4,993 research outputs found

    Reported prevalence of gestational diabetes in Scotland: the relationship with obesity, age, socioeconomic status, smoking and macrosomia, and how many are we missing?

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    Aims/Introduction: Gestational diabetes mellitus (GDM) is defined as ‘carbohydrate intolerance of varying degrees of severity with onset or first recognition during pregnancy,’ and is associated with increased fetal and maternal risks. The aims of the present study were to investigate the prevalence of GDM in Scotland over 32 years (1981–2012), and using the data from 2012, to assess how GDM related to maternal body mass index, maternal age, parity, smoking, Scottish Index of Multiple Deprivation, infant gender and macrosomia status. Materials and Methods: GDM prevalence along with anthropometric, obstetric and demographic data were collected on a total of 1,891,097 women with a delivery episode between 1 January 1981 and 31 December 2012 using data extracted from the Scottish Morbidity Record 02. Univariate and multivariate logistic regression analysis was undertaken to investigate their association with GDM. Results: A ninefold increase in GDM prevalence was observed from 1981 to 2012 (P < 0.001). GDM prevalence in 2012 was 1.9%. Maternal body mass index, age, parity status, Scottish index of multiple deprivation and fetal macrosomia were positively associated with GDM. Reported smoking status at booking was inversely associated with GDM. Multivariable analysis showed that fetal macrosomia was not associated with GDM status. Conclusions: The present study confirmed that the reporting of GDM is low in Scotland, and that GDM is associated with maternal body mass index, maternal age, multiparity and social deprivation. GDM was negatively associated with smoking and requires further investigation. The lack of association between GDM and macrosomia (following multivariate analysis) might reflect the screening processes undertaken in Scotland

    Maternal body mass index in outcome of pregnancy

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    Background: The increasing prevalence of obesity in young women is a major public health concern. These trends have a major impact on pregnancy outcomes in these women, which have been documented by several researchers. The objective of this study was to assess antenatal, intra-partum complications, perinatal outcome in pregnant women with high BMI.Methods: A total number of 100 cases were included in the study out of which, 50 cases were pregnant women with high BMI (> or = 30 kg/m2), 50 were pregnant women with normal BMI (20-24 kg/m2). Their pregnancy outcome were observed and compared. The outcome variables evaluated in study were rates of preeclampsia, gestational diabetes, cesarean delivery, failed induction, operative vaginal deliveries, birth weight, and postpartum infection.Results: Most of the patients that is, 60% of obese group and 68% of control group were between 20-25years, 28% of obese group and 8% of control group were between 31-35years. In our study most of the patients, 66% of obese group and 56% of control group were primiparas, whereas 34% of obese and 44% of normal group were multipara. There is a fourfold increase in the incidence of pre-eclampsia in the obese group compared to normal BMI group. Incidence of gestational diabetes is 2% in normal group compared to 8% in obese group that is fourfold increase in incidence in obese group. Pre-term labor is 8% among obese and 2% among control groups, a significant increase. Incidence of induction of labor is doubled in obese group, incidence being 20% in control group and 40% in obese group. Incidence of instrumental delivery is 14% in obese group and 6% in control group. 32% of obese group underwent cesarean section when compared to 12% of control group. The incidence of cesarean section is 3times higher in obese group. Macrosomia is the most common complication observed in the study, the incidence being 22% in obese group and 2% in control group. There is increase in incidence by eleven fold. Incidence of low APGAR score is increased by twofold.Conclusions: Maternal BMI shows strong associations with pregnancy complications and outcome. Both maternal and fetal complications are increased

    Effect of maternal body mass index on pregnancy outcomes

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    Background: BMI is widely accepted as a better measure of underweight or overweight than weight alone. The developing countries including India are facing a dual burden of undernutrition and obesity. Extremes of BMI in pregnancy have been associated with multiple complications affecting maternal and perinatal outcome. The objectives of the present study was to observe distribution of antenatal patients in underweight, normal, overweight and obese categories according to booking BMI and to examine the association of BMI with obstetric and perinatal outcomes in singleton pregnancies.Methods: This was an observational prospective study with a sample size of 610 patients carried out during the period Dec 2016 to Nov 2017 in Dr PDMMC, Amravati. The antenatal patients were categorized into four categories of BMI according to WHO classification and pregnancy outcomes were compared.Results: Depending on booking BMI, 73.8% patients enrolled in the study had normal booking BMI and 16.7%, 8.5% and 1% were underweight, overweight and obese respectively. Postdatism, preterm births, induction of labour, LSCS and prolonged hospital stay were commoner in overweight patients while IUGR, oligohydramnios and BOH were seen more in underweight group. Neonatal resuscitation and neonatal complications were common in both underweight and overweight patients as compared to normal BMI patients.Conclusions: Based on this study, we conclude that majority of antenatal patients being catered in our hospital have normal BMI. Adverse maternal and perinatal outcomes are seen more commonly with the extremes of BMI

    Maternal body mass index and feto-maternal outcome: a comparative study

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    Background: Increasing BMI in women poses multiple threat of illness especially in the reproductive age group impacting pregnancy. Pregnant women with overweight and obesity are at a higher risk of developing complications at all stages of the physiological pregnancy. A focus on the methods to prevent this trend of increasing weight gain in adolescence is essential curb the complications due to obesity.Methods: This prospective study was conducted in the Department of Obstetrics and Gynecology, Madras Medical College, Chennai. Written informed consent was obtained and pregnant women visiting the antenatal OP were registered. Detailed history taking and examination was carried out with the measurement of body mass index as weight in kg/height in meter square. The women were followed up for the antepartum, intrapartum, post-partum variables and neonatal outcome.Results: Two hundred pregnant women with high BMI >25 kg/m2 and two hundred pregnant women with normal BMI were selected and were followed prospectively.  Present study showed an increased incidence of pre-eclampsia in patients with high BMI (28% as compared to 8% of the normal BMI) and a higher incidence of Gestational diabetes mellitus among women with high BMI with a value of 27.5 % compared to a value of 7.5% in women with normal BMI. Caesarean delivery was found in 54.5% of the high BMI mothers compared to 31.5% in normal BMI mothers. Postoperatively, wound gaping was found with an incidence of 4.5% in high BMI mothers. IUGR was found in 10% of babies of women with high BMI and still birth occurred in 2.5% of deliveries of high BMI mothers compared to 0.5% in mothers of normal BMI group.Conclusions: The obstetrician needs to be well versed with dietary advice and life style pattern advice to the women of the reproductive age group in order to prevent the complications of high Body mass index in pregnancy. Its imperative to counsel these women about the pre-pregnancy loss of weight, healthy food and exercise, and healthy life style pattern during pregnancy in order to have a healthy outcome

    Maternal body mass index: how much it affects mother and baby

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    Background: Overweight, obesity, and morbid obesity in the mother are associated with adverse obstetrics well as neonatal outcome. Aim of this study was to assess the prevalence of overweight and obesity, and the impact of body mass index (BMI) on maternal and neonatal outcome.Methods: This is a retrospective study from January 2018 to September 2018 on 180 women with singleton term pregnancies. Maternal and neonatal outcomes at delivery were noted.Results: In present study, 3 (1.66%) pregnant women were underweight, 57 (31.66%) pregnant women had normal BMI, 71 (39.44%) pregnant women were overweight while 49 (27.22%) pregnant women were obese. Gestational weight gain was less than 8 kgs in 40 (22.22%) pregnant women, weight gain was 8-15.9 kgs in 132 (73.33%) pregnant women while weight gain was more than 16 kgs in 8 (4.44%) pregnant women. Out of 3 underweight women, 1 delivered by cesarean section and 2 had normal delivery, out of 57 women with normal BMI, 21 delivered by cesarean section and 36 had normal delivery, out of 71 overweight women, 47 delivered by cesarean section and 34 had normal delivery while out of 49 obese women, 38 delivered by cesarean section and 11 had normal delivery. PET and GDM was seen in 9 (7.5%) women each while macrosomia were seen in 5 (4.16%) women.Conclusions: Increased association was seen with maternal obesity and adverse outcome of pregnancy like PIH, GDM, cesarean section

    Maternal Body Mass Index influences Umbilical Artery Doppler Velocimetry in physiologic pregnancies.

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    OBJECTIVES: The aim of our study was to assess whether there is a relationship between maternal body mass index (BMI) and umbilical artery Doppler velocimetry in physiologic pregnancies. METHODS: Healthy pregnancy women, referred to our center at or before 32 weeks of gestation, were recruited. According to BMI, they were divided into underweight (BMI < 18.5), normal weight (BMI 18.5-24.9), overweight (BMI 25.0-29.9) and obese women (BMI ≥ 30). At 32(+0)  weeks of gestation, maternal BMI and umbilical artery Doppler velocimetry were recorded. A correlation between pulsatility index of umbilical artery and BMI was assessed by one-way ANOVA test, multiple comparison test (Bonferroni correction) and polynomial regression. RESULTS: One hundred eighty-five women were included. Mean pulsatility index of umbilical artery at 32(+0) was significantly higher in obese women (0.95 ± 0.01 vs 0.87 ± 0.01 vs 0.67 ± 0.01; p < 0.05). We found a positive correlation between Pulsatility Index of Umbilical Artery and maternal BMI (r(2)  = 0.7; p < 0.05). CONCLUSION: There is a positive correlation between BMI and pulsatility index of umbilical artery. These findings suggest that obesity has a negative effect on feto-placetal vessels. If our data will be confirmed, maternal BMI should be considered in evaluation of umbilical Doppler velocimetry

    Effect of maternal body mass index on pregnancy outcome and newborn weight

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    <p>Abstract</p> <p>Background</p> <p>Maternal obesity has been associated with adverse pregnancy outcomes, such as pre-eclampsia, eclampsia, pre- and post-term delivery, induction of labor, macrosomia, increased rate of caesarean section, and post-partum hemorrhage. The objective of this study was to determine the effect of maternal Body Mass Index (BMI) on pregnancy outcomes.</p> <p>Methods</p> <p>1000 pregnant women were enrolled in the study. In order to explore the relationship between maternal first trimester Body Mass Index and pregnancy outcomes, participants were categorized into five groups based on their first trimester Body Mass Index. The data were analyzed using Pearson Chi-square tests in SPSS 18. Differences were considered significant if p < 0.05.</p> <p>Results</p> <p>Women with an above-normal Body Mass Index had a higher incidence of pre-eclampsia, induction of labor, caesarean section, pre-term labor, and macrosomia than women with a normal Body Mass Index (controls). There was no significant difference in the incidence of post-term delivery between the control group and other groups.</p> <p>Conclusion</p> <p>Increased BMI increases the incidence of induction of labor, caesarean section, pre-term labor and macrosomia. The BMI of women in the first trimester of pregnancy is associated with the risk of adverse pregnancy outcome.</p

    The impact of maternal body mass index on maternal and perinatal outcome

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    Background: The incidence of obesity has increased to pandemic proportions over the last 20 years. Obesity is a chronic illness which is associated with metabolic disease, nutritional deficiency, musculoskeletal complications and carcinomas. The aim of the study was to evaluate and compare the maternal and perinatal outcome in patients with BMI 20-24.9 kg/m2 (normal), with BMI 25-29.9 kg/m2 (overweight) and with BMI >30 kg/m2 (obese).Methods: This cross-sectional study was conducted on 300 singleton pregnant women with gestational age>37 weeks with cephalic presentation. The selected women were categorized into three groups of 100 each according to their BMI: Category I included normal women (BMI 20-24.9 kg/m2), Category II included overweight women (BMI 25-29.9 kg/m2) and Category III included obese women (BMI >30 kg/m2).Results: There was increased incidence of antepartum complications in obese women. The difference in the occurrence of pre-eclampsia among the three categories was statistically significant (p=0.001). Similarly, more obese women had eclampsia (5%) and gestational diabetes mellitus (6%) as compared to overweight and normal women and the difference was statistically significant in both these complications (p=0.02 for each). The risk of induction of labour was highest in obese women and so was the incidence of caesarean and instrumental deliveries and the difference was statistically significant. The difference in the onset of labour as well as mode of delivery among the three categories was statistically significant (p4 kg) among babies of three BMI categories was statistically significant (p<0.05). The difference in the incidence of NICU admissions was statistically significant (p=0.02).Conclusions: Obesity is an independent risk factor for adverse pregnancy outcomes and hence preventable steps should be taken for reducing the maternal and perinatal morbidity and mortality

    Raised maternal body mass index and caesarean section

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    Phd ThesisIntroduction Maternal obesity (defined as a body mass index (BMI) ≥30kg/m2) and overweight (defined as BMI 25-29.9kg/m2) have adverse implications for both the mother and the baby, including an increased risk of caesarean section. The prevalence of caesarean section among the UK obstetric population has been increasing in recent years. Evidence suggests that caesarean section in obese women may carry a higher risk of postoperative complications, such as haemorrhage, wound infection and delayed healing. These complications may result in a longer length of stay in hospital after caesarean delivery. To date, UK evidence on the association between maternal BMI and caesarean section has been limited. Aim The overall aim of my PhD was to investigate the association between maternal BMI and caesarean section within the North East of England. Methods and Results My PhD consists of three phases: Phase one: a review of the available published literature that investigated the association between maternal BMI and caesarean section rate. The review found that most studies been carried out in the US with only six from the UK. The review highlighted the need for further research in the UK. Phase two: an investigation of the association between maternal early pregnancy BMI and caesarean section using an existing dataset of 42,362 deliveries in five hospitals in the North East of England. The objectives of this phase were; to identify the caesarean section rate among five hospitals in the North East of England; to describe the caesarean section rate by booking BMI; and to examine the independent impact of BMI on caesarean section, adjusting for potentially confounding variables including maternal age, gestational age, birth weight, ethnicity and socio-economic status in overweight and obese pregnant women compared to pregnant women with recommended BMI. In phase two, the overall caesarean section rate was 20.6%; 28.4% of obese and 21.9% of overweight women delivered by caesarean section, compared to 17.8% of women with recommended BMI. After adjusting for available confounding factors, the adjusted odds ratio (aOR) for caesarean section among obese women was 1.81 (95%CI: 1.67-1.97; p<0.0005) and 1.29 (95%CI: 1.20-1.39; p<0.0005) among overweight women compared to women with recommended BMI. Thus, there was an almost two-fold increased risk of delivery by caesarean section among women who were obese at the start of pregnancy and an increased risk for women who were overweight. Phase three: a case note review of 205 women with a singleton pregnancy in 2008, aged ≥16 years and delivered by caesarean section in a district general hospital in the North East of England. The study hypothesis was that overweight and obese pregnant women have more post-caesarean section complications than pregnant women with recommended BMI, resulting in a longer length of stay in hospital. The results of this study showed that from 205 cases (28% of all caesarean section deliveries in 2008), 86 (42.0%) were to women with recommended BMI, 54 (26.3%) to overweight and 65 (31.7%) to obese women. The median length of maternal stay in hospital was three days, with an inter quartile range (IQR) of 2-3. Twelve (18.5%) obese women stayed in hospital after caesarean section for four days compared to five (9.3%) overweight and eight (9.4%) women with recommended BMI, (p=0.44) but this was not significant. There were no significant differences in postoperative complications or length of stay in hospital between overweight and obese pregnant women compared to women with recommended BMI. Conclusion Overall, my study confirms that obese and overweight women in the North East of England are at increased risk of caesarean section. Among women delivered by caesarean section, however, there was no association between maternal BMI and post-operative complications or length of stay in hospital.Iraqi Ministry of Higher Education and Scientific Research

    Breast is best: Positive mealtime interactions in breastfeeding mothers from Israel and the United Kingdom

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    We examined mealtime interactions to assess whether they varied according to maternal body mass index, country and mode of feeding in 41 Israeli and UK mother–infant dyads. Feeding behaviours were coded using the Simple Feeding Element Scale. Significantly, more UK mothers breastfed during the filmed meal compared to Israeli mothers. Mealtime interactions did not vary according to maternal body mass index or country. Women who breastfed (as opposed to those who bottle fed or fed solids) provided fewer distractions during the meal, a more ideal feeding environment and fed more responsively
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