Stillbirth, Inflammatory Markers, and Obesity: Results from the Stillbirth Collaborative Research Network
Margo S Harrison1, Vanessa R Thorsten2, Donald J Dudley3
1Columbia University Medical Center, New York, New York.
American Journal of Perinatology
|April 3, 2018
Summary
Obesity increases stillbirth risk. Inflammatory markers like serum ferritin and white blood cell count are linked to stillbirth, but do not fully explain the obesity-stillbirth connection. Histologic chorioamnionitis partially confounds the association between obesity and stillbirth.
Area of Science:
- Reproductive Medicine
- Perinatal Health
- Inflammation and Pregnancy
Background:
- Obesity is a known risk factor for stillbirth, yet the underlying mechanisms remain unclear.
- Inflammation is frequently observed in obese individuals and may play a role in pregnancy complications.
- Key inflammatory markers include serum ferritin, C-reactive protein (CRP), white blood cell (WBC) count, and histologic chorioamnionitis.
Purpose of the Study:
- To investigate the association between specific inflammatory markers and stillbirth.
- To examine the relationship between these inflammatory markers and body mass index (BMI) categories.
- To determine if inflammatory markers mediate the link between obesity and stillbirth.
Main Methods:
- A case-control study comparing 497 stillbirths and 1,414 live births.
- Assessment of WBC count, maternal serum biomarkers (ferritin, CRP), and placental histology for chorioamnionitis.
- Logistic regression models were used to analyze associations between BMI, inflammatory markers, and stillbirth, controlling for confounders and assessing interactions.
Main Results:
- Overweight and obese women had a higher risk of stillbirth compared to normal weight women.
- Elevated serum ferritin, increased WBC count, and histologic chorioamnionitis were significantly associated with stillbirth.
- While inflammatory markers were linked to stillbirth, they did not fully explain the obesity-stillbirth relationship. Histologic chorioamnionitis showed a confounding effect on the association between obesity and stillbirth.
Conclusions:
- Maternal serum ferritin, elevated WBC count, and histologic chorioamnionitis are associated with stillbirth.
- Obesity (overweight and obese BMI) is independently associated with increased stillbirth risk.
- Inflammatory markers do not fully account for the obesity-stillbirth association, though chorioamnionitis acts as a confounder. The link between serum ferritin and stillbirth is stronger in preterm births.
Related Concept Videos
01:24Obesity
1.4K
The Body Mass Index (BMI) is a numerical value derived from a person's weight and height, used to categorize individuals into weight ranges. It is calculated using the formula: weight in kilograms divided by height in meters squared. Obesity is a health condition characterized by excessive accumulation of adipose tissue that poses health risks, often diagnosed with a BMI ≥ 30. This excess fat storage occurs when surplus dietary calories are converted into triglycerides and stored in...
1.4K
01:29Chronic Pancreatitis II: Collaborative Care
383
The management of chronic pancreatitis is multifaceted, involving a comprehensive approach that includes thorough assessment, diagnostic testing, and a variety of management strategies.
Assessment:
Assessment:
383
02:26Protein Networks
4.6K
An organism can have thousands of different proteins, and these proteins must cooperate to ensure the health of an organism. Proteins bind to other proteins and form complexes to carry out their functions. Many proteins interact with multiple other proteins creating a complex network of protein interactions.
These interactions can be represented through maps depicting protein-protein interaction networks, represented as nodes and edges. Nodes are circles that are representative of a protein,...
These interactions can be represented through maps depicting protein-protein interaction networks, represented as nodes and edges. Nodes are circles that are representative of a protein,...
4.6K
02:26Protein Networks
2.9K
2.9K
01:28Inflammatory Response
17.0K
An inflammatory response is a localized, nonspecific immune reaction that occurs when a tissue is injured. It is characterized by redness, swelling, heat, and pain, which are commonly called the cardinal signs and symptoms of inflammation. Inflammation can sometimes result in a loss of function.
Inflammation can be triggered by various stimuli, such as impact, abrasion, chemical irritation, infections, and extreme hot or cold temperatures. These can damage cells and connective tissue fibers,...
Inflammation can be triggered by various stimuli, such as impact, abrasion, chemical irritation, infections, and extreme hot or cold temperatures. These can damage cells and connective tissue fibers,...
17.0K
02:18Network Covalent Solids
16.2K
Network covalent solids contain a three-dimensional network of covalently bonded atoms as found in the crystal structures of nonmetals like diamond, graphite, silicon, and some covalent compounds, such as silicon dioxide (sand) and silicon carbide (carborundum, the abrasive on sandpaper). Many minerals have networks of covalent bonds.
To break or to melt a covalent network solid, covalent bonds must be broken. Because covalent bonds are relatively strong, covalent network solids are typically...
To break or to melt a covalent network solid, covalent bonds must be broken. Because covalent bonds are relatively strong, covalent network solids are typically...
16.2K