Directed preconception health programs and interventions for improving pregnancy outcomes for women who are overweight or obese

Opray, Nicolle; Grivell, Rosalie M; Deussen, Andrea R; Dodd, Jodie M

doi:10.1002/14651858.cd010932.pub2

Cited by 55 publications

(31 citation statements)

References 41 publications

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“…Whether a more extensive GDM screening programme and a more stringent treatment regimen would reduce the risks of neonatal morbidity need to be further studied and explored. Further research is also needed into pre-pregnancy and antenatal interventions that will reduce the risk of adverse neonatal outcomes among overweight and obese women [35,36]. Improvements in uncommon, but serious outcomes such as stillbirth and perinatal mortality need research into interventions that both reduce the effects of hyperglycaemia and prevent/better manage overweight/obesity.…”

Section: Discussionmentioning

confidence: 99%

Gestational diabetes and adiposity are independent risk factors for perinatal outcomes: a population based cohort study in Sweden

et al. 2019

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Aims To evaluate the interaction effects of gestational diabetes ( GDM ) with obesity on perinatal outcomes. Methods A population‐based cohort study in Sweden excluding women without pre‐gestational diabetes with a singleton birth between 1998 and 2012. Logistic regression was performed to evaluate the potential independent associations of GDM and BMI with adverse perinatal outcomes as well as their interactions. Main outcome measures were malformations, stillbirths, perinatal mortality, low Apgar score, fetal distress, prematurity and Erb's palsy. Results Some 1,294,006 women were included, with a GDM prevalence of 1% ( n = 14,833). The rate of overweight/obesity was 67.7% in the GDM ‐group and 36.1% in the non‐ GDM ‐group. No significant interaction existed. Offspring of women with GDM had significantly increased risk of malformations, adjusted odds ratio ( aOR ) 1.16 (95% confidence intervals 1.06–1.26), prematurity, aOR 1.86 (1.76–1. 98), low Apgar score, aOR 1.36 (1.10–1.70), fetal distress, aOR 1.09 (1.02–1.16) and Erb's palsy aOR 2.26 (1.79–2.86). No risk for stillbirth or perinatal mortality was seen. Offspring of overweight ( BMI 25–29.9 kg/m 2 ), obese ( BMI 30–34.9 kg/m 2 ) and severely obese women ( BMI ≥ 35.0 kg/m 2 ) had significantly increased risks of all outcomes including stillbirth 1.51 (1.40–1.62) to 2.85 (2.52–3.22) and perinatal mortality 1.49 (1.40–1.59) to 2.83 (2.54–3.15). Conclusions There is no interaction effect between GDM and BMI for the studied outcomes. Higher BMI and GDM are major independent risk factors for most serious adverse perinatal outcomes. More effective pre‐pregnancy and antenatal interventions are required to prevent serious adverse pregnancy outcomes among women with either GDM or high BMI .

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Section: Discussionmentioning

confidence: 99%

Gestational diabetes and adiposity are independent risk factors for perinatal outcomes: a population based cohort study in Sweden

et al. 2019

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“…A few years ago, there was a lack of structured studies, but with growing numbers of bariatric procedures, more and more studies were started, such as the multicenter prospective cohort Aurora study [61,86,87].…”

Section: Pregnancy and Breastfeedingmentioning

confidence: 99%

Review: Sex-Specific Aspects in the Bariatric Treatment of Severely Obese Women

Jäger

Wolicki

Spohnholz

et al. 2020

IJERPH

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This systematic literature review aims to point out sex-specific special features that are important in the bariatric treatment of women suffering from severe obesity. A systematic literature search was carried out according to Cochrane and Preferred Reporting Items for Systematic review and Meta-Analysis Protocols (PRISMA-P) guidelines. After the literature selection, the following categories were determined: sexuality and sexual function; contraception; fertility; sex hormones and polycystic ovary syndrome; menopause and osteoporosis; pregnancy and breastfeeding; pelvic floor disorders and urinary incontinence; female-specific cancer; and metabolism, outcome, and quality of life. For each category, the current status of research is illuminated and implications for bariatric treatment are determined. A summary that includes key messages is given for each subsection. An overall result of this paper is an understanding that sex-specific risks that follow or result from bariatric surgery should be considered more in aftercare. In order to increase the evidence, further research focusing on sex-specific differences in the outcome of bariatric surgery and promising treatment approaches to female-specific diseases is needed. Nevertheless, bariatric surgery shows good potential in the treatment of sex-specific aspects for severely obese women that goes far beyond mere weight loss and reduction of metabolic risks.

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“…Согласно Кокрановской базе данных, в 2015 г. был проведен обзор работ с целью оценки эффективности программ и мероприятий прегравидарной подготовки, направ-ленных на улучшение исходов беременности у женщин с избыточной массой тела и ожирением. Авторы обзора не обнаружили никаких рандомизированных контро-лируемых исследований, позволяющих оценить эф-фект программ прегравидарной подготовки, и пришли к выводу, что до тех пор, пока эффективность программ прегравидарной подготовки не будет установлена пато-генетически, никакие практические рекомендации не могут быть сделаны [27].…”

Section: влияние ожирения на репродукциюunclassified

Obesity, reproduction and oxidative stress

2017

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The prevalence of obesity and overweight is one of the most pressing problems nowadays. Obesity as a comorbid condition affects all body systems. Obesity has been reported to be a risk factor not only for cardiovascular diseases and oncopathology, but also for fertility problems, many obstetric and perinatal complications worsening the maternal and infant health. The balance between the oxidative and antioxidant system is one of the indicators of the state of human homeostasis. Today it is proved that obesity is associated with an increase in oxidative stress and a decrease in antioxidant protection. This review reveals a close relationship between obesity, oxidative stress and reproductive problems.

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Directed preconception health programs and interventions for improving pregnancy outcomes for women who are overweight or obese

Cited by 55 publications

References 41 publications

Gestational diabetes and adiposity are independent risk factors for perinatal outcomes: a population based cohort study in Sweden

Gestational diabetes and adiposity are independent risk factors for perinatal outcomes: a population based cohort study in Sweden

Review: Sex-Specific Aspects in the Bariatric Treatment of Severely Obese Women

Obesity, reproduction and oxidative stress

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