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Obesity during pregnancy alters maternal oxidant balance and micronutrient status

Abstract

Objective:

Little is known about the effect of obesity on inflammatory status in pregnant women. The objective of this study was to determine the effect of obesity on markers of inflammation, oxidative stress and micronutrient status in obese pregnant women and their infants compared with lean controls (Lc).

Study Design:

This was a prospective case–control study. A total of 15 obese (Ob; body mass index (BMI) >30 kg m−2) and 15 lean (BMI 18–25 kg m−2) women were recruited based on prepregnancy BMI. Vitamins A, B6, C, E and 25-hydroxyvitamin D (25(OH)D), zinc, red blood cell (RBC) folate, C-reactive protein (CRP), interleukin-6 (IL-6), tumor necrosis factor-α and oxidized and reduced glutathione were measured from maternal blood between 24 and 28 weeks of gestation. Vitamins A, B6, C and E, 25(OH)D, zinc, red blood cell folate, CRP and IL-6 were measured from cord blood at delivery.

Result:

Ob pregnant women have statistically significantly lower levels of vitamin B6, vitamin C, vitamin E, RBC folate, higher CRP and IL-6 levels and higher ratio of oxidized to reduced glutathione compared with Lc pregnant women. Infants born to Ob mothers did not have statistically significantly higher measures of inflammation or oxidative stress. There were no differences in micronutrient concentrations between Lc and Ob infants, but folate, vitamin B6 and zinc levels correlated strongly between mother and infant. There was no statistically significant difference in any parameter between Ob and Lc cord blood.

Conclusion:

Ob pregnant women have increased inflammation and oxidative stress, and lower levels of nutritional antioxidant defenses compared with Lc pregnant women. We speculate that lower antioxidant defenses combined with increased oxidative stress and inflammation may contribute to the adverse outcomes associated with pregnancy in Ob women.

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References

  1. Flegal KM, Carroll MD, Ogden CL, Curtin LR . Prevalence and trends in obesity among US adults, 1999-2008. JAMA 2010; 303 (3): 235–241.

    Article  CAS  PubMed  Google Scholar 

  2. Heslehurst N, Simpson H, Ells LJ, Rankin J, Wilkinson J, Lang R et al. The impact of maternal BMI status on pregnancy outcomes with immediate short-term obstetric resource implications: a meta-analysis. Obes Rev 2008; 9 (6): 635–683.

    Article  CAS  PubMed  Google Scholar 

  3. Ehrenberg HM, Mercer BM, Catalano PM . The influence of obesity and diabetes on the prevalence of macrosomia. Am J Obstet Gynecol 2004; 191 (3): 964–968.

    Article  CAS  PubMed  Google Scholar 

  4. Dennedy MC, Dunne F . The maternal and fetal impacts of obesity and gestational diabetes on pregnancy outcome. Best Pract Res Clin Endocrinol Metab 2010; 24 (4): 573–589.

    Article  PubMed  Google Scholar 

  5. Catalano PM, Farrell K, Thomas A, Huston-Presley L, Mencin P, de Mouzon SH et al. Perinatal risk factors for childhood obesity and metabolic dysregulation. Am J Clin Nutr 2009; 90 (5): 1303–1313.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  6. Catalano PM, Ehrenberg HM . The short- and long-term implications of maternal obesity on the mother and her offspring. BJOG 2006; 113 (10): 1126–1133.

    Article  CAS  PubMed  Google Scholar 

  7. Koch L . Obesity: maternal weight linked to congenital anomalies in offspring. Nat Rev Endocrinol 2010; 6 (8): 418.

    Article  PubMed  Google Scholar 

  8. Rankin J, Tennant PW, Stothard KJ, Bythell M, Summerbell CD, Bell R . Maternal body mass index and congenital anomaly risk: a cohort study. Int J Obes (Lond) 2010; 34 (9): 1371–1380.

    Article  CAS  Google Scholar 

  9. Oddy WH, De Klerk NH, Miller M, Payne J, Bower C . Association of maternal pre-pregnancy weight with birth defects: evidence from a case-control study in Western Australia. Aust N Z J Obstet Gynaecol 2009; 49 (1): 11–15.

    Article  PubMed  Google Scholar 

  10. Stothard KJ, Tennant PW, Bell R, Rankin J . Maternal overweight and obesity and the risk of congenital anomalies: a systematic review and meta-analysis. JAMA 2009; 301 (6): 636–650.

    Article  CAS  PubMed  Google Scholar 

  11. Shaw GM, Carmichael SL . Prepregnant obesity and risks of selected birth defects in offspring. Epidemiology 2008; 19 (4): 616–620.

    Article  PubMed  PubMed Central  Google Scholar 

  12. Blomberg MI, Kallen B . Maternal obesity and morbid obesity: the risk for birth defects in the offspring. Birth Defects Res A Clin Mol Teratol 2010; 88 (1): 35–40.

    CAS  PubMed  Google Scholar 

  13. Keaney JF Jr, Larson MG, Vasan RS, Wilson PW, Lipinska I, Corey D et al. Obesity and systemic oxidative stress: clinical correlates of oxidative stress in the Framingham Study. Arterioscler Thromb Vasc Biol 2003; 23 (3): 434–439.

    Article  CAS  PubMed  Google Scholar 

  14. Al-Aubaidy HA, Jelinek HF . Oxidative DNA damage and obesity in type 2 diabetes mellitus. Eur J Endocrinol 2011; 164 (6): 899–904.

    Article  CAS  PubMed  Google Scholar 

  15. Vincent HK, Taylor AG . Biomarkers and potential mechanisms of obesity-induced oxidant stress in humans. Int J Obes (Lond) 2006; 30 (3): 400–418.

    Article  CAS  Google Scholar 

  16. Challis JR, Lockwood CJ, Myatt L, Norman JE, Strauss JF 3rd, Petraglia F . Inflammation and pregnancy. Reprod Sci 2009; 16 (2): 206–215.

    Article  CAS  PubMed  Google Scholar 

  17. Basu S, Haghiac M, Surace P, Challier JC, Guerre-Millo M, Singh K et al. Pregravid obesity associates with increased maternal endotoxemia and metabolic inflammation. Obesity (Silver Spring) 2011; 19 (3): 476–482.

    Article  CAS  Google Scholar 

  18. Challier JC, Basu S, Bintein T, Minium J, Hotmire K, Catalano PM et al. Obesity in pregnancy stimulates macrophage accumulation and inflammation in the placenta. Placenta 2008; 29 (3): 274–281.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  19. Radaelli T, Uvena-Celebrezze J, Minium J, Huston-Presley L, Catalano P, Hauguel-de Mouzon S . Maternal interleukin-6: marker of fetal growth and adiposity. J Soc Gynecol Investig 2006; 13 (1): 53–57.

    Article  CAS  PubMed  Google Scholar 

  20. Poston L, Igosheva N, Mistry HD, Seed PT, Shennan AH, Rana S et al. Role of oxidative stress and antioxidant supplementation in pregnancy disorders. Am J Clin Nutr 2011; 94 (6 Suppl): 1980S–1985S.

    Article  CAS  PubMed  Google Scholar 

  21. Mistry HD, Williams PJ . The importance of antioxidant micronutrients in pregnancy. Oxid Med Cell Longev 2011; 2011: 841749.

    Article  PubMed  PubMed Central  Google Scholar 

  22. Agarwal A, Gupta S, Sikka S . The role of free radicals and antioxidants in reproduction. Curr Opin Obstet Gynecol 2006; 18 (3): 325–332.

    Article  PubMed  Google Scholar 

  23. Traber MG, Stevens JF . Vitamins C and E: beneficial effects from a mechanistic perspective. Free Radic Biol Med 2011; 51 (5): 1000–1013.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  24. Reitman A, Friedrich I, Ben-Amotz A, Levy Y . Low plasma antioxidants and normal plasma B vitamins and homocysteine in patients with severe obesity. Isr Med Assoc J 2002; 4 (8): 590–593.

    CAS  PubMed  Google Scholar 

  25. Kimmons JE, Blanck HM, Tohill BC, Zhang J, Khan LK . Associations between body mass index and the prevalence of low micronutrient levels among US adults. MedGenMed 2006; 8 (4): 59.

    PubMed  PubMed Central  Google Scholar 

  26. Han YS, Ha EH, Park HS, Kim YJ, Lee SS . Relationships between pregnancy outcomes, biochemical markers and pre-pregnancy body mass index. Int J Obes (Lond) 2011; 35 (4): 570–577.

    Article  CAS  Google Scholar 

  27. Stern SJ, Matok I, Kapur B, Koren G . A comparison of folic acid pharmacokinetics in obese and nonobese women of childbearing age. Ther Drug Monit 2011; 33 (3): 336–340.

    Article  CAS  PubMed  Google Scholar 

  28. Gustafsson S, Lind L, Soderberg S, Zilmer M, Hulthe J, Ingelsson E . Oxidative stress and inflammatory markers in relation to circulating levels of adiponectin. Obesity (Silver Spring) 2013; 21 (7): 1467–1473.

    Article  CAS  Google Scholar 

  29. Powell SR . The antioxidant properties of zinc. J Nutr 2000; 130 (5S Suppl): 1447S–1454SS.

    Article  CAS  PubMed  Google Scholar 

  30. James SJ, Cutler P, Melnyk S, Jernigan S, Janak L, Gaylor DW et al. Metabolic biomarkers of increased oxidative stress and impaired methylation capacity in children with autism. Am J Clin Nutr 2004; 80 (6): 1611–1617.

    Article  CAS  PubMed  Google Scholar 

  31. Sakakeeny L, Roubenoff R, Obin M, Fontes JD, Benjamin EJ, Bujanover Y et al. Plasma pyridoxal-5-phosphate is inversely associated with systemic markers of inflammation in a population of U.S. adults. J Nutr 2012; 142 (7): 1280–1285.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  32. Behrens WA, Mdere R . A highly sensitive high-performance liquid chromatography method for the estimation of ascorbic and dehydroascorbic acid in tissues, biological fluids, and foods. Anal Biochem 1987; 165 (1): 102–107.

    Article  CAS  PubMed  Google Scholar 

  33. Bieri JG, Tolliver TJ, Catignani GL. . Simultaneous determination of alpha-tocopherol and retinol in plasma or red cells by high pressure liquid chromatography. Am J Clin Nutr 1979; 32 (10): 2143–2149.

    Article  CAS  PubMed  Google Scholar 

  34. Smith JC Jr, Butrimovitz GP, Purdy WC. . Direct Measurement of zinc in plasma by atomic absorption spectroscopy. Clin Chem 1979; 25 (8): 1487–1491.

    CAS  PubMed  Google Scholar 

  35. Babson AL, Olson DR, Palmieri T, Ross AF, Becker DM, Mulqueen PJ. . The IMMULITE assay tube: a new approach to heterogeneous ligand assay. Clin Chem 1991; 37 (9): 1521–1522.

    CAS  PubMed  Google Scholar 

  36. Camp VM, Chipponi J, Faraj BA . Radioenzymatic assay for direct measurement of plasma pyridoxal 5′-phosphate. Clin Chem 1983; 29 (4): 642–644.

    CAS  PubMed  Google Scholar 

  37. Sen S, Simmons RA . Maternal antioxidant supplementation prevents adiposity in the offspring of Western diet-fed rats. Diabetes 2010; 59 (12): 3058–3065.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  38. Farah N, Hogan AE, O'Connor N, Kennelly MM, O'Shea D, Turner MJ . Correlation between maternal inflammatory markers and fetomaternal adiposity. Cytokine 2012; 60 (1): 96–99.

    Article  CAS  PubMed  Google Scholar 

  39. Raijmakers MT, Peters WH, Steegers EA, Poston L . Amino thiols, detoxification and oxidative stress in pre-eclampsia and other disorders of pregnancy. Curr Pharm Des 2005; 11 (6): 711–734.

    Article  CAS  PubMed  Google Scholar 

  40. Hsieh TT, Chen SF, Lo LM, Li MJ, Yeh YL, Hung TH . The association between maternal oxidative stress at mid-gestation and subsequent pregnancy complications. Reprod Sci 2012; 19 (5): 505–512.

    Article  PubMed  Google Scholar 

  41. Berniakovich I, Trinei M, Stendardo M, Migliaccio E, Minucci S, Bernardi P et al. p66Shc-generated oxidative signal promotes fat accumulation. J Biol Chem 2008; 283 (49): 34283–34293.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  42. Furukawa S, Fujita T, Shimabukuro M, Iwaki M, Yamada Y, Nakajima Y et al. Increased oxidative stress in obesity and its impact on metabolic syndrome. J Clin Invest 2004; 114 (12): 1752–1761.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  43. Dao MC, Sen S, Iyer C, Klebenov D, Meydani SN . Obesity during pregnancy and fetal iron status: is Hepcidin the link? J Perinatol 2013; 33 (3): 177–181.

    Article  CAS  PubMed  Google Scholar 

  44. Shaw GM, Schaffer D, Velie EM, Morland K, Harris JA . Periconceptional vitamin use, dietary folate, and the occurrence of neural tube defects. Epidemiology 1995; 6 (3): 219–226.

    Article  CAS  PubMed  Google Scholar 

  45. Watkins ML, Rasmussen SA, Honein MA, Botto LD, Moore CA . Maternal obesity and risk for birth defects. Pediatrics 2003; 111 (5 Part 2): 1152–1158.

    PubMed  Google Scholar 

  46. Conde-Agudelo A, Romer R, Kusanovic JP, Hassan SS. . Supplementation with vitamins C and E during pregnancy for the prevention of preeclampsia and other adverse maternal and perinatal outcomes: a systematic review and metaanalysis. Am J Obstet Gynecol 2011; 204 (6): 503.e1–503.12.

    Article  Google Scholar 

  47. Vobecky JS, Vobecky J, Shapcott D, Blanchard R . Vitamin E and C levels in infants during the first year of life. Am J Clin Nutr 1976; 29 (7): 766–771.

    Article  CAS  PubMed  Google Scholar 

  48. Tsang R, Uauy R, Koletzko B, Zlotkin S (eds) Water Soluble Vitamins for Premature Infants 2nd edn. Digital Educational Publishing: Cincinnati, OH, 2005.

    Google Scholar 

  49. Laraia BA, Bodnar LM, Siega-Riz AM . Pregravid body mass index is negatively associated with diet quality during pregnancy. Public Health Nutr 2007; 10 (9): 920–926.

    Article  PubMed  Google Scholar 

  50. Rifas-Shiman SL, Rich-Edwards JW, Kleinman KP, Oken E, Gillman MW . Dietary quality during pregnancy varies by maternal characteristics in Project Viva: a US cohort. J Am Diet Assoc 2009; 109 (6): 1004–1011.

    Article  PubMed  PubMed Central  Google Scholar 

  51. Rifas-Shiman SL, Rich-Edwards JW, Willett WC, Kleinman KP, Oken E, Gillman MW . Changes in dietary intake from the first to the second trimester of pregnancy. Paediatr Perinat Epidemiol 2006; 20 (1): 35–42.

    Article  PubMed  PubMed Central  Google Scholar 

  52. Hanley MJ, Abernethy DR, Greenblatt DJ . Effect of obesity on the pharmacokinetics of drugs in humans. Clin Pharmacokinet 2010; 49 (2): 71–87.

    Article  CAS  PubMed  Google Scholar 

  53. Poston L, Raijmakers MT . Trophoblast oxidative stress, antioxidants and pregnancy outcome—a review. Placenta 2004; 25 (Suppl A): S72–S78.

    Article  CAS  PubMed  Google Scholar 

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Acknowledgements

This research was funded by the Tufts Medical Center Research Grant, The Natalie Zucker Research Grant and USDA contract no. 58-1950-7-707.

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Sen, S., Iyer, C. & Meydani, S. Obesity during pregnancy alters maternal oxidant balance and micronutrient status. J Perinatol 34, 105–111 (2014). https://doi.org/10.1038/jp.2013.153

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