Prepregnancy Body Mass Index and the Occurrence of Severe Hypertensive Disorders of Pregnancy

Bodnar, Lisa M.; Catov, Janet M.; Klebanoff, Mark A.; Ness, Roberta B.; Roberts, James M.

doi:10.1097/01.ede.0000254119.99660.e7

Cited by 224 publications

(182 citation statements)

References 35 publications

Supporting

Mentioning

155

Contrasting

Unclassified

Order By: Relevance

“…Health problems during pregnancy related to pregestational weight gain have been reported in the literature, especially hypertensive disorders of pregnancy and low birth weight [19][20] . These findings demonstrate the importance of monitoring weight gain during the prenatal period and the identification of pregnant women at nutritional risk.…”

Section: R E S U L T S a N D Discussionmentioning

confidence: 99%

Nutritional care during prenatal and postpartum periods: A report of experiences in a city on São Paulo's coast

Laporte-Pinfildi

Medeiros

2016

Rev. Nutr.

View full text Add to dashboard Cite

The purpose of this study is to present a report of the experiences of the adoption of the Approach to Nutritional Care during Prenatal and Postpartum Periods, resulting from a partnership between the university and the municipal primary health care system of Santos, SP, Brazil. This approach was developed through joint work plans based on the need to incorporate nutritional care into the prenatal and postpartum care. All stages of design and implementation and the results of this strategy were documented in a field diary. This approach was adopted in two basic health units between 2010 and 2014. The stages of this process were planned in conjunction with health care teams and consisted of putting together interdisciplinary groups for nutrition education during the prenatal period. Interdisciplinary educational group meetings were held focusing on listening to the needs of pregnant women, the provision of prenatal nutritional care, and on the project to monitor the nutritional status of newborns through home visits up to the 15 days of postpartum. The interdisciplinary activities strengthened the bond between the users and the health care team members, contributing to the provision of effective care and promoting integrality. Home visiting contributed to encourage exclusive breastfeeding.

show abstract

Section: R E S U L T S a N D Discussionmentioning

confidence: 99%

Nutritional care during prenatal and postpartum periods: A report of experiences in a city on São Paulo's coast

Laporte-Pinfildi

Medeiros

2016

Rev. Nutr.

View full text Add to dashboard Cite

show abstract

“…Estudos brasileiros com gestantes da rede básica de saúde Tabela 3. Análise ajustada do risco gestacional para hipertensão, diabetes, parto pré-termo, realização de cesárea e baixo peso ao nascer em relação ao ganho de peso na gestação em estudo de base populacional encontraram uma incidência de ganho ponderal excessivo de 29% e insuficiente de 36,5 a 38% 25,[27][28][29] .…”

Section: Discussionunclassified

Índice de massa corporal e ganho de peso gestacional como fatores preditores de complicações e do desfecho da gravidez

Gonçalves

Mendoza-Sassi

César

et al. 2012

Rev. Bras. Ginecol. Obstet.

View full text Add to dashboard Cite

ResumoOBJETIVO: Avaliar o impacto do índice de massa corporal (IMC) no início da gestação e do ganho de peso no desfecho gestacional, para que esta medida possa ser implantada e valorizada pelos serviços de saúde de pré-natal. MÉTODO: Estudo transversal de base populacional. Na pesquisa, foram incluídos todos os nascimentos ocorridos nas duas únicas maternidades do município do Rio Grande (RS), em 2007. Dentre as 2.557 puérperas entrevistadas, o cálculo do IMC só pôde ser realizado em 1.117 puérperas. A análise foi realizada no programa Stata 11. Nos desfechos hipertensão, diabetes mellitus, trabalho de parto prematuro e cesárea foi realizada regressão logística. No caso do peso ao nascer, o ajuste ocorreu pela regressão logística multinomial, tendo como categoria base o grupo de 2.500 a 4.000 g. Em todas as análises foi adotado valor p<0,05 de um teste bicaudal. RESULTADOS: Não foi observado aumento do risco de hipertensão e diabetes nas pacientes dos diferentes grupos de IMC e ganho de peso. O risco de parto pré-termo foi evidenciado no grupo com ganho de peso ≤8 kg (p<0,05). Em relação à via de parto, observa-se uma tendência, quanto maiores o IMC no início da gestação e o ganho de peso durante a gestação, maior o risco de parto cirúrgico, chegando 11% no grupo de obesas (p=0,004) e a 12% no grupo com ganho ≥17 kg (p=0,001). O peso do recém-nascido foi influenciado pelo IMC e pelo ganho de peso, sendo que quanto maiores o IMC no início da gestação e o ganho de peso gestacional, maior o risco de macrossomia. CONCLUSÕES: O monitoramento do IMC e o ganho ponderal durante a gestação é procedimento de baixo custo e de grande utilidade para o estabelecimento de intervenções nutricionais visando à redução de riscos maternos e fetais. Abstract PURPOSE:To evaluate the impact of body mass index (BMI) at the beginning of pregnancy and weight gain on pregnancy outcome so that this measure can be implemented and valued by prenatal care health services. METHOD: Crosssectional population-based study of all births in the only two hospitals in Rio Grande city (Brazil), in 2007. Among the 2,557 mothers interviewed, it was possible to calculate BMI in only 1,117. The Stata 11 software was used for data analysis. Logist regression was applied to the outomes involving diabetes mellitus, premature labor and cesarean section. Regarding birth weight, data were adjusted by multinomial logistic regression using as base category the group of 2,500 to 4,000 g. The level of significance was set at p-value <0.05 in a two-tailed test. RESULTS: There was no increased risk of hypertension or diabetes in patients in the different groups of BMI and weight gain. The risk of preterm delivery was evident in the group with a weight gain ≤8 kg (p<0.05). Regarding the route of delivery, it was observed that the higher the BMI in early pregnancy (p=0.001) and the greater the weight gain during pregnancy (p=0.004), the greater the risk of surgical delivery, which reached 11% in the group of obese mothers (p=0.004) and 12% in the group with a weight ga...

show abstract

“…Matching for BMI was within 2 kg/m 2 and nulliparous or multiparous for parity. The rationale for the matching was that high and low maternal age, nulliparity, and high BMI are risk factors for PE [48][49][50][51][52][53][54][55][56].…”

Section: Methodsmentioning

confidence: 99%

The change in concentrations of angiogenic and anti-angiogenic factors in maternal plasma between the first and second trimesters in risk assessment for the subsequent development of preeclampsia and small-for-gestational age

Erez

Romero

Espinoza

et al. 2008

The Journal of Maternal-Fetal & Neonatal Medicine

273

233

View full text Add to dashboard Cite

The change in concentrations of angiogenic and anti-angiogenic factors in maternal plasma between the first and second trimesters in risk assessment for the subsequent development of preeclampsia and small-for-gestational age, The Journal of Maternal-Fetal & Neonatal Medicine, 21:5, 279-287, DOI: 10.1080 AbstractIntroduction. An imbalance between angiogenic and anti-angiogenic factors has been proposed as central to the pathophysiology of preeclampsia (PE). Indeed, patients with PE and those delivering small-for-gestational age (SGA) neonates have higher plasma concentrations of soluble vascular endothelial growth factor receptor-1 (sVEGFR-1) and the soluble form of endoglin (s-Eng), as well as lower plasma concentrations of vascular endothelial growth factor (VEGF) and placental growth factor (PlGF) than do patients with normal pregnancies. Of note, this imbalance has been observed before the clinical presentation of PE or the delivery of an SGA neonate. The objective of this study was to determine if changes in the profile of angiogenic and anti-angiogenic factors in maternal plasma between the first and second trimesters are associated with a high risk for the subsequent development of PE and/or delivery of an SGA neonate. Methods. This longitudinal case-control study included 402 singleton pregnancies in the following groups: (1) normal pregnancies with appropriate for gestational age (AGA) neonates (n ¼ 201); (2) patients who delivered an SGA neonate (n ¼ 145); and (3) patients who developed PE (n ¼ 56). Maternal plasma samples were obtained at the time of each prenatal visit, scheduled at 4-week intervals from the first or early second trimester until delivery. In this study, we included two samples per patient: (1) first sample obtained between 6 and 15 weeks of gestation ('first trimester' sample), and (2) second sample obtained between 20 and 25 weeks of gestation ('second trimester' sample). Plasma concentrations of s-Eng, sVEGFR-1, and PlGF were determined by specific and sensitive immunoassays. Changes in the maternal plasma concentrations of these angiogenesis-related factors were compared among normal patients and those destined to develop PE or deliver an SGA neonate while adjusting for maternal age, nulliparity, and body mass index. General linear models and polytomous logistic regression models were used to relate the analyte concentrations, ratios, and product to the subsequent development of PE and SGA. Results.(1) An increase in the maternal plasma concentration of s-Eng between the first and second trimesters conferred risk for the development of preterm PE and SGA (OR 14.9, 95% CI 4.9-45.0 and OR 2.9, 95% CI 1.5-5.6, respectively).(2) An increase in the maternal plasma concentration of sVEGFR-1 between the first and second trimester conferred risk for the development of preterm PE (OR 3.9, 95% CI 1.2-12.6). (3) A subnormal increase in maternal plasma PlGF concentration between the first and the second trimester was a risk factor for the subsequent development of preterm and term PE (OR 4....

show abstract

Prepregnancy Body Mass Index and the Occurrence of Severe Hypertensive Disorders of Pregnancy

Abstract: Incidence of both mild and severe hypertensive disorders of pregnancy rises with increasing BMI. Escalating obesity rates may increase pregnancy hypertensive disorders and ensuing perinatal morbidity.

Cited by 224 publications

References 35 publications

Nutritional care during prenatal and postpartum periods: A report of experiences in a city on São Paulo's coast

Nutritional care during prenatal and postpartum periods: A report of experiences in a city on São Paulo's coast

Índice de massa corporal e ganho de peso gestacional como fatores preditores de complicações e do desfecho da gravidez

The change in concentrations of angiogenic and anti-angiogenic factors in maternal plasma between the first and second trimesters in risk assessment for the subsequent development of preeclampsia and small-for-gestational age

Contact Info

Product

Resources

About