Obstetrics and Gynecology Service, Hospital Universitario La Paz, Paseo de la Castellana 261, 28046 Madrid, Spain.
Department of Physiology, Faculty of Medicine, Universidad Autónoma de Madrid, C/Arzobispo Morcillo 2, 28049 Madrid, Spain.
Nutrients. 2022 Mar 22;14(7):1326. doi: 10.3390/nu14071326.
There are more and more obese mothers with twin gestations. For a long time before, the responses of lymphocytes and platelets in obese women can cause a low-grade inflammation. In addition, a proper control of gestational weight gain would improve the outcomes in mothers with high pre-gestational body mass index (BMI). In women with high pre-gestational BMI and twin pregnancy, our aims were to explore the biochemical and hematological parameters and to study the rate of obstetric adverse outcomes. This was an observational and retrospective study conducted in the Hospital Universitario La Paz (Madrid, Spain). We included 20 twin pregnancies as the lean group (BMI = 18.5-24.9 kg/m), homogeneous in the maternal age and ethnicity, and having parity with other 20 twin pregnancies as the obese group (BMI ≥ 30 kg/m). The maternal data and maternal, fetal, obstetric, and neonatal complications were collected from the medical records. In the first and third trimester of pregnancy, the biochemical and hematological parameters of the blood were assayed. In this cohort, gestational weight gain was significantly lower in the obese than lean group. In the first trimester, the hemoglobin levels in obese women (12.1 ± 0.8 g/dL) were lower than lean women (12.6 ± 0.7 g/dL; -Value = 0.048). In addition, the tendency of glucose levels, TSH levels and platelets was to increase in obese compared to lean women. In the third trimester, the TSH levels were higher in obese (3.30 ± 1.60 mUI/L) than lean women (1.70 ± 1.00 mUI/L; -Value = 0.009). Furthermore, there was a tendency for levels of platelets and lymphocytes to increase in obese compared to lean women. No significant differences were detected in the rate of maternal, fetal, obstetrical, and neonatal complications between the groups. The hemoglobin, platelets, lymphocytes and TSH levels need further investigation to understand potential subclinical inflammation in obese women. Furthermore, obese women with twin pregnancies should follow-up with a specialist nutritionist, to help them control their gestational weight gain with appropriate dietary measures.
越来越多的肥胖双胞胎孕妇。很久以前，肥胖女性的淋巴细胞和血小板反应会引起低度炎症。此外，适当控制妊娠体重增加可以改善高孕前体重指数（BMI）母亲的结局。对于高孕前 BMI 和双胞胎妊娠的女性，我们的目的是探讨生化和血液学参数，并研究产科不良结局的发生率。这是一项在西班牙马德里拉巴斯大学医院进行的观察性回顾性研究。我们纳入了 20 例双胞胎妊娠作为瘦组（BMI=18.5-24.9kg/m），在母亲年龄和种族上是同质的，并有与其他 20 例双胞胎妊娠作为肥胖组（BMI≥30kg/m）的产次。从病历中收集了母亲的数据以及母亲、胎儿、产科和新生儿并发症。在妊娠的第一和第三阶段，测定了血液的生化和血液学参数。在该队列中，肥胖组的妊娠体重增加明显低于瘦组。在妊娠早期，肥胖妇女的血红蛋白水平（12.1±0.8g/dL）低于瘦妇女（12.6±0.7g/dL；-值=0.048）。此外，与瘦妇女相比，肥胖妇女的血糖水平、TSH 水平和血小板有升高的趋势。在妊娠晚期，肥胖妇女的 TSH 水平（3.30±1.60mUI/L）高于瘦妇女（1.70±1.00mUI/L；-值=0.009）。此外，与瘦妇女相比，肥胖妇女的血小板和淋巴细胞水平有升高的趋势。两组间母亲、胎儿、产科和新生儿并发症的发生率无显著差异。血红蛋白、血小板、淋巴细胞和 TSH 水平需要进一步研究，以了解肥胖女性潜在的亚临床炎症。此外，肥胖的双胞胎孕妇应向营养师寻求随访，以帮助他们通过适当的饮食措施控制妊娠体重增加。
