Email this article Obesity and pregnancy: possible ways to overcome complications and improve reproductive outcomes
- Authors: Lapina I.A.1,2, Dobrokhotova Y.Е.1, Taranov V.V.1,2, Sorokin Y.A.2, Chirvon T.G.1, Malakhova A.A.1,2
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Affiliations:
- Pirogov Russian National Research Medical University
- Medsi Clinical Diagnostic Center on Solyanka
- Issue: Vol 24, No 6 (2022)
- Pages: 518-524
- Section: ORIGINAL ARTICLE
- URL: https://journal-vniispk.ru/2079-5831/article/view/148274
- DOI: https://doi.org/10.26442/20795696.2022.6.202024
- ID: 148274
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Abstract
Introduction. Obesity, due to its high prevalence and relevance, can be considered an epidemic of modern society. Obesity-related microcirculatory vascular disease and chronic inflammation with endothelial dysfunction are associated with adverse effects on reproductive potential. Sulodexide reduces the risk of hemostatic complications in patients planning pregnancy due to its polypotent effect, which is especially important in metabolic disorders and comorbidities. Therefore, it is promising to assess the effectiveness of integrated management of obese patients as part of pregnancy planning.
Aim. To modify the complex treatment of obesity in patients planning pregnancy to reduce the risk of reproductive losses and gestational complications.
Materials and methods. The prospective analysis included 92 patients with grade 1 obesity. According to the clinical protocols and guidelines of the Reproductive Health Professional Medical Association, 46 patients in the control group (group 1) were prescribed treatment to reduce the body mass index, including lifestyle correction, folic acid, and vitamin D. Patients in the comparison group (Group 2, n=46) also received endotheliotropic agent sulodexide. The treatment efficacy was analyzed based on the frequency of pregnancy, the change of laboratory markers of endothelial dysfunction, the incidence of gestational complications, and reproductive losses.
Results. The study showed that in comparison group patients, the frequency of pregnancy (58.7% of cases in Group 1, 71.7% in Group 1), favorable course of the first trimester (39.1% in Group 1, 63.0% in Group 2), and delivery at term (30.4% in Group 1, 56.5% in Group 2) were higher compared to the control group. There was also a more significant decrease in the body mass index and endothelial dysfunction factors (homocysteine level in group 1 before treatment was 17±2.4 μmol/L, and 14±1.8 μmol/L after treatment; 19±1.7 μmol/L before treatment and 9±1.4 μmol/L after treatment in Group 2, respectively) in patients receiving complex treatment with sulodexide. Analysis of the pregnancy course showed a lower risk of gestational diabetes (33.3% in Group 1 and 13.8% in Group 2).
Conclusion. Treatment of obesity in patients planning pregnancy requires a complex effect aimed at correcting lifestyle, reducing body weight, restoring the endothelial layer, and reducing the severity of chronic inflammation, thus improving reproductive outcomes and minimizing the risk of gestational complications.
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##article.viewOnOriginalSite##About the authors
Irina A. Lapina
Pirogov Russian National Research Medical University; Medsi Clinical Diagnostic Center on Solyanka
Author for correspondence.
Email: doclapina@mail.ru
ORCID iD: 0000-0001-9680-4887
D. Sci. (Med.), Pirogov Russian National Research Medical University, Medsi Clinical Diagnostic Center on Solyanka
Russian Federation, Moscow; MoscowYulia Е. Dobrokhotova
Pirogov Russian National Research Medical University
Email: doclapina@mail.ru
ORCID iD: 0000-0002-7830-2290
D. Sci. (Med.), Prof., Pirogov Russian National Research Medical University
Russian Federation, MoscowVladislav V. Taranov
Pirogov Russian National Research Medical University; Medsi Clinical Diagnostic Center on Solyanka
Email: doclapina@mail.ru
ORCID iD: 0000-0003-2338-2884
Graduate Student, Pirogov Russian National Research Medical University, Medsi Clinical Diagnostic Center on Solyanka
Russian Federation, Moscow; MoscowYury A. Sorokin
Medsi Clinical Diagnostic Center on Solyanka
Email: doclapina@mail.ru
ORCID iD: 0000-0001-9305-323X
Obstetrician-Gynecologist, Medsi Clinical Diagnostic Center on Solyanka
Russian Federation, MoscowTatiana G. Chirvon
Pirogov Russian National Research Medical University
Email: doclapina@mail.ru
ORCID iD: 0000-0002-8302-7510
Graduate Student, Pirogov Russian National Research Medical University
Russian Federation, MoscowAnastasiya A. Malakhova
Pirogov Russian National Research Medical University; Medsi Clinical Diagnostic Center on Solyanka
Email: doclapina@mail.ru
ORCID iD: 0000-0002-2140-8000
Graduate Student, Pirogov Russian National Research Medical University, Medsi Clinical Diagnostic Center on Solyanka
Russian Federation, Moscow; MoscowReferences
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