ТHE METABOLIC ASPECTS OF PREECLAMPSIA DEVELOPMENT

Abstract

Complications associated with preeclampsia (PE) include fetal growth retardation, premature birth, prenatal and postpartum hemorrhage, perinatal loss, and more. Obese women have an increased risk of developing PE, probably due to impaired placental development due to altered metabolic homeostasis. The aim was to generalize current knowledge about the role of risk factors associated with obesity and hypercholesterolemia in PE with an emphasis on the results of preclinical models. Material and methods. In reviewing the literature, we used Medline systems from PubMed (2011). The search was adapted for Embase (2014-2022) and Scopus (2015-2022). The inclusion criteria were: the effect of obesity on pregnancy; experimental models of the pathogenesis of obesity during pregnancy; the features of predictive diagnosis of obese women at the stage of preconception and during pregnancy; features of antenatal care in obese women. The study was performed at Vinnytsya National Pirogov Memorial Medical University, according to research work № 0121U109141 “Optimization of early diagnosis and preventive treatment of perinatal complications caused by gestational endotheliopathy.” Results. Inflammatory cytokines from maternal adipose tissue and hypercholesterolemia have been associated with systemic inflammation, hypertension, and other adverse effects associated with PE. The main pathways of the negative influence of obesity on the genesis of PE were realized due to the manifested gestational endotheliopathy. Decreases in adipose tissue and associated adipokines were associated with optimization of placental angiogenesis and an overall improvement in the adverse effects associated with PE. Conclusions. Increased maternal adipose tissue mass and cholesterol levels contribute to metabolic disorders and systemic inflammation, which may contribute to the development of gestational endotheliopathy and subsequent abnormal placenta vascularization. Further research will need to further clarify the contribution of pharmacotherapy, as well as some lifestyle adjustments, including preconceptional weight loss and the results of PE in women at high risk of obesity.