SRI Supplement to Reproductive Sciences - Volume 25 Number 1 - March 2018 - 165A

Scientific Abstracts

Reproductive Sciences Vol. 25, Supplement 1, March 2018

Africa, East Europe, South America. Data are presented as mean ± SD.
Differences between groups were assessed with the chi squared test.
p>0.05 were considered significant.
RESULTS: Women followed at HCM were mostly African (48.8%) and
Asiatic (36.4%), on the contrary 79.7% of East European and 84.2% of
South American with antenatal care were followed elsewhere. INAC
varied between 5.9% of SW Asian to 18% of African. The table shows
that although gestational age at delivery was not different among groups,
the rate of prematurity (PTB) was highest in INAC and lowest in IW. The
rate of gestational diabetes (GDM) was higher in HCM and IACE than in
IW and INAC. Mode of delivery was not different among groups as was
the rate of post partum hemorrhage both at vaginal and cesarean delivery.
CONCLUSION: Our data show that PTB is increased in immigrant
women with no antenatal care whereas GDM is increased in HCM women.
These differences most likely reflect the fact that women followed at HCM
represent a high risk population followed in a III level institution, whereas
women with IACE are low risk women followed in I level outpatient
clinics and with a good knowledge of the local health care system.
Table 1

Table I - Outcomes in Different SGA Populations

HCM
n=352

IACE
n=1131

INAC
n=217

p

Non-SGA
(n=63842)

SGA-IG
(n=2399)

SGA-cust
(n=7599)

GA weeks mean

39,4

39,1

39,2

39,9

BMI >30kg/m2 (%)

9550 (15.0)

248 (10.3)

1463 (19.3) 1215 (23.2)

< 37 w %

4.7

9.1

6.5

10.6

<0.0001

Primigravida (%)

33609 (52.6)

1662
(69.3)

4131 (54.4) 2515 (47.9)

CD %

20.6

26.4

22.1

22.6

0.09

Apgars <7 at 5 mins
(OR, 95%CI)

Reference

2.09 (1.62- 1.78 (1.522.69)
2.09)

1.60 (1.341.97)

Apgars <5 at 5 mins
(OR, 95%CI)

Reference

3.43 (2.31- 2.64 (1.995.11)
3.50)

2.26 (1.593.17)

NICU admission
(OR, 95%CI)

Reference

2.12 (1.69- 1.57 (1.325.33)
1.84)

4.82 (4.275.43)

Reference

6.12 (3.311.7)

4.32 (2.457.40)

Stillbirth (OR,
95%CI)

4.92 (3.107.79)

SGA-cust
only (n=5246)

IW
n=2199

CONCLUSION: INTERGROWTH-21 st in a real-life population
identifies only 3.4% of infants as SGA. It is less likely to identify a SGA
infant in obese women, which is not representative of perinatal morbidity.
Customised centiles identify almost all infants classified as SGA by
INTERGROWTH-21st charts, with an additional group (SGA-cust-only)
at higher risk of stillbirth and adverse outcomes compared with non-SGA
infants. Use of INTERGROWTH-21st in a real obstetric population will
fail to identify a substantial group at increased risk or perinatal morbidity
and mortality.

T-167
Pregnancy and Birth: The Role of Access to Care. Miriam Acunzo†,1
Maria Chiara Autuori*,1 Ivan Cortinovis*,2 Anna Maria Marconi*.1 1San
Paolo Hospital Medical School University of Milano, Milano, Italy;
2
University of Milano, Milano, Italy.
INTRODUCTION: Previous studies have reported that immigrants have
higher risks for some adverse obstetric outcome. However, some of the
differences might be related to differences in the access of health care
between immigrant and native populations. The "Health Center for migrant
women and their children" [HCM] at San Paolo is a dedicated service
for immigrants with obstetric, psychological and social professionals and
linguistic cultural mediators. The aim of our study was to compare the
obstetric outcome of immigrant women followed at HCM with that of:
1. Italian women (IW); 2. immigrants with regular antenatal care carried
out elsewhere (IACE); 3. immigrants without antenatal care (INAC).
METHODS: This transversal retrospective study analyzes the obstetric
and neonatal outcome of women who delivered in our Institution between
January 1st 2014 and December 31st 2016. Only singleton pregnancies
were included and only the first gestation was considered if more than one
had occurred during the study period in the same woman. Our population
(N= 3899) was divided into four groups: 352 immigrant women followed
at HCM; 2199 IW; 1131 IACE and 217 INAC. The geographical areas
of origin of immigrants were: South West Asia, East and Central Asia,

POST PARTUM HEMORRHAGE
VD 500mL %

21.2

21.2

19.4

14.9

0.2

CD > 1000 mL %

5.8

2.2

7.6

2.0

0.2

PREGNANCY PATHOLOGIES
GDM %

7.5

9.1

10.1

4.6

0.01

IPA %

6.6

4.0

5.0

3.7

0.05

T-168
Retinoic Acid Modulates sFlt1 Production in Placental Decidual
Stromal Cells. Deepak Venkataraman†, Molly Ross, Margaret Sahu,
Martina Badell, Neil Sidell, Augustine Rajakumar*. Emory University
School of Medicine, Atlanta, GA, United States.
INTRODUCTION: Uterine stromal cell decidualization is an essential
event at the maternal fetal interface associated with successful embryo
implantation and placental growth. Previous studies have suggested a
cross-talk between the retinoic acid (RA) signaling pathway and the
decidualization of endometrial stromal cells (ESC). Recently, we showed
that decidualization of ESC markedly suppresses expression of sFlt1,
an antiangiogenic protein implicated in placental pathologies such as
preeclampsia (PMID: 28494174). Based on our understanding of RAdependent signaling during the decidualization process, along with the
known presence of an RXR/RAR binding element in the regulatory region
of the Flt/sFlt1 promoter, we sought to determine the direct effect of RA
on sFlt1 production in decidual stromal cells (DSCs). Thus, our specific
aim was to determine the effect of RA on sFlt1 production in primary DSC
and to compare this action with that cause by decidualization of the cells.
METHODS: DSCs were isolated from placentas of normal pregnant
women (n=4) by sequential enzyme digestion. The cells were treated with
0.1µM of RA or 0.5 mM cAMP (to induce decidualization) for 12 days.
HESC-T3 (a connexin 43 knockout endometrial cell line that doesn't
respond to decidualization stimuli) was also subjected to the aforesaid
treatments. sFLT1, PRL, IGFBP1 and VEGF levels were determined by
using both qPCR and ELISA. Group means were analyzed by MannWhitney U test. p≤0.05 is considered significant.
RESULTS: RA treatment of DSCs significantly downregulated the sFlt1
production by (0.4 ± 0.3) and cAMP treatment by (0.24 ±0.18) on 12th
day. Treatment with cAMP significantly upregulated the decidualization
markers PRL and IGFBP1 and marginally upregulated VEGF levels.
However, RA treatment failed to show any significant change in levels
of these markers. Interestingly, in the decidualization resistant HESC-T3
cells, sFlt1 production remained unaffected by the decidualization stimuli,
but RA treatment resulted in sFlt1 downregulation.

Thursday Posters

were considered SGA by INTERGROWTH-21st (SGA-IG), SGA by
customised charts (SGA-cust), or SGA by customised charts only but
not by INTERGROWTH-21st (SGA-cust-only). Infants not SGA by any
charts (non-SGA) were used as a reference.
RESULTS: 71487 births were available for analysis after exclusion
of women missing height or weight data. Only 2399 (3.4%) of infants
were considered SGA by INTERGROWTH-21st charts (SGA-IG), while
7599 (10.6%) were considered SGA by customised charts (SGA-cust).
INTERGROWTH-21st identified only 47 additional women (<0.1%) that
were not identified by customised charts; none experienced any adverse
outcomes.
Significantly more obese women had infants considered SGA-cust than
SGA-IG (19% vs 10%, p<0.001), and SGA-cust-only than SGA-IG (23%
vs 10%, p<0.001). SGA-IG were also more likely to be primiparous than
SGA-cust (69% vs 54%, p<0.001). The SGA group not identified by
INTERGROWTH-21st (SGA-cust only, n=5246) still had significantly
higher odds of stillbirth (OR 4.32, 95%CI 2.45-7.4), low Apgars <7 (1.6,
1.34-1.97) or <5 (2.26, 1.59-3.17), and NICU admissions (OR 4.82, 95%CI
4.27-5.43) than a non-SGA infant.

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Table of Contents for the Digital Edition of SRI Supplement to Reproductive Sciences - Volume 25 Number 1 - March 2018

SRI Supplement to Reproductive Sciences - Volume 25 Number 1 - March 2018 - Cover1
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SRI Supplement to Reproductive Sciences - Volume 25 Number 1 - March 2018 - Cover3
SRI Supplement to Reproductive Sciences - Volume 25 Number 1 - March 2018 - Cover4
https://www.nxtbook.com/nxtbooks/sage/hospitalpharmacy_december2020
https://www.nxtbook.com/nxtbooks/sage/psychologicalscience_demo
https://www.nxtbook.com/nxtbooks/sage/hospitalpharmacy_october2020
https://www.nxtbook.com/nxtbooks/sage/fai_202009
https://www.nxtbook.com/nxtbooks/sage/hospitalpharmacy_august2020
https://www.nxtbook.com/nxtbooks/sage/hospitalpharmacy_june2020
https://www.nxtbook.com/nxtbooks/sage/hospitalpharmacy_april2020
https://www.nxtbook.com/nxtbooks/sage/hospitalpharmacy_february2020
https://www.nxtbook.com/nxtbooks/sage/hospitalpharmacy_december2019
https://www.nxtbook.com/nxtbooks/sage/hospitalpharmacy_october2019
https://www.nxtbook.com/nxtbooks/sage/fai_201909
https://www.nxtbook.com/nxtbooks/sage/hospitalpharmacy_july2019
https://www.nxtbook.com/nxtbooks/sage/hospitalpharmacy_june2019
https://www.nxtbook.com/nxtbooks/sage/canadianpharmacistsjournal_05062019
https://www.nxtbook.com/nxtbooks/sage/hospitalpharmacy_april2019
https://www.nxtbook.com/nxtbooks/sage/sri_supplement_201903
https://www.nxtbook.com/nxtbooks/sage/hospitalpharmacy_february2019
https://www.nxtbook.com/nxtbooks/sage/hospitalpharmacy_december2018
https://www.nxtbook.com/nxtbooks/sage/tec_20180810
https://www.nxtbook.com/nxtbooks/sage/hospitalpharmacy_october2018
https://www.nxtbook.com/nxtbooks/sage/hospitalpharmacy_julyaugust2018
https://www.nxtbook.com/nxtbooks/sage/fai_201807
https://www.nxtbook.com/nxtbooks/sage/hospitalpharmacy_june2018
https://www.nxtbook.com/nxtbooks/sage/hospitalpharmacy_april2018
https://www.nxtbook.com/nxtbooks/sage/sri_supplement_201803
https://www.nxtbook.com/nxtbooks/sage/slas_discovery_201712
https://www.nxtbook.com/nxtbooks/sage/hospitalpharmacy_february2018
https://www.nxtbook.com/nxtbooks/sage/hospitalpharmacy_december2017
https://www.nxtbook.com/nxtbooks/sage/hospitalpharmacy_november2017
https://www.nxtbook.com/nxtbooks/sage/hospitalpharmacy_october2017
https://www.nxtbook.com/nxtbooks/sage/hospitalpharmacy_september2017
https://www.nxtbook.com/nxtbooks/sage/hospitalpharmacy_julyaugust2017
https://www.nxtbook.com/nxtbooks/sage/fai_supplement_201709
https://www.nxtbook.com/nxtbooks/sage/hospitalpharmacy_june2017
https://www.nxtbook.com/nxtbooks/sage/hospitalpharmacy_may2017
https://www.nxtbook.com/nxtbooks/sage/fai_201706
https://www.nxtbook.com/nxtbooks/sage/fai_201607
https://www.nxtbookmedia.com