Placental insufficiency in pregnant women with high body mass index and without gestational diabetes

Objective: To investigate blood levels of two adipokines in the first trimester and expression of placental vascular endothelial growth factor (VEGF) in the third trimester in women with a high body mass index (BMI) and without gestational diabetes. Materials and methods: The prospective observational study included 70patients with grade I-III obesity (24, 24, and 22 women, respectively) who gave birth at full term to newborns with an Apgar score of 7-8. The control group consisted of 22 postpartum women with a normal BMI. Blood adiponectin and omentin were determined using an enzyme-linked immunosorbent assay (ELISA) before nine weeks of gestation. The expression of vascular endothelial growth factor (VEGF) was examined in 24 placenta samples. Results: At the gestational age of 8-9 weeks, blood adiponectin level in women with grade I-III obesity was statistically significantly lower than in the controls. Omentin levels in the control group and those with grade I obesity did not differ and exceeded those with grade II and III obesity. There was a moderate negative correlation between the BMI of women of all groups and the blood omentin levels (r=-0.565, p<0.0001). The IHCA showed that the total VEGF expression in terminal villi and capillaries of the fetal placentae in obesity is reduced compared to the control group. In a pairwise comparison of groups with high BMI, the highest VEGF expression was found in obesity grade I relative to grades II and III, which did not differ from each other. Conclusion: In the first trimester of pregnancy, maternalpregravid obesity is associated with decreased adiponectin and omentin concentrations and placental VEGF expression. A high BMI, starting with II grade obesity, can be considered a risk factor for placental insufficiency.

obesity, adiponectin, omentin, placenta, vascular endothelial growth factor, immunohistochemistry, enzyme immunoassay