scholarly journals A review of maternal overweight and obesity and its impact on cardiometabolic outcomes during pregnancy and postpartum

2021 ◽  
Vol 15 ◽  
pp. 263349412098654
Author(s):  
Jessica A. Grieger ◽  
Melinda J. Hutchesson ◽  
Shamil D. Cooray ◽  
Mahnaz Bahri Khomami ◽  
Sarah Zaman ◽  
...  
Keyword(s):  
Weight Gain ◽  
Gestational Diabetes ◽  
Polycystic Ovary Syndrome ◽  
Gestational Weight Gain ◽  
Polycystic Ovary ◽  
Overweight And Obesity ◽  
Ovary Syndrome ◽  
Cardiometabolic Diseases ◽  
Gestational Weight ◽  
Maternal Overweight

The rates of maternal overweight and obesity, but also excess gestational weight gain, are increasing. Pregnancy complications, including gestational diabetes mellitus, gestational hypertension, pre-eclampsia and delivery of a preterm or growth restricted baby, are higher for both women with overweight and obesity and women who gain excess weight during their pregnancy. Other conditions such as polycystic ovary syndrome are also strongly linked to overweight and obesity and worsened pregnancy complications. All of these conditions place women at increased risk for future cardiometabolic diseases. If overweight and obesity, but also excess gestational weight gain, can be reduced in women of reproductive age, then multiple comorbidities associated with pregnancy complications may also be reduced in the years after childbirth. This narrative review highlights the association between maternal overweight and obesity and gestational weight gain, with gestational diabetes, pre-eclampsia, polycystic ovary syndrome and delivery of a preterm or growth restricted baby. This review also addresses how these adverse conditions are linked to cardiometabolic diseases after birth. We report that while the independent associations between obesity and gestational weight gain are evident across many of the adverse conditions assessed, whether body mass index or gestational weight gain is a stronger driving factor for many of these is currently unclear. Mechanisms linking gestational diabetes mellitus, gestational hypertension, pre-eclampsia, preterm delivery and polycystic ovary syndrome to heightened risk for cardiometabolic diseases are multifactorial but relate to cardiovascular and inflammatory pathways that are also found in overweight and obesity. The need for post-partum cardiovascular risk assessment and follow-up care remains overlooked. Such early detection and intervention for women with pregnancy-related complications will significantly attenuate risk for cardiovascular disease.

scholarly journals Gestational Weight Gain in Women With Polycystic Ovary Syndrome: A Controlled Study

2018 ◽  
Vol 103 (11) ◽  
pp. 4315-4323 ◽  
Author(s):  
James Kent ◽  
William C Dodson ◽  
Allen Kunselman ◽  
Jaimey Pauli ◽  
Alicia Stone ◽  
...  
Keyword(s):  
Weight Gain ◽  
Polycystic Ovary Syndrome ◽  
Gestational Weight Gain ◽  
Polycystic Ovary ◽  
Controlled Study ◽  
Ovary Syndrome ◽  
Gestational Weight

scholarly journals Associations between pre-pregnancy body mass index and gestational weight gain with pregnancy outcomes in women with polycystic ovary syndrome

2020 ◽  
Vol 12 (1) ◽  
Author(s):  
Lirui Zhang ◽  
Wei Zheng ◽  
Cheng Liu ◽  
Xin Liang ◽  
Li Zhang ◽  
...  
Keyword(s):  
Body Mass Index ◽  
Weight Gain ◽  
Polycystic Ovary Syndrome ◽  
Gestational Age ◽  
Pregnancy Outcomes ◽  
Protective Factor ◽  
Polycystic Ovary ◽  
Perinatal Outcomes ◽  
Ovary Syndrome ◽  
Gestational Weight

Abstract Background The influence of pre-pregnancy body mass index (BMI) and gestational weight gain (GWG) on perinatal outcomes of women with polycystic ovary syndrome (PCOS) remains unclear. Therefore, we explored how the above indicators influence pregnancy outcomes in women with PCOS. Methods A retrospective study was conducted involving the baseline characteristics, laboratory data, and pregnancy outcomes of 722 pregnant women with PCOS. Subjects were grouped in a way to find out risks in their pregnancy outcomes. Multivariable logistic regression analysis was performed to investigate how BMI and GWG were associated with perinatal outcomes. Results Among women with PCOS, underweight increased the risk of small for gestational age (SGA) (OR 12.35, 95% CI 3.56–42.82), but reduced the risk of large for gestational age (LGA). Overweight but not obese women were more susceptible to developing preeclampsia (PE) than women with normal weight. In PCOS women with BMI < 25 kg/m2 before pregnancy, inadequate GWG was a protective factor for gestational hypertension (GH) and postpartum hemorrhage (PPH), excessive GWG exhibited a positive correlation with LGA. But in PCOS women with BMI ≥ 25 kg/m2, excessive GWG increased the probability of undergoing a cesarean section. Inadequate GWG did not reduce the likelihood of LGA in women with BMI ≥ 25 kg/m2, and excessive GWG did not reduce the probability of SGA in women with BMI < 25 kg/m2. Conclusion The impacts of pre-pregnancy BMI, GWG on maternal and infant outcomes among PCOS women are similar to reported results in general pregnant women. However, some unique trends were also observed in PCOS women. While the underweight factor significantly increased the risk of SGA birth, overweight but not obesity was correlated with the risk of PE. Inadequate GWG was a protective factor for GH and PPH only in women with pregestational BMI < 25 kg/m2. Inadequate GWG did not reduce the probability of LGA in women with BMI ≥ 25 kg/m2, and similarly, excessive GWG did not reduce the probability of SGA in women with BMI < 25 kg/m2. Overall, these findings indicate that women with PCOS should begin weight management before pregnancy.

scholarly journals Associations between pre-pregnancy body mass index and gestational weight gain with pregnancy outcomes in women with polycystic ovary syndrome

2020 ◽  
Author(s):  
Lirui Zhang ◽  
Wei Zheng ◽  
Cheng Liu ◽  
Xin Liang ◽  
Li Zhang ◽  
...  
Keyword(s):  
Body Mass Index ◽  
Weight Gain ◽  
Polycystic Ovary Syndrome ◽  
Gestational Age ◽  
Pregnancy Outcomes ◽  
Protective Factor ◽  
Polycystic Ovary ◽  
Perinatal Outcomes ◽  
Ovary Syndrome ◽  
Gestational Weight

Abstract Background: The influence of pre-pregnancy body mass index (BMI) and gestational weight gain (GWG) on perinatal outcomes of women with polycystic ovary syndrome (PCOS) remains unclear. Therefore, we explored how the above indicators influence pregnancy outcomes in women with PCOS. Methods: A retrospective study was conducted involving the baseline characteristics, laboratory data, and pregnancy outcomes of 722 pregnant women with PCOS. Subjects were grouped in a way to find out risks in their pregnancy outcomes. Multivariable logistic regression analysis was performed to investigate how BMI and GWG were associated with perinatal outcomes.Results：Among women with PCOS, underweight increased the risk of small for gestational age (SGA) (OR 12.35, 95% CI 3.56-42.82), but reduced the risk of large for gestational age (LGA). Overweight but not obese women were more susceptible to developing preeclampsia (PE) than women with normal weight. In PCOS women with BMI＜25 kg/m2 before pregnancy, inadequate GWG was a protective factor for gestational hypertension (GH) and postpartum hemorrhage (PPH), excessive GWG exhibited a positive correlation with LGA. But in PCOS women with BMI ≥25 kg/m2, excessive GWG increased the probability of undergoing a cesarean section. Inadequate GWG did not reduce the likelihood of LGA in women with BMI ≥ 25 kg/m2, and excessive GWG did not reduce the probability of SGA in women with BMI＜25 kg/m2.Conclusion: The impacts of pre-pregnancy BMI, GWG on maternal and infant outcomes among PCOS women are similar to reported results in general pregnant women. However, some unique trends were also observed in PCOS women. While the underweight factor significantly increased the risk of SGA birth, overweight but not obesity was correlated with the risk of PE. Inadequate GWG was a protective factor for GH and PPH only in women with pregestational BMI＜25 kg/m2. Inadequate GWG did not reduce the probability of LGA in women with BMI ≥ 25 kg/m2, and similarly, excessive GWG did not reduce the probability of SGA in women with BMI＜25 kg/m2. Overall, these findings indicate that women with PCOS should begin weight management before pregnancy.

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