Clinical and basic science research findings of several studies were presented by Pitt faculty members at the 25th annual meeting of the Society for Maternal Fetal Medicine in Reno, Nev., Feb. 7-12. Research was conducted at the Magee-Womens Research Institute (MWRI). Among the findings were:
Immunologic changes in a common bacterial infection may be linked to higher risk for preterm birth.
Pregnant women with a common gynecological disorder called bacterial vaginosis (BV) had significantly lower levels of vital immune system proteins, indicating a possibly decreased ability to meet other immune-system challenges, such as sexually transmitted diseases and infection-related preterm birth, reported Hyagriv Simhan, assistant professor of obstetrics, gynecology, and reproductive sciences in Pitt’s School of Medicine, and his colleagues.
“Bacterial vaginosis is known to alter many aspects of reproductive immunity,” said Simhan, the study’s first author, who also is an assistant investigator at the MWRI. “A robust immune system response is needed to defend against infection that can carry grave consequences for pregnant women.”
Researchers studied vaginal swab samples collected from 98 pregnant women between four and 16 weeks’ gestation. Analysis to determine BV status found infection present in slightly more than 30 percent of study participants.
“Symptoms of BV are the No. 1 reason women visit a gynecologist,” said Simhan, adding that infection rates in some populations are estimated as high as 50 percent. Symptoms of BV include a foul-smelling, milky discharge.
Further analysis found that concentrations of anti-inflammatory immune system proteins interleukin 4, 10, and 13 were significantly lower among women with BV, compared to those who did not have it. “BV in pregnancy is associated with an alteration of cervical innate immunity, as represented by a decreased concentration of the three most important anti-inflammatory proteins,” Simhan said. “This may have an important impact upon a woman’s response to immune challenges.”
Concentrations of blood protein may point to higher risk of gestational diabetes.
Even as early as the first trimester, reduced blood levels of the protein adiponectin were associated with later development of gestational diabetes, reported Kristine Yoder Lain, assistant professor of obstetrics, gynecology, and reproductive sciences in the Pitt medical school, and her colleagues.
Levels of adiponectin, a protein specific to fat tissue that is known to be involved in obesity, diabetes, and heart disease, were analyzed in blood samples taken early in pregnancy from 38 women who later developed gestational diabetes, as compared to those from 30 women who did not develop the condition.
“Women with the lowest adiponectin concentrations were 11.2 times more likely to develop gestational diabetes, and this persisted after controlling for body mass index and race,” said Lain, who is first author of the study and also medical director of the Center for Diabetes and Pregnancy at Magee-Womens Hospital of the University of Pittsburgh Medical Center. “This suggests that women with glucose intolerance of pregnancy may have significant alteration in adiponectin levels long before a diagnosis of gestational diabetes is made.”
