The effect of pre-pregnancy BMI on intention, initiation and duration of breast-feeding

AbstractObjectiveTo determine whether pre-pregnancy BMI influences breast-feeding practice.DesignRetrospective epidemiological study.SettingUniversity Hospital Leuven, Catholic University Leuven, Belgium.SubjectsTwo hundred women (median age 29 years, interquartile range (IQR) 4; 52 % nulliparae) were grouped into four categories according to pre-pregnancy BMI using WHO cut-offs.ResultsThe incidence of intention and initiation of breast-feeding was significantly lower in underweight (64 %) and obese women (68 %) compared with normal weight (92 %) and overweight women (80 %). Initiation was also related to parity (OR = 0·582; 95 % CI 0·400, 0·846), but not to gestational weight gain, method of delivery or hypertensive disorders. Fifty-two per cent of underweight, 70 % of normal weight and 56 % of overweight women were exclusively breast-feeding their infant during the first month of life. This incidence was significantly lower in the obese group (34 %; P = 0·030). Only 40 % of all infants were exclusively breast-fed at 3 months of age, with the lowest prevalence among women with obesity (P = 0·0 0 1). The median duration of any breast-feeding in the obese group (1·8 months, IQR 3·4) was significantly shorter than in the underweight (3·0 months, IQR 3·1), normal weight (3·0 months, IQR 2·4) and overweight group (3·0 months, IQR 3·5; P = 0·024). Reasons given for ceasing breast-feeding in the obese group were maternal complications (29 %), insufficient milk supply (23 %), sucking problems (21 %) and work resumption (21 %).ConclusionsBreast-feeding practice in the total population, but especially among women with obesity, fell short of global WHO recommended standards. Policy initiatives and local interventions should continue to support breast-feeding, but also prevent maternal obesity.

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The Effect of Maternal Obesity on Oxytocin Requirements to Achieve Vaginal Delivery

American Journal of Perinatology ◽

10.1055/s-0039-1694982 ◽

2019 ◽

Vol 37 (04) ◽

pp. 349-356

Author(s):

April D. Adams ◽

Elizabeth M. Coviello ◽

Daphnie Drassinower

Keyword(s):

Vaginal Delivery ◽

Maternal Obesity ◽

Normal Weight ◽

University Hospital ◽

Obese Women ◽

Class Iii ◽

Class I Obesity ◽

Class Iii Obesity ◽

Higher Doses ◽

Hospital Center

Abstract Objective Our objective was to determine if obese women are more likely to require oxytocin rates > 20 mU/min to achieve vaginal delivery, compared with normal weight women. Study Design This is a retrospective cohort study of deliveries at the MedStar Washington Hospital Center and MedStar Georgetown University Hospital. Results There were 4,284 births included in the analysis. Thirty-three per cent of deliveries were among women classified as overweight (body mass index [BMI] 25–29.9 kg/m2) and 58% were among women classified as obese (BMI >30.0 kg/m2), 12% were classified as class III obesity (BMI >40 kg/m2). Overall 110 (2.6%) women required an oxytocin rate of >20 mU/min. Doses of oxytocin >20 mU/min for women in the overweight, class I obesity, and class II obesity groups were 2.6, 1.9, and 1.6%, respectively. Deliveries among women with class III obesity had a significantly longer duration of oxytocin exposure (10.7 hours) compared with the normal weight group (8.2 hours, p < 0.001), and had a higher maximum rate of oxytocin compared (10 mU/min) to normal weight women (8 mU/min, p < 0.001). Conclusion Obese women are more likely to require oxytocin rates more than 20 mU/min, higher doses of oxytocin, and greater duration of oxytocin exposure to achieve a vaginal delivery.

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The correlation between the sociodemographic characteristics and some hormones with the infertility of women and men

Al Mustansiriyah Journal of Pharmaceutical Sciences ◽

10.32947/357 ◽

2018 ◽

Vol 18 (1) ◽

pp. 1-10

Keyword(s):

Soft Drink ◽

Serum Prolactin ◽

Age Group ◽

Tea Consumption ◽

Obese Women ◽

Overweight Women ◽

Infertile Women ◽

Infertile Men ◽

Overweight Group ◽

Prolactin Hormone

Thirty three infertile women were divided into two groups according to their BMI (21 obese and 12 overweight) there age ranges between (16-41) years, with their husbands twenty one infertile men and twelve fertile men and their ages range between (23-46) years. In the present study we observed that several indicators affect the fertility such as BMI in infertile obese women which was 34.65 kg/m2. That is higher than that of overweight infertile women that recorded 24.87 kg/m2. obese housewives scored the highest percentage (85.71%) compared with the overweight group (25%), In addition the obese age group between 30-41 years scored (66.67%) compared with the overweight group whose members’ age 16-29.9 years scored 75%. However, drinking cola (soft drink) percentage in obese infertile women was (85.71%) and the tea consumption was higher in overweight group (66.67%). The hormones FSH and LH decrease in obese women but serum prolactin hormone increased twice about 29.27 ng/ml in comparison with overweight group. Testosterone hormone decreased in obese women but Leptin in obese women (19.52 μg/L) was higher than that of overweight women (11.03 μg/L). Infertile unemployed men got the highest percentage of 66.67%. Besides, the smoker infertile men were higher in percentage (80.95%) compared with fertile men 41.67%. The elevated LH, FSH and prolactin values are significantly high (p<0.01) (7.895 mlU/ml, 9.89 mlU/ml and 13.33 ng/ml) respectively, but the testosterone was significantly low (3.91 ng/dl) in comparison with fertile men(21.76ng/dl). Whileleptin significantly increased in infertile men more than the fertile ones. These changes in hormones have a great correlation with semen characteristics as the abnormalities in sperms increased to (64.52) and the percentage of rapid, progressive and non -progressive motility decreased, but the immotile motility was highly significant (65.71) in infertile men. As a result this indicates that the reason of infertility is shared between the wife and husband.

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Maternal obesity influences the endocrine cord blood profile of their offspring

Journal of Perinatal Medicine ◽

10.1515/jpm-2019-0387 ◽

2020 ◽

Vol 48 (3) ◽

pp. 242-248 ◽

Cited By ~ 1

Author(s):

Carolina Carvalho Mocarzel ◽

Guillermo Coca Velarde ◽

Roberto de Azevedo Antunes ◽

Renato Augusto Moreira de Sá ◽

Asim Kurjak

Keyword(s):

Cord Blood ◽

Maternal Obesity ◽

Density Lipoprotein ◽

Obese Group ◽

Lipoprotein Cholesterol ◽

Control Group ◽

Healthy Controls ◽

Obese Women ◽

Blood Profile ◽

The Mean

AbstractObjectiveTo compare the endocrine cord blood characteristics of offspring from obese mothers with those of offspring from healthy controls.MethodsCross-sectional case control study. Setting: University medical centers. Patient(s): Offspring from obese mothers (n = 41) and healthy controls (n = 31). Intervention(s): Cord blood withdrawal from neonates. Main outcome measure(s): Cord blood total cholesterol (TC), triglycerides (TGs), high-density lipoprotein-cholesterol (HDL-C), low-density lipoprotein-cholesterol (LDL-C), blood glucose (GL) and insulin (Ins).Result(s)Fetal GL and TGs were reduced in the offspring of obese women when compared to those in the offspring of the controls. The mean cord blood GL level was 47.8 mg/dL standard deviation (SD 33.1) in the offspring of the obese group vs. 57.9 mg/dL (SD 12.5) in the offspring of the control group, and the mean cord blood TG level was 26.5 (SD 33.6) in the offspring of the obese group vs. 34.6 (SD 12.3) in the offspring of the control group. Maternal obesity was also associated with reduced levels of TC and HDL-C in the pregnant women.ConclusionThe observed results suggest that GL and TGs in the cord blood of the offspring of obese mothers were significantly lower than those in the offspring of the control group.

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Impact of Maternal Obesity and Mobile Phone Use on Fetal Cardiotocography Pattern

Open Access Macedonian Journal of Medical Sciences ◽

10.3889/oamjms.2018.405 ◽

2018 ◽

Vol 6 (10) ◽

pp. 1813-1817 ◽

Cited By ~ 1

Author(s):

Zaheera Saadia

Keyword(s):

Clinical Trial ◽

Mobile Phone ◽

Maternal Obesity ◽

Well Being ◽

Obese Group ◽

Control Group ◽

Cardiovascular Development ◽

Obese Women ◽

Mobile Phone Use ◽

The Impact

BACKGROUND: The fetal heart rate (FHR) is a good marker of fetal well-being during labour. Cardiotocography is used to record the FHR and uterine contractions and can detect possible fetal hypoxia. Mobile phones use, and obesity is suggested to influence the FHR and cardiovascular development. AIM: The present study aimed to study the differences in FHR pattern between fetuses of obese vs non-obese groups when using a mobile phone. METHODS: We conducted a clinical trial to test the impact of mobile phone use on FHR using a single mobile phone with Specific Absorption Rate rating of 0.99 W/kg for 10 minutes. Data from this clinical trial were analysed to compare the FHR pattern between fetuses of obese women (exposed group) vs those of non-obese women (control group). The two study groups (obese vs non-obese) were compared regarding four FHR patterns: baseline FHR, variability, acceleration and deceleration scores. Data were analysed by SPSS software version 23.0 using the independent-samples t-tests. RESULTS: Sixty-nine women were included in the final analysis (obese group: n = 22 and non-obese group: n = 47). Fetuses of the obese women had significantly higher baseline FHR and less FHR variability scores when compared with fetuses of the non-obese women (mean difference 2.9 and 3.18, respectively). CONCLUSION: Fetuses of obese women had abnormal FHR pattern compared with fetuses of non-obese women. The use of mobile phone slightly influenced the FHR variability score. These results highlight the importance of proper management of obesity in women within the childbearing period.

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Correlation between obesity and clinicopathological characteristics in patients with papillary thyroid cancer: a study of 1579 cases: a retrospective study

PeerJ ◽

10.7717/peerj.9675 ◽

2020 ◽

Vol 8 ◽

pp. e9675

Author(s):

Huijuan Wang ◽

Pingping Wang ◽

Yu Wu ◽

Xiukun Hou ◽

Zechun Peng ◽

...

Keyword(s):

Clinicopathological Characteristics ◽

Normal Weight ◽

Obese Group ◽

Papillary Thyroid ◽

Weight Group ◽

Normal Weight Group ◽

Advanced Tumor ◽

Tumor Node Metastasis Stage ◽

Overweight Group ◽

The Relationship

Objective To explore the relationship between body mass index (BMI) and clinicopathological characteristics in patients with papillary thyroid carcinoma (PTC). Methods The clinical data of 1,579 patients with PTC, admitted to our hospital from May 2016 to March 2017, were retrospectively analyzed. According to the different BMI of patients, it can be divided into underweight recombination (BMI < 18.5 kg/m), normal body recombination (18.5 ≤ BMI < 24.0 kg/m2), overweight recombination (24.0 ≤ BMI < 28.0 kg/m2) and obesity group (BMI ≥ 28.0 kg/m2). The clinicopathological characteristics of PTC in patients with different BMIs group were compared. Results In our study, the risk for extrathyroidal extension (ETE), advanced T stage (T III/IV), and advanced tumor-node-metastasis stage (TNM III/IV) in the overweight group were higher, with OR (odds ratio) = 1.99(1.41–2.81), OR = 2.01(1.43–2.84), OR = 2.94(1.42–6.07), respectively, relative to the normal weight group. The risk for ETE and T III/IV stage in the obese group were higher, with OR = 1.82(1.23–2.71) and OR = 1.82(1.23–2.70), respectively, relative to the normal weight group. Conclusion BMI is associated with the invasiveness of PTC. There is a higher risk for ETE and TNM III/IV stage among patients with PTC in the overweight group and for ETE among patients with PTC in the obese group.

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Maternal Obesity and Risk for Birth Defects

PEDIATRICS ◽

10.1542/peds.111.s1.1152 ◽

2003 ◽

Vol 111 (Supplement_1) ◽

pp. 1152-1158 ◽

Cited By ~ 5

Author(s):

Margaret L. Watkins ◽

Sonja A. Rasmussen ◽

Margaret A. Honein ◽

Lorenzo D. Botto ◽

Cynthia A. Moore

Keyword(s):

Spina Bifida ◽

Birth Defects ◽

Maternal Obesity ◽

Heart Defects ◽

Average Weight ◽

Maternal Body Mass Index ◽

Healthy Weight ◽

Obese Women ◽

Overweight Women ◽

Increased Risk

Objective. Several studies have shown an increased risk for neural tube defects associated with prepregnancy maternal obesity. Because few recent studies have examined the relation between maternal prepregnancy obesity and overweight and other birth defects, we explored the relation for several birth defects and compared our findings with those of previous studies. Methods. We conducted a population-based case-control study of several selected major birth defects using data from the Atlanta Birth Defects Risk Factor Surveillance Study. Mothers who delivered an infant with and without selected birth defects in a 5-county metropolitan Atlanta area between January 1993 and August 1997 were interviewed. Maternal body mass index (BMI) was calculated from self-reported maternal prepregnancy weight and height. Women with known preexisting diabetes were excluded. The risks for obese women (BMI ≥30) and overweight women (BMI 25.0–29.9) were compared with those for average-weight women (BMI 18.5–24.9). Results. Obese women were more likely than average-weight women to have an infant with spina bifida (unadjusted odds ratio [OR]: 3.5; 95% confidence interval [CI]: 1.2–10.3), omphalocele (OR: 3.3; 95% CI: 1.0–10.3), heart defects (OR: 2.0; 95% CI: 1.2–3.4), and multiple anomalies (OR: 2.0; 95% CI: 1.0–3.8). Overweight women were more likely than average-weight women to have infants with heart defects (OR: 2.0; 95% CI: 1.2–3.1) and multiple anomalies (OR: 1.9; 95% CI: 1.1–3.4). Conclusions. Our study confirmed the previously established association between spina bifida and prepregnancy maternal obesity and found an association for omphalocele, heart defects, and multiple anomalies among infants of obese women. We also found an association between heart defects and multiple anomalies and being overweight before pregnancy. A higher risk for some birth defects is yet another adverse pregnancy outcome associated with maternal obesity. Obesity prevention efforts are needed to increase the number of women who are of healthy weight before pregnancy.

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Prepregnancy maternal obesity and fetal-perinatal death in a Mediterranean country

Journal of Perinatal Medicine ◽

10.1515/jpm-2014-0044 ◽

2015 ◽

Vol 43 (3) ◽

Cited By ~ 1

Author(s):

Eleni Papachatzi ◽

Vassilis Papadopoulos ◽

Gabriel Dimitriou ◽

Spyros Paparrodopoulos ◽

Mattheos Papadimitriou-Olivgeris ◽

...

Keyword(s):

Early Pregnancy ◽

Maternal Age ◽

Maternal Obesity ◽

Fetal Death ◽

Perinatal Death ◽

Perinatal Period ◽

University Hospital ◽

Mediterranean Country ◽

Obese Women ◽

Prepregnancy Bmi

AbstractPre- or early-pregnancy obesity carries significant health implications. This retrospective cohort study investigates the association between pre- or early-pregnancy body mass index (BMI) and the risk of fetal and neonatal death in pregnancies implicated by obesity in a Mediterranean country.Data on pregnancies delivered during 2003–2008 at a University hospital was linked to data from regional registry. Logistic regression models were used to determine the odds ratios of a spontaneous fetal death and perinatal death among overweight, obese, and morbid obese women.Independent predictors of fetal death were maternal prepregnancy BMI over 25, maternal age, maternal co-morbidities, and maternal residence in an island. Perinatal mortality was independently correlated to neonatal birthweight, maternal age, maternal residence in towns and villages, and maternal BMI over 40. Overall, maternal residence in an island, maternal autoimmune disease, and maternal prepregnancy BMI (over 25) were independent risk factors predicting offspring death (both intrauterine and perinatal).Maternal obesity is correlated to offspring’s mortality during fetal and/or perinatal period. This is one of the very few studies in a Mediterranean country. This study underlines the need for public health interventions to prevent obesity in young women.

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Sex Steroid, Gonadotropin, Cortisol, and Prolactin Levels in Healthy, Massively Obese Women: Correlation with Abdominal Fat Cell Size and Effect of Weight Reduction*

The Journal of Clinical Endocrinology & Metabolism ◽

10.1210/jcem-63-6-1257 ◽

1986 ◽

Vol 63 (6) ◽

pp. 1257-1261 ◽

Cited By ~ 72

Author(s):

S. GRENMAN ◽

T. RÖNNEMAA ◽

K. IRJALA ◽

H. L. KAIHOLA ◽

M. GRÖNROOS

Keyword(s):

Cell Size ◽

Weight Reduction ◽

Relative Weight ◽

Abdominal Fat ◽

Normal Weight ◽

Obese Group ◽

Obese Women ◽

Fat Cell ◽

Waist To Hip Ratio ◽

Fat Cell Size

Abstract To examine hormonal status in obese, gynecologically normal women we studied 25 regularly menstruating, massively obese (mean weight, 120 kg) women participating in a weight reduction program and 25 age-matched normal weight (mean weight, 60 kg) women. Serum 17β-estradiol (E2), estrone (E1), androstenedione (A), dehydroepiandrosterone sulfate, testosterone, LH, FSH, PRL, and cortisol concentrations were measured during the follicular phase of the menstrual cycle. Waist to hip ratio and abdominal fat cell size were measured at the beginning of the study. The serum levels of E2 (P < 0.04) as well as those of A, SHBG, and LH (P < 0.002) were lower in the obese group. Consequently, the testosterone to SHBG ratio and the E1 to A ratio were higher and the LH to FSH ratio was lower in this group. Waist to hip ratio did not correlate with the levels of circulating hormones or SHBG, but an inverse correlation was found between abdominal fat cell size and A as well as the LH to FSH ratio in the nonhirsute women of the obese group. Subsequent to moderate weight reduction (13.2 kg), serum A and Ei levels (P < 0.01) increased, and serum cortisol levels decreased (P < 0.001). Thus, massive obesity is associated with abnormalities in hormonal balance in gynecologically symptomless women, there being an association between E1, E2, A, LH, cortisol, and relative weight and/or abdominal fat cell size.

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A longitudinal study of maternal anthropometric changes in normal weight, overweight and obese women during pregnancy and postpartum

British Journal Of Nutrition ◽

10.1017/s0007114500001276 ◽

2000 ◽

Vol 84 (1) ◽

pp. 95-101 ◽

Cited By ~ 85

Author(s):

Hora Soltani ◽

Robert B. Fraser

Keyword(s):

Longitudinal Study ◽

Fat Mass ◽

Postpartum Period ◽

Skinfold Thickness ◽

Normal Weight ◽

Obese Group ◽

Obese Women ◽

Maternal Weight ◽

Pregnancy And Postpartum ◽

Significant Difference

Many women associate one or more of their pregnancies with the development of adult obesity. Such an association has not been fully explored. This longitudinal study examines the changes in maternal anthropometric indices during pregnancy and postpartum. Seventy-seven pregnant subjects were investigated longitudinally at about 13, 25 and 36 weeks gestation, of whom forty-seven continued taking part into the postpartum period. Maternal weight, height and skinfold thickness (triceps, biceps, subscapular, suprailiac and mid thigh) were measured at each visit. Maternal fat mass was estimated from the conversion of the first four skinfold thicknesses. Maternal waist and hip circumferences were also measured at the first visit and 6 weeks and 6 months postpartum. Weight and fat gain during pregnancy (13–36 weeks gestation) was 10·9 (SD 4·7) KG AND 4·6 (sd 3·3) kg (P < 0·001) respectively. A significant increase in fat mass from 13 weeks gestation to 6-months postpartum was observed (2·6 (sd 4·5), P < 0·001). The increased weight at 6-months postpartum, however, was not statistically significant (1·1 (sd 6·0) kg, P = 0·20). Based on BMI in early pregnancy, the subjects were divided into groups of underweight, normal weight, overweight and obese. The last three groups were compared using ANOVA. The obese group showed a significant difference in the pattern of changes in the skinfold thickness, waist: hip ratio and fat mass at the postpartum period, in comparison with the other two groups. In conclusion, there is a tendency in the obese group to develop central obesity at the postpartum period.

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Maternal obesity and stillbirth at term; placental pathology—A case control study

PLoS ONE ◽

10.1371/journal.pone.0250983 ◽

2021 ◽

Vol 16 (4) ◽

pp. e0250983

Author(s):

Hanna Åmark ◽

Magnus Westgren ◽

Meeli Sirotkina ◽

Ingela Hulthén Varli ◽

Martina Persson ◽

...

Keyword(s):

Logistic Regression ◽

Potential Role ◽

Maternal Obesity ◽

Case Control Study ◽

Case Control ◽

Normal Weight ◽

Obese Women ◽

Control Study ◽

Velamentous Cord Insertion

Objective The aim was to explore the potential role of the placenta for the risk of stillbirth at term in pregnancies of obese women. Methods This was a case-control study comparing placental findings from term stillbirths with placental findings from live born infants. Cases were singleton term stillbirths to normal weight or obese women, identified in the Stockholm stillbirth database, n = 264 and n = 87, respectively. Controls were term singletons born alive to normal weight or obese women, delivered between 2002–2005 and between 2018–2019. Placentas were compared between women with stillborn and live-born infants, using logistic regression analyses. Results A long and hyper coiled cord, cord thrombosis and velamentous cord insertion were stronger risk factors for stillbirth in obese women compared to normal weight women. When these variables were adjusted for in the logistic regression analysis, also adjusted for potential confounders, the odds ratio for stillbirth in obese women decreased from 1.89 (CI 1.24–2.89) to 1.63 (CI 1.04–2.56). Conclusion Approximately one fourth of the effect of obesity on the risk of stillbirth in term pregnancies is explained by umbilical cord associated pathology.

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