Kazan medical journalKazan medical journalКазанский медицинский журнал0368-48142587-9359Eco-Vector62682910.17816/KMJ626829ReviewsОбзорыReview ArticleThe role of the placenta in the formation of gestational complications in women with metabolic syndromeРоль плаценты в формировании гестационных осложнений у женщин с метаболическим синдромомhttps://orcid.org/0000-0003-0145-69343240-2959OrazmuradovAgamurad A.ОразмурадовАгамурад Акмамедович
Russian Federation

MD, Dr. Sci. (Med.), Prof., Depart. of Obstetrics and Gynecology with a Course of Perinatology, Medical Institute

д-р мед. наук, проф., каф. акушерства и гинекологии с курсом перинатологии, Медицинский институт

orazmurzdov_aa@rudn.universityhttps://orcid.org/0000-0001-9646-01563246-7372MukovnikovaEkaterina V.МуковниковаЕкатерина Васильевна
Russian Federation

P.G. (Med.), Depart. of Obstetrics and Gynecology with a Course of Perinatology, Medical Institute

асп., каф. акушерства и гинекологии с курсом перинатологии, Медицинский институт

mukovnikova1997@gmail.comhttps://orcid.org/0000-0002-8679-40614486-1063BekbaevaIrina V.БекбаеваИрина Викторовна
Russian Federation

MD, Cand. Sci. (Med.), Assistant, Depart. of Obstetrics and Gynecology with a Course of Perinatology, Medical Institute

канд. мед. наук, асс., каф. акушерства и гинекологии с курсом перинатологии, Медицинский институт

iridescentgirl@yandex.ruhttps://orcid.org/0000-0001-5637-419X3458-1392OrazmuradovaAylar A.ОразмурадоваАйлар Агамурадовна
Russian Federation

Resident, Depart. of Obstetrics and Gynecology with a Course of Perinatology, Medical Institute

клин. орд., каф. акушерства и гинекологии с курсом перинатологии, Медицинский институт

leily_oraz@mail.ruhttps://orcid.org/0000-0003-1232-57531393-7291SuleymanovaZhasmin Zh.СулеймановаЖасмина Жигерхановна
Russian Federation

P.G., (Med.), Depart. of Obstetrics and Gynecology with a Course of Perinatology, Medical Institute

асп., каф. акушерства и гинекологии с курсом перинатологии, Медицинский институт

1042210350@pfur.ruPeoples' Friendship University of RussiaРоссийский университет дружбы народов2507202410545966061302202421042024Copyright ©; 2024, Eco-VectorCopyright ©; 2024, Эко-Вектор2024Eco-VectorЭко-Векторhttps://kazanmedjournal.ru/kazanmedj/article/view/626829

Over the past decade, the prevalence of metabolic syndrome has increased significantly worldwide, and in most countries around the world this non-communicable disease has become a major health threat. Today, the mechanisms of metabolic syndrome influence on the development of various pregnancy complications are actively discussed. Studies of the pathophysiological mechanisms of the relationship between metabolic disorders and placental-associated pregnancy complications deserve special attention. The placenta performs essential functions throughout pregnancy and serves as a site for nutrient exchange and gas exchange between the pregnant woman and the fetus. Metabolic changes in women are closely associated with a number of placentally mediated obstetric complications, including preeclampsia, placental insufficiency, macrosomia, fetal growth restriction and antenatal fetal death. It is believed that it is in the first trimester of pregnancy that trophoblast cells are most sensitive to metabolic changes in homeostasis, which leads to their ischemia, impaired proliferation, invasion and angiogenesis. In pregnancies complicated by metabolic syndrome, the placenta is exposed to inflammation, oxidative stress, dyslipidemia, hyperglycemia, and altered hormone levels. Such metabolic changes can affect the development and function of the placenta, leading to abnormal fetal growth, as well as metabolic and cardiovascular disorders in children in the long term. Despite the wide range of pregnancy complications with metabolic syndrome, the mechanisms of their development have not been sufficiently studied. The purpose of this review was to summarize current knowledge about the pathophysiological mechanisms of the influence of metabolic syndrome on the development and function of the placenta.

За последнее десятилетие распространённость метаболического синдрома значительно выросла во всём мире, а в большинстве стран мира это неинфекционное заболевание стало основной угрозой для здоровья. На сегодняшний день механизмы влияния метаболического синдрома на развитие различных осложнений беременности активно обсуждаются. Отдельного внимания заслуживают исследования патофизиологических механизмов взаимосвязи метаболических нарушений и плацентарно-ассоциированных осложнений беременности. Плацента выполняет важнейшие функций на протяжении всей беременности и служит местом обмена питательных веществ и газообмена между беременной и плодом. Метаболические изменения в организме женщины тесно связаны с рядом плацентарно-опосредованных акушерских осложнений, включая преэклампсию, плацентарную недостаточность, макросомию, задержку роста плода и антенатальную гибель плода. Считают, что именно в I триместре беременности клетки трофобласта наиболее чувствительны к метаболическим изменениям в гомеостазе, что приводит к их ишемии, нарушению пролиферации, инвазии и ангиогенеза. При беременности, осложнённой метаболическим синдромом, плацента подвергается воздействию воспаления, окислительного стресса, дислипидемии, гипергликемии и изменённого уровня гормонов. Подобные метаболические сдвиги могут повлиять на развитие и функционирование плаценты, привести к аномальному росту плода, а также к метаболическим и сердечно-сосудистым нарушениям у детей в долгосрочной перспективе. Несмотря на обширный спектр осложнений беременности при метаболическом синдроме, механизмы их развития изучены недостаточно. Целью данного обзора стало обобщение современных знаний о патофизиологических механизмах влияния метаболического синдрома на развитие и функцию плаценты.

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