scholarly journals Hypopituitarism and pregnancy: clinical characteristics, management and pregnancy outcome

Pituitary ◽  
2021 ◽  
Author(s):  
Anna Aulinas ◽  
Nicole Stantonyonge ◽  
Apolonia García-Patterson ◽  
Juan M. Adelantado ◽  
Carmen Medina ◽  
...  
Keyword(s):  
Weight Gain ◽  
Cesarean Section ◽  
Pregnancy Outcome ◽  
Gestational Weight Gain ◽  
Clinical Characteristics ◽  
High Rate ◽  
Gestational Weight ◽  
Replacement Treatment ◽  
Reproductive Techniques ◽  
Gestational Age At Birth

Abstract Purpose To describe the clinical characteristics, management and pregnancy outcome of women with prepregnancy hypopituitarism (HYPO) that received care at our center. Methods Retrospective study describing 12 pregnancies in women with prepregnancy HYPO (two or more pituitary hormonal deficiencies under replacement treatment) that received care during pregnancy at Hospital Santa Creu i Sant Pau. Clinical characteristics, management and pregnancy outcome were systematically collected. Results Average patients’ age was 35 years and HYPO duration at the beginning of pregnancy was 19 years. The most frequent cause of HYPO was surgical treatment of a sellar mass (8 pregnancies). Eight pregnancies were in primigravid women and 10 required assisted reproductive techniques. The hormonal deficits before pregnancy were as follows: GH in 12 women, TSH in 10, gonadotropin in 9, ACTH in 5 and ADH in 2. All deficits were under hormonal substitution except for GH deficit in 4 pregnancies. During pregnancy, 4 new deficits were diagnosed. The dosage of replacement treatment for TSH, ACTH and ADH deficits was increased and GH was stopped. Average gestational age at birth was 40 weeks, gestational weight gain was excessive in 9 women, 8 patients required induction/elective delivery and cesarean section was performed in 6. Average birthweight was 3227 g. No major complications were observed. Five women were breastfeeding at discharge. Conclusions In this group of women with long-standing HYPO, with careful clinical management (including treatment of new-onset hormonal deficits) pregnancy outcome was satisfactory but with a high rate of excessive gestational weight gain and cesarean section.

scholarly journals Association of gestational weight gain with cesarean section: a prospective birth cohort study in Southwest China

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Lujiao Huang ◽  
Ju Zhang ◽  
Hong Sun ◽  
Hongli Dong ◽  
Run Li ◽  
...  
Keyword(s):  
Weight Gain ◽  
Cesarean Section ◽  
Birth Cohort ◽  
Gestational Weight Gain ◽  
Southwest China ◽  
The Other ◽  
Public Health Issue ◽  
Birth Cohort Study ◽  
Gestational Weight ◽  
Prospective Birth Cohort

Abstract Background Cesarean section (CS) is a rising public health issue globally, and is particularly serious in China. Numerous studies have suggested that gestational weight gain (GWG) control may be an effective way to reduce the rate of CS. However, rare study has examined the association between GWG and CS among women in Southwest China. We proposed to examine their association based on a prospective birth cohort, and further to explore the optimal GWG range. Methods We retrieved data from a prospective birth cohort from Sichuan Provincial Hospital for Women and Children, Southwest China. Unconditional multivariable logistic regression was used to examine the association between GWG and CS by adjusting for potential confounders. In one analysis, we incorporated the GWG as a categorical variable according to the Institute of Medicine (IOM) recommendation, similar to the method used in the majority of previous studies. In the other analysis, we directly incorporated GWG as a continuous variable and natural cubic splines were used to characterize the potential nonlinear exposure-response relationship, aiming to identify the optimal GWG. We further stratified the above analysis by pre-pregnancy BMI and GDM, and then a heterogeneity test based on a multivariate meta-analysis was conducted to examine whether the stratum specific estimations agreed with each other. Results A total of 1363 participants were included. By adopting the IOM recommendation, the adjusted OR of CS was 0.63 (0.47, 0.84) for insufficient GWG and 1.42 (1.06, 1.88) for excessive GWG. After stratification by pre-pregnancy BMI, we found a higher risk of CS in associated with excessive GWG in the stratum of underweight compared with the other strata, which implied that pre-pregnancy BMI may be an effect modifier. By applying a flexible spline regression, the optimal GWG levels in terms of reducing the CS rate based on our data were more stringent than those of IOM recommendation, which were 9–12 kg for underweight women, < 19 kg for normal weight women and < 10 kg for overweight/obese women. Conclusions These results suggested that a more stringent recommendation should be applied in Southwest China, and that more attention should be given to underweight women.

scholarly journals Maternal Body Mass Index and Gestational Weight Gain and Their Association with Pregnancy Complications and Perinatal Conditions

2019 ◽  
Vol 16 (10) ◽  
pp. 1751 ◽  
Author(s):  
Martin Simko ◽  
Adrian Totka ◽  
Diana Vondrova ◽  
Martin Samohyl ◽  
Jana Jurkovicova ◽  
...  
Keyword(s):  
Weight Gain ◽  
Cesarean Section ◽  
Gestational Weight Gain ◽  
Gestational Hypertension ◽  
Overweight And Obesity ◽  
University Hospital ◽  
Maternal Body Mass Index ◽  
Gestational Weight ◽  
Gynecology And Obstetrics ◽  
The Impact

This study aimed to evaluate the impact of selected pregnancy pathologies statistically depending on overweight/obesity and excessive maternal weight gain during pregnancy on women who gave birth in the years 2013–2015 at the Second Department of Gynecology and Obstetrics at the University Hospital in Bratislava, Slovakia. In a retrospective study, we analyzed data gathered from the sample, which consisted of 7122 women. Our results suggest a statistically significant, higher risk for the groups of women with overweight and obesity and gestational hypertension (adjusted odds ratio (AOR) = 15.3; 95% CI 9.0−25.8 for obesity), preeclampsia (AOR = 3.4; 95% CI 1.9−6.0 for overweight and AOR = 13.2; 95% CI 7.7−22.5 for obesity), and gestational diabetes mellitus (AOR = 1.9; 95% CI 1.2−2.9 for overweight and AOR = 2.4; 95% CI 1.4−4.0 for obesity). A higher incidence of pregnancies terminated by cesarean section was observed in the group of obese women. Gestational weight gain above IOM (Institute of Medicine) recommendations was associated with a higher risk of pregnancy terminated by C-section (AOR = 1.2; 95% CI 1.0−1.3), gestational hypertension (AOR = 1.7; 95% CI 1.0−2.7), and infant macrosomia (AOR = 1.7; 95% CI 1.3−2.1). Overweight and obesity during pregnancy significantly contribute to the development of pregnancy pathologies and increased incidence of cesarean section. Systematic efforts to reduce weight before pregnancy through prepregnancy dietary counseling, regular physical activity, and healthy lifestyle should be the primary goal.

Size for gestational age at birth according to offspring sex and gestational weight gain in underweight women

2019 ◽  
Vol 10 (5) ◽  
pp. 536-541 ◽  
Author(s):  
Y. Kasuga ◽  
D. Shigemi ◽  
M. Tamagawa ◽  
T. Suzuki ◽  
S.-H. Kim ◽  
...  
Keyword(s):  
Weight Gain ◽  
Gestational Weight Gain ◽  
Gestational Age ◽  
Normal Weight ◽  
Weight Group ◽  
Normal Weight Group ◽  
Gestational Weight ◽  
Offspring Sex ◽  
Gestational Age At Birth ◽  
Age At Birth

AbstractAlthough maternal pre-pregnancy body mass index (BMI) and gestational weight gain (GWG) are related to fetal growth, there is a paucity of data regarding how offspring sex affects the relationship between maternal BMI in underweight mothers (pre-pregnancy BMI <18.5 kg/m2) and size for gestational age at birth. The aim of this study was to investigate the effect of offspring sex on the relationships among maternal pre-pregnancy BMI, GWG and size for gestational age at birth in Japanese underweight mothers. Records of women with full-term pregnancies who underwent perinatal care at Kawasaki Municipal Hospital (Kawasaki, Japan) between January 2013 and December 2017 were retrospectively reviewed. The study cohort included underweight (n=566) and normal-weight women (18.5 kg/m2⩽pre-pregnancy BMI<25 kg/m2; n=2671). The incidence of small for gestational age (SGA) births in the underweight group was significantly higher than that in the normal-weight group (P<0.01). Additionally, SGA incidence in the underweight group was significantly higher than that in the normal-weight group (P<0.01) in female, but not male (P=0.30) neonates. In the women with female neonates, pre-pregnancy underweight was associated with a significantly increased probability of SGA (odds ratio [OR]: 1.80; P<0.01), but inadequate GWG was not (OR: 1.38; P=0.11). In contrast, in women with male neonates, inadequate GWG was associated with a significantly increased probability of SGA (OR: 1.53; P=0.03), but not with pre-pregnancy underweight (OR: 1.30; P=0.10). In conclusion, the present results suggest that pre-pregnancy underweight is associated with SGA in female offspring but not in male offspring.

scholarly journals 293: Impact of BMI and gestational weight gain on term pregnancy outcome in Rwanda

2019 ◽  
Vol 220 (1) ◽  
pp. S207
Author(s):  
Pascal Nkubito ◽  
Diomede Ntasumbumuyange ◽  
Stephen Rulisa ◽  
Maria Small ◽  
Urania Magriples
Keyword(s):  
Weight Gain ◽  
Pregnancy Outcome ◽  
Gestational Weight Gain ◽  
Term Pregnancy ◽  
Gestational Weight

scholarly journals Impact of Gestational Weight Gain on Perinatal Outcomes:Appropriateness of IOM Recommendations in Mainland China

2020 ◽  
Author(s):  
Jing Hu ◽  
Jinsong Gao ◽  
Juntao Liu ◽  
Xietong Wang ◽  
Jing He ◽  
...  
Keyword(s):  
Weight Gain ◽  
Cesarean Section ◽  
Gestational Weight Gain ◽  
Mainland China ◽  
Perinatal Outcomes ◽  
Institute Of Medicine ◽  
Birth Registry ◽  
Gestational Weight ◽  
Increased Risk ◽  
Iom Recommendations

Abstract Abstract The study was conducted to evaluate the clinical feasibility of Institute of Medicine (IOM) recommendations on gestational weight gain (GWG) in mainland China. 88,297 singleton pregnancies from a nationwide birth registry study were included. GWG per week was calculated and grouped into within, below and above IOM (IOM) guidelines based on first trimester Chinese body weight index (BMI) status. Univariable and multivariable analyses were performed to determine the relationship between GWG category and perinatal outcomes. We found that excessive GWG was associated with increased risk in pregnancy induced hypertensive disorders (aOR 2.41, 95%CI 2.16-2.69), cesarean section (aOR 1.55, 95%CI 1.47–1.63 for nulliparas, aOR 1.51, 95%CI 1.38–1.65 for multiparas with no prior cesarean section), severe postpartum hemorrhage (aOR 1.15, 95%CI 1.06-1.26), large for gestational neonates (aOR1.76, 95%CI 1.69-1.85) and macrosomia (aOR 1.83, 95%CI 1.72-1.96), while inadequate GWG was correlated with higher risk in placenta abruption (aOR 1.54, 95%CI 1.29-1.85) , fetal distress (aOR 1.19, 95%CI 1.12-1.26), and small for gestational neonates (aOR 1.50, 95%CI 1.41-1.60). Either GWG above or below was associated with increased risk in preterm birth (aOR 1.48, 95%CI 1.38-1.58 for above, aOR 1.47, 95%CI 1.31–1.64 for below), and neonatal asphyxia (aOR 2.28, 95%CI 2.00-2.61 for above, aOR 1.42, 95%CI 1.25-1.61 for below). GWG within IOM recommendations may help prevent various adverse perinatal outcomes and seemed suitable in Chinese population.

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