Category Archives: Preterm Birth

Study Finds Maternal Intake of High Fructose Leads to Fetal Programming of Adult Obesity, Hypertension and Metabolic Dysfunction Especially in Female Offspring

ATLANTA (Feb. 4, 2016)—In a study to be presented on Feb. 5 in the oral session at 1:15 p.m. EST, at the Society for Maternal-Fetal Medicine’s annual meeting, The Pregnancy Meeting™, in Atlanta, researchers will present findings on the effects of antenatal exposure to a high fructose diet on the offspring’s development of metabolic syndrome-like phenotype and cardiovascular disease later in life.

The study, titled High fructose diet in pregnancy leads to fetal programming of hypertension, insulin resistance and obesity in adult offspring, randomly allocated either a fructose solution or water as the only drinking fluid for pregnant mice from first day of pregnancy through delivery. Offspring were then started on regular chow and evaluated after one year of life.  Percent of visceral adipose tissue was measured along with liver fat infiltrates using computed tomography, and blood pressure using a non-invasive monitor. Glucose tolerance testing was also performed and serum concentrations of glucose, insulin, triglycerides, total cholesterol, leptin and adiponectin were measured.

Maternal weight, pup number and average weight at birth were similar between the two groups. Male and female offspring born to mothers who received the fructose solution group had higher peak glucose compared with controls. Female offspring from the fructose group were heavier and had a higher percent of visceral adipose tissue, liver fat infiltrates, fasting homeostatic model assessment scores, higher serum concentrations of leptin and lower concentrations of adiponectin.

No significant differences in these parameters were noted in male offspring. Serum concentrations of triglycerides and total cholesterol were not different between the two groups or either gender.

“While this study was done in a mouse model, it is an important indicator of the effect of the mothers’ diet during pregnancy on the health of their children later in life,” explained Antonio Saad, M.D. with UTMB Galveston and the lead researcher of the study. “Through this study, we know that consuming high fructose during pregnancy putts the child at future risk for a variety of health conditions including obesity and the many complications it causes.”

The study concluded that, while maternal intake of high fructose leads to fetal programming of adult obesity, hypertension, and metabolic dysfunction—all of which risk factors for cardiovascular disease; limiting high fructose enriched diets in pregnancy may have a significant impact on long term health.

 

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A copy of the abstract is available at http://www.smfmnewsroom.org and below. For interviews please contact Vicki Bendure at Vicki@bendurepr.com 202-374-9259 (cell).

 

The Society for Maternal-Fetal Medicine (est. 1977) is the premiere membership organization for obstetricians/gynecologists who have additional formal education and training in maternal-fetal medicine. The society is devoted to reducing high-risk pregnancy complications by sharing expertise through continuing education to its 2,000 members on the latest pregnancy assessment and treatment methods. It also serves as an advocate for improving public policy, and expanding research funding and opportunities for maternal-fetal medicine. The group hosts an annual meeting in which groundbreaking new ideas and research in the area of maternal-fetal medicine are shared and discussed.  For more information visit www.smfm.org.

 

Abstract 67    High Fructose Diet in Pregnancy Leads to Fetal Programming of Hypertension, Insulin Resistance and Obesity in Adult Offspring

 

Authors: Antonio Saad1, Joshua Disckerson1, Phyllis Gamble1, Huaizhi Yin1, Talar Kechichian1, Ashley Salazar1, Igor Patrikeev2, Massoud Motamedi2, George Saade1, Maged Costantine1

1UTMB Galveston, Galveston, TX, 2UTMB Center of Biomedical Engineering, Galveston, TX

 

Objective: Consumption of fructose rich diets in the U.S is on the rise and thought to be associated with obesity and cardio-metabolic diseases. Our objective was to determine the effects of antenatal exposure to high fructose diet on offspring’s development of metabolic syndrome-like phenotype and other cardiovascular disease (CVD) risk factors later in life.
Study Design: Pregnant C57BL/6J dams were randomly allocated to fructose solution (FRC, 10% W/V, n=10) as only drinking fluid or water (CTR, n=10) from day 1 of pregnancy until delivery. Pups were then started on regular chow, and evaluated at 1 year of life. We measured % visceral adipose tissue (VAT) and liver fat infiltrates using computed tomography (CT), and blood pressure using CODA/ non-invasive monitor. Intraperitoneal glucose tolerance testing (IPGTT), with corresponding insulin concentrations were obtained. Serum concentrations of glucose, insulin, triglycerides (TG), total cholesterol (TC), leptin, and adiponectin were measured in duplicate using standardized assays. Fasting homeostatic model assessment (HOMA- IR) was also calculated to assess insulin resistance.
Results: Maternal weight, pup number and average weight at birth were similar between the two groups. Male and female FRC offspring had higher peak glucose and area under the IPGTT curve, compared with CTR (Figures 1A&B), and higher mean arterial pressure compared to CTR (Figure 1C). Female FRC offspring were heavier and had higher % VAT (Figure 1D), liver fat infiltrates, HOMA-IR scores, insulin area under the IPGTT curve, serum concentrations of leptin, and lower concentrations of adiponectin compared to female CTR offspring (Table). No significant differences in these parameters were noted in male offspring. Serum concentrations of TG or TC were not different between the 2 groups for either gender.
Conclusion: Maternal intake of high fructose leads to fetal programming of adult obesity, hypertension and metabolic dysfunction, all risk factors for CVD. This fetal programming is more pronounced in female offspring. Limiting intake of high fructose enriched diets in pregnancy may have significant impact on long term health.

 

Abstract 67a

Abstract 67b

Study Associates Gene with Cerebral Palsy and Death in Very Preterm Babies

In a study to be presented on Feb. 6 at 2:45 p.m. CST, at the Society for Maternal-Fetal Medicine’s annual meeting, The Pregnancy Meeting ™, in New Orleans, researchers will report that a variant in SERPINE1, a gene involved in inflammation and blood clotting, is associated with cerebral palsy and death in very preterm babies. This gene has been associated with increased risk of cerebral palsy in one previous study of preterm babies.

Previous genetic studies of very preterm babies have suggested several genetic variations that might predispose to brain injury and developmental problems. However, different studies have had different results.

This study, titled Genetic Predisposition to Adverse Neurodevelopmental Outcome After Early Preterm Birth: A Validation Analysis, was a collaborative effort between the Eunice Kennedy Shriver NICHD Maternal-Fetal Medicine Units and Neonatal Research Networks.

Researchers evaluated two different populations of very early preterm births (earlier than 32 weeks) with the goal of confirming the same genetic risk factors in both groups. The first population of preterm births was enrolled in a large Neonatal Research Network study, and the other group was of births that were enrolled in a Maternal Fetal Medicine Units Network study of magnesium sulfate before preterm birth for prevention of cerebral palsy.

Results revealed a variant in the gene SERPINE1, a gene involved in inflammation and blood clotting, was associated with cerebral palsy and death after early preterm birth in both populations of preterm babies.

“Preterm birth is the leading cause of childhood brain injury in otherwise normal children. The earlier a baby is born, the higher the risk of brain injury. However, even among the tiniest preemies, some babies develop quite normally, while others have devastating brain injury and life-long disability,” said Erin Clark, M.D., the study’s author. “The reason for this difference in outcomes is not well understood. Genetics may allow identification of babies at increased risk so that we can target those babies for prevention and treatment strategies. These results add to the evidence that genes may play a role in risk of brain injury and death in preterm babies.”

Clark, assistant professor of Maternal Fetal Medicine, University of Utah School of Medicine’s Department of Obstetrics and Gynecology, also noted that additional research is necessary to further evaluate genes that may influence risk and to determine how to apply these results to clinical care.

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A copy of the abstract is available at http://www.smfmnewsroom.org and below.  For interviews please contact Vicki Bendure at Vicki@bendurepr.com 202-374-9259 (cell), or Meghan Blackburn at Meghan@bendurepr.com, 540-687-5099 (office) or 859-492-6303 (cell).

The Society for Maternal-Fetal Medicine (est. 1977) is the premiere membership organization for obstetricians/gynecologists who have additional formal education and training in maternal-fetal medicine.  The society is devoted to reducing high-risk pregnancy complications by sharing expertise through continuing education to its 2,000 members on the latest pregnancy assessment and treatment methods. It also serves as an advocate for improving public policy, and expanding research funding and opportunities for maternal-fetal medicine. The group hosts an annual meeting in which groundbreaking new ideas and research in the area of maternal-fetal medicine are shared and discussed.  For more information visit www.smfm.org.

Financial Disclosure:  The authors did not report any potential conflicts of interest.

 

Abstract 15: Genetic Predisposition to Adverse Neurodevelopmental Outcome After Early Preterm Birth: A Validation Analysis

Author: Erin A. S. Clark, The Eunice Kennedy Shriver NICHD Maternal-Fetal Medicine Units and Neonatal Research Networks, Bethesda, MD  

Objective: Validate genetic risk loci associated with adverse neurodevelopment after early preterm birth.

Study Design: We previously conducted a large candidate gene association study in a cohort of 1013 extremely low birth weight infants (<1000 gms). The case-control analysis utilized samples in the NICHD Neonatal Research Network’s DNA Bank and evaluated 1634 SNPs in 145 genes in hypothesized causal pathways, with emphasis on inflammation, angiogenesis, and brain development. Cases were children who died by age 1 or who were diagnosed with CP or neurodevelopmental delay (Bayley II MDI or PDI <70) by 18-22 months. Controls were survivors with normal neurodevelopment. The outcomes of CP, combined CP or death, mental delay (MDI<70), and motor delay (PDI<70) were evaluated. Twenty-five SNPs with P<0.01 for one or more outcomes in the previous analysis were selected for validation in this analysis. Validation samples were derived from an RCT of magnesium sulfate before anticipated early preterm birth (<32 weeks) for prevention of cerebral palsy (CP). Case/control definitions were equivalent to the primary cohort, with the exception that neurodevelopmental outcomes were evaluated at 24 months. As in the primary analysis, four outcomes were evaluated. Cases and controls were matched for race and infant sex; covariates included gestational age at birth, small for gestational age, maternal education level, treatment group, and antenatal corticosteroids. Significance in the validation cohort was defined as P<0.05.

Results: The validation cohort included 364 infants, 170 cases and 192 controls. Three genetic loci from the primary analysis were significantly associated with the outcomes CP, CP/death and mental delay after early preterm birth in the validation analysis (Table).

Conclusion: Genetic loci involved in inflammation and brain development are associated with CP, CP/death, and mental delay after early preterm birth in primary and validation genetic analyses.

Table

Study Suggests That Genetic Predisposition to Brain Injury After Preterm Birth is Sex-Specific

In a study to be presented on February 14 between 1:15 p.m., and 3:30 p.m. PST, at the Society for Maternal-Fetal Medicine’s annual meeting, The Pregnancy Meeting ™, in San Francisco, researchers will report that variation in a gene involved in inflammation is associated with developmental problems after preterm birth in females, but not males.

Study Finds That Caloric Restriction and Exercise Help to Prevent Weight Gain and Other Pregnancy Complications in Obese Women

In a study to be presented on February 15 between 1:15 p.m., and 3:30 p.m. PST, at the Society for Maternal-Fetal Medicine’s annual meeting, The Pregnancy Meeting ™, in San Francisco, researchers will report findings that suggest that consistent physical activity and healthier lifestyle changes beginning in a woman’s first trimester can prevent excessive weight gain in obese pregnant women (with a Body Mass Index greater than 30), helping to avoid preterm delivery, hypertension and gestational diabetes.

MOD Award Abstract: Study Shows Progesterone Shots Do Not Reduce Preterm Delivery in Twin Pregnancies

In a study to be presented on February 14 between 8 a.m. and 10 a.m. PST, at the Society for Maternal-Fetal Medicine’s 33rd annual meeting, The Pregnancy Meeting ™, researchers will report findings that suggest that 17P, a form of progesterone, is not effective in preventing preterm birth among women with twin pregnancies — and may possibly be harmful.

Policy Changes in Elective Delivery Proven Successful

In a study to be presented on February 14 between 1:15 p.m., and 3:30 p.m. PST, at the Society for Maternal-Fetal Medicine’s annual meeting, The Pregnancy Meeting ™, in San Francisco, California, researchers will present data showing changes in elective delivery policy have been successful in reducing elective deliveries prior to 39 weeks.

Presence of Intra-amniotic Debris a Risk for Early Preterm Birth in First Pregnancy

In a study to be presented on February 14 between 8 a.m. and 10 a.m. PST, at the Society for Maternal-Fetal Medicine’s annual meeting, The Pregnancy Meeting ™, in San Francisco, California, researchers will report findings suggesting an increased risk of early (less than 35 weeks) preterm birth when intra-amniotic debris is present in nulliparous women with a short cervix. The babies born to women with debris had worse outcomes than those born to women without debris, likely due to the earlier delivery.

Society for Maternal Fetal Medicine Recognizes Medical Advancements on World Prematurity Day

Improved screening and effective treatments for prevention of preterm birth are saving infants

In the last five years, multiple medical advancements have led to a decline in the nation’s premature birthrate. On Nov. 17, the Society for Maternal-Fetal Medicine (SMFM) will celebrate World Prematurity Awareness Day to raise global awareness of the problems with premature birth

Study Finds Preterm Labor Diagnostic Markers Not Universal, Diagnosis and Interventions Should Not Be Generalized

Full abstract at the bottom of the page. Click Here to view all 2012 abstracts.

Study Finds Preterm Labor Diagnostic Markers Not Universal, Diagnosis and Interventions Should Not Be Generalized

In a study to be presented today at the Society for Maternal-Fetal Medicine’s annual meeting, The Pregnancy Meeting ™, in Dallas, Texas, researchers will report findings that indicate that preterm birth interventions should be tailored for underlying risk factors and pathways.

Study Finds Residence in U.S. a Risk Factor for Preterm Birth

Full abstract at the bottom of the page. Click Here to view all 2012 abstracts.

Study Finds Residence in U.S. a Risk Factor for Preterm Birth

 In a study to be presented today at the Society for Maternal-Fetal Medicine’s annual meeting, The Pregnancy Meeting ™, in Dallas, Texas, researchers will report findings that indicate that duration of stay in the United States is associated with increased risk of preterm birth for Hispanic women.

Study Finds Some Medications May Interact with Common Anti- Recurrent Preterm Birth Medication

Full abstract at the bottom of the page. Click Here to view all 2012 abstracts.

Study Finds Some Medications May Interact with Common Anti- Recurrent Preterm Birth Medication

In a study to be presented today at the Society for Maternal-Fetal Medicine’s annual meeting, The Pregnancy Meeting ™, in Dallas, Texas, researchers will report findings that indicate that prescription medications may affect the body’s ability to metabolize 17-alpha-hydroxyprogesterone caproate (17-OHPC), the only FDA approved medication for the prevention of recurrent preterm birth.

Study Indicates That Cesarean Delivery May Not Be More Protective for Small, Premature Newborns

Full abstract at the bottom of the page. Click Here to view all 2012 abstracts.

Study Indicates That Cesarean Delivery May Not Be More Protective for Small, Premature Newborns 

In a study to be presented today at the Society for Maternal-Fetal Medicine’s annual meeting, The Pregnancy Meeting ™, in Dallas, Texas, researchers will report findings that suggest that delivery by cesarean section may not be protective compared to vaginal deliveries for babies who are small for their gestational age (those weighing less than the 10th percentile at birth based on national growth curves) born more than six weeks before their due date.

Study Finds Prior Preterm Delivery Indicates Subsequent Baby Will Be Small Even if Carried to Term

Full abstract at the bottom of the page. Click Here to view all 2012 abstracts.

Study Finds Prior Preterm Delivery Indicates Subsequent Baby Will Be Small Even if Carried to Term

In a study to be presented today at the Society for Maternal-Fetal Medicine’s annual meeting, The Pregnancy Meeting ™, in Dallas, Texas, researchers will report findings that indicate that women who deliver their first baby early are more likely to have a subsequent baby that is small for its gestational age, even when the second pregnancy is carried to term.

2011: Society for Maternal-Fetal Medicine commends senators on letter to KV Pharmaceutical Company

Letter Urges Manufacturer to Drop Pricing of Makena

The Society for Maternal-Fetal Medicine weighed in on a recent letter sent by members of the United States Senate Committee on Health, Education, Labor, and Pensions to Greg Divis and Terry Hatfield with KV Pharmaceutical Company. Divis is the company’s CEO and Hatfield is chairman of the board of directors. Senators Harkin, Mikulski, Murray, Sanders, Casey, Franken, Whitehouse, and Blumenthal each signed the letter requesting the company to lower the price of Makena.

Letter: Senate Committee on Health, Education, Labor, and Pensions to KV Pharmaceuticals

Mssrs. Divis and Hatfield,

We join together today to call on KV Pharmaceuticals to lower the price of Makena, your newly-approved drug used to prevent pre-term birth

Prior to Makena’s approval, the same progesterone treatment was widely available through compounding pharmacies for $10 – $20 per dose. We note your price reduction from the original, shocking, $1,500 to per does to the current list price of $690 per dose as a step in the right direction. At approximately $10,000 for a course of treatment, however, the new price still poses an unreasonable burden on patients and the healthcare system.

2011: Society for Maternal-Fetal Medicine commends FDA on Makena announcement

FDA Announcement Allows Continued Compounding of Drug

The Society for Maternal-Fetal Medicine (SMFM) weighed in on today’s FDA announcement to continue to allow pharmacies to compound hydroxyprogesterone caproate, also known as 17P. This FDA announcement comes in response to an outcry from SMFM, ACOG and others regarding the costs of the just-released pharmaceutical version of the drug. The new drug, Makena, made by KV Pharmaceuticals, is being sold at $1,500 per dose as opposed to the pharmacy compound which typically costs $10 to $20 per dose.

2011: Society for Maternal-Fetal Medicine strongly opposes skyrocketing increase in cost of drug proven to prevent preterm labor in high-risk pregnancies

The Society for Maternal-Fetal Medicine (SMFM) announced today strong opposition to KV Pharmaceutical’s recent pricing of its drug “Makena.” SMFM represents more than 2,000 physicians who have specialized training in maternal-fetal medicine and work with high-risk pregnancies where drugs such as Makena are often prescribed. The drug, designed to prevent preterm pregnancies is being sold at $1,500 per dose. Makena, which has been produced as compound 17-hydroxyprogesterone by compounding pharmacies for several years, has typically cost $10 to $20 per dose.

2011: Study finds that use of alcohol-free antibacterial mouth rinse is associated with decreased incidence of preterm birth

In a study to be presented today at the Society for Maternal-Fetal Medicine’s (SMFM) annual meeting, The Pregnancy Meeting ™, in San Francisco, researchers will present findings that show that use of non alcohol antibacterial mouth-rinse containing cetylpyridinium chloride (CPC) decreases the incidence of preterm birth (PTB).

2011: Study finds that use of 17-Hydroxyprogesterone does not reduce the rate of preterm delivery or neonatal complications in twins

In a study to be presented today at the Society for Maternal-Fetal Medicine’s (SMFM) annual meeting, The Pregnancy Meeting ™, in San Francisco, researchers will present findings that show that the use of the hormone 17-Hydroxyprogesterone does not reduce the rate of preterm delivery or neonatal complications in twins.

2011 March of Dimes Award Abstract: New research helps explain how progesterone prevents preterm birth

Research presented today at the 31st Annual meeting of the Society for Maternal-Fetal Medicine (SMFM) ― The Pregnancy Meeting™ has found that three proteins known as XIAP, BID, and Bcl-2 are responsible in part for the success of progesterone treatments in the prevention of preterm labor. They may also play an important role in triggering normal labor.

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