Prediction of fetal growth restriction in obese women

Objective. To develop a way of prediction of fetal growth restriction in the first trimester of pregnancy in obese women. Materials and methods. 85 obese pregnant women at 6–9 weeks of gestation took part in the study. Obesity was determined by body mass index, as squared height (m)-to-weight (kg) ratio, with a BMI 30 kg/m2. In the blood serum of all patients the level of total copper (Cuvol.) was determined by the colorimetric method, and ceruloplasmin (CP) by of V.S. Kamyshnikov`s method and the percentage of free copper (Cufree) was calculated. The free copper index was calculated using the formula: Cufree = (Cuvol. – (ceruloplasmin · 3)) / Cuvol. · 100, where Cufree is the percentage of free copper in the blood serum, %; Cuob. – content of total copper in blood serum, µmol/l; CP – content of ceruloplasmin in blood serum, mg/l; 3 – conversion factor. All pregnant women were divided into two groups depending on the percentage of free copper: group A – pregnant women with obesity and free copper content 25 % (n = 26); group B – obese pregnant women with a percentage of free copper 25 %, (n = 59). The control group consisted of 20 pregnant women with normal body weight. Results. Among the studied groups, in pregnant women with obesity statistically significant differences in the content of total copper (p = 0.013), and the percentage of free copper (p = 0.041) were revealed. In the group of pregnant women with a free copper content 25 % chronic placental insufficiency occurred 1.5 times more frequently and fetal growth restriction syndrome was 6.4 times more frequent than in the group of patients with a free copper content of 25 %. Conclusion. The free copper level, determined in the first trimester of pregnancy equal to 25% or more, can be considered as a predictor of fetal growth restriction in obese pregnant women.