1The Ohio State University College of Medicine, Department of Obstetrics and Gynecology, Columbus, OH, 2Yale School of Medicine, Department of. Obstetrics ...
Poster Session III
ajog.org throughout gestation may contribute to the adverse pregnancy outcomes associated with obese pregnancy and these patterns are established in early pregnancy.
Adipocytokine levels in early and late pregnancy in normal weight and obese women
422 Evidence for the participation of neutrophil gelatinaseassociated lipocalin (NGAL)/matrix metalloproteinase-9 (MMP-9) complex in the amniotic fluid inflammatory response to infection
Kara Rood1, Katherine Rodewald Millen1, Sammy Tabbah1, Mert Bahtiyar2, Stephen Thung1, Taryn Summerfield1, Guomao Zhao3, William Ackerman1, Cynthia Shellhaas1, Philip Samuels1, Irina Buhimschi3, Catalin Buhimschi1
1 The Ohio State University College of Medicine, Department of Obstetrics and Gynecology, Columbus, OH, 2Yale School of Medicine, Department of Obstetrics, Gynecology and Reproductive Sciences, New Haven, CT, 3 Nationwide Children’s Hospital, Center for Perinatal Research, Columbus, OH
421 Weight loss in the obese gravida reduces the risk of macrosomia Julie Phillips1, Stephanie Mann1 1
University of Vermont, South Burlington, VT
OBJECTIVE: In the obese gravida, excessive gestational weight gain is
associated with adverse perinatal outcome, including an increased rate of macrosomia. Macrosomia is associated with cesarean delivery, shoulder dystocia, birth trauma, and long term childhood sequlae. The objective of this study was to examine the relationship between gestational weight change, particularly gestational weight loss, and neonatal birthweight in obese women. STUDY DESIGN: IRB approval was obtained. 1823 term, singleton deliveries to healthy non-smoking women with a BMI 30 kg/m2 between 2006-2013 were included. Gestational weight change was calculated as weight at delivery minus prepregnancy weight or weight at first prenatal visit. Women were divided into five weight change groups : weight loss < 5% or >5% of prepregnancy body weight, insufficient (0-10 lb), adequate (11-20 lbs), or excessive (>20 lbs) weight gain. Continuous variables are described by mean + SD and outcomes were calculated as a % for each weight change category. ANOVA, Chi-square for trend, and logistic regression were used for statistical analysis. P 5% of their prepregnancy body weight had a decreased odds of macrosomia (OR, 0.15; 95% CI 0.01 -0.72) compared to obese women who gained an adequate amount of weight. There were no SGA neonates in the cohort of women who lost weight (Table). CONCLUSION: Obese women who lose weight during pregnancy have lower rates of macrosomia than those gaining within guidelines, with no increased rate of SGA neonates. Minimizing gestational weight gain, and even modest weight loss, in obese women during pregnancy can be beneficial for the neonate.
Perinatal outcomes in obese women by gestational weight change
OBJECTIVE: NGAL is expressed in neutrophils and is involved in innate immunity by sequestering iron. A novel discovery is NGAL’s ability to complex with MMP-9, to extend its gelatinolytic activity. This emerging knowledge led us to investigate co-expression of NGAL/MMP-9 in the amniotic fluid (AF) and reproductive tissues of pregnancies complicated by intra-amniotic infection (IAI). STUDY DESIGN: AF was retrieved trans-abdominally from 308 singleton pregnancies. We analyzed the following groups: 1) 2nd trimester control (CRL, genetic karyotype), n¼23, GA: 18 [15-21w]; 2) 3rd trimester (CRL, lung maturity), n¼25, GA: 36 [31-39w]; 3) rule-out infection, n¼260, GA: 28 [20-34w]. Out of the last group, 221 women delivered preterm in the setting of either (+) IAI, n¼89, or (-) IAI, n¼132. 39 women had (-) IAI and delivered at term. Levels of NGAL, MMP-9 and NGAL/MMP-9 complex were confirmed by ELISA. Immunoreactivity of NGAL and NGAL/MMP9 complex was confirmed by Western Blot. Expression of NGAL and MMP9 in placenta and amniochorion was investigated by IHC and RT-PCR. RESULTS: 1) In physiologic pregnancy the levels of NGAL are GA regulated with lower levels at term (r¼-0.47, p
