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Alem AZ, Yeshaw Y, Liyew AM, Tessema ZT, Worku MG, Tesema GA, Alamneh TS, Teshale AB, Chilot D, Ayalew HG. Double burden of malnutrition and its associated factors among women in low and middle income countries: findings from 52 nationally representative data. BMC Public Health 2023; 23:1479. [PMID: 37537530 PMCID: PMC10398981 DOI: 10.1186/s12889-023-16045-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2022] [Accepted: 06/02/2023] [Indexed: 08/05/2023] Open
Abstract
BACKGROUND Double burden of malnutrition (DBM) is an emerging global public health problem. The United Nations member states adopted eradicating all forms of malnutrition as an integral component of the global agenda. However, there is evidence of a high burden of undernutrition among women and rising rates of overweight and obesity, especially in low and middle income countries (LMICs). Therefore, this study aimed to investigate the prevalence and associated factors of underweight, overweight, and obesity among women of reproductive age in LMICs. METHODS Data for the study were drawn from a recent 52 Demographic and Health Surveys (DHS) conducted in LMICS. We included a sample of 1,099,187 women of reproductive age. A multilevel multinomial logistic regression model was used to identify factors associated with DBM. Adjusted relative risk ratio (RRR) with a 95% Confidence Interval (CI) was reported to show an association. RESULTS The prevalence of underweight, overweight, and obesity in LMICs among women of reproductive age was 15.2% (95% CI: 15.1-15.3), 19.0% (95% CI: 18.9- 19.1), and 9.1% (95% CI: 9.0-9.2), respectively. This study found that women aged 24-34 years, aged ≥ 35 years, with primary, secondary, and above educational level, from wealthy households, using modern contraceptives, exposed to media (radio and television), and with high parity (more than one birth) were more likely to have overweight and obesity and less likely to have underweight. Moreover, the risk of having obesity (RRR = 0.59; 95% CI = 0.58-0.60 and overweight (RRR = 0.78; 95% CI = 0.77-0.79) were lower among rural women, while the risk of being underweight was (RRR = 1.13; 95% CI = 1.11-1.15) higher among rural women compared to urban women. CONCLUSION The prevalence of underweight, overweight, and obesity was high among women of reproductive age in LMICs. Underweight, overweight, and obesity are influenced by sociodemographic, socioeconomic, and behavioral-related factors. This study shows that, in order to achieve Sustainable Development Goal 2, a multifaceted intervention approach should be considered to prevent both forms of malnutrition in women of reproductive age. This can be achieved by raising awareness and promoting healthy behaviors such as healthy eating and physical activity, especially among educated women, women from wealthy households, and women exposed to the media.
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Affiliation(s)
- Adugnaw Zeleke Alem
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.
| | - Yigizie Yeshaw
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
- Department of Physiology, School of Medicine, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Alemneh Mekuriaw Liyew
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Zemenu Tadesse Tessema
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Misganaw Gebrie Worku
- Department of Human Anatomy, College of Medicine and Health Science, School of Medicine, University of Gondar, Gondar, Ethiopia
| | - Getayeneh Antehunegn Tesema
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Tesfa Sewunet Alamneh
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Achamyeleh Birhanu Teshale
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Dagmawi Chilot
- Department of Physiology, School of Medicine, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
- College of Health Sciences, Center for Innovative Drug Development and Therapeutic Trials for Africa (CDT-Africa), Addis Ababa University, Addis Ababa, Ethiopia
| | - Hiwotie Getaneh Ayalew
- Department of Midwifery, School of Nursing and Midwifery, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
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Khair H, Bataineh MF, Zaręba K, Alawar S, Maki S, Sallam GS, Abdalla A, Mutare S, Ali HI. Pregnant Women's Perception and Knowledge of the Impact of Obesity on Prenatal Outcomes-A Cross-Sectional Study. Nutrients 2023; 15:nu15112420. [PMID: 37299384 DOI: 10.3390/nu15112420] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2023] [Revised: 04/17/2023] [Accepted: 05/10/2023] [Indexed: 06/12/2023] Open
Abstract
The prevalence of obesity and overweight has been rapidly increasing and is significantly higher among adult females in the Arab States. The aim of the present study was to explore pregnant Emirati women's perception of their weight, their knowledge of the healthy gestational weight gain, and the possible weight-related pregnancy complications. A total of 526 self-administered questionnaires were obtained with a response rate of 72%. The majority (81.8%, n = 429) entered pregnancy as overweight or obese. The percentage of pregnant women who underestimated their weight category was 12.1% in normal weight participants, 48.9% in overweight participants, and 73.5% in obese participants (p < 0.001). The overweight and obese participants were 13 times more likely to underestimate their weight status and 3.6 times more likely to correctly select their healthy gestational weight gain. Women's awareness of pregnancy-related complications due to weight varied from 80.3% for diabetes to 44.5% for fetal complications; their awareness of breastfeeding difficulty was the lowest at 2.5%. Moreover, there was a misconception about personal BMI and the appropriate range for gestational weight gain (GWG). Healthy lifestyle counselling urgently needs to be addressed in preventative health programs such as pre-marital and preconception counselling.
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Affiliation(s)
- Howaida Khair
- Department of Obstetrics and Gynecology, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain 17666, United Arab Emirates
| | - Mo'ath F Bataineh
- Department of Nutrition and Health, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain 17666, United Arab Emirates
| | - Kornelia Zaręba
- Department of Obstetrics and Gynecology, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain 17666, United Arab Emirates
| | - Shamsa Alawar
- Department of Obstetrics and Gynecology, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain 17666, United Arab Emirates
| | - Sara Maki
- Department of Obstetrics and Gynecology, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain 17666, United Arab Emirates
| | - Gehan Sayed Sallam
- Department of Obstetrics and Gynecology, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain 17666, United Arab Emirates
| | - Afra Abdalla
- Department of Veterinary Medicine, College of Agriculture and Veterinary Medicine, United Arab Emirates University, Al Ain 15551, United Arab Emirates
| | - Sharon Mutare
- Department of Obstetrics and Gynecology, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain 17666, United Arab Emirates
| | - Habiba I Ali
- Department of Nutrition and Health, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain 17666, United Arab Emirates
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Ramos-Leví AM, Fernández-Pombo A, García-Fontao C, Gómez-Vázquez E, Cantón-Blanco A, Martínez-Olmos MÁ, Andújar-Plata P, Mariño PB, Rodríguez-Carnero MG, Villar-Taibo R. Gestational weight gain influences neonatal outcomes in women with obesity and gestational diabetes. ENDOCRINOL DIAB NUTR 2022; 69:852-858. [PMID: 36526355 DOI: 10.1016/j.endien.2022.11.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2021] [Accepted: 01/11/2022] [Indexed: 06/17/2023]
Abstract
INTRODUCTION Obesity and gestational diabetes mellitus (GDM) are associated with an increased risk of perinatal complications and obesity in the offspring. However, the impact of gestational weight gain (GWG) on maternal and foetal outcomes is controversial. PATIENTS AND METHODS Retrospective study of 220 women with GDM and pre-pregnancy body mass index (BMI)>30kg/m2. Pregnant women were classified according to the Institute of Medicine (IOM) recommendations regarding their prior BMI and GWG. We evaluated the impact of GWG on perinatal and obstetric outcomes. RESULTS Mean maternal age was 34.7±5.3 years. Pre-pregnancy obesity was classified as class I in 55.3% of the cases, class II in 32.0% and class III in 12.7%. GWG was adequate (5-9kg) in 24.2%, insufficient (<5kg) in 41.8% and excessive (>9kg) in 34.2%. Birth weight was within normal range in 81.9%, 3.6% were small for gestational age (microsomia) and 14.4% were large for gestational age (macrosomia). Insufficient GWG was associated with a higher rate of microsomal offspring, excessive GWG was associated to macrosomia and adequate GWG with normal birth weight. CONCLUSION GWG in women with pre-pregnancy obesity and GDM impacts neonatal birthweight. Insufficient GWG is associated with microsomia and excessive GWG is associated with macrosomia. Women with adequate GWG according to the IOM guidelines obtained better perinatal outcomes.
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Affiliation(s)
- Ana M Ramos-Leví
- Department of Endocrinology and Nutrition, Hospital Universitario La Princesa, Instituto de Investigación Princesa, Universidad Autónoma, Madrid, Spain
| | - Antía Fernández-Pombo
- Department of Endocrinology and Nutrition, Complejo Hospitalario Universitario de Santiago de Compostela, Universidad de Santiago de Compostela, Spain
| | - Cristina García-Fontao
- Department of Endocrinology and Nutrition, Complejo Hospitalario Universitario de Santiago de Compostela, Universidad de Santiago de Compostela, Spain
| | - Eva Gómez-Vázquez
- Department of Endocrinology and Nutrition, Complejo Hospitalario Universitario de Santiago de Compostela, Universidad de Santiago de Compostela, Spain
| | - Ana Cantón-Blanco
- Department of Endocrinology and Nutrition, Complejo Hospitalario Universitario de Santiago de Compostela, Universidad de Santiago de Compostela, Spain
| | - Miguel Ángel Martínez-Olmos
- Department of Endocrinology and Nutrition, Complejo Hospitalario Universitario de Santiago de Compostela, Universidad de Santiago de Compostela, Spain
| | - Paula Andújar-Plata
- Department of Endocrinology and Nutrition, Complejo Hospitalario Universitario de Santiago de Compostela, Universidad de Santiago de Compostela, Spain
| | - Pilar Bolaño Mariño
- Department of Endocrinology and Nutrition, Complejo Hospitalario Universitario de Santiago de Compostela, Universidad de Santiago de Compostela, Spain
| | - Maria Gemma Rodríguez-Carnero
- Department of Endocrinology and Nutrition, Complejo Hospitalario Universitario de Santiago de Compostela, Universidad de Santiago de Compostela, Spain.
| | - Rocío Villar-Taibo
- Department of Endocrinology and Nutrition, Complejo Hospitalario Universitario de Santiago de Compostela, Universidad de Santiago de Compostela, Spain
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Gestational weight gain influences neonatal outcomes in women with obesity and gestational diabetes. ENDOCRINOL DIAB NUTR 2022. [DOI: 10.1016/j.endinu.2022.01.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Langley-Evans SC. Early life programming of health and disease: the long-term consequences of obesity in pregnancy: a narrative review. J Hum Nutr Diet 2022; 35:816-832. [PMID: 35475555 PMCID: PMC9540012 DOI: 10.1111/jhn.13023] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Accepted: 04/06/2022] [Indexed: 11/28/2022]
Abstract
The prevalence of overweight and obesity is rising in all parts of the world and among young women it presents a very clear danger during pregnancy. Women who are overweight or who gain excessive weight during pregnancy are at greater risk of complications in pregnancy and labour, and are more likely to lose their child to stillbirth, or themselves die during pregnancy. This narrative review considers the evidence that in addition to increasing risk of poor pregnancy outcomes, obesity has the capacity to programme fetuses to be at greater risk of cardiometabolic disorders later in life. An extensive body of evidence from prospective and retrospective cohorts, and record linkage studies demonstrates associations of maternal obesity and/or gestational diabetes with cardiovascular disease, type-1 and type-2 diabetes. Studies in animals suggest that these associations are underpinned by adaptations that occur in fetal life, which remodel the structures of major organs including the brain, kidney and pancreas. This article is protected by copyright. All rights reserved.
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Affiliation(s)
- Simon C Langley-Evans
- School of Biosciences, University of Nottingham, Sutton Bonington Campus, Loughborough, LE12 5RD
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Maternal Obesity in Twin Pregnancy: The Role of Nutrition to Reduce Maternal and Fetal Complications. Nutrients 2022; 14:nu14071326. [PMID: 35405938 PMCID: PMC9003274 DOI: 10.3390/nu14071326] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2022] [Revised: 03/12/2022] [Accepted: 03/20/2022] [Indexed: 11/16/2022] Open
Abstract
There are more and more obese mothers with twin gestations. For a long time before, the responses of lymphocytes and platelets in obese women can cause a low-grade inflammation. In addition, a proper control of gestational weight gain would improve the outcomes in mothers with high pre-gestational body mass index (BMI). In women with high pre-gestational BMI and twin pregnancy, our aims were to explore the biochemical and hematological parameters and to study the rate of obstetric adverse outcomes. This was an observational and retrospective study conducted in the Hospital Universitario La Paz (Madrid, Spain). We included 20 twin pregnancies as the lean group (BMI = 18.5–24.9 kg/m2), homogeneous in the maternal age and ethnicity, and having parity with other 20 twin pregnancies as the obese group (BMI ≥ 30 kg/m2). The maternal data and maternal, fetal, obstetric, and neonatal complications were collected from the medical records. In the first and third trimester of pregnancy, the biochemical and hematological parameters of the blood were assayed. In this cohort, gestational weight gain was significantly lower in the obese than lean group. In the first trimester, the hemoglobin levels in obese women (12.1 ± 0.8 g/dL) were lower than lean women (12.6 ± 0.7 g/dL; p-Value = 0.048). In addition, the tendency of glucose levels, TSH levels and platelets was to increase in obese compared to lean women. In the third trimester, the TSH levels were higher in obese (3.30 ± 1.60 mUI/L) than lean women (1.70 ± 1.00 mUI/L; p-Value = 0.009). Furthermore, there was a tendency for levels of platelets and lymphocytes to increase in obese compared to lean women. No significant differences were detected in the rate of maternal, fetal, obstetrical, and neonatal complications between the groups. The hemoglobin, platelets, lymphocytes and TSH levels need further investigation to understand potential subclinical inflammation in obese women. Furthermore, obese women with twin pregnancies should follow-up with a specialist nutritionist, to help them control their gestational weight gain with appropriate dietary measures.
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Andersen BR, Ammitzbøll I, Hinrich J, Lehmann S, Ringsted CV, Løkkegaard ECL, Tolsgaard MG. Using machine learning to identify quality-of-care predictors for emergency caesarean sections: a retrospective cohort study. BMJ Open 2022; 12:e049046. [PMID: 35256439 PMCID: PMC8905885 DOI: 10.1136/bmjopen-2021-049046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
OBJECTIVES Emergency caesarean sections (ECS) are time-sensitive procedures. Multiple factors may affect team efficiency but their relative importance remains unknown. This study aimed to identify the most important predictors contributing to quality of care during ECS in terms of the arrival-to-delivery interval. DESIGN A retrospective cohort study. ECS were classified by urgency using emergency categories one/two and three (delivery within 30 and 60 min). In total, 92 predictor variables were included in the analysis and grouped as follows: 'Maternal objective', 'Maternal psychological', 'Fetal factors', 'ECS Indication', 'Emergency category', 'Type of anaesthesia', 'Team member qualifications and experience' and 'Procedural'. Data was analysed with a linear regression model using elastic net regularisation and jackknife technique to improve generalisability. The relative influence of the predictors, percentage significant predictor weight (PSPW) was calculated for each predictor to visualise the main determinants of arrival-to-delivery interval. SETTING AND PARTICIPANTS Patient records for mothers undergoing ECS between 2010 and 2017, Nordsjællands Hospital, Capital Region of Denmark. PRIMARY OUTCOME MEASURES Arrival-to-delivery interval during ECS. RESULTS Data was obtained from 2409 patient records for women undergoing ECS. The group of predictors representing 'Team member qualifications and experience' was the most important predictor of arrival-to-delivery interval in all ECS emergency categories (PSPW 25.9% for ECS category one/two; PSPW 35.5% for ECS category three). In ECS category one/two the 'Indication for ECS' was the second most important predictor group (PSPW 24.9%). In ECS category three, the second most important predictor group was 'Maternal objective predictors' (PSPW 24.2%). CONCLUSION This study provides empirical evidence for the importance of team member qualifications and experience relative to other predictors of arrival-to-delivery during ECS. Machine learning provides a promising method for expanding our current knowledge about the relative importance of different factors in predicting outcomes of complex obstetric events.
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Affiliation(s)
- Betina Ristorp Andersen
- Department of Gynecology and Obstetrics, Nordsjællands Hospital & Department of Clinical Medicine, University of Copenhagen, Hillerod, Capital Region, Denmark
| | - Ida Ammitzbøll
- Department of Gynecology and Obstetrics, Nordsjællands Hospital & Department of Clinical Medicine, University of Copenhagen, Hillerod, Capital Region, Denmark
| | - Jesper Hinrich
- Cognitive Systems, Department of Applied Mathematics and Computer Science, Technical University of Denmark, Lyngby, Denmark
| | - Sune Lehmann
- Cognitive Systems, Department of Applied Mathematics and Computer Science, Technical University of Denmark, Lyngby, Denmark
| | | | - Ellen Christine Leth Løkkegaard
- Department of Gynecology and Obstetrics, Nordsjællands Hospital & Department of Clinical Medicine, University of Copenhagen, Hillerod, Capital Region, Denmark
| | - Martin G Tolsgaard
- Copenhagen Academy of Medical Education and Simulation, Rigshospitalet, Kobenhavn, Capital Region, Denmark
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Langley-Evans SC, Pearce J, Ellis S. Overweight, obesity and excessive weight gain in pregnancy as risk factors for adverse pregnancy outcomes: a narrative review. J Hum Nutr Diet 2022; 35:250-264. [PMID: 35239212 PMCID: PMC9311414 DOI: 10.1111/jhn.12999] [Citation(s) in RCA: 43] [Impact Index Per Article: 21.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2021] [Accepted: 02/22/2022] [Indexed: 12/01/2022]
Abstract
The global prevalence of overweight and obesity in pregnancy is rising and this represents a significant challenge for the management of pregnancy and delivery. Women who have a pre‐pregnancy body mass index greater than 25 kg m–2 are more likely than those with a body mass index in the ideal range (20–24.99 kg m–2) to have problems conceiving a child and are at greater risk of miscarriage and stillbirth. All pregnancy complications are more likely with overweight, obesity and excessive gestational weight gain, including those that pose a significant threat to the lives of mothers and babies. Labour complications arise more often when pregnancies are complicated by overweight and obesity. Pregnancy is a stage of life when women have greater openness to messages about their lifestyle and health. It is also a time when they come into greater contact with health professionals. Currently management of pregnancy weight gain and the impact of overweight tends to be poor, although a number of research studies have demonstrated that appropriate interventions based around dietary change can be effective in controlling weight gain and reducing the risk of pregnancy complications. The development of individualised and flexible plans for avoiding adverse outcomes of obesity in pregnancy will require investment in training of health professionals and better integration into normal antenatal care. Overweight and obesity before pregnancy and excessive gestational weight gain are major determinants of risk for pregnancy loss, gestational diabetes, hypertensive conditions, labour complications and maternal death. Pregnancy is regarded as a teachable moment when women are at their most receptive to messages about their health. However, unclear guidance on diet and physical activity, weight stigma from health professionals, inexperience and reluctance among professionals about raising issues about weight, and stretched resources put the health of women and babies at risk. Excessive weight gain in pregnancy and post‐partum weight retention compromise future fertility and increase risk for future pregnancies. Large randomised controlled trials have had little success in addressing excessive gestational weight gain or antenatal complications. Individualised, culturally sensitive and responsive interventions appear to have greater success.
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Affiliation(s)
- Simon C Langley-Evans
- School of Biosciences, University of Nottingham, Sutton Bonington, Loughborough, LE12 5RD, UK
| | - Jo Pearce
- Food & Nutrition Subject Group, Sheffield Hallam University, Sheffield, UK
| | - Sarah Ellis
- School of Biosciences, University of Nottingham, Sutton Bonington, Loughborough, LE12 5RD, UK
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Dupont C, Didon S, Ciangura C, Selleret L, Bachelot A, Lévy R, Sermondade N. Impact of Bariatric Surgery-Induced Weight Loss on Ovarian Reserve in Women with Obesity: A Systematic Review. Bariatr Surg Pract Patient Care 2021. [DOI: 10.1089/bari.2021.0030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Charlotte Dupont
- Service de Biologie de la Reproduction CECOS, Hôpital Tenon (AP-HP), Sorbonne-Université, Paris, France
- Sorbonne Université, Centre de Recherche Saint-Antoine, Paris, France
| | - Samia Didon
- Service de Biologie de la Reproduction CECOS, Hôpital Tenon (AP-HP), Sorbonne-Université, Paris, France
| | - Cécile Ciangura
- Service de Nutrition, Institute of Cardiometabolism and Nutrition, ICAN, Hôpital Pitié-Salpêtrière (AP-HP), Sorbonne Université, Paris, France
| | - Lise Selleret
- Service de Gynécologie, Obstétrique et Médecine de la Reproduction, Hôpital Tenon (AP-HP), Sorbonne-Université, Paris, France
| | - Anne Bachelot
- Service d'Endocrinologie et Médecine de la Reproduction, IE3M, Centre de Référence des Maladies Endocriniennes Rares de la Croissance et du Développement, Centre de Maladies Gynécologiques Rares, Institute of Cardiometabolism and Nutrition, ICAN, Hôpital Pitié-Salpêtrière (AP-HP), Sorbonne Université, Paris, France
| | - Rachel Lévy
- Service de Biologie de la Reproduction CECOS, Hôpital Tenon (AP-HP), Sorbonne-Université, Paris, France
- Sorbonne Université, Centre de Recherche Saint-Antoine, Paris, France
| | - Nathalie Sermondade
- Service de Biologie de la Reproduction CECOS, Hôpital Tenon (AP-HP), Sorbonne-Université, Paris, France
- Sorbonne Université, Centre de Recherche Saint-Antoine, Paris, France
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Otero-Naveiro A, Gómez-Fernández C, Álvarez-Fernández R, Pérez-López M, Paz-Fernández E. Maternal and fetal outcomes during pregnancy and puerperium in obese and overweight pregnant women. A cohort study. Arch Gynecol Obstet 2021; 304:1205-1212. [PMID: 33830346 DOI: 10.1007/s00404-021-06059-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2021] [Accepted: 03/30/2021] [Indexed: 02/04/2023]
Abstract
PURPOSE compare incidences of maternal-fetal complications during pregnancy, labor, and early puerperium according to baseline BMI in a consecutive cohort of pregnant women. METHODS This retrospective cohort study compares pregnancy outcome indicators by body mass index (BMI) in 1236 pregnant women managed over the period January 2017 to May 2018. Data were collected regarding the personal history (smoking, diabetes and hypertension), obstetrics and BMI (kg/m2) (normoweight 18.5-24.9, overweight 25-29.9, obese ≥ 30). RESULTS Of the 1236 women, 354 (28.6%) were overweight and 206 (16.7%) were obese at the start of pregnancy follow-up. Mean age at this time was 33 years (SD 6). Risk factors for a cesarean-section delivery assessed through logistic regression were maternal age (OR 1.05 95% CI 2.06-6.15; p < 0.001) and previous C-section (OR 4.21 95% CI 2.89-6.14; p < 0.001) regardless of BMI. In a propensity score analysis, pregnancy weight gain was found lower in obese vs normoweight (- 2.73 kg 95% CI - 3.74 to - 1.72 p < 0.001), and newborn weight higher in obese vs normoweight women (161.21 g 95% CI 57.94-264.48 p = 0.002). Labor duration and weight gain were reduced in overweight vs normoweight subjects (- 0.72 h 95% CI - 1.27 to - 0.17 p = 0.010 and 0.81 kg 95% CI - 1.50 to - 0.12 p = 0.021, respectively). CONCLUSIONS In this cohort, obese women showed higher rates of prenatal complications yet obesity and overweight were not related to worse puerperium outcomes.
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Affiliation(s)
- Ana Otero-Naveiro
- Department of Obstetrics and Gynecology, Hospital Universitario Lucus Augusti. C/Ulises, Romero nº1, 27003, Lugo, Spain.
| | - Cristina Gómez-Fernández
- Department of Obstetrics and Gynecology, Hospital Universitario Lucus Augusti. C/Ulises, Romero nº1, 27003, Lugo, Spain
| | - Rebeca Álvarez-Fernández
- Department of Obstetrics and Gynecology, Hospital Universitario Lucus Augusti. C/Ulises, Romero nº1, 27003, Lugo, Spain
| | - Marta Pérez-López
- Department of Obstetrics and Gynecology, Hospital Universitario Lucus Augusti. C/Ulises, Romero nº1, 27003, Lugo, Spain
| | - Eugenio Paz-Fernández
- Department of Obstetrics and Gynecology, Hospital Universitario Lucus Augusti. C/Ulises, Romero nº1, 27003, Lugo, Spain
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