scholarly journals Impact of Obesity on Perinatal Outcomes among Asthmatic Women

2013 ◽  
Vol 20 (5) ◽  
pp. 345-350 ◽  
Author(s):  
Meggie Thuot ◽  
Marc-André Coursol ◽  
Sonia Nguyen ◽  
Vanessa Lacasse-Guay ◽  
Marie-France Beauchesne ◽  
...  

BACKGROUND: Only one study has investigated the combined effect of maternal asthma and obesity on perinatal outcomes; however, it did not consider small-for-gestational age and large-for-gestational age infants.OBJECTIVES: To examine the impact of obesity on perinatal outcomes among asthmatic women.METHODS: A cohort of 1386 pregnancies from asthmatic women was reconstructed using three of Quebec’s administrative databases and a questionnaire. Women were categorized using their prepregnancy body mass index. Underweight, overweight and obese women were compared with normal weight women. The primary outcome was the birth of a small-for-gestational-age infant, defined as a birth weight below the 10th percentile for gestational age and sex. Secondary outcomes were large-for-gestational-age infants (birth weight >90th percentile for gestational age) and preterm birth (<37 weeks’ gestation). Logistic regression models were used to obtain the ORs of having small-for-gestational-age infants, large-for-gestational-age infants and preterm birth as a function of body mass index.RESULTS: The proportions of underweight, normal weight, overweight and obese women were 10.8%, 53.3%, 19.7% and 16.2%, respectively. Obese asthmatic women were not found to be significantly more at risk for giving birth to small-for-gestational-age infants (OR 0.6 [95% CI 0.4 to 1.1]), large-for-gestational-age infants (OR 1.2 [95% CI 0.7 to 2.2]) or having a preterm delivery (OR 0.7 [95% CI 0.4 to 1.3]) than normal-weight asthmatic women.CONCLUSIONS: No significant negative interaction between maternal asthma and obesity on adverse perinatal outcomes was observed.

2021 ◽  
Vol 10 (4) ◽  
pp. 643
Author(s):  
Veronica Giorgione ◽  
Corey Briffa ◽  
Carolina Di Fabrizio ◽  
Rohan Bhate ◽  
Asma Khalil

Twin pregnancies are commonly assessed using singleton growth and birth weight reference charts. This practice has led to a significant number of twins labelled as small for gestational age (SGA), causing unnecessary interventions and increased risk of iatrogenic preterm birth. However, the use of twin-specific charts remains controversial. This study aims to assess whether twin-specific estimated fetal weight (EFW) and birth weight (BW) charts are more predictive of adverse outcomes compared to singleton charts. Centiles of EFW and BW were calculated using previously published singleton and twin charts. Categorical data were compared using Chi-square or McNemar tests. The study included 1740 twin pregnancies, with the following perinatal adverse outcomes recorded: perinatal death, preterm birth <34 weeks, hypertensive disorders of pregnancy (HDP) and admissions to the neonatal unit (NNU). Twin-specific charts identified prenatally and postnatally a smaller proportion of infants as SGA compared to singleton charts. However, twin charts showed a higher percentage of adverse neonatal outcomes in SGA infants than singleton charts. For example, perinatal death (SGA 7.2% vs. appropriate for gestational age (AGA) 2%, p < 0.0001), preterm birth <34 weeks (SGA 42.1% vs. AGA 16.4%, p < 0.0001), HDP (SGA 21.2% vs. AGA 13.5%, p = 0.015) and NNU admissions (SGA 69% vs. AGA 24%, p < 0.0001), when compared to singleton charts (perinatal death: SGA 2% vs. AGA 1%, p = 0.029), preterm birth <34 weeks: (SGA 20.6% vs. AGA 17.4%, p = 0.020), NNU admission: (SGA 34.5% vs. AGA 23.9%, p < 0.000). There was no significant association between HDP and SGA using the singleton charts (p = 0.696). In SGA infants, according to the twin charts, the incidence of abnormal umbilical artery Doppler was significantly more common than in SGA using the singleton chart (27.0% vs. 8.1%, p < 0.001). In conclusion, singleton charts misclassify a large number of twins as at risk of fetal growth restriction. The evidence suggests that the following twin-specific charts could reduce unnecessary medical interventions prenatally and postnatally.


2006 ◽  
Vol 91 (11) ◽  
pp. 4645-4649 ◽  
Author(s):  
Germán Iñiguez ◽  
Ken Ong ◽  
Rodrigo Bazaes ◽  
Alejandra Avila ◽  
Teresa Salazar ◽  
...  

Abstract Introduction: Insulin resistance (IR) develops as early as age 1 to 3 yr in small for gestational age (SGA) infants who show rapid catch-up postnatal weight gain. In contrast, greater insulin secretion is related to infancy height gains. We hypothesized that IGF-I levels could be differentially related to gains in length and weight and also differentially related to IR and insulin secretion. Methods: In a prospective study of 50 SGA (birth weight &lt; 5th percentile) and 14 normal birth weight [appropriate for gestational age (AGA)] newborns, we measured serum IGF-I levels at birth, 1 yr, and 3 yr. IR (by homeostasis model assessment) and insulin secretion (by short iv glucose tolerance test) were also measured at 1 yr and 3 yr. Results: SGA infants had similar mean length and weight at 3 yr compared with AGA infants. SGA infants had lower IGF-I levels at birth (P &lt; 0.0001), but conversely they had higher IGF-I levels at 3 yr (P = 0.003) than AGA infants. Within the SGA group, at 1 yr IGF-I was associated with length gain from birth and insulin secretion (P &lt; 0.0001); in contrast at 3 yr IGF-I was positively related to weight, body mass index, and IR. Conclusions: IGF-I levels increased rapidly from birth in SGA, but not AGA children. During the key first-year growth period, IGF-I levels were related to β-cell function and longitudinal growth. In contrast, by 3 yr, when catch-up growth was completed, IGF-I levels were related to body mass index and IR, and these higher IGF-I levels in SGA infants might indicate the presence of relative IGF-I resistance.


2021 ◽  
Author(s):  
Mingze Du ◽  
Junwei Zhang ◽  
Xiaona Yu ◽  
Jiaheng Li ◽  
Xinmi Liu ◽  
...  

Abstract Background: The number of frozen embryo transfer (FET) cycles has substantially increased in the past decade. Preparing the endometrium in artificial cycles is widely used in clinical practice. Therefore, how to optimize this program, improve the clinical outcome and ensure the safety of the perinatal period is the focus of our attention. The purpose of this study was to explore whether the duration of estrogen treatment before progesterone application affects neonatal and perinatal outcomes in single frozen blastocyst transfer cycles.Methods: It was a retrospective cohort study. Patients receiving single frozen blastocyst transfer and delivering a single live birth between January 2015 and December 2019 were included. Primary outcome was small for gestational age (SGA). Secondary outcomes were neonatal birthweight, gestational weeks at delivery, preterm birth, low birth weight (LBW), macrosomia, large for gestational age (LGA), neonatal malformation and rate of pregnancy-related complications.Cycles were allocated to four groups according to the estrogen-treatment duration before single frozen blastocyst transfer ①≤12 days (n=306), ②13-15 days (n=620), ③16-18 days (n=471), ④≥19 days (n=275).Results: In total, 1672 cycles were analyzed. Cycles were allocated to four groups according to the estrogen-treatment duration before single frozen blastocyst transfer ①≤12 days (n=306), ②13-15 days (n=620), ③16-18 days (n=471), ④≥19 days (n=275). The rates of SGA among the four groups were 7.8% (24/306), 4.8% (30/620), 5.7% (27/471), and 7.6% (21/275), with no statistical significance (P=0.20). Other neonatal outcomes, including mean neonatal birth weight, gestational weeks at delivery, preterm birth rate, LBW, macrosomia, LGA and neonatal malformation, were comparable among the groups (P=0.38, P=0.16, P=0.20, P=0.58, P=0.20, P=0.34, P=0.96). The rate of pregnancy-related complications was similar among the groups. Multiple logistics regression showed that the duration of estrogen treatment did not affect the rate of singleton SGA (13-15 days, AOR=1.37, 95% CI= 0.70-2.70, P=0.36; 16-18 days, AOR=0.74, 95% CI= 0.40-1.36, P=0.34; ≥19 days, AOR=0.81, 95% CI= 0.44-1.49, P=0.50).Conclusion: The estrogen-treatment duration before progesterone application does not affect neonatal and perinatal outcomes in single frozen blastocyst transfer cycles.


2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Jiaying Lin ◽  
Jialyu Huang ◽  
Ningling Wang ◽  
Yanping Kuang ◽  
Renfei Cai

Abstract Background Previous studies have shown that among women with polycystic ovary syndrome who have difficulties conceiving, frozen-embryo transfer resulted in increased live birth rates and decreased ovarian hyperstimulation syndrome risk than did fresh-embryo transfer. In the present retrospective analysis, we sought to determine the effect of body mass index (BMI) on pregnancy and perinatal outcomes in women with PCOS undergoing FET. Methods Women with PCOS (n = 1556) undergoing FET were divided into groups based on weight, with those with normal weight having a BMI of 18.5–24.9 kg/m2,those who were overweight having a BMI of 25–29.9 kg/m2, and those who were obese having a BMI ≥30 kg/m2. Both pregnancy and perinatal outcomes were compared among these groups. Results The normal-weight, overweight, or obese groups exhibited similar pregnancy outcomes, including clinical pregnancy rate, miscarriage rate, ongoing pregnancy rate and live birth rate. In singletons, birth characteristics regarding newborn gender, gestational age, birthweight and length at birth were comparable between the three groups. For adverse neonatal outcomes, the three groups showed no significant differences on the rates of low birthweight, very low birthweight, preterm birth, and very preterm birth after adjustment. In addition, the obstetric complications and the frequencies of live-birth defects were also comparable between the three groups except that overweight and obese women were more likely than women of normal weight to have delivered via cesarean section. Conclusion BMI did not affect the pregnancy or perinatal outcomes in women with PCOS undergoing FET.


2021 ◽  
Vol 2021 ◽  
pp. 1-6
Author(s):  
Junita Indarti ◽  
Sulaeman Andrianto Susilo ◽  
Purnomo Hyawicaksono ◽  
Jimmy Sakti Nanda Berguna ◽  
Galuh Anindya Tyagitha ◽  
...  

Obesity is a pandemic found in many countries. It is estimated that, in 2025, more than 21% of women in the world will suffer from obesity and its number keeps increasing yearly. Obesity in pregnancy is one of the important challenges in obstetric services given the prevalence and potential adverse effects on the mother and fetus. Obese women have a higher risk of developing gestational diabetes, gestational hypertension, preeclampsia, venous thromboembolism, postpartum hemorrhage, cesarean delivery, and maternal death. The aim of this research is to determine the prevalence of maternal and perinatal complication in various obesity grades. This research was an observational descriptive study using the cross-sectional design. The inclusion criterion is obese pregnant women whose delivery was done in Dr. Cipto Mangunkusumo National General Hospital (RSCM) from 2014 to 2019. The exclusion criterion in this study is the incomplete medical record. A total of 111 subjects were included in the study. Obesity grades in this study were based on World Health Organization (WHO) obesity, divided into 3 classifications which are obese I (30–34.9 kg/m2), obese II (35–39.9 kg/m2), and obese III (≥40 kg/m2). Maternal outcomes in this study were birth method, gestational diabetes, preeclampsia, and premature rupture of membrane (PROM). Perinatal outcomes in this study were preterm birth, birth weight, APGAR score, and postdelivery neonatal care. In this study, obese patients had a mean age of 31.23 years, mean gravida 2, parity 1, and abortion 0. Most of these patients used an intrauterine device (IUD) for family planning (74.8%). There were no differences in age, parity status, and family planning methods in each group of patients with different body mass index ( p > 0.05 ). Maternal characteristics are the majority of deliveries performed cesarean delivery (86.5%), cases of diabetes mellitus are more common in obese I patients (50%), preeclampsia is more prevalent in obese grade II patients (34,4%), and premature rupture of membranes (PROM) is more common in patients with obese II (52,4%). However, there was no difference in the prevalence of maternal outcomes between groups. There was a median gestational age of 37 weeks in all obesity grades, the highest percentage of preterm births owned by obese II patients (32,6%), the mean birth weight of babies tends to increase along with the weighting of the body mass index group, and neonatal intensive care unit (NICU) treatment rooms were mostly occupied from mother with obese II groups (18%). There was no difference in the first-minute and fifth-minute APGAR scores between study groups ( p > 0.05 ). There were no differences in perinatal outcomes between groups. There were no significant differences in maternal and perinatal outcomes prevalence between different obesity grades. However, the rate of maternal and perinatal complications in obese women is higher than the normal population, thus requiring sophisticated prevention and approach toward handling the pregnancy.


2016 ◽  
Vol 134 (2) ◽  
pp. 146-152 ◽  
Author(s):  
Mariana Sbrana ◽  
Carlos Grandi ◽  
Murilo Brazan ◽  
Natacha Junquera ◽  
Marina Stevaux Nascimento ◽  
...  

ABSTRACT CONTEXT AND OBJECTIVE: Alcohol consumption during pregnancy is a significant social problem that may be associated with adverse perinatal outcomes. The aim of this study was to describe alcohol consumption during pregnancy and to study its association with low birth weight, newborns small for gestational age and preterm birth. DESIGN AND SETTING: Nested cohort study, in the city of Ribeirão Preto, São Paulo, Brazil. METHODS: 1,370 women and their newborns were evaluated. A standardized questionnaire on health and lifestyle habits was applied to the mothers. Anthropometry was performed on the newborns. Alcohol consumption was defined as low, moderate or high, as defined by the World Health Organization. Adjusted logistic regression analysis was used. RESULTS: 23% of the women consumed alcohol during pregnancy. Consumption mainly occurred in the first trimester (14.8%) and decreased as the pregnancy progressed. The median alcohol intake was 3.89 g (interquartile range, IQR = 8 g) per day. In the unadjusted analysis, alcohol consumption increased the risk of low birth weight almost twofold (odds ratio, OR 1.91; 95% confidence interval, CI: 1.25-2.92). The risk was lower in the adjusted analysis (OR 1.62; 95% CI: 1.03-2.54). Alcohol consumption did not show associations with small for gestational age or preterm birth. There was greater risk of low birth weight and newborns small for gestational age and preterm birth among mothers who were both smokers and drinkers. CONCLUSIONS: The alcohol consumption rate during pregnancy was 23% and was independently associated with low birth weight, but there was no risk of newborns small for gestational age or preterm birth.


2015 ◽  
Vol 2015 ◽  
pp. 1-6 ◽  
Author(s):  
Camile Boscaini ◽  
Lucia Campos Pellanda

Studies have shown associations of birth weight with increased concentrations of high sensitivity C-reactive protein. This study assessed the relationship between birth weight, anthropometric and metabolic parameters during childhood, and high sensitivity C-reactive protein. A total of 612 Brazilian school children aged 5–13 years were included in the study. High sensitivity C-reactive protein was measured by particle-enhanced immunonephelometry. Nutritional status was assessed by body mass index, waist circumference, and skinfolds. Total cholesterol and fractions, triglycerides, and glucose were measured by enzymatic methods. Insulin sensitivity was determined by the homeostasis model assessment method. Statistical analysis included chi-square test, General Linear Model, and General Linear Model for Gamma Distribution. Body mass index, waist circumference, and skinfolds were directly associated with birth weight (P<0.001,P=0.001, andP=0.015, resp.). Large for gestational age children showed higher high sensitivity C-reactive protein levelsP<0.001than small for gestational age. High birth weight is associated with higher levels of high sensitivity C-reactive protein, body mass index, waist circumference, and skinfolds. Large for gestational age altered high sensitivity C-reactive protein and promoted additional risk factor for atherosclerosis in these school children, independent of current nutritional status.


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