Altered maternal and placental lipid metabolism and fetal fat development in obesity: Current knowledge and advances in non-invasive assessment

Delhaes, Flavien; Giza, Stephanie A.; Koreman, Tianna; Eastabrook, Genevieve; McKenzie, Charles A.; Bedell, Samantha; Regnault, Timothy R. H.; Vrijer, Barbra de

doi:10.1016/j.placenta.2018.05.011

Cited by 64 publications

(39 citation statements)

References 93 publications

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“…24,25 It is predicted that pregnancy itself induces metabolic changes in adipose tissue, thereby altering autophagic activity and regulation. 26 Therefore, the pathophysiology underlying autophagy in adipose tissue of pregnant compared to nonpregnant obese women must also be considered, especially in obese patients with complications of pregnancy including IUGR, gestational diabetes and pre-eclampsia. It is suspected that the inability to utilize autophagy as a homeostatic response to stressful stimuli may heighten the obese patient population's susceptibility to placentally-mediated diseases of pregnancy.…”

Section: Discussionmentioning

confidence: 99%

Maternal obesity reduces placental autophagy marker expression in uncomplicated pregnancies

Cohen

Guo

Pucchio

et al. 2020

J of Obstet and Gynaecol

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Aim Obesity has been associated with changes in autophagy and its increasing prevalence among pregnant women is implicated in higher rates of placental‐mediated complications of pregnancy such as pre‐eclampsia and intrauterine growth restriction. Autophagy is involved in normal placentation, thus changes in autophagy may lead to impaired placental function and development. The aim of this study was to investigate the connection between obesity and autophagy in the placenta in otherwise uncomplicated pregnancies. Methods Immunohistochemistry and western blot analysis were done on placental and omental samples from obese (body mass index [BMI] ≥30 kg/m2) and normal weight (BMI <25 kg/m2) pregnant women with singleton pregnancies undergoing planned Caesarean delivery without labor at term. Samples were analyzed for autophagic markers LC3B and p62 in the peripheral, middle and central regions of the placenta and in omental adipocytes, milky spots and vasculature. Results As pre‐pregnancy BMI increased, there was an increase in both placental and fetal weight as well as decreased levels of LC3B in the central region of the placenta (P = 0.0046). Within the obese patient group, LC3B levels were significantly decreased in the placentas of male fetuses compared to females (P < 0.0001). Adipocytes, compared to milky spots and vasculature, had lower levels of p62 (P = 0.0127) and LC3B (P = 0.003) in obese omenta and lower levels of LC3B in control omenta (P = 0.0071). Conclusion Obesity leads to reduced placental autophagy in uncomplicated pregnancies; thus, changes in autophagy may be involved in the underlying mechanisms of obesity‐related placental diseases of pregnancy.

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Section: Discussionmentioning

confidence: 99%

Maternal obesity reduces placental autophagy marker expression in uncomplicated pregnancies

Cohen

Guo

Pucchio

et al. 2020

J of Obstet and Gynaecol

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“…Obesity is implicated in increased levels of placental in ammatory markers and lipid esteri cation, and altered levels of maternal adipokines. This may play a role in long-term insulin resistance of offspring [44]. Additionally, dyslipidemia and obesity reduce n-3 long-chain polyunsaturated fatty acid in tissue, which is a type of fatty acid and signaling molecule acting on intracellular sensing systems to alter embryonic and fetal development.…”

Section: Discussionmentioning

confidence: 99%

Early postpartum dyslipidemia and its potential predictors during pregnancy in women with a history of gestational diabetes mellitus

Pei

Xiao

Lai

et al. 2020

Preprint

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Background: This study aimed to analyze the incidence of early postpartum dyslipidemia and its potential predictors in women with a history of gestational diabetes mellitus (GDM).Methods: This was a retrospective study. 589 women diagnosed with GDM were enrolled and followed up at 6–12 weeks after delivery. A 75g oral glucose tolerance test (OGTT) and lipid levels were performed during mid-trimester and the early postpartum period. Participants were divided into the normal lipid group and dyslipidemia group according to postpartum lipid levels. Demographic and metabolic parameters were analyzed. Multiple logistic regression was performed to analyze the potential predictors for early postpartum dyslipidemia. A receiver operating characteristic curve (ROC) was calculated to determine the cut-off values.Results: A total of 38.5% of the 589 women developed dyslipidemia in early postpartum and 60% of them had normal glucose metabolism. Delivery age, systolic blood pressure (SBP), glycated hemoglobin (HbA1c) and low-density lipoprotein cholesterol (LDL-C) were independent predictors of early postpartum dyslipidemia in women with a history of GDM. The cut-offs of maternal age, SBP, HbA1c values, and LDL-C levels were 35 years, 123mmHg, 5.1%, and 3.56 mmol/L, respectively. LDL-C achieved a balanced mix of high sensitivity (63.9%) and specificity (69.2%), with the highest area under the receiver operating characteristic curve (AUC) (0.696). When LDL-C was combined with age, SBP, and HbA1c, the AUC reached to 0.733.Conclusions: A lipid metabolism evaluation should be recommended in women with a history of GDM after delivery, particularly those with a maternal age > 35 years, SBP > 123 mmHg before labor, HbA1c value > 5.1%, or LDL-C levels > 3.56 mmol/L in the second trimester of pregnancy.

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“…The normal physiological structure and function of the placenta are crucial to the growth and development of the fetus [28]. However, abnormal maternal lipid levels during pregnancy will affect the normal transport function of the placenta [29,30], thus damaging the intrauterine development of the fetus and increasing the risk of adverse birth outcomes. Over the course of pregnancy, due to the enrichment of triglycerides and the decrease of liver lipase activity, the particles of LDL become smaller and denser, which are more easily oxidized into oxidized LDL (Ox-LDL) [31].…”

Section: Discussionmentioning

confidence: 99%

Association between maternal serum lipids during late pregnancy and adverse birth outcomes

Dai

Wang

Wu³

et al. 2020

Preprint

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Background: Adverse birth outcomes have short- and long-term impacts on maternal and child health. Maternal dyslipidemia during late pregnancy has been found to be associated with increased risk of adverse birth outcomes. However, similar evidence on association between maternal blood lipid levels and adverse birth outcomes is limited in China.Methods: The data were extracted from Guangdong Women and Children Hospital Information System from September 2014 to March 2018. A total of 3951 mother-newborn pairs were included in our study. Logistic regression model and linear trend analysis were conducted to analyze the correlation between maternal blood lipid levels and adverse birth outcomes after controlling potential confounders including gestational age, pre-pregnancy body mass index, fetal sex, and parity. Results: Among the 3951 subjects, the rates of macrosomia, large-for-gestational age (LGA), low birth weight infants (LBW), and preterm birth were 3.9% (154/3951), 8.5% (334/3951), 9.5% (377/3951), and 9.8% (388/3951), respectively. LDL was a risk factor for preterm birth (OR: 1.20; 95% CI: 1.08-1.34) while HDL was a protective factor (OR: 0.73; 95% CI: 0.55-0.96) after adjusting for covariates. As every unit increase in TG, the risk of macrosomia and LGA increased by 25% (adjusted OR: 1.25; 95% CI: 1.12-1.38) and 16% (adjusted OR: 1.16; 95% CI: 1.07-1.26), respectively. However, every unit increase in HDL concentration was associated with decreased risk for LGA (adjusted OR: 0.60; 95% CI: 0.44-0.81) and macrosomia (adjusted OR: 0.64; 95% CI: 0.41-0.99). High LDL concentrations were associated with a decreased risk of macrosomia (adjusted OR: 0.82; 95% CI: 0.68-0.99) and LGA (adjusted OR: 0.86; 95% CI: 0.76-0.98) but an increased risk of LBW (adjusted OR: 1.16; 95% CI: 1.04-1.30). The results of linear trend analysis were similar to those of logistic regression model.Conclusions: Maternal dyslipidemia during the third trimester is closely related to adverse birth outcomes. Monitoring and managing maternal blood lipid levels in an appropriate range may help to reduce the burden of adverse birth outcomes.

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Altered maternal and placental lipid metabolism and fetal fat development in obesity: Current knowledge and advances in non-invasive assessment

Cited by 64 publications

References 93 publications

Maternal obesity reduces placental autophagy marker expression in uncomplicated pregnancies

Maternal obesity reduces placental autophagy marker expression in uncomplicated pregnancies

Early postpartum dyslipidemia and its potential predictors during pregnancy in women with a history of gestational diabetes mellitus

Association between maternal serum lipids during late pregnancy and adverse birth outcomes

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