[The metabolic syndrome and the risks of unfavourable outcome of pregnancy].
The metabolic syndrome is defined by abdominal obesity, elevation of blood pressure, fasting glucose and triglycerides and low levels of high-density lipoprotein cholesterol. The metabolic syndrome may play an important role in the pathogenesis of unsuccessful pregnancy, by including a pro-inflammatory and prothrombotic state. Some authors have suggested that in case of metabolic syndrome the LMW heparin therapy given from the time of conception has a favourable effect. The aim of our study was to elucidate the association of the metabolic syndrome with the risk of unsuccessful pregnancy.


METHODS
During the study period 2005-2008 (4 years) we followed 5869 pregnancies. Retrospectively, 172 (2.9%) patients met the criteria of metabolic syndrome at the time of the first trimester.


RESULTS
The rate of premature birth was 15.1% [26/172 in the metabolic syndrome group vs. 11.7%; OR: 1.52 (95% CI: 0.996-2.33) p=0.051], in control group. Within the affected group 32 pregnancies were complicated with intrauterine grow retardation (18.6%); versus 3.6%, in the unaffected group; OR: 6.38 (95% CI: 4.24-9.61 p<0.001). In 47 cases we observed preeclampsia during pregnancy [27.3%; vs. 4.7%; OR: 7.93 (95% CI: 5.54-11.33) p<0.001] in the control group. Among the patients affected by the metabolic syndrome 67 patients (38.2%) had more then one pregnancy complications during pregnancy, and only 47 cases (27.3%) were lacking adverse events during pregnancy and delivery [OR: 3.11 (2.27-4.26) p<0.001].


CONCLUSIONS
Our study demonstrated higher rate of complicated pregnancies in association with metabolic syndrome compared to the control group. In addition, we started a prospective study in 2007, using LMWH therapy to prevent thromboplastic and atherosclerotic effects of the metabolic syndrome. The study is planned to be reported in 2010 to assess the effect of LMWH therapy on the outcome of pregnancies.
Horváth
Boldizsár
B
Vas Megyei Markusovszky Kórház Nonprofit Zrt. Thrombosis Klub Szombathely Markusovszky u. 3. 9700. horvath.boldizsar@markusovszky.hu
Kovács
Lajos
L
Riba
Mária
M
Farkas
György
G
Bödecs
Tamás
T
Bódis
József
J
D000328:Adult; D015992:Body Mass Index; D005260:Female; D005317:Fetal Growth Retardation / Q000175:diagnosis / Q000209:etiology; D006801:Humans; D006814:Hungary / Q000453:epidemiology; D024821:Metabolic Syndrome / Q000150:complications* / Q000175:diagnosis* / Q000453:epidemiology; D009765:Obesity / Q000150:complications / Q000175:diagnosis; D011225:Pre-Eclampsia / Q000175:diagnosis / Q000209:etiology; D011247:Pregnancy; D011248:Pregnancy Complications / Q000175:diagnosis* / Q000209:etiology*; D011249:Pregnancy Complications, Cardiovascular / Q000175:diagnosis / Q000209:etiology; D011256:Pregnancy Outcome; D047928:Premature Birth / Q000175:diagnosis / Q000209:etiology