Research progress of obesity and pregnancy complications

doi:10.3877/cma.j.issn.2095-9605.2024.03.002

Abstract

Abstract:

Obesity is associated with various metabolic diseases, including type 2 diabetes, hypertension, fatty liver, obstructive sleep apnea, and hyperuricemia. Compared with women of normal weight, women with obesity before pregnancy have a significantly increased risk of developing pregnancy complications such as gestational diabetes, cardiovascular diseases, depression, and stillbirth. This increased risk may be due to hormonal imbalances and changes in adipokines in women with obesity. Interventions such as behavioral changes, medication, and surgical treatments to reduce pre-pregnancy obesity can effectively lower the incidence of these complications. This article aims to elucidate the research progress on obesity and pregnancy complications and to explore treatment strategies for related complications.

Key words: Obesity, Pregnancy, Pregnant complications.

Jiyuan Liu, Xinxiu Zhou, Zhou Shang, Yuezhi Chen. Research progress of obesity and pregnancy complications[J]. Chinese Journal of Obesity and Metabolic Diseases(Electronic Edition), 2024, 10(03): 163-169.

/ / Recommend

Add to citation manager EndNote|Ris|BibTeX

URL: https://zhfpydxbdzzz.cma-cmc.com.cn/EN/10.3877/cma.j.issn.2095-9605.2024.03.002

https://zhfpydxbdzzz.cma-cmc.com.cn/EN/Y2024/V10/I03/163

Figures/Tables 1

References 58

[1]	Poston L, Caleyachetty R, Cnattingius S et al. Preconceptional and maternal obesity: epidemiology and health consequences [J]. Lancet Diabetes Endocrinol, 2016, 4(12): 1025-1036.
[2]	Wang Y, Zhao L, Gao L et al. Health policy and public health implications of obesity in China [J]. Lancet Diabetes Endocrinol, 2021, 9(7): 446-461.
[3]	Harper LM, Jauk V, Longo S, et al. Early gestational diabetes screening in obese women: a randomized controlled trial [J]. Am J Obstet Gynecol, 2020, 222(5): 495. e1-495. e8.
[4]	Wang Y, Wu P, Huang Y et al. BMI and lipidomic biomarkers with risk of gestational diabetes in pregnant women [J]. Obesity (Silver Spring), 2022, 30(10): 2044-2054.
[5]	Mokkala K, Vahlberg T, Houttu N, et al. Distinct metabolomic profile because of gestational diabetes and its treatment mode in women with overweight and obesity [J]. Obesity (Silver Spring), 2020, 28(9): 1637-1644.
[6]	Mokkala K, Vahlberg T, Pellonperä O, et al. Distinct metabolic profile in early pregnancy of overweight and obese women developing gestational diabetes [J]. J Nutr, 2020, 150(1): 31-37.
[7]	Kereliuk SM, Dolinsky VW. Recent experimental studies of maternal obesity, diabetes during pregnancy and the developmental origins of cardiovascular disease [J]. Int J Mol Sci, 2022, 23(8): 4467.
[8]	Saravanan P, Magee LA, Banerjee A, et al. Gestational diabetes: opportunities for improving maternal and child health [J]. Lancet Diabetes Endocrinol, 2020, 8(9): 793-800.
[9]	Wu P, Green M, Myers JE. Hypertensive disorders of pregnancy [J]. BMJ, 2023, 381: e071653.
[10]	Khan SS, Petito LC, Huang XN, et al. Body mass index, adverse pregnancy outcomes, and cardiovascular disease risk [J]. Circ Res, 2023, 133(9): 725-735.
[11]	Messerli FH. Cardiovascular effects of obesity and hypertension [J]. Lancet, 1982, 1(8282): 1165-1168.
[12]	Lopes Van Balen VA, Van Gansewinkel TAG, De Haas S, et al. Maternal kidney function during pregnancy: systematic review and meta‐analysis [J]. Ultrasound Obstet Gynecol, 2019, 54(3): 297-307.
[13]	Dustan HP. Obesity and hypertension [J]. Ann Intern Med, 1985, 103(6 ( Pt 2)): 1047-1049.
[14]	Gruber T, Pan C, Contreras RE, et al. Obesity-associated hyperleptinemia alters the gliovascular interface of the hypothalamus to promote hypertension [J]. Cell Metab, 2021, 33(6): 1155-1170.e10.
[15]	中华医学会妇产科学分会妊娠期高血压疾病学组. 妊娠期血压管理中国专家共识（2021） [J]. 中华妇产科杂志, 2021, 56(11): 737-745.
[16]	Hellgren M, Blombäck M. Studies on blood coagulation and fibrinolysis in pregnancy, during delivery and in the puerperium [J]. Gynecol Obstet Invest, 1981, 12(3): 141-154.
[17]	Macklon NS, Greer IA, Bowman AW. An ultrasound study of gestational and postural changes in the deep venous system of the leg in pregnancy [J]. Br J Obstet Gynaecol, 1997, 104(2): 191-197.
[18]	桂顺平, 漆洪波.《2019 SOGC妊娠期肥胖管理指南》解读 [J]. 实用妇产科杂志, 2020, 36(3): 5.
[19]	Samad F, Ruf W. Inflammation, obesity, and thrombosis [J]. Blood, 2013, 122(20): 3415-3422.
[20]	Florido R, Kwak L, Echouffo-Tcheugui JB, et al. Obesity, galectin-3, and incident heart failure: the ARIC study[J]. J Am Heart Assoc, 2022, 11(9): e023238.
[21]	Cantwell R, Clutton-Brock T, Cooper G et al. Saving mothers' lives: reviewing maternal deaths to make motherhood safer: 2006-2008. The Eighth report of the confidential enquiries into maternal deaths in the United Kingdom [J]. BJOG, 2011, 118(Suppl 1): 1-203.
[22]	Blacher J, Lailler G, Gabet A et al. Acute coronary syndrome during pregnancy and postpartum in France: the nationwide CONCEPTION study [J]. Am J Obstet Gynecol MFM, 2023, 5(1): 100781.
[23]	Choi KM. The impact of organokines on insulin resistance, inflammation, and atherosclerosis [J]. Endocrinol Metab (Seoul), 2016, 31(1): 1.
[24]	Reardon CA, Lingaraju A, Schoenfelt KQ, et al. Obesity and insulin resistance promote atherosclerosis through an IFNγ-regulated macrophage protein network [J]. Cell Rep, 2018, 23(10): 3021-3030.
[25]	James AH, Jamison MG, Biswas MS et al. Acute myocardial infarction in pregnancy: a United States population-based study [J]. Circulation, 2006, 113(12): 1564-1571.
[26]	Ismail S, Wong C, Rajan P, et al. ST-elevation acute myocardial infarction in pregnancy: 2016 update [J]. Clin Cardiol, 2017, 40(6): 399-406.
[27]	Sliwa K, Mebazaa A, Hilfiker-Kleiner D et al. Clinical characteristics of patients from the worldwide registry on peripartum cardiomyopathy (PPCM) [J]. Eur J Heart Fail, 2017, 19(9): 1131-1141.
[28]	Haque R, Keramat SA, Rahman SM et al. Association of maternal obesity with fetal and neonatal death: evidence from South and South-East Asian countries [J]. PLOS ONE, 2021, 16(9): e0256725.
[29]	Li MF, Ke JF, Ma L, et al. Maternal pre-pregnancy obesity combined with abnormal glucose metabolism further increases adverse pregnancy outcomes in chinese pregnant women [J]. Front Endocrinol (Lausanne), 2022, 12: 754406.
[30]	Desoye G, Herrera E. Adipose tissue development and lipid metabolism in the human fetus: the 2020 perspective focusing on maternal diabetes and obesity [J]. Prog Lipid Res, 2021, 81: 101082.
[31]	Best K, Tennant P, Bell R, et al. Impact of maternal body mass index on the antenatal detection of congenital anomalies [J]. BJOG, 2012, 119(12): 1503-1511.
[32]	Kumpulainen SM, Girchenko P, Lahti-Pulkkinen M, et al. Maternal early pregnancy obesity and depressive symptoms during and after pregnancy [J]. Psychol Med, 2018, 48(14): 2353-2363.
[33]	王娜, 陆虹. 孕前或孕早期肥胖与妊娠的相互影响 [J]. 中国生育健康杂志, 2018, 29(5): 487-490.
[34]	Chen J, Sun M, Huang C, et al. Pathways from neuroticism, social support, and sleep quality to antenatal depression during the third trimester of pregnancy [J]. Int J Environ Res Public Health, 2022, 19(9): 5602.
[35]	Shakeri M, Jafarirad S, Amani R et al. A longitudinal study on the relationship between mother’s personality trait and eating behaviors, food intake, maternal weight gain during pregnancy and neonatal birth weight [J]. Nutr J, 2020, 19(1): 67.
[36]	Hinkle SN. A longitudinal study of depression and gestational diabetes in pregnancy and the postpartum period [J]. Diabetologia, 2016,59(12): 2594-2602.
[37]	刘治祥. 肥胖继发阻塞性睡眠呼吸暂停低通气综合征的研究进展 [J].中国社区医师, 2023, 39(36): 10-12.
[38]	Han F. Development of sleep medicine in China [J]. Chin Med J (Engl), 2009, 122(12): 1462-1463.
[39]	Ghesquière L, Deruelle P, Ramdane Y, et al. Obstructive sleep apnea in obese pregnant women: a prospective study [J]. PLoS One, 15(9), e0238733.
[40]	Tan HS, Habib AS. Obesity in women: anaesthetic implications for peri‐operative and peripartum management [J]. Anaesthesia, 2021, 76(S4): 108-117.
[41]	Karataş M, Çam OH, Tekin M. Assessment of nasal airway patency during pregnancy and postpartum period: correlation between subjective and objective techniques [J]. Kulak Burun Bogaz Ihtis Derg, 2016, 26(2): 92-100.
[42]	刘永丽, 黄蓉. 妊娠期阻塞性睡眠呼吸暂停的研究进展 [J]. 中国医学科学院学报, 2022, 44(2): 299-304.
[43]	Izci-Balserak B, Zhu B, Gurubhagavatula I, et al. A screening algorithm for obstructive sleep apnea in pregnancy [J]. Ann Am Thorac Soc, 2019, 16(10): 1286-1294.
[44]	Kalkhoff SM. A randomized controlled trial of sleep study surveillance with targeted autoregulated positive airway pressure therapy for obstructive sleep apnea in pregnancy [J]. Am J Obstet Gynecol MFM, 2022, 4(3): 100571.
[45]	范建高, 杨荣. 全球非酒精性脂肪性肝病的流行趋势与疾病负担 [J]. 中华消化杂志, 2023, 43(04): 248-252.
[46]	Sarkar M, Grab J, Dodge JL, et al. Non-alcoholic fatty liver disease in pregnancy is associated with adverse maternal and perinatal outcomes [J]. J Hepatol, 2020, 73(3): 516-522.
[47]	姜煜资, 聂红明, 汪蓉. 非酒精性脂肪性肝病的发病机制 [J]. 临床肝胆病杂志, 2019, 35(11): 2588-2591.
[48]	Qian Y, Zhang Y, Fan X, et al. Nonalcoholic fatty liver disease and adverse pregnancy outcomes in women with normal prepregnant weight [J]. J Clin Endocrinol Metab, 2023, 108(2): 463-471.
[49]	段兴平, 王燕, 黄常友, 等. 妊娠期肝病的临床特征及研究进展 [J]. 临床肝胆病杂志, 2020, 36(6): 1407-1411.
[50]	Ekanem E, Ngene NC, Moodley J, et al. Prevention of surgical site infection and sepsis in pregnant obese women [J]. Best Pract Res Clin Obstet Gynaecol, 2023, 91: 102406.
[51]	Zhang LJ, Guerrero-Juarez CF, Hata T, et al. Innate immunity. Dermal adipocytes protect against invasive Staphylococcus aureus skin infection [J]. Science, 2015, 347(6217): 67-71.
[52]	Zhang LJ, Guerrero-Juarez CF, Chen SX, et al. Diet-induced obesity promotes infection by impairment of the innate antimicrobial defense function of dermal adipocyte progenitors [J]. Sci Transl Med, 2021, 13(577): eabb5280.
[53]	Orr K, Chien P. Sepsis in obese pregnant women [J]. Best Pract Res Clin Obstet Gynaecol, 2015, 29(3): 377-393.
[54]	Turunen R, Pulakka A, Metsälä J, et al. Maternal diabetes and overweight and congenital heart defects in offspring [J]. JAMA Netw Open, 2024, 7(1): e2350579.
[55]	Obesity in pregnancy: ACOG practice bulletin, number 230 [J]. Obstet Gynecol, 2021, 137(6): e128-e144.
[56]	Johansson K, Bodnar LM, Stephansson O, et al. Safety of low weight gain or weight loss in pregnancies with class 1, 2, and 3 obesity: a population-based cohort study [J]. Lancet, 2024, 403(10435): 1472-1481.
[57]	Ogunwole SM, Zera CA, Stanford FC. Obesity management in women of reproductive age [J]. JAMA, 2021, 325(5): 433-434.
[58]	Marsh CA, Hecker E. Maternal obesity and adverse reproductive outcomes: reducing the risk [J]. Obstet Gynecol Surv, 2014, 69(10): 622-628.

Please choose a citation manager

Content to export