49th Annual Meeting
September 7 - 9, 2018
Hilton Inverness Hotel and Conference Center
|3:00 pm - 6:00 pm||CHECK-IN and REGISTRATION|
|6:00 pm||Welcome Reception|
|7:00 pm||Welcome by PRS President Jeff Reese MD and dinner|
|8:00 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 theories 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||Questions and Answers|
|6:45am - 7:45 am||BREAKFAST|
|8:00 am - 8:45am||Vanderbilt Lecturer
Sylvain Chemtob MD PhD FRCPC FAAP FCAHS FARVO
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 tissues and correlates with the severity of perinatal complications. At present PTB is treated with tocolytics as though t 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 receptors antagonists are generally ineffective and considerably immunosuppressive. We will present novel IL-1-targeting agents effective in relevant-clinical models of PTB - which also preserve fetal/newborn tissue integrity.
Moderator: Beth Plunkett MD MPh
|8:45am - 9:00am||Questions and Answers|
|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 persists 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 obesity.
Moderator: Lisa Joss-Moore PhD
|9:20am - 9:30am||Questions and Answers|
|9:30am - 9:50am||Mead Johnson Nutrition Early Career Speaker
Heather Brockway PhD
Title: A role for placental maturity in idiopathic spontaneous preterm birth
Idiopathic spontaneous preterm birth (isPTB) birth before 37 weeks gestation is a global public health concern and the leading cause of death for children under 5 years of age. While risk factors include: smoking- stress-infection-and family history- there is a lack of understanding regarding the underlying molecular mechanisms involved in isPTB. Previous histological studies have implicated advanced placental villous maturation (AVM) in isPTB. Utilizing placental morphology and transcriptomics we demonstrate a role for the placenta in isPTB and that aberrant placental aging is likely a key factor in isPTB pathogenesis. We identified candidate genes associated placental maturation gestational age and isPTB pathology. By combining comprehensive transcriptomic profiling and morphological assessment this study will provide a valuable resource for understanding the underlying pathophysiology of isPTB placentas.
Moderator: Lisa Joss-Moore PhD
|9:50am - 10:00am||Questions and Answers|
|10:00 am - 10:30am||BREAK|
|10:30 am - 11:15am|| Abbott Nutrition Lecturer
David Keefe MD
Title: 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 (PGD). 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.
Jeff Reese MD
|11:15am - 11:30am||Questions and Answers|
|11:30 am- 11:50am||Abbott Nutrition Early Career Speaker
Brigid Gregg MD Title: 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
|11:50am - 12:00 noon||Questions and Answers|
|12:00- 12:20pm||Abbott Nutrition Early Career Speaker
Teresa Sparks MD
Title: Non-immune hydrops fetalis: Toward a precision-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|
|12:30 pm 2:30pm||LUNCH and free time|
|2:30 pm- 3:30pm||BUSINESS MEETING|
|3:30pm - 4:15pm||Liley Award Winner
Jane Harding ONZM MBCHB DPhil FRCPC FRSNZ
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 currently 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|
|4:30pm - 4:50 pm||PSANZ-PRS MONT LIGGINS EARLY CAREER SPEAKER
Aidan 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 an 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 CDH and their parents can breathe a little easier.
Moderator: Tony Gregg MD
|4:50 pm - 5:00 pm||Questions and Answers|
|5:00pm - 7:00pm||Salsa making and beer tasting|
|7:00 pm - 8:00pm||Dinner - Awards|
|7:45 pm||Dinner and Trainee Awards|
|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 affective 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 indicates that earlier treatment offers the best prospect for a robust response and that pre-sympotomatic treatments appear 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|
|6:45 am - 7:45am||BREAKFAST|
|8:00 am - 8:45am||NICHD LECTURER
Stephen Kingsmore MD DSC
Title: Perinatal Genomic Medicine. Genetic diseases re 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 ha consequent chage 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|
|9:00am - 9:45am||MEMBER LECTURER
Thomas Jansson MD PhD
Title: The placenta and life-long health: How understanding the placenta can help us Building Better Babies Impaired placental development and/or changes in placental function cause important pregnancy complications and programs the infant for disease later in life. Thus a better understanding of how the placenta functions in normal and complicated pregnancies will pave the way for the development of specific intervention strategies to improve pregnancy outcome and curb the epidemic of metabolic cardiovascular and neurodevelopmental disease in the next generation. New research suggests that placental mechanisms underpin the fetal programming in maternal obesity and emerging evidence indicate that the placenta holds the key to improve the outcomes of premature infants for early identification of IUGR and better understanding the pathophysiology of gestational diabetes.
Moderator: James Wynn MD
|9:45am - 10:00am||Questions and Answers|
|10:00am - 10:15am||Break|
|10:15am - 11:00am||MEMBER LECTURER
Jennifer Sucre PhD
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 MDr
|11:00am - 11:15am||Questions and Answers|
|11:15am - 12:00 pm||MEMBER LECTURER
James Wynn MD
Title: Modifiable Determinants of Neurodevelopmental Impact in Neonatal Sepsis: Neonatal sepsis survivors suffer significant neurodevelopmental impairment (NDI) including cerebral palsy cognitive deficits and attention-deficit disorder (ADD) that extends into the second decade of life. The overlap (anatomic and developmental) in the survivor findings in humans and our murine mechanistic modeling may provide a platform from which to discover and test desperately needed translational strategies.
Moderator: Sonnet Jonker BS PhD
|12:00pm - 12:15pm||Questions and Answers|
|12:15pm||CLOSING REMARKS - Adjournment - Lunch|