SRI Supplement to Reproductive Sciences - Volume 25 Number 1 - March 2018 - 171A

Scientific Abstracts

Reproductive Sciences Vol. 25, Supplement 1, March 2018

Variation in Blood Pressure in Predicting Impeding Preeclampsia.
Darios Getahun,1 Michael J Fassett,2 Fagen Xie*.1 1Kaiser Permanente
Southern California, Pasadena, CA, United States; 2Kaiser Permanente
West Los Angeles Medical Center, Los Angeles, CA, United States.
INTRODUCTION: Previous studies have suggested that prenatal
sequential measured blood pressure (BP) levels predict preecalmpsia risk.
However, they have in common that they investigated its perdictability
by examining the overall variability of BP levels. We hypothesized that
the predictability of BP levels on impending preeclampsia depend on the
severity (mild versus severe form) of the condition. Patients with sever
form of preeclampsia may have high blood pressure levels with low degree
of variability in their systolic (SBP) and diastolic (DBP) blood preassure
prior to the onset of symptoms. We examined the BP variability measures
in predicting mild and sever preeclampsia.
METHODS: We conducted a retrospective cohort study of all singleton
pregnancies (n=332,021) delivered in all Kaiser Permanente Southern
California hospitals between 2008-2016. Preeclampsia diagnosis was
ascertained from health plan outpatient and inpatient electronic medical
records. We assessed the risk of preeclampsia subtypes in relation to
visit-to-visit variation during prenatal care in SBP and DBP (expressed
as standard deviation [SD] and coefficient of variation [CV]). Adjusted
odd ratios (OR) were used to estimate the association.
RESULTS: The incidence of preeclampsia was 5.6%. Among women with
mild preeclampsia, compared to those with variability in SBP and DBP
in the bottom quartile, BP variation in higher quartil was not a predictor
(Table). However, among women with sever preeclampsia, variability
in SBP and DBP was a strong predictor for preeclampsia. The ability of
visit-to-visit variability in BP to predicat severe preecalmpsia was stronger
for blacks and Hispanics than whites (SD: 1.52 [95% CI 1.43-1.61] and
SD: 1.16 [95% CI 1.11-1.21]).
Odds ratios (95%
Prenatal care blood pressure
Confidence Intervals)
variability
for preeclampsia
Systolic Blood Pressure

Mild

Severe

Standard Deviation

1.47 (1.37, 1.59)

19.7 (18.4,
21.2)

Coefficient of Variation

0.61 (0.56, 0.66)

7.42 (6.95,
7.92)

Standard Deviation

2.41 (2.23, 2.61)

23.75 (21.97,
25.68)

Coefficient of Variation

0.73 (0.68, 0.79)

6.96 (6.50,
7.45)

Diastolic Blood Pressure

CONCLUSION: High visit-to-visit variability in SBP and DBP can be
used to predict impending preeclampsia. However, its ability in predicting
preeclampsia risk depends on its clinical subtypes.

T-186
CLA Isomers Offer Potential Therapeutic Benefits for Endothelial
Dysfunction in Preeclampsia by Improvingthe Monolayer and Ca2+
Signaling in HUVECs. Amanda K Mauro†, Ian Bird*, Derek Boeldt*.
University of Wisconsin-Madison, Madison, WI, United States.
INTRODUCTION: Preeclampsia is a condition of hypertension
accompanied with proteinuria or other signs of organ dysfunction during
pregnancy. Endothelial dysfunction is a hallmark of preeclampsia, but
there are currently no effective endothelial-targeted therapies. Conjugated
linoleic acid (CLA) is naturally found in a variety of food products and is
approved in certain formulations by the FDA for use in pregnant women.
t10,c12 CLA is a known Src inhibitor while c9,t11 CLA is a known NFĸB inhibitor. Both pathways play a role in endothelial cell connectivity
can directly or indirectly affect Ca2+ signaling, a crucial function of
vascular endothelial cells as it is necessary for nitric oxide production.
We have previously shown that acutely, t10,c12, but not c9,t11 CLA can
reverse Src-mediated Ca2+ signaling inhibition in human umbilical vein
endothelial cells (HUVEC). Here, we examine the long-term effects of

CLA isomers on HUVEC monolayer integrity and Ca2+ signaling. We
hypothesize that long term, both CLA isomers will improve monolayer
integrity and Ca2+ responses.
METHODS: HUVECs were plated on 96 well plates for ECIS (electric
cell-substrate impedance sensing - cell growth and monolayer integrity)
and Ca2+ signaling, and were administered c9,t11 CLA (10uM), t10,c12
CLA (10 uM), or complete media as a control every 6 hours for 42 hours.
24 hours after the last treatment was administered the ECIS assay was
stopped (for 68 total hours) and the second plate of cells was loaded with
5uM fluo-8 AM dye for Ca2+ measurement. For Ca2+, 100uM ATP was
added after 5 baseline reads for a total of 30 minutes. Statistical analysis
was by students test, paired t-test, or rank sum test.
RESULTS: For ECIS, CLA addition showed improvement in monolayer
integrity in the 24hr to 36hr time period after cell seeding, when the cells
are estimated to be ~60-90% confluent. c9,t11 significantly improved
monolayer integrity (p <0.05 during the 24hr-36hr post-seeding window),
while t10,c12 improved monolayer integrity at 24hr after seeding only
(p<0.05). For the Ca2+ signaling assay CLA administration offered
improvement at all time points (t10,c12 p≤0.001, c9,t11 p<0.05). However,
t10,c12 offered greater improvement than c9,t11 overall (p<0.05).
CONCLUSION: The treatment of endothelial cells with CLA offers
improvement in monolayer integrity as well as in Ca2+ signaling.
Specifically the c9,t11 isomer preferentially improved the monolayer
(likely via NF-ĸB inhibiton) while the t10,c12 isomer preferentially
increased the capacity for Ca2+ signaling (likely via Src inhibition).
Therefore CLA isomers could be useful therapeutics for the repair of leaky
vessels by encouraging endothelial cells to develop a more functional
monolayer (c9,t11) or improving Ca2+ signaling/vasodilator production
capabilities (t10,c12).NIH HD079865, HD38843.

T-187
A Dynamic Endothelium: Characterizing the Microcirculatory
Glycocalyx during Pregnancy and Preeclampsia. Julia M BregandWhite,1 Judith Brands,2 Arun Jeyabalan,2 Gong Tang,2 Carl Hubel*,2
Robin Gandley*.2 1University of Chicago, Chicago, IL, United States;
2
University of Pittsburgh, Pittsburgh, PA, United States.
INTRODUCTION: The apical surface of the vascular endothelium
comprises a complex meshwork of membrane-bound proteoglycans and
glycoproteins, the glycocalyx (GC). The GC has important functional
and vasoprotective roles; e.g., growth factor binding, signal transduction
(including nitric oxide mechanotransduction), and regulation of
coagulation and permeability. Damage to the GC is implicated several
vascular diseases. We hypothesized that GC structural barrier integrity and
microvascular perfusion are reduced in women with preeclampsia (PE).
METHODS: We compared 17 women with PE to 27 women with
uncomplicated pregnancy (NL), admitted to labor and delivery
(LD) and again within 24-48 hours postpartum (PP). The sublingual
microvasculature was interrogated using a sidestream-darkfield camera
(GlycoCheck) to detect red blood cells (RBC) and software to calculate
the microvascular density and mean percentage of time vascular segments
are perfused (% RBC). Using the dynamic lateral movement of RBC
the software also determines the part of the GC accessible by RBC, the
RBC accessible region (AR). A greater AR signifies a diminished ability
of GC to exclude RBCs. Patient AR values for vessels 5-25 µm are
averaged. Plasma soluble syndecan-1 (Sdc1), a shed component of GC,
was measured by ELISA.
RESULTS: Sublingual microvascular density was greater in NL-LD
(478+28 segments/mm2) compared to PE-LD (378+35; p=0.03) or
NL-PP (355+28; p=0.002) (PE-PP 306+35; NS vs NL-PP). % RBC was
not different between groups. AR in NL-LD (2.33+0.05microns) was
surprisingly greater compared to PE-LD (2.17+0.06; p=0.03) or NL-PP
(2.19+0.05; p=0.05), but not different from PE-PP (2.26+0.06). Maternal
plasma Sdc1 was significantly higher in NL-LD (1126+110.3ng/mL)
compared to PE-LD (715.5+112.1 ng/mL; p=0.008), and levels declined
in both groups PP (NL-PP 210+98, PE-PP 173+120; NS).
CONCLUSION: PE lacked the increase in functional microvascular
density seen in NL. The increase in RBC accessibility (AR) in
microvascular GC during NL compared to PE was opposite to our

Thursday Posters

T-185

171A
Table of Contents for the Digital Edition of SRI Supplement to Reproductive Sciences - Volume 25 Number 1 - March 2018
