Michelsen Trond Melbye, Skytte Hege Nyhus, Gunnes Nina, Holven Kirsten Bjørklund, Christensen Jacob Juel, Roland Marie Cecilie Paasche
Department of Obstetrics, Division of Obstetrics and Gynecology, Oslo University Hospital, Oslo, Norway; Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway.
Department of Obstetrics, Division of Obstetrics and Gynecology, Oslo University Hospital, Oslo, Norway; Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway; Norwegian Research Centre for Women's Health, Oslo University Hospital, Oslo, Norway.
J Reprod Immunol. 2024 Dec;166:104397. doi: 10.1016/j.jri.2024.104397. Epub 2024 Nov 19.
Higher maternal body mass index (BMI) is associated with metabolic disturbances and pregnancy complications. We aimed to examine whether metabolic profiles in early pregnancy were associated with metabolic pregnancy complications in women with obesity (BMI ≥ 30 kg/m).
Nested cohort study from a prospective longitudinal cohort (n = 1031) of women who were healthy prior to pregnancy and gave birth at Oslo University Hospital from 2002-2008. The sample comprised 81 women with obesity. Metabolic pregnancy complications included gestational diabetes mellitus, gestational hypertension and preeclampsia. In plasma samples from gestational weeks 14-16, 91 metabolites were analyzed by nuclear magnetic resonance spectroscopy. We performed a principal component analysis to reduce the metabolic dimensions. Logistic regression models were fitted to estimate crude and adjusted odds ratios (ORs) of metabolic pregnancy complications.
Twenty-four out of 81 women developed metabolic pregnancy complications (gestational hypertension, preeclampsia, and/or gestational diabetes). Two of five principal components (80 % explained variance) were significantly associated with metabolic pregnancy complications. The ratio of monounsaturated to total fatty acids increased the risk of metabolic pregnancy complications (OR 2.09, 95 % confidence interval [CI] 1.25-3.75), while the ratio of polyunsaturated to monounsaturated fatty acids decreased the risk (OR 0.54, 95 % CI 0.30-0.89). The ratio of omega-3 to total fatty acids (OR 0.59, 95 % CI 0.34-0.98) and the ratio of docosahexaenoic acid to total fatty acids (OR 0.57, 95 % CI 0.31-0.97) also decreased the risk of metabolic pregnancy complications.
Metabolic profile in early pregnancy was associated with risk of metabolic pregnancy complications in women with obesity. We observed the strongest associations between fatty acid composition and metabolic pregnancy complications.
较高的孕妇体重指数（BMI）与代谢紊乱及妊娠并发症相关。我们旨在研究妊娠早期的代谢谱是否与肥胖女性（BMI≥30 kg/m²）的代谢性妊娠并发症有关。
对2002年至2008年在奥斯陆大学医院分娩的孕前健康女性的前瞻性纵向队列（n = 1031）进行巢式队列研究。样本包括81名肥胖女性。代谢性妊娠并发症包括妊娠期糖尿病、妊娠期高血压和先兆子痫。在妊娠第14至16周的血浆样本中，通过核磁共振波谱分析了91种代谢物。我们进行了主成分分析以减少代谢维度。采用逻辑回归模型估计代谢性妊娠并发症的粗比值比（OR）和调整后的比值比。
81名女性中有24名出现代谢性妊娠并发症（妊娠期高血压、先兆子痫和/或妊娠期糖尿病）。五个主成分中的两个（解释方差80%）与代谢性妊娠并发症显著相关。单不饱和脂肪酸与总脂肪酸的比值增加了代谢性妊娠并发症的风险（OR 2.09，95%置信区间[CI] 1.25 - 3.75），而多不饱和脂肪酸与单不饱和脂肪酸的比值则降低了风险（OR 0.54，95% CI 0.30 - 0.89）。ω-3脂肪酸与总脂肪酸的比值（OR 0.59，95% CI 0.34 - 0.98）以及二十二碳六烯酸与总脂肪酸的比值（OR 0.57，95% CI 0.31 - 0.97）也降低了代谢性妊娠并发症的风险。
妊娠早期的代谢谱与肥胖女性代谢性妊娠并发症的风险相关。我们观察到脂肪酸组成与代谢性妊娠并发症之间的关联最为强烈。
