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2020, Número 4

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Revista Cubana de Obstetricia y Ginecología 2020; 46 (4)


Obesidad, inflamación y embarazo, una tríada peligrosa

Miguel-Soca PE, Feria DGE, González BSN, Leyva MMÁ
Texto completo Cómo citar este artículo Artículos similares

Idioma: Español
Referencias bibliográficas: 63
Paginas: 1-26
Archivo PDF: 560.06 Kb.


PALABRAS CLAVE

obesidad materna, inflamación, embarazo, complicaciones del embarazo.

RESUMEN

Introducción: La obesidad, es un estado común durante la etapa pregestacional y el embarazo, la cual representa una condición peligrosa para la salud materno-infantil por sus notables complicaciones obstétricas y perinatales a corto y largo plazo.
Objetivo: Describir los vínculos patogénicos de la triada obesidad, inflamación y embarazo.
Métodos: Esta revisión bibliográfica se realizó principalmente en PubMed Central, SciELO y ClinicalKey, con los descriptores obesity, inflammation y pregnancy.
Análisis y síntesis de la información: Entre los efectos desfavorables de la obesidad se encuentran abortos, diabetes gestacional, hipertensión, macrostomia, parto pretérmino, anomalías congénitas y muerte fetal. A largo plazo se asocia también con trastornos metabólicos y enfermedades en las madres y su descendencia. Estos efectos desfavorables se relacionan con un estado de inflamación crónica de bajo grado que acompaña el exceso de peso corporal. En este proceso inflamatorio juegan un papel importante el tejido adiposo y la placenta con la secreción excesiva de citoquinas proinflamatorias y la reducción de citoquinas antiinflamatorias. Dos mediadores como la leptina y la adiponectina tienen papeles cruciales.
Conclusiones: Aunque no se conocen bien los mecanismos que vinculan los efectos negativos de la obesidad sobre el embarazo, es probable que la inflamación crónica de bajo grado sea el vínculo principal, por tanto, la tríada obesidad, inflamación y embarazo representa una relación peligrosa para la salud maternofetal.


REFERENCIAS (EN ESTE ARTÍCULO)

  1. Catalano PM, Shankar K. Obesity and pregnancy: mechanisms of short term and long term adverse consequences for mother and child. Br Med J [Internet]. 2017 [citado 11/05/2020];356:j1. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6888512/?report=reader

  2. Gaillard R. Maternal obesity during pregnancy and cardiovascular development and disease in the offspring. Eur J Epidemiol [Internet]. 2015 [citado 11/05/2020];30:1141–52. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4684830/pdf/10654_2015_Article_85.pdf

  3. Godfrey KM, Reynolds RM, Prescott SL, Nyirenda M, Jaddoe VWV, Eriksson JG, et al. Influence of maternal obesity on the long-term health of offspring. Lancet Diabetes Endocrinol [Internet]. 2017 Jan [citado 11/05/2020];5(1):53–64. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5245733/pdf/emss-71112.pdf

  4. Glastras SJ, Chen H, Pollock CA, Saad S. Maternal obesity increases the risk of metabolic disease and impacts renal health in offspring. Biosci Rep [Internet]. 2018 Apr 27;38(2):BSR20180050. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5874265/pdf/bsr-38-bsr20180050.pdf

  5. Álvarez Ponce VA, Martos Benítez FD. El sobrepeso y la obesidad como factores de riesgo para la preeclampsia. Rev Cubana Obstet Ginecol [Internet]. 2017 [citado 11/05/2020];43(2):[aprox. 0 p.]. Disponible en: http://revginecobstetricia.sld.cu/index.php/gin/article/view/208

  6. Cedeño Escobar D, Checa Martínez Y, Ochoa Roca TZ, San José Pérez DM, Leyva Sánchez A. Comportamiento de los trastornos hipertensivos gestacionales, en el policlínico René Ávila Reyes, Holguín, Cuba, desde el año 2015 al 2016. Correo Científico Médico [Internet]. 2018 [citado 12/05/2020];22(3):[aprox. 0 p.]. Disponible en: http://revcocmed.sld.cu/index.php/cocmed/article/view/2787

  7. Gillespie SL, Christian LM. Body Mass Index as a Measure of Obesity: Racial Differences in Predictive Value for Health Parameters During Pregnancy. Journal of Women’s Health [Internet]. 2016 [citado 10/05/2020];25(12):1210-8. DOI: https://doi.org/10.1089/jwh.2016.5761 Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5175427/pdf/jwh.2016.5761.pdf

  8. Cancello R. Obesity and Inflammation in Pregnancy. En: Ferrazzi E, Sears B (editors). Metabolic Syndrome and Complications of Pregnancy. The Potential Preventive Role of Nutrition. Switzerland: Springer International Publishing; 2015. p. 65-75.

  9. Moll U, Olsson H, Landin-Olsson M. Impact of Pregestational Weight and Weight Gain during Pregnancy on Long-Term Risk for Diseases. PLoS ONE [Internet]. 2017 [citado 11/05/2020];12(1):e0168543. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5207749/pdf/pone.0168543.pdf

  10. de la Plata Daza M, Pantoja Garrido M, Frías Sánchez Z, Rojo Novo S. Influencia del índice de masa corporal pregestacional y ganancia ponderal materna en los resultados perinatales materno-fetales. Rev Cuba Obstet Ginecol [Internet]. 2018 [citado 11/05/2020];44(1):[aprox. 0 p.]. Disponible en: http://revginecobstetricia.sld.cu/index.php/gin/article/view/309

  11. Dutton HP, Borengasser SJ, Gaudet LM, Barbour LA, Keely EJ. Obesity in Pregnancy – Optimizing outcomes for mom and baby. Med Clin North Am [Internet]. 2018 Jan [citado 11/05/2020];102(1):87–106. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6016082/pdf/nihms944677.pdf

  12. Carlson NS, Leslie SL, Dunn A. Antepartum Care of Women Who Are Obese During Pregnancy: Systematic Review of the Current Evidence. J Midwifery Womens Health [Internet]. 2018 May [citado 11/05/2020];63(3):259–72. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6363119/pdf/nihms-1005399.pdf

  13. Mitchell AM, Porter K, Christian LM. Examination of the role of obesity in the association between childhood trauma and inflammation during pregnancy. Health Psychol [Internet]. 2018 Feb [citado 11/05/2020];37(2):114–24. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5794605/pdf/nihms909656.pdf

  14. McDade TW, Borja JB, Largado F, Adair LS, Kuzawa CW. Adiposity and Chronic Inflammation in Young Women Predict Inflammation during Normal Pregnancy in the Philippines. J Nutr [Internet]. 2016 Feb [citado 11/05/2020];146(2):353–7. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4725437/pdf/jn224279.pdf

  15. Zacarías MF, Collado MC, Gómez-Gallego C, Flinck H, Aittoniemi J, Isolauri E, et al. Pregestational overweight and obesity are associated with differences in gut microbiota composition and systemic inflammation in the third trimester. PLoS ONE. 2018;13(7):e0200305. DOI: https://doi.org/10.1371/journal.pone.0200305

  16. Broadney MM, Chahal N, Michels KA, McLain AC, Ghassabian A, Lawrence DA, et al. Impact of Parental Obesity on Neonatal Markers of Inflammation and Immune Response. Int J Obes (Lond) [Internet]. 2017 Jan [citado 11/05/2020];41(1):30–7. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5209273/pdf/nihms-819518.pdf

  17. Shin D, Hur J, Cho EH, Chung HK, Shivappa N, Wirth MD, et al. Pre-Pregnancy Body Mass Index Is Associated with Dietary Inflammatory Index and C-Reactive Protein Concentrations during Pregnancy. Nutrients [Internet]. 2017 [citado 11/05/2020];9(351). DOI: https://doi.org/10.3390/nu9040351 Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5409690/pdf/nutrients-09-00351.pdf

  18. Bjørke-Monsen AL, Ulvik A, Nilsen RM, Midttun Ø, Roth C, Magnus P, et al. Impact of Pre-Pregnancy BMI on B Vitamin and Inflammatory Status in Early Pregnancy: An Observational Cohort Study. Nutrients [Internet]. 2016 Dec [citado 11/05/2020];8(12):776. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5188431/pdf/nutrients-08-00776.pdf

  19. Groer M, Fuchs D, Duffy A, Louis-Jacques A, D’Agata A, Postolache TT. Associations Among Obesity, Inflammation, and Tryptophan Catabolism in Pregnancy. Biol Res Nurs [Internet]. 2018 May [citado 11/05/2020];20(3):284–91. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6346309/pdf/10.1177_1099800417738363.pdf

  20. Sharp GC, Salas LA, Monnereau C, Allard C, Yousefi P, Everson TM, et al. Maternal BMI at the start of pregnancy and offspring epigenome-wide DNA methylation: findings from the pregnancy and childhood epigenetics (PACE) consortium. Hum Mol Genet [Internet]. 2017 Oct 15 [citado 11/05/2020];26(20):4067–85. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5656174/pdf/ddx290.pdf

  21. Myers JE. What are the metabolic precursors which increase the risk of pre-eclampsia and how could these be investigated further. Placenta. 2017;60:110-4. DOI: http://dx.doi.org/10.1016/j.placenta.2017.08.011

  22. Stubert J, Reister F, Hartmann S, Janni W. The risks associated with obesity in pregnancy. Dtsch Arztebl Int 2018;115:276–83. DOI: https://doi.org/10.3238/arztebl.2018.0276 Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5954173/pdf/Dtsch_Arztebl_Int-115_0276.pdf

  23. Schaefer-Graf U, Napoli A, Nolan CJ. Diabetes in pregnancy: a new decade of challenges ahead. Diabetologia. 2018;61:1012–21. DOI: https://doi.org/10.1007/s00125-018-4545-y

  24. Wan Ma RC, Schmidt MI, Tam WH, McIntyre HD, Catalano PM. Clinical management of pregnancy in the obese mother: before conception, during pregnancy, and postpartum. Lancet Diabetes Endocrinol [Internet]. 2016 Dec [citado 11/05/2020];4(12):1037–49. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6691730/pdf/nihms-1044995.pdf

  25. Botchlett R, Woo SL, Liu M, Pei Y, Guo X, Li H, et al. Nutritional Approaches for Managing Obesity-Associated Metabolic Diseases. J Endocrinol [Internet]. 2017 Jun [citado 11/05/2020];233(3):R145–R171. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5511693/pdf/nihms872979.pdf

  26. Dhana K, Zong G, Yuan C, Schernhammer E, Zhang C, Wang X, et al. Lifestyle of women before pregnancy and the risk of offspring obesity during childhood through early adulthood. Int J Obes (Lond) [Internet]. 2018 Jul [citado 11/05/2020];42(7):1275–84. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6727198/pdf/nihms-1048386.pdf

  27. Mariona FG. Perspectives in obesity and pregnancy. Women’s Health [Internet]. 2016 [citado 11/05/2020];12(6):523–32. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5373261/pdf/10.1177_1745505716686101.pdf

  28. Tauqeer Z, Gomez G, Stanford FC. Obesity in Women: Insights for the Clinician. JOURNAL OF WOMEN’S HEALTH [Internet]. 2018 [citado 11/05/2020];27(4):444-57. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6110123/pdf/jwh.2016.6196.pdf

  29. Roberts JM, Redman CWG. Global Pregnancy Collaboration symposium: Prepregnancy and very early pregnancy antecedents of adverse pregnancy outcomes: Overview and recommendations. Placenta. 2017;60:103-9. DOI: http://dx.doi.org/10.1016/j.placenta.2017.07.012

  30. Valerio G, Maffeis C, Saggese G, Ambruzzi MA, Balsamo A, Bellone S, et al. Diagnosis, treatment and prevention of pediatric obesity: consensus position statement of the Italian Society for Pediatric Endocrinology and Diabetology and the Italian Society of Pediatrics. Ital J Pediatr. 2018;44:88. DOI: https://doi.org/10.1186/s13052-018-0525-6

  31. Frias AE, Grove KL. Obesity: A Transgenerational Problem Linked to Nutrition during Pregnancy. Semin Reprod Med. 2012 December;30(6):472–8. DOI: http://dx.doi.org/10.1055/s-0032-1328875. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3615704/pdf/nihms449455.pdf

  32. O’Rourke RW. Adipose tissue and the physiologic underpinnings of metabolic disease. Surg Obes Relat Dis [Internet]. 2018 November [citado 11/05/2020];14(11):1755–63. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6289667/pdf/nihms-991913.pdf

  33. Rodríguez López CP, González Torres MC, Aguilar Salinas CA, Nájera Medina O. Mecanismos inmunológicos involucrados en la obesidad. Invest Clin [Internet]. 2017 [citado 11/05/2020];58(2):175–96. Disponible en: https://www.redalyc.org/pdf/3729/372951141008.pdf

  34. Suárez González JA, Gutiérrez Machado M. Evaluación antropométrica como expresión del método clínico en gestantes obesas. Rev Cuba Obstetr Ginecol [Internet]. 2016 [citado 11/05/2020];42(1):[aprox. 0 p.]. Disponible en: http://revginecobstetricia.sld.cu/index.php/gin/article/view/34

  35. Adabimohazab R, Garfinkel A, Milam EC, Frosch O, Mangone A, Convit A. Does inflammation mediate the association between obesity and insulin resistance? Inflammation [Internet]. 2016 Jun [citado 11/05/2020];39(3):994–1003. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4884488/pdf/nihms766957.pdf

  36. Lindsay KL, Buss C, Wadhwa PD, Entringer S. Maternal Stress Potentiates the Effect of an Inflammatory Diet in Pregnancy on Maternal Concentrations of Tumor Necrosis Factor Alpha. Nutrients [Internet]. 2018 Sep [citado 11/05/2020];10(9):1252. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6163870/pdf/nutrients-10-01252.pdf

  37. Bravo-Flores E, Mancilla-Herrera I, Espino y Sosa S, Ortiz-Ramirez M, Flores-Rueda V, Ibargüengoitia-Ochoa F, et al. Macrophage Populations in Visceral Adipose Tissue from Pregnant Women: Potential Role of Obesity in Maternal Inflammation. Int J Mol Sci. 2018;19:1074. DOI: http://dx.doi.org/10.3390/ijms19041074. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5979476/pdf/ijms-19-01074.pdf

  38. Singer K, Lumeng CN. The initiation of metabolic inflammation in childhood obesity. J Clin Invest [Internet]. 2017 Jan 3 [citado 11/05/2020];127(1):65–73. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5199687/pdf/jci-127-88882.pdf

  39. Van der Burg JW, Sen S, Chomitz VR, Seidell JC, Leviton A, Dammann O. The role of systemic inflammation linking maternal body mass index to neurodevelopment in children: Inflammation and neurodevelopment. Pediatr Res [Internet]. 2016 January [citado 11/05/2020];79(1-1):3–12. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4888781/pdf/nihms-789339.pdf

  40. Sanchez CE, Barry C, Sabhlok A, Russell K, Majors A, Kollins SH, et al. Maternal pre-pregnancy obesity and child neurodevelopmental outcomes: A Meta-analysis. Obes Rev [Internet]. 2018 April [citado 11/05/2020];19(4):464-84. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6059608/pdf/nihms915615.pdf

  41. Perichart-Perera O, Muñoz-Manrique C, Reyes-López A, Tolentino-Dolores M, Espino Sosa S, Ramı́rez-González MC. Metabolic markers during pregnancy and their association with maternal and newborn weight status. PLoS ONE. 2017;12(7):e0180874. DOI: https://doi.org/10.1371/journal.pone.0180874

  42. Neri C, Edlow AG. Effects of Maternal Obesity on Fetal Programming: Molecular Approaches. Cold Spring Harb Perspect Med. 2016 Feb;6(2):a026591. DOI: http://dx.doi.org/10.1101/cshperspect.a026591. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5033901/pdf/jciinsight-1-85560.pdf

  43. Menting MD, Mintjens S, van de Beek C, Frick CJ, Ozanne SE, Limpens J, et al. Maternal obesity in pregnancy impacts offspring cardiometabolic health: Systematic review and meta‐analysis of animal studies. Obesity Reviews [Internet]. 2019 [citado 11/05/2020]; 20:675–85. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6849816/pdf/OBR-20-675.pdf

  44. Korkmaz L, Baştuğ O, Kurtoğlu S. Maternal Obesity and its Short- and Long-Term Maternal and Infantile Effects. J Clin Res Pediatr Endocrinol [Internet]. 2016 [citado 11/05/2020];8(2):114-24. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5096465/pdf/JCRPE-8-114.pdf

  45. Ovalle A, Martínez MA, Fuentes A, Marques X, Vargas F, Vergara P, et al. Obesidad, factor de riesgo de infección bacteriana ascendente durante el embarazo. Rev Méd Chile [Internet]. 2016 Abr [citado 07/05/2020];144(4):476-82. Disponible en: http://dx.doi.org/10.4067/S0034-98872016000400008

  46. Pacheco-Romero J. Gestación en la mujer obesa: consideraciones especiales. An Fac Med [Internet]. 2017 Abr [citado 07/05/2020];78(2):207-14. Disponible en: http://www.scielo.org.pe/scielo.php?script=sci_arttext&pid=S1025-55832017000200017&lng=es. http://dx.doi.org/10.15381/anales.v78i2.13219

  47. Suárez Arana M, González-Mesa E. Obesidad e hipertensión en el embarazo. Nutr Hosp. 2018 Ago;35(4):751-2. DOI: http://dx.doi.org/10.20960/nh.2186

  48. Vieira MC, Begum S, Seed PT, Badran D, Briley AL, Gill C, et al. Gestational diabetes modifies the association between PlGF in early pregnancy and preeclampsia in women with obesity. Pregnancy Hypertension. 2018;13:267–72. DOI: https://doi.org/10.1016/j.preghy.2018.07.003

  49. Spradley FT, Palei AC, Granger JP. Immune Mechanisms Linking Obesity and Preeclampsia. Biomolecules [Internet]. 2015 Dec [citado 11/05/2020];5(4):3142–76. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4693273/pdf/biomolecules-05-03142.pdf

  50. Edlow G. Maternal obesity and neurodevelopmental and psychiatric disorders in offspring. Prenat Diagn [Internet]. 2017 Jan [citado 11/05/2020];37(1):95–110. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5572633/pdf/nihms896816.pdf

  51. Voerman E, Santos S, Patro Golab B, Amiano P, Ballester F, Barros H, et al. (2019). Maternal body mass index, gestational weight gain, and the risk of overweight and obesity across childhood: An individual participant data meta-analysis. PLoS Med. 2019;16(2):e1002744. DOI: https://doi.org/10.1371/journal.pmed.1002744

  52. Gaillard R, Rifas-Shiman SL, Perng W, Oken E, Gillman MW. Maternal inflammation during pregnancy and childhood adiposity. Obesity (Silver Spring) [Internet]. 2016 Jun [citado 11/05/2020];24(6):1320–7. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4918508/pdf/nihms795120.pdf

  53. Singh S, Karagas MR, Mueller NT. Charting the Maternal and Infant Microbiome: What Is the Role of Diabetes and Obesity in Pregnancy? Curr Diab Rep [Internet]. 2017 Feb [citado 11/05/2020];17(2):11. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5450943/pdf/nihms861937.pdf

  54. Persson M, Razaz N, Edstedt Bonamy AK, Villamor E, Cnattingius S. Maternal Overweight and Obesity and Risk of Congenital Heart Defects. J Am Coll Cardiol [Internet]. 2019 [citado 11/05/2020];73:44–53. Disponible en: https://www.clinicalkey.com/service/content/pdf/watermarked/1s2.0S0735109718390867.pdf?locale=en_US&searchIndex=

  55. Hajagos-Tóth J, Ducza E, Samavati R, Vari SG, Gaspar R. Obesity in pregnancy: a novel concept on the roles of adipokines in uterine contractility. Croat Med J. 2017;58:96-104. DOI: https://doi.org/10.3325/cmj.2017.58.96

  56. Howell KR, Powell TL. Effects of maternal obesity on placental function and fetal development. Reproduction [Internet]. 2017 March [citado 11/05/2020];153(3):R97–R108. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5432127/pdf/nihms832222.pdf

  57. Mahany EB, Han X, Borges BC, da Silveira Cruz-Machado S, Allen SJ, Garcia-Galiano D, et al. Obesity and High-Fat Diet Induce Distinct Changes in Placental Gene Expression and Pregnancy Outcome. Endocrinology [Internet]. 2018 Apr [citado 11/05/2020];159(4):1718–33. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6456933/?report=reader

  58. Liong S, Barker G, Lappas M. Placental Ras Regulates Inflammation Associated with Maternal Obesity. Mediators Inflamm [Internet]. 2018 [citado 11/05/2020];2018:3645386. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6196914/pdf/MI2018-3645386.pdf

  59. Sun B, Parks WT, Simhan HN, Bertolet M, Catov JM. Early pregnancy immune profile and preterm birth classified according to uteroplacental lesions. Placenta [Internet]. 2020 [citado 11/05/2020];89:99–106. Disponible en: https://www.clinicalkey.com/service/content/pdf/watermarked/1s2.0S0143400419307180.pdf?locale=en_US&searchIndex=

  60. Huda SS, Jordan F, Bray J, Love G, Payne R, Sattar N, et al. Visceral adipose tissue activated macrophage content and inflammatory adipokine secretion is higher in pre-eclampsia than in healthy pregnancy. Clinical Science [Internet]. 2017 [citado 11/05/2020]; 131:1529–40. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6376613/pdf/cs-131-cs20160832.pdf

  61. Becerril S, Rodríguez A, Catalán V, Ramírez B, Unamuno X, Portincasa P, et al. Functional Relationship between Leptin and Nitric Oxide in Metabolism. Nutrients. 2019;11: 2129. DOI: https://doi.org/10.3390/nu11092129. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6769456/pdf/nutrients-11-02129.pdf

  62. Carlson NS, Hernandez TL, Hurt KJ. Parturition dysfunction in obesity: time to target the pathobiology. Reproductive Biology and Endocrinology [Internet]. 2015 [citado 11/05/2020]; 13(1):135. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4683915/pdf/12958_2015_Article_129.pdf

  63. Mejia-Montilla J, Reyna-Villasmil E. Obesidad, insulinorresistencia e hipertensión durante el embarazo. Revista Venezolana de Endocrinología y Metabolismo [Internet]. 2017 [citado 11/05/2020];15(3):169-81. Disponible en: https://www.redalyc.org/pdf/3755/375553465002.pdf




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