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

2018 ◽  
Vol 2018 ◽  
pp. 1-6 ◽  
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.

scholarly journals Maternal Body Mass Index and Risk of Obstetric Anal Sphincter Injury

2014 ◽  
Vol 2014 ◽  
pp. 1-8 ◽  
Author(s):  
Marie Blomberg
Keyword(s):  
Anal Sphincter ◽  
Normal Weight ◽  
Obstetric Anal Sphincter Injury ◽  
Morbidly Obese ◽  
Maternal Body Mass Index ◽  
Perineal Laceration ◽  
Obese Women ◽  
Sphincter Injury ◽  
Fourth Degree ◽  
Anal Sphincter Injury

Objective. To estimate the association between maternal obesity and risk of three different degrees of severity of obstetric anal sphincter injury.Methods. The study population consisted of 436,482 primiparous women with singleton term vaginal cephalic births between 1998 and 2011 identified in the Swedish Medical Birth Registry. Women were grouped into six categories of BMI. BMI 18.5–24.9 was set as reference. Primary outcome was third-degree perineal laceration, partial or total, and fourth-degree perineal laceration. Adjustments were made for year of delivery, maternal age, fetal head position at delivery, infant birth weight and instrumental delivery.Results. The overall prevalence of third- or four-degree anal sphincter injury was 6.6% (partial anal sphincter injury 4.6%, total anal sphincter injury 1.2%, unclassified as either partial and total 0.2%, or fourth degree lacerations 0.6%). The risk for a partial, total, or a fourth-degree anal sphincter injury decreased with increasing maternal BMI most pronounced for total anal sphincter injury where the risk among morbidly obese women was half that of normal weight women, OR 0.47 95% CI 0.28–0.78.Conclusion. Obese women had a favourable outcome compared to normal weight women concerning serious pelvic floor damages at birth.

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

BMJ Open ◽  
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.

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

2021 ◽  
Author(s):  
Eleanor Duffley ◽  
David Grynspan ◽  
Hailey Scott ◽  
Anthea Lafreniere ◽  
Cherley Borba Vieira de Andrade ◽  
...  
Keyword(s):  
Preterm Birth ◽  
Birth Outcomes ◽  
Normal Weight ◽  
Overweight And Obesity ◽  
Maternal Body Mass Index ◽  
Percentage Increase ◽  
Placental Development ◽  
Prepregnancy Bmi ◽  
Exposures During Pregnancy ◽  
Infant Birth

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.

Changes in PPAR-γ Expression Are Associated with microRNA Profiles during Fetal Programming due to Maternal Overweight and Obesity

2021 ◽  
pp. 1-12
Author(s):  
Noemí Gaytán-Pacheco ◽  
Victoria Lima-Rogel ◽  
Alejandro Méndez-Mancilla ◽  
Francisco Escalante-Padrón ◽  
Juan Carlos Toro-Ortíz ◽  
...  
Keyword(s):  
Cell Cultures ◽  
Maternal Obesity ◽  
Normal Weight ◽  
Overweight And Obesity ◽  
Epigenetic Changes ◽  
Maternal Weight ◽  
Ppar Γ ◽  
Microrna Profile ◽  
In Cells

<b><i>Background:</i></b> There has been a global increase in the prevalence of obesity in pregnant women in recent years. Animal studies have shown that intrauterine environment associated with maternal obesity leads to epigenetic changes. However, the effects of epigenetic changes occurring before birth in response to maternal conditions have not been clearly characterized in humans. <b><i>Objective:</i></b> The aim of the study was to analyze peroxisome proliferator-activated receptor (PPAR)-γ expression in cell cultures from newborns from mothers with overweight and obesity, in response to in vitro metabolic challenges and their relationship with microRNA profile and cytokine expression. <b><i>Methods/Study design:</i></b> The profile of circulating microRNAs from 72 mother-child pairs (including healthy infants born to normal weight [<i>n</i> = 35], overweight [<i>n</i> = 25], and obese [<i>n</i> = 12] mothers) was determined through real-time PCR, and the PPAR-γ expression in peripheral blood mononuclear cell cultures from offspring was analyzed after in vitro challenges. <b><i>Results:</i></b> miR-146a, miR-155, and miR-378a were upregulated in overweight mothers, while miR-378a was upregulated in obese mothers compared to normal weight mothers. In children from overweight mothers, miR-155 and miR-221 were downregulated and miR-146a was upregulated, while offspring of mothers with obesity showed downregulation of miR-155, miR-221, and miR-1301. These microRNAs have direct or indirect relation with PPAR-γ expression. In vitro exposure to high triglyceride and exposure to miR-378a induced a higher expression of PPAR-γ in cells from offspring of mothers with overweight and obesity. In contrast, cells from offspring of mothers with obesity cultured with high glucose concentrations showed PPAR-γ downregulation. IL-1ß, IL-6, and TNF-α expression in cells of offspring of overweight and obese mothers differed from that of offspring of normal weight mothers. Limitation of our study is the small sample size. <b><i>Conclusion:</i></b> The blood microRNA profile, and in vitro PPAR-γ and inflammatory cytokine expression in cells of newborn infants are associated with maternal obesity indicating that epigenetic marks may be established during intrauterine development. <b><i>Key Message:</i></b> Neonatal microRNA profile is associated with maternal weight. Neonatal microRNA profile is independent of maternal microRNA profile. PPAR-γ expression in newborn cell cultures is affected by maternal weight

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

2000 ◽  
Vol 84 (1) ◽  
pp. 95-101 ◽  
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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