Risk of Pregnancy Complications in Relation to Maternal Prepregnancy Body Mass Index: Population‐Based Study from <scp>F</scp>inland 2006–10

Metsälä, Johanna; Stach‐Lempinen, Beata; Gissler, Mika; Eriksson, Johan G.; Koivusalo, Saila B.

doi:10.1111/ppe.12248

Cited by 38 publications

(31 citation statements)

References 30 publications

(53 reference statements)

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“…Distal ileal FXR expression has been correlated with body mass index, with obese individuals having 3-fold higher FGF19 mRNA measured 24 . Notably, ICP is not associated with maternal obesity 25 . Furthermore, the effects of pregnancy and obesity on the composition of the gut microbiota differ considerably: pregnancy is associated with an increase in bacterial diversity and higher Bacteroidetes 13 whilst a number of studies of obesity report reduced diversity with lower Bacteroidetes [26][27][28][29] .…”

Section: Discussionmentioning

confidence: 87%

Ursodeoxycholic acid enriches intestinal bile salt hydrolase-expressing Bacteroidetes in cholestatic pregnancy

Ovadia

Perdones-Montero

Fan

et al. 2020

Sci Rep

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Ursodeoxycholic acid (UDcA) treatment can reduce itch and lower endogenous serum bile acids in intrahepatic cholestasis of pregnancy (ICP). We sought to determine how it could influence the gut environment in icp to alter enterohepatic signalling. the gut microbiota and bile acid content were determined in faeces from 35 pregnant women (14 with uncomplicated pregnancies and 21 with ICP, 17 receiving UDCA). Faecal bile salt hydrolase activity was measured using a precipitation assay. Serum fibroblast growth factor 19 (FGF19) and 7α-hydroxy-4-cholesten-3-one (C4) concentrations were measured following a standardised diet for 21 hours. Women with a high ratio of Bacteroidetes to Firmicutes were more likely to be treated with UDcA (fisher's exact test p = 0.0178) than those with a lower ratio. Bile salt hydrolase activity was reduced in women with low Bacteroidetes:Firmicutes. Women taking UDcA had higher faecal lithocholic acid (p < 0.0001), with more unconjugated bile acids than women with untreated ICP or uncomplicated pregnancy. UDCA-treatment increased serum FGF19, and reduced C4 (reflecting lower bile acid synthesis). During ICP, UDCA treatment can be associated with enrichment of the gut microbiota with Bacteroidetes. these demonstrate high bile salt hydrolase activity, which deconjugates bile acids enabling secondary modification to FXR agonists, enhancing enterohepatic feedback via FGF19.The serum and faecal bile acid composition is intimately related to biotransformation of bile acids by intestinal bacteria, and their subsequent enterohepatic circulation. Deconjugation of primary bile acids by bacterial bile salt hydrolase (BSH) enables unconjugated bile acids to be modified to secondary bile acids. Bile acids act as signalling molecules for many different end organs (e.g. liver, pancreas, adipose tissue, inflammatory cells), with individual bile acid species of differing ligand potency for different receptors (e.g. farnesoid X receptor (FXR), Takeda G-protein-coupled receptor 5 (TGR5)) 1-3 .Intrahepatic cholestasis of pregnancy (ICP) is predominantly a liver disorder specific to pregnancy, defined by pruritus and elevated serum bile acids beyond the normal asymptomatic hypercholanaemia of pregnancy. Fetal adverse outcomes are related to the extent of elevation of serum concentrations of total bile acids 4,5 . Women with ICP have increased rates of impaired glucose tolerance, gestational diabetes mellitus, and dyslipidaemia 6,7 .

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Section: Discussionmentioning

confidence: 87%

Ursodeoxycholic acid enriches intestinal bile salt hydrolase-expressing Bacteroidetes in cholestatic pregnancy

Ovadia

Perdones-Montero

Fan

et al. 2020

Sci Rep

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“…The literature shows that women who have a high prepregnancy BMI are more likely to experience or develop the following symptoms or conditions: cesarean delivery, postpartum hemorrhage, premature delivery, premature rupture of membranes, GDM, preeclampsia, small-forgestational-age births, dysfunctional labor, cephalopelvic disproportion, and prolonged pregnancy (Enomoto et al, 2016;Johanna, Beata, Mika, Johan, & Saila, 2016;Liu, Hong, & Zhang, 2015). In addition, high incidences of cesarean delivery, premature delivery, preeclampsia, largefor-gestational-age births, and macrosomia were found in women with excessive GWG (Hung, Chen, Hsu, & Hsieh, 2015;Hung & Hsieh, 2016).…”

Section: Introductionmentioning

confidence: 99%

The Impact of Prepregnancy Body Mass Index and Gestational Weight Gain on Perinatal Outcomes for Women With Gestational Diabetes Mellitus

Chiou

Hung

Liao

2018

Worldviews Ev Based Nurs

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“…Exposures from both the physical and social environment, air pollution (8, 9), neighborhood deprivation (9), and racial discrimination (10), for example, which occur prior to conception can alter the likelihood of a complication arising during pregnancy. Women entering pregnancy with a history of chronic disease (11, 12), stress (13), depression/anxiety (14), dyslipidemia (15), or high body mass index (16, 17) are more likely to experience adverse pregnancy health including development of GDM, PIH, and preeclampsia.…”

Section: Introductionmentioning

confidence: 99%

Maternal childhood cardiometabolic risk factors and pregnancy complications

Wallace

Bazzano

Chen

et al. 2017

Annals of Epidemiology

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Purpose The influence of childhood health on later life health outcomes is increasingly hypothesized but rarely tested. We examined the relationship between cardiometabolic indicators in childhood and risk of pregnancy induced hypertension, preeclampsia, and gestational diabetes. Methods Childhood measurements from 755 women in the Bogalusa Heart Study included body mass index, systolic and diastolic blood pressure (SBP and DBP), low- and high-density lipoprotein cholesterol, total cholesterol, triglycerides, insulin, and glucose. Average childhood values were estimated by area under the curve computed from longitudinal quadratic random-effects growth models to account for the unequally-spaced repeated measures. Women reported pregnancy complications, and medical records were linked to interview data where possible. Log-Poisson models predicted adjusted risk associated with an interquartile range increase in cardiometabolic indicators. Results Elevated childhood insulin was associated with 10–15% increased risk across the three outcomes. Elevated childhood SBP was associated with preeclampsia (SBP RR=1.50, 95% CI:1.13, 2.01) and SBP, DBP, and body mass index predicted pregnancy induced hypertension (SBP RR=2.15, 95 % CI:1.65, 2.82; DBP RR=1.83, 95% CI:1.38, 2.43; BMI RR=1.67, 95% CI:1.41, 1.98). Blood pressure mediated the association between childhood body mass index and pregnancy induced hypertension. Conclusions Results suggest the potential long-term impact of early-life cardiometabolic profiles on complications of pregnancy.

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Risk of Pregnancy Complications in Relation to Maternal Prepregnancy Body Mass Index: Population‐Based Study from Finland 2006–10

Abstract: Efforts to reduce prepregnancy overweight and obesity need to be intensified, and also, measures to better identify those normal weight women who are at increased risk of gestational diabetes, pre-eclampsia and gestational hypertension should be developed.

Cited by 38 publications

References 30 publications

Ursodeoxycholic acid enriches intestinal bile salt hydrolase-expressing Bacteroidetes in cholestatic pregnancy

Ursodeoxycholic acid enriches intestinal bile salt hydrolase-expressing Bacteroidetes in cholestatic pregnancy

The Impact of Prepregnancy Body Mass Index and Gestational Weight Gain on Perinatal Outcomes for Women With Gestational Diabetes Mellitus

Maternal childhood cardiometabolic risk factors and pregnancy complications

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