SRI Supplement to Reproductive Sciences - Volume 25 Number 1 - March 2018 - 278A

278A

Reproductive Sciences Vol. 25, Supplement 1, March 2018

agents for ovarian hormones. Data was manually obtained from KGML
files using R environment, and network analysis for interacting genes and
pathways was performed using Cytoscape tool.
RESULTS: A extremely connected network with a strong relationship
between reproductive physiology and drug action mechanism of
analgesic, antidepressants, anti-inflammatory and anxiolytics groups
has been found. Steroid hormone biosynthesis pathway was affected by
analgesic compounds handily by glucuronosyltransferase (UGT genes)
and anxiolytics and antidepressant by Cytochrome P450 family. Antiinflammatory compounds were also affecting ovarian steroidogenesis
pathway targeting prostaglandins (PTGS2). Other pathways directly
connected with ovarian response hormones as MAPK signaling,
GABAergic synapse, Vascular smooth muscle contraction, Calcium
signaling pathway, and cAMP signaling pathways were also affected by
these therapeutic drugs.
CONCLUSION: The molecular model built in this research highlighted
possible effect of therapeutic drugs that are commonly used in the patient
population, although their side effect in fertility remains unclear. The
detailed molecular relationship between reproductive physiology actors
provides a framework for understand the pharmacogenomics of each
patient as a potential prediction model for personalizing ARTs in infertility.

S-078
Secular Trends in Obese Women Who Get Pregnant after Bariatric
Surgery: Racial/Ethnic Disparity. Michael J Fassett,2 Darios Getahun*.1
1
Kaiser Permanente Southern California, Pasadena, CA, United States;
2
Kaiser Permanente West Los Angeles Medical Center, Los Angeles, CA,
United States.
INTRODUCTION: To describe recent trends in obese women who
get pregnant after bariatric surgery (BS) procedure by maternal age and
race/ethnicity.
METHODS: The 2007-2016 Kaiser Permanente Southern California
(KPSC) electronic medical records comprising inpatient and outpatient
information for all KPSC births to obese women who were eligible for
BS (n= 13,987) were used to examine age and race/ethnicity-specific
rates in pregnancy after BS procedure as well as trends by race/ethnicity.
We compared event rates in the earliest (2007-2008) versus most recent
(2015-2016) periods. The criteria for BS was based on the National
Institute for Health recommendations: (i) a body mass index (BMI) that
is ≥ 40 kg/m2, or (ii) a BMI between 35-40 kg/m2 in the presence of other
comorbidities, and (iii) where other nonsurgical methods have proven
unsuccessful. Relative risks (RR) were used to estimate these changes
after adjusting for confounders.
RESULTS: Rates of obese women who get pregnant after BS procedure
among non-Hispanic White (NHW), non-Hispanic Black (NHB), Hispanic
and Other racial/ethnic groups increased by 93%, 350%, 334%, and
86%, respectively (p<0.001). Although increasing trends in the rate of
pregnancy after BS procedures was observed across all age groups, most
of the increase for NHB (RR 4.4, 95% confidence intervals [CI] 2.6-7.8)
and Hispanics (RR 4.5, 95% CI 3.0-6.6) was attributable to an excess of
pregnancies to women aged ≥30 years, while the increase among NHW
(RR 1.8, 95% CI 1.1-2.8) was attributable to an excess among women
aged 18-29 years.
CONCLUSION: This study demonstrated variation in the rate of
pregnancies after BS procedure by race/ethnicity. The preponderance
of births after BS procedure to women ≥30 years among Hispanics and
NHB women appears responsible for the racial disparity in pregnancies
after BS procedures.

Scientific Abstracts

S-079
Temporal Trends of Preterm Birth and Its Clinical Subtypes: Race/
Ethnicity. Michael J Fassett,2 Vicky Chiu,1 Darios Getahun*.1 1Kaiser
Permanente Southern California, Pasadena, CA, United States; 2Kaiser
Permanente West Los Angeles Medical Center, Los Angeles, CA, United
States.
INTRODUCTION: Preterm birth is a major cause of infant morbidity
and mortality around the world with long-term sequelae. This study
examines the recent trends in preterm birth and its clinical subtypes by
maternal race/ethnicity.
METHODS: An ecological study of trends in preterm birth and its
subtypes (spontaneous [SPTB] and medically-indicated preterm birth
[MIPTB]) was performed using the Kaiser Permanente Southern
California (KPSC) health plan outpatient and inpatient electronic medical
records for all KPSC births between 2007-2016 (n=331,438). Maternal
race/ethnicity was categorized as White, Blacks, Hispanic, and Asian/
Pacific Islander. Adjusted rates and relative risks (RR) were used to
quantify these changes.
RESULTS: Rates of preterm birth remained essentially unchanged at
about 8.3% from 2007 through 2011, then decreased to 7.5% by 2016;
for a relative decrease of 8.5% (95% confidence interval [CI] 5%-12%,
p<0.001). Between 2007-2008 and 2015-2016, the SPTB rates decreased
by 28% among Whites (from 1.5% to 1.1%, p=0.001), by 41% among
Blacks (from 1.7% to 1.2%, p=0.003), by 14% among Hispanics (from
1.7% to 1.5%, p=0.008), and by 37% among Asian/Pacific Islanders (from
2.1% to 1.4%, p<0.001). MIPTB rates decreased by 12% among Whites
(from 6.1% to 5.2%, p=0.007), by 14% among Blacks (from 9.2% to
8.3%, p=0.016), and by 10% among Asian/Pacific Islanders (from 7.5%
to 6.8%, p=0.068). The rate for Hispanics remained stable at 6.2% during
the study period.
CONCLUSION: During the study period, the rate of both SPTB and
MIPTB decreased. The recent decrease in MIPTB corresponds to a
decrease in rates for all race/ethnicity groups, except for Hispanics.

S-080
Place-Based Variation in Early Pregnancy Loss: Evidence from
Population Data. Jenna Nobles*,2 Amar Hamoudi*,2 Robert Nowak*,2
Erin Landau†,1 Alex Baron†,1 Jane Brittingham†,2 Blake Mason†.2 1Ovia
Health, Boston, MA, United States; 2University of Wisconsin, Madison,
Madison, WI, United States.
INTRODUCTION: Pre-clinical pregnancy loss is logistically difficult
and expensive to measure in large, population samples with geographic
diversity. As a result, knowledge of variability in early pregnancy loss is
limited in two ways: (1) most research identifies individual-level factors
that influence pregnancy termination; (2) relevant correlates can be
difficult to detect with small samples. Contextual social, economic, and
environmental exposures like place-based poverty, housing conditions,
air quality, and even exposure to criminal activity are known correlates
of biological processes-like inflammation and stress reactivity-that,
in turn, have been shown to be associated with early pregnancy loss. We
hypothesize that net of individual-level sociodemographic and health
factors, early-pregnancy loss is also shaped by place-based environmental
and socioeconomic conditions. To study variability in early pregnancy
loss across the United States, we leverage population administrative data
against data recorded by one million users of a suite of commercial health
tracking applications.
METHODS: We use the 2010 Census, 2010-2015 U.S. natality files, and
the 2011-2015 American Community Survey to create post-stratification
population weights for a sample of one million women who used one of
two linked health tracking applications, Ovia Fertility and Ovia Pregnancy,
during January 2014 to September 2016. We measure variability in
recorded positive pregnancy tests that terminated prior to the 8th week
of pregnancy. Data on last menstrual period data are used to measure
gestational age. Termination is measured through women's reports of
termination or via the initiation of women's period cycles prior to the
9th week of gestation. Data on county-level variation in poverty, violent

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