Correlation of leptin hormone level in obese women with post term pregnancy rate

Post-term pregnancy is defined as the passing of ۴۲ weeks (۲۹۴ days) from LMP. The effective factors in the occurrence of post-term pregnancy are: null parity, maternal genes, cervical length in the middle of pregnancy and BMI higher than ۲۵ and fetal anencephaly, adrenal hypoplasia and sulphatase deficiency. There are several factors that put a woman at risk of having an extended pregnancy. The occurrence of this is more for the first pregnancy and in women who have a history of prolonged pregnancy, genetic factors may also play a role. Complications of post-term pregnancy include: stillbirth or death of the baby: the prevalence of stillbirth is higher in post-term pregnancy. In every ۱۰۰۰ post-term pregnancies, the risk of stillbirth is ۴ to ۷ cases, while this statistic is ۲ to ۳ cases out of every ۱۰۰۰ births for normal pregnancies. Large body size: The fetus is more at risk of experiencing complications related to increased body size following a post-term pregnancy. In this way, the weight of the baby may be more than ۴۵۰۰ grams. In this situation, it becomes difficult for the fetus to pass through the birth canal and there is a possibility of trauma (for example, bone fracture or nerve damage) because the fetus' shoulders may not come out easily. Also, the delivery time is prolonged in post-term pregnancy. Oligohydraminos: In post-term pregnancy, the decrease in the amount of amniotic fluid affects the heart rate of the fetus and compresses the umbilical cord of the fetus during contractions. Restriction in growth: Fetal growth is restricted in post-term pregnancy because the blood supply to the fetus through the umbilical cord is impaired. Aspiration of meconium: In post-term pregnancy, the fetus may introduce compounds called meconium into the amniotic fluid as a result of bowel movements. If the fetus is under pressure, then there will be a possibility of inhaling the meconium that is in the amniotic fluid, as a result, the fetus will have breathing problems after birth. The increase in the size of the fetus in post-term pregnancy makes pregnancy and delivery difficult for the mother, thus there is a possibility of damage to the perineum area (vagina, labia and rectum). There is also the possibility of prolonging the pregnancy process and performing a cesarean section. Caesarean section also causes problems such as bleeding, infection and damage to other organs. Leptin is produced only in fat cells and to a lesser extent in the epithelium of the intestine and placenta. Leptin receptor is mainly expressed in brain areas including arcuate nucleus neurons, ventromedial hypothalamus, which are involved in the regulation of eating behavior. This receptor is also expressed in the cells of the cortical part of the adrenal glands and beta cells of the pancreas, although in a low amount. Leptin carries the message that the fat reserves are sufficient and reduces fuel consumption andincreases energy consumption. Leptin also stimulates the sympathetic nervous system and thus increases blood pressure, heart rate and heat production (heat production at the cost of metabolic energy) by separating electron transfer from ATP synthesis in fat tissue mitochondria. Leptin reduces the production of neuropeptide y in the hypothalamus, which is a strong stimulant of appetite (so it reduces appetite). It also increases a-msh, which is an appetite suppressant in the hypothalamus (again, decreases appetite). Leptin increases the secretion of TRh and GnRh, therefore it increases energy consumption. Also, in lipogenesis in fat cells, by inhibiting SREBP, leptin inhibits lipogenesis and reduces the production of new fatty acids from a high-carbohydrate diet.