scholarly journals Short term effects of maternal obesity on mother and fetus: a prospective study

Author(s):  
Amrutha R. Thota ◽  
Ambarisha Bhandiwad ◽  
Vineet Sakhireddy

Background: Obesity is such a common health care problem of female population that have major impact on pregnancy. The worldwide prevalence of obesity is more than doubled in between 1980 and 2015. The objectives of present study are to observe whether obese women have an increased risk of pregnancy related complications and adverse fetal outcome and also to compare pregnancy outcomes in different classes of BMI in obese group.Methods: A prospective observational study conducted in OBG department JSS Hospital, Mysore from November 2014 to July 2016. All pregnant women attending OPD and inpatients of antenatal wards were screened for pre-pregnancy BMI. Total number of singleton births were 5727 in our institution. Out of which 314 obese pregnant women were included in the study group, remaining 5413 non-obese pregnant mothers were taken as control group respectively. They are closely monitored in every antenatal visit for development of complications such as pre-eclampsia, gestational diabetes mellitus, increased rate of caesarean section and presence of macrosomia (B.wt >3.5kg).Results: In comparison to normal BMI pregnant women, obese mothers had an increased risk of gestational hypertension (16.9% versus 2.0%, OR-2.3) gestational diabetes mellitus (35.7% versus 3.1%, OR-2.84), preeclampsia (23.9% versus 5%,0R-1.64) cesarean sections (75.2% versus 65.4%), macrosomia (45.9% versus 22%, OR-1.64), it was also found that as BMI increases the incidence of these complications increase as seen in different classes of obese population.Conclusions: Pregnancy associated with obesity is considered as a high-risk pregnancy and obesity being a modifiable risk factor, educating women in early pregnancy and preconceptional counseling regarding harmful effects of obesity and information regarding appropriate gestational weight gain is essential. 

Author(s):  
Jenniferbritto John ◽  
Mary Mahendran

Background: Obesity in Indian women had increased from 10.6% to 14.8% in India. Mothers who are overweight or obese during pregnancy and childbirth cause significant antenatal, intrapartum, postpartum and also neonatal complications. The present study aimed to explore various maternal and fetal outcomes influenced by maternal obesity. The objective was to find the effect of obesity on maternal and perinatal outcome among obese pregnant women compared to those of normal weight.Methods: The study was conducted in antenatal women attending antenatal outpatient department of CSI rainy multispecialty hospital located in North Chennai of South India. Consecutive sampling method was followed to include 50 cases and 50 controls. Analysis was done with IBM SPSS v.21.0. Chi square test was applied to find difference between proportions. For comparison of means independent t-test and ANOVA was applied. Pearson's correlation was done to find association between maternal BMI and birth weight.Results: Sixteen (32%) cases developed gestational diabetes mellitus during their antenatal period and 19 (38%) developed gestational hypertension. 10% underwent in emergency caesarean section and in 28% cases elective caesarean section was done. The proportion of cases who developed ante partum complications including gestational diabetes mellitus, gestational hypertension and preeclampsia were higher than in control groups (p value = 0.03,0.00,0.004 respectively). The need for induction of labour and caesarean section was found to be higher in cases than in controls (p = 0.014,0.03 respectively). Increased NICU admissions for stabilization of the newborn among cases was higher than control group (p = 0.012).Conclusions: It was clearly evident from the present study that maternal obesity had adverse maternal and fetal outcomes. Maternal obesity was strongly associated with antenatal complications like gestational diabetes mellitus, gestational hypertension, preeclampsia and increase in need for induction of labour and operative interference.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Yan Wang ◽  
Biru Luo ◽  
Jie Xiang

Abstract Background The association between soy intake and adverse pregnancy outcomes remains unclear. The objectives of this study were to investigate the soy consumption of pregnant women in the second trimester and explore the prospective association between soy intake and the risk of adverse pregnancy outcomes. Methods Pregnant women between 13 and 24 weeks of gestation were recruited at a women’s and children’s hospital in southwest China from June to December 2019. Dietary intakes in the middle trimester were assessed by a semi-quantitative food frequency questionnaire. Participants were divided into the insufficient group (< 40 g/day) and the control group (≥40 g/day) according to daily soy consumption. Participants were followed up until delivery. Pregnancy outcomes including gestational diabetes mellitus (GDM), cesarean section, and macrosomia were obtained. Multiple logistic regression was used to analyze the association between soy intake and risk of adverse pregnancy outcomes. Sociodemographic information, histories of diseases, and duration of physical activities were obtained and used for covariate adjustments. Results A total of 224 participants were included in this study, of which identified 36 (16.1%) cases of GDM, and 120 (53.6%) cases of cesarean section. More than half (125, 55.8%) pregnant women consumed less soy than 40 g/day. Daily soy intake less than 40 g was associated with the increased risk of GDM (OR = 2.755 95%CI 1.230-6.174, P = 0.014) and cesarean section (OR = 1.792 95%CI 1.035-3.101, P = 0.037) without adjustment for confounders such as age, pre-pregnancy body mass index, parity, daily intake of vegetables, fruits, seafood and, nuts. After adjusting for these factors, daily soy intake of less than 40 g increased 2.116-fold risk of GDM (95%CI 1.228-7.907, P = 0.017), but not with the significantly increased risk of cesarean section. Conclusion Insufficient soy intake may increase the risk of GDM, suggesting adequate soy intake may have a beneficial role in the prevention of GDM. Trial registration Registration number: ChiCTR1900023721. Date of registration: June 9, 2019.


2020 ◽  
Vol 16 (8) ◽  
pp. 895-899 ◽  
Author(s):  
Shahin Safian ◽  
Farzaneh Esna-Ashari ◽  
Shiva Borzouei

Aims: Investigation thyroid dysfunction and autoimmunity in pregnant women with gestational diabetes mellitus. Background: This article was written to evaluate the thyroid function and anti-thyroid peroxidase (anti- TPO) antibodies in pregnant women with gestational diabetes mellitus (GDM). Method: A total of 252 women with GDM and 252 healthy pregnant women were enrolled. Thyroid tests, including TSH, FreeT3, Free T4, and anti-TPO were performed for all women at 24–28 weeks of gestation. Data analysis was then carried out using SPSS ver. 22. Result: There was a significant difference between the experimental group (38.4%) and the control group (14.06%) in terms of the prevalence of subclinical hypothyroidism (p= 0.016). The frequency of anti-TPO was higher in the experimental group than the control group and positive anti-TPO was observed in 18.6% of women with GDM and 10.3% of healthy pregnant women (P= 0.008). Conclusion: Thyroid disorders are observed in pregnant women with GDM more frequently than healthy individuals and it may be thus reasonable to perform thyroid tests routinely.


2017 ◽  
Vol 10 (3) ◽  
pp. 120-124 ◽  
Author(s):  
Margaret Bublitz ◽  
Suzanne De La Monte ◽  
Susan Martin ◽  
Lucia Larson ◽  
Ghada Bourjeily

Background Women with childhood maltreatment histories are at increased risk for adverse birth outcomes. Mechanisms explaining this link are poorly understood. Past research is limited by sampling pregnant women at low risk for adverse maternal and neonatal outcomes. Methods This pilot study was a secondary data analysis of 24 women with gestational diabetes mellitus; 17% of the sample also reported a maltreatment history. Women provided a blood sample to measure inflammatory cytokines and insulin resistance, and saliva samples to measure diurnal cortisol. Birth outcomes for past and current pregnancies were recorded. Results Histories of maltreatment were associated with elevated interleukin-15 and a marginally greater incidence of preterm delivery in current and past pregnancies. Conclusions This pilot study was the first to demonstrate an association between childhood maltreatment history and inflammatory cytokine levels in pregnant women diagnosed with gestational diabetes mellitus.


2021 ◽  
Vol 8 ◽  
Author(s):  
Wendy N. Phoswa

Purpose of the Review: The main objective of this study is to investigate mechanisms associated with gestational diabetes mellitus (GDM) and hypertensive disorders of pregnancy (HDP) in HIV infected pregnant women by looking how placental hormones such as (progesterone and prolactin) and basic haemostatic parameters are regulated in HIV infected pregnancies.Recent Findings: HIV/AIDS are a major global obstetric health burden that lead to increased rate of morbidity and mortality. HIV/AIDS has been associated with the pathophysiology of GDM and HDP. Increased risk of GDM due to highly active antiretroviral therapy (HAART) usage has been reported in HIV infected pregnancies, which causes insulin resistance in both pregnant and non-pregnant individuals. HAART is a medication used for lowering maternal antepartum viral load and pre-exposure and post-exposure prophylaxis of the infant. In pregnant women, HAART induces diabetogenic effect by causing dysregulation of placental hormones such as (progesterone and prolactin) and predispose HIV infected women to GDM. In addition to HIV/AIDS and GDM, Studies have indicated that HIV infection causes haemostatic abnormalities such as hematological disorder, deregulated haematopoiesis process and the coagulation process which results in HDP.Summary: This study will help on improving therapeutic management and understanding of the pathophysiology of GDM and HDP in the absence as well as in the presence of HIV infection by reviewing studies reporting on these mechanism.


2021 ◽  
Vol 29 (1) ◽  
pp. 33-38
Author(s):  
Melike Nur Akın ◽  
Burcu Kasap ◽  
Fatih Akın ◽  
Burak Sezgin ◽  
İbrahim Altun ◽  
...  

Objective We aimed to assess the relationship between gestational diabetes mellitus and coronary artery disease by measuring epicardial fat tissue thickness and aortic stiffness in pregnant women diagnosed with gestational diabetes mellitus. Methods 28 pregnant women diagnosed with gestational diabetes mellitus and 25 pregnant women without gestational diabetes mellitus were included in the research. Body mass index, laboratory values, blood pressure measurements and obstetric history findings of the study population were recorded. All participants of the study population were evaluated with transthoracic echocardiography between 24 and 28 weeks of gestational period. The measurement of epicardial fat tissue thickness was taken and aortic stiffness index was also calculated. Results The age, gravidity, parity and obstetric history of the two groups were similar. Epicardial fat tissue thickness was found significantly higher in gestational diabetes mellitus group than control group (0.416 cm and 0.336 cm, respectively; p<0.001). However, no significant difference was found in aortic stiffness measurements of the two groups (p=0.079). Conclusion According to the results of our study, epicardial fat tissue thickness was found to be statistically significantly higher in pregnant women with gestational diabetes mellitus compared to the control group. The fact that no difference was detected in other cardiovascular parameters suggests that measurement of epicardial fat tissue thickness in gestational period may be a beneficial adjunctive tool in early detection of gestational diabetes mellitus.


2009 ◽  
pp. 73-86
Author(s):  
Renata Tambelli ◽  
Manuela Errante

- In this review are discussed the main researches about high-risk pregnancy and, particularly, gestational diabetes mellitus (GDM). The results of these researches highlight that pregnant women with GDM are extremely vulnerable, anxious and worried. However there are not many clinical studies about the effect of GDM on the quality of mother-child relationship.


2020 ◽  
Author(s):  
Adnette Fagninou ◽  
Magloire Pandoua Nekoua ◽  
Salomon Ezéchiel Mahougnon Fiogbe ◽  
Kabirou Moutairou ◽  
Akadiri YESSOUFOU

Abstract Background : Immunological and biochemical parameters are gaining more and more importance in the prognosis of diabetes and its complications. Here we assessed the predictive power of immunological parameters correlated with biochemical ones in gestational diabetes mellitus (GDM). Material and Methods : 217 pregnant women were screened for GDM between the 2 nd and the 3 rd trimester of gestation, based on IAGDP methods in this cross-sectional descriptive study. Immunological and biochemical parameters were determined using appropriate methods. Receiver operating characteristics (ROC) curve analyses were conducted to assess the optimal cutoff and value of immunological to biochemical parameter ratios for predicting GDM. Results : 11.90% of pregnant women were diagnosed GDM positive. Serum glucose levels, total cholesterol, LDL-cholesterol, triglycerides and total proteins were significantly increased while HDL-cholesterol decreased in women with GDM compared to controls. The levels of glycosylated hemoglobin and creatinine, as well as transaminase (AST and ALT) activities did not significantly differ between GDM and pregnant controls. Total leucocytes (white blood cell), lymphocyte and platelet numbers were significantly higher in women with GDM than in pregnant controls. We also found that the lymphocyte:HDL-C, monocyte:HDL-C and granulocyte:HDL-C ratios were significantly higher in women with GDM than in pregnant controls ( p = 0.001; p = 0.009 and p = 0.004 respectively). Women with a lymphocyte:HDL-C ratio greater than 3.66 had a 4-fold increased risk of developing GDM than those with lower ratios (odds ratio 4.00; 95% CI: 1.094 – 14.630; p =0.041). Conclusion : The lymphocyte:HDL-C, monocyte:HDL-C and granulocyte:HDL-C ratios may represent valuable makers, and the lymphocyte:HDL-C ratio in particular may have strong predictive power for GDM. This ratio can be easily assessed in patients.


2021 ◽  
Vol 11 (4) ◽  
pp. 414-417
Author(s):  
Agamurad Orazmuradov ◽  
Irina Bekbaeva ◽  
Gayane Arakelyan ◽  
Anastasia Minaeva ◽  
Anastasiya Akhmatova ◽  
...  

Background: Changes in the course of gestational diabetes mellitus (GDM) at the present stage determine the emergence of a certain spectrum of completely new problems associated with the health status of newborns from mothers with GDM. The aim of the study was to investigate early neonatal complications in newborns from mothers with GDM. Methods and Results: The study included 404 pregnant women (gestational age of 37.0–41.0 weeks) with GDM. All patients with GDM were divided into 2 groups. Group 1 included 188 patients receiving insulin therapy; Group 2 included 216 patients receiving a well-balanced diet. The control group (Group 3) consisted of 68 pregnant women without disorders of carbohydrate metabolism. In Group 1, macrosomia occurred in 44(23.4%) newborns, in Group 2 - in 48(22.0%) newborns; in newborns from mothers of the control group, the frequency of macrosomia was only in 7.35% of newborns (P=0.01). Morpho-functional immaturity of newborns had the highest frequency of occurrence, despite the fact that all children were born on time; 80(42.6%) newborns from mothers of Group 1 and 77(35.6%) newborns from mothers of Group 2 had signs of morpho-functional immaturity. Conclusion: Diabetic fetopathy in newborns from mothers with GDM is manifested by morpho-functional immaturity of organs and systems developing in unfavorable hyperglycemic conditions.


Author(s):  
Kondapuram Veena ◽  
Srilakshmi Ambarkar ◽  
Srilakshmi Ambarkar

Background: To study the prevalence of gestational diabetes mellitus among antenatal mothers and to assess the importance of universal screening to detect gestational diabetes mellitus (GDM).Methods: A total of 300 antenatal women irrespective of gestational age were screened for GDM at their antenatal visit during the period of January 2020 to June 2020. All women were screened with 75gm oral glucose load irrespective of last meal followed by blood glucose estimation by glucose oxidase peroxidase method 2 hours following glucose load. A cut-off of 140mg/dl or more were labelled as gestational diabetes mellitus as per DIPSI guidelines.Results: Out of 300 antenatal women tested, 24 women (8%) were positive for gestational diabetes mellitus. During the first, second and third trimesters 12.5%, 33.33% and 54.17% were diagnosed with gestational diabetes mellitus respectively. The number of gestational diabetes mellitus patients for the age groups ≤20 years, 21-25 years, 26-30 years and >30 years are 2 (8.33%), 3 (12.5%), 8 (33.33%) and 11 (45.83%) respectively. The number of pregnant women tested positive for gestational diabetes mellitus with BMI ≤18.5, 18.6-24.9, 25-29.9 and 30-35 are 2 (8.33%), 4(16.67%), 8(33.33%) and 10(41.67%) respectively.Conclusions: Prevalence of GDM in our study is 8%. About 29.16% of GDM did not have any risk factors. This emphasizes the importance of universal screening for GDM of all pregnant women irrespective of gestational age. There is an increased association of GDM with age, BMI, family history and parity according to our study.


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