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Zhuang Y, Li L, Zhang Y, Liu X, Zeng B, Zhu B, Dai F. Association between Life's Essential 8 and Infertility as Well as the Mediating Effects of Oxidative Stress and Inflammatory Factors Among U.S. Women Aged 18-45 Years. Reprod Sci 2025; 32:738-747. [PMID: 38977640 DOI: 10.1007/s43032-024-01635-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2024] [Accepted: 06/24/2024] [Indexed: 07/10/2024]
Abstract
Management of cardiovascular disease in pregnancy is important, yet the association between cardiovascular health and infertility is rarely reported. In this study, we aimed to explore the association between Life's Essential 8 (LE8), a novel cardiovascular health (CVH) measure, and infertility, and to investigate potential mediating mechanisms. This study investigated cross-sectional data from the 2013-2018 National Health and Nutrition Examination Survey. LE8 score (ranging from 0 to 100) was calculated as the unweighted average of eight CVH metrics. The association between LE8 and infertility was explored through weighted multiple logistic regression. Restricted cubic splines were used to explore nonlinear correlation. In addition, mediation analysis was conducted to investigate the role of oxidative stress and inflammatory markers systematically. After strict exclusion criteria, 1703 American women aged 18-45 years were included. After full adjustment, the LE8 score showed a negative correlation with infertility [per 1 SD increase, OR = 0.675, 95% CI: 0.553-0.824], with a linear dose-response relationship (non-linear P = 0.122). Similar linear negative correlations were found between health factor scores and infertility, with higher body mass index and glucose scores having a significantly lower risk of infertility. Stratified analyses showed a stronger inversed relationship between LE8 and infertility in younger populations. Moreover, mediation analysis revealed that uric acid concentration and lymphocyte count mediated the effect of LE8 on infertility (P < 0.05). LE8 and its subscale scores were linearly and negatively associated with infertility, which may be mediated in part through uric acid and lymphocyte count. Focusing on weight management and glycemic control can effectively reduce the risk of infertility.
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Affiliation(s)
- Yan Zhuang
- Department of Gastroenterology, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Laifu Li
- Department of Gastroenterology, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Yanqi Zhang
- Department of Gastroenterology, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Xuna Liu
- Department of Gastroenterology, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Beibei Zeng
- Department of Gastroenterology, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Boxu Zhu
- Department of Gastroenterology, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Fei Dai
- Department of Gastroenterology, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China.
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Kubler JM, Beetham KS, Steane SE, Holland OJ, Borg DJ, Rae KM, Kumar S, Clifton VL. Sex-specific associations between feto-placental growth and maternal physical activity volume and sitting time: Findings from the Queensland Family Cohort study. Placenta 2025; 160:107-117. [PMID: 39787953 DOI: 10.1016/j.placenta.2024.12.027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/10/2024] [Revised: 12/18/2024] [Accepted: 12/30/2024] [Indexed: 01/12/2025]
Abstract
INTRODUCTION Antenatal physical activity (PA) is associated with beneficial changes in placental growth and function; however, the effect of excessive sitting time is less clear. The aim of this study was to investigate whether feto-placental growth changes with maternal activity, and whether these associations differ in a sex-specific manner. METHODS This study included women enrolled in the Queensland Family Cohort study who self-reported PA and sitting time at 24 or 36 weeks of gestation. Placental growth factors and feto-placental growth parameters at delivery were analysed by PA volume and sitting time, as well as by fetal sex. RESULTS Women who reported excessive sitting time during mid-pregnancy and had a female fetus showed higher placental PlGF (p = 0.031) and FLT1 (p = 0.032) mRNA expression with no difference in placental size at delivery. For the male, excessive sitting time during mid-pregnancy was associated with a lower placental weight (p = 0.001) and placental surface area (p = 0.012) and a higher birthweight to placental weight (BWPW) ratio (p = 0.042), with no change in placental growth factors. Moderate volume PA during mid-pregnancy was associated with lower VEGFA mRNA expression in the male placenta (p = 0.005) and a higher abdominal circumference in the female neonate (p = 0.042), with no overall difference in placental weight or birthweight for either sex. CONCLUSIONS The results of this study suggest that mid-pregnancy may be an important timepoint for programming of feto-placental growth in relation to maternal activity. Our findings highlight the independent benefits of reducing sitting time during pregnancy, particularly for women carrying male fetuses.
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Affiliation(s)
- Jade M Kubler
- Faculty of Medicine, Mater Research Institute-University of Queensland, South Brisbane, Australia
| | - Kassia S Beetham
- School of Behavioural and Health Sciences, Australian Catholic University, Banyo, Australia
| | - Sarah E Steane
- School of Biomedical Sciences, University of Queensland, St Lucia, Australia
| | - Olivia J Holland
- School of Pharmacy and Medical Sciences, Griffith University, Southport, Australia
| | - Danielle J Borg
- Faculty of Medicine, Mater Research Institute-University of Queensland, South Brisbane, Australia
| | - Kym M Rae
- Faculty of Medicine, Mater Research Institute-University of Queensland, South Brisbane, Australia; Indigenous Health Research Group, Mater Research Institute, Aubigny Place, South Brisbane, Australia
| | - Sailesh Kumar
- Faculty of Medicine, Mater Research Institute-University of Queensland, South Brisbane, Australia
| | - Vicki L Clifton
- Faculty of Medicine, Mater Research Institute-University of Queensland, South Brisbane, Australia.
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Chen A, Tian M, Luo Z, Cao X, Gu Y. Analysis of the evolution of placental oxidative stress research from a bibliometric perspective. Front Pharmacol 2024; 15:1475244. [PMID: 39484166 PMCID: PMC11524950 DOI: 10.3389/fphar.2024.1475244] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2024] [Accepted: 10/07/2024] [Indexed: 11/03/2024] Open
Abstract
Background Research on placental oxidative stress is pivotal for comprehending pregnancy-related physiological changes and disease mechanisms. Despite recent advancements, a comprehensive review of current status, hotspots, and trends remains challenging. This bibliometric study systematically analyzes the evolution of placental oxidative stress research, offering a reference for future studies. Objective To conduct a comprehensive bibliometric analysis of the literature on placental oxidative stress to identify research hotspots, trends, and key contributors, thereby providing guidance for future research. Methods Relevant data were retrieved from the Web of Science Core Collection database and analyzed using VOSviewer, CiteSpace, and the bibliometrix package. An in-depth analysis of 4,796 publications was conducted, focusing on publication year, country/region, institution, author, journal, references, and keywords. Data collection concluded on 29 April 2024. Results A total of 4,796 papers were retrieved from 1,173 journals, authored by 18,835 researchers from 4,257 institutions across 103 countries/regions. From 1991 to 2023, annual publications on placental oxidative stress increased from 7 to 359. The United States (1,222 publications, 64,158 citations), the University of Cambridge (125 publications, 13,562 citations), and Graham J. Burton (73 publications, 11,182 citations) were the most productive country, institution, and author, respectively. The journal Placenta had the highest number of publications (329) and citations (17,152), followed by the International Journal of Molecular Sciences (122 publications). The most frequent keywords were "oxidative stress," "expression," "pregnancy," "preeclampsia," and "lipid peroxidation." Emerging high-frequency keywords included "gestational diabetes mellitus," "health," "autophagy," "pathophysiology," "infection," "preterm birth," "stem cell," and "inflammation." Conclusion Over the past 3 decades, research has concentrated on oxidative stress processes, antioxidant mechanisms, pregnancy-related diseases, and gene expression regulation. Current research frontiers involve exploring pathophysiology and mechanisms, assessing emerging risk factors and environmental impacts, advancing cell biology and stem cell research, and understanding the complex interactions of inflammation and immune regulation. These studies elucidate the mechanisms of placental oxidative stress, offering essential scientific evidence for future intervention strategies, therapeutic approaches, and public health policies.
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Affiliation(s)
| | | | | | - Xiaohui Cao
- Department of Obstetrics and Gynecology, Women’s Hospital of Jiangnan University, Wuxi Maternity and Child Health Care Hospital, Wuxi, China
| | - Yanfang Gu
- Department of Obstetrics and Gynecology, Women’s Hospital of Jiangnan University, Wuxi Maternity and Child Health Care Hospital, Wuxi, China
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Zhang CXW, Candia AA, Sferruzzi-Perri AN. Placental inflammation, oxidative stress, and fetal outcomes in maternal obesity. Trends Endocrinol Metab 2024; 35:638-647. [PMID: 38418281 DOI: 10.1016/j.tem.2024.02.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/23/2023] [Revised: 02/01/2024] [Accepted: 02/02/2024] [Indexed: 03/01/2024]
Abstract
The obesity epidemic has led to a growing body of research investigating the consequences of maternal obesity on pregnancy and offspring health. The placenta, traditionally viewed as a passive intermediary between mother and fetus, is known to play a critical role in modulating the intrauterine environment and fetal development, and we now know that maternal obesity leads to increased inflammation, oxidative stress, and altered placental function. Here, we review recent research exploring the involvement of inflammation and oxidative stress as mechanisms impacting the placenta and fetus during obese pregnancy. Understanding them is crucial for informing strategies that can mitigate the adverse health effects of maternal obesity on offspring development and disease risk.
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Affiliation(s)
- Cindy X W Zhang
- Department of Physiology, Development and Neuroscience, University of Cambridge, Cambridge, UK
| | - Alejandro A Candia
- Department of Physiology, Development and Neuroscience, University of Cambridge, Cambridge, UK; Institute of Health Sciences, University of O'Higgins, Santiago, Chile
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Kubler JM, Edwards C, Cavanagh E, Mielke GI, Gardiner PA, Trost SG, Fontanarosa D, Borg DJ, Kumar S, Clifton VL, Beetham KS. Maternal physical activity and sitting time and its association with placental morphology and blood flow during gestation: Findings from the Queensland Family Cohort study. J Sci Med Sport 2024; 27:480-485. [PMID: 38508889 DOI: 10.1016/j.jsams.2024.02.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2023] [Revised: 02/17/2024] [Accepted: 02/28/2024] [Indexed: 03/22/2024]
Abstract
OBJECTIVES Antenatal exercise is associated with placental morphological alterations, however research in this area is limited. Given the emphasis on the beneficial effects of antenatal exercise, it is important to understand its effect on placental function and the relationship to foetal development. The aim of this study was to investigate the association between physical activity, sitting time, and placental outcomes measured during gestation. DESIGN Prospective cohort study. METHODS Pregnant women in the Queensland Family Cohort study self-reported physical activity at 24 and 36 weeks of gestation (n = 203) and were categorised into physical activity volume groups of nil-low (0-<500 metabolic equivalent of task·minutes/week), moderate (500-<1000 metabolic equivalent of task·minutes/week), or high-volume activity (≥1000 metabolic equivalent of task·minutes/week). Participants reported average daily sitting time, whereby excessive sitting time was considered as ≥8h/day. Placental stiffness, thickness, and uteroplacental blood flow resistance were measured by ultrasound imaging at each timepoint. RESULTS Physical activity volume was not associated with changes to placental morphometrics or uteroplacental blood flow resistance at 24 or 36 weeks of gestation. Excessive sitting time at 36 weeks was associated with greater placental stiffness (p = 0.046), and a lower umbilical artery pulsatility index (p = 0.001). CONCLUSIONS Placental tissue stiffness and umbilical artery resistance were altered in late gestation with higher maternal sitting time but not with physical activity volume. Overall, excessive sitting time may be a risk for suboptimal placental function and could be an important focus for antenatal care.
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Affiliation(s)
- Jade M Kubler
- Faculty of Medicine, Mater Research Institute-University of Queensland, Australia. https://twitter.com/jadekubler
| | - Christopher Edwards
- School of Clinical Sciences, Queensland University of Technology, Australia. https://twitter.com/edchris_
| | - Erika Cavanagh
- Faculty of Medicine, Mater Research Institute-University of Queensland, Australia. https://twitter.com/ejcav
| | - Gregore I Mielke
- School of Public Health, University of Queensland, Australia. https://twitter.com/GregoreMielke
| | - Paul A Gardiner
- School of Public Health, University of Queensland, Australia. https://twitter.com/drpaulgardiner
| | - Stewart G Trost
- School of Human Movement and Nutrition Sciences, University of Queensland, Australia. https://twitter.com/StewartTrost
| | - Davide Fontanarosa
- School of Clinical Sciences, Queensland University of Technology, Australia
| | - Danielle J Borg
- Faculty of Medicine, Mater Research Institute-University of Queensland, Australia. https://twitter.com/DrDanBorg
| | - Sailesh Kumar
- Faculty of Medicine, Mater Research Institute-University of Queensland, Australia. https://twitter.com/MFMresearch
| | - Vicki L Clifton
- Faculty of Medicine, Mater Research Institute-University of Queensland, Australia. https://twitter.com/VickiClifton842
| | - Kassia S Beetham
- School of Behavioural and Health Sciences, Australian Catholic University, Australia.
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Lv C, Lu Q, Zhang C, Yan S, Chen H, Pan XF, Fu C, Wang R, Song X. Relationship between first trimester physical activity and premature rupture of membranes: a birth cohort study in Chinese women. BMC Public Health 2024; 24:1736. [PMID: 38944666 PMCID: PMC11214697 DOI: 10.1186/s12889-024-18791-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Accepted: 05/08/2024] [Indexed: 07/01/2024] Open
Abstract
OBJECTIVE This study aimed to examine prospective associations of different intensity levels and types of physical activity (PA) in early pregnancy with premature rupture of membranes (PROM) among Chinese pregnant women. METHODS A total of 6284 pregnant women were included from the Tongji-Shuangliu Birth Cohort. Household/caregiving, occupational, sports/exercise and transportation activities during early pregnancy were investigated by the pregnancy physical activity questionnaire (PPAQ), and the diagnosis of PROM was ascertained during the whole pregnancy. Multivariate logistic regression models were used to estimate the odds ratios (ORs) and 95% confidence interval (CI) for the associations between PA and PROM. RESULTS Among the 6284 pregnant women, 1246 were identified to have PROM (19.8%). Women undertaking the highest level (3 third tertile) of PA during pregnancy appeared to have a lower risk of PROM [OR = 0.68, 95%CI 0.58-0.80) when compared to those at the lowest tertile of PA. Similarly, women with increased levels of light intensity activity, moderate-vigorous intensive, household/caregiving activity and meeting exercise guidelines during pregnancy were associated with reduced risks of PROM (OR = 0.69, 95% CI 0.59-0.81, OR = 0.70, 95% CI 0.60-0.82, OR = 0.62, 95% CI 0.53-0.73 and OR = 0.82, 95% CI 0.70-0.97, respectively). CONCLUSIONS High levels of PA of different intensities and PA of household/caregiving activities and meeting exercise guidelines during the first trimester were associated with a lower incidence of PROM. TRIAL REGISTRATION The data of human participants in this study were conducted in accordance with the Helsinki Declaration. This study has been approved by the Ethics Committee of Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China ([2017] No. S225). All participants provided written informed consent prior to enrollment. A statement to confirm that all methods were carried out in accordance with relevant guidelines and regulations.
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Affiliation(s)
- Chuanzhu Lv
- Emergency Medicine Center, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, 610072, Sichuan, China
- Research Unit of Island Emergency Medicine, Hainan Medical University, Chinese Academy of Medical Sciences, (No. 2019RU013), Haikou, 570100, Hainan, China
| | - Qian Lu
- School of Public Health, Hainan Medical University, Haikou, 570100, Hainan, China
| | - Caihong Zhang
- International school of Nursing, Hainan Medical University, Haikou, 570100, China
| | - Shijiao Yan
- School of Public Health, Hainan Medical University, Haikou, 570100, Hainan, China
| | - Huanjun Chen
- School of Public Health, Hainan Medical University, Haikou, 570100, Hainan, China
| | - Xiong-Fei Pan
- Section of Epidemiology and Population Health, Department of Gynecology and Obstetrics, Ministry of Education Key Laboratory of Birth Defects and Related Diseases of Women and Children & National Medical Products Administration Key Laboratory for Technical Research on Drug Products In Vitro and In Vivo Correlation, West China Second University Hospital, Sichuan University, Chengdu, 610041, Sichuan, China
- West China Biomedical Big Data Center, West China Hospital, Sichuan University, Chengdu, 610041, Sichuan, China
- Shuangliu Institute of Women's and Children's Health, Shuangliu Maternal and Child Health Hospital, Chengdu, 610200, Sichuan, China
- Center for Epidemiology and Population Health, Integrated Traditional Chinese and Western Medicine Institute & Chengdu Integrated Traditional Chinese and Western Medicine Hospital, Chengdu University of Traditional Chinese Medicine, Chengdu, 610041, Sichuan, China
| | - Chao Fu
- Department of Emergency, Hainan Clinical Research Center for Acute and Critical Diseases, The Second Affiliated Hospital of Hainan Medical University, Haikou, 570100, Hainan, China.
| | - Rixing Wang
- Department of Emergency, Hainan Clinical Research Center for Acute and Critical Diseases, The Second Affiliated Hospital of Hainan Medical University, Haikou, 570100, Hainan, China.
| | - Xingyue Song
- Department of Emergency, Hainan Clinical Research Center for Acute and Critical Diseases, The Second Affiliated Hospital of Hainan Medical University, Haikou, 570100, Hainan, China.
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Zafaranieh S, Stadler JT, Pammer A, Marsche G, van Poppel MNM, Desoye G. The Association of Physical Activity and Sedentary Behavior with Maternal and Cord Blood Anti-Oxidative Capacity and HDL Functionality: Findings of DALI Study. Antioxidants (Basel) 2023; 12:antiox12040827. [PMID: 37107203 PMCID: PMC10135087 DOI: 10.3390/antiox12040827] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2023] [Revised: 03/13/2023] [Accepted: 03/20/2023] [Indexed: 03/30/2023] Open
Abstract
Obesity is one of the most common health issues in pregnancy with short and long-term consequences for both mother and her offspring. Promoting moderate to vigorous physical activity (MVPA) and decreasing sedentary time (ST) could have a positive impact on weight and obesity management, and therefore adiposity-induced oxidative stress, inflammation, and atherogenesis. However, the effects of MVPA and ST on anti-oxidative and anti-atherogenic markers in pregnancy have not been studied to date. This study aimed to assess the association of longitudinally and objectively measured MVPA and ST in 122 overweight/obese women (BMI ≥ 29 kg/m2) with maternal and cord blood markers of oxidative stress measured by advanced oxidation protein products (AOPP), anti-oxidative capacity, as well as high-density lipoproteins (HDL) related paraoxonase-1 (PON-1) activity and cholesterol efflux. Linear regression models showed no associations of MVPA and ST with outcomes in maternal blood. In contrast, MVPA at <20 weeks and 24–28 weeks of gestation were positively associated with anti-oxidative capacity, as well as PON-1 activity of HDL in cord blood. MVPA at 35–37 weeks correlated with higher AOPP, as well as higher anti-oxidative capacity. ST <20 weeks was also positively associated with inhibition of oxidation in cord blood. We speculate that increasing MVPA of overweight/obese women during pregnancy attenuates the oxidative stress state in the new-born.
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