The prenatal period is critical for auditory development; thus, prenatal influences on auditory development may significantly impact long-term hearing ability. While previous studies identified a protective effect of carotenoids on adult hearing, the impact of these nutrients on hearing outcomes in neonates is not well understood. The purpose of this study is to investigate the relationship between maternal and umbilical cord plasma retinol and carotenoid concentrations and abnormal newborn hearing screen (NHS) results. Mother–infant dyads (n = 546) were enrolled at delivery. Plasma samples were analyzed using HPLC and LC–MS/MS. NHS results were obtained from medical records. Statistical analysis utilized Mann–Whitney U tests and logistic regression models, with p ≤ 0.05 considered statistically significant. Abnormal NHS results were observed in 8.5% of infants. Higher median cord retinol (187.4 vs. 162.2 μg/L, p = 0.01), maternal trans-β-carotene (206.1 vs. 149.4 μg/L, p = 0.02), maternal cis-β-carotene (15.9 vs. 11.2 μg/L, p = 0.02), and cord trans-β-carotene (15.5 vs. 8.0 μg/L, p = 0.04) were associated with abnormal NHS. Significant associations between natural log-transformed retinol and β-carotene concentrations and abnormal NHS results remained after adjustment for smoking status, maternal age, and corrected gestational age. Further studies should investigate if congenital metabolic deficiencies, pesticide contamination of carotenoid-rich foods, maternal hypothyroidism, or other variables mediate this relationship.

Objectives Omega-3 (n-3) polyunsaturated fatty acids (PUFAs) are essential in fetal growth and development and have been shown to modulate inflammatory processes throughout the lifespan. Previous studies have demonstrated that individuals with lower socioeconomic status (SES) may be at risk for low intake of n-3 PUFAs, however, no research has compared the concentrations of these nutrients present in maternal and cord serum between markers of SES. The purpose of this study is to assess the relationship between markers of SES and levels of n-3 PUFAs in maternal and cord serum in a group of patients delivering at a Midwest Academic Medical Center. Methods An IRB-approved study enrolled mother-infant pairs (n = 55) at the time of delivery for collection of maternal and cord serum samples. n-3 PUFA levels quantified included Eicosapentaenoic acid (EPA), Docosahexaenoic acid (DHA), and total n-3 PUFAs. Markers of SES include private vs public insurance, income ≤ 150% of the poverty line vs > 150%, and college degree earners vs no college degree. The Mann-Whitney U test was used to assess differences in n-3 PUFA levels between SES groups. A P < 0.05 was considered statistically significant. Results Median gestational age at delivery was 39.3 weeks. Significantly higher nutrient levels were present in college-educated mothers vs less than college-educated mothers in median maternal EPA (9.44 µg/mL vs 5.13 µg/mL, p = 0.010), cord EPA (1.88 µg/mL vs 1.40 µg/mL, p = 0.011), cord DHA (37.96 µg/mL vs 32.80 µg/mL, p = 0.014), and total cord n-3 PUFAs (44.23 µg/mL vs 39.34 µg/mL, p = 0.024). Median cord EPA levels were significantly higher in those with private insurance compared to public (1.79 µg/mL, 1.18 µg/mL, p = 0.022). Additionally, median cord EPA levels were significantly higher in those > 150% the poverty line (1.79 µg/mL, 1.10 µg/mL, p = 0.030). Conclusions Our findings suggest that individuals with lower SES may be at risk for lower serum levels of n-3 PUFAs in pregnancy, which could increase their susceptibility to adverse birth and pregnancy outcomes. Future studies should focus on replicating these results in a larger, more heterogeneous sample and should consider analyzing additional markers of SES. Funding Sources UNMC Pediatrics Department; Child Health Research Institute.

Objectives Maternal obesity produces inflammation, which may result in adverse pregnancy outcomes such as preterm birth. Polyunsaturated fatty acids (PUFA), including omega-6 (n-6) and omega-3 (n-3) fatty acids, regulate inflammation and may mitigate the negative effects of inflammation. Previous studies report higher n-6 and lower n-3 PUFA concentration in early to mid-pregnancy for individuals with higher pre-pregnancy BMI (pBMI). However, the relationship between PUFA concentration at delivery and pBMI are not well understood. The purpose of this study is to determine the relationship between pBMI and maternal plasma, umbilical cord plasma, and placental PUFA concentrations, as well as PUFA intrauterine transfer percentage (IUTP). Methods Following IRB approval, maternal plasma, umbilical cord plasma, and placental samples were collected at delivery from 55 maternal-infant dyads. IUTPs for each PUFA (linoleic acid (LA), α-linolenic acid (ALA), arachidonic acid (AA), docosapentaenoic acid (DPA), docosahexaenoic acid (DHA), eicosapentaenoic acid (EPA)) were calculated as [cord blood]/[maternal blood] × 100. Spearman's correlations assessed relationships between PUFA levels, PUFA IUTP, and pBMI. Linear regression models were adjusted for smoking status. A p-value < 0.05 was considered statistically significant. Results The mean pBMI for our cohort was 28.7 kg/m2. Preceding pregnancy, 21% of mothers were normal or underweight, 36% overweight, and 43% obese. Maternal LA (R = −0.3, p = 0.03), maternal DHA (R = −0.27, p = 0.04), and placental EPA (R = −0.42, p = 0.02) were significantly correlated with maternal pBMI. After adjusting for smoking status, no correlations remained significant. PUFA cord levels and PUFA IUTP were not correlated to pBMI. Conclusions To our knowledge, this is the first study exploring relationships between pBMI and PUFA levels at delivery. Our findings contrast with previous research reporting correlations between PUFA levels and pBMI in early to mid-pregnancy. The effects of pBMI on PUFA status may be most prominent early in pregnancy. Future research should explore the relationship between pBMI and PUFA levels across all stages of pregnancy. Funding Sources UNMC Pediatrics Department; Child Health Research Institute.

Objectives Polyunsaturated fatty acids (PUFAs) are critical for appropriate development of the fetal brain and are known to reduce pregnancy complications like preeclampsia and preterm birth. Their benefits are thought to be mediated through bioactive metabolites; upon ingestion, PUFAs are converted to specialized pro-resolving mediators (SPMs). These SPMs resolve inflammatory processes by binding receptors, including the formyl-peptide receptor-2 (FPR2) in placental extra-villous trophoblasts tissue. The purpose of this study was to quantify FPR2 expression in placental tissue samples and correlate these levels with maternal-fetal outcomes and characteristics. Methods Placental tissue samples were collected from postpartum mothers (n = 27) and stained for FPR2. QuPath was used to quantify FPR2 expression and determine the percentages of low, medium, and high expression in each sample. A Kruskal-Wallis test was performed to compare FPR2 expression across race. Mann-Whitney U-tests compared FPR2 expression from vaginal vs cesarean deliveries, and with vs without chorioamnionitis. A p-value < 0.05 was considered statistically significant. Results There was a significant difference in distribution of % high FPR2 expression based on race and ethnicity. In post-hoc pairwise comparisons, Hispanic mothers had significantly higher % high FPR2 expression than White mothers (2.95%, 0.11%, p = 0.031) and African American mothers (2.95%, 0.10%, p = 0.049). Mothers who gave birth vaginally had a greater % high FPR2 expression, but this difference only approached significance (0.126%, 0.027%, p = 0.07). Mothers with chorioamnionitis also appeared to have a lower % medium FPR2 expression, but this difference did not reach statistical significance (7.16%, 13.62%, p = 0.076). Conclusions This study demonstrates the potential role FPR2 plays in perinatal outcomes. Greater % high FPR2 expression in Hispanic mothers suggests a genetic upregulation of FPR2 expression. The data also suggests FPR2 expression may be related to clinical outcomes such as delivery mode and chorioamnionitis; however, further investigation with a higher sample size is warranted. Funding Sources UNMC Pediatrics Department; Child Health Research Institute.

Objectives Previous studies show that pre-pregnancy BMI (pBMI) is an independent determinant for pregnancy outcomes, but less is known about what mediates this relationship. Carotenoids are dietary antioxidants that may be able to attenuate inflammation and oxidative stress generated by maternal obesity. The objective of this study is to determine whether carotenoid levels have the potential to modify the relationship between pBMI pregnancy outcomes in a cohort of mothers who delivered at a Midwestern academic medical center. Methods Following IRB approval, maternal and cord blood samples were collected in mother-infant pairs. Serum nutrient levels were measured using High Performance Liquid Chromatography. Maternal serum carotenoids (including lutein + zeaxanthin, beta-cryptoxanthin, total lycopene, alpha-carotene, total beta-carotene, and retinol) and pBMI data were available for 229 mothers. BMIs recorded up to 10 weeks into pregnancy were considered pBMI. Logistic regression models assessed relationships between pBMI and binary pregnancy outcomes (caesarian section (CS), preeclampsia, and gestational diabetes). Initial models were adjusted for infant gestational age (GA). Subsequent models adjusted for levels of pro-vitamin A (retinol) and non-provitamin A (lutein + zeaxanthin) carotenoids. A p-value of < 0.05 was considered statistically significant. Results Preceding pregnancy, 1.3% (n = 3), 40.2% (n = 92), 27.5% (n = 63), and 31.0% (n = 71) of the mothers were underweight, normal weight, overweight, and obese, respectively. In the models adjusted for GA, pBMI was associated with higher risk of CS (odds ratio [OR] 1.06, p = 0.01), preeclampsia (OR 1.07, p < 0.001) and gestational diabetes (OR 1.10, p = 0.007). In two separate models, one adjusting for retinol levels and one for non-provitamin A carotenoid levels, associations with preeclampsia were no longer significant. Associations with CS and gestational diabetes remained significant after adjustment. Conclusions In this population, there was evidence of maternal carotenoid levels modifying the relationship between pBMI and preeclampsia. Future studies should further explore the ability of carotenoids to influence pregnancy outcomes. Funding Sources UNMC Pediatrics Department; Child Health Research Institute.