Maternal abdominal subcutaneous fat thickness as a predictor for adverse pregnancy outcome: a longitudinal cohort study

Abstract

Objective To assess maternal abdominal subcutaneous fat thickness (SFT) measured by ultrasound as an independent predictor of adverse pregnancy outcomes.Design A prospective longitudinal cohort study performed on pregnancies delivered between 2012 and 2014.Setting Sydney, Australia.Population About 1510 pregnant women attending routine obstetric ultrasounds.Methods Maternal SFT was measured on routine ultrasounds at 11-14 weeks' gestation (SFT1) and 18-22 weeks' gestation (SFT2). SFT measurements were assessed for estimating risks for obesityrelated pregnancy outcomes using logistic regression modelling adjusted for maternal age, parity, smoking status and body mass index (BMI).Main outcome measures Hypertensive disease, gestational diabetes, caesarean section, low birthweight, preterm delivery, neonatal respiratory distress, Apgar scores, and admission to a neonatal intensive care unit.Results SFT1 and SFT2 were measured on 1461 and 1363 women, respectively. Mean thickness (range) were 21.2 mm (6.9-73.9) for SFT1 and 20.3 mm (7.5-68.0) for SFT2. Complete outcome data were available for 1385 pregnancies. In all, 54% of the women were overweight/obese. The SFT measures decreased from early to mid-pregnancy in overweight/obese women. There was moderate correlation between BMI and SFT1 (R 2 = 0.56) and BMI and SFT2 (R 2 = 0.55). In a multivariate model, SFT1 and SFT2 were better predictors for adverse pregnancy outcomes than BMI.Conclusion Maternal SFT is a significant independent predictor of adverse pregnancy outcomes. Incorporation of SFT into future models for adverse pregnancy outcome may prove valuable.

The mutual effect of pre-pregnancy body mass index, waist circumference and gestational weight gain on obesity-related adverse pregnancy outcomes: A birth cohort study

“…In our cohort of 919 pregnant women, the prevalence of pre-pregnancy overweight/obesity was 15.5%, which is a bit higher than the previously reported prevalence in Chinese women (10.4%) and Korean women (9.4%), mainly because the BMI categories they used were WHO classification criteria, while we used Chinese adult BMI classification criteria that were lower than the former for overweight and obese [11,20]. However, the prevalence of pre-pregnancy overweight/obesity in our cohort is significantly lower than the prevalence in a Ghanaian cohort study (48.2%) and an Australian longitudinal cohort study (54.7%) [21–22]. 41.8% of pregnant women in this population were above the recommended GWG ranges by IOM guidelines(2009).…”

Interpregnancy weight change and adverse maternal outcomes: a retrospective cohort study

“…However, this should not over or underestimate our exposure of interest which is the difference in weight measurement between two consecutive pregnancies.. 25,26 Other than interpregnancy weight change, waist-to-hip ratio, waist circumference, and abdominal subcutaneous fat change might be better predictors of second pregnancy outcomes. 27 …”

Increased maternal abdominal subcutaneous fat thickness and body mass index are associated with increased cesarean delivery: A prospective cohort study

“…Greater maternal abdominal subcutaneous fat thickness has been shown to correlate with higher serum levels of hemoglobin A1C and C reactive protein in pregnant women . Recently, the utility of maternal abdominal subcutaneous fat thickness (SCFT) as a measure of abdominal obesity in pregnancy and as a predictor of pregnancy outcomes has been explored . Suresh et al retrospectively studied 1200 nulliparous women and found an ultrasound measurement of abdominal SCFT was better than BMI at predicting gestational diabetes, cesarean delivery and large‐for‐gestational‐age neonates.…”

“…Suresh et al retrospectively studied 1200 nulliparous women and found an ultrasound measurement of abdominal SCFT was better than BMI at predicting gestational diabetes, cesarean delivery and large‐for‐gestational‐age neonates. Authors of that group subsequently prospectively studied 1385 women and concluded that SCFT was a significant independent predictor of adverse pregnancy outcomes . These are the only published studies evaluating the relation between maternal abdominal SCFT and maternal and fetal outcomes.…”