Beomsoo Han, PhD, Edison Dong, BSc, Onur Turkoglu, MD,. Amna Zeb, MD ... STUDY DESIGN: This was a prospective population-based case con- trol study.
Poster Session I
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132 First-trimester metabolomics prediction of subsequent stillbirth
131 Does magnesium sulfate exposure attenuate the effect of steroids administered for fetal lung maturation? Kathleen Brookfield, Katharine O’Malley, Amanda Yeaton-Massey, Alexander J. Butwick 1
Oregon Health & Science University, Portland, OR, 2Stanford University School of Medicine, Stanford, CA
OBJECTIVE: Tocolysis with magnesium sulfate (MgSO4) may often be
considered for women with PPROM who receive steroids. Data from animal studies suggest that MgSO4 can interfere with the fetal lung maturation effect of corticosteroids through an intracellular calcium-dependent mechanism. However, there is a dearth of clinical data to verify this phenomenon. In this retrospective study, we examined whether fetal exposure to MgSO4 among women with PPROM receiving steroids is associated with an increased risk of respiratory neonatal morbidity. STUDY DESIGN: This is a secondary analysis of the MFMU BEAM study. We included all women who received one course of antenatal steroids and had PPROM at < 32 wks. We compared rates of respiratory distress syndrome (RDS) and the need for ventilator support for infants born to women who received MgSO4 compared to those born to mothers who received placebo. To account for potential confounders, we performed multivariate logistic regression, adjusting for diabetes, delivery route, other tocolytics, and gestational age at delivery. RESULTS: Our cohort comprised 1496 women who received one course of steroids and had PPROM; 735 (49.1%) women received MgSO4 and 761 (50.9%) women received placebo. We observed a lower likelihood of RDS and ventilatory support among infants exposed to MgSO4 compared to non-exposed infants (table). After adjustment, the risk of RDS and need for ventilator support did not differ according to MgSO4 exposure. CONCLUSION: Among women receiving steroids for PPROM, our findings suggest that the risk of neonatal respiratory morbidity is not adversely influenced by fetal exposure to MgSO4.
Ray O. Bahado-Singh, Argyro Syngelaki, Rupsari Mandal, PhD, Trent C. Bjondahl, PhD, Liang Li, PhD, Dev Maulik, MD, PhD, Beomsoo Han, PhD, Edison Dong, BSc, Onur Turkoglu, MD, Amna Zeb, MD, Mark Redman, MD, David S. Wishart, PhD, Kypros H. Nicolaides, MD 1
Oakland University- William Beaumont School of Medicine, Department of Obstetrics and Gynecology, Royal Oak, MI, 2King’s College Hospital, Department of Obstetrics and Gynecology, London, United Kingdom, 3 University of Alberta, Department of Biological Sciences, Edmonton, AB, Canada, 4University of Missouri, Department of Obstetrics and Gynecology, Kansas City, MO, 5University of Missouri, Department of Obstetrics and Gynecology, Kanas City, MO, 6University of Alberta, Department of Computing Sciences, Edmonton, AB, Canada, 7King’s College Hospital, Department of Obstetrics and Gyencology, London, United Kingdom
OBJECTIVE: Metabolomics is the newest member of the “omics” family and most accurately describes cellular phenotype. Our objective was to evaluate the accuracy of first-trimester metabolomics biomarkers for the prediction of non-anomalous stillbirth(SB). STUDY DESIGN: This was a prospective population-based case control study. Multiple metabolomics platforms: Direct injection Mass Spectrometry (MS), Nuclear Magnetic Resonance spectroscopy and untargeted MS were used to quantify metabolite in firsttrimester maternal serum. The overall study population was randomly stratified into discovery (60% of cases) and validation (40%) groups to generate and then independently verify the accuracy of the predicative algorithms. Sub analysis was performed in an early (30 minutes, birth injury, seizures, or 5-minute Apgar3. Groups were compared using Student’s t-test and chisquared as appropriate. RESULTS: In 5,309 diabetic pregnancies reaching 36 weeks, 1,122 (21.1%) were insulin dependent (IDDM). The risk of perinatal death at any gestational age examined was low (
