Obesity and Antiphospholipid Syndrome: A Particular Challenge in Pregnancy.
Obesity during pregnancy is of major concern due to the well-known risk factors for both the mother and the child. Complications in pregnancy include recurrent miscarriages, gestational diabetes, hypertensive disorders, thromboembolism, and stillbirth. Additionally, maternal obesity seems to have long-term consequences for offspring, predisposing or “programming” them to the development of metabolic disease in adulthood. These antibodies are associated with arterial and/or venous thromboses and with adverse obstetric outcomes such as recurrent fetal loss, Preeclampsia (PE), Intrauterine growth restriction (IUGR) and Intrauterine fetal death.
Hypertensive disorders in pregnancy might also be due to maternal obesity. Robinson et al evaluated in their retrospective study over 15 years (1988-2002) an association of obesity and hypertensive disorders in pregnancy. The authors compared women whose weight was 55 to 75 kg with those whose weight was >90 kg. Compared with the normal weight group, the odds ratio of pregnancy induced hypertension for women with weight 90-120 kg (moderate obesity) was 2.38 (95% CI 2.24 to 2.52). The odds ratio for the group with women >120 kg (severe obesity) was 3.00 (95% CI 2.49 to 3.62).
The mechanisms suggested for increased still-birth risk in the obese woman might be a decreased ability to perceive a reduction in fetal movement, as well as hyperlipidemia leading to atherosclerosis affecting placental blood flow, and increased snoring and sleep apnea associated with oxygen desaturation and hypoxia.
In addition, epidemiological evidence and data derived from animal models have demonstrated that maternal obesity has long-term consequences for offspring, predisposing or “programming” them to the development of metabolic disease in adulthood. More and more literature demonstrates that the in utero environment is a predictor of future neonatal, child, and adult health.
Obes Res Open J. 2015; 2(2): 46-56. doi: 10.17140/OROJ-2-109
