Tarasenko K. Metabolic disorders in pregnant women of different obesity classes, their association with obstetric complications and validation of pathogenetic correction.

Thedissertationworkisaimedata decrease of obstetric pathology in pregnant women ofdifferentobesityclassesbased on analysis of association of obstetric complications and metabolic disorders that cause systemic inflammation and endothelial dysfunction, as well as at validation of their pathogenetic correction. Theresultsoftheresearchsuggest that pregnant women with obesity demonstrate an increase in frequency and severity of complications of pregnancy and childbirth, depending on the obesity class, compared to pregnant women with normal body mass. Pathologic insulin resistance is themetabolic base of obstetric complications in pregnant women with obesity, and its progression during pregnancy leads to tissue energy shortage. Obesity in pregnantwomen promotes atherogenic hyperlipoproteinemia type IV depending on the obesity class. We found that lipidindices can be used as diagnostic markers for screening pregnant women with obesityfor insulin resistance. We confirmed pathogenetic association of systemic inflammation with metabolic disorders and development of complications of pregnancy and childbirth.We obtained new data on imbalanced activity of endothelial (eNOS) and inducible (iNOS) NO-synthases as a manifestation of local endothelial dysfunction of the fetoplacental complex inpregnant women with obesity. Based on an analysis of the association of metabolic disorders with complications of pregnancy and childbirth from the standpoint of fundamental medicine we validated acomplex metabolic correction of obstetric complications with omega-3 polyunsaturated fatty acids in fish oil and L-arginine aspartate in combination with lifestyle modifications. The proposed metabolic correction increases sensitivity of cells to insulin, normalizes concentration of triacylglycerols and very low density lipoproteinsin blood,mitigates endothelial dysfunction and reduces frequency and severity of obstetric complications. Theresearchsubstantiatespathogeneticroleofmetabolicdisordersinobstetricandperinatalcomplicationsinpregnantwomenof different obesity classes.