Obesity, inflammation and pregnancy, a dangerous triad

Abstract

Introduction: Obesity, a common condition during pre-pregnancy and pregnancy, represents a dangerous condition for maternal and child health because of its significant obstetric and perinatal complications.

Objective: To describe the pathogenic links between obesity, inflammation and pregnancy.

Methods: This literature review was mainly conducted in PubMed Central, SciELO and ClinicalKey, with the descriptors obesity, inflammation and pregnancy.

Results: The unfavourable effects of obesity include abortions, gestational diabetes, hypertension, macrosomia, preterm delivery, congenital anomalies and fetal death. In the long term it is also associated with metabolic disorders and diseases in mothers and their offspring. These adverse effects are associated with a state of chronic low-grade inflammation that accompanies excess body weight. Adipose tissue and the placenta play an important role in this inflammatory process with excessive secretion of pro-inflammatory cytokines (TNFα, IL-6, IL-1β, monocyte chemotactic protein 1, serum amyloid protein A) and reduction of anti-inflammatory cytokines. Two mediators such as leptin and adiponectin have crucial roles.

Conclusions: Although the mechanisms linking the negative effects of obesity on pregnancy are not well known, it is likely that chronic low-grade inflammation is the main link; therefore, the triad of obesity, inflammation and pregnancy represents a dangerous relationship for maternal-fetal health.