Abstract

ContextLittle is known about soluble HLA-G (sHLA-G) concentrations in obese pregnant women with uncomplicated pregnancies. ObjectiveTo investigate the role of sHLA-G in obese pregnancies. DesignCase-control study, from 2013 to 2015. SettingA tertiary care centre. Patients168 healthy normal weight women and 59 overweight/obese women; to avoid the effect of preeclampsia on sHLA-G concentrations, cases were further divided in two groups: 42 with normotensive pregnancy and 17 who developed preeclampsia. Interventionsall the women enrolled received standard antenatal care and plasma sample collections were performed. Main outcome measuressHLA-G concentrations during pregnancy, before delivery and in cord blood. ResultsMaternal sHLA-G concentrations in overweight/obese with normotensive pregnancies increased by 14.7% (IQR=−26.4 to +89.6) in the 2nd trimester and by 19.6% (IQR=–33 to +104) before delivery and were significantly higher than in controls (p=0.024). Median cord blood sHLA-G concentrations were 53.5ng/ml (IQR=36–62.7) in the overweight/obese women with uncomplicated pregnancies (p<0.001 compared to controls) and 19.7ng/ml (IQR=7.5–36.3) in controls. Maternal concentrations of sHLA-G in the two trimesters and before delivery were significantly lower among subjects who developed preeclampsia than in controls (p<0.001) or in obese subjects with normotensive pregnancies (p<0.001). ConclusionssHLA-G concentratons are higher in normotensive overweight/obese women and their babies while lower in preeclamptic overweight/obese women and their cords. Obesity influences maternal and fetal sHLA-G concentrations during pregnancy, to optimize the reproductive success, while preeclampsia impairs the mother-offspring antinflammatory response.

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