Association Between Prepregnancy Body Mass Index and Severe Maternal Morbidity

Lisonkova, Sarka; Muraca, Giulia M.; Potts, Jayson; Liauw, Jessica; Chan, Wee‐Shian; Skoll, Amanda; Lim, Kenneth

doi:10.1001/jama.2017.16191

Cited by 156 publications

(87 citation statements)

References 30 publications

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“…hBAT activation capacity was reduced in obese subjects [12, 16]. Furthermore, it was demonstrated that the reduced ADRB3 expression in adipose tissue of obese rats [9, 10] increased after weight loss following Roux-en-Y gastric bypass surgery [25].…”

Section: Discussionmentioning

confidence: 99%

“…BMI was calculated as weight (kilograms) divided by height (meters) squared. Participants were divided into two subgroups according to BMI: normal-weight group (NW group; BMI < 25 kg/m 2 ) and overweight group (OW group; (25 ≤ BMI < 30 kg/m 2 ) [12]. This study was conducted in terms of Declaration of Helsinki and approved by the local Ethical and Research Committee of Jinan Central Hospital (Shandong, China).…”

Section: Methodsmentioning

confidence: 99%

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Adipocyte ADRB3 Down-Regulated in Chinese Overweight Individuals Adipocyte ADRB3 in Overweight

et al. 2018

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Objectives: Activation of β3-adrenoceptor (ADRB3) is essential in the process of human adipose tissue browning, but obese subjects suffered from reduced ability of brown adipose tissue activation. The present study aims to detect the adipocyte ADRB3 expression in overweight individuals and the relationship between adipocyte ADRB3 expression and adiposity in adults. Methods: Visceral adipose tissue samples were obtained from 85 subjects who underwent abdominal surgery. ADRB3 mRNA and protein expression levels in mature adipocytes and adipose tissue stromal vascular cells were examined by quantitative real-time PCR and Western blot assay, respectively. UCP-1mRNA expression levels in mature adipocytes were examined by quantitative real-time PCR. Results: The data revealed that ADRB3 mRNA (p = 0.021) and protein (p = 0.025) expression levels in mature adipocytes were significantly higher in the normal-weight than in the overweight group. Similar results were also found for ADRB3 mRNA (p = 0.041) and protein (p = 0.025) expressions of stromal vascular cells. An inverse correlation was verified between mature adipocyte ADRB3 mRNA expression and BMI (r = –0.362, p = 0.012). UCP-1 mRNA expression levels in mature adipocytes were higher in the normal-weight group compared with the overweight group (p = 0.045). Conclusion: Adipocyte ADRB3 expression levels were down-regulated before the onset of obesity, which indicated that the reduction of ADRB3 expression might be the cause of compromised adipose tissue browning and obesity rather than the result. Thus, the interference of the ADRB3 pathway in adipocytes may provide a potential treatment target for obesity.

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Adipocyte ADRB3 Down-Regulated in Chinese Overweight Individuals Adipocyte ADRB3 in Overweight

et al. 2018

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“…[ 11 ] A population-based retrospective cohort study over a 10-year period (2004–2013) in Washington State showed that there were statistically significant increases in risk of severe maternal morbidity among women with obesity. [ 12 ]…”

Section: Introductionmentioning

confidence: 99%

Prepregnancy obesity status and risks on pregnancy outcomes in Shanghai

et al. 2018

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Obesity in women of reproductive age is not only associated with numerous adverse maternal and fetal effects prenatally but also exerts a negative influence on female fertility. The aim of this study was to investigate the situation of prepregnant obesity in Shanghai and explore the impact of prepregnant obesity on gestational weight gain as well as other pregnancy outcomes. A prospective hospital-based pregnant women cohort was established in Shanghai since January 2015. All pregnant women who were registered and expected to deliver in this hospital were included in the cohort. Nearly one fourth of pregnant women in Shanghai were overweight/obese and the prevalence of overweight/obesity was more common among women with advancing age (P < .001). Women prepregnancy overweight/obesity was associated with 3.5-fold higher risk of excessive gestational weight gain (odds ratio, OR 3.58; 95% confidence interval, CI, 2.82–4.55; P < .001). Women prepregnancy BMI was statistically related to pregnancy outcomes as macrosomia (OR 2.24; 95% CI, 1.55–3.23; P < .001), cesarean delivery (OR 2.04; 95% CI, 1.60–2.62; P < .001), maternal complications (OR 1.53; 95% CI, 1.18–1.98; P < .001). Prepregnancy obesity is associated with a much higher risk of excessive gestational weight gain and pregnancy outcomes in Shanghai. Further interventions targeting maternal obesity, especially prepregnancy obesity are required.

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“…Compared to normal weigh women, obese women are also more likely to have a stillbirth (odds ratio 5.2, 95% CI 2.5-10.9) or perinatal death, particularly in later gestations (Hazard ratios (95% CI) for foetal death before week 14: 0.8 (0.5-1.4), weeks 14-19: 1.6 (1.0-2.5), weeks 20-27: 1.9 (1.1-3.3), weeks 28-36: 2.1 (1.0-4.4), weeks 37-39: 3.5 (1.9-6.4) and weeks 40+: 4.6 (1.6-13.4) (Nohr et al 2005). There is a dose-response relationship between maternal pre-pregnancy weight and severe maternal morbidity or mortality (Lisonkova et al 2017). The absolute increases in numbers of deaths or cases of serious morbidity per 10,000 women were 17.6 for overweight women, and 24.9, 35.8 and 61.1 for women with obesity classes 1, 2 and 3, respectively.…”

Section: Obesity and Maternal Health In Pregnancy And In The Longer Termmentioning

confidence: 98%

Obesity, fertility and pregnancy: can we intervene to improve outcomes?

Reynolds

Gordon

2018

Journal of Endocrinology

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Rates of obesity among women of reproductive age have risen dramatically in recent decades. Obesity impacts on health of women across their reproductive lifespan with adverse effects on not only fertility and short-term complications of pregnancy, but also on longer term health outcomes for both women and their children. This places considerable burden and cost on health services. Here, we review the evidence linking maternal obesity to adverse fertility, pregnancy and longer term health outcomes for women and their children. We discuss the outcomes of recent lifestyle, pharmacological and surgical intervention studies. As many of these studies have not shown a significant improvement in clinical outcomes, we discuss the need for better study design in future trials.

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Association Between Prepregnancy Body Mass Index and Severe Maternal Morbidity

Abstract: Among pregnant women in Washington State, low and high prepregnancy BMI, compared with normal BMI, were associated with a statistically significant but small absolute increase in severe maternal morbidity or mortality.

Cited by 156 publications

References 30 publications

Adipocyte ADRB3 Down-Regulated in Chinese Overweight Individuals Adipocyte ADRB3 in Overweight

Adipocyte ADRB3 Down-Regulated in Chinese Overweight Individuals Adipocyte ADRB3 in Overweight

Prepregnancy obesity status and risks on pregnancy outcomes in Shanghai

Obesity, fertility and pregnancy: can we intervene to improve outcomes?

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