Maternal obesity: the interplay between inflammation, mother and fetus

Abstract

Obesity has reached epidemic proportions in our patients who are of childbearing age, with pregnant patients of normal weight being in the minority. The pregnancy-related complications attributable to obesity affect not only the pregnant women, but also her fetus and potentially both mother and child for their lifetimes. Pregnancy is associated with altered immunity. The physiologic state of chronic inflammation in obesity affects systemic immunity and metabolism, and may be associated with several of the complications associated with maternal obesity. The interplay between pregnancy, obesity and inflammation may have far-reaching implications for fertility, pregnancy, the fetus and neonate.

Maternal abdominal subcutaneous fat thickness as a predictor for adverse pregnancy outcome: a longitudinal cohort study

“…1,2 Pregnancy in itself is associated with natural inflammatory and metabolic changes, which can be significantly confounded in obese women, leading to specific obesity-related complications. [3][4][5][6] There is growing prevalence of obesity worldwide; in Australia, 40-50% of the pregnant population is overweight and obese. 7,8 This increases related pregnancy complications such as gestational diabetes, pre-eclampsia and fetal growth disorders.…”

“…7,8 This increases related pregnancy complications such as gestational diabetes, pre-eclampsia and fetal growth disorders. [4][5][6] Postnatal complications include neonatal low Apgar score, hypoglycaemia, jaundice, and maternal infection and haemorrhage. [9][10][11][12] For practical reasons, body mass index (BMI) is used clinically for risk stratification of obesity-related pregnancy complications.…”

Caesarean Section and Maternal Obesity

“…Numerous studies have demonstrated pregestational diabetes to be independent risk factor for caesarean delivery (Sebire et al, 2001;Ray et al, 2001;Rosenberg, 2005). The complex interaction of obesity, diabetes, insulin resistance and the inflammatory milieu during pregnancy is the subject of ongoing research and these factors may have an effect on the progression of labour (Hauguel-de Mouzon, 2006;Chu, 2007;Schmatz, 2010). Ethnicity is also associated with the rate of caesarean delivery and studies have shown higher caesarean section rates in women of African descent (Rosenberg et al, 2005;Bragg et al, 2010).…”

Adverse effects of perinatal nicotine exposure on reproductive outcomes

“…Acute inflammatory activation is necessary in responding to infectious or environmental insults, yet, prolonged inflammation may lead to many potential reproductive complications including impaired placental development/function and infertility (Weiss et al 2009, Schmatz et al 2010, Christiansen 2013, Bachir & Jarvi 2014.…”