scholarly journals Liver Transplantation in Recipients With Class III Obesity: Posttransplant Outcomes and Weight Gain

2022 ◽  
Vol 8 (2) ◽  
pp. e1242
Author(s):  
Daiki Soma ◽  
Yujin Park ◽  
Plamen Mihaylov ◽  
Burcin Ekser ◽  
Marwan Ghabril ◽  
...  
Keyword(s):  
Liver Transplantation ◽  
Weight Gain ◽  
Class Iii ◽  
Class Iii Obesity

scholarly journals Liver transplantation in recipients with class III obesity: post-transplant outcomes and weight gain

2020 ◽  
Author(s):  
Daiki Soma ◽  
Yujin Park ◽  
Plamen Mihaylov ◽  
Burcin Ekser ◽  
Marwan Ghabril ◽  
...  
Keyword(s):  
Liver Transplantation ◽  
Weight Gain ◽  
The United States ◽  
Class Iii ◽  
Obesity Class ◽  
Post Transplant ◽  
Significant Difference ◽  
Class Iii Obesity ◽  
The Impact

Abstract BackgroundOver the past decades, there has been a dramatic increase in obesity in the United States. Several studies have reported conflicting results for the impact of obesity on outcomes of liver transplantation (LT). This study aims to assess the impact of severe obesity on outcomes of LT and change in body mass index (BMI) after transplantation.MethodsAll adult LT performed between July 2001 and December 2018 were reviewed. A retrospective analysis was conducted. BMI of recipients is subdivided into six categories: underweight, normal, overweight, class Ⅰ obesity, class Ⅱ obesity, and class Ⅲ obesity (<18.5; 18.5-24.9; 25‐29.9; 30‐34.9; 35‐39.9; ≥40 kg/m2, respectively). Survival outcomes were compared between each group. Post-transplant BMI was followed up in a sub-group of patients receiving LT from January 2008 to December 2018.ResultsAmong 2024 patients in the analytic cohort, 1.9% were underweight, 24.5% were normal, 32.6% were overweight, 25% were in class Ⅰ obesity, 9.3% were in class Ⅱ obesity, and 1.1% were in class Ⅲ obesity. There was no significant difference in patient and graft survival at 10-year follow-up with respect to recipient obesity. The 1, 3, 5, and 10-year graft and patient survivals in class Ⅲ obesity group were 97.0%, 92.1%, 87.0%, and 79.8% for patient survival and 94.4%, 85.1%, 79.8%, and 72.5% for graft survival.BMI of all groups except the underweight group declined in the first three months postoperatively. After the three months, BMI of all groups except the class Ⅲ obesity group returned to the pre LT level by two years and reached a plateau by five years. In patients with class Ⅲ obesity, there was a significant increase in body weight after long term follow up.ConclusionIn this study, class Ⅲ obesity is not associated with higher mortality. Obesity, including class Ⅲ obesity, should not be considered to be a contraindication to LT in the absence of other contraindications. Post-LT interventions are required to prevent significant weight gain in recipients with class Ⅲ obesity after transplantation.

Maternal Weight Gain and Infant Birth Weight in Women with Class III Obesity

2019 ◽  
Author(s):  
Ann R. Tucker ◽  
Haywood L. Brown ◽  
Sarah K. Dotters-Katz
Keyword(s):  
Weight Gain ◽  
Birth Weight ◽  
Gestational Age ◽  
Morbidly Obese ◽  
Maternal Weight Gain ◽  
Class Iii ◽  
Maternal Weight ◽  
Class Iii Obesity ◽  
Iom Recommendations ◽  
Infant Birth

Abstract Objective The aim of this study is to describe the impact of maternal weight gain on infant birth weight among women with Class III obesity. Study Design Retrospective cohort of women with body mass index (BMI) ≥40 kg/m2 at initial prenatal visit, delivered from July 2013 to December 2017. Women presenting 14/0 weeks of gestational age (GA), delivering preterm, or had multiples or major fetal anomalies excluded. Maternal demographics and complications, intrapartum events, and neonatal outcomes abstracted. Primary outcomes were delivery of large for gestational age or small for gestational age (SGA) infant. Bivariate statistics used to compare women gaining less than Institute of Medicine (IOM) recommendations (LTR) and women gaining within recommendations (11–20 pounds/5–9.1 kg) (at recommended [AR]). Regression models used to estimate odds of primary outcomes. Results Of included women (n = 230), 129 (56%) gained LTR and 101 (44%) gained AR. In sum, 71 (31%) infants were LGA and 2 (0.8%) were SGA. Women gaining LTR had higher median entry BMI (46 vs. 43, p < 0.01); other demographics did not differ. LTR women were equally likely to deliver an LGA infant (29 vs. 34%, p = 0.5) but not more likely to deliver an SGA infant (0.8 vs. 1%, p > 0.99). After controlling for confounders, the AOR of an LGA baby for LTR women was 0.79 (95% CI: 0.4–1.4). Conclusion In this cohort of morbidly obese women, gaining less than IOM recommendations did not impact risk of having an LGA infant, without increasing risk of an SGA infant.

scholarly journals 625: Impact of excess weight gain on risk of postpartum infection in class III obesity

2019 ◽  
Vol 220 (1) ◽  
pp. S413-S414
Author(s):  
Courtney J. Mitchell ◽  
Anne M. Siegel ◽  
LaMani Adkins ◽  
Haywood Brown ◽  
Sarah Dotters-Katz
Keyword(s):  
Weight Gain ◽  
Excess Weight ◽  
Class Iii ◽  
Excess Weight Gain ◽  
Class Iii Obesity

scholarly journals 573: Gestational weight gain and postpartum depression in women with class III obesity

2019 ◽  
Vol 220 (1) ◽  
pp. S380-S381
Author(s):  
LaMani D. Adkins ◽  
Ann Tucker ◽  
Luke Gatta ◽  
Anne Siegel ◽  
Emily Reiff ◽  
...  
Keyword(s):  
Weight Gain ◽  
Postpartum Depression ◽  
Gestational Weight Gain ◽  
Class Iii ◽  
Gestational Weight ◽  
Class Iii Obesity

scholarly journals Impact of Excess Weight Gain on Risk of Postpartum Infection in Class III Obesity

2020 ◽  
Vol 10 (03) ◽  
pp. e213-e216
Author(s):  
Courtney J. Mitchell ◽  
LaMani Adkins ◽  
Ann Tucker ◽  
Haywood Brown ◽  
Anne Siegel ◽  
...  
Keyword(s):  
Weight Gain ◽  
Wound Infection ◽  
Multiple Gestation ◽  
Institute Of Medicine ◽  
Class Iii ◽  
Infectious Morbidity ◽  
Increased Risk ◽  
Significant Difference ◽  
Class Iii Obesity ◽  
The Impact

Abstract Objective To assess the impact of gestational weight gain >20 pounds (more than Institute of Medicine [IOM] recommendations) on postpartum infectious morbidity in women with class III obesity. Methods This is a retrospective cohort of term, nonanomalous singleton pregnancies with body mass index ≥40 at a single institution from 2013 to 2017. Pregnancies with multiple gestation, late entry to care, and missing weight gain data are excluded. Primary outcome is a composite of postpartum infection (endometritis, urinary tract, respiratory, and wound infection). Secondary outcomes include components of composite, wound complication, readmission, and blood transfusion. Bivariate statistics compared demographics, pregnancy complications, and delivery characteristics of women exceeding IOM guidelines (GT20) with those who did not (LT20). Regression models were used to estimate adjusted odds of outcomes. Results Of 374 women, 144 (39%) gained GT20 and 230 (62%) gained LT20. Primiparous, nonsmokers more likely gained GT20 (p < 0.05). No significant difference in other demographics. Among women who gained GT20, 10.4% had postpartum infectious morbidity compared with 3.0% in LT20 (p < 0.01). Wound infection is more common in the GT20 group (7.6 vs. 2%, p = 0.02). After adjustment, women who gained GT20 had threefold higher odds of postpartum infectious morbidity (adjusted odds ratio: 3.17, 95% confidence interval: 1.17, 8.60). Conclusion Women with class III obesity who gain more than the IOM recommends are at increased risk for postpartum infectious morbidity.

Maternal Weight Gain and Neonatal Outcomes in Women With Class III Obesity [29C]

2019 ◽  
Vol 133 (1) ◽  
pp. 39S-39S
Author(s):  
Emily S. Reiff ◽  
Lamani Adkins ◽  
Ann Robin Tucker ◽  
Luke Gatta ◽  
Haywood L. Brown ◽  
...  
Keyword(s):  
Weight Gain ◽  
Neonatal Outcomes ◽  
Maternal Weight Gain ◽  
Class Iii ◽  
Maternal Weight ◽  
Class Iii Obesity

Gestational Weight Gain and Postpartum Depression in Women with Class III Obesity

2019 ◽  
Vol 37 (01) ◽  
pp. 019-024
Author(s):  
LaMani D. Adkins ◽  
Ann Tucker ◽  
Luke A. Gatta ◽  
Anne M. Siegel ◽  
Emily Reiff ◽  
...  
Keyword(s):  
Weight Gain ◽  
Postpartum Depression ◽  
Gestational Weight Gain ◽  
Primary Outcome ◽  
Depression Scale ◽  
Institute Of Medicine ◽  
Obese Women ◽  
Class Iii ◽  
Gestational Weight ◽  
Class Iii Obesity

Abstract Objective We investigated the association between gestational weight gain (GWG) and postpartum depression (PPD) in women with class III obesity. Study Design This is a retrospective cohort of women with body mass index (BMI) ≥ 40 kg/m2 at entry to care, first prenatal visit ≤14 weeks gestation, with singleton, nonanomalous pregnancies who delivered at term from July 2013 to December 2017. Women missing data regarding PPD were excluded. Primary outcome was PPD; classified as Edinburgh Postnatal Depression Scale (EPDS) score >13/30 or provider's report of depression. Participants were classified, according to Institute of Medicine GWG guidelines (11–20 pounds), as either less than 11 pounds (LT11) or at/more than 11 pounds (GT11). Bivariate statistics compared demographics and pregnancy characteristics. Logistic regression used to estimate odds of primary outcome. Results Of 275 women, 96 (34.9%) gained LT11 and 179 (65.1%) gained GT11 during pregnancy. The rate of PPD was 8.7% (n = 24), 9 (9.4%) in the LT11 group and 15 (8.4%) in the GT11 group (p = 0.82, odds ratio: 1.13, 95% confidence interval [CI]: 0.48, 2.69). When controlling for entry BMI and multiparity, adjusted odds of PPD was 1.07 (95% CI: 0.44, 2.63). No correlation was found between GWG and EPDS. Conclusion A relationship between GWG and PPD in class III obese women was not found in this cohort.

Maternal weight gain and neonatal outcomes in women with class III obesity

2020 ◽  
pp. 1-5 ◽  
Author(s):  
Ravyn Njagu ◽  
LaMani Adkins ◽  
Ann Tucker ◽  
Luke Gatta ◽  
Haywood L. Brown ◽  
...  
Keyword(s):  
Weight Gain ◽  
Neonatal Outcomes ◽  
Maternal Weight Gain ◽  
Class Iii ◽  
Maternal Weight ◽  
Class Iii Obesity

scholarly journals Liver transplantation in recipients with class III obesity: post-transplant outcomes and weight gain

2021 ◽  
Author(s):  
Daiki Soma ◽  
Yujin Park ◽  
Plamen Mihaylov ◽  
Burcin Ekser ◽  
Marwan Ghabril ◽  
...  
Keyword(s):  
Liver Transplantation ◽  
Weight Gain ◽  
Graft Survival ◽  
The United States ◽  
University Hospital ◽  
Class Iii ◽  
Post Transplant ◽  
Significant Difference ◽  
The Impact

Abstract Introduction Over the past decades, there has been a dramatic increase in obesity in the United States. Several studies have reported conflicting results for the impact of obesity on outcomes of liver transplantation (LT). This study aims to assess severe obesity's impact on LT outcomes and changes in body mass index (BMI) after transplantation.Methods All adult LT performed at Indiana University Health University Hospital between July 2001 and December 2018 were reviewed. A retrospective analysis for identified 2024 patients was conducted. BMI of recipients is subdivided into underweight, normal, overweight, class Ⅰ obesity, class Ⅱ obesity, and class Ⅲ obesity (<18.5; 18.5-24.9; 25‐29.9; 30‐34.9; 35‐39.9; ≥40 kg/m2, respectively). Survival outcomes were compared across the sub-group. Post-transplant BMI was followed up in a smaller cohort of patients receiving LT from January 2008 to December 2018 (n = 1004).Results Among 2024 patients in the analytic cohort, 1.9% were underweight, 24.5% were normal, 32.6% were overweight, 25% were in class Ⅰ obesity, 9.3% were in class Ⅱ obesity, and 1.1% were in class Ⅲ obesity. There was no significant difference in patient and graft survival at 10-year follow-up with respect to recipient obesity. The 1, 3, 5, and 10-year graft and patient survivals in class Ⅲ obesity group were 97.0%, 92.1%, 87.0%, and 79.8% for patient survival and 94.4%, 85.1%, 79.8%, and 72.5% for graft survival. Among 1004 patients identified in the sub-group, BMI of all groups except the underweight group declined in the first three months postoperatively. After the three months, the BMI of all groups except the class Ⅲ obesity group returned to the pre-LT level by two years and reached a plateau by five years. In patients with class Ⅲ obesity, there was a significant increase in body weight at long-term follow-up.Conclusion In this study, class Ⅲ obesity is not associated with higher post-transplant mortality. Obesity, including class Ⅲ obesity, should not be considered a contraindication to LT in the absence of other contraindications. Post-LT interventions are required to prevent significant weight gain in recipients with class Ⅲ obesity.

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