Obesity in Pregnancy: Implications for the Mother and Lifelong Health of the Child. A Consensus Statement

Poston, Lucilla; Harthoorn, Lucien F.; Beek, Eline M. van der

doi:10.1203/pdr.0b013e3182055ede

Cited by 258 publications

(228 citation statements)

References 62 publications

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“….Maternal obesity seems to be associated with short-term adverse maternal and fetal outcomes (1)(2)(3)(4)(5). It has also been suggested that maternal obesity is associated with long-term maternal and offspring consequences, such as postpartum weight retention, metabolic syndrome, and obesity in the offspring (1,3,6).…”

Section: Introductionmentioning

confidence: 99%

Risk factors and outcomes of maternal obesity and excessive weight gain during pregnancy

Gaillard

Durmuş

Hofman

et al. 2013

Obesity

418

359

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Objective: The prevalence of overweight and obesity among women of reproductive age is increasing. We aimed to determine risk factors and maternal, fetal and childhood consequences of maternal obesity and excessive gestational weight gain. Design and Methods: The study was embedded in a population-based prospective cohort study among 6959 mothers and their children. The study was based in Rotterdam, The Netherlands (2001-2005. Results: Maternal lower educational level, lower household income, multiparity, and FTO risk allel were associated with an increased risk of maternal obesity, whereas maternal European ethnicity, nulliparity, higher total energy intake, and smoking during pregnancy were associated with an increased risk of excessive gestational weight gain (all p-values <0.05). As compared to normal weight, maternal obesity was associated with increased risks of gestational hypertension (OR 6.31 (95% CI 4.30, 9.26)), preeclampsia (OR (3.61, (95% CI 2.04, 6.39)), gestational diabetes (OR 6.28 (95%CI 3.01, 13.06)), caesarean delivery (OR 1.91 (95% CI 1.46, 2.50)), delivering large size for gestational age infants (OR 2.97 (95% CI 2.16, 4.08)), and childhood obesity (OR 5.02 (95% CI:2.97, 8.45)). Weaker associations of excessive gestational weight gain with maternal, fetal and childhood outcomes were observed, with the strongest effects for first trimester weight gain. Conclusions: Our study shows that maternal obesity and excessive weight gain during pregnancy are associated with socio-demographic, lifestyle, and genetic factors and with increased risks of adverse maternal, fetal and childhood outcomes. As compared to prepregnancy overweight and obesity, excessive gestational weight gain has a limited influence on adverse pregnancy outcomes.

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Section: Introductionmentioning

confidence: 99%

Risk factors and outcomes of maternal obesity and excessive weight gain during pregnancy

Gaillard

Durmuş

Hofman

et al. 2013

Obesity

418

359

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“…ECG signal quality was not correlated with BMI, while a correlation was found between CTG signal quality and BMI. This is particularly important because a distinct increase in maternal BMI has been noted in the past few decades [15]. The limitations of this study include the limited numbers of patients and the use of a CTG device from only a single manufacturer.…”

mentioning

confidence: 98%

Prenatal Foetal Non-invasive ECG instead of Doppler CTG - A Better Alternative?

Sänger

Hayes‐Gill

Schiermeier

et al. 2012

Geburtsh Frauenheilk

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Introduction !In the last 30 years cardiotocography (CTG) has become the most common method to monitor foetal health during birth [1,2].The benefits of electronic foetal monitoring are still discussed [3][4][5]. To solve the problem of high inter-and intra-observer variability [1,[6][7][8], guidelines and computer-assisted analysis pro- Abstract !Introduction: This study aimed to evaluate foetal signal quality obtained using an antenatal foetal ECG system (Monica 24™) and compare it with Doppler ultrasound CTG monitoring (Corometrics ® 250 series). Material and Methods: Seventy pregnant women (gestational age: between 20 + 0 weeks and 40 + 0 weeks) were examined using the Monica AN24™ system and also underwent Doppler CTG. The signal quality of both methods was compared and correlated with gestational age and pre-pregnancy body mass index (BMI). Results: Overall, ECG had a signal quality of 77.4 % and CTG had a signal quality of 73.1 % (p > 0.05). In gestational weeks (GW) 20-26, the signal quality of ECG was significantly better compared to that obtained with CTG (75.5 vs. 45.3 %; p = 0.003), while in GW 27-36, the signal quality was better with CTG (72.3 vs. 83.0 %, p = 0.001). No difference in signal quality was found between the two methods after the 37th GW (87.7 vs. 86.1 %; p > 0.05). CTG showed a statistically significant correlation with BMI (rho 0.25, p < 0.05) while ECG showed no such correlation. Conclusion: The use of non-invasive ECG is particularly indicated in the early weeks of pregnancy, while CTG offers superior results during the vernix period. There was no difference in signal quality after the vernix period. The signal quality with ECG was found to be independent of BMI, while the signal quality of CTG deteriorated with increasing BMI. A recently licensed non-invasive ECG system which monitors foetal heart rate while simultaneously monitoring maternal heart rate could be useful in this context. This method would allow episodes in which the maternal heart rate is mistaken for the foetal heart rate to be identified. Alternatively, there are also CTG devices available which are used to monitor twin pregnancies. They give an acoustic warning signal when the heart rates of the twins coincide. It would be theoretically possible to use such a twin CTG device so that maternal and foetal heart rates could be recorded simultaneously, with a warning signal appearing when the heart rates coincide. Other proposals include the use of pulse oximetry or more frequent monitoring of the maternal pulse rate by the midwife as well as more attention to be focused on capturing the "typical" acoustic sounds of the foetal heart. This study aimed to investigate which monitoring method offers a better foetal signal quality in gestational weeks 20 + 0 to 40 + 0 before carrying out a larger study which will analyse the risk of misidentifying the foetal heart rate. Zusammenfassung Material and Methods !The Monica AN24™ system is a small, portable, battery-operated, electrophysiological monitoring system which detects fo...

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“…Infants born to overweight and obese women are more likely to suffer fetal macrosomia and shoulder dystocia (22,23,26,27) .…”

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confidence: 99%

Nutrition in Colombian pregnant women

Sarmiento

Ramírez

Kutschbach³

et al. 2012

Public Health Nutr.

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Objective: The present study aimed to evaluate the nutritional status of pregnant women in Colombia and the associations between gestational BMI and sociodemographic and gestational characteristics. Design: Cross-sectional study. A secondary analysis was made of data from the 2005 Demographic and Health Survey of Colombia. Setting: Bogotá, Colombia. Subjects: Pregnant adolescents aged 13-19 years (n 430) and pregnant women aged 20-49 years (n 1272). Results: The gestational BMI and sociodemographic characteristics of the adolescents differed from those of the pregnant adult women. Thirty-one per cent of the adolescents were underweight for gestational age, compared with 14?5 % of the adult women. Eighteen per cent of adolescents were overweight for gestational age, in contrast to 37?3 % of adult women. The overall prevalence of anaemia was 44?7 % and the prevalence of low serum ferritin was 38?8 %. Women within the high quintiles of the wealth index (prevalence odds ratio (POR) 5 0?56; 95 % CI 0?34, 0?91, P , 0?02) had lower odds of being underweight. Women who received prenatal care (POR 5 2?17; 95 % CI 1?48, 3?09, P , 0?001) and were multiparous (POR 5 2?10; 95 % CI 1?43, 3?15, P , 0?0 0 1) had higher odds of being overweight. Women in extended families (POR 5 0?63; 95 % CI 0?50, 0?95, P , 0?025) had lower odds of being overweight. Conclusions: Underweight in pregnant adolescents and overweight in adult women coexist as a double burden in Colombia. Factors associated with malnutrition among pregnant women and adolescents should be considered for future interventions in countries experiencing nutritional transition.

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Obesity in Pregnancy: Implications for the Mother and Lifelong Health of the Child. A Consensus Statement

Cited by 258 publications

References 62 publications

Risk factors and outcomes of maternal obesity and excessive weight gain during pregnancy

Risk factors and outcomes of maternal obesity and excessive weight gain during pregnancy

Prenatal Foetal Non-invasive ECG instead of Doppler CTG - A Better Alternative?

Nutrition in Colombian pregnant women

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