Gestational age and infection are greater predictors of placental histopathology than maternal prepregnancy BMI.

The placenta undergoes morphological and functional adaptions to adverse exposures during pregnancy. The effects of suboptimal maternal body mass index (BMI), preterm birth, and infection on placental histopathological phenotypes remain unclear, despite the association between these conditions and poor offspring outcomes. We hypothesized that suboptimal maternal prepregnancy BMI and preterm birth (with and without infection) would associate with altered placental maturity and morphometry, and that altered placental maturity would associate with poor birth outcomes. Clinical data and human placentae were collected from 96 pregnancies where mothers were underweight, normal weight, overweight, or obese, without other major complications. Placental histopathological characteristics were scored with an anatomical pathologist. Associations between maternal BMI, placental pathology (immaturity and hypermaturity), placental morphometry, and infant outcomes were investigated at term and preterm, with and without infection. Fetal vascular endothelium volumetric proportion was decreased, whereas syncytial knot volumetric proportion was increased, in placentae from preterm pregnancies with chorioamnionitis compared to term placentae. At term and preterm, pregnancies with overweight and obesity had a high percentage increase in proportion of immature placentae compared to normal weight. Placental maturity did not associate with infant birth outcomes. We observed placental hypermaturity and altered placental morphometry among preterm pregnancies with chorioamnionitis, suggestive of altered placental development, which may inform about pregnancies susceptible to preterm birth and infection. Our data increase our understanding of how common metabolic exposures and preterm birth, in the absence of other comorbidities or perinatal events, potentially contribute to poor pregnancy outcomes and the programming of offspring development.

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Does geography matter? comparing maternal stressors to birth outcomes

10.32469/10355/88144 ◽

2021 ◽

Author(s):

◽

Amy E. Reed

Keyword(s):

Birth Weight ◽

Preterm Birth ◽

Low Birth Weight ◽

Birth Outcomes ◽

Gestational Age ◽

Rural Women ◽

Care Providers ◽

Experience Of Stress ◽

Infant Birth ◽

Childbearing Women

Background: The US continues to see rising trends in the incidence of maternal morbidity and mortality, which contributes to poor infant birth outcomes of preterm birth and low birth weight. The purpose of this dissertation study was to examine the relationship between the experience of stress and birth outcomes of weight and gestational age based on whether the mother resided in a rural or urban location in the state of Missouri. Methods: A secondary data analysis was conducted using the Missouri Department of Health and Senior Services PRAMS survey between 2007-2019. There were 15,938 respondents -- 11,475 urban and 4,463 rural. Stress measures included responses from 13 items on the PRAMS survey related to the experience of stress within the 12 months before delivery of their infant. A mean stress score for each participant was created, which was an average of the 13 stressors experienced. The 13 stressors were also grouped into four different domains: Community, Family/Relationshipd Health. Participant responses are tied to birth certificate data to obtain outcome variables related to infant birth weight (<2500 grams) and gestational age (<37 weeks) at time of delivery. Univariate and multivariate models were analyzed for the total sample and also for urban and rural participants with and without covariates. Results: Rural childbearing women were younger, less likely to have received prenatal care during the first trimester and more likely to have smoked cigarettes than urban childbearing women. Urban women were more likely to have education beyond high school, and more likely to use alcohol during pregnancy. Similar to other research, Black women were more likely to experience PTB or have a LBW infant than other race/ethnicities. The number of stressors reported by both urban and rural women is similar, with rural women reporting slightly more. The experience of stress is significant for both urban and rural women, even when controlling for covariates. Stress scores significantly predicted low birth weight and preterm birth for urban participants. The four different categories of grouped stress scores were not significant for either urban or rural participants and did not significantly predict low birth weight or preterm birth. Conclusion: Health care providers should screen women for stressors related to the social determinants of health in order to provide opportunities for support and intervention. Policies that ensure access to convenient, appropriate obstetric resources for pregnant women, regardless of location could improve outcomes. Research that seeks to understand differences in health between rural and urban populations should consider additional measures related to urban and rural classification of participants.

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Cohort study of high maternal body mass index and the risk of adverse pregnancy and delivery outcomes in Scotland

BMJ Open ◽

10.1136/bmjopen-2018-026168 ◽

2020 ◽

Vol 10 (2) ◽

pp. e026168

Author(s):

Lawrence Doi ◽

Andrew James Williams ◽

Louise Marryat ◽

John Frank

Keyword(s):

Body Mass Index ◽

Body Mass ◽

Gestational Hypertension ◽

Normal Weight ◽

Overweight And Obesity ◽

Maternal Body Mass Index ◽

Delivery Outcomes ◽

Term Delivery ◽

Pregnancy And Delivery ◽

Adverse Pregnancy

ObjectiveTo examine the association between high maternal weight status and complications during pregnancy and delivery.SettingScotland.ParticipantsData from 132 899 first-time singleton deliveries in Scotland between 2008 and 2015 were used. Women with overweight and obesity were compared with women with normal weight. Associations between maternal body mass index and complications during pregnancy and delivery were evaluated.Outcome measuresGestational diabetes, gestational hypertension, pre-eclampsia, placenta praevia, placental abruption, induction of labour, elective and emergency caesarean sections, pre-term delivery, post-term delivery, low Apgar score, small for gestational age and large for gestational age.ResultsIn the multivariable models controlling for potential confounders, we found that, compared with women with normal weight, the odds of the following outcomes were significantly increased for women with overweight and obesity (overweight adjusted ORs; 95% CI, followed by the same for women with obesity): gestational hypertension (1.61; 1.49 to 1.74), (2.48; 2.30 to 2.68); gestational diabetes (2.14; 1.86 to 2.46), (8.25; 7.33 to 9.30); pre-eclampsia (1.46; 1.32 to 1.63) (2.07; 1.87 to 2.29); labour induction (1.28; 1.23 to 1.33), (1.69; 1.62 to 1.76) and emergency caesarean section (1.82; 1.74 to 1.91), (3.14; 3.00 to 3.29).ConclusionsWomen with overweight and obesity in Scotland are at greater odds of adverse pregnancy and delivery outcomes. The odds of these conditions increases with increasing body mass index. Health professionals should be empowered and trained to deliver promising dietary and lifestyle interventions to women at risk of overweight and obesity prior to conception, and control excessive weight gain in pregnancy.

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Maternal Body Mass Index and Anovaginal Distance in Active Phase of Term Labor

BioMed Research International ◽

10.1155/2018/1532949 ◽

2018 ◽

Vol 2018 ◽

pp. 1-6 ◽

Cited By ~ 3

Author(s):

Linda Hjertberg ◽

Eva Uustal ◽

Sofia Pihl ◽

Marie Blomberg

Keyword(s):

Anal Sphincter ◽

Active Phase ◽

Normal Weight ◽

Overweight And Obesity ◽

Transperineal Ultrasound ◽

Maternal Body Mass Index ◽

Obese Women ◽

Maternal Weight ◽

Anal Sphincter Injury ◽

Pregnancy And Delivery

Introduction. To evaluate if there was a difference in the anovaginal distance (AVD) measured by transperineal ultrasound between obese and normal weight women. Material and Methods. A prospective observational study including 207 primiparous women at term in first stage of labor. Transperineal ultrasound with a vaginal probe was used to measure the AVD. Maternal, pregnancy, and delivery characteristics potentially associated with perineal thickness were extracted from woman’s medical records. The participants were divided into three BMI groups based on maternal weight in early pregnancy: normal weight (BMI < 25), overweight (BMI 25–29.9), and obesity (BMI ≥ 30). Obese and overweight women were compared with normal weight women regarding the AVD. Results. The mean AVD was 24.3, 24.9, and 27.0 mm in the normal weight, overweight, and obesity group, respectively. There were no group differences in background characteristics. The AVD was significantly longer in obese women compared with normal weight women (p=0.018). Conclusions. The observed longer AVD in obese women might be protective of the anal sphincter complex, explaining lower rates of anal sphincter injuries in this group. Further studies are indicated to evaluate whether the length of the AVD plays a role in the risk assessment of obstetric anal sphincter injury. The trial is registered in ClinicalTrials.gov and the trial registration ID is NCT03149965.

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Prepregnancy Body Mass Index as a Significant Predictor of Total Gestational Weight Gain and Birth Weight

Canadian Journal of Dietetic Practice and Research ◽

10.3148/cjdpr-2016-035 ◽

2017 ◽

Vol 78 (2) ◽

pp. 66-73 ◽

Cited By ~ 8

Author(s):

Anne-Sophie Morisset ◽

Lise Dubois ◽

Cynthia K. Colapinto ◽

Zong-Chen Luo ◽

William D. Fraser

Keyword(s):

Weight Gain ◽

Birth Weight ◽

Gestational Weight Gain ◽

Normal Weight ◽

Institute Of Medicine ◽

3D Design ◽

Gestational Weight ◽

Prepregnancy Bmi ◽

Iom Recommendations ◽

Infant Birth

Purpose: We aimed to describe adherence to gestational weight gain (GWG) recommendations and identify determinants of excessive GWG in a sample of women from Quebec, Canada. Methods: Data were collected from the multi-centre 3D (Design, Develop, Discover) pregnancy cohort study, which included women who delivered between May 2010 and August 2012 at 9 obstetrical hospitals in Quebec, Canada. GWG was calculated for 1145 women and compared to the 2009 Institute of Medicine (IOM) recommendations. Results: Overall, 51% of participants exceeded the recommendations. Approximately 68% of women with obesity gained weight in excess of the IOM recommendations. The corresponding numbers were 75%, 44%, and 27% in overweight, normal weight, and underweight women, respectively. A prepregnancy BMI of 25 kg/m2 or more was the only significant predictor of exceeding GWG recommendations (OR 3.35, 95% CI 2.44–4.64) in a multivariate model. Birth weight was positively associated with GWG. GWG and prepregnancy BMI could explain 3.13% and 2.46% of the variance in birth weight, respectively. Conclusion: About half of women exceeded GWG recommendations, and this was correlated with infant birth weight. This reinforces the need to develop and evaluate strategies, including nutritional interventions, for pregnant women to achieve optimal GWG.

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843: Relationship of early pregnancy maternal body mass index to preterm birth outcomes in nulliparous women

American Journal of Obstetrics and Gynecology ◽

10.1016/j.ajog.2015.10.893 ◽

2016 ◽

Vol 214 (1) ◽

pp. S439-S440

Author(s):

Deborah Wing

Keyword(s):

Body Mass Index ◽

Preterm Birth ◽

Body Mass ◽

Birth Outcomes ◽

Early Pregnancy ◽

Maternal Body Mass Index ◽

Maternal Body ◽

Nulliparous Women ◽

Relationship Of

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Effect of overweight and obesity on the left ventricular systolic and diastolic functions in patients with acute myocardial infarction

Clinical & Investigative Medicine ◽

10.25011/cim.v35i4.17152 ◽

2012 ◽

Vol 35 (4) ◽

pp. 229 ◽

Cited By ~ 2

Author(s):

Fatih Poyraz ◽

Murat Turfan ◽

Sinan A. Kocaman ◽

Huseyin U. Yazici ◽

Nihat Sen ◽

...

Keyword(s):

Myocardial Infarction ◽

Diastolic Function ◽

Systolic Function ◽

Study Groups ◽

Left Ventricular ◽

Normal Weight ◽

Overweight And Obesity ◽

Weight Group ◽

Normal Weight Group ◽

Diastolic Functions

Purpose: The purpose of this study was to evaluate whether a association exits among overweight and obesity and left ventricular systolic and diastolic functions in patients admitted with first ST-elevation myocardial infarction (STEMI). Methods: The present study was performed on 451 consecutive patients diagnosed with first STEMI (376 men, 75 women; mean age 56.1±10.8 years). The patients were classified into three groups based on their body mass index (BMI) as normal weight (BMI < 25 kg/m2), overweight (BMI: 25-29.9 kg/m2) and obese (BMI > 30 kg/m2). Echocardiographic features were evaluated and compared among the three groups. Results: Mitral annulus E velocities were higher in obese individuals than normal weight group (p < 0.01). In contrast, mitral A velocities were lower (p =0.03); consequently, E\A and E'\A' ratios were lower (both p =0.01) in the obese group with respect to normal weight group. When the correction of entire variations existing among the groups were performed using multivariate linear regressions analyses, it turned out that BMI was independently associated with E/A (β= -0.19, p =0.044) and with E'/A' (β= -0.016, p=0.021). Ejection fraction, wall motion score index and myocardial S velocities were comparable among the study groups (p > 0.05). Conclusion: These results suggest that while obesity has no adverse effect on the left ventricular systolic function, it has unfavorable consequences on the left ventricular diastolic function in the patients with first STEMI. In contrast, no unfavorable effects of overweight on the left ventricular systolic and diastolic function were detected.

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Mass incarceration and public health: the association between black jail incarceration and adverse birth outcomes among black women in Louisiana

BMC Pregnancy and Childbirth ◽

10.1186/s12884-019-2690-z ◽

2019 ◽

Vol 19 (1) ◽

Cited By ~ 1

Author(s):

Lauren Dyer ◽

Rachel Hardeman ◽

Dovile Vilda ◽

Katherine Theall ◽

Maeve Wallace

Keyword(s):

Birth Weight ◽

Preterm Birth ◽

Black Women ◽

Low Birth Weight ◽

Racial Disparities ◽

Population Health ◽

Birth Outcomes ◽

Mass Incarceration ◽

Interquartile Range ◽

Adverse Birth Outcomes

Abstract Background A growing body of evidence is beginning to highlight how mass incarceration shapes inequalities in population health. Non-Hispanic blacks are disproportionately affected by incarceration and criminal law enforcement, an enduring legacy of a racially-biased criminal justice system with broad health implications for black families and communities. Louisiana has consistently maintained one of the highest rates of black incarceration in the nation. Concurrently, large racial disparities in population health persist. Methods We conducted a cross-sectional analysis of all births among non-Hispanic black women in Louisiana in 2014 to identify associations between parish-level (county equivalent) prevalence of jail incarceration within the black population and adverse birth outcomes (N = 23,954). We fit a log-Poisson model with generalized estimating equations to approximate the relative risk of preterm birth and low birth weight associated with an interquartile range increase in incarceration, controlling for confounders. In sensitivity analyses, we additionally adjusted for the parish-level index crime prevalence and analyzed regression models wherein white incarceration was used to predict the risk of adverse birth outcomes in order to quantify the degree to which mass incarceration may harm health above and beyond living in a high crime area. Results There was a significant 3% higher risk of preterm birth among black women associated with an interquartile range increase in the parish-level incarceration prevalence of black individuals, independent of other factors. Adjusting for the prevalence of index crimes did not substantively change the results of the models. Conclusion Due to the positive significant associations between the prevalence of black individuals incarcerated in Louisiana jails and estimated risk of preterm birth, mass incarceration may be an underlying cause of the persistent inequities in reproductive health outcomes experienced by black women in Louisiana. Not only are there economic and social impacts stemming from mass incarceration, but there may also be implications for population health and health inequities, including the persistence of racial disparities in preterm birth and low birth weight.

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Accuracy of Age-Based Formula to Predict the Size and Depth of Cuffed Oral Preformed Endotracheal Tubes in Children Undergoing Tonsillectomy

Ear Nose & Throat Journal ◽

10.1177/0145561320980511 ◽

2021 ◽

pp. 014556132098051

Author(s):

Matula Tareerath ◽

Peerachatra Mangmeesri

Keyword(s):

Body Mass Index ◽

Endotracheal Tube ◽

Body Mass ◽

Normal Weight ◽

Overweight And Obesity ◽

The Body ◽

Insertion Depth ◽

Endotracheal Tubes ◽

Endotracheal Tube Size ◽

Actual Size

Objectives: To retrospectively investigate the reliability of the age-based formula, year/4 + 3.5 mm in predicting size and year/2 + 12 cm in predicting insertion depth of preformed endotracheal tubes in children and correlate these data with the body mass index. Patients and Methods: Patients were classified into 4 groups according to their nutritional status: thinness, normal weight, overweight, and obesity; we then retrospectively compared the actual size of endotracheal tube and insertion depth to the predicting age-based formula and to the respective bend-to-tip distance of the used preformed tubes. Results: Altogether, 300 patients were included. The actual endotracheal tube size corresponded with the Motoyama formula (64.7%, 90% CI: 60.0-69.1), except for thin patients, where the calculated size was too large (0.5 mm). The insertion depth could be predicted within the range of the bend-to-tip distance and age-based formula in 85.0% (90% CI: 81.3-88.0) of patients. Conclusion: Prediction of the size of cuffed preformed endotracheal tubes using the formula of Motoyama was accurate in most patients, except in thin patients (body mass index < −2 SD). The insertion depth of the tubes was mostly in the range of the age-based-formula to the bend-to-tip distance.

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The Role of Obesity in Predicting the Clinical Outcomes of COVID-19

Obesity Facts ◽

10.1159/000517180 ◽

2021 ◽

pp. 1-9

Author(s):

Serdar Sahin ◽

Havva Sezer ◽

Ebru Cicek ◽

Yeliz Yagız Ozogul ◽

Murat Yildirim ◽

...

Keyword(s):

Clinical Outcomes ◽

Health Care Providers ◽

Study Groups ◽

Normal Weight ◽

Overweight And Obesity ◽

Care Providers ◽

Significant Difference ◽

Group A ◽

Group B ◽

Group D

Introduction: The aim of this was to describe the predictors of mortality related to COVID-19 infection and to evaluate the association between overweight, obesity, and clinical outcomes of COVID-19. Methods: We included the patients >18 years of age, with at least one positive SARS-CoV-2 reverse transcriptase-polymerase chain reaction. Patients were grouped according to body mass index values as normal weight <25 kg/m2 (Group A), overweight from 25 to <30 kg/m2 (Group B), Class I obesity 30 to <35 kg/m2 (Group C), and ≥35 kg/m2 (Group D). Mortality, clinical outcomes, laboratory parameters, and comorbidities were compared among 4 groups. Results: There was no significant difference among study groups in terms of mortality. Noninvasive mechanical ventilation requirement was higher in group B and D than group A, while it was higher in Group D than Group C (Group B vs. Group A [p = 0.017], Group D vs. Group A [p = 0.001], and Group D vs. Group C [p = 0.016]). Lung involvement was less common in Group A, and presence of hypoxia was more common in Group D (Group B vs. Group A [p = 0.025], Group D vs. Group A [p < 0.001], Group D vs. Group B [p = 0.006], and Group D vs. Group C [p = 0.014]). The hospitalization rate was lower in Group A than in the other groups; in addition, patients in Group D have the highest rate of hospitalization (Group B vs. Group A [p < 0.001], Group C vs. Group A [p < 0.001], Group D vs. Group A [p < 0.001], Group D vs. Group B [p < 0.001], and Group D vs. Group C [p = 0.010]). Conclusion: COVID-19 patients with overweight and obesity presented with more severe clinical findings. Health-care providers should take into account that people living with overweight and obesity are at higher risk for COVID-19 and its complications.

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Prognostic value of different maternal obesity phenotypes in predicting offspring obesity in a family-based cohort study

BMC Public Health ◽

10.1186/s12889-021-10932-4 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Sara Jalali-Farahani ◽

Parisa Amiri ◽

Bita Lashkari ◽

Leila Cheraghi ◽

Farhad Hosseinpanah ◽

...

Keyword(s):

Metabolic Syndrome ◽

Childhood Obesity ◽

Maternal Obesity ◽

Female Offspring ◽

Normal Weight ◽

Metabolic Status ◽

World Health ◽

Metabolic Phenotype ◽

Maternal Body Mass Index ◽

Obesity In Children

Abstract Background Parental weight is studied as an important determinant of childhood obesity; however, obesity-related metabolic abnormalities have been less considered as determinants of childhood obesity. This study aimed to investigate the association between maternal obesity phenotypes and incidence of obesity in their offspring. Methods This longitudinal study was conducted within the framework of the Tehran Lipid and Glucose Study. A total of 2151 non-obese children who had complete parental information were followed for incidence of obesity over a mean of 148.7 ± 34.7 months. Obesity in children was defined using the World Health Organization criteria. Maternal body mass index (BMI) was classified into three categories: normal weight, overweight and obese. Dysmetabolic status was considered as having metabolic syndrome or diabetes. Metabolic syndrome and diabetes were defined according to the Joint Interim Statement and American diabetes association criteria, respectively. Considering maternal BMI categories and metabolic status, six obesity phenotypes were defined as followed: 1) normal weight and normal metabolic status, 2) overweight and normal metabolic status, 3) obese and normal metabolic status, 4) normal weight and dysmetabolic status, 5) overweight and dysmetabolic status, and 6) obese and dysmetabolic status. The association between maternal obesity phenotypes and incidence of obesity in children was studied using Cox proportional regression hazard model. Results In male offspring, the risk of incidence of obesity significantly increased in those with maternal obesity phenotypes including overweight/normal metabolic: 1.75(95% CI: 1.10–2.79), obese/normal metabolic: 2.60(95%CI: 1.51–4.48), overweight/dysmetabolic: 2.34(95%CI: 1.35–4.03) and obese/dysmetabolic: 3.21(95%CI: 1.94–5.03) compared to the normal weight/normal metabolic phenotype. Similarly, in girls, the risk of incidence of obesity significantly increased in offspring with maternal obesity phenotypes including overweight/normal metabolic: 2.39(95%CI: 1.46–3.90), obese/normal metabolic: 3.55(95%CI: 1.94–6.46), overweight/dysmetabolic: 1.92(95%CI: 1.04–3.52) and obese/dysmetabolic: 3.89(95%CI: 2.28–6.64) compared to normal weight/normal metabolic phenotype. However, maternal normal weight/dysmetabolic phenotype did not significantly change the risk of obesity in both male and female offspring. Conclusion Except for normal weight/dysmetabolic phenotype, all maternal obesity phenotypes had significant prognostic values for incidence of offspring obesity with the highest risk for obese/dysmetabolic phenotype. This study provides valuable findings for identifying the first line target groups for planning interventions to prevent childhood obesity.

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