Incidence of obese parturients and the outcomes of their pregnancies: A nationwide register study in Finland

Kuitunen, Ilari; Huttunen, Tuomas T.; Ponkilainen, Ville; Kekki, Maiju

doi:10.1016/j.ejogrb.2022.05.006

Cited by 11 publications

(7 citation statements)

References 41 publications

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“…For example, women are older and the incidence of gestational diabetes and obesity has increased. [18][19][20] These changes can also be associated with the increased rate of FOC. According to the previous literature, other risk factors such challenging or complicated previous deliveries and maternal depression are not available in our data.…”

Section: Discussionmentioning

confidence: 99%

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Trends in the epidemiology of fear of childbirth and association with intended mode of delivery: A nationwide register‐based cohort study in Finland

Vaajala

Liukkonen

Kuitunen

et al. 2023

Acta Obstet Gynecol Scand

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Introduction Fear of childbirth (FOC) is a common obstetrical challenge that affects the health of women. The epidemiology of FOC has not been studied in Finland for the last decade. The aim of this study was to analyze the epidemiology and risk factors for FOC and to evaluate the association between FOC and the rate of elective cesarean section (CS) as an intended mode of delivery. Material and methods Data from the National Medical Birth Register were used to evaluate the epidemiology of FOC and to determine the main risk factors for FOC in Finland between 2004 and 2018. Nulliparous and multiparous women were analyzed separately. Logistic regression model was used to determine the main risk factors for FOC. Multivariable logistic regression model was used to assess the intended mode of delivery in those pregnancies with diagnosed maternal FOC. Adjusted odds ratios (aOR) with 95% confidence intervals (CIs) were calculated. Results A total of 1 million pregnancies were included. The annual rate of pregnancies with maternal FOC increased from 1.5% (CI: 1.4–1.6) in 2004 to 9.1% (CI: 8.7–9.3) in 2018 for all women. For nulliparous women, the rate increased from 1.1% (CI: 1.0–1.3) in 2004 to 7.1% (CI: 6.7–7.5) in 2018, and from 1.8% (CI: 1.7–2.0) in 2004 to 10.3% (10.0–10.7) in 2018 for multiparous women. The strongest risk factors for maternal FOC were higher maternal age and gestational diabetes. For multiparous women, the strongest risk factors were gestational diabetes and previous CS. The total odds for elective CS were notably higher among women with FOC (aOR 8.63, CI: 8.39–8.88). Conclusions The incidence of maternal FOC rose six‐fold during our study period. However, the numbers of elective CS among women with this diagnosis, which had earlier risen in parallel, leveled off in 2014.

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Section: Discussionmentioning

confidence: 99%

“…The overall health of women giving birth has changed during the last decade. For example, women are older and the incidence of gestational diabetes and obesity has increased 18–20 . These changes can also be associated with the increased rate of FOC.…”

Section: Discussionmentioning

confidence: 99%

Trends in the epidemiology of fear of childbirth and association with intended mode of delivery: A nationwide register‐based cohort study in Finland

Vaajala

Liukkonen

Kuitunen

et al. 2023

Acta Obstet Gynecol Scand

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“…The prevalence of pre-eclampsia in the female relatives did not differ from the controls, indicating that familial aggregation of pre-eclampsia does not explain the higher prevalence in sIA females. A slightly higher prevalence in daughters (9%) might originate from behavioral or methodological factors, as maternal obesity in Finland has increased rapidly [48], and the new guidelines for diagnosing pre-eclampsia were published in 2013 [29]. We identified seven families with both familial sIA disease and familial pre-eclampsia, fewer than initially expected.…”

Section: Discussionmentioning

confidence: 99%

Prevalence of pre‐eclampsia in 265 patients with an intracranial aneurysm, 393 female relatives versus a control cohort: A case–control study

Kotikoski,

Paavola,

Nurmonen

et al. 2023

Euro J of Neurology

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Background and objectivesThere is emerging evidence on the connection between pre‐eclampsia and saccular intracranial aneurysms (sIAs). Our aim was to study the prevalence of pre‐eclampsia in sIA patients, their female relatives, and matched controls, and to examine familial sIA disease and familial pre‐eclampsia in sIA patients' families.MethodsWe included all female sIA patients in the Kuopio Intracranial Aneurysm Patient and Family Database from 1995 to 2018. First, we identified the sIA patients, their female relatives, and matched population controls with the first birth in 1987 or later and studied the prevalence of pre‐eclampsia. Second, all female sIA patients and all female relatives were analyzed for familial sIA disease and familial pre‐eclampsia. Using the Finnish nationwide health registries, we obtained data on drug purchases, hospital diagnoses, and causes of death.ResultsIn total, 265 sIA patients, 57 daughters, 167 sisters, 169 nieces, and 546 matched controls had the first birth in 1987 or later. Among them, 29 (11%) sIA patients, 5 (9%) daughters, 10 (6%) sisters, 10 (6%) nieces, and 32 (6%) controls had pre‐eclampsia. Of all the 1895 female sIA patients and 12,141 female relatives, 68 sIA patients and 375 relatives had pre‐eclampsia, including 32 families with familial pre‐eclampsia.ConclusionsPre‐eclampsia was significantly more common in the sIA patients than in their matched controls. Familial sIA disease and familial pre‐eclampsia co‐occurred in seven families. Further studies of the mechanisms by which pre‐eclampsia could affect the walls of brain arteries and increase the rupture risk in sIA disease are indicated.

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“…In addition, as multiple pregnancies are associated with increased risk for gestational diabetes 23,24 and obesity is known to be one of the biggest risk factors for the development of gestational diabetes, 25 studies assessing the association among these factors are important in the prevention of adverse maternal and fetal outcomes. In addition, the rapidly increasing prevalence of obese parturients makes this an important research topic 11,26 …”

Section: Discussionmentioning

confidence: 99%

Obesity increases the odds of multiple pregnancies: A nationwide register‐based cohort study in Finland

Vaajala

Liukkonen

Kuitunen

et al. 2023

Intl J Gynecology & Obste

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The effects of overweight and obesity on the risk of multiple pregnancies have been studied. Multiple pregnancies are relatively rare, making the phenomenon challenging to study without proper data.Only a few studies have investigated the effects of a higher body mass index (BMI; calculated as weight in kilograms divided by the square of height in meters) on the risk of multiple pregnancies. A 2005 study that analyzed the US population found that women with a higher BMI had an increased risk of having twins. 1 The same study found that the risk of dizygous twins was higher, but the risk of homozygous twins was not increased. 1 Another study using a twin register in the Netherlands also found higher risk for multiple pregnancies in the obese population. 2 According to a large National

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Incidence of obese parturients and the outcomes of their pregnancies: A nationwide register study in Finland

Cited by 11 publications

References 41 publications

Trends in the epidemiology of fear of childbirth and association with intended mode of delivery: A nationwide register‐based cohort study in Finland

Trends in the epidemiology of fear of childbirth and association with intended mode of delivery: A nationwide register‐based cohort study in Finland

Prevalence of pre‐eclampsia in 265 patients with an intracranial aneurysm, 393 female relatives versus a control cohort: A case–control study

Obesity increases the odds of multiple pregnancies: A nationwide register‐based cohort study in Finland

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