SRI Supplement to Reproductive Sciences - Volume 25 Number 1 - March 2018 - 295A

Scientific Abstracts

synthase activity, or impaired endothelial function. Novel therapies to
increase CSE activity or vascular H2S synthesis could reduce pregnancy
complications due to inadequate uterine perfusion.

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S-130
Physiologic Proteinuria in Labor and Postpartum: The Results of
the Postpartum Proteinuria Trial (PoPPy). Michael M Aziz†,2 Ankita
Kulkarni†,1 Leena Shah*,1 Susan Lashley*,1 Yinka Oyelese*.1 1Atlantic
Health System, Morristown, NJ, United States; 2University of Tennessee
Health Sciences Center, Memphis, TN, United States.
INTRODUCTION: The urine protein to creatinine ratio (PC) is a
sensitive and specific means of diagnosing preeclampsia in the antepartum
period, but the 0.3 g protein per gram of creatinine threshold may be
non-specific postpartum due to physiologic proteinuria after delivery.
METHODS: This single-center prospective cohort study included two
groups: term uncomplicated nulliparous patients in labor with epidural
analgesia and patients for scheduled repeat cesarean deliveries. Patients
with hypertension, antepartum proteinuria, renal disease, gross hematuria,
or evidence of infection were excluded. Catheterized pre- and postdelivery urine PC were compared using paired t-tests.
RESULTS: 27 and 40 patients were included in the vaginal and cesarean
delivery groups, respectively. 52% of the vaginal delivery and 58% of
the cesarean delivery groups were positive for proteinuria at the 0.3 g
protein per g creatinine threshold. Pre- and post-delivery specimens were
significantly different in the vaginal (mean difference 0.28, p=0.05) and
cesarean (mean difference 0.25, p<0.01) delivery groups.

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CONCLUSION: PC measurements are unreliable in the immediate
postpartum period regardless of mode of delivery, and utilizing the 0.3
g protein per gram of creatinine threshold to diagnose preeclampsia in
close proximity to delivery would lead to increased false positive tests
and inappropriate interventions.

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Kidney Funtion during Pregnancy: A Systematic Review and MetaAnalyses. Tessa AG van Gansewinkel†,2 Veronica A Lopes van Balen†,2
Sander de Haas,2 Julia J Spaan,2 Chahinda Ghossein-Doha,2 Sander MJ van
Kuijk,2 Joris van Drongelen,3 Tom Cornelis,1 Marc EA Spaanderman*.2
1
Jessa Hospital, Hasselt, Belgium; 2Maastricht University Medical Centre,
Maastricht, Netherlands; 3Radboud University Nijmegen Medical Centre,
Nijmegen, Netherlands.
INTRODUCTION: The purpose of this meta-analysis is to systematically
review and quantify current literature on kidney function during
pregnancy, to estimate the extent of adaptation over the course of both
physiological and hypertensive complicated singleton pregnancies and to
determine a possible threshold defining normal from abnormal.
METHODS: PubMed (NCBI) and Embase (Ovid) electronic databases
were used for the literature search, which was performed from inception
to July 2017. Studies were required to report a non-pregnant reference
value of kidney function (matched control group, pre-pregnancy- or
postpartum- measurement) and a pregnancy measurement during a
predetermined and reported gestational age. Pooled mean differences
between reference value and pregnancy measurements were calculated
for predefined intervals of gestational age using random-effects model
described by DerSimonian and Laird.
RESULTS: As early as the first trimester, glomerular filtration rate
increased and serum creatinine decreased during uncomplicated pregnancy
when compared to non-pregnant conditions. In women with hypertensive
complicated pregnancies glomerular filtration rate was lower, and serum
creatinine higher when compared to uncomplicated pregnancies. A serum
creatinine above 0.75 mg/dl always exceeds the upper references value.
CONCLUSION: In healthy pregnancy kidney function accelerates
as early as in the first trimester and remains to function at higher rate
throughout gestation. In contrast, even though kidney function increases in
hypertensive gestation, it is lower as compared to normotensive pregnancy.
Although the upper limit of the reference curve changes throughout
gestation, from a clinical perspective, serum creatinine above 0.75 mg/
dl should be considered abnormal during pregnancy.
*Figure(s) will be available online.

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Maternal Metabolic Features and Body Composition in Late Gestation
Associated with Exclusive Lactation at 6 Weeks Postpartum. Nicole E
Marshall, Bernard Lau, Jonathan Q Purnell, Kent L Thornburg*. Oregon
Health & Science University, Portland, OR, United States.
INTRODUCTION: Despite recommendations for 6 months exclusive
breastfeeding, only 22% of US women meet this goal, with even lower
rates in women with obesity. Therefore, we undertook a study of metabolic
markers and body composition during late gestation to determine
predictors of successful exclusive lactation among women intending to
exclusively breastfeed.
METHODS: Women of normal (n=60), overweight (n=38) and obese
(n=24) pre-pregnancy BMI underwent body composition measurements
at 37-38 weeks gestation via BodPod air displacement plethysmography
and skin fold thickness as well as a fasting blood draw for insulin,
glucose, C-reactive protein (CRP), leptin, and adiponectin levels. Intent
to breastfeed and breastfeeding exclusivity were determined via online
survey data collected at 6 weeks gestation.
RESULTS: At 6 weeks postpartum, 91 women were exclusively
breastfeeding (74.6%) and 31 women had started supplementation (6 had
stopped nursing (4.9%)). Women who were exclusively breastfeeding
had lower pre-pregnancy BMI (25.2 vs. 29.1 kg/m2), fat mass (27.5 vs.
34.5 kg), glucose (76.7 vs. 80.2 kg/dL), and leptin (42.6 vs. 62.9 ng/mL)
with no difference in CRP compared to women who had started infant
supplementation. When limited to women who were overweight or obese,

Saturday Posters

Pregnancy Mediates the Inflammatory and Vasoactive Effects of
Uterine Perivascular Adipose Tissue. Oluwatobiloba Osikoya†, Styliani
Goulopoulou*. University of North Texas Health Science Center, Fort
Worth, TX, United States.
INTRODUCTION: Healthy pregnancy involves substantial remodeling
of the uterine vasculature and expansion of adipose tissue. Perivascular
adipose tissue is a modulator of vascular tone and its vasoactive effects
vary with anatomic location and disease state. We hypothesize that
perivascular adipose tissue (PVAT) surrounding the uterine artery (UtA)
has vasoactive effects, which are mediated by pregnancy.
METHODS: Pregnant (gestational day 16) and aged-matched nonpregnant rats were used. Segments of main UtA were mounted onto a
wire myograph. Concentration-response curves to potassium chloride
(KCl, 10-80 mM), phenylephrine (10-9 - 3x10-5 M), and acetylcholine
(10-9 - 3x10-5 M) were studied in the presence and absence of PVAT (0.1
g) or PVAT-conditioned media (30 min exposure).
RESULTS: 1) To determine the vasoactive effects of PVAT on UtA, we
measured vascular responses in the presence and absence of PVAT. UtA
incubated with PVAT had increased contractile responses to KCl [KCl
(30 mM), control: 4.0 ± 0.81 mN vs. + PVAT: 14.7 ± 1.68 mN, p<0.05].
Phenylephrine-induced contractions were greater in UtA exposed to PVAT
(EC50, control: 6.0 ± 0.08 vs. +PVAT: 6.3 ± 0.10, p<0.05). UtA exposed
to PVAT had reduced responses to acetylcholine. These effects were not
seen in UtA from non-pregnant rats. 2) To determine the vasoactive effect
of PVAT-released factors, UtA from pregnant rats were incubated with
PVAT-conditioned media. PVAT-media increased contractile responses
[KCl (30 mM), control: 6.0 ± 1.28 mN vs. PVAT-media: 13.3 ± 1.21
mN, p<0.05] in UtA from pregnant but not from non-pregnant rats. 3)
To determine whether the pro-contractile effects of PVAT are mediated
by pregnancy, UtA from pregnant and non-pregnant rats were incubated
with non-pregnant and pregnant PVAT, respectively (crossover studies).
PVAT from non-pregnant rats blunted endothelium-dependent relaxation
in UtA from pregnant rats but PVAT from pregnant rats had no effect on
UtA from non-pregnant rats. 4) Using a proteome profiler rat adipokine
array, we found that inflammation and extracellular matrix-related proteins
were upregulated in PVAT from pregnant compared to non-pregnant rats.
CONCLUSION: Our data demonstrate that pregnancy renders uterine
PVAT pro-inflammatory and pro-contractile. The potentiated contractile
UtA responses to PVAT are attributed to pregnancy specific changes in
both uterine smooth muscle and PVAT.

Reproductive Sciences Vol. 25, Supplement 1, March 2018

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