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Programming of Hypertonicity in Neonatal Lambs: Resetting of the Threshold for Vasopressin Secretion

Perinatal Research Laboratories, Department of Obstetrics and Gynecology, David Geffen School of Medicine at University of California Los Angeles, Harbor/UCLA Medical Center, Torrance, California 90502

Address all correspondence and requests for reprints to: Mina Desai, Ph.D., Harbor/UCLA Medical Center, 1124 West Carson Street, RB-1 Building, Torrance, California 90502. E-mail: mdesai{at}obgyn.humc.edu.

Lambs exposed in utero to maternal hypertonicity demonstrate plasma hypertonicity and arterial hypertension. To determine whether hypertonicity is due to an altered osmoregulatory set point, we examined arginine-vasopressin and cardiovascular responses to hypertonic saline infusion in these offspring. Study lambs [dehydrated (Dehy)] were exposed to maternal hypernatremia (8–10 mEq/liter increase; 110–150 d gestation) induced by water restriction. Control singleton and Control twins were born to ewes provided ad libitum water. We anticipated reduced birth weight due to maternal dehydration-induced anorexia and therefore included a Control group of twin gestations to approach a similar birth weight near term. After delivery, ewes from all three groups were provided ad libitum water, and their newborns were allowed ad libitum nursing. At 15 ± 2 d of age, lambs were prepared with bladder and vascular catheters. At 23 ± 2 d, after a 2-h basal period, neonatal lambs were iv infused with hypertonic 0.83 M NaCl (0.075 ml/kg·h) for 2 h, followed by a 2-h recovery. Neonatal mean arterial pressure and urine flow were continuously monitored, and blood samples were obtained before, during, and after infusion. During the basal period, Dehy neonates and Control twins demonstrated significantly increased plasma sodium levels and mean arterial pressure than Control singletons. In addition, the Dehy neonates had significantly increased plasma osmolality compared with Control singletons and twins. In response to hypertonic infusion, the Dehy offspring continued to exhibit hypertonicity and hypertension. Importantly, plasma tonicity and blood pressure were greatest in Dehy singletons, lowest in singleton controls, and intermediate in twin controls. Furthermore, the plasma osmolality threshold for AVP secretion was significantly higher in Dehy singletons (290 ± 2 mOsm/kg) than Control twins (285 ± 1 mOsm/kg) and Control singletons (280 ± 2 mOsm/kg), indicating in utero programming of an altered set point for systemic osmolality and blood pressure regulation. Because both twin gestation and dehydration-anorexia incur potential fetal nutritional stress, the results suggest that both in utero hypertonicity and nutrition reduction contribute to offspring programming. We postulate that the nutritional stress associated with twins (as well as dehydration-induced anorexia) contributes to increased plasma sodium levels, whereas the increased plasma osmolality is due to in utero hypertonicity.

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