY 2012
Academic Issues, Antepartum Fetal Assessment, Genetics, Hypertension, Medical-Surgical-Disease
Poster Session V
819 Antenatal depression, altered maternal and neonatal neuroendocrine profiles, and fetal growth patterns Deborah Berman1, Elizabeth Campbell2, Marjorie Treadwell1, Delia Vasquez3, Juan Lopez3, Sheila Marcus3 1 University of Michigan Medical Center, Obstetrics and Gynecology, Division of Maternal-Fetal Medicine, Ann Arbor, MI, 2University of Michigan Medical Center, Obstetrics and Gynecology, Ann Arbor, MI, 3University of Michigan Medical Center, Department of Psychiatry, Ann Arbor, MI
818 Maternal depression and impaired fetal growth Deborah Berman1, Elizabeth Campbell2, Juan Lopez3, Delia Vasquez3, Sheila Marcus3, Marjorie Treadwell1 1 University of Michigan Medical Center, Obstetrics and Gynecology, Division of Maternal-Fetal Medicine, Ann Arbor, MI, 2University of Michigan Medical Center, Department of Obstetrics and Gynecology, Ann Arbor, MI, 3University of Michigan Medical Center, Department of Psychiatry, Ann Arbor, MI
OBJECTIVE: Maternal depression is known to be associated with small for gestational age neonates. We seek to assess whether an association between maternal depression and abnormal fetal growth can be determined by prenatal ultrasound and to define the timing of abnormal fetal growth. STUDY DESIGN: One hundred and thirty eight women receiving prenatal care through the University of Michigan Health System were recruited, including 105 depressed/high risk (HR) and 33 non-depressed /low risk (LR) patients. Depressive symptomatology was assessed using Beck Depression Inventory (BDI) scores at 24, 32, and 37 weeks gestation. Ultrasounds performed at 20, 24,32,and 37 weeks included measurements and corresponding percentiles for biparietal diameter (BPD), head circumference (HC), abdominal circumference (AC), and femur length (FL). RESULTS: Baseline EFW at 20 weeks gestation is similar in both HR and LR groups (p⫽0.833), however the rate of fetal growth between 20 and 37 weeks is significantly decreased in HR versus LR women, using either the calculated EFW or EFW percentiles (p⫽0.02 and p⫽0.01, respectively). Mean EFW was lower in the HR group as compared to the LR at all gestational ages, and approached statistical significance at 32 and 37 wks (p⫽0.05 and p⫽0.06, respectively). When controlling for smoking, the mean EFW in the HR group was significantly lower than LR group at both 32 and 37 wks (p⬍0.05 and p⬍0.01, respectively). Mean AC and FL measurements were significantly lower in HR pregnancies at 37 wks (p⬍0.01 and p⫽0.02, respectively). Head measurements were not different between the HR and LR groups during the third trimester. Although none of the growth parameters were significantly associated with severity of depressive symptomatology as assessed by the BDI, overall growth was decreased with depression. CONCLUSION: Our findings suggest that ultrasound can detect decreased fetal growth patterns in depressed women. Whether impaired growth can be improved by adequate treatment of maternal depression deserves further study.
OBJECTIVE: An association has been identified between maternal depression and adverse neonatal outcomes, including altered growth. Marcus, et al (2011) has previously reported that maternal cortisol and ACTH increase in depressed pregnant women. It has been proposed that these effects may be mediated through the neuroendocrine axis. The aim of our study was to examine the relationship between maternal and neonatal neuroendocrine profiles and fetal growth patterns as determined by prenatal ultrasound. STUDY DESIGN: We designed a prospective case-control study of 138 women receiving prenatal care at University of Michigan Health System, 105 depressed/high risk (HR) and 33 non-depressed/low risk (LR) patients were enrolled. Maternal cortisol and ACTH levels were obtained at 24, 32, and 37 weeks gestation. Neonatal cortisol and ACTH levels were obtained from cord blood. Ultrasounds performed at 24, 32, and 37 weeks included measurements for biparietal diameter (BPD), head circumference (HC), abdominal circumference (AC), femur length (FL), and estimated fetal weight (EFW). RESULTS: Cortisol is higher at all gestational ages in HR as compared to LR women and reaches significance at 37 weeks (p⬍0.05). ACTH is significantly increased in HR women beginning at 32 weeks (p⫽0.02). Neonatal ACTH levels are elevated in offspring of HR as compared to LR mothers (p⬍0.01), while neonatal cortisol levels are not different. Increased maternal cortisol and ACTH in HR women were not associated with decreased estimated fetal weights, and neonatal ACTH and cortisol levels did not correlate with fetal morphometrics (EFW, BPD, HC, AC, FL) (p⫽0.76) CONCLUSION: Antenatal depression is associated with elevated neuroendocrine markers and may contribute to poor neonatal outcomes such as low birth weight. We did not find an association between maternal or infant neuroendocrine status and fetal ultrasound morphometrics. While this suggests that the neuroendocrine system does not mediate fetal growth patterns as measured by fetal biometry, further evaluation of the association between depression, markers, and fetal growth is warranted.
820 L-Arginine-Nitric Oxide (NO) pathway in overweight/obese pregnant women: effects on endothelial and metabolic function Fabio Facchinetti1, Francesca Fontanesi1, Lucrezia Pignatti2, Elisabetta Petrella2, Isabella Neri3 1 Univ. of Modena & Reggio Emilia, Mother-Infant Departement, Modena, Italy, 2Univ. of Modena & Reggio Emilia, Mother-Infant Departement, AOU, via del Pozzo 71, Italy, 3Mother-Infant Dept., Univ. of MO & RE, Mother-Infant Departement, Modena, Italy
OBJECTIVE: Endothelial dysfunction and insulin resistance characterize obese women. Both glucose metabolism and vascular activity are modulated by L-Arg-NO pathway. We aim at evaluating this regulatory system in overweight and obese women in pregnancy. STUDY DESIGN: Eight normal weight (BMI 18.3-24.9) and 14 overweight/obese pregnant women with increased BMI (26.3-45.2) underwent twice (at 9-12th week and at 24-27th week) L-Arginine infusion (30g in 3 hours). Serum assay for glucose, insulin and nitrite/ nitrate (NOx) levels were performed hourly. Endothelial-dependent flow mediated vasodilation (FMD) was evaluated as the percent change of brachial artery diameter in response to increased blood flow shear stress. RESULTS: NOx levels were similar in lean and overweight/obese women at 1st trimester. On the contrary, the difference between
Supplement to JANUARY 2012 American Journal of Obstetrics & Gynecology
S359
Poster Session V
Academic Issues, Antepartum Fetal Assessment, Genetics, Hypertension, Medical-Surgical-Disease
groups became significant at 2nd trimester with L-Arginine induced NOx values less than 1/3 in women with BMI⬎25 after 120 (p⫽0.03) and 180 minutes (p⫽0.05) respect with lean controls. FMD of brachial artery at 2nd trimester was significantly reduced in overweight/ obese (1613%) vs lean (326%, p⫽0.03) women. Fasting insulin levels were significantly higher in overweight/obese (21.38.0 ìUI/ml) vs lean women (12.17.4 ìUI/ml, p⫽0.03). At 1st trimester, L-Arginine significantly reduced insulin levels in both groups whereas at 2nd trimester such effect was attenuated in overweight/obese vs lean women (p⫽0.05). CONCLUSION: L-Arginine-NO pathway is impaired in overweight/ obese women at 2nd trimester and it is associated with a reduction in endothelial-dependent vasodilation. Despite lower NO availability in such patients, insulin decrease was maintained in overweight/obese women. L-Arginine-NO pathway seems more influent on vascular system rather than on metabolic side.
821 A randomized controlled trial comparing a multi-modal intervention and standard obstetrical care for low back and pelvic pain in pregnancy Gilad Gross1, James W. George2, Paul A. Thompson3, D. Michael Nelson4, Clayton Skaggs5 1 Saint Louis University School of Medicine, Obstetrics, Gynecology and Women’s Health, Saint Louis, MO, 2Logan College, Chiropractic, Chesterfield, MO, 3Sanford Research/USD, Methodology and Data Analysis Center, Sioux Falls, SD, 4Washington University School of Medicine in St. Louis, Obstetrics and Gynecology, St. Louis, MO, 5Central Institute of Human Perforemance, Chiropractic, Kirkwood, MO
OBJECTIVE: Musculoskeletal pain in pregnancy is commonly viewed as transient, physiologic and self-limited. Many women report either low back pain (LBP) or pelvic pain (PP) during pregnancy but are rarely formally treated. This study tested the hypothesis that a multimodal approach of manual therapy, exercise, and education for LBP/PP in pregnancy is superior to standard obstetrical care for the reduction of pain, impairment, and disability in the antepartum and postpartum periods. STUDY DESIGN: This is a prospective, randomized, clinical trial that compared standard obstetric care (STOB) to a multi-modal musculoskeletal and obstetric management (MOM). A single masked chiropractor performed a baseline evaluation at enrollment between 24-28 weeks gestation with follow up exams at 33 weeks gestation and 3 months post partum. Subjective questionnaires included the numerical rating scale (NRS), Quebec disability questionnaire (QDQ) and personal pain history (PPH). Objective physical tests included straight leg raise (SLR), posterior pelvic pain provocation (P4), and long dorsal ligament tests (LDLT), which were used to quantify pain, disability and physical function at each assessment. Patients in both the STOB and MOM group received routine obstetrical care. The MOM group also had visits with a chiropractic specialist who provided manual therapy, stabilization exercises, and patient education. RESULTS: STOB (n⫽82) and MOM (n⫽87) groups were demographically similar and baseline evaluation showed no differences in pain, disability, or physical assessments between the two groups. Compared to baseline, patients in the MOM group demonstrated a significant reduction in NRS, QDQ, PPH, and SLR scores at the 33 week visit (all p ⬍ 0.05). STOB patients showed improvement in QDQ alone (p ⬍0.05). The STOB and MOM groups were similar in all parameters studied at the post partum visit. CONCLUSION: A chiropractic approach to musculoskeletal LBP/PP instituted in the late second and early third trimesters of pregnancy benefits patients above and beyond standard obstetrical provider care. Supported by Grant # R18HP07640.
S360
www.AJOG.org
822 The expression of the omega-3 fatty acid receptor, GPR120, is more sensitive to inflammatory cytokines and maternal obesity in male infants than in females Gina Westhoff1, Bernadette Grayson2, David Barker3, Cynthia Morris4, Kent Thornburg3, Perrie O’Tierney3 1 Oregon Health & Science University, Department of Obstetrics and Gynecology, Portland, OR, 2University of Cincinnati, Metabolic Disease Institute, Cincinnati, OH, 3Oregon Health & Science University, Heart Research Center, Portland, OR, 4OHSU, Public Health and Preventative Medicine, Portland, OR
OBJECTIVE: Maternal obesity is associated with a pro-inflammatory intrauterine environment and alterations in fetal metabolism that increase the risk for metabolic diseases later in life. A recently discovered novel G-protein coupled receptor, GPR120, has been shown to decrease inflammation and improve insulin sensitivity after stimulation by omega-3 fatty acids. The presence and role of the GPR120 receptor have not yet been determined in the human placenta. STUDY DESIGN: We studied a cohort of 41 women from Klamath Falls, OR. Demographic information, maternal and umbilical plasma samples, and placental tissue were previously collected. Expression levels of GPR120 mRNA in the placenta were determined by qPCR standardized to -actin expression. Associations between GPR120 expression levels and experimental variables were determined using Spearmans rank correlation coefficient. RESULTS: GPR120 mRNA expression was detected in all placental samples. In males, placental GPR120 expression was negatively associated with maternal obesity (r⫽⫺0.62; p⬍0.05) and placental IL-6 (r⫽⫺0.50; p⬍0.05). In females, placental GPR120 expression was negatively associated with maternal cholesterol (r⫽⫺0.47; p⬍0.05) and maternal LDL (r⫽⫺0.43; p⬍0.05) and positively associated with neonatal total omega-3 levels (r⫽ 0.71, p⬍0.01). CONCLUSION: This study shows that the GPR120 omega-3 fatty acid receptor is present in the human placenta and that its expression is suppressed by two inflammatory indicators, maternal obesity and placental IL-6 in males but not females. In female placentas, GPR120 expression is suppressed by alterations in the maternal lipid profile including cholesterol and LDL. A positive correlation between neonatal total omega-3 levels and placental GPR120 was seen in female infants, but not in males. Our studies show for the first time that placentas from male and female infants express the omega-3 fatty acid receptor, GPR120, and that its expression is regulated by pro-inflammatory conditions in males and by maternal lipid profile in females.
American Journal of Obstetrics & Gynecology Supplement to JANUARY 2012