SGI Annual Meeting

ORLANDO – Women with a history of severe preeclampsia show signs of small artery dysfunction as early as 2 years after delivery, an indication of cardiovascular disease later in life if not addressed by ob.gyns. and cardiologists early on, according to a small, unpublished study.

Researchers led by Dr. Karolina Kublickiene found that in women with a history of preeclampsia, endothelium-dependent dilation to flow was reduced, a change that could be due to nitric oxide contribution deficiency. The small arteries seen in the study group also exhibited increased myogenic tone, with enhanced sensitivity to the vasoconstrictor norepinephrine.

Dr. Louise Kenny, who moderated the session at the annual meeting of the Society for Gynecologic Investigation, said the study was "exquisitely executed."

"This is very basic science, but has massive clinical implications," said Dr. Kenny, a professor of obstetrics at the University College Cork, Ireland.

Several studies have shown that a history of preeclampsia is a risk factor for developing cardiovascular disease (Circulation 2012;125:1367-80). However, many women with preeclampsia go back to the community without proper follow-up with a cardiologist.

"I’m a high-risk maternal medicine obstetrician, and I’m very well aware that the long-term follow-up for women with preeclampsia is quite patchy," said Dr. Kenny. "We have a complete disconnect at several levels, and it is time to act."

Researchers hypothesized that functional and structural abnormalities in peripheral arteries are present as early as 2 years after delivery in mothers who had a pregnancy complicated by early-onset and severe preeclampsia.

They selected 15 women with a history of severe preeclampsia who had delivered between 2007 and 2011 at Karolinska University Hospital in Stockholm. They selected 15 closely matched controls who had normal pregnancies and gave birth during the same period. The women were on average 35 years old.

The investigators defined severe preeclampsia as systolic blood pressure of more than 160 mm Hg and/or diastolic blood pressure of more than 110 mm Hg on two occasions, at least 6 hours apart, and/or proteinuria of more than 5 g in a 24-hour period and/or organ damage.

The preeclampsia group and the control group were closely matched with regard to several biochemical characteristics, including the low-density lipoprotein to high-density lipoprotein (LDL/HDL) ratio (1.9 and 1.6, respectively). However, women in the preeclampsia group had higher blood pressure, insulin levels, and hemostatic model assessment index than did controls: The average diastolic blood pressure in the preeclampsia group was 74 mm Hg, versus 66 mm Hg in the control group. The average fasting insulin level in the preeclampsia group was almost twice as high as that of the control group (83 pmol/L vs. 44 pmol/L). Neither group showed evidence of early renal damage.

Researchers took subcutaneous fat biopsies from the women. They used pressure myography to compare the structure and function of the isolated small subcutaneous resistance arteries. They used immunostaining to compare endothelial nitric oxide synthase (eNOS) and lectin-like oxidized LDL receptor-1 (LOX-1) expression.

The arteries in both groups had similar diameters, wall thickness, wall-lumen ratio, and cross-sectional area.

Results showed that eNOS expression was similar in both groups, but LOX-1 expression was significantly enhanced in the study group. Inhibition of NOS had no effect on either group.

Myogenic tone was enhanced in the arteries of women with a history of preeclampsia, and was positively correlated with the LDL/HDL ratio, a change characterizing small artery dysfunction.

Basal tone in the study group also was positively correlated with the LDL/HDL ratio, triglycerides, glycated hemoglobin, and high-sensitivity C-reactive protein, and was negatively correlated with HDL. Basal tone at 60 mm Hg was 8 in the preeclampsia group, compared with 5 in the control group (P = .07).

Meanwhile, the study group had higher sensitivity to norepinephrine and angiotensin II, and showed reduced distensibility. Distensibility was negatively correlated with homocysteine level, which has been associated with cardiovascular disease, in the study group only.

"The changes in passive properties of vascular wall are characterized by reduced distensibility that will affect stiffness of the arteries in women with a history of preeclampsia," said Dr. Kublickiene, an associate professor of obstetrics and gynecology and senior researcher at the Karolinska Institute Hospital-Huddinge in Stockholm. She also leads the Center for Gender Medicine at the institute.

Endothelium-dependent dilation to bradykinin (BK) and NO donor compounds were similar between the two groups. But endothelium-dependent response to flow was significantly attenuated in the study group, which could mean possible impairment of flow detection and signaling, according to Dr. Kublickiene.

"Preserved relaxation and the contribution of NO to BK-induced responses to NO donor and eNOS expression between the groups further support the specific importance of NO deficiency in flow-mediated dilation," she said.

"The observed changes will contribute to an increased peripheral resistance and blood pressure, which are of critical importance for long-term women’s cardiovascular health," she said. Counseling following a preeclamptic pregnancy and preterm delivery should include a discussion about reproduction and cardiovascular risks, she said.

And, she emphasized, "Let’s work with cardiologists."

A 2012 study that focused on a different group of women showed that collaboration between cardiologists and ob.gyns. is indeed possible.

Dr. Kublickiene said that several questions remain: What are the appropriate preventive strategies? What screening schedules should be recommended? What are the clinical targets? And, what are the treatment regimens?

"I think now clinical trials of statins and other early interventions in these women are warranted," said Dr. Kenny.

Dr. Kublickiene and Dr. Kenny said they had no disclosures. The study was funded by the Center for Gender Medicine at the Karolinska Institute, by the Karolinska Institute, and by the ALF fund of the Stockholm County Council.

nmiller@frontlinemedcom.com

On Twitter @NaseemSMiller

ORLANDO – Women with a history of severe preeclampsia show signs of small artery dysfunction as early as 2 years after delivery, an indication of cardiovascular disease later in life if not addressed by ob.gyns. and cardiologists early on, according to a small, unpublished study.

Researchers led by Dr. Karolina Kublickiene found that in women with a history of preeclampsia, endothelium-dependent dilation to flow was reduced, a change that could be due to nitric oxide contribution deficiency. The small arteries seen in the study group also exhibited increased myogenic tone, with enhanced sensitivity to the vasoconstrictor norepinephrine.

Dr. Louise Kenny, who moderated the session at the annual meeting of the Society for Gynecologic Investigation, said the study was "exquisitely executed."

"This is very basic science, but has massive clinical implications," said Dr. Kenny, a professor of obstetrics at the University College Cork, Ireland.

Several studies have shown that a history of preeclampsia is a risk factor for developing cardiovascular disease (Circulation 2012;125:1367-80). However, many women with preeclampsia go back to the community without proper follow-up with a cardiologist.

"I’m a high-risk maternal medicine obstetrician, and I’m very well aware that the long-term follow-up for women with preeclampsia is quite patchy," said Dr. Kenny. "We have a complete disconnect at several levels, and it is time to act."

Researchers hypothesized that functional and structural abnormalities in peripheral arteries are present as early as 2 years after delivery in mothers who had a pregnancy complicated by early-onset and severe preeclampsia.

They selected 15 women with a history of severe preeclampsia who had delivered between 2007 and 2011 at Karolinska University Hospital in Stockholm. They selected 15 closely matched controls who had normal pregnancies and gave birth during the same period. The women were on average 35 years old.

The investigators defined severe preeclampsia as systolic blood pressure of more than 160 mm Hg and/or diastolic blood pressure of more than 110 mm Hg on two occasions, at least 6 hours apart, and/or proteinuria of more than 5 g in a 24-hour period and/or organ damage.

The preeclampsia group and the control group were closely matched with regard to several biochemical characteristics, including the low-density lipoprotein to high-density lipoprotein (LDL/HDL) ratio (1.9 and 1.6, respectively). However, women in the preeclampsia group had higher blood pressure, insulin levels, and hemostatic model assessment index than did controls: The average diastolic blood pressure in the preeclampsia group was 74 mm Hg, versus 66 mm Hg in the control group. The average fasting insulin level in the preeclampsia group was almost twice as high as that of the control group (83 pmol/L vs. 44 pmol/L). Neither group showed evidence of early renal damage.

Researchers took subcutaneous fat biopsies from the women. They used pressure myography to compare the structure and function of the isolated small subcutaneous resistance arteries. They used immunostaining to compare endothelial nitric oxide synthase (eNOS) and lectin-like oxidized LDL receptor-1 (LOX-1) expression.

The arteries in both groups had similar diameters, wall thickness, wall-lumen ratio, and cross-sectional area.

Results showed that eNOS expression was similar in both groups, but LOX-1 expression was significantly enhanced in the study group. Inhibition of NOS had no effect on either group.

Myogenic tone was enhanced in the arteries of women with a history of preeclampsia, and was positively correlated with the LDL/HDL ratio, a change characterizing small artery dysfunction.

Basal tone in the study group also was positively correlated with the LDL/HDL ratio, triglycerides, glycated hemoglobin, and high-sensitivity C-reactive protein, and was negatively correlated with HDL. Basal tone at 60 mm Hg was 8 in the preeclampsia group, compared with 5 in the control group (P = .07).

Meanwhile, the study group had higher sensitivity to norepinephrine and angiotensin II, and showed reduced distensibility. Distensibility was negatively correlated with homocysteine level, which has been associated with cardiovascular disease, in the study group only.

"The changes in passive properties of vascular wall are characterized by reduced distensibility that will affect stiffness of the arteries in women with a history of preeclampsia," said Dr. Kublickiene, an associate professor of obstetrics and gynecology and senior researcher at the Karolinska Institute Hospital-Huddinge in Stockholm. She also leads the Center for Gender Medicine at the institute.

Endothelium-dependent dilation to bradykinin (BK) and NO donor compounds were similar between the two groups. But endothelium-dependent response to flow was significantly attenuated in the study group, which could mean possible impairment of flow detection and signaling, according to Dr. Kublickiene.

"Preserved relaxation and the contribution of NO to BK-induced responses to NO donor and eNOS expression between the groups further support the specific importance of NO deficiency in flow-mediated dilation," she said.

"The observed changes will contribute to an increased peripheral resistance and blood pressure, which are of critical importance for long-term women’s cardiovascular health," she said. Counseling following a preeclamptic pregnancy and preterm delivery should include a discussion about reproduction and cardiovascular risks, she said.

And, she emphasized, "Let’s work with cardiologists."

A 2012 study that focused on a different group of women showed that collaboration between cardiologists and ob.gyns. is indeed possible.

Dr. Kublickiene said that several questions remain: What are the appropriate preventive strategies? What screening schedules should be recommended? What are the clinical targets? And, what are the treatment regimens?

"I think now clinical trials of statins and other early interventions in these women are warranted," said Dr. Kenny.

Dr. Kublickiene and Dr. Kenny said they had no disclosures. The study was funded by the Center for Gender Medicine at the Karolinska Institute, by the Karolinska Institute, and by the ALF fund of the Stockholm County Council.

nmiller@frontlinemedcom.com

On Twitter @NaseemSMiller

ORLANDO – Women with a history of severe preeclampsia show signs of small artery dysfunction as early as 2 years after delivery, an indication of cardiovascular disease later in life if not addressed by ob.gyns. and cardiologists early on, according to a small, unpublished study.

Researchers led by Dr. Karolina Kublickiene found that in women with a history of preeclampsia, endothelium-dependent dilation to flow was reduced, a change that could be due to nitric oxide contribution deficiency. The small arteries seen in the study group also exhibited increased myogenic tone, with enhanced sensitivity to the vasoconstrictor norepinephrine.

Dr. Louise Kenny, who moderated the session at the annual meeting of the Society for Gynecologic Investigation, said the study was "exquisitely executed."

"This is very basic science, but has massive clinical implications," said Dr. Kenny, a professor of obstetrics at the University College Cork, Ireland.

Several studies have shown that a history of preeclampsia is a risk factor for developing cardiovascular disease (Circulation 2012;125:1367-80). However, many women with preeclampsia go back to the community without proper follow-up with a cardiologist.

"I’m a high-risk maternal medicine obstetrician, and I’m very well aware that the long-term follow-up for women with preeclampsia is quite patchy," said Dr. Kenny. "We have a complete disconnect at several levels, and it is time to act."

Researchers hypothesized that functional and structural abnormalities in peripheral arteries are present as early as 2 years after delivery in mothers who had a pregnancy complicated by early-onset and severe preeclampsia.

They selected 15 women with a history of severe preeclampsia who had delivered between 2007 and 2011 at Karolinska University Hospital in Stockholm. They selected 15 closely matched controls who had normal pregnancies and gave birth during the same period. The women were on average 35 years old.

The investigators defined severe preeclampsia as systolic blood pressure of more than 160 mm Hg and/or diastolic blood pressure of more than 110 mm Hg on two occasions, at least 6 hours apart, and/or proteinuria of more than 5 g in a 24-hour period and/or organ damage.

The preeclampsia group and the control group were closely matched with regard to several biochemical characteristics, including the low-density lipoprotein to high-density lipoprotein (LDL/HDL) ratio (1.9 and 1.6, respectively). However, women in the preeclampsia group had higher blood pressure, insulin levels, and hemostatic model assessment index than did controls: The average diastolic blood pressure in the preeclampsia group was 74 mm Hg, versus 66 mm Hg in the control group. The average fasting insulin level in the preeclampsia group was almost twice as high as that of the control group (83 pmol/L vs. 44 pmol/L). Neither group showed evidence of early renal damage.

Researchers took subcutaneous fat biopsies from the women. They used pressure myography to compare the structure and function of the isolated small subcutaneous resistance arteries. They used immunostaining to compare endothelial nitric oxide synthase (eNOS) and lectin-like oxidized LDL receptor-1 (LOX-1) expression.

The arteries in both groups had similar diameters, wall thickness, wall-lumen ratio, and cross-sectional area.

Results showed that eNOS expression was similar in both groups, but LOX-1 expression was significantly enhanced in the study group. Inhibition of NOS had no effect on either group.

Myogenic tone was enhanced in the arteries of women with a history of preeclampsia, and was positively correlated with the LDL/HDL ratio, a change characterizing small artery dysfunction.

Basal tone in the study group also was positively correlated with the LDL/HDL ratio, triglycerides, glycated hemoglobin, and high-sensitivity C-reactive protein, and was negatively correlated with HDL. Basal tone at 60 mm Hg was 8 in the preeclampsia group, compared with 5 in the control group (P = .07).

Meanwhile, the study group had higher sensitivity to norepinephrine and angiotensin II, and showed reduced distensibility. Distensibility was negatively correlated with homocysteine level, which has been associated with cardiovascular disease, in the study group only.

"The changes in passive properties of vascular wall are characterized by reduced distensibility that will affect stiffness of the arteries in women with a history of preeclampsia," said Dr. Kublickiene, an associate professor of obstetrics and gynecology and senior researcher at the Karolinska Institute Hospital-Huddinge in Stockholm. She also leads the Center for Gender Medicine at the institute.

Endothelium-dependent dilation to bradykinin (BK) and NO donor compounds were similar between the two groups. But endothelium-dependent response to flow was significantly attenuated in the study group, which could mean possible impairment of flow detection and signaling, according to Dr. Kublickiene.

"Preserved relaxation and the contribution of NO to BK-induced responses to NO donor and eNOS expression between the groups further support the specific importance of NO deficiency in flow-mediated dilation," she said.

"The observed changes will contribute to an increased peripheral resistance and blood pressure, which are of critical importance for long-term women’s cardiovascular health," she said. Counseling following a preeclamptic pregnancy and preterm delivery should include a discussion about reproduction and cardiovascular risks, she said.

And, she emphasized, "Let’s work with cardiologists."

A 2012 study that focused on a different group of women showed that collaboration between cardiologists and ob.gyns. is indeed possible.

Dr. Kublickiene said that several questions remain: What are the appropriate preventive strategies? What screening schedules should be recommended? What are the clinical targets? And, what are the treatment regimens?

"I think now clinical trials of statins and other early interventions in these women are warranted," said Dr. Kenny.

Dr. Kublickiene and Dr. Kenny said they had no disclosures. The study was funded by the Center for Gender Medicine at the Karolinska Institute, by the Karolinska Institute, and by the ALF fund of the Stockholm County Council.

nmiller@frontlinemedcom.com

On Twitter @NaseemSMiller

ORLANDO – A higher ratio of serum omega-6 to omega-3 fatty acids was associated with an improved chance of pregnancy through in vitro fertilization, according to a prospective cohort study.

The study, which investigated the relationship between serum levels of polyunsaturated fatty acids (PUFAs) and embryo implantation in women undergoing IVF, found no association between IVF success and any of the PUFAs alone, or total fatty acid levels.

"While interesting, our findings should not be interpreted to influence current clinical practice, as they were not the result of a clinical trial," said Antonina I. Frolova, an M.D./Ph.D. student in the department of obstetrics and gynecology at Washington University, St. Louis.

"Our study suggests that PUFAs may also play a role in endometrial receptivity, but again, to our knowledge there is no clinical trial data to guide clinicians in counseling women on their intake of specific PUFAs to improve pregnancy rates in IVF," Ms. Frolova said in an interview. She presented the study at the annual meeting of the Society for Gynecologic Investigation.

The measurement of PUFA levels is currently not a part of standard assisted reproductive technology (ART) practice, said Dr. Vasiliki A. Moragianni, a reproductive endocrinologist at Beth Israel Deaconess Medical Center in Boston, who moderated the session.

The study "certainly adds a valuable piece of information and can be used as a springboard for more targeted investigations," Dr. Moragianni said in an interview. Once strong evidence and more data become available, "we will be able to make specific dietary recommendations and/or measure certain markers that can help improve couples’ fertility," she said.

Using the Women and Infants Health Specimen Consortium, Ms. Frolova and her colleagues measured the fasting serum levels of PUFAs in 200 women undergoing IVF. The women were divided into two groups: those who conceived and those who did not.

PUFA measurements included levels of linoleic acid (LA), alpha-linoleic acid (ALA), eicosapentaenoic acid (EPA), arachidonic acid (AA), and docosahexaenoic acid (DHA).

Researchers used standard regression to find out if any of the serum PUFAs was associated with pregnancy. They also analyzed the relationship between omega-6 to omega-3 ratios (LA:ALA) and (AA:EPA) and the odds of pregnancy

Although they found no association between individual PUFAs and the odds of pregnancy through IVF, they found a significant difference in LA:ALA ratios between women who conceived after their IVF cycle and those who did not (14.5 vs. 13.8, respectively; P = .03).

Women in the highest tertile of LA:ALA ratios had the highest chance of pregnancy compared with women with the lowest LA:ALA ratios (odds ratio, 2.5).

Embryo implantation was also weakly associated with LA:ALA ratios (P = .003), the researchers reported in the abstract. 

There was no association between pregnancy and AA:EPA in this study, Ms. Frolova said. However, AA:EPA was positively correlated with the LA:ALA ratio (r = 0.4, P less than .001).

"Our findings are significant, as they suggest dietary intake of specific PUFAs may be altered to benefit women undergoing IVF," Ms. Frolova said. "Specifically, the study suggests that omega-3 and omega-6 PUFAs may have opposing effects in the endometrium, similar to other tissues."

She noted that further studies are needed to elucidate this mechanism, adding, "Prior to making any clinical recommendations, however, we would like to see a clinical trial investigating supplementation of certain PUFAs and pregnancy outcomes after IVF."

Ms. Frolova and Dr. Moragianni said they had no disclosures.

nmiller@frontlinemedcom.com

On Twitter @naseemsmiller

ORLANDO – A higher ratio of serum omega-6 to omega-3 fatty acids was associated with an improved chance of pregnancy through in vitro fertilization, according to a prospective cohort study.

The study, which investigated the relationship between serum levels of polyunsaturated fatty acids (PUFAs) and embryo implantation in women undergoing IVF, found no association between IVF success and any of the PUFAs alone, or total fatty acid levels.

"While interesting, our findings should not be interpreted to influence current clinical practice, as they were not the result of a clinical trial," said Antonina I. Frolova, an M.D./Ph.D. student in the department of obstetrics and gynecology at Washington University, St. Louis.

"Our study suggests that PUFAs may also play a role in endometrial receptivity, but again, to our knowledge there is no clinical trial data to guide clinicians in counseling women on their intake of specific PUFAs to improve pregnancy rates in IVF," Ms. Frolova said in an interview. She presented the study at the annual meeting of the Society for Gynecologic Investigation.

The measurement of PUFA levels is currently not a part of standard assisted reproductive technology (ART) practice, said Dr. Vasiliki A. Moragianni, a reproductive endocrinologist at Beth Israel Deaconess Medical Center in Boston, who moderated the session.

The study "certainly adds a valuable piece of information and can be used as a springboard for more targeted investigations," Dr. Moragianni said in an interview. Once strong evidence and more data become available, "we will be able to make specific dietary recommendations and/or measure certain markers that can help improve couples’ fertility," she said.

Using the Women and Infants Health Specimen Consortium, Ms. Frolova and her colleagues measured the fasting serum levels of PUFAs in 200 women undergoing IVF. The women were divided into two groups: those who conceived and those who did not.

PUFA measurements included levels of linoleic acid (LA), alpha-linoleic acid (ALA), eicosapentaenoic acid (EPA), arachidonic acid (AA), and docosahexaenoic acid (DHA).

Researchers used standard regression to find out if any of the serum PUFAs was associated with pregnancy. They also analyzed the relationship between omega-6 to omega-3 ratios (LA:ALA) and (AA:EPA) and the odds of pregnancy

Although they found no association between individual PUFAs and the odds of pregnancy through IVF, they found a significant difference in LA:ALA ratios between women who conceived after their IVF cycle and those who did not (14.5 vs. 13.8, respectively; P = .03).

Women in the highest tertile of LA:ALA ratios had the highest chance of pregnancy compared with women with the lowest LA:ALA ratios (odds ratio, 2.5).

Embryo implantation was also weakly associated with LA:ALA ratios (P = .003), the researchers reported in the abstract. 

There was no association between pregnancy and AA:EPA in this study, Ms. Frolova said. However, AA:EPA was positively correlated with the LA:ALA ratio (r = 0.4, P less than .001).

"Our findings are significant, as they suggest dietary intake of specific PUFAs may be altered to benefit women undergoing IVF," Ms. Frolova said. "Specifically, the study suggests that omega-3 and omega-6 PUFAs may have opposing effects in the endometrium, similar to other tissues."

She noted that further studies are needed to elucidate this mechanism, adding, "Prior to making any clinical recommendations, however, we would like to see a clinical trial investigating supplementation of certain PUFAs and pregnancy outcomes after IVF."

Ms. Frolova and Dr. Moragianni said they had no disclosures.

nmiller@frontlinemedcom.com

On Twitter @naseemsmiller

ORLANDO – A higher ratio of serum omega-6 to omega-3 fatty acids was associated with an improved chance of pregnancy through in vitro fertilization, according to a prospective cohort study.

The study, which investigated the relationship between serum levels of polyunsaturated fatty acids (PUFAs) and embryo implantation in women undergoing IVF, found no association between IVF success and any of the PUFAs alone, or total fatty acid levels.

"While interesting, our findings should not be interpreted to influence current clinical practice, as they were not the result of a clinical trial," said Antonina I. Frolova, an M.D./Ph.D. student in the department of obstetrics and gynecology at Washington University, St. Louis.

"Our study suggests that PUFAs may also play a role in endometrial receptivity, but again, to our knowledge there is no clinical trial data to guide clinicians in counseling women on their intake of specific PUFAs to improve pregnancy rates in IVF," Ms. Frolova said in an interview. She presented the study at the annual meeting of the Society for Gynecologic Investigation.

The measurement of PUFA levels is currently not a part of standard assisted reproductive technology (ART) practice, said Dr. Vasiliki A. Moragianni, a reproductive endocrinologist at Beth Israel Deaconess Medical Center in Boston, who moderated the session.

The study "certainly adds a valuable piece of information and can be used as a springboard for more targeted investigations," Dr. Moragianni said in an interview. Once strong evidence and more data become available, "we will be able to make specific dietary recommendations and/or measure certain markers that can help improve couples’ fertility," she said.

Using the Women and Infants Health Specimen Consortium, Ms. Frolova and her colleagues measured the fasting serum levels of PUFAs in 200 women undergoing IVF. The women were divided into two groups: those who conceived and those who did not.

PUFA measurements included levels of linoleic acid (LA), alpha-linoleic acid (ALA), eicosapentaenoic acid (EPA), arachidonic acid (AA), and docosahexaenoic acid (DHA).

Researchers used standard regression to find out if any of the serum PUFAs was associated with pregnancy. They also analyzed the relationship between omega-6 to omega-3 ratios (LA:ALA) and (AA:EPA) and the odds of pregnancy

Although they found no association between individual PUFAs and the odds of pregnancy through IVF, they found a significant difference in LA:ALA ratios between women who conceived after their IVF cycle and those who did not (14.5 vs. 13.8, respectively; P = .03).

Women in the highest tertile of LA:ALA ratios had the highest chance of pregnancy compared with women with the lowest LA:ALA ratios (odds ratio, 2.5).

Embryo implantation was also weakly associated with LA:ALA ratios (P = .003), the researchers reported in the abstract. 

There was no association between pregnancy and AA:EPA in this study, Ms. Frolova said. However, AA:EPA was positively correlated with the LA:ALA ratio (r = 0.4, P less than .001).

"Our findings are significant, as they suggest dietary intake of specific PUFAs may be altered to benefit women undergoing IVF," Ms. Frolova said. "Specifically, the study suggests that omega-3 and omega-6 PUFAs may have opposing effects in the endometrium, similar to other tissues."

She noted that further studies are needed to elucidate this mechanism, adding, "Prior to making any clinical recommendations, however, we would like to see a clinical trial investigating supplementation of certain PUFAs and pregnancy outcomes after IVF."

Ms. Frolova and Dr. Moragianni said they had no disclosures.

nmiller@frontlinemedcom.com

On Twitter @naseemsmiller

ORLANDO – Fetal thigh measurement at 28 weeks can help identify babies who are at risk of neonatal adiposity, according to a small exploratory study.

The study also showed that abdominal circumference and estimated fetal weight at 28 weeks’ gestation were not correlated with adiposity at birth, nor were prepregnancy body mass index, maternal weight gain, or birth weight.

With a nation facing an obesity epidemic, the study may provide yet another tool to combat the trend by opening the possibility of fetal-based interventions, hence reducing the risk of childhood obesity.

Compared with birth weight, adiposity at birth has been known to be a stronger predictor of childhood obesity, said Dr. Gaea S. Moore of the University of Colorado, Aurora, who presented the abstract at the annual meetingof the Society of Gynecologic Investigation.

But, there’s not yet a good way of measuring how much fat the baby is going to have, said Dr. Anna L. David of University College London Elizabeth Garrett Anderson Institute for Women’s Health, London, who moderated the session. "So this study looks very promising," she said.

While 2D fetal ultrasound has not been a strong tool in measuring fetal adiposity, adding 3D fractional limb volumes (FLV) has helped improve the prediction of both adiposity at birth and macrosomia.

Dr. Moore and her colleagues conducted a prospective cohort study of 18 pregnant women, collecting data from standard 2D ultrasound biometry and mid-thigh cross sectional areas (MTA), and 3D FLV, measuring thigh volume at the 50% of the femur, using a 5-slice technique. Both measurements were analyzed with the 4D View software.

Seven of the 18 subjects were excluded due to poor image quality.

The mean age of mothers was 30 years, with prepregnancy body mass index of 26, parity of 0.83, and the mean gestational age at birth of 39 weeks and 3 days.

Researchers measured neonatal body composition with air displacement plethysmography (Pea Pod) 14 days after birth. The mean birth weight of the infants was 3,383 g, and the mean body fat was 10.68%.

Analyses showed that fetal thigh measurement at 28 weeks correlated with neonatal adiposity. FLV and MTA correlated with adiposity at 28 weeks when normalized for femur length (FL). (FLV/FL, r = 0.77; P = .005. MTA/FL, r = 0.75; P = .007)

The correlation further improved with adjustment of thigh volumes by femur length, and by adjustment for Pea Pod timing and gestational age adjustments.

The study opens the possibility of obtaining data that could lead to a conversation with pregnant moms whose babies might be at risk of neonatal adiposity, Dr. David said. "Maybe there’s an intervention that could reduce the adiposity," she said, whether it’s giving the mother medications that would reduce the sugar going across the placenta, or manipulation of diet.

She also pointed out that larger studies were needed, and that 28 weeks may not be the optimum time for measurement, as seven subjects were excluded due to poor image quality. "At 20 weeks there’s relatively more fluid around the baby, so maybe that might be a better time to take the measurement." She said that the measurement’s accuracy is yet to be determined.

Dr. Moore and her colleagues have obtained measurements at 36 weeks, but have not analyzed the data. She said the group had not evaluated data for earlier than 20 weeks’ gestation.

Dr. Moore and Dr. David reported no disclosures.

nmiller@frontlinemedcom.com

On Twitter @naseemsmiller

ORLANDO – Fetal thigh measurement at 28 weeks can help identify babies who are at risk of neonatal adiposity, according to a small exploratory study.

The study also showed that abdominal circumference and estimated fetal weight at 28 weeks’ gestation were not correlated with adiposity at birth, nor were prepregnancy body mass index, maternal weight gain, or birth weight.

With a nation facing an obesity epidemic, the study may provide yet another tool to combat the trend by opening the possibility of fetal-based interventions, hence reducing the risk of childhood obesity.

Compared with birth weight, adiposity at birth has been known to be a stronger predictor of childhood obesity, said Dr. Gaea S. Moore of the University of Colorado, Aurora, who presented the abstract at the annual meetingof the Society of Gynecologic Investigation.

But, there’s not yet a good way of measuring how much fat the baby is going to have, said Dr. Anna L. David of University College London Elizabeth Garrett Anderson Institute for Women’s Health, London, who moderated the session. "So this study looks very promising," she said.

While 2D fetal ultrasound has not been a strong tool in measuring fetal adiposity, adding 3D fractional limb volumes (FLV) has helped improve the prediction of both adiposity at birth and macrosomia.

Dr. Moore and her colleagues conducted a prospective cohort study of 18 pregnant women, collecting data from standard 2D ultrasound biometry and mid-thigh cross sectional areas (MTA), and 3D FLV, measuring thigh volume at the 50% of the femur, using a 5-slice technique. Both measurements were analyzed with the 4D View software.

Seven of the 18 subjects were excluded due to poor image quality.

The mean age of mothers was 30 years, with prepregnancy body mass index of 26, parity of 0.83, and the mean gestational age at birth of 39 weeks and 3 days.

Researchers measured neonatal body composition with air displacement plethysmography (Pea Pod) 14 days after birth. The mean birth weight of the infants was 3,383 g, and the mean body fat was 10.68%.

Analyses showed that fetal thigh measurement at 28 weeks correlated with neonatal adiposity. FLV and MTA correlated with adiposity at 28 weeks when normalized for femur length (FL). (FLV/FL, r = 0.77; P = .005. MTA/FL, r = 0.75; P = .007)

The correlation further improved with adjustment of thigh volumes by femur length, and by adjustment for Pea Pod timing and gestational age adjustments.

The study opens the possibility of obtaining data that could lead to a conversation with pregnant moms whose babies might be at risk of neonatal adiposity, Dr. David said. "Maybe there’s an intervention that could reduce the adiposity," she said, whether it’s giving the mother medications that would reduce the sugar going across the placenta, or manipulation of diet.

She also pointed out that larger studies were needed, and that 28 weeks may not be the optimum time for measurement, as seven subjects were excluded due to poor image quality. "At 20 weeks there’s relatively more fluid around the baby, so maybe that might be a better time to take the measurement." She said that the measurement’s accuracy is yet to be determined.

Dr. Moore and her colleagues have obtained measurements at 36 weeks, but have not analyzed the data. She said the group had not evaluated data for earlier than 20 weeks’ gestation.

Dr. Moore and Dr. David reported no disclosures.

nmiller@frontlinemedcom.com

On Twitter @naseemsmiller

ORLANDO – Fetal thigh measurement at 28 weeks can help identify babies who are at risk of neonatal adiposity, according to a small exploratory study.

The study also showed that abdominal circumference and estimated fetal weight at 28 weeks’ gestation were not correlated with adiposity at birth, nor were prepregnancy body mass index, maternal weight gain, or birth weight.

With a nation facing an obesity epidemic, the study may provide yet another tool to combat the trend by opening the possibility of fetal-based interventions, hence reducing the risk of childhood obesity.

Compared with birth weight, adiposity at birth has been known to be a stronger predictor of childhood obesity, said Dr. Gaea S. Moore of the University of Colorado, Aurora, who presented the abstract at the annual meetingof the Society of Gynecologic Investigation.

But, there’s not yet a good way of measuring how much fat the baby is going to have, said Dr. Anna L. David of University College London Elizabeth Garrett Anderson Institute for Women’s Health, London, who moderated the session. "So this study looks very promising," she said.

While 2D fetal ultrasound has not been a strong tool in measuring fetal adiposity, adding 3D fractional limb volumes (FLV) has helped improve the prediction of both adiposity at birth and macrosomia.

Dr. Moore and her colleagues conducted a prospective cohort study of 18 pregnant women, collecting data from standard 2D ultrasound biometry and mid-thigh cross sectional areas (MTA), and 3D FLV, measuring thigh volume at the 50% of the femur, using a 5-slice technique. Both measurements were analyzed with the 4D View software.

Seven of the 18 subjects were excluded due to poor image quality.

The mean age of mothers was 30 years, with prepregnancy body mass index of 26, parity of 0.83, and the mean gestational age at birth of 39 weeks and 3 days.

Researchers measured neonatal body composition with air displacement plethysmography (Pea Pod) 14 days after birth. The mean birth weight of the infants was 3,383 g, and the mean body fat was 10.68%.

Analyses showed that fetal thigh measurement at 28 weeks correlated with neonatal adiposity. FLV and MTA correlated with adiposity at 28 weeks when normalized for femur length (FL). (FLV/FL, r = 0.77; P = .005. MTA/FL, r = 0.75; P = .007)

The correlation further improved with adjustment of thigh volumes by femur length, and by adjustment for Pea Pod timing and gestational age adjustments.

The study opens the possibility of obtaining data that could lead to a conversation with pregnant moms whose babies might be at risk of neonatal adiposity, Dr. David said. "Maybe there’s an intervention that could reduce the adiposity," she said, whether it’s giving the mother medications that would reduce the sugar going across the placenta, or manipulation of diet.

She also pointed out that larger studies were needed, and that 28 weeks may not be the optimum time for measurement, as seven subjects were excluded due to poor image quality. "At 20 weeks there’s relatively more fluid around the baby, so maybe that might be a better time to take the measurement." She said that the measurement’s accuracy is yet to be determined.

Dr. Moore and her colleagues have obtained measurements at 36 weeks, but have not analyzed the data. She said the group had not evaluated data for earlier than 20 weeks’ gestation.

Dr. Moore and Dr. David reported no disclosures.

nmiller@frontlinemedcom.com

On Twitter @naseemsmiller