Elevated Lipid Oxidation Is Associated with Exceeding Gestational Weight Gain Recommendations and Increased Neonatal Anthropometrics: A Cross-Sectional Analysis

BACKGROUND: Deviations from gestational weight gain (GWG) recommendations are associated with unfavorable maternal and neonatal outcomes. There is a need to understand how maternal substrate metabolism, independent of weight status, may contribute to GWG and neonatal outcomes. The purpose of this study was to explore the potential link between maternal lipid oxidation rate, GWG, and neonatal anthropometric outcomes. METHODS: Women (N = 32) with a lean pre-pregnancy BMI were recruited during late pregnancy and substrate metabolism was assessed using indirect calorimetry, before and after consumption of a high-fat meal. GWG was categorized as follows: inadequate, adequate, or excess. Shortly after delivery (within 48 h), neonatal anthropometrics were obtained. RESULTS: Using ANOVA, we found that fasting maternal lipid oxidation rate (grams/minute) was higher (p = 0.003) among women with excess GWG (0.1019 ± 0.0416) compared to women without excess GWG (inadequate = 0.0586 ± 0.0273, adequate = 0.0569 ± 0.0238). Findings were similar when lipid oxidation was assessed post-meal and also when expressed relative to kilograms of fat free mass. Absolute GWG was positively correlated to absolute lipid oxidation expressed in grams/minute at baseline (r = 0.507, p = 0.003), 2 h post-meal (r = 0.531, p = 0.002), and 4 h post-meal (r = 0.546, p = 0.001). Fasting and post-meal lipid oxidation (grams/minute) were positively correlated to neonatal birthweight (fasting r = 0.426, p = 0.015; 2-hour r = 0.393, p = 0.026; 4-hour r = 0.540, p = 0.001) and also to neonatal absolute fat mass (fasting r = 0.493, p = 0.004; 2-hour r = 0.450, p = 0.010; 4-hour r = 0.552, p = 0.001). CONCLUSIONS: A better understanding of the metabolic profile of women during pregnancy may be critical in truly understanding a woman\u27s risk of GWG outside the recommendations. GWG counseling during prenatal care may need to be tailored to women based not just on their weight status, but other metabolic characteristics

The Beta-decay Paul Trap Mk IV: Design and commissioning

The Beta-decay Paul Trap is an open-geometry, linear trap used to measure the decays of $^8$Li and $^8$B to search for a tensor contribution to the weak interaction. In the latest $^8$Li measurement of Burkey et al. (2022), $\beta$ scattering was the dominant experimental systematic uncertainty. The Beta-decay Paul Trap Mk IV reduces the prevalence of $\beta$ scattering by a factor of 4 through a redesigned electrode geometry and the use of glassy carbon and graphite as electrode materials. The trap has been constructed and successfully commissioned with $^8$Li in a new data campaign that collected 2.6 million triple coincidence events, an increase in statistics by 30% with 4 times less $\beta$ scattering compared to the previous $^8$Li data set.Comment: 17 pages, 7 figure

Does a History of Unintended Pregnancy Lessen the Likelihood of Desire for Sterilization Reversal?

BackgroundUnintended pregnancy has been significantly associated with subsequent female sterilization. Whether women who are sterilized after experiencing an unintended pregnancy are less likely to express desire for sterilization reversal is unknown.MethodsThis study used national, cross-sectional data collected by the 2006-2010 National Survey of Family Growth. The study sample included women ages 15-44 who were surgically sterile from a tubal sterilization at the time of interview. Multivariable logistic regression was used to examine the relationship between a history of unintended pregnancy and desire for sterilization reversal while controlling for potential confounders.ResultsIn this nationally representative sample of 1,418 women who were sterile from a tubal sterilization, 78% had a history of at least one unintended pregnancy and 28% expressed a desire to have their sterilization reversed. In unadjusted analysis, having a prior unintended pregnancy was associated with higher odds of expressing desire for sterilization reversal (odds ratio [OR]: 1.80; 95% confidence interval [CI]: 1.15-2.79). In adjusted analysis controlling for sociodemographic factors, unintended pregnancy was no longer significantly associated with desire for reversal (OR: 1.46; 95% CI: 0.91-2.34).ConclusionAmong women who had undergone tubal sterilization, a prior history of unintended pregnancy did not decrease desire for sterilization reversal

INVESTIGATION OF BLOOD LACTATE AS A MARKER OF METABOLIC DYSFUNCTION DURING PREGNANCY

Jill M. Maples1, Nicholas T. Broskey2, Maire Blankenship3, Alissa Paudel1, Alicia Mastronardi1, Nikki B. Zite1, Jaclyn B. van Nes1, Kimberly B. Fortner1, Rachel A. Tinius, FACSM3. 1University of Tennessee Graduate School of Medicine, Knoxville, TN. 2East Carolina University, Greenville, NC. 3Western Kentucky University, Bowling Green, KY. BACKGROUND: Previous work suggests blood lactate can be used as an indicator of metabolic disease and is a useful predictor of clinical outcomes in non-pregnant populations. However, the utility of lactate as an indicator of metabolic dysfunction during pregnancy is unknown. The purpose of this study is to determine if fasting or postprandial lactate is related to established markers of metabolic dysfunction (weight status, insulin resistance, substrate oxidation) during pregnancy. The ability to detect metabolic dysfunction during pregnancy has the potential to impact the immediate and future health of both mother and infant. METHODS: Lactate, glucose, and insulin values were assessed in 64 participants during late pregnancy (34.5±1.7 weeks gestation) before (fasting) and after a high-fat meal (1hr). Insulin and glucose levels were used to calculate HOMA-IR, which is an index of insulin resistance. Respiratory quotient (RQ), which reflects the relative contribution of fat and carbohydrate oxidation, was estimated using indirect calorimetry. Height (objectively assessed) and pre-pregnancy weight (self-reported) were used to estimate pre-pregnancy Body Mass Index (BMI). Means were compared and potential correlations were assessed using nonparametric tests. Partial correlations were used to adjust for potential confounders. RESULTS: Fasting and 1hr lactate were higher among those with pre-pregnancy overweight/obese (OWOB, n=29) compared to lean (n=35) (fasting: OWOB 0.90±0.26 v lean 0.72±0.26, p=0.007; 1hr: OWOB 1.01±0.37 v lean 0.76±0.28, p=0.005). Fasting and 1hr lactate values were positively correlated to fasting and 1hr insulin and HOMA-IR (p\u3c0.05). When adjusting for pre-pregnancy BMI, only 1hr lactate (not fasting) was correlated to insulin (1hr) and HOMA-IR (fasting and 1hr)(p\u3c0.05). Fasting and 1hr lactate was positively correlated to 1hr RQ and this remained when adjusting for pre-pregnancy BMI and HOMA-IR(p\u3c0.05). CONCLUSIONS: These data indicate lactate is associated with other markers of metabolic dysfunction during pregnancy. Future work should assess the clinical utility of lactate (fasting or postprandial), assessed at time points throughout pregnancy, as a potential biomarker for metabolic dysfunction or adverse obstetric outcomes, as in gestational or pre-pregnancy diabetes or fetal growth restriction. Funding was provided by NIH NIGMS Grant 5P20GM103436, WKU RCAP Grant 17-8011, and UTGSM Coffman Pediatric Research Endowment

Development of My Decision/Mi Decisión, a web-based decision aid to support permanent contraception decision making

Objective: To develop a patient-centered, web-based decision aid to support informed and value-concordant decision making among Medicaid enrollees considering tubal sterilization. Methods: We used the Ottawa Decision Support Framework and the International Patient Decision Aids Standards (IPDAS) to guide systematic development of our decision aid. We interviewed 15 obstetrician-gynecologists and 40 women, who had considered or were considering tubal sterilization. A Steering Committee—comprising healthcare providers, social scientists, reproductive health and justice advocates, and people with lived experience—provided feedback and direction. We developed English and Spanish prototypes, which were beta tested with 24 women. Results: The resulting web-based My Decision/Mi Decisión tool (English/Spanish) includes written and video information about tubal sterilization procedures; an interactive table of contraception options; values clarification exercises; reflection and deliberation; knowledge checks; and a summary report to share with one's provider. Users found the decision aid to be informative, engaging, easy to use, and helpful in informing contraception decision making. Conclusion: My Decision/Mi Decisión is a scalable tool that could be implemented widely to support informed decision making about tubal sterilization. Innovation: This is a novel and timely web-based decision tool for tubal sterilization, when demand for permanent contraception is rapidly increasing post-Dobbs. While designed for Medicaid enrollees, further investigation will explore more generalized use