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First Trimester Evaluation of Maternal Visceral Fat and Its Relationship with Adverse Pregnancy Outcomes

SIMPLE SUMMARY: Maternal adipose tissue grows during pregnancy to secure the fetus’s nutritional supply, and too much visceral adipose tissue at the start of pregnancy can increase metabolic risk and gestational problems. The distribution of fat, and more particularly the rise in visceral fat or cen...

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Autores principales: Brenes-Martín, Francisco, Melero-Jiménez, Victoria, López-Guerrero, Miguel Ángel, Calero-Ruiz, María Mercedes, Vázquez-Fonseca, Luis, Ábalos-Martínez, Jessica, Quintero-Prado, Rocío, Torrejón, Rafael, Visiedo, Francisco, Bugatto, Fernando
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9953059/
https://www.ncbi.nlm.nih.gov/pubmed/36829423
http://dx.doi.org/10.3390/biology12020144
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author Brenes-Martín, Francisco
Melero-Jiménez, Victoria
López-Guerrero, Miguel Ángel
Calero-Ruiz, María Mercedes
Vázquez-Fonseca, Luis
Ábalos-Martínez, Jessica
Quintero-Prado, Rocío
Torrejón, Rafael
Visiedo, Francisco
Bugatto, Fernando
author_facet Brenes-Martín, Francisco
Melero-Jiménez, Victoria
López-Guerrero, Miguel Ángel
Calero-Ruiz, María Mercedes
Vázquez-Fonseca, Luis
Ábalos-Martínez, Jessica
Quintero-Prado, Rocío
Torrejón, Rafael
Visiedo, Francisco
Bugatto, Fernando
author_sort Brenes-Martín, Francisco
collection PubMed
description SIMPLE SUMMARY: Maternal adipose tissue grows during pregnancy to secure the fetus’s nutritional supply, and too much visceral adipose tissue at the start of pregnancy can increase metabolic risk and gestational problems. The distribution of fat, and more particularly the rise in visceral fat or central obesity, has been found to be more closely linked to the onset of cardiovascular disease and metabolic syndrome than obesity itself. Our goal is to examine the association between the thickness of the mother’s visceral fat, as determined by a first trimester ultrasound exam, and the risk of poor pregnancy outcomes. We observed that women who experienced complications during pregnancy had greater levels of maternal visceral fat, especially gestational diabetes, which was linked to metabolic risk factors including insulin resistance and arterial blood pressure. This fact may imply that the risk of complications would increase more when the distribution of visceral fat (associated with metabolic risk) is greater than expected for a given degree of obesity/body mass index. ABSTRACT: Obese women are more likely to experience pregnancy complications. The distribution of fat, and more particularly the rise in visceral fat, is well established to be more closely linked to the onset of cardiovascular disease and metabolic syndrome than obesity itself. We aim to examine the relationship between maternal visceral fat assessment in the first trimester and the appearance of adverse pregnancy outcomes. A prospective cohort study including 416 pregnant women was conducted. During the first trimester scan (11–13 + 6 weeks), all individuals had their visceral fat and subcutaneous thicknesses measured by ultrasonography. Blood samples were obtained, and maternal demographics and clinical information were documented. After delivery, the obstetric outcomes were evaluated. We contrasted two groups: one with healthy pregnancies and the other with adverse pregnancy outcomes (APO), defined as the development of at least one of the following complications: gestational diabetes mellitus, hypertensive disorders of pregnancy, abnormal fetal growth, preterm delivery or preterm premature rupture of membranes. Median maternal age was 33 and 34 years old for the uncomplicated and adverse pregnancy outcomes groups, respectively. We found that women with adverse pregnancy outcomes had higher VFT (median 30 vs. 26.5 mm, p = 0.001) and SFT (median 18.9 vs. 17.1 mm, p = 0.03). However, the visceral/subcutaneous fat ratio was not statistically different between groups. Finally, we performed a subanalysis for metabolic and placental vascular dysfunction complications. After performing a multivariate logistic regression analysis adjusted for maternal age, smoking, and mean arterial pressure, both the VFT (aOR 1.03, p < 0.001) and the ratio of visceral/subcutaneous fat (aOR 1.37, p = 0.04) were significantly associated with the development of adverse pregnancy outcomes; however, the associations of VFT and the VFT-to-SFT ratio were higher for the occurrence of gestational diabetes (aOR 1.07, p < 0.001; aOR 2.09, p = 0.001; respectively) and showed no relationships with placental complications. When conducting a first-trimester ultrasound assessment, sonographers may measure VFT without additional time or cost involved. Identification of pregnant women with increased VFT (>37 mm) may benefit from a close follow-up, especially for the development of gestational diabetes, independent of BMI.
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spelling pubmed-99530592023-02-25 First Trimester Evaluation of Maternal Visceral Fat and Its Relationship with Adverse Pregnancy Outcomes Brenes-Martín, Francisco Melero-Jiménez, Victoria López-Guerrero, Miguel Ángel Calero-Ruiz, María Mercedes Vázquez-Fonseca, Luis Ábalos-Martínez, Jessica Quintero-Prado, Rocío Torrejón, Rafael Visiedo, Francisco Bugatto, Fernando Biology (Basel) Article SIMPLE SUMMARY: Maternal adipose tissue grows during pregnancy to secure the fetus’s nutritional supply, and too much visceral adipose tissue at the start of pregnancy can increase metabolic risk and gestational problems. The distribution of fat, and more particularly the rise in visceral fat or central obesity, has been found to be more closely linked to the onset of cardiovascular disease and metabolic syndrome than obesity itself. Our goal is to examine the association between the thickness of the mother’s visceral fat, as determined by a first trimester ultrasound exam, and the risk of poor pregnancy outcomes. We observed that women who experienced complications during pregnancy had greater levels of maternal visceral fat, especially gestational diabetes, which was linked to metabolic risk factors including insulin resistance and arterial blood pressure. This fact may imply that the risk of complications would increase more when the distribution of visceral fat (associated with metabolic risk) is greater than expected for a given degree of obesity/body mass index. ABSTRACT: Obese women are more likely to experience pregnancy complications. The distribution of fat, and more particularly the rise in visceral fat, is well established to be more closely linked to the onset of cardiovascular disease and metabolic syndrome than obesity itself. We aim to examine the relationship between maternal visceral fat assessment in the first trimester and the appearance of adverse pregnancy outcomes. A prospective cohort study including 416 pregnant women was conducted. During the first trimester scan (11–13 + 6 weeks), all individuals had their visceral fat and subcutaneous thicknesses measured by ultrasonography. Blood samples were obtained, and maternal demographics and clinical information were documented. After delivery, the obstetric outcomes were evaluated. We contrasted two groups: one with healthy pregnancies and the other with adverse pregnancy outcomes (APO), defined as the development of at least one of the following complications: gestational diabetes mellitus, hypertensive disorders of pregnancy, abnormal fetal growth, preterm delivery or preterm premature rupture of membranes. Median maternal age was 33 and 34 years old for the uncomplicated and adverse pregnancy outcomes groups, respectively. We found that women with adverse pregnancy outcomes had higher VFT (median 30 vs. 26.5 mm, p = 0.001) and SFT (median 18.9 vs. 17.1 mm, p = 0.03). However, the visceral/subcutaneous fat ratio was not statistically different between groups. Finally, we performed a subanalysis for metabolic and placental vascular dysfunction complications. After performing a multivariate logistic regression analysis adjusted for maternal age, smoking, and mean arterial pressure, both the VFT (aOR 1.03, p < 0.001) and the ratio of visceral/subcutaneous fat (aOR 1.37, p = 0.04) were significantly associated with the development of adverse pregnancy outcomes; however, the associations of VFT and the VFT-to-SFT ratio were higher for the occurrence of gestational diabetes (aOR 1.07, p < 0.001; aOR 2.09, p = 0.001; respectively) and showed no relationships with placental complications. When conducting a first-trimester ultrasound assessment, sonographers may measure VFT without additional time or cost involved. Identification of pregnant women with increased VFT (>37 mm) may benefit from a close follow-up, especially for the development of gestational diabetes, independent of BMI. MDPI 2023-01-17 /pmc/articles/PMC9953059/ /pubmed/36829423 http://dx.doi.org/10.3390/biology12020144 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Brenes-Martín, Francisco
Melero-Jiménez, Victoria
López-Guerrero, Miguel Ángel
Calero-Ruiz, María Mercedes
Vázquez-Fonseca, Luis
Ábalos-Martínez, Jessica
Quintero-Prado, Rocío
Torrejón, Rafael
Visiedo, Francisco
Bugatto, Fernando
First Trimester Evaluation of Maternal Visceral Fat and Its Relationship with Adverse Pregnancy Outcomes
title First Trimester Evaluation of Maternal Visceral Fat and Its Relationship with Adverse Pregnancy Outcomes
title_full First Trimester Evaluation of Maternal Visceral Fat and Its Relationship with Adverse Pregnancy Outcomes
title_fullStr First Trimester Evaluation of Maternal Visceral Fat and Its Relationship with Adverse Pregnancy Outcomes
title_full_unstemmed First Trimester Evaluation of Maternal Visceral Fat and Its Relationship with Adverse Pregnancy Outcomes
title_short First Trimester Evaluation of Maternal Visceral Fat and Its Relationship with Adverse Pregnancy Outcomes
title_sort first trimester evaluation of maternal visceral fat and its relationship with adverse pregnancy outcomes
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9953059/
https://www.ncbi.nlm.nih.gov/pubmed/36829423
http://dx.doi.org/10.3390/biology12020144
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