Adverse outcomes of women with body mass index 60 kg/m2 or greater per delivery mode

AbstractBackground:Obesity is a modifiable, independent risk factor for mortality and morbidity after cardiovascular surgery in adults. Our objective was to evaluate the impact of obesity on short-term outcomes in adolescents undergoing surgery for congenital heart disease (CHD).Methods:This retrospective chart review included patients 10–18 years of age who underwent CHD surgery. Our exclusion criteria were patients with a known genetic syndrome, heart transplantation, and patients with incomplete medical records. The clinical data collected included baseline demographics and multiple perioperative variables. Charting the body mass index in the Centers for Disease Control and Prevention growth curves, the entire cohort was divided into three categories: obese (>95th percentile), overweight (85th–95th percentile), and normal weight (<85th percentile). The composite outcome included survival, arrhythmias, surgical wound infection, acute neurologic injury, and acute kidney injury.Results:The study cohort (n = 149) had a mean standard deviation (SD), body mass index (BMI) of 22.6 ± 6.5 g/m2, and 65% were male. There were 27 obese (18.1%), 24 overweight (16.1%), and 98 normal weight (65.8%) patients. Twenty-seven (18%) patients had composite adverse outcomes. Overweight and obese patients had significantly higher adverse outcomes compared with normal weight patients (odds ratio (OR): 2.9; confidence interval (CI): 1–8.5, p = 0.04 and OR: 3; CI: 1–8.5, p = 0.03, respectively). In multivariate analysis, obesity was an independent predictor of adverse outcome in our cohort (p = 0.04).Conclusions:Obesity is associated with short-term adverse outcome and increased health resource utilisation in adolescents following surgery for CHD. Further studies should evaluate if intervention in the preoperative period can improve outcomes in this population.

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Effect of Maternal Body Mass Index on Postpartum Hemorrhage

Anesthesiology ◽

10.1097/aln.0000000000002082 ◽

2018 ◽

Vol 128 (4) ◽

pp. 774-783 ◽

Cited By ~ 17

Author(s):

Alexander J. Butwick ◽

Anisha Abreo ◽

Brian T. Bateman ◽

Henry C. Lee ◽

Yasser Y. El-Sayed ◽

...

Keyword(s):

Body Mass Index ◽

Body Mass ◽

Postpartum Hemorrhage ◽

Class I ◽

Normal Body Mass Index ◽

Delivery Mode ◽

Obese Women ◽

Obesity Class ◽

Normal Body ◽

Severe Hemorrhage

Abstract Background It is unclear whether obesity is a risk factor for postpartum hemorrhage. The authors hypothesized that obese women are at greater risk of hemorrhage than women with a normal body mass index. Methods The authors conducted a cohort study of women who underwent delivery hospitalization in California between 2008 and 2012. Using multilevel regression, the authors examined the relationships between body mass index with hemorrhage (primary outcome), atonic hemorrhage, and severe hemorrhage (secondary outcomes). Stratified analyses were performed according to delivery mode. Results The absolute event rate for hemorrhage was 60,604/2,176,673 (2.8%). In this cohort, 4% of women were underweight, 49.1% of women were normal body mass index, 25.9% of women were overweight, and 12.7%, 5.2%, and 3.1% of women were in obesity class I, II, and III, respectively. Compared to normal body mass index women, the odds of hemorrhage and atonic hemorrhage were modestly increased for overweight women (hemorrhage: adjusted odds ratio [aOR], 1.06; 99% CI, 1.04 to 1.08; atonic hemorrhage: aOR, 1.07; 99% CI, 1.05 to 1.09) and obesity class I (hemorrhage: aOR, 1.08; 99% CI, 1.05 to 1.11; atonic hemorrhage; aOR, 1.11; 99% CI, 1.08 to 1.15). After vaginal delivery, overweight and obese women had up to 19% increased odds of hemorrhage or atonic hemorrhage; whereas, after cesarean delivery, women in any obesity class had up to 14% decreased odds of severe hemorrhage. Conclusions The authors’ findings suggest that, at most, maternal obesity has a modest effect on hemorrhage risk. The direction of the association between hemorrhage and body mass index may differ by delivery mode.

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Epigenome-wide association study of body mass index, and the adverse outcomes of adiposity

Nature ◽

10.1038/nature20784 ◽

2016 ◽

Vol 541 (7635) ◽

pp. 81-86 ◽

Cited By ~ 395

Author(s):

Simone Wahl ◽

Alexander Drong ◽

Benjamin Lehne ◽

Marie Loh ◽

William R. Scott ◽

...

Keyword(s):

Body Mass Index ◽

Association Study ◽

Body Mass ◽

Adverse Outcomes

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Diabetes Status Affects Odds of Body Mass Index–dependent Adverse Outcomes After Total Hip Arthroplasty

Journal of the American Academy of Orthopaedic Surgeons ◽

10.5435/jaaos-d-20-00028 ◽

2021 ◽

Vol 29 (2) ◽

pp. 71-77

Author(s):

Kareem J. Kebaish ◽

Varun Puvanesarajah ◽

Sandesh Rao ◽

Bo Zhang ◽

Taylor D. Ottesen ◽

...

Keyword(s):

Body Mass Index ◽

Total Hip Arthroplasty ◽

Body Mass ◽

Hip Arthroplasty ◽

Adverse Outcomes ◽

Total Hip ◽

Diabetes Status

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Maternal Body Mass Index and Ethnicity in Relation to The Adverse Outcomes of Large for Gestational Age and Gestational Diabetes Mellitus in a Retrospective Cohort of Australian Pregnant Women.

10.21203/rs.3.rs-152021/v1 ◽

2021 ◽

Author(s):

Catherine Knight-Agarwal ◽

Jani Rati ◽

Meisa Al-Foraih ◽

Dionne Eckley ◽

Carrie Ka Wai Lui ◽

...

Keyword(s):

Diabetes Mellitus ◽

Body Mass Index ◽

Gestational Diabetes ◽

Gestational Diabetes Mellitus ◽

Body Mass ◽

Gestational Age ◽

Retrospective Cohort ◽

Adverse Outcomes ◽

Large For Gestational Age ◽

Maternal Body Mass Index

Abstract Background: The prevalence of maternal overweight and obesity has been increasing. This research explored the association between maternal body mass index and ethnicity in relation to the adverse outcomes of large for gestational age and gestational diabetes mellitus. Method: A retrospective cohort study was undertaken with 27 814 Australian women of various ethnicities, who gave birth to a singleton infant between 2008 and 2017. Variables were examined using logistic regression. Results: A significantly higher proportion of large for gestational age infants were born to overweight and obese women compared to those who were classified as underweight and healthy weight. Asian-born women with a body mass index of ≥ 40kg/m2 had an adjusted odds ratio of 9.926 (3.859 - 25.535) for birthing a large for gestational age infant whereas Australian-born women had an adjusted odds ratio of 2.661 (2.256 - 3.139) for the same outcome. Women born in Australia were at high risk of birthing a large for gestational age infant in the presence of insulin controlled gestational diabetes mellitus, but this risk was not significant for those with the diet-controlled type. Asian-born women did not present an elevated risk of birthing a large for gestational infant, in either the diet controlled, or insulin controlled gestational diabetes mellitus groups. Conclusion: Large for gestational age and gestational diabetes mellitus are adverse pregnancy outcomes that can lead to significant maternal and neonatal morbidity. Women who are overweight or obese, and considering a pregnancy, are encouraged to seek culturally appropriate nutrition and weight management advice during the periconception period.

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Impact of Body Mass Index on In-Hospital Outcomes after Percutaneous Coronary Interventions

Cardiovascular Journal ◽

10.3329/cardio.v10i1.34359 ◽

2017 ◽

Vol 10 (1) ◽

pp. 31-39

Author(s):

Mohammad Khalilur Rahman Siddiqui ◽

STM Abu Azam ◽

Pradip Kumar Karmakar ◽

Shaila Nabi ◽

Pranob Karmaker ◽

...

Keyword(s):

Body Mass Index ◽

Body Mass ◽

Left Ventricular ◽

Adverse Outcomes ◽

Obese People ◽

Hospital Outcomes ◽

Hospital Outcome ◽

Group I ◽

Percutaneous Coronary ◽

Group Ii

Background: Obesity, measured on the basis of body mass index (BMI), is an independent cardiovascular risk factor. However, some studies have reported the obesity paradox after percutaneous coronary intervention (PCI). The relationship between BMI and clinical outcomes after PCI has not been thoroughly investigated, especially in Bangladesh.Method: This cross sectional observational study was conducted at National Institute of Cardiovascular Diseases, on total 100 patients who underwent PCI with two equally divided groups on the basis of BMI of Asian ethnicity: Group I (BMI < 23 kg/m2) and Group II (BMI e 23.0 kg/m2). In-hospital outcomes were observed and recorded after PCI.Results: The mean BMI of study population was 23.9 ± 1.9 kg/m2. The sum of occurrence of adverse in-hospital outcomes was 14.0%. Complications were significantly (p < 0.01) higher in Group I than Group II. Among all adverse in-hospital outcomes, only acute left ventricular failure was found to be statistically significant between groups (p < 0.01). The difference of mean duration of hospital stay after PCI was higher in Group-I which was statistically significant (p < 0.01). Diabetes mellitus and dyslipidemia were found to be the independent predictors for developing adverse in-hospital outcome (OR= 1.68 and 1.46; 95% CI = 1.25 2.24 and 1.16 1.83; p = 0.018 and 0.040, respectively). BMI was inversely associated with adverse in-hospital outcome after PCI (OR = 0.95; 95% CI = 0.91 0.98; p = 0.007).Conclusion: BMI is inversely associated with adverse in-hospital outcomes after PCI. The underweight and normal weight people are at greater risk to experience in-hospital adverse outcomes than overweight and obese people following PCI.Cardiovasc. j. 2017; 10(1): 31-39

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