The impact of early pregnancy metabolic disorders on pregnancy outcome and the specific mechanism

Abstract

Miscarriage is the most common complication of pregnancy. The most common causes of early miscarriage are chromosomal abnormalities of the embryo, maternal endocrine abnormalities, organ malformations, and abnormal immune factors. Late miscarriages are mostly caused by factors such as cervical insufficiency. However, the causes of 50% of miscarriages remain unknown. Recently, increasing attention has been given to the role of metabolic abnormalities in miscarriage. In this review, we mainly discuss the roles of four major metabolic pathways (glucose, lipid, and amino acid metabolism, and oxidation‒reduction balance) in miscarriage and the metabolism-related genes that lead to metabolic disorders in miscarriage. Depending on aetiology, the current treatments for miscarriage include hormonal and immunological drugs, as well as surgery, while there are few therapies for metabolism. Therefore, we also summarize the drugs for metabolism-related targets. The study of altered metabolism underlying miscarriage not only helps us to understand the mechanisms involved in miscarriage but also provides an important basis for clinical research on new therapies.

Frequency of Gene Polymorphisms in Admixed Venezuelan Women with Recurrent Pregnancy Loss: Microsomal Epoxy Hydroxylase (rs1051740) and Enos (rs1799983)

“…Alemán and colleagues [31] in Vargas Hospital, Caracas, reported an increased amount of nitrite serum levels in preeclampsia patients compared to healthy pregnant women, as well as increased expression of NOS enzymes (eNOS and iNOS) in the placenta of these patients compared to controls. These results differ from other reports independently of the ethnic difference [32,33]. Our group [34] demonstrated, as have different authors [32,33], a significant reduction in serum levels of nitric oxide products (nitrites and nitrates) in preeclamptic patients compared to a control group [34].…”

“…These results differ from other reports independently of the ethnic difference [32,33]. Our group [34] demonstrated, as have different authors [32,33], a significant reduction in serum levels of nitric oxide products (nitrites and nitrates) in preeclamptic patients compared to a control group [34].…”

“…Evidence suggests that a reduction in nitric oxide production related to polymorphisms of the eNOS enzyme may be linked to implantation failure and frequent miscarriages [19,[23][24][25][26][27]33]. The polymorphism can affect the response of the vascular endothelium to oxidative stress and, therefore, promote vascular remodelling and cause pregnancy complications.…”

Diabetic and hypertensive disorders following early pregnancy loss: a systematic review and meta-analysis

“…There was no obvious distinction in study design, sample populations, country-level income or risk of bias that differentiated the results among the included studies. Although the exact biological mechanisms that link early pregnancy loss to a future maternal risk of a of hypertension disorders are difficult to elucidate; however, it is likely due to a complex interplay between genetics, endothelial dysfunction and metabolic syndrome 80 that could differentiate between maternal populations. Strengthening the evidence for this genetic link is that women who have a history of RPL prior to their first birth have a higher risk of coronary heart disease, which is both diabetic and hypertensive disorders are a precursor to cardiovascular disease.…”