Authors:
Irina Savelyeva,Olga Shirokova,Elena Bukharova,Elena Galyanskaya, Irina Polyanskaya,Elena Krasnikova, NataliyaNosova,DOI NO:
https://doi.org/10.26782/jmcms.spl.10/2020.06.00012Keywords:
Obesity, placental growth factor, placental insufficiency, lipid metabolism,Abstract
Researchers interest to the problem of extra genital diseases in mothers has increased during the past years. Obesity rate worldwide achieved the level of one of the most significant problems in XXI century. The Purpose of the Study: Evaluation of placental insufficiency syndrome risk development in pregnant women with obesity. Materials and Methods: Prospective controlled study enrolled 494 patients. The 1st group included 262 patients with obesity (mean body weight index 33.1 (31.4; 35.9) kg/m2), aged 30 (27; 34) years old. The 2nd group (control) included 232 patients with normal body weight (mean body weight index 22.6 (21.0; 23.8) kg/m2) aged (25; 31.5) years old. The authors evaluated anthropometric data, conducted coagulotests, assessed lipid and carbohydrate metabolism, performed fetometry and Dopplerometry. All the patients had their level of human placenta growth factor identified (PlGF, pg/ml) in blood serum. Morphological study of secundines was conducted. Results. It was defined that pregnant women with obesity had low level of P1GF in comparison with the women in the control group (р<0.01). Critical level of PlGF in prognosis of placental insufficiency development is considered to be lower than 100 pg/ml. Morphological study of secundines from delivered women with obesity showed significantly higher rate of placenta maturation disorders at low level of P1GF. Conclusion: In pregnant women with obesity the level of P1GF on the 8-9th week of gestation was lower in comparison with the control group. The level of PlGF lower than 100 pg/ml at obesity in mother is considered as a marker of placental insufficiency development risk, which is confirmed by the morphological study of secundines.Refference:
I. Aviram A., Guy L., Ashwal E., Hiersch L., Yogev Y., Hadar E. Pregnancy outcome in pregnancies complicated with gestational diabetes mellitus and late preterm birth. Diabetes Res ClinPract. 2016; 113: 198-203
II. Banoo E, Sharifi F, Badamchizadeh Z, Hossein-Nezhad A, Larijani B, Mirarefin M, Fakhrzadeh H. Association of metabolic syndrome with inflammatory mediators in women with previous gestational diabetes mellitus. J Diabetes MetabDisord. 2013; 12: 8.
III. Bhorat I.E., BagrateeJ.S.,Pillay M., Reddy T. Use of the myocardial performance index as a prognostic indicator of adverse fetal outcome in poorly controlled gestational diabetic pregnancies. Prenataldiagnosis. 2014; 34: 13: 1301-1306.
IV. Black M.N., Sacks D.A., Xiang A.H., Lawrence J.M. The relative contribution of prepregnancy overweight and obesity, gestational weight gain and IADPSG-defined gestational diabetes mellitus to fetal overgrowth. DiabetesCare. 2013; 36(1); 56-62.
V. Cnattingius S.L., Villamor E., Johansson S., EdstedtBonamyA.K., Persson M., Wikstrom AK., Granath F. Maternal obesity and risk of preterm delivery. JAMA. 2013; 309: 2362-2370.
VI. CrujeirasA.B., CasanuevaF.F. Obesity and the reproductive system disorders: epigenetics as a potential bridge. Hum. Reporod. Update. 2014; 34(5): 123-36.
VII. Department of Reproductive Health, World Health Organization. Medical eligibility for contraceptive use. 5th ed. Geneva: WorldHealthOrganization; 2015. PMID: 26447268.
VIII. Fenton T.R., Kim J.H. A systematic review and meta-analysis to revise the Fenton growth chart for preterm infants. BMCpediatrics. 2013; 13: 59.
IX. Hayes JF, Bhaskaran K, Batterham R, Smeeth L, Douglas I. The effect of sibutramine prescribing in routine clinical practice on cardiovascular outcomes Int J Obes. JournalofObesity (2005). 2015; 39(9): 1359-1364. doi:10.1038/ijo.2015.86.
X. Horvath B. Metabolic syndrome in normal and complicated pregnancies. Metab. Syndr. Relat. Disord. 2013: 11(3): 185–8
XI. JungheimES, TraviesoJL, Carson KR, MoleyKH. Obesity and Reproductive Function. Obstetrics and Gynecology Clinics of North America. 2012;39(4):479–493. doi: 10.1016/j.ogc.2012.09.002
XII. LegroR.S.,Arslanian S.A., Ehrmann D.A., HoegerK.M., Murad M.H., Pasquali R et al. Diagnosis and treatment of polycystic ovary syndrome: an Endocrine Society clinical practice guideline. J. Clin. Endocrinol. Metab. 2013; 98(12): 4565-92.
XIII. Li N., Liu E., Guo J., Pan L., Li B., Wang P. et al. Maternal prepregnancy body mass index and gestational weight gain on pregnancy outcomes. PLOSOne. 2013; 8(12): e82310.
XIV. Lui L., Oza S., Hogan D., Perin J., Rudan I., Lawn J.E., Cousens S., Mathers C., Black R.E. Global, Regional, and National Causes of Child Mortality in 2000-2013, with Projections to Inform Post-2015 Priorities: An Updated Systematic Analysis. TheLancet. 2015; 385:9966:430-440
XV. Lumeng CN, Saltiel AR. Inflammatory links between obesity and metabolic disease. J ClinInvest. 2011; 121(6): 2111–2117.
XVI. Macdonald-Wallis C., Tilling K, Fraser A., Nelson S.M., Lawlor D.A. Associations of blood pressure change in pregnancy with fetal growth and gestational age at delivery findings from a prospective cohort. Hypertension. 2014; 64: 1: 36-44.
XVII. Meenakshi, Srivastava R, Sharma NR, KushwahaKP, Aditya V. Obstetric Behavior and Pregnancy Outcome in Overweight and Obese Women. TheJournalofObstetricsandGynecologyofIndia. 2012; 62(3): 276-280.
XVIII. Niu JM, Lei Q, LüLJ, Wen JY, Lin XH, DuanDM, Chen X, Zhou YH, Mai CY, Liu GC, Hou MM, Zhao LN, Yi J. Evaluation of the diagnostic criteria of gestational metabolic syndrome and analysis of the risk factors. ZhonghuaFuChanKeZaZhi. 2013 Feb; 48(2): 92-7.
XIX. Park S., Kim M.N., Kim S.N. Early gestational weight gains within current recommendations result in increased risk of gestational diabetes mellitus among Korean women. DiabetesMetab. Res. Rev. 2014; 30(8): 716-25.
XX. Radulescu L., Munteanu O., Popa F., Cirstoiu M. The implications and consequences of maternal obesity on fetal intrauterine growth restriction. J MedLife. 2013; 6: 3: 292-298.
XXI. Scott-Pillai R., Spence D., Cardwell C., Hunter A., Holmes V. The impact of body mass index on maternal and neonatal outcomes: a retrospective study in a UK obstetric population, 2004-2011. BJOG. 2013; 120: 8: 932-939.
XXII. Sommer C., Morkrid K., JenumA.K., Sletner L., Mosdol A., BirkelandK.L. Weight gain, total fat gain and regional fat gain during pregnancy and the association with gestational diabetes: a population-based cohort study. Int. J. Obes. 2014; 38(1): 76-81.
XXIII. Spradley F.T., PaleiA.C., Granger J.P. Increased risk for the development of preeclampsia in obese pregnancies: weighing in on the mechanisms. Am. J. Physiol. Regul. Integr. Comp. Physiol. 2015: 309(11): R 1326-43
XXIV. Stekkinger E, Scholten R, van der Vlugt MJ, van Dijk AP, Janssen MC, Spaanderman ME. Metabolic syndrome and the risk for recurrent pre-eclampsia: a retrospective cohort study. BJOG. 2013 Jul; 120(8): 979-86.
XXV. Tutino G.E., Tam W.H., Yang X., Chan J.C.N., Lao T.T.H. and Ma R.C.W. Diabetes and pregnancy: perspectives from Asia. DiabeticMedicine. 2014; 31: 3: 302-318.
XXVI. Wang D., Hong Y., Zhu L. et al. Risk factor and outcomes of macrosomia in China: A multicentric survey based on birth data // J. Matern. Fetal. Naonatal. Med. 2016: 1-5.
View | Download