Pregnancy in metabolic syndrome: risks and outcomes

Abstract

Aim - to assess the impact of metabolic syndrome (MS) on the course of pregnancy and perinatal outcomes.

Materials and methods. During 2021-2024, a clinical study was conducted involving 120 pregnant women with metabolic syndrome, who were randomized into two groups: the main group (n=60), in which pregravid nutritional correction using symbiotics (Lactobacillus rhamnosus GG with prebiotic fibers) was applied, and the comparison group (n=60), which received only standard pregnancy management. The control group consisted of 30 pregnant women with normal body weight and physiological pregnancy. Examinations were performed with additional determination of leptin levels by enzyme-linked immunosorbent assay and ultrasound monitoring of fetal development. Primary endpoints included the frequency of perinatal complications, cases of intrauterine growth restriction (IUGR), and length of hospital stay.

Results. Pregnant women with MS were found to have a significantly higher incidence of endometrial hyperplastic processes (51.7% vs 16.7% in the control group), arterial hypertension (48.3% vs 13.3%), dyslipidemia, and harmful habits. The incidence of IUGR in this cohort was 40.0%, compared with only 13.3% in the control group. Correlations were identified between leptin levels, dyslipidemia, and placental dysfunction. In the main group, a reduction in the incidence of preeclampsia, labor abnormalities, and operative deliveries was recorded. At the same time, newborns from mothers with MS had lower weight-length parameters and Apgar scores.

Conclusions. MS in pregnant women is an independent predictor of adverse obstetric and perinatal outcomes, in particular significantly increasing the risk of IUGR and placental dysfunction. Hyperleptinemia and dyslipidemia were identified as key pathogenetic factors associated with gestational complications. The use of symbiotics at the pregravid and intragravid stages demonstrates effectiveness in reducing the incidence of preeclampsia and labor disorders, which substantiates the feasibility of implementing microbiome-oriented preventive strategies in the management of women with MS.

The study was conducted in accordance with the principles of the Declaration of Helsinki. The study protocol was approved by the Bioethics Committee of the institution specified in the work. Written informed consent was obtained from all participants.

The author declares no conflict of interest.