Pathogenesis of insulin resistance in pregnant women with obesity

Introduction: Obesity is one of the most important medical and social problems in many countries of the world, as it is associated with the development of the most common non-communicable diseases: cardiovascular, type II diabetes mellitus, motor disorders, non-alcoholic fatty liver disease (NHAHP) and others. The aim of this paper is to analyze the pathogenetic mechanisms of insulin resistance development in pregnant women with varying obesity degrees in early and late gestation periods.

Materials and methods: 459 pregnant women were examined at the Poltava City Clinical Maternity Hospital in the early (9-13 weeks) and late gestation periods (34-38 weeks). Metabolic disorders in pregnant women were studied by carbohydrate and lipid metabolism indices.

Results: Due to increased insulin resistance and reduced glucose absorption by tissues of pregnant women with obesity, there are prerequisites for the development of energy insufficiency. Obese women pregnancy runs on the background of hypertriglyceridemia and type IV hyperlipoproteinemia. The general pathogenic consequence of the insulin resistance progression during pregnancy in obese women is an energy deficiency increase, which causes a threatening obstetric and perinatal complications frequency increase.

Conclusions: The progression of insulin resistance during pregnancy of women with varying degrees of obesity is the pathogenetic basis of energy insufficiency and the reduction of adaptive mechanisms of pregnant women with obesity, as evidenced by the increase in obstetric and perinatal complications frequency.