Metabolic profiles in early pregnancy associated with metabolic pregnancy complications in women with obesity

Trond Melbye Michelsen; Hege Nyhus Skytte; Nina Gunnes; Kirsten Bjørklund Holven; Jacob Juel Christensen; Marie Cecilie Paasche Roland

doi:10.1016/j.jri.2024.104397

Metabolic profiles in early pregnancy associated with metabolic pregnancy complications in women with obesity

J Reprod Immunol. 2024 Nov 19:166:104397. doi: 10.1016/j.jri.2024.104397. Online ahead of print.

Authors

Trond Melbye Michelsen¹, Hege Nyhus Skytte², Nina Gunnes³, Kirsten Bjørklund Holven⁴, Jacob Juel Christensen⁵, Marie Cecilie Paasche Roland⁶

Affiliations

¹ Department of Obstetrics, Division of Obstetrics and Gynecology, Oslo University Hospital, Oslo, Norway; Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway. Electronic address: trmi1@ous-hf.no.
² Department of Obstetrics, Division of Obstetrics and Gynecology, Oslo University Hospital, Oslo, Norway; Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway; Norwegian Research Centre for Women's Health, Oslo University Hospital, Oslo, Norway.
³ Norwegian Research Centre for Women's Health, Oslo University Hospital, Oslo, Norway.
⁴ Department of Nutrition, University of Oslo, Oslo, Norway; Norwegian National Advisory Unit on Familial Hypercholesterolemia, Oslo University Hospital, Oslo, Norway.
⁵ Department of Nutrition, University of Oslo, Oslo, Norway.
⁶ Department of Obstetrics, Division of Obstetrics and Gynecology, Oslo University Hospital, Oslo, Norway; Department of Medical Biochemistry, Oslo University Hospital, Oslo, Norway.

PMID: 39577057
DOI: 10.1016/j.jri.2024.104397

Abstract

Introduction: Higher maternal body mass index (BMI) is associated with metabolic disturbances and pregnancy complications. We aimed to examine whether metabolic profiles in early pregnancy were associated with metabolic pregnancy complications in women with obesity (BMI ≥ 30 kg/m²).

Material and methods: Nested cohort study from a prospective longitudinal cohort (n = 1031) of women who were healthy prior to pregnancy and gave birth at Oslo University Hospital from 2002-2008. The sample comprised 81 women with obesity. Metabolic pregnancy complications included gestational diabetes mellitus, gestational hypertension and preeclampsia. In plasma samples from gestational weeks 14-16, 91 metabolites were analyzed by nuclear magnetic resonance spectroscopy. We performed a principal component analysis to reduce the metabolic dimensions. Logistic regression models were fitted to estimate crude and adjusted odds ratios (ORs) of metabolic pregnancy complications.

Results: Twenty-four out of 81 women developed metabolic pregnancy complications (gestational hypertension, preeclampsia, and/or gestational diabetes). Two of five principal components (80 % explained variance) were significantly associated with metabolic pregnancy complications. The ratio of monounsaturated to total fatty acids increased the risk of metabolic pregnancy complications (OR 2.09, 95 % confidence interval [CI] 1.25-3.75), while the ratio of polyunsaturated to monounsaturated fatty acids decreased the risk (OR 0.54, 95 % CI 0.30-0.89). The ratio of omega-3 to total fatty acids (OR 0.59, 95 % CI 0.34-0.98) and the ratio of docosahexaenoic acid to total fatty acids (OR 0.57, 95 % CI 0.31-0.97) also decreased the risk of metabolic pregnancy complications.

Conclusion: Metabolic profile in early pregnancy was associated with risk of metabolic pregnancy complications in women with obesity. We observed the strongest associations between fatty acid composition and metabolic pregnancy complications.

Keywords: body mass index; high-risk pregnancy; metabolic pregnancy complications; metabolomics; molecular biology; obesity.