Pregnancy Specific Adaptations in Leptin and Melanocortin Neuropeptides in Early Human Gestation

Introduction Pregnancy is characterized by increased appetitive drive beginning early in gestation, yet the central mechanisms underlying this adaptation are poorly understood in humans. To elucidate central mechanisms underlying appetite regulation in early pregnancy, we examine plasma and CSF leptin and AgRP as well as CSF POMC as surrogates for brain melanocortin activity. Methods Plasma leptin, Ob-Re, AgRP, and CSF leptin, POMC, and AgRP were collected from pregnant women prior to cerclage placement (16.6±1.1wks; N=24), scheduled cesarean section (39.2±0.2wks; N=24), and from non-pregnant controls (N=24), matched for age and BMI. Results Plasma leptin was 1.5 times higher in pregnancy vs. controls (P=0.01), but CSF leptin did not differ. CSF/plasma leptin percentage was lower in early pregnancy vs. controls (0.8±0.1 vs. 1.7±0.2; P<0.0001) and remained unchanged at term (0.9 ±0.1), supporting a decrease in leptin transport into CSF in pregnancy. Plasma AgRP, a peripheral biomarker of the orexigenic hypothalamic neuropeptide, was higher in early pregnancy vs. controls (95.0±7.8 vs. 67.5±5.3; P = 0.005). In early gestation, CSF AgRP did not differ from controls, but CSF POMC was 25% lower (P=0.006). In contrast, at term, CSF AgRP was 42% higher vs. controls (P=0.0001), but CSF POMC no longer differed. Overall, the CSF AgRP/POMC ratio was 1.5-fold higher in early pregnancy vs. controls, reflecting a decrease in melanocortin tone favoring appetitive drive. Conclusions Pregnancy-specific adaptions in the central regulation of energy balance occur early in human gestation and are consistent with decreased leptin transport into brain and resistance to the effects of leptin on target melanocortin neuropeptides.

The Experimental Conception Hospital: Dating Pregnancy and the Gothic Imagination

The Experimental Conception Hospital is a fictional laboratory described in a note by Robert Lyall on the medical evidence given in the Gardner Peerage dispute (1825–26). This fantasy institution would discover the natural length of human gestation and ascertain from when and what to date conception, calculations which eluded the House of Lords Peerage Committee which heard the case. This article introduces the Gardner case and Lyall’s writing about it, focusing on the Gothicism which emerges particularly in relation to the perceived secrecy of the female reproductive body. By considering Lyall’s Experimental Conception Hospital alongside three other technologies—the Panopticon, the hot air balloon and anatomical drawings of the gravid uterus—this article discovers the anachronistic persistence of supposedly out-dated modes of thoughts around female sexuality and reproductive biology in an apparently hyper-modern moment.

Meir ben Simeon ha-Meʿili on Protracted Pregnancy

Since antiquity, many people have believed that the length of human gestation is variable, ranging from seven months to ten or even twelve months. The significance of this belief is not confined to the medical sphere, since it has important legal ramifications. If pregnancy could last for an extended period, a mother could claim that her offspring was legitimately conceived from her husband even if she had not had physical contact with her husband for more than nine months prior to the birth. After surveying the history of the belief in prolonged pregnancy in ancient Greek and Talmudic literature, this article presents a new rabbinic discussion of the topic from medieval Languedoc, a hitherto unknown passage from Rabbi Meir ben Simeon ha-Meʿili’s work Sefer ha-Meʾorot.