Preterm birth increases placental expression of multidrug resistance (MDR) transporters irrespective of prepregnancy body mass index (BMI)

Context: Preterm birth (PTB) and suboptimal prepregnancy body mass index (BMI) operate through inflammatory pathways to impair fetoplacental development. Placental efflux transporters mediate fetal protection and nutrition, however few studies consider the effect of both PTB and BMI on fetal protection. We hypothesized that PTB would alter the expression of placental multidrug resistance (MDR) transporters and selected pro-inflammatory cytokines, and that maternal underweight and obesity would further impair placental phenotype. Objective: To determine whether placental MDR transporters P-glycoprotein (P-gp, encoded by ABCB1) and breast cancer resistance protein (BCRP/ABCG2), and pro-inflammatory cytokine levels are altered by PTB and maternal BMI. Design and Outcomes: A cross-sectional study was conducted to assess the effect of PTB (+/- chorioamnionitis), or the effect of maternal prepregnancy BMI on placental MDR transporter and interleukin [IL]-6 and 8 expression in 60 preterm and 36 term pregnancies. Results: ABCB1 expression was increased in preterm compared to term placentae (p=0.04). P-gp (p=0.008) and BCRP (p=0.01) immunolabeling was increased among all preterm compared to term placentae, with P-gp expression further increased in preterm pregnancies with chorioamnionitis (PTC, p=0.007). Placental IL-6 mRNA expression was decreased in PTC compared to term placentae (p=0.0005), and PTC was associated with the greatest proportion of anti-inflammatory medications administered during pregnancy. Maternal BMI group did not influence placental outcomes. Conclusions: PTB and infection, but not prepregnancy BMI, alter placental expression of MDR transporters and IL-6. This may have implications for fetal exposure to xenobiotics that may be present in the maternal circulation in pregnancies complicated by PTB.

Download Full-text

Preterm birth associates with increased placental expression of MDR transporters irrespective of prepregnancy BMI

The Journal of Clinical Endocrinology & Metabolism ◽

10.1210/clinem/dgab813 ◽

2021 ◽

Author(s):

Hailey Scott ◽

Lilian M Martinelli ◽

David Grynspan ◽

Enrrico Bloise ◽

Kristin L Connor

Keyword(s):

Preterm Birth ◽

Cross Sectional Study ◽

Cancer Resistance ◽

Maternal Circulation ◽

Cross Sectional ◽

Glycoprotein P ◽

Fetal Protection ◽

Prepregnancy Bmi ◽

Cytokine Levels ◽

Maternal Bmi

Abstract Context Preterm birth (PTB) and suboptimal prepregnancy body mass index (BMI) operate through inflammatory pathways to impair fetoplacental development. Placental efflux transporters mediate fetal protection and nutrition, however few studies consider the effect of both PTB and BMI on fetal protection. We hypothesized that PTB would alter the expression of placental multidrug resistance (MDR) transporters and selected pro-inflammatory cytokines, and that maternal underweight and obesity would further impair placental phenotype. Objective To determine whether placental MDR transporters P-glycoprotein (P-gp, encoded by ABCB1) and breast cancer resistance protein (BCRP/ABCG2), and pro-inflammatory cytokine levels are altered by PTB and maternal BMI. Design and Outcomes A cross-sectional study was conducted to assess the effect of PTB (+/- chorioamnionitis), or the effect of maternal prepregnancy BMI on placental MDR transporter and interleukin [IL]-6 and 8 expression in 60 preterm and 36 term pregnancies. Results ABCB1 expression was increased in preterm compared to term placentae (p=0.04). P-gp (p=0.008) and BCRP (p=0.01) immunolabeling was increased among all preterm compared to term placentae, with P-gp expression further increased in preterm pregnancies with chorioamnionitis (PTC, p=0.007). Placental IL-6 mRNA expression was decreased in PTC compared to term placentae (p=0.0005), and PTC associated with the greatest proportion of anti-inflammatory medications administered during pregnancy. Maternal BMI group did not influence placental outcomes. Conclusions PTB and infection, but not prepregnancy BMI, alter placental expression of MDR transporters and IL-6. This may have implications for fetal exposure to xenobiotics that may be present in the maternal circulation in pregnancies complicated by PTB.

Download Full-text

Preterm birth increases placental expression of multidrug resistance (MDR) transporters irrespective of maternal prepregnancy body mass index (BMI).

Placenta ◽

10.1016/j.placenta.2021.07.143 ◽

2021 ◽

Vol 112 ◽

pp. e44

Author(s):

Hailey Scott ◽

Lilian Martinelli ◽

Enrrico Bloise ◽

Kristin Connor

Keyword(s):

Body Mass Index ◽

Multidrug Resistance ◽

Preterm Birth ◽

Body Mass ◽

Prepregnancy Body Mass Index

Download Full-text

Association between maternal prepregnancy body mass index and risk of preterm birth in more than 1 million Asian American mothers

Journal of Diabetes ◽

10.1111/1753-0407.13124 ◽

2020 ◽

Author(s):

Rui Gao ◽

Buyun Liu ◽

Wenhan Yang ◽

Yuxiao Wu ◽

Linda G. Snetselaar ◽

...

Keyword(s):

Body Mass Index ◽

Preterm Birth ◽

Body Mass ◽

Asian American ◽

Prepregnancy Body Mass Index

Download Full-text

The Influence of Increased Prepregnancy Body Mass Index and Excessive Gestational Weight Gain on Pregnancy Course and Fetal and Maternal Perinatal Outcomes

Healthcare ◽

10.3390/healthcare8040362 ◽

2020 ◽

Vol 8 (4) ◽

pp. 362

Author(s):

Milan Lackovic ◽

Dejan Filimonovic ◽

Sladjana Mihajlovic ◽

Biljana Milicic ◽

Ivana Filipovic ◽

...

Keyword(s):

Body Mass Index ◽

Weight Gain ◽

Gestational Weight Gain ◽

Body Mass ◽

Perinatal Period ◽

Close Monitoring ◽

Gestational Weight ◽

Prepregnancy Bmi ◽

Prepregnancy Body Mass Index ◽

Excessive Gestational Weight Gain

Background: The aim of our study was to assess the influence of prepregnancy Body Mass Index (BMI) changes as well as excessive gestational weight gain (GWG) on maternal and fetal perinatal parameters. Furthermore, we aimed to analyze the influence of increased prepregnancy BMI values and excessive GWG on neonatal early motoric development. Methods: The 203 eligible female participants were evaluated. Prepregnancy Body Mass Index (BMI) and excessive gestational weight gain (GWG) defined according to Institute of Medicine 2009 guidelines in the USA were assessed with tested maternal and fetal perinatal parameters and infants early motoric development (Alberta Infant Motor Scale—AIMS). Results: Significant predictors of increased prepregnancy BMI in perinatal period include: weight at delivery (p = 0.001), GWG (p = 0.002) and BMI at delivery (p < 0.001), while significant predictors of excessive GWG in perinatal period are: prepregnancy BMI (p = 0.029) and BMI at delivery (p < 0.001). In the group of participants with both increased prepregnancy BMI and excessive GWG versus others, significant predictors were: hypertension (HTA) (p = 0.019), amniotic fluid index (AFI) (p = 0.047), Pronation (AIMS) (p = 0.028) and Supination (AIMS) (p = 0.029). Conclusion: Increased prepregnancy BMI and excessive GWG are significantly associated with numerous perinatal factors that could alter the pregnancy course, pregnancy outcome and early motoric development of newborn. Moreover, increased prepregnancy BMI is shown to be a significant predictor of excessive GWG; thus, early selection of pregnant women for close monitoring of weight gain during pregnancy will have positive effects on reducing the risk of less favorable pregnancy course and early motoric development of newborn.

Download Full-text

The effect of prepregnancy body mass index on maternal micronutrient status: a meta-analysis

Scientific Reports ◽

10.1038/s41598-021-97635-3 ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Yan Yang ◽

Zixin Cai ◽

Jingjing Zhang

Keyword(s):

Body Mass Index ◽

Vitamin D ◽

Vitamin B12 ◽

Body Mass ◽

Meta Analysis ◽

Micronutrient Deficiency ◽

Prepregnancy Bmi ◽

Prepregnancy Body Mass Index ◽

Micronutrient Status ◽

Prepregnancy Obesity

AbstractThe relationship between prepregnancy body mass index (BMI) and maternal micronutrient status is inconsistent and has not received sufficient attention. This meta-analysis aimed to evaluate the effect of prepregnancy BMI on micronutrient levels in pregnant women. PubMed, Embase, Web of Science, and the Cochrane Library were searched for articles that contained information on micronutrient levels and prepregnancy BMI. A random-effects model was used to determine the association between prepregnancy BMI and maternal micronutrient status. Sixty-one eligible articles were eventually included, with 83,554 participants. Vitamin B12, folate, vitamin D, iron and ferritin were the main micronutrients evaluated in our meta-analysis. Prepregnancy obesity and overweight may lead to an increased risk of micronutrient deficiency, including vitamin B12, folate and vitamin D deficiency, while prepregnancy obesity or overweight may have no significant association with ferritin deficiency. Additionally, the results of the dose–response analyses demonstrated a possible significant inverse correlation between prepregnancy BMI and levels of micronutrient, except for iron and ferritin. Compared with women with normal weight, women who were overweight or obese prepregnancy have lower micronutrient concentrations and are more likely to exhibit micronutrient deficiency during pregnancy, which is harmful to both mothers and neonates.

Download Full-text