The impact of parity and maternal obesity on the fetal outcomes of a non-selected Lower Saxony population

2021 ◽  
Vol 0 (0) ◽  
Author(s):  
Lars Brodowski ◽  
Niels Rochow ◽  
Efrah I. Yousuf ◽  
Fabian Kohls ◽  
Constantin S. von Kaisenberg ◽  
...  
Keyword(s):  
Maternal Obesity ◽  
Fetal Distress ◽  
Maternal Body Mass Index ◽  
Obese Women ◽  
Lower Saxony ◽  
Fetal Outcomes ◽  
Increased Risk ◽  
Longitudinal Position ◽  
The Impact ◽  
Maternal Bmi

Abstract Objectives Maternal obesity during pregnancy is associated with adverse intrauterine events and fetal outcomes and may increase the risk of obesity and metabolic disease development in offspring. Higher parity, regardless of socioeconomic status, is associated with increased maternal body mass index (BMI). In this study, we examined the relationship between parity, maternal obesity, and fetal outcomes in a large sample of mother-neonate pairs from Lower Saxony, Germany. Methods This retrospective cohort study examined pseudonymized data of a non-selected singleton cohort from Lower Saxony’s statewide quality assurance initiative. 448,963 cases were included. Newborn outcomes were assessed in relation to maternal BMI and parity. Results Maternal obesity was associated with an increased risk of placental insufficiency, chorioamnionitis, and fetal distress while giving birth. This effect was present across all parity groups. Fetal presentation did not differ between BMI groups, except for the increased risk of high longitudinal position and shoulder dystocia in obese women. Maternal obesity was also associated with an increased risk of premature birth, low arterial cord blood pH and low 5-min APGAR scores. Conclusions Maternal obesity increases the risk of adverse neonatal outcomes. There is a positive correlation between parity and increased maternal BMI. Weight-dependent fetal risk factors increase with parity, while parity-dependent outcomes occur less frequently in multipara. Prevention and intervention programs for women planning to become pregnant can be promising measures to reduce pregnancy and birth complications.

scholarly journals The impact of high maternal body mass index on obstetric and perinatal outcomes

2021 ◽  
Vol 10 (3) ◽  
pp. 1031
Author(s):  
Natasha Sharma ◽  
Manasi Patnaik
Keyword(s):  
Body Mass Index ◽  
Body Mass ◽  
Pregnancy Outcomes ◽  
Maternal Obesity ◽  
Gestational Hypertension ◽  
First Trimester ◽  
Maternal Body Mass Index ◽  
Obese Women ◽  
Adverse Pregnancy ◽  
The Impact

Background: The incidence of obesity has increased to pandemic proportions over the last 20 years. Maternal obesity is associated with a wide array of adverse maternal pregnancy outcomes and increased risks in the offspring. The aim of the study was to find the effect of obesity on maternal and perinatal outcome in obese women in comparison to those of normal weight women.Methods: The study was designed as a case-control study. Antenatal women with first trimester body mass index (BMI) of more than 30 kg/m2 constituted the cases and those with BMI between 18 and 24.9 kg/m2 formed the controls.Results: There was increased incidence of antepartum complications in obese women. Obese women had a significant history of prior treatment for infertility (p<0.00001). The incidence of gestational diabetes (OR 4.76, 95%CI 1.267-17.72 p=0.014), gestational hypertension (OR 3.05, 95%CI 1.01-9.20 p=0.04), induction of labor (OR 2.5, 95%CI 1.0-6.28 p=0.04), preeclampsia (OR 2.38, 95%CI 1.0-5.64 p=0.04, Caesarean section (OR 1.98, 95%CI 1.24-3.14 p=0.003), postpartum haemorrhage (OR 8.57, 95%CI 1.07-76.15 p=0.04) and wound infection (OR 8.57, 95%CI 1.07-76.15 p=0.04) and adverse neonatal outcomes such as higher mean birth weight (p<0.0001) and requirement of NICU (OR 2.79, 95%CI 1.33 -5.84 p=0.006) was higher in obese women.Conclusions: Obesity is an independent risk factor for adverse pregnancy outcomes and hence, interventions directed towards weight loss and prevention of excessive weight gain must begin in the preconception period. 

scholarly journals The impact of gestational diabetes and maternal obesity on the mother and her offspring

2010 ◽  
Vol 1 (4) ◽  
pp. 208-215 ◽  
Author(s):  
P. M. Catalano
Keyword(s):  
Insulin Resistance ◽  
Gestational Diabetes ◽  
Glucose Intolerance ◽  
Maternal Obesity ◽  
Insulin Response ◽  
Obese Women ◽  
Increased Risk ◽  
Short And Long Term ◽  
The Impact

Thein uteromaternal metabolic environment is important relative to both short and long term development of the offspring. Although poor fetal growth remains a significant factor relative to long-term outcome, fetal overgrowth is assuming greater importance because of the increase in obesity in the world’s populations. Maternal obesity and gestational diabetes are the most common metabolic complications of pregnancy related to fetal overgrowth and more specifically adiposity.Women with gestational diabetes have increased insulin resistance and inadequate insulin response compared with weight-matched controls. Gestational diabetes increases the risk of maternal hypertensive disease (preeclampsia) as well as cesarean delivery. At birth the neonate has increased adiposity and is at risk for birth injury. Multiple studies have reported that children of women with gestational diabetes have a greater prevalence childhood obesity and glucose intolerance; even at glucose concentrations less than currently used to define gestational diabetes, compared with normoglycemic women.Obese women also have increased insulin resistance, insulin response and inflammatory cytokines compared with average weight women both before and during pregnancy. They too are at increased risk for the metabolic syndrome-like disorders during pregnancy that is hypertension, hyperlipidemia, glucose intolerance and coagulation disorders. Analogous to women with gestational diabetes, neonates of obese women are heavier at delivery because of increased fat and not lean body mass. Similarly, these children have an increased risk of childhood adiposity and metabolic dysregulation. Hence, the preconceptional and perinatal period offers a unique opportunity to modify both short and long term risks for both the woman and her offspring.

Maternal Obesity and Risk for Birth Defects

PEDIATRICS ◽  
2003 ◽  
Vol 111 (Supplement_1) ◽  
pp. 1152-1158 ◽  
Author(s):  
Margaret L. Watkins ◽  
Sonja A. Rasmussen ◽  
Margaret A. Honein ◽  
Lorenzo D. Botto ◽  
Cynthia A. Moore
Keyword(s):  
Spina Bifida ◽  
Birth Defects ◽  
Maternal Obesity ◽  
Heart Defects ◽  
Average Weight ◽  
Maternal Body Mass Index ◽  
Healthy Weight ◽  
Obese Women ◽  
Overweight Women ◽  
Increased Risk

Objective. Several studies have shown an increased risk for neural tube defects associated with prepregnancy maternal obesity. Because few recent studies have examined the relation between maternal prepregnancy obesity and overweight and other birth defects, we explored the relation for several birth defects and compared our findings with those of previous studies. Methods. We conducted a population-based case-control study of several selected major birth defects using data from the Atlanta Birth Defects Risk Factor Surveillance Study. Mothers who delivered an infant with and without selected birth defects in a 5-county metropolitan Atlanta area between January 1993 and August 1997 were interviewed. Maternal body mass index (BMI) was calculated from self-reported maternal prepregnancy weight and height. Women with known preexisting diabetes were excluded. The risks for obese women (BMI ≥30) and overweight women (BMI 25.0–29.9) were compared with those for average-weight women (BMI 18.5–24.9). Results. Obese women were more likely than average-weight women to have an infant with spina bifida (unadjusted odds ratio [OR]: 3.5; 95% confidence interval [CI]: 1.2–10.3), omphalocele (OR: 3.3; 95% CI: 1.0–10.3), heart defects (OR: 2.0; 95% CI: 1.2–3.4), and multiple anomalies (OR: 2.0; 95% CI: 1.0–3.8). Overweight women were more likely than average-weight women to have infants with heart defects (OR: 2.0; 95% CI: 1.2–3.1) and multiple anomalies (OR: 1.9; 95% CI: 1.1–3.4). Conclusions. Our study confirmed the previously established association between spina bifida and prepregnancy maternal obesity and found an association for omphalocele, heart defects, and multiple anomalies among infants of obese women. We also found an association between heart defects and multiple anomalies and being overweight before pregnancy. A higher risk for some birth defects is yet another adverse pregnancy outcome associated with maternal obesity. Obesity prevention efforts are needed to increase the number of women who are of healthy weight before pregnancy.

scholarly journals Oxytocin Augmentation in Spontaneously Laboring, Nulliparous Women: Multilevel Assessment of Maternal BMI and Oxytocin Dose

2017 ◽  
Vol 19 (4) ◽  
pp. 382-392 ◽  
Author(s):  
Nicole S. Carlson ◽  
Elizabeth J. Corwin ◽  
Nancy K. Lowe
Keyword(s):  
Vaginal Delivery ◽  
Maternal Obesity ◽  
Maternal Body Mass Index ◽  
Obese Women ◽  
Cervical Dilation ◽  
Nulliparous Women ◽  
Oxytocin Augmentation ◽  
Amniotic Membranes ◽  
Higher Doses ◽  
Maternal Bmi

Background: Synthetic oxytocin, the primary tool for labor augmentation, is less effective among obese women, leading to more unplanned cesarean deliveries for slow labor progress. It is not known if obese women require higher doses of oxytocin due to maternal, fetal, or labor factors related to maternal obesity. Objectives: This study had two main objectives: (1) examine the influence of maternal body mass index (BMI) on hourly doses of oxytocin from augmentation initiation until vaginal delivery in obese women; and (2) examine the influence of other maternal, fetal, and labor factors on hourly doses of oxytocin in obese women. Study Design: Longitudinal study of a cohort ( N = 136) of healthy, nulliparous, spontaneously laboring obese women (BMI ≥ 30 kg/m2) who received oxytocin augmentation and achieved vaginal delivery. We performed iterative multilevel analyses to examine the influence of maternal BMI and other factors on hourly oxytocin doses. Results: Maternal BMI explained 16.56% (95% confidence interval [CI] = [13.7, 20.04], p < .001) of the variance in hourly oxytocin doses received in a multilevel model controlling for influence of maternal, fetal, and labor characteristics. Maternal age, gestational age, status of amniotic membranes at hospital admission, and admission cervical dilation examination were not significant; however, neonatal birthweight and cervical dilation at oxytocin initiation were significant predictors of hourly oxytocin dose in these women ( p < .001). Conclusions: Even when parturition preparation has progressed adequately for spontaneous labor initiation, there still may be some obesity-related blunting of myometrial contractility and response to oxytocin used for augmentation.

scholarly journals A study of Maternal BMI as Determinant of Pregnancy & Perinatal Outcomes in Hazaribagh Medical College and Hospital, Hazaribagh.

2021 ◽  
Vol 7 (1) ◽  
pp. 13-20
Author(s):  
Dr. Snehlata Snehlata ◽  
◽  
Dr. Sweta Lal ◽  
Keyword(s):  
Maternal Nutrition ◽  
Perinatal Outcomes ◽  
Fetal Distress ◽  
Adverse Outcomes ◽  
Maternal Body Mass Index ◽  
Medical College ◽  
Pregnant Females ◽  
Increased Risk ◽  
Low Bmi ◽  
Maternal Bmi

Introduction: Maternal nutrition plays an important role in maternal and fetal outcomes. The lowmaternal BMI or Obesity are both associated with adverse outcomes. Objectives: To evaluate theimpact of the maternal body mass index on the pregnancy outcome and neonatal outcomes.Materials and Methods: This is a prospective cohort study in which a total of 200 patients meetingthe inclusion criteria were enrolled in the study after informed consent of which 100 patientsenrolled after 18 weeks of gestation had a low BMI and 100 patients with a higher BMI than normal.Results: Pregnant females having low BMI as baseline had more risk of IUGR, fetal distress and lowbirth weight in newborns while those having high maternal BMI had more incidence of PIH inmothers, oligohydramnios, increased birth weight, increased risk of LSCS and NICU admissions anddelayed maternal wound healing. Conclusion: The health of women, throughout their childbearingages, should be cared, to improve their obstetrical and perinatal outcomes. Also, the high-riskgroups should be managed properly.

scholarly journals Associations between maternal obesity and infectious morbidity in Zimbabwean infants

2021 ◽  
Author(s):  
Thomas Althaus ◽  
Bernard Chasekwa ◽  
Ruairi C. Robertson ◽  
Robert Ntozini ◽  
Katie Greenland ◽  
...  
Keyword(s):  
Maternal Obesity ◽  
Overweight And Obesity ◽  
Reproductive Age ◽  
Sub Saharan Africa ◽  
Maternal Body Mass Index ◽  
Obese Women ◽  
Middle Income ◽  
Infectious Morbidity ◽  
Maternal Bmi ◽  
Clinic Visits

AbstractThe prevalence of overweight and obesity is increasing among reproductive-age women in sub-Saharan Africa. Whether maternal body mass index (BMI) influences the risk of infant infections in low- and middle-income countries (LMIC) is uncertain. We used data from a birth cohort of 5344 HIV-unexposed Zimbabwean infants with available data on maternal BMI, to calculate rates of sick clinic visits for infections during the first 12 months postpartum, and adjusted hazard ratios (aHR) for each maternal BMI group. Compared to infants of mothers with normal BMI, the rate of sick clinic visits for any infection progressively rose among infants of overweight (aHR 1.05; 95%CI 0.99, 1.11) and obese women (aHR 1.15; 95%CI 1.05, 1.25). Excess clinic attendances were particularly due to skin, respiratory and ear infections. Maternal obesity may therefore influence infant infectious morbidity in LMIC over the first year after birth.

The cumulative impact of parity on the body mass index (BMI) in a non-selected Lower Saxony population

2020 ◽  
Vol 0 (0) ◽  
Author(s):  
Lars Brodowski ◽  
Niels Rochow ◽  
Efrah I. Yousuf ◽  
Fabian Kohls ◽  
Constantin S. von Kaisenberg ◽  
...  
Keyword(s):  
Body Mass Index ◽  
Pregnant Women ◽  
Body Mass ◽  
Maternal Obesity ◽  
The Body ◽  
Obese Women ◽  
Perinatal Complications ◽  
Lower Saxony ◽  
Cumulative Impact ◽  
Increased Risk

AbstractObjectivesDuring the last decade obesity has been continuously rising in adults in industrial countries. The increased occurrence of perinatal complications caused by maternal obesity poses a major challenge for obstetricians during pregnancy and childbirth. This study aims to examine the association between parity, pregnancy, birth risks, and body mass index (BMI) of women from Lower Saxony, Germany.MethodsThis retrospective cohort study examined pseudonymized data of a non-selected singleton cohort from Lower Saxony’s statewide quality assurance initiative. Mothers were categorized according to BMI as normal weight (18.5 to <25 kg/m2) or obese (≥30 kg/m2).ResultsMost of the mothers in this study population were either in their first (33.9%) or second pregnancy (43.4%). The mean age of women giving birth for the first time was 28.3 years. Maternal age increased with increasing parity. The proportion of pregnant women with a BMI over 30 was 11% in primiparous women, 14.3% in second para, 17.3% in third para and 24.1% in fourth para or more women. Increasing parity was positively correlated with the incidence of classical diseases related to obesity, namely diabetes mellitus, gestational diabetes, hypertension, pregnancy-related hypertension and urinary protein excretion. An increased risk of primary or secondary cesarean section was observed in the obese women, particularly during the first deliveries.ConclusionsThere is a positive and significant correlation between parity and increased maternal BMI. The highest weight gain happens during the first pregnancy. The rate of operative deliveries and complications during delivery is increased in obese pregnant women.

Maternal Obesity and the Risk for Orofacial Clefts in the Offspring

2005 ◽  
Vol 42 (4) ◽  
pp. 367-371 ◽  
Author(s):  
Marie Cedergren ◽  
Bengt Källén
Keyword(s):  
Early Pregnancy ◽  
Cleft Lip ◽  
Maternal Obesity ◽  
Reference Group ◽  
Average Weight ◽  
Maternal Body Mass Index ◽  
Obese Women ◽  
Orofacial Clefts ◽  
Increased Risk ◽  
Significant Difference

Objective To estimate whether obese women have an increased risk of orofacial clefts in their offspring, compared with average-weight women. Design and Participants The study was based on information on maternal body mass index (BMI) collected in early pregnancy and on the existence of orofacial clefts in the offspring, ascertained from multiple sources. The study included 1686 women who had infants with an orofacial cleft and as controls all delivered women (n = 988,171) during the study period, 1992 through 2001. Infants with chromosome anomalies were excluded. The women were divided into underweight (BMI <19.8), average weight (reference group, BMI 19.8 to 26), overweight (BMI 26.1 to 29), and obese (BMI >29). Adjustments were made for year of birth, maternal age, parity, and maternal smoking. Results Obese (BMI >29) mothers had an overall increased risk for having an infant with orofacial clefts: odds ratio 1.30 (95% confidence interval 1.11 to 1.53). This increased risk was higher when the cleft was associated with other major malformations than when it was isolated. There was no statistically significant difference between the risk estimates for cleft lip and cleft palate. Conclusions In this large sample, a positive association appears between maternal obesity in early pregnancy and orofacial clefts in the offspring. The explanation for this association is not known, but a relationship with undetected type 2 diabetes is one possibility.

scholarly journals Intergenerational Cycle of Obesity and Diabetes: How Can We Reduce the Burdens of These Conditions on the Health of Future Generations?

2011 ◽  
Vol 2011 ◽  
pp. 1-19 ◽  
Author(s):  
Marie-Claude Battista ◽  
Marie-France Hivert ◽  
Karine Duval ◽  
Jean-Patrice Baillargeon
Keyword(s):  
Diabetes Mellitus ◽  
Maternal Obesity ◽  
Obese Women ◽  
Excessive Gestational Weight Gain ◽  
Obesity And Diabetes ◽  
Increased Risk ◽  
Metabolic Conditions ◽  
Intergenerational Effect ◽  
Intergenerational Cycle ◽  
The Impact

Prepregnancy overweight or obesity and excessive gestational weight gain have been associated with increased risk of maternal and neonatal complications. Moreover, offspring from obese women are more likely to develop obesity, diabetes mellitus, and cardiovascular diseases in their lifetime. Gestational diabetes mellitus (GDM) is one of the most common complications associated with obesity and appears to have a direct impact on the future metabolic health of the child. Fetal programming of metabolic function induced by obesity and GDM may have intergenerational effect and thus perpetuate the epidemic of cardiometabolic conditions. The present paper thus aims at discussing the impact of maternal obesity and GDM on the developmental programming of obesity and metabolic disorders in the offspring. The main interventions designed to reduce maternal obesity and GDM and their ability to break the vicious circle that perpetuates the transmission of obesity and metabolic conditions to the next generations are also addressed.

scholarly journals Development of a Lifestyle Intervention Program to Support Preconception, Pregnant and Postnatal Women Who are Overweight or Obese: A Qualitative Study

2021 ◽  
Author(s):  
Chee Wai Ku ◽  
Shu Hui Leow ◽  
Lay See Ong ◽  
Christina Erwin ◽  
Isabella Ong ◽  
...  
Keyword(s):  
Lifestyle Intervention ◽  
Goal Setting ◽  
Intervention Program ◽  
Maternal Obesity ◽  
Healthy Lifestyle ◽  
Target Population ◽  
Lifestyle Changes ◽  
Lifestyle Behaviors ◽  
Obese Women ◽  
The Impact

Abstract Background: Poor lifestyle behaviors, including unhealthy diet and physical inactivity, contribute to the global obesity pandemic and result in long-term adverse health effects on mothers and their children. The time period before, during and after pregnancy represents a unique opportunity for interventions to cultivate sustained healthy lifestyle behaviors. Since the success of a lifestyle intervention is heavily dependent on uptake and continued compliance, the intervention components should be acceptable, sustainable, and tailored to the concerns and needs of the target population. This study aims to identify enablers and barriers towards engagement with a lifestyle intervention for improving the metabolic health of prospective mothers and their offspring, among a sample of the target population.Methods: In-depth interviews were conducted with 15 overweight or obese women in the preconception, pregnancy or postpartum periods. Interviews were transcribed verbatim and thematic analysis was undertaken using NVivo. Factors influencing adoption of a novel lifestyle intervention were systematically charted using the integrated–Promoting Action on Research Implementation in Health Services (i-PARIHS) framework, that comprises Recipient, Context, Innovation and Facilitation constructs.Results: Ten enablers and barriers were identified. Barrier factors within the Recipient construct include time constraints as participants juggled multiple roles, and poor baseline knowledge about healthy behaviors and the impact of maternal obesity on maternal and offspring health. Within Context, a family culture of communal meals, convenient access to unhealthy foods in the environment, as well as lack of relevant data sources, were barriers to dietary change. Recipient motivation to be healthy for themselves and their offspring is an enabler, along with family and social support within the Context construct. In the Innovation construct, a holistic delivery platform providing desired information delivered at appropriate times increases engagement. Lastly, in Facilitation, regular feedback, goal setting and nudges would ensure continued engagement and sustainability of lifestyle changes.Conclusions: The features of a successful lifestyle intervention targeting overweight and obese women include (i) a holistic life-course approach to provide education and guidance, (ii) using mobile health platforms to reduce barriers, provide personalized feedback and promote goal-setting, and (iii) health nudges to cultivate sustained lifestyle habits.

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