The impact of obesity and uncontrolled asthma during pregnancy on metabolic and inflammatory pathways
Sreeparna Bhaumik1, Jack Lockett1,2, Zarqa Saif1
1The University of Queensland, Brisbane, Australia.
Insights
In obese pregnant women, metabolic markers largely remained unchanged with asthma. However, altered metabolic-inflammatory pathway associations in asthmatic women may contribute to uncontrolled asthma.
Area of Science:
- Reproductive Medicine
- Immunology
- Metabolic Disorders
Background:
- Asthma and obesity are inflammatory conditions during pregnancy, increasing risks for uncontrolled asthma and adverse perinatal outcomes.
- Maternal asthma is linked to placental inflammation and reduced fetal growth.
- Obesity exacerbates pregnancy-related inflammatory complications.
Purpose of the Study:
- To investigate the relationships between immunomodulatory metabolic pathways and inflammation in obese pregnant women.
- To determine if these pathways are associated with uncontrolled asthma in this population.
Main Methods:
- Prospective recruitment of 53 obese pregnant women (BMI >30).
- Classification of participants into no asthma, controlled asthma, and uncontrolled asthma groups using the Asthma Control Questionnaire (ACQ).
- Measurement of plasma leptin, adiponectin, insulin, glucose, and extracellular vesicle (EV)-associated cytokines at 18 and 36 weeks gestation.
Main Results:
- Metabolic and inflammatory markers did not significantly differ between obese women with or without asthma throughout gestation.
- Adiponectin increased with gestation in non-asthmatic obese women but not in those with asthma.
- Uncontrolled asthma showed positive correlations between adiponectin/leptin and EV inflammatory markers (GM-CSF, IL-6, TNFα, IFNγ).
Conclusions:
- Most metabolic markers are unaffected by asthma presence or severity in obese pregnant women.
- Distinct associations between metabolic and inflammatory pathways in asthmatic women suggest a potential mechanism for uncontrolled asthma.
- Further research into these pathways could inform management strategies for obese pregnant women with asthma.
Objective:
Asthma and obesity are both inflammatory complications of pregnancy and when combined contribute to an increased risk of uncontrolled asthma during pregnancy and poor perinatal outcomes. Our previous work has identified the presence of maternal asthma is associated with a proinflammatory milieu in the placenta and reduced fetal growth. The current study was designed to determine the relationships between immunomodulatory metabolic pathways and inflammation and establish whether these pathways are associated with uncontrolled asthma in obese pregnant women.
Methods:
Fifty-three obese (BMI >30) pregnant women were recruited prospectively. Participants were classified as having no asthma, controlled asthma, and uncontrolled asthma based on a doctor diagnosis and assessment using the Asthma Control Questionnaire (ACQ). Circulating plasma concentrations of metabolic hormones leptin, adiponectin, insulin, glucose, and extracellular vesicle (EVs) associated cytokines were measured at 18- and 36-weeks gestation.
Results:
Concentrations of metabolic and inflammatory markers among obese participants with or without asthma were not significantly different throughout gestation. However total adiponectin concentrations increased as gestation progressed in obese, non-asthmatic women but did not increase in women with asthma. Plasma adiponectin and leptin levels in women with uncontrolled asthma were positively correlated with EV inflammatory markers including GM-CSF, IL-6, TNFα and IFNγ protein.
Conclusions:
This study demonstrated that most metabolic markers remain unchanged with the presence and severity of asthma in obese pregnant women. However, differences in the associations between metabolic and inflammatory pathways were observed in women with asthma and may be one of the mechanisms contributing to uncontrolled asthma in obese pregnant women.
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