Effects of maternal obesity on placental function and fetal development.
Effects of maternal obesity on placental function and fetal development.
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DOI：
10.1530/rep-16-0495
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发表时间：
2017-03
期刊：
影响因子：
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通讯作者：
Powell TL
中科院分区：
文献类型：
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作者：
Howell KR;Powell TL
肥胖已达到流行病的比例，肥胖母亲怀孕增加了并发症的风险，包括妊娠糖尿病，高血压疾病，早产和剖腹产。肥胖母亲所生的孩子患肥胖症和代谢疾病的风险增加，容易患神经精神和认知障碍。胎盘功能的变化不仅在妊娠并发症的发展中起着关键作用，而且还可能涉及将母亲肥胖与婴儿的长期健康风险联系起来。母体脂肪因子，白细胞介素6（IL-6）、肿瘤坏死因子α（TNF-α）、瘦素和脂联素将母体营养状况和脂肪组织代谢与胎盘功能联系起来。脂肪因子和代谢激素通过调节胎盘营养物质的转运，直接影响胎盘功能。胎儿的营养输送受胰岛素信号传导、细胞因子谱和胰岛素反应性之间的复杂相互作用调节，胰岛素反应性由脂联素和IL-1β调节。此外，肥胖孕妇有患高血压和先兆子痫的风险，胎盘血管分布和血流减少，这将限制胎盘向发育中的胎儿输送营养。这些有时相反的信号调节胎盘功能可能有助于在妊娠肥胖妇女中观察到的短期和长期结果的多样性。本文就脂肪因子和肥胖相关代谢激素的变化，以及这些因素如何影响胎盘功能和胎儿发育，从而导致肥胖母亲所生子女的长期代谢和行为后果进行综述。
Obesity has reached epidemic proportions and pregnancies in obese mothers have increased risk for complications including gestational diabetes, hypertensive disorders, preterm birth and caesarian section. Children born to obese mothers are at increased risk of obesity and metabolic disease and are susceptible to develop neuropsychiatric and cognitive disorders. Changes in placental function not only play a critical role in the development of pregnancy complications but may also be involved in linking maternal obesity to long-term health risks in the infant. Maternal adipokines i.e., interleukin 6 (IL-6), tumor necrosis factor alpha (TNF-α), leptin and adiponectin link maternal nutritional status and adipose tissue metabolism to placental function. Adipokines and metabolic hormones have direct impact on placental function by modulating placental nutrient transport. Nutrient delivery to the fetus is regulated by a complex interaction between insulin signaling, cytokine profile and insulin responsiveness, which is modulated by adiponectin and IL-1β. In addition, obese pregnant women are at risk for hypertension and preeclampsia with reduced placental vascularity and blood flow, which would restrict placental nutrient delivery to the developing fetus. These sometimes opposing signals regulating placental function may contribute to the diversity of short and long-term outcomes observed in pregnant obese women. This review focuses on the changes in adipokines and obesity-related metabolic hormones, how these factors influence placental function and fetal development to contribute to long-term metabolic and behavioral consequences of children born to obese mothers.