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肥胖孕妇孕期及脐血中可溶性HLA - G的浓度

Soluble HLA-G concentrations in obese women during pregnancy and in cord blood.

作者信息

Beneventi Fausta, Locatelli Elena, De Amici Mara, Martinetti Miryam, Spinillo Arsenio

机构信息

Department of Obstetrics and Gynecology, IRCCS Foundation Policlinico San Matteo and University of Pavia, 27100 Pavia, Italy.

Department of Obstetrics and Gynecology, IRCCS Foundation Policlinico San Matteo and University of Pavia, 27100 Pavia, Italy.

出版信息

J Reprod Immunol. 2017 Feb;119:31-37. doi: 10.1016/j.jri.2016.11.005. Epub 2016 Nov 24.

Abstract

CONTEXT

Little is known about soluble HLA-G (sHLA-G) concentrations in obese pregnant women with uncomplicated pregnancies.

OBJECTIVE

To investigate the role of sHLA-G in obese pregnancies.

DESIGN

Case-control study, from 2013 to 2015.

SETTING

A tertiary care centre.

PATIENTS

168 healthy normal weight women and 59 overweight/obese women; to avoid the effect of preeclampsia on sHLA-G concentrations, cases were further divided in two groups: 42 with normotensive pregnancy and 17 who developed preeclampsia.

INTERVENTIONS

all the women enrolled received standard antenatal care and plasma sample collections were performed.

MAIN OUTCOME MEASURES

sHLA-G concentrations during pregnancy, before delivery and in cord blood.

RESULTS

Maternal sHLA-G concentrations in overweight/obese with normotensive pregnancies increased by 14.7% (IQR=-26.4 to +89.6) in the 2nd trimester and by 19.6% (IQR=-33 to +104) before delivery and were significantly higher than in controls (p=0.024). Median cord blood sHLA-G concentrations were 53.5ng/ml (IQR=36-62.7) in the overweight/obese women with uncomplicated pregnancies (p<0.001 compared to controls) and 19.7ng/ml (IQR=7.5-36.3) in controls. Maternal concentrations of sHLA-G in the two trimesters and before delivery were significantly lower among subjects who developed preeclampsia than in controls (p<0.001) or in obese subjects with normotensive pregnancies (p<0.001).

CONCLUSIONS

sHLA-G concentratons are higher in normotensive overweight/obese women and their babies while lower in preeclamptic overweight/obese women and their cords. Obesity influences maternal and fetal sHLA-G concentrations during pregnancy, to optimize the reproductive success, while preeclampsia impairs the mother-offspring antinflammatory response.

摘要

背景

对于无并发症的肥胖孕妇中可溶性人类白细胞抗原G(sHLA - G)的浓度了解甚少。

目的

研究sHLA - G在肥胖妊娠中的作用。

设计

2013年至2015年的病例对照研究。

地点

一家三级医疗中心。

患者

168名健康体重正常的女性和59名超重/肥胖女性;为避免子痫前期对sHLA - G浓度的影响,病例进一步分为两组:42名血压正常的孕妇和17名患子痫前期的孕妇。

干预措施

所有入选女性均接受标准产前护理并采集血浆样本。

主要观察指标

孕期、分娩前及脐血中的sHLA - G浓度。

结果

血压正常的超重/肥胖孕妇,其母体sHLA - G浓度在孕中期增加了14.7%(四分位间距IQR = - 26.4至 + 89.6),分娩前增加了19.6%(IQR = - 33至 + 104),且显著高于对照组(p = 0.024)。无并发症的超重/肥胖女性脐血sHLA - G浓度中位数为53.5ng/ml(IQR = 36 - 62.7)(与对照组相比p < 0.001),对照组为19.7ng/ml(IQR = 7.5 - 36.3)。患子痫前期的受试者,其孕早、中晚期及分娩前的母体sHLA - G浓度显著低于对照组(p < 0.001)或血压正常的肥胖受试者(p < 0.001)。

结论

血压正常的超重/肥胖女性及其婴儿的sHLA - G浓度较高,而患子痫前期的超重/肥胖女性及其脐血中的浓度较低。肥胖会影响孕期母体和胎儿的sHLA - G浓度,以优化生殖成功率,而子痫前期会损害母婴的抗炎反应。

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