2018 Annual Meeting Program

49th Annual Meeting

September 7 - 9, 2018
Hilton Inverness Hotel and Conference Center

note: The program is confirmed 30 days prior to the event.

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Friday, September 7
Time Event Location
3:00 pm - 6:00 pm CHECK-IN and REGISTRATION Location
6:00 pm Welcome Reception Location
7:00 pm Welcome by PRS President Jeff Reese MD and dinner Location
8:00pm-8:45  pm Mead Johnson Nutrition Lecturer
Jeff Alberts PhD
Title: Gravid without Gravity: Spaceflight Experiments Yield Insights into Perinatal Development.  All of life on Earth evolved in the presence of gravity.  There has long been speculation about the roles of gravitational forces in reproductive and developmental processes.  Over several decades the micro-gravity environment of spaceflight has been used to probe into some of these speculations.  Numerous studies have been conducted on unmanned Russian satellites on NASA's Space Shuttle and on the International Space Station.  Previously unknown influences of gravity on mammalian reproduction and development have been revealed.
Moderator: Jeff Reese MD
8:45pm - 9:00pm Questions and Answers Location
Saturday, September 8
Time Event Location
6:45am - 7:45 am BREAKFAST Location
8:00 am - 8:45am Vanderbilt Lecturer
Sylvain Chemtob MD PhD FRCPC
Title: Discovery of new IL-1 Receptor - Modulator - prevention of preterm labor and preservation of fetal integrity
Preterm birth (PTB) is a leading cause of neonatal mortality and morbidity worldwide - and surviving infants are at increased risks of lifelong complications.  PTB has been firmly linked to inflammation regardless of infection - specific aetiology or time of birth. Deleterious inflammation is observed in maternal and fetal tissue and correlates with the severity of perinatal complications. At present PTB is treated with tocolytics as though it is exclusively a myometrial contractile disorder.  These agents do not address underlying inflammatory processes and are thus vastly ineffective at improving neonatal outcomes.  Of all inflammatory mediators - IL-1 is central to the pathophysiology of PTB and most adverse neonatal outcomes.  Yet current IL-1 receptor antagonists are generally ineffective and considerably immunosuppressive.  We will present novel IL-1-targeting agents effective in relevant pre-clinical models of PTB - which also preserve fetal/newborn tissue integrity.-Moderator: Beth Plunkett MD MPh
8:45am - 9:00am Questions and Answers Location
9:00am - 9:20am Mead Johnson Nutrition Early Career Speaker
Andrea Edlow MD
Title: Maternal Obesity and Fetal Inflammation: Brain-Placenta Crosstalk and Consequences Across the Lifespan  Large epidemiologic studies have demonstrated associations between pre-pregnancy obesity and adverse neurodevelopmental outcomes in children - but underlying mechanisms remain unclear.  Microglia - innate immune cells of the brain- originate in the fetal yolk sac and colonize the developing central nervous system - forming a pool of resident brain macrophages that persist into adulthood.  Microglia therefore have an early connection to the developing placenta - and are potentially vulnerable to exposures in pregnancy - with enduring effects on brain development and function.  Data from our mouse model of maternal diet-induced obesity demonstrate correlations between microglial activation in the fetal hippocampus and adult deficits in memory and social behavior.  Placental immune cells may provide insight into the activation and function of microglia in obese pregnancy.  
Moderator: Lisa Joss-Moore PhD
9:20am - 9:30am Questions and Answers Location
9:30am - 9:50am Mead Johnson Nutrition Early Career Speaker
Heather Brockway PhD
A role for placental maturity in idiopathic spontaneous preterm birth      
Moderator: Lisa Joss-Moore PhD
9:50am - 10:00am Questions and Answers Location
10:00am - 10:30am BREAK Location
10:30 am - 11:15am Abbott Nutrition Lecturer  David Keefe MD
Preimplantation Genetic Testing - Past- Present and Future transmission of Mendelian diseases can be prevented by testing embryos before transfer - a process called preimplantation genetic diagnosis
Preimplantation embryos also harbor a high level of genomic instability  - including numeric chromosome abnormalities copy number variants and insertions/deletions.  Preimplantation genetic testing for aneuploidy (PGT-A or PGS) enhances implantation and decreases miscarriage rates in some patients.  Still 40% of euploid embryos fail to implant.  We are investigating possible contributions of other forms of genomic instability to developmental failure during early human development.                                                                                                        Moderator: Jeff Reese MD
11:30 am- 11:50am Abbott Nutrition Early Career Speaker Brigid Gregg MD
Lactational programming of offspring insulin resistance and adiposity by lactational high fat diet exposure.                                                                                                                                                  
The focus of my current research is to understand the plasticity of neonatal organs responsible for glucose homeostasis in response to lactational interventions. This set of experiments looks at a mouse model of high fat diet confined to the lactation window. We have found that offspring have an increase in body fat percentage- fat pad weight and are insulin resistant by insulin tolerance testing and HOMA-IR index.   Moderator:Lisa Joss-Moore PhD
11:50am - 12:00 noon Questions and Answers Location
12:00- 12:20pm Abbott Nutrition Early Career Speaker
Teresa Sparks MD
Title: Non-immune hydrops fetailis: Toward a preceision-based approach
Brief topic overview:   Non-immune hydrops fetalis (NIHF) comprises the vast majority of hydrops cases- but the underlying cause remains unclear in up to 55% following the recommended prenatal evaluation. Understanding the etiology is imperative to effectively manage these pregnancies- anticipate neonatal care requirements- and counsel about recurrence risk. We are launching a novel- multi-center collaboration through the University of California Fetal-Maternal Consortium (UCfC) to create a NIHF registry- apply whole exome sequencing (WES) to discover the underlying genetic causes and develop a precision-based approach to care. This will significantly improve our ability to care for women with pregnancies complicated by NIHF- and importantly- facilitate both a targeted approach to care and development of innovative in utero treatments such as stem cell transplantation and enzyme replacement therapy to optimize fetal and neonatal outcomes.  Moderator:Lisa Joss-Moore PhD
12:20pm - 12:30pm Questions and Answers Location
12:30 pm 2:30pm LUNCH and free time Location
2:30 pm- 3:30pm BUSINESS MEETING Location
3:30pm - 4:15pm Liley Award Winner
Jane Harding DPhil FRCPC 
Title:Glucose levels in babies: Too high - too low - too variable - and does it matter?  In older children and adults-  the risks of hyper- and hypoglycaemia and their treatment are reasonably well understood.  In the newborn - all of these problems are much more common - but there is little evidence to support any of the current widely varying treatment approaches.  Recent research is beginning to reveal the long-term sequellae of early dysglycaemia - but there remains much uncertainty about causal relationships and appropriate management.
Moderator: Paul Rozance MD
4:15pm - 4:30pm Questions and Answers
Adian James Kashyap 
Title: A bundle of care for congenital diaphragmatic hernia - bigger lungs - better vessels - and a smoother transition
Despite standardized neonatal management - babies born with congenital diaphragmatic hernia (CDH) continue to face significant mortality and morbidity - particularly when respiratory insufficiency is complicated by severe pulmonary hypertension.  Current approaches to antenatal management involve tracheal occlusion- which increases lung size but does not completely prevent pulmonary hypertension.  We are investigating novel antenatal therapies that may improve pulmonary vascular development - and changes to the timing of umbilical cord clamping that may prevent reactive vasoconstriction during the transition to neonatal life.  We aim to combine these approaches into a bundle of care that ensures all babies diagnosed with CHD- and their parents - can breathe a little easier.
Moderator:Tony Gregg MD
4:50 pm - 5:00 pm Questions and Answers location
5:00pm - 7:00pm Salsa making and beer tasting Location
7:00 pm - 8:00pm Dinner - Awards Location
7:45 pm Dinner and Trainee Awards Location
8:00pm- 8:45pm March of Dimes Lecturer
Richard Finkel MD 
Title: Genetic modulation strategies for Spinal Muscular Atrophy - current and future treatments
Spinal muscular atrophy (SMA) - a progressive degenerative disease affecting motor reunions - is the most common fatal genetic disorder of infancy.  Treatment strategies to modulate gene expression have demonstrated remarkable clinical responses in infants and children with SMA.  Data from several clinical trials uniformly indicate that earlier treatment offers the best prospect for a robust response and that pre-symptomatic treatment appears optimal.  These observations support the effort to add SMA to the newborn screening panel.  If widely endorsed - newborn screening and pre-sympotomatic treatment may virtually extinguish SMA type 1.  Moderator: Jeff Reese MD
8:45pm -  9:00pm Questions and Answers Location
Sunday, September 9
Time Event Location
6:45 am - 7:45am BREAKFAST Location
8:00 am - 8:45am NICHD LECTURER
Stephen Kingsmore MD DSC
Title: Perinatal Genomic Medicine.  Genetic diseases are the leading cause of death in infants - NICUs - PICUs and CVICUs.  Rapid whole genome sequencing (rWGS) can improve outcomes of infants in intensive care units by informing targeted treatments of genetic diseases.  The turnaround time of rWGs - from blood spot to provisional diagnosis - can be less than 20 hours.  Approximately 1/3 of symptomatic infants undergoing rWGs receive a diagnosis.  About 2/3 of infants diagnosed by rWGS have a consequent change in management - and about 1/3 have decreased mortality or morbidity.  It will be interesting to determine the impact of rWGS on perinatology
Moderator: Louise Laurent MD PhD
8:45am - 9:00am Questions and Answers Location
9:00am - 9:45am Member Lecturer
David Aronoff MD FIDSA FAAM
Title: Paracrine Communication in Bacterial Chorioamnionitis
 Infection of the fetal membranes is a major cause of chorioamnionitis and its complications.  Despite this there are significant gaps in our understanding of how these membranes function to protect the developing fetus from infection and why they sometimes fail.  To better define the pathogenesis of bacterial chorioamnionitis we are deconstructing fetal membranes into component cell types (both immune and non-immune) and modeling for autocrine and paracrine responses to microbial threat agents using new systems such as organ-on-chip technologies. Moderator: James Wynn MD
9:45am - 10:00am Questions and Answers Location
10:00am - 10:15am Break Location
10:15am - 11:00am MEMBER LECTURER
Jennifer Sucre MD
Title: Bioengineering Human Lung Development and Disease
While there are excellent mammalian models of lung development and lung disease- there are species-specific differences in the development of the human lung - creating significant knowledge gaps in our understanding of chronic lung disease after preterm birth.  This talk will describe how we have developed a reductionist 3D human model of bronchopulmonary dysplasia and are using this model to gain insights in the molecular pathophysiology of BPD - with a goal of identifying new potential therapeutic targets.
Moderator: Trent Tipple MD
11:00am - 11:15am Questions and Answers Location
11:15am - 12:00 pm MEMBER LECTURER
Emily Su MD MS
Title: Fetoplacental Vessels ARNT Small Business.
Abnormal umbilical artery Doppler velocimetry in growth-restricted fetuses is an ominous finding that substantially increases risk for adverse perinatal and long-term outcomes.  Placentas from these pregnancies of demonstrate impaired fetoplacental angiogenesis.  In a model of an fetopental endothelial cells we have found that aryl hydrocarbon receptor nuclear traslocator (ARNT also known as HIF1-bet) is a major mediator of fetoplacental angiogenesis and its decreased expression in severe fetal growth restriction may impair proper development of placental vasculature.
Moderator: Sonnet Jonker BS PhD
12:00pm - 12:15pm Questions and Answers Location
12:15pm CLOSING REMARKS - Adjournment - Lunch Location