Estado nutricional pré-gestacional e ganho de peso na gestação: relação com pré-eclâmpsia e com o comprimento relativo dos telômeros maternos e neonatais

Abstract

Pregnancy is a period marked by important metabolic, hormonal, nutritional, and inflammatory adaptations that are essential for adequate fetal development and the maintenance of maternal health. Alterations in maternal nutritional status, represented by pre-pregnancy body mass index (BMI) and gestational weight gain (GWG), have been associated with an increased risk of gestational complications, such as preeclampsia (PE), and may also be related to maternal and neonatal telomere dynamics. The aim of this study was to investigate, among postpartum women, the relationship between pre-pregnancy nutritional status, gestational weight gain, and the occurrence of preeclampsia, as well as to evaluate the relationship of these variables with maternal and neonatal relative telomere length. This was an observational, cross- sectional, descriptive, and analytical study with a quantitative approach, conducted with mother–newborn dyads receiving care at the maternity ward of the Hospital Regional do Oeste, in Chapecó, Santa Catarina, Brazil. Sociodemographic, clinical, obstetric, and nutritional information was collected, and pre-pregnancy BMI and GWG were classified according to the recommendations of the Institute of Medicine (IOM). Relative telomere length was determined by quantitative polymerase chain reaction (qPCR) using the T/S ratio, which represents the relationship between telomeric sequences (T) and a reference gene (S), using oral mucosa samples from mothers and newborns. Statistical analyses were performed using PSPP software, adopting a significance level of 5%. Results: The study included 100 postpartum women and their newborns, with a predominance of adolescents or young adults (86.0%), women self- identifying as non-White (52.0%), those with a high level of education (62.0%) and average family income (65.0%), residents of Chapecó (75.0%), and multigravidae (36.0%). The prevalence of preeclampsia was 13.0%. Pre-pregnancy BMI was related to the occurrence of preeclampsia, with a higher proportion of cases among women with obesity, whereas GWG was not related to this outcome. Newborns of mothers with pre-pregnancy underweight had longer telomeres compared with those born to mothers with normal pre-pregnancy BMI (p=0.0153). Higher maternal and neonatal T/S ratios were also observed in cases of insufficient gestational weight gain (p<0.05). Women with preeclampsia had a higher T/S ratio compared with those without the condition (p=0.0314). Gestational weight gain was inversely correlated with the maternal T/S ratio. In conclusion, maternal nutritional status may influence the occurrence of preeclampsia and maternal and neonatal telomere dynamics, reinforcing the importance of health promotion strategies and nutritional monitoring before and during pregnancy to improve maternal and neonatal outcomes.