«Perinatal portrait», reproductive health parameters and risk factors for fat metabolism disorders in young overweight women

Abstract

Overweight and obesity are one of the most serious social and medical problems today. It is appropriate to single out a special category of young women aged 18–35 years with excessive body weight, that is, the age which is capable of ensuring the reproductive potential of the future.The objective: to determine the probable factors of metabolic imbalance and the main parameters of reproductive health disorders in young overweight women.Materials and methods. Reproductive health parameters and the main predictors of its impairment were evaluated in two groups of patients – the main group (890 women with BMI > 25.0 kg/m2) and a control group (40 patients with BMI of 18.5–24.9 kg/m2).The main group was divided into two subgroups taking into account the age of formation of overweight and obesity: I subgroup – 596 women with pubertal obesity (66.9%) and II subgroup – 294 women with overweight in the postpubertal period (33.1%).Results. A high rate of pregnancy complications (86.9%), gestational diabetes (25.8%), preeclampsia (34.1%), premature birth and low birth weight fetus (20.9%), as well as the birth of a girl with a large body weight (24.4%), can become modified factors in the formation of the reproductive system according to the characteristics of the “perinatal portrait” and form the basis of screening programs. The relationship between the early introduction of complementary foods and the absence of breastfeeding and the presence of obesity in the girl in the future was established (OR=7.25; 95% CI: 2.99–17.59; χ2=23.53, p<0.0001).Attention should be paid to reproductive function disorders: amenorrhea was found 1.7 times more often in the case of postpubertal obesity, as well as abnormal uterine bleeding or metrorrhagia, infertility (24.4%), dyshormonal breast diseases (34.7%), polycystic ovary syndrome (59.8%), proliferative processes of the endometrium and myometrium (34.7%), as well as the formation of endometrial hyperplasia and polyposis with age (25.8%).A high percentage of stressogenic factors was determined in the examined cohort of patients, which could initiate the manifestation of metabolic and endocrine disorders in 569 cases – 63.9% (OR=4.14; 95% CI: 2.07–8.25; χ2=17.38, p<0.0001).Conclusions. Probable predictors of impaired fat metabolism in young women were statistically identified: heredity from the mothers of such patients regarding metabolic and endocrine disorders, body weight at birth more than 4000 g and artificial feeding, early age of menarche, pubertal paratrophy, stress factors, infectious diseases during menarche, hypodynamia and a high level of intellectual differentiation.The reproductive health of women with overweight and obesity is characterized by a high frequency of menstrual cycle disorders, increased manifestations of changes in the vaginal microbiome and dysuric symptoms, as well as infertility, hormone-dependent diseases, and impaired reproductive function.