Avaliação dos níveis séricos de adiponectina em gestantes adolescentes

Estudo prospectivo e transversal incluindo 67 gestantes normais entre 30 a 36 semanas e eutróficas (índice de massa corporal [IMC]: 18,5-25 kg/m2), sendo 36 adolescentes (< 20 anos) e 31 adultas (≥ 20 anos). Os níveis séricos de adiponectina foram avaliados por teste imunoenzimático (ELISA, na sigla em inglês). Para a comparação entre os grupos, utilizou-se os testes t-Student ou Mann-Whitney.

Resultados

As gestantes adolescentes apresentaram significativamente maiores concentrações séricas de adiponectina do que as adultas (p=0,04). Não houve diferenças nos níveis de adiponectina quando comparadas as gestantes adolescentes precoces (< 16 anos) às tardias (≥ 16 anos). Os valores de adiponectina foram subdivididos em3 grupos:<3.000 ng/mL, entre 3.000 e 5.000 ng/mL e>5.000 ng/mL. O peso do recém-nascido foi significantemente maior nas mulheres com>5.000 ng/mL, quando comparadas as com<3.000 ng/mL no grupo das adolescentes. Não foi observada associação entre os níveis de adiponectina e o IMC pré-gestacional, ganho de peso gestacional e a idade gestacional, porém houve relação positiva com o peso do recém-nascido (p=0,0239).

Conclusão

Os valores séricos de adiponectina em gestantes adolescentes entre 30 e 36 semanas de gestação foram maiores do que os das gestantes adultas; contudo, sem diferenças entre gestantes adolescentes precoces e tardias.

Palavras-chave:
adiponectina; adolescência; gestação; inflamação

Variable	Adolescents n = 36	Adults n = 31	p-value
Age (years old)^a a mean (standard deviation).	16.53 (1.98)	28.06 (4.99)	< 0.0001^* * t-Student Test.
Race^b b absolute number (percentage).			0.19^ Chi-squared Test.
White	13 (36.1%)	13 (41.9%)
Multiracial	15 (41.7%)	16 (51.6%)
Black	8 (22.2%)	2 (6.5%)
Marital status^b b absolute number (percentage).			0.003^ Chi-squared Test.
Single	23 (63.9%)	6 (19.4%)
Married	5 (13.9%)	11 (35.5%)
Stable union	8 (22.2%)	13 (41.9%)
Divorced	0 (0%)	1 (3.2%)
Years of study (years)^a a mean (standard deviation).	10.25 (1,96)	10.89 (2,13)	0.22^* * t-Student Test.
Salaried work^b b absolute number (percentage).			< 0.0001^† † Fisher Test.
Yes	8 (22.2%)	22 (71.0%)
No	28 (77.8%)	9 (29.0%)
Smoking^b b absolute number (percentage).			0.02^† † Fisher Test.
Yes	1 (2.8%)	7 (22.6%)
No	35 (97.2%)	24 (78.4%)
Alcohol abuse^b b absolute number (percentage).			0.002^† † Fisher Test.
Yes	1 (2.8%)	10 (32.3%)
No	35 (97.2%)	21 (67.7%)
BMI (Kg/m²)^a a mean (standard deviation).	21.59 (2.20)	21.25 (1.62)	0.48^* * t-Student Test.
GA at collection (weeks) ^a a mean (standard deviation).	32.45 (1.58)	33.19 (1.51)	0.055^* * t-Student Test.
Number of pregnancies^b b absolute number (percentage).			< 0.0001^† † Fisher Test.
1	35 (97.2%)	11 (35.5%)
≥ 2	1 (2.8%)	20 (64.5%)
Parturition^b b absolute number (percentage).			< 0.0001^ Chi-squared Test.
0	35 (97.2%)	14 (45.2%)
1	1 (2.8%)	12 (38.7%)
≥ 2	0 (0%)	5 (16.1%)
Birthweight (grams)^a a mean (standard deviation).	3103 (570.5)	3065 (245.0)	0.72^§ § Welch adjusted t-Student Test.

Variable	Adolescents <16 n = 12	Adolescents ≥16 n = 24	p-value
Age (years old)^a a mean (standard deviation).	14.25 (0.75)	17.67 (1.27)	< 0.0001^* * t-Student Test.
Race^b b absolute number (percentage).			0.82^ Chi-square Test.
White	5 (41.7%)	8 (33.3%)
Multiracial	5 (41.7%)	10 (41.7%)
Black	2 (16.6%)	6 (25.0%)
Marital status^b b absolute number (percentage).			0.13^ Chi-square Test.
Single	6 (50.0%)	17 (70.8%)
Married	1 (8.3%)	4 (16.7%)
Stable union	5 (41.7%)	3 (12.5%)
Years of study (years) ^a a mean (standard deviation).	8.83 (1.40)	10.96 (1.83)	0.001^* * t-Student Test.
Salaried work^b b absolute number (percentage).			0.22^† † Fisher Test.
Yes	11 (91.7%)1 (8.3%)	17 (70.8%)7 (29.2%)
No
Smoking^b b absolute number (percentage).			0.33^† † Fisher Test.
Yes	1 (8.3%)	0 (0%)
No	11 (91.7%)	24 (100%)
Alcohol abuse^b b absolute number (percentage).			1.00^† † Fisher Test.
Yes	0 (0%)	1 (4.2%)
No	12 (100%)	23 (95.8%)
BMI (Kg/m²) ^a a mean (standard deviation).	20.95 (1.97)	21.91 (2.28)	0.22^* * t-Student Test.

	Adolescents			Adults			Statistic F
	< 3,000(n = 10)	3,000–5,000(n = 12)	> 5,000(n = 14)	< 3,000(n = 12)	3,000–5000(n = 11)	> 5,000(n = 8)	F_{(1, 66)}; p-value ^* * Adolescents and adults.	F_{(2, 66)}; p-value ^ Categories of adiponectin concentration.	F_{(2, 66)}; p-value ^* ***** Interaction between ‘adolescents and adults’ and ‘categories of adiponectin concentration’.
Gestational age (days)	224.20(11.16)	230.50(11.67)	226.43(10.54)	230.83(9.76)	233.91(14.09)	230.63(9.16)	2.91; 0.09	1.08; 0.34	0.12; 0.88
Weightgain (kg)	13.45(4.42)	13.47(4.69)	13.34(5.02)	10.85(4.66)	10.47(4.30)	11.94(4.28)	4.15; 0.05	0.12; 0.89	0.17; 0.84
BMI (kg/m²)	21.26(1.68)	21.53(2.66)	21.89(2.21)	20.83(1.75)	21.16(1.26)	22.00(1.81)	0.22; 0.64	1.12; 0.33	0.12; 0.89
SBP (mm Hg)	104.00(13.50)	105.83(14.43)	107.14(9.14)	90.00(11.28)	102.73(11.04)^a a Significant difference in adiponectin concentration < 3,000 ng/mL. ^§ § Significant difference for adolescents.	95.00(10.69)^§ § Significant difference for adolescents.	11.17; < 0.01	2.15; 0.13	1.38; 0.26
DBP (mm Hg)	65.00(10.80)	70.00(11.28)	69.29(11.41)	54.17(9.00)^§ § Significant difference for adolescents.	65.45(11.28)^a a Significant difference in adiponectin concentration < 3,000 ng/mL.	58.75(12.46)^§ § Significant difference for adolescents.	10.00; < 0.01	3.06; 0.05	0.58; 0.56
Birth weight (g)	2828.00(564.88)	3037.58(525.60)	3355.71(539.18)^a a Significant difference in adiponectin concentration < 3,000 ng/mL.	2950.83(210.00)	3056.36(210.00)	3248.13(310.11)	0.01; 0.91	5.01; 0.01	0.39; 0.68

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