Poster session II Diabetes, labor, medical-surgical-disease, obstetric quality & safety, prematurity, ultrasound-imaging: Abstracts 237 – 386| Volume 206, ISSUE 1, SUPPLEMENT , S148-S149, January 01, 2012

312: Differential mRNA expression in myometrial tissue of obese gravidas


      This study investigates differential expression of genes in myometrial tissue of obese women undergoing cesarean section. Obese women have an increased risk of dysfunctional labor, with higher rates of induction, failed induction, and cesarean section. Understanding the differences in gene expression patterns may provide a foundation by which to understand the mechanisms of dysfunctional labor in obese women.

      Study Design

      We recruited women presenting for term cesarean delivery. They were divided into four groups: Group 1, primary cesarean, BMI 25-34.9 (n=2); Group 2, primary cesarean, BMI 35-44.9 (n=3); Group 3 primary cesarean, BMI ≥ 45 (n=3); Group 4, repeat cesarean, BMI ≥ 45 (n=4). At delivery, a full thickness myometrial biopsy was acquired. For each group, the pooled mRNA was analyzed with an Affymetrix GeneChip Human Gene 1.0 ST Array (Affymetrix, Santa Clara, CA). Trends were evaluated across the strata of BMI in a pair wise fashion; ie, Group 1 to 2, 1 to 3, etc. Target gene products were identified by magnitude of fold-change across groups as well as analysis for trend on the following scales: linear, logarithmic, squared, square root. Gene products of interest were identified by a P-value < 0.001 being deemed statistically significant.


      We identified 33 candidate genes that were found to be significantly different between patient groups. These genes are primarily involved in muscle contraction, cell proliferation, cell cycle control, transcription/translation, immunity, intracellular maintenance, and extracellular communication. TMEM127 (trans-membrane protein involved in protein transport and inhibition of cell proliferation) was significantly down regulated with increasing obesity. Other genes (PAK7, LTK, EIF5A, GLUL) involved in initiation of cell proliferation were significantly up regulated.


      These results suggest obesity is associated with differential expression of genes within the myometrial tissue of obese women. Further exploration of these genes may provide insight into the dysfunctional labor patterns of overweight and obese women.
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