scholarly journals Identifying ‘at risk’ women and the impact of maternal obesity on National Health Service maternity services

2011 ◽  
Vol 70 (4) ◽  
pp. 439-449 ◽  
Author(s):  
Nicola Heslehurst
Keyword(s):  
Maternal Obesity ◽  
Perinatal Care ◽  
Epidemiological Data ◽  
Health Concern ◽  
Individual Choice ◽  
National Guidelines ◽  
Maternity Services ◽  
Published Evidence ◽  
Increased Risk ◽  
The Impact

Obesity is a public health concern worldwide, arising from multifaceted and complex causes that relate to individual choice and lifestyle, and the influences of wider society. In addition to a long-standing focus on both childhood and adult obesity, there has been more recent concern relating to maternal obesity. This review explores the published evidence relating to maternal obesity incidence and associated inequalities, the impact of obesity on maternity services, and associated guidelines. Epidemiological data comprising three national maternal obesity datasets within the UK have identified a significant increase in maternal obesity in recent years, and reflect broad socio-demographic inequalities particularly deprivation, ethnicity and unemployment. Obese pregnancies present increased risk of complications that require more resource intensive antenatal and perinatal care, such as caesarean deliveries, gestational diabetes, haemorrhage, infections and congenital anomalies. Healthcare professionals also face difficulties when managing the care of women in pregnancy as obesity is an emotive and stigmatising topic. There is a lack of good-quality evidence for effective interventions to tackle maternal obesity. Recently published national guidelines for the clinical management and weight management of maternal obesity offer advice for professionals, but acknowledge the limitations of the evidence base. The consequence of these difficulties is an absence of support services available for women. Further evaluative research is thus required to assess the effectiveness of interventions with women before, during and after pregnancy. Qualitative work with women will also be needed to help inform the development of more sensitive risk communication and women-centred services.

scholarly journals Assessing the Impact of Heat Treatment of Food on Antimicrobial Resistance Genes and Their Potential Uptake by Other Bacteria—A Critical Review

Antibiotics ◽  
2021 ◽  
Vol 10 (12) ◽  
pp. 1440
Author(s):  
Christian James ◽  
Ronald Dixon ◽  
Luke Talbot ◽  
Stephen J. James ◽  
Nicola Williams ◽  
...  
Keyword(s):  
Resistance Genes ◽  
Heat Treatments ◽  
Health Concern ◽  
Sufficient Evidence ◽  
Functional Genes ◽  
Effective Heat ◽  
Published Evidence ◽  
Heat Treated ◽  
Antimicrobial Resistance Genes ◽  
The Impact

The dissemination of antibiotic resistance genes (ARGs) is a global health concern. This study identifies and critically reviews the published evidence on whether cooking (heating) food to eliminate bacterial contamination induces sufficient damage to the functionality of ARGs. Overall, the review found that there is evidence in the literature that Antimicrobial Resistant (AMR) bacteria are no more heat resistant than non-AMR bacteria. Consequently, recommended heat treatments sufficient to kill non-AMR bacteria in food (70 °C for at least 2 min, or equivalent) should be equally effective in killing AMR bacteria. The literature shows there are several mechanisms through which functional genes from AMR bacteria could theoretically persist in heat-treated food and be transferred to other bacteria. The literature search found sparce published evidence on whether ARGs may actually persist in food after effective heat treatments, and whether functional genes can be transferred to other bacteria. However, three publications have demonstrated that functional ARGs in plasmids may be capable of persisting in foods after effective heat treatments. Given the global impact of AMR, there is clearly a need for further practical research on this topic to provide sufficient evidence to fully assess whether there is a risk to human health from the persistence of functional ARGs in heat-treated and cooked foods.

The Impact of Hurricane Maria on Individuals Living with Non-Communicable Disease in Puerto Rico: The experience of 10 communities

2021 ◽  
Author(s):  
Elizabeth L. Andrade ◽  
Amalis Cordova Mustafa ◽  
Courtney Riggle-vanSchagen ◽  
Megan Jula ◽  
Carlos E. Rodriguez-Diaz ◽  
...  
Keyword(s):  
Puerto Rico ◽  
Natural Hazards ◽  
Structural Damage ◽  
Communicable Disease ◽  
Community Level ◽  
Morbidity And Mortality ◽  
Health Concern ◽  
Increased Risk ◽  
The Impact ◽  
Non Communicable Disease

Abstract Background Coinciding with the rising non-communicable disease (NCD) prevalence worldwide is the increasing frequency and severity of natural hazards. Protecting populations with NCDs against natural hazards is ever more pressing given their increased risk of morbidity and mortality in disaster contexts. Methods This investigation examined Hurricane Maria’s impact across 10 communities in Puerto Rico to determine whether and how disaster impact and community attributes affected NCD management. We conducted 40 qualitative interviews with mayors, first responders, faith leaders, community leaders, and municipal employees, with 4 interviews per selected municipality. Using QSR NVivo software, we coded interview transcripts and created categorical community-level impact variables based on participant responses. We undertook thematic analysis to characterize community-level impact and consequences for NCD management, and to identify convergent and divergent themes. Using a matrix coding query, we compared NCD management experiences across communities by impact variables and community attributes. Results The delivery of healthcare, pharmacy, and dialysis services was compromised due to facility structural damage and ineffective contingencies for electrical power and water supply. The challenges resulting from power outages were immediate, and individuals who were reliant on life-sustaining medical equipment, dialysis, or the refrigeration of medications were most vulnerable. Inaccessible roadways and the need to travel greater distances to locate operational health services were major impediments to transporting patients in need of NCD care, with those requiring dialysis and living in remote, mountainous communities at highest risk due to landslides and lengthy roadway obstruction. These barriers were compounded by limited communication to locate services and coordinate care. Two weeks post-hurricane, emerging challenges to NCD management included widespread diesel fuel shortages for generators, and shortages in medications, oxygen, and medical supplies. In the weeks to months post-hurricane, the emergence or exacerbation of mental health disorders was characterized as a pressing health concern. Conclusions Study findings identify contributors to morbidity and mortality among individuals with NCDs following Hurricane Maria. The degree to which these impacts were experienced across communities with different characteristics is discussed, offering important lessons regarding the impact of catastrophic disasters on NCD management for improve community disaster resilience.

scholarly journals The impact of maternal obesity on maternal and fetal outcome

2019 ◽  
Vol 9 (1) ◽  
pp. 104
Author(s):  
Esther Kamalarani A. ◽  
Ramyajothi . ◽  
Ramalakshmi S.
Keyword(s):  
Developing Countries ◽  
Adverse Effects ◽  
Maternal Obesity ◽  
Gestational Hypertension ◽  
Developed Countries ◽  
Fetal Outcome ◽  
Health Concern ◽  
The Past ◽  
Group 2 ◽  
The Impact

Background: Obesity continues to be a global health concern. Although the increasing obesity rates in developed countries has slowed down in the past 10 years, obesity rates in developing countries continue to increase, as much as three times in some developing countries over the past 30 years. The aim of the study was to determine the adverse effects of obesity in pregnancy and maternal and fetal outcome.Methods: In all patients, a detailed history was taken and examinations and investigations were carried out.  Based on BMI (body mass index), patients were divided into 2 groups. Group 1 = patients with BMI >30 kg/m2 and Group 2 = patients with BMI <30 kg /m2.Results: In our study, comparing pregnant mothers with BMI >30 kg/m2 and normal BMI, authors found that the prevalence of maternal and fetal complications was higher in the obese group. Prevalence of antenatal complications like gestational hypertension, preeclampsia, imminent eclampsia and gestational diabetes mellitus requiring control with insulin was higher in obese women.Conclusions: Obesity is associated with increased adverse effects on pregnancy and its outcome.

scholarly journals Helminths in South Africa: management of cestode and trematode infections in humans

2020 ◽  
pp. 33-38
Author(s):  
RL van Zyl
Keyword(s):  
South Africa ◽  
South African ◽  
Age Groups ◽  
Signs And Symptoms ◽  
Epidemiological Data ◽  
Sub Saharan Africa ◽  
The South ◽  
Increased Risk ◽  
Sub Saharan ◽  
The Impact

Sub-Saharan Africa has to contend with many challenges, including inadequate healthcare systems, lack of optimal sanitation, and clean water and food. All of these contribute to malnutrition and an increased risk of infections, including parasitism by cestodes and trematodes. Schistosomiasis is a category-2 notifiable trematode (fluke) infection, whereas cestode (tapeworm) infections need not be reported to the South African Department of Health. Epidemiological data for helminthiasis in South Africa is scant, with a paucity of publications on the South African scenario. As such, a complete picture of the impact of helminth infections on all age groups in South Africa does not exist. These parasitic diseases not only have an impact on socio economic development of a country, community and families, but also contribute to the chronic and detrimental effects on the health and nutritional status of the host, including the impaired development of children. In order to break the cycle of poverty and disease, a strong education drive is required in schools and communities to provide effective strategies and guidelines on preventative measures that result in avoidance of exposure to infective stages of Schistosoma and Taenia tapeworms. Also, it is imperative that healthcare professionals are able to recognise the signs and symptoms, so that interventions can be promptly initiated. The current anthelmintic treatments available in South Africa are effective against cestodes and trematodes, with no drug resistance having being reported. The need for compliancy when taking anthelmintic drugs must be emphasised.

scholarly journals Guidelines for the endoscopic nasal surgery during COVID-19 pandemic

2020 ◽  
Vol 6 (12) ◽  
pp. 2334
Author(s):  
Parvez Husain ◽  
Shaheen Khalil Ahmed ◽  
Benazeer Husain
Keyword(s):  
Endoscopic Sinus Surgery ◽  
Care Staff ◽  
Sinus Surgery ◽  
World Health ◽  
Health Concern ◽  
Health Care Staff ◽  
National Guidelines ◽  
High Resolution Computed Tomography ◽  
Health Crisis ◽  
Published Evidence

<p>COVID-19, the respiratory illness caused by the novel SARS-CoV-2 virus has rapidly emerged as a serious global health concern. The world health organization (WHO) and has enacted various protocols for healthcare institutions internationally in an attempt to slow the spread of disease, including adjustments for procedures performed by otolaryngologists. Based upon published evidence we highlight different strategies to reduce infection transmission during endoscopic sinus surgery. All patients undergoing endoscopic sinus surgery should be discussed with health care staff to be involved in procedure. The patients should be divided into elective, semi-elective, and urgent/emergency. COVID-19 test should be done in all patients prior to surgery along with high resolution computed tomography (HRCT) chest. Irrespective of COVID screening results, it is advisable to treat all patients undergoing aerosol generating procedures as COVID-19 positive, and the whole theatre team should wear personal protection equipment (PPE) as per current national guidelines. Preoperative nasal decongestion to be undertaken with atomization devices. Consider telephone/video clinic follow up appointments unless clinical examination is considered essential. Considering the current health crisis caused by COVID-19, the following guidelines are recommended for performing nasal surgeries: patient visits must be limited to only urgent/emergent cases for the time being. Only vital personnel should remain in the OT while performing any nasal endoscopic procedure as this will both reduce exposure and conserve vital personal protective equipment. Five levels of protection are recommended for the person performing the procedure.</p>

scholarly journals The impact of gestational diabetes and maternal obesity on the mother and her offspring

2010 ◽  
Vol 1 (4) ◽  
pp. 208-215 ◽  
Author(s):  
P. M. Catalano
Keyword(s):  
Insulin Resistance ◽  
Gestational Diabetes ◽  
Glucose Intolerance ◽  
Maternal Obesity ◽  
Insulin Response ◽  
Obese Women ◽  
Increased Risk ◽  
Short And Long Term ◽  
The Impact

Thein uteromaternal metabolic environment is important relative to both short and long term development of the offspring. Although poor fetal growth remains a significant factor relative to long-term outcome, fetal overgrowth is assuming greater importance because of the increase in obesity in the world’s populations. Maternal obesity and gestational diabetes are the most common metabolic complications of pregnancy related to fetal overgrowth and more specifically adiposity.Women with gestational diabetes have increased insulin resistance and inadequate insulin response compared with weight-matched controls. Gestational diabetes increases the risk of maternal hypertensive disease (preeclampsia) as well as cesarean delivery. At birth the neonate has increased adiposity and is at risk for birth injury. Multiple studies have reported that children of women with gestational diabetes have a greater prevalence childhood obesity and glucose intolerance; even at glucose concentrations less than currently used to define gestational diabetes, compared with normoglycemic women.Obese women also have increased insulin resistance, insulin response and inflammatory cytokines compared with average weight women both before and during pregnancy. They too are at increased risk for the metabolic syndrome-like disorders during pregnancy that is hypertension, hyperlipidemia, glucose intolerance and coagulation disorders. Analogous to women with gestational diabetes, neonates of obese women are heavier at delivery because of increased fat and not lean body mass. Similarly, these children have an increased risk of childhood adiposity and metabolic dysregulation. Hence, the preconceptional and perinatal period offers a unique opportunity to modify both short and long term risks for both the woman and her offspring.

The impact of parity and maternal obesity on the fetal outcomes of a non-selected Lower Saxony population

2021 ◽  
Vol 0 (0) ◽  
Author(s):  
Lars Brodowski ◽  
Niels Rochow ◽  
Efrah I. Yousuf ◽  
Fabian Kohls ◽  
Constantin S. von Kaisenberg ◽  
...  
Keyword(s):  
Maternal Obesity ◽  
Fetal Distress ◽  
Maternal Body Mass Index ◽  
Obese Women ◽  
Lower Saxony ◽  
Fetal Outcomes ◽  
Increased Risk ◽  
Longitudinal Position ◽  
The Impact ◽  
Maternal Bmi

Abstract Objectives Maternal obesity during pregnancy is associated with adverse intrauterine events and fetal outcomes and may increase the risk of obesity and metabolic disease development in offspring. Higher parity, regardless of socioeconomic status, is associated with increased maternal body mass index (BMI). In this study, we examined the relationship between parity, maternal obesity, and fetal outcomes in a large sample of mother-neonate pairs from Lower Saxony, Germany. Methods This retrospective cohort study examined pseudonymized data of a non-selected singleton cohort from Lower Saxony’s statewide quality assurance initiative. 448,963 cases were included. Newborn outcomes were assessed in relation to maternal BMI and parity. Results Maternal obesity was associated with an increased risk of placental insufficiency, chorioamnionitis, and fetal distress while giving birth. This effect was present across all parity groups. Fetal presentation did not differ between BMI groups, except for the increased risk of high longitudinal position and shoulder dystocia in obese women. Maternal obesity was also associated with an increased risk of premature birth, low arterial cord blood pH and low 5-min APGAR scores. Conclusions Maternal obesity increases the risk of adverse neonatal outcomes. There is a positive correlation between parity and increased maternal BMI. Weight-dependent fetal risk factors increase with parity, while parity-dependent outcomes occur less frequently in multipara. Prevention and intervention programs for women planning to become pregnant can be promising measures to reduce pregnancy and birth complications.

scholarly journals A comparative study of the effect of body mass index on pregnancy outcomes in normal and overweight women

2017 ◽  
Vol 6 (4) ◽  
pp. 1550
Author(s):  
Seeniammal P. ◽  
Chellamma V. K. ◽  
Umadevi N.
Keyword(s):  
Comparative Study ◽  
Maternal Obesity ◽  
Gestational Hypertension ◽  
Fetal Outcome ◽  
Overweight And Obesity ◽  
Health Concern ◽  
Accurate Information ◽  
Obese Women ◽  
Increased Risk ◽  
Maternal Overweight

Background: Maternal obesity has been reported as a risk factor for various antepartum, intrapartum, postpartum and neonatal complications. Increasing rates of overweight among pregnant women are a significant public health concern with various implications for prenatal care and supervision of delivery. Therefore, the present study is to determine the adverse materno-fetal outcome in primigravid overweight and obese women delivering singleton babies.Methods: A prospective comparative study was conducted for a year at IMCH, Medical College, Calicut. Primigravid women with a singleton uncomplicated pregnancy with cephalic presentation at ≥37 weeks of gestation with accurate information regarding height and weight recorded at the booking visit were included in the study. Comparisons were made between 100 women with BMI >25 and 200 women with BMI 18.5-24.9. Statistical analysis was done using SPSS version 16.0. Data was analysed by Pearson Chi square test and Fisher’s exact test.Results: Overweight mothers are at increased risk quoted as relative risk (RR) and 95% confidence intervals (CI) of adverse materno-fetal outcomes. Gestational hypertension RR 2.39 (CI 1.65-3.47), Gestational diabetes RR 2.67(CI 0.95-7.48), induction of labour RR 2.35 (CI 1.4-3.95), Cesarean section RR 5.73 (CI 3.76-8.73), macrosomia RR 14 (CI 1.75-112.23), NICU admissions RR 4.51(CI 2.61-7.84),perineal lacerations RR 4.72 (CI 1.15-20.4), wound infection RR 2.97 (CI 1.06-8.41), and prolonged hospital stay.Conclusions: It is clearly evident from the study that maternal overweight and obesity is associated with adverse materno-fetal outcome.

The impact of maternal obesity on inflammatory processes and consequences for later offspring health outcomes

2017 ◽  
Vol 8 (5) ◽  
pp. 529-540 ◽  
Author(s):  
S. A. Segovia ◽  
M. H. Vickers ◽  
C. M. Reynolds
Keyword(s):  
Maternal Obesity ◽  
Intervention Strategy ◽  
Later Life ◽  
Developmental Programming ◽  
Health Concern ◽  
Low Grade ◽  
Metabolic Complications ◽  
Metabolic Inflammation ◽  
Inflammatory Processes ◽  
The Impact

Obesity is a global epidemic, affecting both developed and developing countries. The related metabolic consequences that arise from being overweight or obese are a paramount global health concern, and represent a significant burden on healthcare systems. Furthermore, being overweight or obese during pregnancy increases the risk of offspring developing obesity and other related metabolic complications in later life, which can therefore perpetuate a transgenerational cycle of obesity. Obesity is associated with a chronic state of low-grade metabolic inflammation. However, the role of maternal obesity-mediated alterations in inflammatory processes as a mechanism underpinning developmental programming in offspring is less understood. Further, the use of anti-inflammatory agents as an intervention strategy to ameliorate or reverse the impact of adverse developmental programming in the setting of maternal obesity has not been well studied. This review will discuss the impact of maternal obesity on key inflammatory pathways, impact on pregnancy and offspring outcomes, potential mechanisms and avenues for intervention.

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