The progressive increase in overweight worldwide has led to obesity being regarded as one of the most serious public health problems of the 21st century. Obesity during pregnancy deserves special attention.
According to the World Health Organization (WHO), the prevalence of obesity among women of reproductive age and, accordingly, pregnant women ranges from 1.8 to 25.3% in different countries.
What is dangerous and why weight gain occurs during pregnancy, read the article on estet-portal.com.
- Risks of weight gain during pregnancy
- Weight gain during pregnancy and adipose tissue hormones
- Fetal adipose tissue and its role in lipid metabolism during pregnancysti
Risks of weight gain during pregnancy
Overweight women have an increased risk of developing:
- preeclampsia;
- eclampsia;
- gestational diabetes mellitus (GDM);
- fetal macrosomia;
- caesarean section.
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Offspring of overweight women have been shown to be more likely to develop obesity in childhood and metabolic syndrome in adulthood.
During pregnancy, endocrine and metabolic changes occur in the mother's body, leading to an increase in body weight, adipose tissue and insulin resistance.
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These changes reflect not a pathological condition, but a physiological adaptation necessary to meet the energy needs of the fetus, as well as to prepare the mother's body for breastfeeding. In this regard, special attention is paid to the functioning of the adipose tissue of the mother and placenta.
Fetal adipose tissue and its role in lipid metabolism during pregnancy
In recent years, the human placenta has been found to secrete leptin and resistin. This allowed us to consider adipocytokines as potential regulators of trophoblast function during implantation.
In vitro studies suggest that leptin promotes trophoblast entry by modulating various trophoblast growth factors, including interleukin 1 (IL1) and estradiol 17.
Despite previous reports that adiponectin is produced and secreted by the human placenta, more recent studies have not confirmed these initial observations, but rather have shown that during the first trimester the trophoblast expresses AdipoR1 and AdipoR2 receptors, through which adiponectin affects placental functions.
Adiponectin is able to modulate the process of placentation in favor of trophoblast migration and differentiation. It is possible that this adipocytokine protects trophoblast cells from the maternal immune system.
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These observations provide convincing evidence of the important role of leptin, adiponectin and resistin in the peri-implantation period.
At this stage of pregnancy, adipocytokines are able to modulate trophoblast proliferation and invasion and/or influence angiogenesis processes, adding to their known metabolic effects, both in the fetus and in the maternal body, in particular, influencing lipid metabolism in the direction of lipid accumulation with the further goal of using it for the needs of the fetus.
Weight gain during pregnancy and adipose tissue hormones
In obesity, a number of factors lead to metabolic changes, affecting the course of pregnancy. Leptin is of particular importance in the regulation of maternal energy metabolism during pregnancy.
Leptin concentrations increase significantly in early pregnancy: levels are 30% higher in the first 12 weeks of pregnancy compared to non-pregnant women and decline to pregestational levels immediately after delivery.
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The placenta releases large amounts of leptin throughout pregnancy. The reason for this is not exactly clear. Serum leptin levels are generally associated with body fat mass and correlate with body mass index (BMI) in both non-pregnant and pregnant women. It is believed that such changes contribute to the optimization of the availability of substrates necessary for fetal growth, in particular, by mobilizing maternal fat stores.
Metabolic disorders associated with adipocyte dysfunction in adipose tissue in obese women may be affected by leptin levels during pregnancy.
The VK Misra study clearly demonstrates for the first time that pre-pregnancy overweight or obesity determines a qualitatively different leptin profile during pregnancy compared to women without overweight and obesity.
Maternal serum leptin levels are proportional to the increase in body weight from the very beginning of pregnancy. In addition, several studies have shown that serum leptin levels increase significantly with increasing gestational age.
Overweight and obese women had significantly higher serum leptin levels than normal weight pregnant women, which may contribute to adipocyte dysfunction and lead to even more weight gain.
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