• Gestation complications in women with metabolic syndrome: pathogenesis, diagnosis and prevention (literature review)
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Gestation complications in women with metabolic syndrome: pathogenesis, diagnosis and prevention (literature review)

Ukrainian Journal Health of Woman. 2021. 1(157): 33-38; doi 10.15574/HW.2021.157.33
Shelestova L. P., Ushullu L. F.
Donetsk National Medical University, Mariupol, Ukraine

For citation: Shelestova LP, Ushullu LF. (2021). Gestation complications in women with metabolic syndrome: pathogenesis, diagnosis and prevention (literature review). Ukrainian Journal Health of Woman. 1(157): 33-38; doi 10.15574/HW.2021.157.33
Article received: Sep 03, 2021. Accepted for publication: Dec 13, 2021.

The article summarizes modern scientific views on the main links of pathogenesis, diagnostic criteria and methods for the prevention of gestational complications in women with metabolic syndrome.
The aims of study is to analyze modern domestic and foreign studies on the study of pathogenetic mechanisms of influence of metabolic components syndrome for the development of gestational complications, methods of their diagnosis and prevention in women with metabolic syndrome.
Results. It has been proven that the components of metabolic syndrome are associated with the development of pregnancy complications, such as pre-eclampsia, fetal growth retardation and macrosomia, gestational diabetes, preterm labour, fetal death, habitual early termination of pregnancy. On the basis of joint pathogenesis, the above-mentioned complications belong to the group of «the great obstetrical syndromes». It has been shown that pregnant women with metabolic syndrome are at high risk for the occurrence of «the great obstetrical syndromes» and require timely appointment of preventive measures to reduce them.
Almost all scientific studies have demonstrated the importance of regulating metabolic processes in the body of a woman with metabolic syndrome at the stage of preconcepence period. It is reported that a lifestyle modification that aims to reduce body weight by prescribing a balanced low-calorie diet combined with exercise and the use of behavioral therapy leads to improved pregnancy outcomes for both mother and baby.
The conclusion. The problem of metabolic syndrome in women of reproductive age remains relevant in modern medicine and taking into account its social significance, requires further research in the aspect of studying pathogenesis, early diagnosis and prevention of his pathology, since it can significantly improve the condition of the pregnant woman in the future and have a positive effect on the course of pregnancy and childbirth.
No conflict of interest was declared by the authors.
Keywords: metabolic syndrome, pregnancy, gestational complications, diagnosis, pathogenesis, prevention.

REFERENСES

1. Ganchar EP, Kazhina MV. (2017). Pregnancy planning in metabolic syndrome: monograph. Grodno: GrGMU: 144.

2. Makarov IO, Shilov EM, Novikova MS, Borovkova EI. (2011). Effects of pregnancy on the progression of metabolic syndrome components. Obstetrics, Gynecology and Reproduction. 5(4):20-26.

3. Hmіl' SV, Franchuk UJa. (2017). Features of the course of pregnancy in women at high risk of developing late gestosis against the background of metabolic syndrome. Bulletin of scientific research. 4: 16-19.

4. Grieger JA, Bianco-Miotto T, Grzeskowiak LE, Leemaqz SY, Poston L, McCowan LM, Kenny LC, Myers JE, Walker JJ, Dekker GA, Roberts CT. (2018). Metabolic syndrome in pregnancy and risk for adverse pregnancy outcomes: A prospective cohort of nulliparous women. PLoS medicine. 15(12): e1002710. https://doi.org/10.1371/journal.pmed.1002710; PMid:30513077 PMCid:PMC6279018

5. Zaharko AJu, Mit'kovskaja NP, Doronina OK. (2017). Features of the course of pregnancy, childbirth and perinatal outcomes in pregnant women with metabolic syndrome. BGMU v avangarde medicinskoj nauki i praktiki: sb. recenzir. nauch. rabot. Minsk: 7: 86-90.

6. Іvanjuta SO, Dindar OA, Makarenko GІ, Kurochka VV. (2017). Collection of scientific papers of the Association of Obstetricians and Gynecologists. 2(40): 134-138.

7. Mihalevich SI, Eshenko AV. (2015). Features of pregnancy management against the background of metabolic syndrome. Modern perinatal medical technologies in solving demographic security problems: sb. nauch. tr. Minsk. 8: 114-120.

8. Moskalenko TJa, Pavlovs'ka OM, Pavlovs'ka KM. (2015). Features of the course of preterm labor in women with metabolic syndrome. Collection of scientific papers of the Association of Obstetricians and Gynecologists of Ukraine. 1(35): 25-29.

9. Tagieva FA. (2016). Metabolic syndrome in obstetrics and gynaecology. The world of medicine and biology. 2(56): 204-206.

10. Eshenko AV. (2016). Management of pregnancy in women with metabolic syndrome. Avtoreferat dis. na soiskanie uchenoj stepeni kand. Med Nauk akusherstvo i ginekologija. Minsk: 21.

11. Skripnik VJa, Genik NІ, Kіnash NM. (2014). Features of the course of pregnancy and childbirth in women with metabolic syndrome. Current issues of paediatrics, obstetrics and gynaecology. 2: 96-98.

12. Wekker V, Huvinen E, van Dammen L et al. (2019). Long-term effects of a pre-conception lifestyle intervention on cardiometabolic health of overweight and obese women. Eur J Public Health. 29(2): 308-314. https://doi.org/10.1093/eurpub/cky222; PMid:30380017 PMCid:PMC6427693

13. Petrov JuA, Kalinina NS. (2020). Features of the course of pregnancy in women with metabolic syndrome complicated by thrombophilia. Scientific review. Medical sciences. 1: 25-26.

14. Gerjak SM, Shved MІ. Metabolic syndrome and pregnancy. Health of woman. 2014; 4(90): 35-39.

15. Mittal RK. (2014). Evaluation of serum lipid profile in cases of pre-eclampsia and eclampsia Int.J. Reprod. Contracept. Obstet.Gynecol. 3(3): 732-734. https://doi.org/10.5455/2320-1770.ijrcog20140981

16. Lakshmy R. (2013). Metabolic syndrome: Role of maternal undernutrition and fetal programming. Rev Endocr Metab Disord. 14(3): 229-40. https://doi.org/10.1007/s11154-013-9266-4; PMid:24005943

17. Nosenko EN. (2017). Etiopathogenetic principles of prevention of significant obstetric syndromes. Medical aspects of women's health. Special issue. GT and contraception. A modern look at large obstetric syndromes: 28-34.

18. Romanenko TG, Mitsoda RM, Bobik YuYu, Lemish NYu. (2019). A modern look at large obstetric syndromes. Health of woman. 2(138): 96-103. doi 10.15574/HW.2019.138.96

19. Di Renzo GC. (2009). The Great Obstetrical Syndromes.The Journal of Maternal-Fetal & Neonatal Medicine. 22(8): 633-5. https://doi.org/10.1080/14767050902866804; PMid:19736613

20. Romero R. (2009). Prenatal medicine: The child is the father of the man. J Matern Fetal Neonatal Med. 22(8):636-9. https://doi.org/10.1080/14767050902784171; PMid:19736614

21. Gabbay-Benziv R, Baschat A. (2015). Gestational diabetes as one of the «great obstetrical syndromes» – the maternal, placental, and fetal dialogue. Best Practice & Research Clinical Obstetrics & Gynaecology. 29(2): 150-155. https://doi.org/10.1016/j.bpobgyn.2014.04.025; PMid:25225057

22. Saklayen MG. (2018). The Global Epidemic of the Metabolic Syndrome. Curr Hypertens Rep. 20(2): 12. https://doi.org/10.1007/s11906-018-0812-z; PMid:29480368 PMCid:PMC5866840

23. Lorite Mingot D, Gesteiro Е, Bastida S, Sanchez-Muniz JF. (2017). Epigenetic effects of the pregnancy Mediterranean diet adherence on the offspring metabolic syndrome markers. J. Physiol. Biochem. 73(4): 495-510. https://doi.org/10.1007/s13105-017-0592-y; PMid:28921259

24. Davydova IuV, Limanska AIu. (2019). Metabolic syndrome: contemporary views and danger in pregnancy Perinatologiya and pediatriya; 1(77): 74-78. https://doi.org/10.15574/PP.2019.77.74

25. Rusalkіna SG. (2015). Differentiated Approach to the Prevention of miscarriage in women with metabolic syndrome. Dissertation for the degree of candidate of Medical Sciences. Kyiv: 151.

26. Fernandez Alba JJ, Mesa Paez C, Vilar Sanchez A et al. (2018). Overweight and obesity at risk factors for hypertensive states of pregnancy: a retrospective cohort study. Nutr. Hosp. 35(4): 874-880. https://doi.org/10.20960/nh.1702; PMid:30070876

27. Franchini M, Targher G, Montagnana M et al. (2008). The metabolic syndrome and the risk of arterial and venous thrombosis. Thrombosis Research. 122: 727-735. https://doi.org/10.1016/j.thromres.2007.09.010; PMid:17996282

28. Jacobsen AF, Skjeldestad FE, Sandset PM. (2018). Incidence and risk patterns of venous thromboembolism in pregnancy and puerperium – a register-based case-control study. Am J Obstet Gynecol. 198(2): 233.e1-7. https://doi.org/10.1016/j.ajog.2007.08.041; PMid:17997389

29. Hromylev AV, Makacarija AD. (2014). Pathogenetic mechanisms of thromboembolic complications of metabolic syndrome in pregnant women. Obstetrics, gynaecology, reproduction. 8(1): 68-71.

30. Goel A, Maski MR, Bajracharya S at al. (2015). Epidemiology and Mechanisms of De Novo and Persistent Hypertension in the Postpartum Period. Circulation. 132(18): 1726-33. https://doi.org/10.1161/CIRCULATIONAHA.115.015721; PMid:26416810 PMCid:PMC4816491

31. Erickson ML, Mey JT, Axelrod CL et al. (2020). Rationale and study design for lifestyle intervention in preparation for pregnancy: A randomized controlled trial. Contemp Clin Trials. 94(1): 106024. https://doi.org/10.1016/j.cct.2020.106024; PMid:32389808 PMCid:PMC7375196

32. Mayo K, Melamed N, Vandenberghe H, Berger H. (2015). The impact of the adoption of the International Association of Diabetes in Pregnancy Study Group criteria for the screening and diagnosis of gestational diabetes. Am J Obstet Gynecol. 212(2): 224.e1-9. https://doi.org/10.1016/j.ajog.2014.08.027; PMid:25173183

33. Unified clinical protocol of primary, emergency and secondary (specialised) medical care «arterial hypertension». Order of the Ministry of the health of Ukraine No.384 of May 24, 2012.

34. Unified clinical protocol of primary and secondary (specialised) medical care «type 2 diabetes mellitus». Order of the Ministry of Health of Ukraine No.1118 of December 21, 2012.

35. Cohen JB, Gadde KM. (2019). Weight loss medications in the treatment of obesity and hypertension. 21(2): 16. https://doi.org/10.1007/s11906-019-0915-1; PMid:30747357 PMCid:PMC6415530

36. Jiskoot G, Benneheij SH, Beerthuizen A et al. (2017). A three-component cognitive behavioural lifestyle program for pre-conception weight-loss in women with polycystic ovary syndrome (PCOS): a protocol for a randomised controlled trial. Reprod Health. 14(1): 34. https://doi.org/10.1186/s12978-017-0295-4; PMid:28264692 PMCid:PMC5339998

37. Price S, Nankervis A, Permezel M et al. (2018). Health consequences for mother and baby of substantial pre-conception weight loss in obese women: study protocol for a randomised controlled trial. Trials. 19(1): 248. https://doi.org/10.1186/s13063-018-2615-6; PMid:29690917 PMCid:PMC5926510

38. Van Dammen L, Wekker V, de Rooij SR et al. (2019). The effects of a pre-conception lifestyle intervention in women with obesity and infertility on perceived stress, mood symptoms, sleep and quality of life. PLoS One. 14(2): e0212914. https://doi.org/10.1371/journal.pone.0212914; PMid:30802271 PMCid:PMC6388912

39. Wattar BH, Dodds J, Placzek A et al. (2019). ESTEEM study group. Mediterranean-style diet in pregnant women with metabolic risk factors (ESTEEM). А pragmatic multicentre randomised trial. PLoS Med. 16(7): e1002857. https://doi.org/10.1371/journal.pmed.1002857; PMid:31335871 PMCid:PMC6650045

40. Sheehan DV, Herman BK. (2015). The Psychological and Medical Factors Associated With Untreated Binge Eating Disorder. Prim Care Companion CNS Disord. 17(2): 10.4088/PCC.14r01732. https://doi.org/10.4088/PCC.14r01732; PMid:26445695 PMCid:PMC4560195

41. Sim KA, Partridge SR, Sainsbury A. (2014). Does weight loss in overweight or obese women improve fertility treatment outcomes? A systematic review. Obes Rev. 15(10): 839-50. https://doi.org/10.1111/obr.12217; PMid:25132280

42. Baillot A, Chenail S, Barros Polita N. (2021). Physical activity motives, barriers, and preferences in people with obesity: A systematic review. PLoS One. 16(6): e0253114. https://doi.org/10.1371/journal.pone.0253114; PMid:34161372 PMCid:PMC8221526

43. Paccosi S, Cresci B, Pala L et al. (2020). Obesity therapy: how and why? Curr Med Chem. 27(2): 174-186. https://doi.org/10.2174/0929867326666190124121725; PMid:30678612

44. Poon LC, Shennan A, Hyett JA et al. (2019). The International Federation of Gynecology and Obstetrics (FIGO) initiative on pre-eclampsia: A pragmatic guide for first-trimester screening and prevention. Int Gynaecol Obstet. 145; Suppl 1: 1-33. https://doi.org/10.1002/ijgo.12802; PMid:31111484 PMCid:PMC6944283

45. Hofmeyr GJ, Lawrie TA, Atallah AN et al. (2014). Calcium supplementation during pregnancy for preventing hypertensive disorders and related problems. Cochrane Database of Systematic Reviews. 10(10): CD001059. https://doi.org/10.1002/14651858.CD001059.pub5; PMid:30277579 PMCid:PMC6517256