The effects of morbid obesity on maternal and neonatal health outcomes: a systematic review and meta‐analyses

Lutsiv, Olha; Mah, Jordan; Beyene, Joseph; McDonald, Sarah D.

doi:10.1111/obr.12283

Cited by 91 publications

(81 citation statements)

References 94 publications

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“…Weight loss alone has been proven to be an effective intervention in improving the reproductive capacity of women with a raised BMI with unexplained infertility. Furthermore, obese patients have been found to be at increased risk of antenatal complications such as pre-eclampsia and gestational diabetes [36].…”

Section: Discussionmentioning

confidence: 99%

The Impact of Body Mass Index on Assisted Reproductive Treatments

Supramaniam¹,

Mittal²,

Lim³

2017

OJOG

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Multiparity amongst women with a body mass index (BMI) ≥ 30 Kg/m 2 is a common occurrence despite there being a known clear association with a decline in fecundity in women who are overweight or obese. These women, also pose further concerns, as they are at increased risk of antenatal complications such as preeclampsia and gestational diabetes. Over the years, a number of different modalities of fertility treatments have been tried and tested in this cohort of women to find the optimal treatment to improve their reproductive capacity. There has been an exponential increase in knowledge and understanding towards managing patients with a raised BMI, particularly through assisted reproductive treatments. Although the efficacies of various forms of fertility treatments have been shown to be affected by a rise in BMI, there is yet to be a definitive understanding as to the optimal management of these patients. The literature supports weight loss alone as an effective intervention in improving the reproductive capacity of women with a raised BMI with unexplained infertility. Furthermore, if live birth rate is taken as the desired outcome measure, then ovarian drilling and in vitro fertilisation (IVF) treatment have been shown to yield the best results in overweight and obese patients when comparisons are drawn to other interventions such as natural conception and treatment with clomiphene citrate.

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Section: Discussionmentioning

confidence: 99%

The Impact of Body Mass Index on Assisted Reproductive Treatments

Supramaniam¹,

Mittal²,

Lim³

2017

OJOG

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“…There are significantly increased associations with adverse outcomes for women and babies including congenital anomalies, perinatal mortality, macrosomia, gestational diabetes, maternal infections and preterm birth (Heslehurst et al, 2008;Stothard et al, 2009;Tennant et al, 2011;Lutsiv et al, 2015). In the UK, there are clinical guidelines to detect and manage co-morbidities associated with obesity (e.g.…”

Section: Introductionmentioning

confidence: 99%

Lived experiences of routine antenatal dietetic services among women with obesity: A qualitative phenomenological study

et al. 2017

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Objective: To understand the lived experiences and views of being referred to an antenatal dietetic service from the perspective of pregnant women with obesity.Design: A qualitative, interpretive approach using one-to-one in-depth interviews to explore the lived experience of pregnant women with obesity following referral to an antenatal dietetics service. Thematic content analysis was carried out by two researchers independently to develop data-driven themes.Setting: One NHS Trust maternity and dietetic services, North East England, UK Participants: Fifteen pregnant women with a booking body mass index ≥30kg/m 2 attending an obesity-specific antenatal dietetic service. All women were White, parity between 0-2, and BMI range 30-51kg/m 2 .Findings: Four themes were identified within this concept. 1) Women's overall experience of the service: experiences were predominately positive with only two negative cases identified.2) Process of referral: women placed importance on informative and in-person communication about the service, with health professionals, at the point of referral. 3) 2 Delivery of the service: dietitians were considered to be the experts and women wanted more frequent contact. 4) Content of the service: tailored advice enabled behaviour change, and women desired increased physical activity support and weight monitoring.Key conclusions: Women reported an overall positive experience and thought that dietitians were the expert health professionals to support them. Women in this study felt that tailoring advice specific to their personal circumstances helped them implement changes, and had a strong interest in the nutritional benefits for fetal development. Women considered weight monitoring to be a positive element of the service; however, further research is required given the limited and conflicting evidence-base.Implications for practice: It is important to incorporate women's experiences in the development and delivery of antenatal weight management services to facilitate personcentred care. Communication by health professionals at the point of referral is particularly important to provide accurate expectations of services and to reduce anxieties. Dietitians are considered to be appropriate experts to deliver these services, although they may need additional support to address women's physical activity needs in pregnancy.Keywords obesity, body mass index, dietetic, qualitative, experience, pregnancy IntroductionMaternal obesity (body mass index (BMI) ≥30kg/m 2 ) is increasing in prevalence internationally (Brynhildsen et al., 2006;Ray et al., 2007;Heslehurst et al., 2010;Fisher et al., 2013) and is associated with complex inequalities, including deprivation and ethnic minority groups (Heslehurst et al., 2010(Heslehurst et al., , 2012. There are significantly increased associations with adverse outcomes for women and babies including congenital anomalies, perinatal mortality, macrosomia, gestational diabetes, maternal infections and preterm birth (Heslehurst et al., 2008;Stothard et al., 2009;Tenn...

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“…Частота преждевре-менных родов у пациенток с 3-й степенью ожирения выше, чем у пациенток с 1-й и 2-й степенью на 31% и 20% соответственно. Кроме того, выше частота дру-гих неблагоприятных исходов: преэклампсии, геста-ционного сахарного диабета, родоразрешения путем кесарева сечения, кровотечения, внутриутробной гибели плода и макросомии новорожденных [22]. На протяжении всей беременности и родов женщины с избыточной массой тела и ожирением подвергаются повышенному риску венозно-тромботических ослож-нений [23].…”

Section: влияние ожирения на репродукциюunclassified

“…Преждевременный разрыв плодных оболочек как предиктор преждевременных родов у пациенток с ожирением может быть ассоциирован с наличием хронического асептического воспаления вследствие высокого уровня циркулирующих в крови адипоки-нов и провоспалительных белков [25]. Дисфункция эндотелия, инсулинорезистентность, окислительный стресс, гипертриглицеридемия способствуют развитию гестационного сахарного диабета, гипертензивных рас-стройств и преэклампсии [22].…”

Section: влияние ожирения на репродукциюunclassified

“…Результаты многих обзоров подтверждают важность оптимизации ИМТ до бере-менности. Ранее было предложено, что у пациенток с бесплодием лечение следует отложить до тех пор, пока ИМТ не будет менее 35 кг/м 2 [22]. Сегодня есть данные, что даже незначительное снижение ИМТ уменьшает шанс неблагоприятных исходов.…”

Section: влияние ожирения на репродукциюunclassified

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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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The effects of morbid obesity on maternal and neonatal health outcomes: a systematic review and meta‐analyses

Cited by 91 publications

References 94 publications

The Impact of Body Mass Index on Assisted Reproductive Treatments

The Impact of Body Mass Index on Assisted Reproductive Treatments

Lived experiences of routine antenatal dietetic services among women with obesity: A qualitative phenomenological study

Obesity, reproduction and oxidative stress

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