MATERNAL OBESITY AND THE MOTHER-PLACENTA-FETUS SYSTEM: EVIDENCE-BASED MECHANISMS OF INFLUENCE

Abstract

Maternal obesity is associated with complications of pregnancy and increases the child’s risk of obesity, diabetes and cardiovascular disease later in life. Recently, this problem has been actively studied abroad and in our country. The risk of adverse perinatal outcomes in obese mothers is associated with changes in the structure and function of the placenta. Over the past decade, experimental and clinical data on the placenta morphology in maternal obesity have been accumulated. These are decidual arteriopathy and placental infarctions, an increased mass of the placental disc (more than the 90th percentile) and chronic inflammation of the chorionic villi with a decrease in their number. Maternal obesity is associated with placental hypoxia, intense angiogenesis, and increased levels of glucose and amino acid transporter transcripts, which can cause metabolic disturbances in the fetus. Found that maternal obesity often leads to inflammatory changes in the placenta in female fetuses. Analysis of the literature made it possible to identify the main provisions characterizing the placenta as a target organ and an organ that alters fetal metabolism in conditions of maternal obesity. The review describes the main adipokines operating in the mother placenta fetus system: leptin, adiponectin, chemerin, visfatin, resistin, and apelin. In the article, the authors tried to reveal the mechanisms and consequences of the development of pathology of the placenta for the fetus, to emphasize the importance of not only a high body mass index in a pregnant woman, but also excessive high calorie nutrition during pregnancy. This opens up the prospects for therapeutic effects, since a timely begun dietary correction of obesity can improve the course and prognosis of pregnancy, reduce the risk of adverse effects of intrauterine factors on the fetus. Conclusion: the review presents relevant data on the current state of the problem of mechanisms of disorders in the structure and function of the placenta in pregnant women suffering from obesity and on the consequences of these disorders.