Obesity and Pregnancy
Research in to obesity and pre-eclampsia
Overview
Nearly one in five of pregnant women in the UK are obese, meaning a body mass index (BMI) of 30 or higher. This has become increasingly common in recent years and shows no signs of declining.Obesity is linked to an increased risk of many serious complications of pregnancy such as high blood pressure, diabetes and problems during the birthing process, which is a cause for concern. These can occasionally lead to significant long term health problems or even death. It is also far more likely that children of obese mothers will be overweight or obese themselves.
Our researchers are leading an important programme of research aimed at increasing understanding of the reasons why obese women are at increased risk, and how complications occur. Obese women are more likely to have babies that grow larger than expected in pregnancy, which can cause problems during labour and delivery.
The placenta is known to control a baby’s growth during pregnancy, so we are investigating whether obesity changes the development or function of the placenta in pregnancy.
Problem
Pre-eclampsia is a serious complication involving development of high blood pressure and protein in the urine during pregnancy. This occurs in five per cent of all pregnant women. The only treatment available at present is early delivery of the baby; meaning many babies are delivered prematurely because of this condition.Obese women are at much higher risk of developing pre-eclampsia than women of normal weight, but the reasons for this are not understood.
What we have achieved to date:
Research has found that in cardiovascular disease outside of pregnancy, increased adipokine secretion from expanded fat mass is associated with endotheilial dysfunction (high blood pressure). It is also known that abnormal function of the blood vessels, endothelium, plays an important part in causing pre-eclampsia.We propose that altered adipokine secretion in pregnant obese women promotes maternal vascular endothelial dysfunction and that this process also underlies the increased risk of pre-eclampsia in obese women.
What we aim to achieve:
In this study, which is supported by The British Heart Foundation, we aim to increase our understanding of why obese pregnant women are more likely to develop pre-eclampsia. Our researchers will examine maternal arterial function in obese pregnant women to determine whether maternal obesity is linked to altered adipokine.Myometrial and omental (visceral fat) tissue will be obtained from normal weight, overweight and obese pregnant women undergoing caesarean sections. Omental fat cells will then be cultured to assess adipokine release in each weight group. Adipokines will also be measured in maternal blood. The Myometrial arterial function will be assessed by using wire myography and correlating this to the woman’s BMI. In addition to the research above, arterial function in arteries from normal weight women will also be examined after exposure to adipokines or omental “fat-conditioned” media.
If greater levels of hormones from myometrial and omental tissue in pregnancy are found to increase the risk of pre-eclampsia in obese women, it may be possible to reduce these effects by lifestyle changes or drug treatment.
