Last Half Of Pregnancy Research Articles

A Syudy on Comparative Evaluation of Four Different Methods to Quantify Proteinuria in Pre-Eclampsia in a Tertiary Care Hospital

Background: Preeclampsia is a progressive, multisystem disorder due to spasm of small blood vessels of all organ systems characterized by new-onset hypertension and end- organ dysfunction in the last half of pregnancy. Objectives: Estimation of proteinuria by sulphosalicylic acid test in women with preeclampsia. Material & Methods: Prospective hospital based clinical study. Study conducted in the Department of Obstetrics and Gynaecology, Murshidabad Medical college, Berhampore, Murshidabad, West Bengal. Sep. 2021 - Aug. 2022. Pregnant women after 20weeks of gestation diagnosed as preeclampsia and admitted in antenatal ward in obstetrics and gynaecology department, Murshidabad Medical college, Berhampore, Murshidabad, West Bengal. Study consisted a total of 100 subjects. Simple Random sampling method. The pregnant women diagnosed as preeclampsia meeting the inclusion and exclusion criteria included in the study. The study comprised of pregnant women who are more than 20 weeks of gestation diagnosed as preeclampsia fulfilling the inclusion and exclusion criteria. Written and informed consent was taken from all pregnant women participating in the study. The pregnant women in the study were subjected to a detailed history and general abdominal and pelvic examination. A first voided morning urine sample was obtained for sulphosalicylic acid test, dipstick test, spot urine PCR. Subsequent urine samples were collected for 24 h, including a next-day first-morning voided sample for the 24-h urine protein estimation. Results: On assessment of the ROC curve to assess the predictability of three methods for spot urine compared against the 24hr urine protein estimation, the AUC for the Sulphosalicylic acid was found to be significantly better (AUC=0.970, p<0.05) compared to the urinary PCR (AUC=0.964, p<0.05) and for urinary dipstick it was AUC=0.784, p<0.05. Conclusion: This study concluded that spot urine sulphosalicylic acid and urine protein creatinine ratio are reliable investigations compared to the dipstick method to assess the proteinuria in hypertensive pregnant women or for diagnosis of pre-eclampsia. So, spot urine Sulphosalicylic acid and urine protein-creatinine ratio can be used for detection of proteinuria in pregnant women with suspected pre-eclampsia with high accuracy, which is more rapid than time consuming 24-hour urine protein estimation

Do Psychological and Behavioural Factors Change Over Pregnancy?

ObjectivesTo investigate how psychological and behavioural factors change from the first to the last half of pregnancy. MethodsIn this prospective cohort study, we assessed the changes in psychological and behavioural factors across 10 domains among 445 women (mean age = 30.9 years) in Ontario, Canada. We collected data using 2 standardized questionnaires administered at <21 and 32–36 weeks of gestation. We computed intraclass correlation coefficients, percentages of no change, decrease, and increase, and mean differences between the 2 surveys. ResultsMost psychological and behavioural factors had intraclass correlation coefficients < 0.50 between the first and the second half of pregnancy, suggesting remarkable changes over the course of pregnancy. We observed significant decreases in self-efficacy, compensatory health beliefs, guilt regarding binge eating, emotional eating, dietary restriction, pregnancy-related nausea and food cravings, sleep duration, and physical activity. We also found increases in anxious and depressive symptoms and the tendency to accept friends' and family's beliefs regarding pregnancy. ConclusionsIn the first prospective analysis, we found that many psychological and behavioural factors changed significantly over pregnancy.

Effect of a Low-Glycemic Load Diet Intervention on Maternal and Pregnancy Outcomes in Obese Pregnant Women.

The increased prevalence of obese, pregnant women who have a higher risk of glucose intolerance warrants the need for nutritional interventions to improve maternal glucose homeostasis. In this study, the effect of a low-glycemic load (GL) (n = 28) was compared to a high-GL (n = 34) dietary intervention during the second half of pregnancy in obese women (body mass index (BMI) > 30 or a body fat >35%). Anthropometric and metabolic parameters were assessed at baseline (20 week) and at 28 and 34 weeks gestation. For the primary outcome 3h-glucose-iAUC (3h-incremental area under the curve), mean between-group differences were non-significant at every study timepoint (p = 0.6, 0.3, and 0.8 at 20, 28, and 34 weeks, respectively) and also assessing the mean change over the study period (p = 0.6). Furthermore, there was no statistically significant difference between the two intervention groups for any of the other examined outcomes (p ≥ 0.07). In the pooled cohort, there was no significant effect of dietary GL on any metabolic or anthropometric outcome (p ≥ 0.2). A post hoc analysis comparing the study women to a cohort of overweight or obese pregnant women who received only routine care showed that the non-study women were more likely to gain excess weight (p = 0.046) and to deliver large-for-gestational-age (LGA) (p = 0.01) or macrosomic (p = 0.006) infants. Thus, a low-GL diet consumed during the last half of pregnancy did not improve pregnancy outcomes in obese women, but in comparison to non-study women, dietary counseling reduced the risk of adverse outcomes.

Supplementing Merino ewes with melatonin during the last half of pregnancy improves tolerance of prolonged parturition and survival of second-born twin lambs.

High preweaning mortality rates continue to limit sheep production globally, constituting a major economic and welfare concern. Greater losses in twin lambs (≥30%) compared with singletons (≥10%) are attributed primarily to lower birth weight and increased risk of intrapartum hypoxia, leading to impairment of thermoregulation, neuromotor activity, and maternal bonding behavior. Previous intensive studies demonstrated that supplementing pregnant ewes with melatonin reduced the adverse effects of fetal growth restriction and perinatal hypoxia on the neonatal brain via increased umbilical blood flow, placental efficiency, and antioxidant actions. The current study examined the effects of supplementing pregnant ewes with melatonin on lamb survival, birth weight, and behavior under intensive conditions. From gestational day (gD) 80 until parturition, pregnant singleton and twin-bearing ewes were supplemented with melatonin via a 2-mg capsule fed daily (Mel-FED, n = 61) or 18 mg subcutaneous implant (Regulin), with one implant administered at gD80 and another at gD125 (Mel-IMP, n = 60). Control ewes received no supplementation (CTL, n = 60). Ewes and lambs were monitored via video throughout parturition. Postpartum measures were taken from lambs at 4 and 24 h (live weight [LW], rectal temperature, serum immunoglobulin G, and latency to stand and suck after birth) and LW at 72 h, 7 d, marking (49.7 ± 0.2 d), and weaning (124.2 ± 0.8 d). Chi-square analysis was used to compare lamb survival between treatment groups. There were no treatment effects on singleton lamb survival. Melatonin supplementation tended to increase the proportion of twin lambs surviving from birth to weaning (Mel-FED = 85.5%; Mel-IMP = 85.9%; CTL = 72.9%; each P < 0.1). Survival of first-born twins did not differ between treatment (each ~90%, P = 0.745) but within second-born twins, survival of Mel-FED was greater than CTL (81.6 vs. 57.1%, P = 0.023), and Mel-IMP (78.1%) tended to be greater than CTL (P = 0.068). Similarly, in second-born twins exposed to prolonged parturition (≥ 90 min), survival of lambs from Mel-FED ewes was greater than CTL (86.7% vs. 42.9%, P = 0.032), while Mel-IMP was intermediate (66.7%). These data suggest that the neuroprotective actions of melatonin may improve twin lamb survival by increasing tolerance of prolonged parturition and provide a sound basis for continued testing in extensively managed sheep flocks.

Preeclampsia for the Nephrologist: Current Understanding in Diagnosis, Management, and Long-term Outcomes.

Preeclampsia is a multisystem progressive disorder of pregnancy that can be potentially catastrophic for the mother and the fetus. It involves complex perturbations of the kidney and systemic physiology, along with long-term effects on vascular and kidney health. Thus, the nephrologist plays a key role in the peripartum and long-term management of preeclampsia. Recent translational research has improved our understanding of its pathophysiology, and there is hope for novel therapies. In this review, we discuss the evolution of diagnostic criteria and dilemmas in the diagnosis of hypertensive disorders in pregnancy. We summarize the advances in the pathogenesis and prediction of preeclampsia. We describe the management and prevention of preeclampsia focusing specially on the forthcoming strategies from the nephrologist's perspective. We address the evidence regarding long-term outcomes for the mother and the child. We end with exploring areas warranting future research.

Effect of sertraline on central serotonin and hippocampal plasticity in pregnant and non-pregnant rats

One of the most frequently prescribed selective serotonin reuptake inhibitor medications (SSRIs) for peripartum mood and anxiety disorders is sertraline (Zoloft®). Sertraline can help alleviate mood and anxiety symptoms in many women but it is not known how sertraline, or SSRIs in general, affect the neurobiology of the brain particularly when pregnant. The aim of this study was to investigate how sertraline affects plasticity in the hippocampus, a brain area integral in depression and SSRI efficacy (particularly in males), during late pregnancy and whether these effects differ from the effects of sertraline in non-pregnant females. To do this pregnant and age-matched non-pregnant female Sprague-Dawley rats were used. For the last half of pregnancy (10 days), and at matched points in non-pregnant females, rats were given sertraline (2.5 mg/kg/day or 10 mg/kg/day) or vehicle (0 mg/kg/day). Brains were used to investigate effects on the serotonergic system in the hippocampus and prefrontal cortex and measures of neuroplasticity in the hippocampus. Results show that pregnant females have significantly higher serum levels of sertraline compared to non-pregnant females but that rates of serotonin turnover in the hippocampus and PFC are similar between pregnant and non-pregnant females. Sertraline increased synaptophysin density in the dentate gyrus and CA3 and was associated with a decrease in cell proliferation in the dentate gyrus of non-pregnant, but not pregnant, females. During late pregnancy the hippocampus showed significant reductions in neurogenesis and increases in synaptophysin density. This research highlights the need to consider the unique effect of reproductive state on the neuropharmacology of SSRIs.

Dose–response relationship between docosahexaenoic acid (DHA) intake and lower rates of early preterm birth, low birth weight and very low birth weight

As previously reported, intention-to-treat findings from our phase III randomized clinical trial found that a supplement of 600 mg docosahexaenoic acid (DHA)/day during the last half of pregnancy reduced the incidence of early preterm birth (ePTB, <34 weeks gestation) and very low birth weight (VLBW < 1500 g) offspring. Given the potentially immense clinical significance of these findings, the goal of this secondary analysis was to (1) identify maternal characteristics related with capsule intake (i.e. DHA dose exposure) and (2) determine if DHA dose was associated with low (<2500 g) and very low birth weight after controlling for any relevant maternal characteristics. Three hundred forty-five pregnant mothers were recruited from hospitals in the Kansas City metropolitan area between 2006 and 2011. Most participants (n = 299) were from the phase III trial mentioned above, but we also included 46 participants from a second smaller, randomized trial that utilized an identical intervention design and was conducted concurrent to the larger trial. Both trials assigned participants to either 3 daily capsules of vegetable oil without DHA (n = 169) or 3 daily capsules of 200 mg DHA each (n = 176). Total capsules consumed was recorded by pharmacy supervised capsule count or participant self-report when needed. Maternal age, education, race and gestational age at delivery as well as infant birth weight were available for both trials. A Bayesian linear model indicated capsule intake increased with maternal age (p = 0.0100) and years of education (p = 0.0002). A Bayesian bivariate mixture-model associated capsule intake with simultaneous lower probability of ePTB, low birth weight (LBW, <2500 g) and VLBW (p = 0.0327). This, in conjunction with the positive findings in the clinical trial, support the need for future research to examine intervention methods to improve capsule compliance strategies in younger and less educated mothers.

Maternal Predator Odor Exposure in Mice Programs Adult Offspring Social Behavior and Increases Stress-Induced Behaviors in Semi-Naturalistic and Commonly-Used Laboratory Tasks

Maternal stress has a profound impact on the long-term behavioral phenotype of offspring, including behavioral responses to stressful and social situations. In this study, we examined the effects of maternal exposure to predator odor, an ethologically relevant psychogenic stressor, on stress-induced behaviors in both semi-naturalistic and laboratory-based situations. Adult C57BL/6 mice offspring of dams exposed to predator odor during the last half of pregnancy showed increased anti-predatory behavior, more cautious foraging behavior and, in the elevated plus maze, avoidance of elevated open areas and elevated open areas following restraint stress challenge. These offspring also exhibited alterations in social behavior including reduced free interaction and increased initial investigation despite normal social recognition. These changes in behavior were associated with increased transcript abundance of corticotropin-releasing factor, mineralocorticoid receptor and oxytocin (Oxt) in the periventricular nucleus of the hypothalamus. Taken together, the findings are consistent with a long-term increase in ethologically-relevant behavioral and neural responses to stress in male and female offspring as a function of maternal predator odor exposure.

Sex differences in umbilical artery Doppler indices: a longitudinal study

BackgroundSexual dimorphism in placental size and function has been described. Whether this influences the clinically important umbilical artery (UA) waveform remains controversial, although a few cross-sectional studies have shown sex differences in UA pulsatility index (PI). Therefore, we tested whether fetal sex influences the UA Doppler indices during the entire second half of pregnancy and aimed to establish sex-specific reference ranges for UA Doppler indices if needed.MethodsOur main objective was to investigate gestational age-associated changes in UA Doppler indices during the second half of pregnancy and compare the values between male and female fetuses. This was a prospective longitudinal study in women with singleton low-risk pregnancies during 19–40 weeks of gestation. UA Doppler indices were serially obtained at a 4-weekly interval from a free loop of the umbilical cord using color-directed pulsed-wave Doppler ultrasonography. Sex-specific reference intervals were calculated for the fetal heart rate (HR), UA PI, resistance index (RI), and systolic/diastolic ratio (S/D) using multilevel modeling.ResultsComplete data from 294 pregnancies (a total of 1261 observations from 152 male and 142 female fetuses) were available for statistical analysis, and sex-specific reference ranges for the UA Doppler indices and fetal HR were established for the last half of pregnancy. UA Doppler indices were significantly associated with gestational age (P < 0.0001) and fetal HR (P < 0.0001). Female fetuses had 2–8% higher values for UA Doppler indices than male fetuses during gestational weeks 20+0–36+6 (P < 0.05), but not later. Female fetuses had higher HR from gestational week 26+0 until term (P < 0.05).ConclusionsWe have determined gestational age-dependent sex differences in UA Doppler indices and fetal HR during the second half of pregnancy, and correspondingly established new sex-specific reference ranges intended for refining diagnostics and monitoring individual pregnancies.

Effect of renal denervation on urine angiotensinogen excretion in prenatally programmed rats

Prenatal programming results in an increase in blood pressure in adult offspring. We have shown that compared to control adult offspring whose mothers were fed a 20% protein diet, programmed adults whose mothers were fed a 6% protein diet during the last half of pregnancy have an increase in renal sympathetic nerve activity and urinary angiotensinogen/creatinine levels. We hypothesized that the increase in urinary angiotensinogen was mediated by renal sympathetic nerve activity in programmed rats. In this study performed in 3 month old rats, renal denervation resulted in normalization of blood pressure in the 6% programmed group (150 ± 3 Hg in 6% sham vs. 121 ± 4 Hg in 6% denervated, P < 0.001), and a reduction in blood pressure in the 20% group (126 ± 2 Hg 20% sham vs. 113 ± 4 Hg 20% denervated (P < 0.05). We confirm that the intrarenal renin–angiotensin system assessed by urinary angiotensinogen/creatinine is upregulated in offspring of rats fed a 6% protein diet rats compared to 20% controls. To determine if sympathetic nerve activity was mediating the increase in urinary angiotensinogen in programmed rats, we compared denervated to sham‐operated control and programmed rats. Renal denervation had no effect on urinary angiotensinogen/creatinine ratio in the 20% group and no effect on the increased urinary angiotensinogen/creatinine ratio found in programmed rats. This study demonstrates that the increase in urinary angiotensinogen in programmed rats is not mediated by renal sympathetic nerve activity.

Transient enalapril attenuates the reduction in glomerular filtration rate in prenatally programmed rats.

A maternal low‐protein diet has been shown to program hypertension and a reduction in glomerular filtration rate in adult offspring. This study examined the effect of continuous administration of enalapril in the drinking water and transient administration of enalapril administered from 21 to 42 days of age on blood pressure and glomerular filtration rate (GFR) in male rats whose mothers were fed a 20% protein diet (control) or a 6% protein diet (programmed) during the last half of pregnancy. After birth all rats were fed a 20% protein diet. Programmed rats (maternal 6% protein diet) were hypertensive at 15 months of age compared to control rats and both continuous and transient administration of enalapril had no effect on blood pressure on control offspring, but normalized the blood pressure of programmed offspring. GFR was 3.2 ± 0.1 mL/min in the control group and 1.7 ± 0.1 mL/min in the programmed rats at 17 months of age (P < 0.001). The GFR was 3.0 ± 0.1 mL/min in the control and 2.7 ± 0.1 mL/min in the programmed group that received continuous enalapril in their drinking water showing that enalapril can prevent the decrease in GFR in programmed rats. Transient administration of enalapril had no effect on GFR in the control group (3.2 ± 0.1 mL/min) and prevented the decrease in GFR in the programmed group (2.9 ± 0.1 mL/min). In conclusion, transient exposure to enalapril for 3 weeks after weaning can prevent the hypertension and decrease in GFR in prenatal programmed rats.

Preeclampsia and Care of the Newborn.

Preeclampsia is one of the most common complications in the last half of pregnancy. Mother-baby nurses are often present at the birth to provide neonatal care as well as ongoing care during the first days of life. This article discusses the implications of preeclampsia for the neonate and the role of the mother-baby nurse in the care of these infants.

Transrectal ultrasonographic evaluation of combined utero-placental thickness during the last half of pregnancy in Martina Franca donkeys

In the recent years, the donkey population decreased dramatically so that many breeds are presently considered as endangered. In comparison to the horse, the donkey placenta still remains not completely studied. In the horse, one of the diagnostic tools useful to identify pregnant mares at risk of abortion or premature delivery, include the transrectal ultrasound examination of the uterus and its contents; and especially of the combined thickness of the uterus and of the placenta (CUPT). Since the CUPT was never investigated in donkeys, the present study was aimed to define the transrectal CUPT values during the last half of pregnancy in 20 Martina Franca jennies. Foalings times, foals characteristics and placental gross appearance, and measurements were also evaluated and values resulted always within normality. Differently to the mare, a continuous significant CUPT increase between the sixth to the 12 months of pregnancy, and a substantial increase from the ninth to the 12th month of pregnancy, was found. Although statistically not evaluable, the CUPT values recorded from three jennies with pregnancy loss did not show evidence of CUPT increases. In conclusion, normal CUPT values from the sixth to the 12th month of pregnancy in Martina Franca donkeys are provided, but further investigations are needed to define possible breed or body-size CUPT specific differences, as well as the CUPT values during pregnancy disturbances or placental abnormalities.

Transient Exposure of Enalapril Normalizes Prenatal Programming of Hypertension and Urinary Angiotensinogen Excretion.

Maternal low protein diet programs offspring to develop hypertension as adults. Transient exposure to angiotensin converting enzyme inhibitors or angiotensin II receptor blockers can result in improvement in hypertension. Male rats whose mothers received a low protein diet during the last half of pregnancy were given either vehicle, continuous enalapril (CE) in their drinking water or were given transient enalapril exposure (TE) after weaning at 21 days of age. The TE group had enalapril in their drinking water for 21 days starting from day 21 of life. All rats were studied at 6 months of age. Vehicle treated rats whose mothers were fed a low protein diet were hypertensive, had albuminuria, and demonstrated upregulation of the intrarenal renin-angiotensin system as evidenced by higher urinary angiotensinogen and urinary angiotensin II levels. In low protein rats both continuous and transient exposure to enalapril normalized blood pressure, urinary angiotensinogen and urinary angiotensin II levels at 6 months of age, but only continuous administration of enalapril decreased urinary albumin excretion. These data support the importance of the intrarenal renin-angiotensin system in mediating hypertension in programmed rats and transient exposure to enalapril can reprogram the hypertension and dysregulation of the intrarenal renin-angiotensin system.

Interrelationship of some hormonesbelonging to HPG and energy axes inhorses during various reproductive states

In order to reveal interrelationships of hormones during pregnancy and estrus in animals, some reproductive and metabolic hormones including FSH, inhibin B, prolactin and insulin were measured in blood serum of Mongolian horses with respective immunoassays. Concentrations of blood serum FSH, inhibin B and prolactin in mares during their estrus, early, mid and late pregnancy periods were compared. The comparisons demonstrate concentrations of FSH and inhibin B were inversely proportional especially during estrous cycle of mares. As well, these hormones were also measured in blood serum of stallions with the purpose of assessing their reproductive activity. Concentrations of both hormones were lower in blood serum of stallions, which have harems of less conceived mares or it means higher inhibin concentration results in less reproductive activity. Prolactin was minimal during estrus and early pregnancy, while it increases during late pregnancy, but there was no correlations with above two hormones. Measurements of insulin was helpful to learn whether the animal is suffering from metabolic disorder such as insulin resistance, because last half of pregnancy of mares coincides with the period of fattening of pastured animals. However, main outcome of the present study is that all above hormones might be acting in closer relationships during various reproductive states, despite they belong to different axes of endocrine system, including hypothalamic-pituitary-gonadal (FSH and inhibin)and energy (insulin and prolactin) axes.Mongolian Journal of Agricultural Sciences Vol.15(2) 2015; 10-15

Excess Gestational Weight Gain in Low-Income Overweight and Obese Women: A Qualitative Study

ObjectiveExamine factors implicated in gestational weight gain (GWG) in low-income overweight and obese women. DesignQualitative study. SettingCommunity-based perinatal center. ParticipantsEight focus groups with women (black = 48%, white non-Hispanic = 41%, and Hispanic = 10%) in the first half (n = 12) and last half of pregnancy (n = 10) or postpartum (n = 7), 2 with obstetrician-gynecologists (n = 9). Phenomenon of InterestBarriers and facilitators to healthy eating and GWG within different levels of the Social Ecological Model: for example, intrapersonal, interpersonal, and organizational. AnalysisCoding guide was based on the Social Ecological Model. Transcripts were coded by 3 researchers for common themes. Thematic saturation was reached. ResultsAt an intrapersonal level, knowledge/skills and cravings were the most common barriers. At an interpersonal level, family and friends were most influential. At an organizational level, the Special Supplemental Nutrition Program for Women, Infants, and Children and clinics were influential. At the community level, lack of transportation was most frequently discussed. At a policy level, complex policies and social stigma surrounding the Special Supplemental Nutrition Program for Women, Infants, and Children were barriers. There was consensus that ideal intervention approaches would include peer-facilitated support groups with information from experts. Obstetrician-gynecologists felt uncomfortable counseling patients about GWG because of time constraints, other priorities, and lack of training. Conclusions and ImplicationsThere are multilevel public health opportunities to promote healthy GWG. Better communication between nutrition specialists and obstetrician-gynecologists is needed.

Pattern of serum total alkaline phosphatase activity in different stages of normal third trimester pregnancy in Zaria, Northern Nigeria

Background: There are reports from many parts of the world on the increased activity of serum total alkaline phosphatase (TALP) in pregnant women, especially during the last half of pregnancy. There is no such documented finding in this environment. There is the need to determine the serum TALP activity in different stages of normal 3 rd trimester pregnancy in Zaria to allow for proper interpretation of this analyte at this stage of pregnancy. Subjects and Methods: A cross sectional descriptive study carried out among 100 healthy pregnant women in their 3 rd trimester. They were randomly selected from the antenatal clinic of Ahmadu Bello University Teaching Hospital, Zaria. Serum TALP activity was measured using the 4-Nitrophenylphosphate (4-NPP) method. Socio-demographic and obstetrics characteristics were obtained using an administered questionnaire. Microsoft Excel (Microsoft office, 2003) was used for data analysis. Distributions of ALP activities were found to be skewed; hence, non-parametric analyses using percentiles were used in measuring the variation. A P-value of equal to or less than 0.05 (P ≤ 0.05) was considered as statistically significant. Results: The serum TALP activity in normal 3 rd trimester pregnancy was found to be higher when compared to the normal population, with a gradual increase with advancing gestational age. Subjects in the gestational age group of 28 to 30 weeks had a serum TALP activity of 46-138 IU/L, with a continuous increase of up to 213 IU/L at 39 weeks of gestation. A sudden drop in activity was observed at the gestational age of 40 weeks and above. The overall serum TALP activity in normal 3 rd trimester pregnancy was found to be 41-206 IU/L. Conclusion: A higher serum TALP activity for normal 3 rd trimester pregnancy was confirmed for this environment, as has been found elsewhere. There is the need to interpret serum TALP activity in pregnancy with caution.

Maternal fat gain modulates insulin response among overweight/obese women

Gestational weight gain recommendations for varying pre‐pregnancy body mass indexes (PPBMI) are based on healthy pregnancy outcomes. However, among overweight/obese women, the composition of weight gain might be a better indicator of underlying metabolic alterations (i.e., insulin resistance (IR) and/or inflammatory processes). We compared indicators of IR and inflammation between overweight/obese pregnant women, divided into 2 groups: 1) Low fat gain (LFG) ≤0.5 kg and 2) High fat gain (HFG) &gt;0.5 kg, @ 20–34wk gestation. Body composition was estimated using body density. Women were normoglycemic. Weight gain was 3.9±3.0kg in the LFG group (n=24) and 6.9±2.9 kg in the HFG group (n=30); p&lt;0.001. The LFG group lost − 1.2±1.5 kg of fat mass and the HFG group gained 2.9±1.8kg. Glucose &amp; insulin areas under the curve (AUC) were calculated from a 100g OGTT completed at 20 and 34wk gestation. Fasting leptin, cortisol and CRP were also determined. Birth outcomes were obtained from medical records. Increases in leptin, and insulin AUC were significantly greater in the HFG group vs the LFG after controlling for PPBMI: Leptin (−1.1±1.8 vs 1.9±1.3 ng/mL; p&lt;0.017); insulin AUC (51.9±25.6 vs 120.2±30.0uU/hr/mL; p&lt;0.048). No differences were found between changes in CRP, cortisol or glucose AUC between groups. Newborn weight and gestational age at birth were not different between groups. In conclusion, lower fat gain among overweight/obese women during the last half of pregnancy may improve maternal insulin sensitivity without affecting fetal growth. Funded by NIH grant # R01HD46741

CS04-03 - Oily fish and omega-3 fatty acids: what is the effect size?

Introduction There is uncertainty about the benefits of omega-3 long chain polyunsaturated fatty acids (LCPUFA) found in oily fish to prevent depression, particularly in the perinatal period, despite international recommendations that pregnant women increase their intakes of omega-3 LCPUFA. Objective To determine whether increasing omega-3 LCPUFA during the last half of pregnancy will result in fewer women with post-partum depression. Methods Women 12 on the Edinburgh Postnatal Depression Scale at 6 weeks or 6 months post partum. Results Of 2399 women enrolled, 98% completed the trial. The percentage of women with post-partum depression did not differ between the fish oil and control groups (9.7% vs 11.2%, respectively; adjusted relative risk [ARR] 0.85; 95% confidence interval [CI] 0.70 to 1.02; n=2399, P=0.09). Depressive symptoms were more common among women with a history of depression at trial entry but did not differ between groups (20.9% vs 24.2%, ARR 0.87, 95% CI 0.68 to 1.12; n=564, P=0.28) despite the greater effect size. Conclusion The use of fish oil capsules compared with vegetable oil capsules during pregnancy did not result in lower levels of postpartum depression in mothers. Further studies are required to determine whether there are specific benefits of fish oil supplementation for women with a history of depression.

Prenatal programming of rat cortical collecting tubule sodium transport

Prenatal insults have been shown to lead to elevated blood pressure in offspring when they are studied as adults. Prenatal administration of dexamethasone and dietary protein deprivation have demonstrated that there is an increase in transporter abundance for a number of nephron segments but not the subunits of the epithelial sodium channel (ENaC) in the cortical collecting duct. Recent studies have shown that aldosterone is elevated in offspring of protein-deprived mothers when studied as adults, but the physiological importance of the increase in serum aldosterone is unknown. As an indirect measure of ENaC activity, we compared the natriuretic response to benzamil in offspring of mothers who ate a low-protein diet (6%) with those who ate a normal diet (20%) for the last half of pregnancy. The natriuretic response to benzamil was greater in the 6% group (821.1 ± 161.0 μmol/24 h) compared with the 20% group (279.1 ± 137.0 μmol/24 h), consistent with greater ENaC activity in vivo (P < 0.05). In this study, we also directly studied cortical collecting tubule function from adult rats using in vitro microperfusion. There was no difference in basal or vasopressin-stimulated osmotic water permeability. However, while cortical collecting ducts of adult offspring whose mothers ate a 20% protein diet had no sodium transport (-1.9 ± 3.1 pmol·mm(-1)·min(-1)), the offspring of rats that ate a 6% protein diet during the last half of pregnancy had a net sodium flux of 10.7 ± 2.6 pmol·mm(-1)·min(-1) (P = 0.01) in tubules perfused in vitro. Sodium transport was measured using ion-selective electrodes, a novel technique allowing measurement of sodium in nanoliter quantities of fluid. Thus we directly demonstrate that there is prenatal programming of cortical collecting duct sodium transport.