Society for Maternal-Fetal Medicine, Feb. 1-6
The annual meeting of the Society for Maternal-Fetal Medicine was held from Feb. 1 to 6 in Atlanta and attracted more than 2,000 participants from around the world, including obstetricians/gynecologists and other clinical practitioners who specialize in maternal-fetal medicine. The conference highlighted recent advances in maternal-fetal medicine, with presentations and abstracts focusing on reducing high-risk pregnancy complications through pregnancy assessment and management.
In one study, Emily Patel, M.D., of Duke University in Durham, N.C., and colleagues found that women in the first trimester appear to mount a greater cellular response (T-follicular helper cells, specifically) to influenza vaccination compared with women in the second and third trimesters.
"Our findings suggest that women in the first trimester may have a more robust immunologic response to antigen or pathogen exposure in pregnancy. Our finding may be a contributor to why women in the later gestational period tend to have increased morbidity and mortality from respiratory illness," Patel said. "Our findings at this time should not change clinical practice. The influenza vaccine should still be recommended to all pregnant patients regardless of gestational age of pregnancy. Our findings, however, may suggest that women in the second and third trimesters may not mount as robust a response to vaccination. For this reason, future work may evaluate the need for a booster vaccine in pregnancy."
In another study, Lauren Theilen, M.D., of the University of Utah Health Sciences Center in Salt Lake City, and colleagues found that a history of hypertensive disease of pregnancy (including gestational hypertension, preeclampsia, and eclampsia) was associated with increased mortality risk from a variety of causes, including cardiovascular disease, diabetes, and Alzheimer's disease.
"Hypertensive disease of pregnancy is significantly associated with excess mortality risk related to the subsequent development of a variety of medical problems," Theilen said. "Women with a history of hypertensive disease should be encouraged to establish care with a health care provider outside of pregnancy who can initiate appropriate screening and, when possible, interventions to improve long-term health outcomes."
Kristen Meyer, of the Baylor College of Medicine in Houston, and colleagues found that the diverse community of bacteria in breast milk is significantly affected by short-term changes in maternal diet.
"More specifically, we found that a high-fat maternal diet is associated with a decrease in the abundance of predicted bacterial pathways involved in the regulation of energy metabolism," Meyer said.
The investigators also found evidence that when an infant consumes breast milk, rather than simply passing through the digestive tract, some of the bacteria in breast milk take up residence inside the infant gut.
"Putting these all together, we speculate that maternal diet during lactation affects regulation of energy intake and metabolism in the infant gut by changing the structure of the infant gut microbiome," Meyer said. "From this study we know that a high-fat maternal diet during lactation affects the breast milk microbiome. The next step will be to see how this affects the gut microbiome and energy metabolism in nursing infants. As far as impact on clinical practice, while we cannot make any firm recommendations based on the results of our studies, our results are in line with the currently recommended guidelines to consume a well-balanced diet during breastfeeding, with the added knowledge that balanced nutrition not only benefits the mother, but possibly her infant as well."
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