leptin and Fetal-Death

This paper presents current data on the pathophysiology of gestational diabetes mellitus, classification and new diagnostic methods. Gestational Diabetes Mellitus (GDM) is defined as carbohydrate intolerance first detected during pregnancy. It is the most common metabolic disorder of pregnant women. The frequency of its occurrence depends on inter alia body weight, belonging to a particular ethnic group and diagnostic methods. GDM reveals usually between 24 and 28 weeks of gestation. The development of diabetes in pregnancy poses a threat to both the mother and the fetus. It is associated with an increased incidence of birth defects in newborns, impaired intrauterine fetal growth, higher incidence of premature births and greater percentage of the intrauterine fetus death. Amongst women complicated by gestational diabetes arterial hypertension more often unfolds. In the development of gestational diabetes mellitus important role apart from maternal and fetal hyperinsulinemia play: antagonistic to insulin placental hormones, TNFα, placental pro-inflammatory cytokines, resistin, leptin ghrelin.

Topics: Congenital Abnormalities; Cytokines; Diabetes, Gestational; Female; Fetal Death; Humans; Infant, Newborn; Infant, Premature; Insulin; Leptin; Pregnancy; Prenatal Exposure Delayed Effects

Maternal obesity results in a number of obstetrical and fetal complications with both immediate and long-term consequences. The increased prevalence of obesity has resulted in increasing numbers of women of reproductive age in this high-risk group. Since many of these obese women have been subjected to hypercaloric diets from early childhood we have developed a rodent model of life-long maternal obesity to more clearly understand the mechanisms that contribute to adverse pregnancy outcomes in obese women. Female Sprague Dawley rats were fed a control diet (CON--16% of calories from fat) or high fat diet (HF--45% of calories from fat) from 3 to 19 weeks of age. Prior to pregnancy HF-fed dams exhibited significant increases in body fat, serum leptin and triglycerides. A subset of dams was sacrificed at gestational day 15 to evaluate fetal and placental development. The remaining animals were allowed to deliver normally. HF-fed dams exhibited a more than 3-fold increase in fetal death and decreased neonatal survival. These outcomes were associated with altered vascular development in the placenta, as well as increased hypoxia in the labyrinth. We propose that the altered placental vasculature may result in reduced oxygenation of the fetal tissues contributing to premature demise and poor neonatal survival.

Topics: Adipose Tissue; Animals; Dietary Fats; Disease Models, Animal; Female; Fetal Death; Fetus; Humans; Hypoxia; Leptin; Obesity; Placenta; Pregnancy; Rats; Rats, Sprague-Dawley; Triglycerides