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妊娠肥胖与亚临床炎症:从简单评估到复杂结局的途径(符合 STROBE 规范的文章)。

Gestational obesity and subclinical inflammation: The pathway from simple assessment to complex outcome (STROBE-compliant article).

机构信息

Department of Pediatrics.

Research Laboratory, Center for Advanced Medical and Pharmaceutical Research.

出版信息

Medicine (Baltimore). 2021 May 21;100(20):e26055. doi: 10.1097/MD.0000000000026055.

Abstract

Maternal obesity and excessive gestational weight gain (GWG) are associated with pregnancy-related complications, poor birth outcomes, and increased birth weight (BW).The aims of this study were to assess the relationship between excessive GWG and gestational inflammatory status in terms of blood parameters, as well as its influence on newborn's outcomes.We performed a prospective study on 176 pregnant women divided into 2 groups depending on the GWG: group 1-normal GWG, 80 cases; and group 2-high GWG, 96 cases. The statistical analysis was performed using the GraphPad Prism program, trial variant. We performed a thorough anamnesis and clinical examination in all mothers and their newborns, as well as an assessment of multiple laboratory parameters.The levels of both platelets and triglycerides were significantly higher in pregnant women from high GWG group (P = .0165/P = .0247). The newborns whose mothers presented an excessive GWG were found with a significantly higher BW as compared to those with normal GWG mothers (P = .0023). We obtained a positive correlation between the mothers' and newborns' values for hemoglobin, high-density lipoprotein, leucocytes, and platelets/lymphocytes ratio (P = .0002/P = .0313/P = .0137). Moreover, a significant positive correlation was found between GWG and BW (r = 0.2049, 95% CI: 0.0588-0.3425, P = .0064).Our findings sustain the hypothesis that maternal obesity is a risk factor for macrosomia and childhood obesity since we found a positive correlation between GWG and BW. Women with high GWG expressed significantly higher levels of platelets and triglycerides suggesting a subclinical inflammation associated to excessive fat accumulation. The inflammation transfer from mother to fetus in our study was suggested by the positive correlations between maternal and neonatal leukocytes and platelets/lymphocytes ratio.

摘要

母亲肥胖和妊娠期间体重过度增加(GWG)与妊娠相关并发症、不良出生结局和增加的出生体重(BW)有关。本研究旨在评估 GWG 与血液参数方面的妊娠炎症状态之间的关系,以及其对新生儿结局的影响。我们对 176 名孕妇进行了一项前瞻性研究,根据 GWG 将其分为 2 组:第 1 组为正常 GWG,80 例;第 2 组为高 GWG,96 例。统计分析使用 GraphPad Prism 程序进行。我们对所有母亲及其新生儿进行了详细的病史询问和临床检查,以及对多个实验室参数的评估。高 GWG 组孕妇的血小板和甘油三酯水平明显高于低 GWG 组(P=0.0165/P=0.0247)。与正常 GWG 母亲相比,GWG 过度的母亲所生的新生儿 BW 明显更高(P=0.0023)。我们发现母亲和新生儿的血红蛋白、高密度脂蛋白、白细胞和血小板/淋巴细胞比值之间存在正相关(P=0.0002/P=0.0313/P=0.0137)。此外,还发现 GWG 与 BW 之间存在显著正相关(r=0.2049,95%CI:0.0588-0.3425,P=0.0064)。我们的研究结果支持这样一种假设,即母亲肥胖是巨大儿和儿童肥胖的危险因素,因为我们发现 GWG 与 BW 之间存在正相关。高 GWG 的女性表达出明显更高水平的血小板和甘油三酯,这表明与脂肪过度积累相关的亚临床炎症。我们的研究表明,炎症从母亲传递到胎儿,这是通过母亲和新生儿白细胞和血小板/淋巴细胞比值之间的正相关关系提示的。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f2bb/8137052/b30f200ad9c8/medi-100-e26055-g001.jpg

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