scholarly journals Body Mass Index Changes during Pregnancy and Perinatal Outcomes - A Cross-Sectional Study

Author(s):  
Sirlei Morais ◽  
Simony Nascimento ◽  
Ana Godoy-Miranda ◽  
Karina Kasawara ◽  
Fernanda Surita

Objective To evaluate the relation between changes the body mass index (BMI) percentile, reflected in the Atalah curve, and perinatal outcomes. Methods A cross-sectional study with 1,279 women was performed. Data regarding gestational weight, sociodemographic characteristics and perinatal outcomes were collected through medical charts, prenatal card and interviews in the postpartum period. Women could be classified according to the Atalah curve in the following categories: low weight, adequate weight, overweight, and obese. The BMI was calculated at the first and at the last prenatal care visits, and these values were compared. Results An increase in the BMI category according to the Atalah classification occurred in 19.9% of pregnant women, and an increase of 3.4, 5.8 and 6.4 points of BMI were found for women respectively classified in the adequate weight, overweight and obese categories at the first prenatal visit. Women with high school education presented a lower chance of increasing their BMI (odds ratio [OR] 0:47 [0.24- 0.95]). Women who evolved with an increase in the the Atalah classification were associated with cesarean section (OR 1.97–2.28), fetal macrosomia (OR 4.13–12.54) and large for gestational age newborn (OR 2.88–9.83). Conclusion Pregnant women who gained enough weight to move up in their BMI classification according to the Atalah curve had a higher chance of cesarean section and macrosomia. Women classified as obese, according to the Atalah curve, at the first prenatal visit had a high chance of cesarean section and delivering a large for gestational age newborn.

Author(s):  
Margit Steinholt ◽  
Shanshan Xu ◽  
Sam Ol Ha ◽  
Duong Trong Phi ◽  
Maria Lisa Odland ◽  
...  

We conducted a cross-sectional study among 194 pregnant women from two low-income settings in Cambodia. The inclusion period lasted from October 2015 through December 2017. Maternal serum samples were analyzed for persistent organic pollutants (POPs). The aim was to study potential effects on birth outcomes. We found low levels of polychlorinated biphenyls (PCBs) and organochlorine pesticides (OCP), except for heptachlors, β-hexachlorocyclohexane (HCH), heptachlor epoxide, and p,p’-DDE. There were few differences between the two study locations. However, the women from the poorest areas had significantly higher concentrations of p,p’-DDE (p < 0.001) and hexachlorobenzene (HCB) (p = 0.002). The maternal factors associated with exposure were parity, age, residential area, and educational level. Despite low maternal levels of polychlorinated biphenyls, we found significant negative associations between the PCB congeners 99 (95% CI: −2.51 to −0.07), 138 (95% CI: −1.28 to −0.32), and 153 (95% CI: −1.06 to −0.05) and gestational age. Further, there were significant negative associations between gestational age, birth length, and maternal levels of o,p’-DDE. Moreover, o,p’-DDD had positive associations with birth weight, and both p,p’-DDD and o,p’-DDE were positively associated with the baby’s ponderal index. The poorest population had higher exposure and less favorable outcomes.


2019 ◽  
Vol 35 (5) ◽  
Author(s):  
Resmiye Özdilek ◽  
Yılda Arzu Aba ◽  
Sena Dilek Aksoy ◽  
Bulat Aytek Şık ◽  
Yaşam Kemal Akpak

Objective: To investigate the adaptation of pregnant women to the recommended weight gain range according to body mass index (BMI) and to determine the factors affecting them. Methods: This cross-sectional study was performed in a university hospital’s obstetrics and gynecology unit (tertiary center) in Turkey. This study was conducted between March 2018 and August 2018 (6 months) in pregnant women. Pregnant women with chronic disease and receiving treatment during antenatal follow-up, with twin pregnancy, with a fetus with a congenital abnormality, and nutritional disturbance were excluded from the study. Eight hundred twelve pregnant women with normal antenatal follow-up and who volunteered to participate were included in the study. Results: The mean age of the participants was 27.66±5.05 years. The mean weight and BMI before pregnancy were near standard in all participants. The group with the highest rate of recommended weight gain according to BMI before pregnancy was the group with low weight pregnant women. The ideal weight gain rate in all groups was 32%. Conclusions: The groups with overweight and obese pregnant women according to BMI before pregnancy had the highest rates of weight gain, above the recommended limits. BMI before pregnancy directly affects weight gain during pregnancy and the importance of pre-pregnancy counseling and weight loss is emphasized once again. doi: https://doi.org/10.12669/pjms.35.5.133 How to cite this:Ozdilek R, Aba YA, Aksoy SD, Sik BA, Akpak YK. The relationship between body mass index before pregnancy and the amount of weight that should be gained during pregnancy: A cross-sectional study. Pak J Med Sci. 2019;35(5):---------.  doi: https://doi.org/10.12669/pjms.35.5.133 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


2020 ◽  
Author(s):  
Yeliz Mercan ◽  
Kevser TARI SELCUK ◽  
Figen DIGIN ◽  
Hasan SAYGIN

Abstract Background: The aim of the present study was to determine the level and predictors of prenatal distress in pregnant women according to gestational age.Methods: This a cross-sectional study was conducted in eight Family Health Centers (FHCs) in Kirklareli, in Turkey. The study included 179 pregnant women who presented to the FHCs, who were at ≥12th week of gestation. Results:The frequency of prenatal distress in the participants was 21.2% (between 12th-27th weeks:16.5%, between 28th-41st weeks: 26.8%). It was found that level of education, age of the spouse, current pregnancy being unplanned, and social support levels were associated with the level of prenatal distress in ≥12th week or between 12th-27th weeks or between 28th-41st weeks (p<0.05). And also, perceived income level, abortion, and the number of pregnancies were associated with the level of prenatal distress in ≥12th weeks; the age of women, perceived income levels, previous abortion experience, and the number of pregnancies were associated with the level of prenatal distress in between 12th-27th weeks; the age of women, education level of spouse', and previous birth experience prenatal distress levels were associated in between 28th-41st weeks (p<0.05).Conclusion: The level of prenatal distress according to the gestational age, the education level of the woman, the age of her spouse’, the unplanned pregnancy, and social support levels were predictors. In both periods, the age of women were determinants in prenatal stress levels in pregnant women. Pregnant women should be screened and evaluated for prenatal distress in their application to FHCs.


2021 ◽  
Author(s):  
Mohammad Rafi Fazli ◽  
Amena Mansouri ◽  
Hania Wahidi

Abstract Background: In the past few decades, the rate of cesarean section (CS) has increased worldwide which is common in high income countries. Although cesarean section has lots of socioeconomic impacts in the career of mothers and babies especially in LMICs like Afghanistan, it is also increasing in such countries. In compare to vaginal delivery the cesarean section has higher risks for maternal health. The most important aim of this study is to search the commonest indications of cesarean section at the only teaching hospital in west region of Afghanistan, Ghalib Teaching Hospital in 2017.Material and Method: This was a cross-sectional study. Among 456 pregnant women who came to Ghalib Teaching Hospital, 287(63%) had vaginal delivery and 169 (37%) had cesarean section delivery in 2017. Data was collected reviewing medical records; patients discharge certificate and a questionnaire which consisted of the data like; history of previous cesarean sections, age, and so on. Data was analyzed by epi info 7.Results: the prevalence of cesarean section in Ghalib Teaching Hospital was 37%, the median age was 28 years old, the mean age was 23.83 and the most ages were between 21-25 (42.5%). The commonest indications were severe oligohydramnios (29.5%) followed by previous cesarean section (12.4%) and elective cesarean section 10.9% (on maternal request). The least indication was cephalopelvic disproportion (3.09%). In our research we had more than one indication about 10.3%.Conclusion: according to the research the commonest indication of cesarean section was severe oligohydromnios which shows emergency indication among pregnant women. As the women in Afghanistan want many children so they usually do not consider having cesarean section deliveries. Cesarean section on maternal request also has high rate which needs appropriate guidelines and also policies to decrease this high rate of selective cesarean section. In our research 52.1% of indications of CS was fetal factors. This shows in LMICs many fathers have valued to the health of babies instead of mothers. It is highly needed to inform fathers to know about health of both babies and mothers.


2020 ◽  
Author(s):  
Almamy Touré ◽  
Abdourahamane Diallo ◽  
Aboubacar Magassouba ◽  
Abdoulaye Doumbouya ◽  
Ibrahima Conté ◽  
...  

Abstract Introduction Pregnancy, apart from any external events, is subject to psychological changes. The COVID-19 pandemic in Guinea led to the implementation of restrictive measures followed by the mitigating ones, but few of them have targeted stress and anxiety management in pregnant women. This study aimed to assess the psychological impact and its associated factors in pregnant women. Methods We conducted a cross-sectional study in three health centres in Conakry capital city. Pregnant women were interviewed during antenatal care visits. We used two tools for stress and anxiety assessment: Impact of Event Scale-Revised (IES-R) and Penn State Worry Questionnaire (PSWQ), and followed three steps to seeking for factors associated with stress and anxiety: univariate analysis, regression tree (CART), and logistic regression. Results We surveyed a total of 649 pregnant women. Most of them presented a state of stress (97.7%) and anxiety (52.7%). Gestational age was the main factor associated with stress and anxiety. Pregnant women with a gestational age ≤ 34 weeks had an odd of 0.09 times lower of being stressed compared to those with a gestational age greater than 34 weeks. Pregnant women living in Ratoma and Kaloum with a gestational age was ≤ 9 weeks had an odds of 15.1 times [95% CI: 8.76, 27.4] higher of being worried compared to those from Matoto, Matam and Dixinn with a gestational age greater than 9 weeks. Similarly, pregnant women living in Matoto, Matam and Dixinn with a gestational age ≤ 9 weeks had an odds of 4.48 times [95% CI: 2.59, 8.12] higher of being worried compared to other women from the same localities. Conclusion Most of our participants were at a higher risk of stress and anxiety caused by COVID-19; women in their earlier stage of pregnancy tended to be more vulnerable to these psychological problems. Therefore, it is vital to implement an appropriate management plan which should prioritise those vulnerable pregnant women.


2020 ◽  
Vol 2020 ◽  
pp. 1-6 ◽  
Author(s):  
Simon Byonanuwe ◽  
Emmanuel Nzabandora ◽  
Baltazar Nyongozi ◽  
Theophilus Pius ◽  
David Santson Ayebare ◽  
...  

Background. Premature rupture of membranes (PROM) is a common condition in developed and developing countries and poses a serious threat to the maternal and fetal well-being if not properly managed. This study delineated the prevalence and predictors of PROM in the western part of Uganda so as to guide specific preventive measures. Methods. A cross-sectional study design was conducted in the months of September 2019 to November 2019. A total of 334 pregnant women above 28 weeks of gestation admitted at the maternity ward of KIU-TH were consecutively enrolled. Interviewer-administered questionnaires were used to obtain the data. Descriptive statistics followed by binary logistic regression were conducted. All data analyses were conducted using STATA 14.2. Results. Of the 334 pregnant women enrolled, the prevalence of PROM was found to be 13.8%. The significant independent predictors associated with lower odds of PROM were no history of urinary tract infection (UTI) in the month preceding enrollment into the study (aOR=0.5, 95% CI: 0.22-0.69, p=0.038) and gestational age of 37 weeks or more (aOR=0.3, 95% CI: 0.14-0.71, p=0.01) while history of 3 or more abortions (aOR=13.1, 95% CI: 1.12-153.62, p=0.05) was associated with higher likelihood of PROM. Conclusions. Majorly urinary tract infections, low gestational age, and abortions influence premature rupture of membranes among women. There is a great need for continuous screening and prompt treatment of pregnant women for UTI especially those with history of 3 or more abortions at less than 34 weeks of gestation.


2021 ◽  
Vol 4 (1) ◽  
pp. p1
Author(s):  
Mahnaz Nosratabadi ◽  
Nasrin Sarabi ◽  
Leila Masoudiyekta ◽  
Zahra Abbaspoor ◽  
Aziz Kassani

Introduction: Choosing the birth method is a major issue for pregnant women that is affected by multifaceted physiological, psychological and socio-cultural factors. Aim(s): The aim research was performed to explore factors influencing pregnant women’s attitude toward birth method. Methods: This is a cross-sectional study on 220 healthy nulliparous pregnant women with uncomplicated pregnancies without any contraindication for vaginal birth in Medical Centers of Dezful, in the south west of Iran. Data collection tool was a questionnaire for factors affecting the choice of delivery method. Differences in attitude were compared between two groups of natural vaginal delivery preference and cesarean delivery preference. Statistical analysis was performed with SPSS Version 16.0 statistic software package. Descriptive statistics were used to report percentages, mean, and standard deviation, and t-test, chi-square were applied to analyze the data. Results: During the study period, 206 primary pregnant women were examined to determine the attitudinal influencing factors the birth method preference. 131 women (64%) chose the natural delivery method and 71 women (36%) chose the cesarean delivery method. In addition, the results showed a statistically significant difference between the two groups regarding the general attitude of the participants towards natural delivery (164.43 in the normal vaginal delivery (NVD) group versus 134.50 in the cesarean section (CS) group (p < 0.001)). Conclusion: There is a direct relationship between the attitude of pregnant women towards vaginal birth and the tendency to normal vaginal delivery and cesarean section. Also, according to the results of the study of 8 components of attitudes, counseling sessions and prenatal training sessions can be identified based on counseling needs and be guided counseling sessions more purposefully.


Author(s):  
Ananya S. L. Tenali ◽  
Ravi Kumar Tenali

Background: India is one of the countries with the highest neonatal mortality, for which preterm birth is considered as major cause (43.7%). Therefore, early identification by a simple screening tool is important for prognostication and follow-up of new-born infants, especially preterm.Methods: Cross-sectional study was conducted on 300 live newborns at Saveetha Hospital in Kanchipuram. Anthropometric measures such as birth weight, crown-heel length, head circumference, foot length were taken within 3 days of life and gestational age assessment was done by new Ballard scoring after calculation by Naegles formula. Neonates were grouped into preterm, term and post-term and also small for gestational age (SGA), appropriate for gestational age (AGA) and large for gestational age (LGA). Minimum to maximum range of variables in each gestational range was calculated. The sensitivity and specificity of each variable was found using receiver operating curve. Parameter having the highest sensitivity and good specificity was considered as potential screening tool to identify high risk babies. SPSS Software version 17 for windows was used.Results: The range of gestational age, length, foot length, birth weight and head circumference was 28-42 weeks, 35-53 cm, 5-8.8 cm, 0.8-4.7 kg and 22.8-54.3 cm respectively. Among all, maximum sensitivity at 37weeks gestational age was seen with foot length (80.57%) at a cut-off of 7.58 cm. A nomogram of foot length for each gestational age group (range of 2 weeks) was also derived.Conclusions: It can be concluded that foot length has the potential to be considered as a screening tool to identify preterm neonates especially at a concentrated community level and is particularly useful in resource constraint countries.


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