B-cell-activating factor (BAFF) and platelet-activating factor (PAF) in pregnancies complicated by maternal obesity and diabetes: a preliminary study

Abstract

Objective

In pregnancies complicated by maternal obesity and diabetes, a disruption in inflammatory mediators occurs, resulting in endothelial microvascular dysfunction, oxidative stress, tissue damage, and maternal and feto-neonatal complications. To outline this proinflammatory status, an innovative approach is represented by the measurement of proinflammatory cytokines. Among these biomarkers, B-cell-activating factor (BAFF) and platelet-activating factor (PAF) play a key role in metabolic regulation, immune response to infections, tissue homeostasis, and “food-related inflammation.” The aim of the present study is to investigate the blood expression of BAFF and PAF in a cohort of pregnant women affected by obesity and diabetes compared with a control group of healthy pregnant women.

Methods

A prospective longitudinal cohort study has been conducted on pregnant women referred to Fondazione Policlinico Universitario Gemelli IRCCS in Rome. For each pregnant woman, a capillary sample was collected with a swab in three different consecutive evaluations carried out in the three trimesters of pregnancy.

Results

A total of 77 pregnant women have been enrolled. No significant differences in BAFF and PAF levels were longitudinally observed between groups. Focusing on the exposed group, in the third trimester of pregnancy, both PAF and BAFF levels were lower than the basal time. Among the selected group of patients who developed Gestational Diabetes, only PAF values were longitudinally lower when compared to other groups. The multivariate analysis showed that BAFF levels were positively correlated with thyroid-stimulating hormone levels. No macrosomia, no shoulder dystocia, no major perineal lacerations at birth, and no intrauterine growth restriction were observed in the whole population.

Conclusions

This study supports the involvement of metabolic and proinflammatory biomarkers in the mechanisms related to pregnancy complications. Improving a good metabolic environment for obese and diabetic pregnant women could break the vicious cycle connecting inflammation, oxidative stress, and metabolic disorders.

Keywords:

• Maternal obesity
• gestational diabetes
• B-cell-activating factor
• platelet-activating factor
• proinflammatory cytokines

Ethics statement

This study was performed in line with the principles of the Declaration of Helsinki. Ethics approval for this study was obtained from the Ethics Committee of Catholic University of the Sacred Heart University in May 2018 (ID 1927).

Author contributions

NC: conception, data collection, analysis, interpretation, and drafting. CA1 and DAD: data collection, analysis, interpretation, and drafting. AC: data analysis, interpretation, and drafting. BK and CA2: data collection, analysis, and interpretation. FA and TC: data collection and analysis. CM: data analysis and interpretation. SAF: data analysis, interpretation, and critical revision. LA: critical revision.

Disclosure statement

The authors declare no conflict of interest.

Data availability statement

The authors agree to make data and materials supporting the results or analyses available upon reasonable request.

Additional information

Funding

This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.