Department of Neonatology, Clinic for Gynecology and Obstetrics, University Clinical Center of Serbia, 11000 Belgrade, Serbia.
Department of Gynecology and Obstetrics, Clinic for Gynecology and Obstetrics, University Clinical Center of Serbia, 11000 Belgrade, Serbia.
Int J Mol Sci. 2023 Jul 26;24(15):11964. doi: 10.3390/ijms241511964.
Metabolic changes in pregnant women begin in the first weeks after conception under the influence of placental hormones that affect the metabolism of all nutrients. An increased concentration of total lipids accompanies pregnancy and an increased accumulation of triglycerides in low-density lipoproteins (LDL) particles. Lipids in small dense LDL particles are more susceptible to oxidative modification than normal-density LDL particles. Unlike LDL high-density lipoproteins (HDL), lipoprotein particles have an atheroprotective role in lipid metabolism. The very growth of the fetus depends on the nutrition of both parents, so obesity is not only in the mother but also in the father. Nutritional programming of the offspring occurs through changes in lipid metabolism and leads to an increased risk for cardiometabolic diseases. Pregnancy is accompanied by an increased need for oxygen in the mitochondria of the placenta and a tendency to develop oxidative stress. Oxidative stress represents a disturbance in the balance of oxidation-reduction processes in the body that occurs due to the excessive production of free oxygen radicals that cellular homeostatic mechanisms are unable to neutralize. When the balance with the antioxidant system is disturbed, which happens when free oxygen radicals are in high concentrations, serious damage to biological molecules occurs, resulting in a series of pathophysiological and pathological changes, including cell death. Therefore, oxidative stress plays a significant role in the pathogenesis of many complications that can occur during pregnancy. The oxidative status of pregnant women is also influenced by socioeconomic living conditions, lifestyle habits, diet, smoking, and exposure to environmental air pollution. During a healthy pregnancy, the altered lipid profile and oxidative stress create an increased risk for premature birth and pregnancy-related diseases, and a predisposition to adult diseases.
孕妇的代谢变化始于受孕后最初几周，受胎盘激素的影响，这些激素影响所有营养素的代谢。总脂质浓度增加伴随着妊娠，而 LDL 颗粒中的甘油三酯（triglycerides）积累增加。小而密 LDL 颗粒中的脂质比正常密度 LDL 颗粒更容易发生氧化修饰。与 LDL 高密度脂蛋白（HDL）不同，脂蛋白颗粒在脂质代谢中具有抗动脉粥样硬化作用。胎儿的生长非常依赖于父母双方的营养，因此肥胖不仅发生在母亲身上，也发生在父亲身上。后代的营养编程通过脂质代谢的变化发生，并导致患心血管代谢疾病的风险增加。怀孕伴随着胎盘线粒体对氧气需求的增加，以及发生氧化应激的趋势。氧化应激代表身体氧化还原过程平衡的破坏，由于细胞内稳态机制无法中和的游离氧自由基的过度产生而发生。当与抗氧化系统的平衡被打乱时，即当游离氧自由基浓度较高时，会对生物分子造成严重损害，导致一系列病理生理和病理变化，包括细胞死亡。因此，氧化应激在许多可能在怀孕期间发生的并发症的发病机制中起着重要作用。孕妇的氧化状态还受到社会经济生活条件、生活习惯、饮食、吸烟和暴露于环境空气污染的影响。在健康妊娠期间，改变的脂质谱和氧化应激会增加早产和与妊娠相关的疾病风险，并导致成年疾病的易感性。
