Impacto da inflamação placentária na antropometria do recém-nascido

Abstract

Pregnancy is a physiological process in which various metabolic and immunological changes occur from implantation to delivery. Maternal pre-gestational nutritional status and excessive weight gain during pregnancy are linked to elevated levels of inflammatory markers, which can adversely affect both maternal and newborn health. This study aims to determine the impact of placental inflammation on newborn anthropometry in pregnant women with normal weight, overweight, and pre-gestational obesity. The study population consisted of 64 pregnant women recruited at the time of delivery at the University Hospital of Paraíba, from February to September 2023. Pregnant women undergoing vaginal and cesarean delivery, aged over 18 years, and with full-term pregnancies were included in the study. Participants with pregestational body mass index classified as malnutrition, fetal abnormalities, stillbirth, smokers, alcohol drinkers, active infectious, autoimmune, hepatic, renal, oncological, and psychiatric diseases were excluded. Umbilical cord blood and placental villous tissue were collected. Plasma and supernatant from placental villous homogenate were used for quantification of cytokines Interleukin (IL)-8, IL-1β, and Monocyte Chemoattractant Protein-1 (CCL2) by enzyme-linked immunosorbent assay (ELISA). Data were analyzed using multiple linear regression models, considering p≤0.05, to assess associations between cytokine concentrations in umbilical cord blood, placental villi, and newborn anthropometry. The mean maternal age was similar across groups (28 years), with the majority receiving up to one minimum wage monthly, and a mean gestational age of 39 weeks. The mean placental weight for mothers with pre-gestational normal weight was 549.2g, for overweight pre-gestational mothers it was 615.1g, and for obese mothers it was 575.7g. Most newborns were male (N=37). Excessive weight gain was observed in all groups (N=58%), especially in the overweight pre-gestational group, where 74% of pregnant women gained weight beyond the recommended amount for pregnancy. Regarding the results obtained through multiple linear regression models, of the cytokines evaluated, IL-8, IL-1β, and CCL2, there was a significant association between IL-8 in plasma (p=0.04) and in placental villi (p=0.03) with newborn head circumference after controlling for confounding factors. There was also a significant association between IL-8 in placental villi (p=0.03) and newborn abdominal circumference. The results suggest that altered inflammatory status may affect newborn anthropometry, with IL-8 cytokine being a key mediator in regulating the intrauterine inflammatory environment, as it is involved in immune modulation, angiogenic, and vascular processes essential for healthy fetal development.