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Summary Aims To develop and validate risk scores for predicting abdominal obesity in South American children and adolescents based on extrinsic and intrinsic variables. Methods Children (n = 358) and adolescents (n = 369) from seven South American cities from the South American Youth Cardiovascular and Environmental (SAYCARE) Study. The primary outcome was abdominal obesity. Potential predictors were based on sociodemographic, maternal, environmental, and behavioural factors and nutritional status. In multilevel logistic models, associated variables were tested to build the scores, which were internally validated. Results We identified 120 children and 98 adolescents who were abdominally obese. We found at least five variables associated with the outcome in children with unacceptable predictive capacity. However, in adolescents, we found that biological sex, age, maternal body mass index (BMI), active commuting by bike, soft drink consumption (for risk score A), and weight (for score B) can predict abdominal obesity. Both scores, A and B, showed acceptable performance in the ROC curve [areas under curve: 0.70 (95% CI: 0.56–0.82) and 0.95 (95% CI: 0.89–1.00), respectively]. Conclusion The SAYCARE risk scores present accurate, individualised estimates for identifying adolescents who are at risk of developing abdominal obesity. However, these have not been externally validated.

The aim of our systematic review and meta-analysis was to evaluate the risk of neural tube defects (NTDs) according to the pre-pregnancy body mass index. Electronic databases were searched (MEDLINE, EMBASE, Web of Sciences, Scopus, ClinicalTrial.gov, OVID, and Cochrane Library). Selection criteria included prospective and retrospective cohort studies reporting the prevalence of fetal NTDs in obese, overweight, and underweight pregnant women. Odds ratios (ORs) comparing risk among these subsets of pregnancies with normal weight mothers were determined with 95% confidence intervals (CI). The evaluated outcome was the association between maternal underweight, overweight, and obesity and the risk of NTDs. We included ten studies published between 2000 and 2017, including underweight, overweight, and obese pregnant women with fetal NTD (cases) and pregnant women with recommended BMI with fetal NTD (controls). Compared with normal BMI women, obese mothers were at significantly higher risk of fetal NTDs (0.53 vs. 0.33%; OR 1.62 95% CI 1.32–1.99, p < .0001), while no difference for the risk of NTDs was found when comparing overweight (0.34 vs. 0.32%; OR 1.09 95% CI 0.92–1.3, p = .3) and underweight (0.65 vs. 0.24%; OR 1.34 95% CI 0.73–2.47, p = .34) with normal weight pregnant women. Obese pregnant women are at significantly higher risk NTDs, while no significant difference has been found in overweight and underweight pregnant women. Key message Obese pregnant women are at significantly higher risk of NTDs, such as spina bifida compared with normal weight women. No difference was found when comparing overweight and underweight with normal weight women. Obese pregnant women are at significantly higher risk of NTDs, such as spina bifida compared with normal weight women. No difference was found when comparing overweight and underweight with normal weight women.

The prevalence of overweight and obesity is increasing among reproductive-age women in sub-Saharan Africa. Whether maternal body mass index (BMI) influences the risk of infant infections in low- and middle-income countries (LMIC) is uncertain. We used data from a birth cohort of 5344 HIV-unexposed Zimbabwean infants with available data on maternal BMI, to calculate rates of sick clinic visits for infections during the first 12 months postpartum, and adjusted hazard ratios (aHR) for each maternal BMI group. Compared to infants of mothers with normal BMI, the rate of sick clinic visits for any infection progressively rose among infants of overweight (aHR 1.05; 95%CI 0.99, 1.11) and obese women (aHR 1.15; 95%CI 1.05, 1.25). Excess clinic attendances were particularly due to skin, respiratory and ear infections. Maternal obesity may therefore influence infant infectious morbidity in LMIC over the first year after birth.

Oxidative stress is related to pregnancy complications that could increase maternal and infant mortality. This study aimed to determine the effect of propolis extract supplementation during pregnancy on oxidative stress level and pregnancy outcomes utilizing Malonedealdehyde (MDA) and 8-Oxo-2′-Deoxogunosine (8-OHdG) levels, maternal body weight, and the average number of fetuses as the parameters. The study was conducted by using a posttest only control group design on 24 pregnant Wistar rats, which were divided into four groups. Group I was control, Group II-IV were the treatment groups given propolis extract of 1.8mg, 3.6mg, and 7.2mg/200gBW/day, respectively. The standard feed given was AIN93G dose of 20g/day and distilled water ad libitum. Propolis extract was given using a gastric feeding tube every morning for 20 days. At the end of the treatment, body weight was meisured and blood collected for assessed MDA and 8-OHdG levels by ELISA method and then we performed abdominal surgery to count number of fetuses. The result are there were decreasing level of MDA and 8-OHDG by administration of propolis significantly (p

The prenatal developmental toxicity of bitumen fume was tested by nose-only inhalation in the rat. The fumes for exposure were collected from the headspace of a storage tank filled with a bitumen corresponding in composition to an anticipated worst-case occupational exposure. The composition of these fumes was compared to actual paving site fumes to ensure its representativeness for workplace exposures. In a dose-range-finding study male and female rats were exposed to 0, 103, 480 or 1043 mg/m3 of fume (as total organic mass), for 6 h/day during 20 days post conception (p.c.). Dose-related effects on body weight and lungs were observed in the mid- and high-dose groups. In the main study, dams were exposed to 0, 52, 151 and 482 mg/m3 of fume, for 6 h/day during 19 days p.c. The maternal NOAEL was 52 mg/m³. In the high-dose group treatment-related effects on body weight (gain), food consumption, lung weights, and histopathological changes in lungs and larynx were observed. In the mid-dose group only histopathological changes in the larynx and lungs were found. The NOAEL for prenatal developmental toxicity was 151 mg/m³ based on reduced fetal weight in the high-dose group (482 mg/m³). However, these changes are most likely a consequence of the maternal toxicity, in particular the reduction of maternal body weight gain by 26 % as compared to control. Nose-only exposure to bitumen fumes in concentrations up to 482 mg/m³ from days 1-19 p.c. did not induce any significant fetal anomalies.

Worldwide, obesity is the prevalent, chronic medical condition (1). The rate of obesity in pregnant women is rising, increasing the significance of its impact on obesity-related pregnancy complications.(2) Maternal body mass index (BMI) is one of the predictors of the nutritional status of pregnant ladies. The problem of rising obesity is not unique to India. In earlier research, the relationship between maternal height and weight with pregnancy complications have been extensively explored, but in recent times, BMI is widely accepted as a better measure of over or underweight [3].

To investigate the effect of birth weight (BW) and maternal pre-pregnancy BMI (mBMI) on blood pressure (BP) in adolescence. A Population-based cohort of 11,729 births in Jerusalem during 1974–1976, with archival data on maternal and birth characteristics was performed. Measurements at age 17 were assessed and linear regression models were used to evaluate the associations of birth characteristics with BP outcomes. BW was inversely associated with both systolic (SBP) and diastolic (DBP) BP at age 17 (SBP: B = − 0.829, p = 0.002; DBP: B = − 0.397, p = 0.033). The interaction term between BW and weight at age 17 was significant for DBP (p = 0.017) and pulse pressure (p = 0.005). mBMI yielded significant positive associations with BP, independent of BW. Our findings indicate that there are at least two distinct pathways linking early life characteristics with subsequent BP: Intrauterine growth, as reflected by BW and other genetic or environmental factors, reflected by mBMI and maternal education, contribute to offspring adolescent BP. These results warrant replication in other birth cohorts and underline the need to explore specific mechanisms that account for these associations.

Background: Obesity is associated with higher surgical and anaesthetic morbidity and difficulties. Aims: We aimed to investigate associations between maternal body mass index (BMI) and the in-theatre time taken to produce an anaesthetised state or to perform surgery for caesarean delivery. Materials and Methods: Using the Strengthening the Reporting of Observational Studies in Epidemiology guidelines, we identified all women who underwent caesarean section at a single institution (2009–2015). The prospectively collected data arising from antenatal and peripartum care were analysed. Generalised linear regression was used to examine associations between maternal BMI and the time taken to anaesthetise the mother and the duration of surgery. Results: Of a total of 24 761 caesarean deliveries, 5607 (22.7%) women were obese at antenatal registration. In-theatre anaesthetic preparation (18 vs 32 min, P < 0.001) and surgical duration (38 vs 52 min, P < 0.001) were longer in women with BMI ≥50 kg/m (BMI-50) than those with normal BMI (BMI-N). This difference remained significant after controlling for antenatal, intra-operative and immediate postoperative variables. Modifiable variables were identified that may mitigate the effects of severe obesity. Senior obstetric and anaesthetic care were both independently associated with a significant reduction in mean in-theatre anaesthetic preparation time and surgical duration, by 11 and three minutes respectively (P < 0.001), while epidural top-up significantly lessened mean anaesthetic in-theatre preparation duration by seven minutes (P < 0.001). Conclusions: Obese women had greater anaesthesia and surgery time, but the effect may potentially be mitigated by provision of care by experienced staff and prior establishment of epidural analgesia.

Anne Bradstreet’s conversion narrative, “To My Dear Children,” has excited less attention from critics than her renowned poetry. Bradstreet composed her letter to her children in 1656 when she beli...

ObjectivesMeasurement of birth length and birth head circumference is part of the newborn assessment. Both measurements aid in distinguishing between proportionate and disproportionate small and large for gestational age newborns. It had been shown that birth weight is related to maternal height and weight. This study aims to analyze birth length and birth head circumference percentiles based on maternal stature.MethodsThis observational study analyzed birth length and birth head circumference percentiles of 2.3 million newborns stratified by maternal height and weight from the first obstetric assessment. Percentiles were calculated for sex and 22–43 gestational weeks for all infants. Eighteen subgroups based on six maternal height and three weight strata were defined and percentiles calculated from 32 to 42 gestational weeks using GAMLSS package for R.ResultsNewborns of mothers with height 177 cm, weight >79 kg). Small stature mothers were 1.7 years younger. Birth length differed by several centimeters for the same percentiles between groups of short and tall stature mothers, whereas birth head circumference differed up to 1.2 cm. The largest deviation of birth length was between the 97th percentiles. For male newborns born at term, birth length at the 97th percentile differed by 3.2 cm, at the 50th percentile by 2.7 cm and at the third percentile by 2.5 cm.ConclusionsBirth length and birth head circumference are related to maternal height and weight. To more completely assess newborns, the maternal size should be considered.

To evaluate the relationship between the maternal body mass index (BMI) and total gestational weight gain (GWG) with the characteristics of newborns, taking into consideration the birth weight (BW), weight for age score (WfA), length for age (LfA), and weight for length (WfL), APGAR score, and premature delivery.We conducted a study, from March 2015 to 2016. We included a number of 1218 pregnant women who delivered single babies, from three different hospitals that serve the entire Mures County and who met our inclusion criteria.We did not find significant differences regarding weight, length at birth, and gestational age, between girls and boys, neither between total GWG during pregnancy and the measured anthropometric parameters of the newborns, or between maternal GWG and gestational age of the newborns. We found a positive correlation between the mothers' BMI and the BW of the newborns (We found a positive correlation between the mothers' BMI and excessive GWG and the BW of their newborns in women delivering a single baby. Women with higher BMI showed significantly higher frequency of preterm delivery.

OBJECTIVE To examine the effects of maternal body mass index (BMI) and gestational age (GA) on the number of single circulating trophoblasts (SCT). METHODS Maternal blood was collected in 20 to 40 mL. All singleton pregnant women at any gestation were recruited. Trophoblasts were recovered by immunomagnetic enrichment and stained for cytokeratin and CD45. Candidate trophoblasts were identified by fluorescence microscopy. RESULTS Blood samples were collected from 425 singleton pregnancies from April 2018 to December 2019. At least one candidate cell was identified in 88% (373/425). There was an inverse correlation between trophoblasts yield and increasing BMI (r = -0.19, P

Objectives To examine the association between maternal body dissatisfaction and mother's (mis)perception of their infant's weight classification among families from low-income households. Methods Mother-infant dyads were recruited during well-child visits from two urban primary care clinics. Maternal body dissatisfaction was measured using the Stunkard Figure Rating Scale. Perception of infant weight was assessed using a 5-point Likert scale. Infant weight-for-length (WFL) percentiles were calculated using WHO growth charts. Associations between maternal body dissatisfaction score and mother's (mis)perception of their infant's weight classification were examined using logistic regression allowing for non-linear associations via restricted cubic splines. Results Mothers (n=180) were 26.6 ± 5.1 years old and 72% Black; infants were 8.8 ± 2.1 months old. Mean infant WFL percentile was 64 ± 26. On average, mothers wanted to be one body figure smaller than their perceived current body size. Most mothers (82%) accurately perceived their infant's weight classification while few overestimated (7%) or underestimated (11%) their child's weight category. The probability of mothers misperceiving their infant's weight classification increased as maternal body dissatisfaction increased in either extreme in unadjusted (p Conclusions Increased maternal body dissatisfaction may be associated with mother's misperception of infant weight classification. Future studies should examine this relationship in a heterogeneous population.

BackgroundMaternal nutrition depletion during pregnancy compromises fetal programming, and is a cause of adverse birth outcomes. Maternal body composition measurement using direct body composition assessment methods such as the deuterium dilution technique provides better prediction of birth outcomes as compared with commonly used techniques like anthropometry. This study assessed body composition of pregnant mothers in urban informal settlements in Nairobi, Kenya, and established the relationship between maternal body composition and infant birth weight.MethodsDeuterium dilution technique was used to determine body composition, including total body water (TBW), fat-free mass (FFM) and fat mass (FM), among 129 pregnant women who were enrolled into the study in their first or second trimester. Descriptive statistics and regression analysis were applied using Stata V.13.ResultsThe mean TBW, FFM and FM were 33.3 L (±4.7), 45.7 kg (±6.5) and 17.01 kg (±7.4), respectively. Both TBW and FFM were significantly related to maternal age and gestation/pregnancy stage during body composition assessment while FM was significantly associated with gestation stage during body composition assessment. TBW and FFM were significantly lower in younger mothers (ConclusionNon-fat components of the body (TBW and FFM) have a positive association with birth weight. Therefore, interventions to improve optimal maternal feeding practices, to enhance optimal gains in FFM and TBW during pregnancy are recommended, especially among young mothers.

Background: The worldwide obesity epidemic continues to be a major public health challenge, particularly in women of childbearing age. There is a need to understand the associations between maternal BMI and perinatal outcome. Objectives: To evaluate recent trends in maternal body mass index (BMI) and to quantify its association with foetal outcome. Methodology: It is a cross sectional study including a total of 384 pregnant women who were primi gravida and carry singleton pregnancy admitted at term in the department of Obstetrics and Gynaecology of DMCH for the management of labour. All the mothers were chosen by purposive sampling. The study populations were classified into four groups according to BMI. Group-I stands for 44 mothers who are underweight, Group-II consists of 234 mothers who are normal weight, Group III represents to 81 mothers who are overweight and Group IV signifies for 25 mothers who are obese. The women with multiple pregnancies, preterm labour and hypertension or diabetes were excluded from the study. Data regarding socio demographic, clinical, obstetrical and foetal outcome were recorded, afterwards the data were edited, managed and analyzed. The observations were plotted into tabular and figure form. The categorical variable was analyzed by chi square test and the quantitative variables were analyzed by ANOVA test. At all level 95% confidence interval & level of significance was p 2.5 kg in Group IV whereas 72.7% had ≤2.5 kg birth weight in Group I. Maximum (57%) mothers underwent NVD in Group I as long as the paramount (71%) mothers endured LSCS in Group III. Out of 384, total 180(46.9%) mothers had NVD and 204(53.1%) mothers deferred LSCS. APGAR score ≤7 was found 31.8%, 12.8%, 38.3% and 20% in Group I, Group II, Group III and Group IV independently. The P-value showed statistically significant of the groups (P=0.00016). Among 204 LSCS, 167(81.9%) mother sustained emergency and 37(18.1%) undertook elective LSCS. 52.9% of mothers went through LSCS were due to meconium staining liquor in Group IV which was subsequently followed by 46.6% in Group-III. 25.0%, 9.8%, 32.1% and 16% neonates required NICU admission in Group I, Group II, Group III and Group IV severally. There was a moderately positive significant correlation between maternal BMI and neonatal birth weight (r=+.383, p

Objective − Maternal general health and diet prior to and during pregnancy create conditions for intrauterine foetal development. This may influence long-term growth, development and health of the child. The aim of this study was to define the influence of maternal body weight (BW) on offspring growth in early childhood. Materials and Methods − 162 Slovenian mothers and their children were included in the study and subsequent analysis. We collected information on anthropometric measurements of mothers prior to and during pregnancy, and of their children (BW, length, head circumference (HC)) up to the age of three. To perform statistical analysis, the Pearson correlation test, linear regression and F-test were utilized. Results − A statistically significant association between the mother’s BW and newborn BW (P

Background: Excessive weight gain during pregnancy is common and has been shown to be associated with increased long-term maternal weight. However, less is known on whether there is a cumulative effect of excessive gestational weight gain (GWG) over multiple pregnancies. Methods: Data from the Study of Women's Health Across the Nation were used, restricted to parous women with no history of stillbirth or premature birth. The effect of the number of excessive GWG pregnancies on body mass index (BMI) in midlife (age 42–53) was analyzed using multivariable linear regression. Fully adjusted models included parity, inadequate GWG, demographic, and behavioral characteristics. Results: The 1181 women included in this analysis reported a total of 2693 births. Overall, 466 (39.5%) were categorized as having at least one pregnancy with excessive GWG. The median BMI at midlife was 26.0 kg/m(2) (interquartile range 22.5–31.1). In fully adjusted models, each additional pregnancy with excessive GWG was associated with 0.021 higher estimated log BMI (p = 0.031). Among women with 1–3 births, adjusted mean (95% confidence interval) BMI for those with 0, 1, 2, and 3 excessive GWG pregnancies was 25.4 (24.9–25.9), 26.8 (26.1–27.5), 27.5 (26.6–28.4), and 28.8 (27.3–30.5), respectively. Conclusions: In this multiethnic study of women with a history of term live births, the number of pregnancies with excessive GWG was associated with increased maternal BMI in midlife. Our findings suggest that prevention of excessive GWG at any point in a woman's reproductive history can have an impact on long-term maternal health.

BACKGROUND: Anemia is the most common type of malnutrition in pregnant women, and when combined with another nutritional problem, it would increase the risk of adverse pregnancy outcomes. AIM: This study aims to analyze the risk of double undernutrition in pregnant women with anemia. MATERIALS AND METHODS: We used secondary data from the 2018 National Basic Health Survey as well as biomedical anemia samples. Anthropometric measurements were maternal body height, middle–upper circumference (MUAC) for chronic energy malnutrition (CEM); anemia was predicted using hemoglobin levels. The number of samples is 484, considering the minimum sample size for each undernutrition proportion. RESULTS: Anemia in pregnant women is not a single malnutrition issue. Almost one–third of pregnant women with anemia also had another form of undenutrition. In this study, the prevalence of anemia among pregnant women (%) is 35.7; stunted is 35.9, and CEM is 16.7. The malnutrition was identified as double nutritional problems coexistence to anemia, such as prevalence stunted–anemia (%) 12.5; anemia–CEM 9.2; and anemia–stunted–CEM 4.4. Overall, CEM is associated with anemia with p < 0.05 and AOR 2.25 (CI; 1.38–3.66), adjusted to height and type of residence, education, and occupation. Urban areas have a similar risk to rural areas with AOR for CEM to anemia, 2.29 (CI; 1.12–4.69); rural areas 2.23 (CI; 1.14–4.33), respectively. Moreover, women with double of undernutrition stunted–CEM in rural areas have a risk of anemia with AOR 2.75 (1.14–6.65). CONCLUSION: The risk of anemia in pregnant women with chronic energy malnutrition has increased more than twice in rural and urban areas.

This chapter examines poetic images of violence in the book of Jeremiah from a literary perspective. In this analysis, Jeremiah’s images of poetic violence are rhetorically constructed and should not be viewed as descriptive of actual events. Although violent events may lie at the heart of these images, this chapter assumes they are designed primarily for their rhetorical impact and theological meaning, and not for their descriptive accuracy. After discussing broadly the meaning and purpose of poetic violence, the author considers three rhetorically effective images that appear frequently in Jeremiah—the wound, the maternal body, and the unburied corpse. These images share a common focus on the body and are intended to unsettle and to induce change in those who encounter them by communicating the physical threat to individuals within Israel, as well as to the community as a whole. Despite their power to unsettle, these images also convey hope by communicating alternative and positive realities, and by suggesting ways in which violence can be a creative force that transforms individuals and communities. If poetic violence is effective, transformation will occur and the wound, the maternal body, and the unburied corpse will make way for the healing, birth, and regeneration of Israel.

Background; the body mass index (BMI) is frequently used to classify the severity of obesity and to inform weight-gain guidelines throughout pregnancy. Aim and objectives; to evaluate the impact of BMI of nulliparous females on progress of labour, incidence of peri-partum complications (1ry outcome) and neonatal outcome of these women (secondary outcome). Subjects and methods; This is a prospective cohort study, was carried out on 330nulliparous patients attending the labor ward of Al-Hussein and Sayed Galal hospitals, Al-Azhar University, Egypt, during active phase of labor, divided into 4 groups, from January 2021 until the end of the specified cases. Result; In terms of weight and BMI, there is a considerable disparity between the 4 groups. Conclusion; Labor development and labor time varied by BMI category, as evaluated by cervical dilatation rates. As per recent research, a higher BMI in nulliparous women is linked to a higher chance of caesarean birth during labor. This training should be available to first-time mothers prior to conception, and labor ward staff should be informed of this group of women before labour, with a concentration on the issues of analgesia and anesthesia in obese parturients.

BACKGROUND: The association between physical activity and adiposity in preschool-aged children is unclear. OBJECTIVE: To assess the cross-sectional association between objectively measured physical activity and body fat in preschool-aged children. METHODS: In the preschool review in an Australian birth cohort study (n = 1074), mean duration and time accumulated in ≥1-min bouts of physical activity at light-intensity (LPA), moderate- to vigorous-intensity (MVPA) and light- to vigorous-intensity (LMVPA) were computed from accelerometer (ActiGraph GT3X+) data. Percent body fat was assessed by bioelectrical impedance. Associations between physical activity and percent body fat were examined by multiple regression, adjusted for accelerometer wear time, MVPA (in analyses of LPA), maternal body mass index (BMI) and maternal education. RESULTS: A total of 450 participants (n = 450) had valid data. There was evidence of associations between physical activity and adiposity: each additional hour of LVPA was associated with 0.6% (CI95 -0.2%, 1.3%) higher body fat; ≥1-min bouts of LPA was associated with 1.0% (CI95 0.1%, 1.9%) higher body fat; each additional hour of MVPA was associated with -0.8% (CI95 -1.6%, -0.1%) less body fat; and ≥1-min bouts of MVPA was associated with -1.3% (CI95 -2.5%, -0.1%) body fat. CONCLUSIONS: Among a cohort of preschool-aged children, there was evidence that more intensive physical activity assessed by an accelerometer is associated with reduced body fat.

Introduction Obese primiparous women with induction of labor are at high risk for a cesarean section. There are contradictory results regarding time in induced labor in relation to maternal body mass index (BMI). It is important to characterize the course of induced labor to prevent unnecessary cesarean section. We aimed to evaluate whether the duration of labor was associated with maternal BMI in primiparous women with induction of labor. Material and methods A national retrospective cohort study, including 15 259 primiparae with a single term pregnancy, admitted for induction of labor from January 2014 to August 2017. Data were obtained from the Swedish Pregnancy Registry. Cox regression analyses were used to illustrate the association between BMI and active labor and between BMI and time from admission until start of active labor. Results Duration of active labor was shorter in underweight women and prolonged in women with BMI amp;gt;= 40 kg/m(2) compared with women in other BMI classes, illustrated by Cox regression graphs (P amp;lt; .001). The median durations of active labor in underweight women were 6.1 and 7.4 hours in women with BMI amp;gt;= 40 kg/m(2). The time from admission until start of active labor increased with maternal BMI, illustrated by Cox regression graphs (P amp;lt; .001) and the median duration increased from 12.9 hours in underweight women to 22.6 hours in women with BMI amp;gt;= 40 kg/m(2). The cesarean section rate in active labor increased significantly with BMI (P amp;lt; .001) from 7.4% in underweight women to 22.0% in women with BMI amp;gt;= 40 kg/m(2). Obese and normal weight women had similar rates of spontaneous vaginal delivery (69.9% in the total study population). Conclusions The duration of active labor was associated with maternal BMI for underweight women and women with BMI amp;gt;= 40 kg/m(2). Although women with BMI amp;gt;= 40 kg/m(2) who reached the active phase of labor had the same chance for a spontaneous vaginal delivery as normal weight women, the duration of active labor and the cesarean section rate were increased. The time from admission until start of active labor increased successively with maternal BMI. Funding Agencies|ALF-grants Region Ostergotland Sweden

The aim of the study was obtain nomogram of fetal transcerebellar diameter at 18–24 weeks of gestation with known prognosis of normal pregnancies. The study included 1236 healthy fetuses in the 18th–24th gestational week of women aged from 18 to 40 years (mean: 28.70 ± 5.26). The transcerebellar diameter, bi-parietal diameter, femur length and abdominal circumference of the fetuses were measured. Additionally, groups were divided according to maternal age and according to body mass index. The transcerebellar diameter of fetuses from 18 to 24 weeks gestation varied from 18.13 ± 2.16 to 26.42 ± 1.91 mm (mean: 22.12 ± 2.57 mm). Additionally, the mean and standard deviation of transcerebellar diameter and fetal parameters were determined according to gestational week, maternal age and maternal body mass index. Later, the correlations between transcerebellar diameter with pregnancy week, maternal age, maternal body mass index and fetal parameters were examined. Transcerebellar diameter was correlated with pregnancy week and fetal parameters (p < 0.01) but was not correlated with maternal age (p > 0.01). Additionally, transcerebellar diameter and fetal parameters were determined to show negative correlation with maternal body mass index (p < 0.01). Comparison of transcerebellar diameter with pregnancy week determined differences between weeks (p < 0.05), but no differences for age groups and body mass index groups (p > 0.05). Maternal age and maternal body mass index are significant factors affecting fetal development. We believe our data related to the transcerebellar diameter obtained at the end of the study will be beneficial for assessment of fetal development and identification of fetal anomalies.

The number of obese pregnant women is increasing. Increased maternal body habitus is related to greater maternal health risks and an increased risk of fetal anomalies. The 18-20-week morphology scan is a routine clinical tool to detect fetal viability, anomalies, gestational age and number. Suboptimal ultrasound visualisation (SUV) affecting image quality increases with larger body habitus. This results in longer scanning times, incomplete and repeat scans, misdiagnosis, sonographer injuries and patient disappointment. This review aims to establish the effect increased maternal body habitus has on ultrasound image quality, specifically, the relationship between maternal body habitus and the 18-20-week morphology scan and detection of fetal anomalies. Inability to assess fetal structures due to SUV creates great challenges for the health system, imaging departments and patients. Studies have used different variables to measure the effect SUV has on the detection of fetal anomalies in obese women such as prenatal/neonatal comparisons, scan completion rates, the number of repeated scans and subjective judgements about diagnostic image quality. Some studies also included other influences such as fetal lie or placental position. Most studies concluded that a linear relationship exists between increased body habitus and decreased detection of fetal anomalies due to SUV particularly cardiac structures. Refereed/Peer-reviewed

Background: A proportion of twin-twin transfusion syndrome (TTTS) patients may have elevated liver enzymes (ELEzs) before fetoscopic laser therapy, but the incidence of ELEzs before laser therapy and the association with the perinatal outcomes after laser therapy remain unclear. Methods: From October 2008 to April 2015, 93 patients with TTTS who received fetoscopic laser therapy at our hospital were included in this study, and aspartate aminotransferase (AST) and alanine aminotransferase (ALT) levels were measured within 24 h before therapy. If ELEzs (AST > 34 U/L or ALT > 36 U/L) were observed before therapy, the AST and ALT levels were evaluated within 24 h after therapy. The pre-operative characteristics and post-therapy outcomes were compared between patients with and without ELEzs. Results: Among 93 TTTS patients before laser operation, 18 patients (were found with ELEzs (19.4%) before laser therapy. In 17 (94.4%) of the 18 cases, their liver enzymes values dropped after laser surgery. Maternal body mass index, age, gestational age of laser therapy, hemoglobin level before laser therapy and survival rates after laser therapy were not significantly different between TTTS with and without ELEzs. The maternal hemoglobin dropped significantly from 10.8 [1.6] g/dL before surgery to 9.6 [1.5] g/dL after laser therapy in TTTS with ELEzs (p

In this prospective trial, we investigate the effectiveness of maternal Body Roundness Index in predicting the spread of spinal anaesthesia and vasopressor requirement in parturients receiving spinal anaesthesia during the elective caesarean section. We prospectively enrolled 175 parturients. Spinal anaesthesia performed with 10 mg 0.5% hyperbaric bupivacaine at the L3-L4 intervertebral space and the optimal cut-off points of the BRI evaluated as 6.59 by receiver operating characteristic analysis calculating area under the curve. Parturients were divided into two groups with BRI6.59 and BRI ≥6.59 for analyses. Multivariate logistic regression analysis was used to test for a relationship between variables and maximum sensory block level and vasopressor requirement. BRI was found as an independent risk factor associated with maximum sensory block level (OR = 1.378, 95% CI: 1.125-1.687

Mercury (Hg), cadmium (Cd), and lead (Pb) are of great concern for food safety and infants are especially sensitive to exposure to the maternal body burden. We quantified these elements in breast milk from Norwegian mothers and determined their association with dietary habits, maternal amalgam fillings, and smoking. Breast milk (n = 300) from the Norwegian Human Milk Study (HUMIS) was analyzed using triple quadrupole inductively coupled plasma mass spectrometry, after an acidic decomposition using microwave technique. We used multiple linear regression to examine predictors of Hg and Cd in breast milk, and logistic regression to test predictors of Pb above the quantification limit. The median breast milk concentrations (minimum - maximum) were 0.20 μg Hg/kg (0.058-0.89), 0.057 μg Cd/kg (0.017-1.2), and0.67 μg Pb/kg (0.2-7.5). Cadmium showed no significant relation with any exposure variable investigated. Lead was associated with intake of liver and kidneys from game. For Hg concentration in breast milk, number of amalgam fillings and high fish consumption were significant predictors (p 0.001). We detected a significant association (p 0.01) between Hg in breast milk and maternal consumption of Atlantic halibut, lean fish, mussels and scallops and lifetime consumption of crab. Seafood intake alone explained 10% of variance, while together with amalgam explained 46% of variance in Hg concentration in breast milk. Our findings emphasize the importance of following consumer advice with respect to fish and seafood and points to amalgam as an important source for Hg exposure.

Objectives: to investigate the relationship between the Diet Quality Index Adapted for Pregnant Women (IQDAG) and excess maternal body weight. Methods: a cross-sectional study was conducted with 754 adult pregnant women, in Ribeirão Preto, São Paulo, between 2011 and 2012. The criteria proposed by Atalah were used to classify the body mass index (BMI). Adjusted multinomial logistic regression models were employed to investigate the relationship between the IQDAG and being overweight and obese, estimating the odds ratio (OR) and the 95% confidence interval (CI95%). Results: the mean (SD) age of women was 28 (5) years, 33.4% were overweight and 25.6% obese. The pregnant women with higher scores in the IQDAG were less likely to be overweight [OR= 0.56 (CI95% = 0.37-0.85)] or obese [0.43 (0.26-0.71)]; those with higher scores in the "Fiber" [0.51 (0.33; 0.78)] and "Iron" [0.62 (0.40-0.96)] components were less likely to be overweight. However, women with higher scores in the percentage of energy from ultra-processed foods were more likely to be overweight [1.72 (1.10-2.94)] or obese [5.24 (2.80-9.80)], when compared to women with lower scores. Conclusions: poorer quality maternal diets were observed among the women who were overweight and obese during pregnancy. Resumo Objetivos: investigar a relação entre o Índice de Qualidade da Dieta Adaptado para Gestantes (IQDAG) e o excesso de peso materno. Métodos: estudo transversal conduzido entre 754 gestantes adultas em Ribeirão Preto, SP, entre 2011 e 2012. Os critérios propostos por Atalah foram empregados para a classificação do índice de massa corporal (IMC). Modelos de regressão logística multinomial ajustados foram utilizados para investigar a relação da pontuação do IQDAG com o sobrepeso e obesidade, estimando-se o odds ratio (OR) e seu intervalo de confiança de 95% (IC95%). Resultados: a média (DP) de idade das mulheres foi de 28 (5) anos, 33,4% e 25,6% eram portadoras de sobrepeso e obesidade, respectivamente. As gestantes com maior pontuação do IQDAG apresentaram menor chance de sobrepeso [OR= 0,56 (IC95%= 0,37-0,85)] e obesidade [0,43 (0,26-0,71)]; as com maior pontuação para os componentes "Fibras" [0,51 (0,33-0,78)] e "Ferro" [0,62 (0,40-0,96)] apresentaram menor chance de sobrepeso. Em contrapartida, mulheres com maior pontuação para o percentual do valor energético proveniente dos alimentos ultraprocessados apresentaram maior chance de sobrepeso [1,72 (1,10-2,94)] e obesidade [5,24 (2,80-9,80)], quando comparadas com as mulheres com menor pontuação. Conclusões: pior qualidade da dieta materna foi observada entre as mulheres portadoras de sobrepeso e obesidade no período gestacional.

To evaluate the association between maternal body mass index and neonatal outcomes in adolescents and to compare neonatal outcomes between overweight and obese adolescents and obstetric low-risk adult women.Retrospective cohort study using data from the Swedish Medical Birth Register.Sweden.All 31,386 primiparous adolescents younger than 20 years of age and 178,844 "standard" women, defined as normal weight, obstetric low-risk adult women who delivered between 1992 and 2013. The adolescents were categorized according to weight and height in early pregnancy into body mass index groups according to the World Health Organization classification. Logistic regression models were used.Neonatal outcomes in relation to maternal body mass index groups.In the adolescents, 6109/31,386 (19.5%) and 2287/31,386 (7.3%) were overweight and obese, respectively. Compared with normal weight adolescents, overweight adolescents had a lower risk of having small for gestational age neonates, and higher risks for having neonates with macrosomia, and being large for gestational age and with Apgar score less than 7 at 5 minutes. The obese adolescents had increased risk for having neonates being large for gestational age (3.8% vs 1.3%; adjusted odds ratio [aOR], 2.97 [95% confidence interval (CI), 2.30-3.84]), with macrosomia (4500 g) (4.6% vs 1.4%; aOR, 2.95 [95% CI, 2.33-3.73]), and with Apgar score less than 7 at 5 minutes (2.2% vs 1.1%; aOR, 1.98 [95% CI, 1.43-2.76]) than normal weight adolescents. Compared with the standard women, overweight and obese adolescents had overall more adverse neonatal outcomes.Overweight and obese adolescents had predominantly increased risks for adverse neonatal outcomes compared with normal weight adolescents and standard women.

Background: This study aimed to determine the correlation between maternal weight gain in each trimester and fetal growth according to pre-pregnancy maternal body mass index in twin pregnancies.Methods: We conducted a retrospective review of the medical records of 500 twin pregnancies delivered at 28 weeks’ gestation or greater at a single tertiary center between January 2011 and December 2020. We measured the height, pre-pregnant body weight, and maternal body weight of women with twin pregnancies and evaluated the relationship between the maternal weight gain at each trimester and fetal growth restriction according to pre-pregnancy body mass index.Results: The overweight pregnant women were older than the normal or underweight pregnant women, and the risk of gestational diabetes was high. The underweight pregnant women were younger, and the incidences of preterm labor and short cervical length during pregnancy was high. Especially in normal weight pregnant women, the heavier the weight of the newborn babies as the second trimester of pregnancy weight gain, the less significant the weight gain in the first trimester of pregnancy and fetal growth. The most predictive single factor for the prediction of small neonates was weight gain during 24-28 weeks and 15-18 weeks, and the cutoff value was 6.2 kg. (area under the curve 0.592, p < 0.001).Conclusions: In twin pregnancy, regardless of the pre-pregnant body mass index, maternal weight gain affected fetal growth. Furthermore, weight gain in the second trimester of pregnancy is considered a powerful indicator of fetal growth, especially in normal weight pregnancies.

To evaluate risk factors and describe the association between maternal pre-pregnancy body-mass-index (BMI) and neonatal brachial plexus palsy (BPP) in vaginal deliveries with and without shoulder dystocia.This is a retrospective cohort study of singleton, non-anomalous, term vaginal deliveries in California (2007-2011). Deliveries were classified as with or without shoulder dystocia. Our primary outcome was BPP and the independent variable of interest was maternal pre-pregnancy BMI, which was categorized as underweight (18.5 kg/mIn our cohort of 1,395,761 women, there were 21,463 deliveries with shoulder dystocia and 1,374,298 deliveries without shoulder dystocia. Among deliveries with shoulder dystocia, BPP was observed more frequently in neonates born to women with BMI categorized as overweight (32% vs. 29%;Rising maternal pre-pregnancy BMI is associated with an increased risk of BPP in vaginal deliveries with and without shoulder dystocia. Preconception interventions targeting weight management may be beneficial in reducing BPP in all deliveries.

Background:. One inevitable shortcoming of non-invasive prenatal screening (NIPS)/cell-free DNA (cfDNA) sequencing is the uninterpretable (“no-call”) result, which is mainly caused by an insufficient fetal fraction. This study was performed to investigate the factors associated with a successful second NIPS in these cases and determine the optimal management for women with initial no-call results. Methods:. We retrospectively analyzed the data of women who underwent NIPS with initial no-call results due to an insufficient fetal fraction from 2017 to 2019 in our center. We compared these women's maternal and pregnancy information with the data of women who had attained a successful second NIPS result and women who had received no-call results for a second time. Results:. Among the 33,684 women who underwent NIPS, 137 with a no-call result underwent a retest. Comparison between the 87 (63.50%) women with a successful retest and the other 50 (36.50%) women showed a significant difference in both the initial fetal fraction and maternal body mass index (BMI), whereas the other factors showed no significant differences. In addition, with an initial fetal fraction of

Postpartum depression is one of the most common mental diseases that occur in women after childbirth; this disorder is extremely painful for women and represents a major burden on the society. Therefore, we designed this study to explore the possible material basis of the disease, and provide potential novel antidepressants therapy using a mouse model. We established a postpartum immobilization stress model. Maternal body weight changes and food intake were recorded for half a month after delivery, and levels of ghrelin and its receptor, growth hormone secretagogue receptor (GHSR) were measured. The mice in the immobilization stress group showed stress activity as well as low body weight and low feeding status. Ghrelin expression was elevated in blood whereas ghrelin or GHSR expression decreased in the hippocampus and prefrontal cortex of the immobilization stress mice, and the number of ghrelin-active and GHSR cells reduced.

Objectives: The overall aim of this thesis was to evaluate the impact of maternal body mass index (BMI) on obstetric and neonatal outcomes in adolescents as well as on treatment with oxytocin infus ...

OBJECTIVE Maternal anthropometry offers a rapid, inexpensive, and non-invasive method for assessing nutritional status during pregnancy. We aimed to assess the changes in maternal anthropometric measurements in the first month after delivery and to investigate the factors associated with longitudinal changes in maternal postpartum nutritional status. DESIGN This prospective longitudinal study included 147 mothers who were on the 5th postpartum day applied to outpatient clinics, from January 2018 through January 2020. Each mother completed a structured questionnaire and baseline anthropometric measurements were performed at the postpartum 5th day and re-evaluated at the end of the first month after delivery. PARTICIPANTS Mother-infant pairs (n = 147). RESULTS At the end of the first postpartum month, maternal body weight (relative change -5.1%, 95% CI: -5.6%;-4.6%), muscle mass ratio (-1.6%, 95% CI: -2.4%;-0.9%) and body fluid ratio (-2.4%, 95% CI: -3.1%;-1.7%) decreased, whereas fat mass ratio increased (10.3%, 95% CI: 9.0%;11.6%).There was a significant association between infants' feeding type and maternal BMI, weight, muscle mass ratio, body fluid ratio, triceps, and biceps skinfold thickness in mothers (p

Pregnancy is a physiological condition with reversible hemodynamic, neurohormonal and coagulation changes to the maternal body during this 9‑month period. The occurrence of atrial fibrillation (AF) is altogether rare among pregnant women, but necessitates immediate treatment und further work-up. Despite numerous pharmacological and invasive therapeutic modalities for AF in non-pregnant patients, very few options are considered safe enough for the fetus and the mother during pregnancy. Commonly used medications such as beta blockers, calcium channel antagonists, antiarrhythmic drugs and anticoagulation therapy must be carefully individualized according to the week of gestation and possible underlying comorbidities of the mother, thus highlighting the importance of an interdisciplinary evaluation by a cardiologist and a gynecologist. The current review summarizes the existing knowledge and treatment options for AF in pregnancy and suggests a simplified algorithm for this clinical constellation.Die Schwangerschaft ist eine 9‑monatige physiologische Phase, die mit reversiblen hämodynamischen, neurohormonellen und hämostaseologischen Veränderungen des mütterlichen Körpers einhergeht. Vorhofflimmern (VHF) ist zwar insgesamt eine seltene Erkrankung bei schwangeren Frauen, erfordert jedoch eine schnelle Behandlung und weitere Abklärung. Für nichtschwangere Patientinnen stehen zahlreiche medikamentöse und invasive Behandlungsoptionen zur Verfügung; dagegen sind die Möglichkeiten bei schwangeren Frauen hinsichtlich der Sicherheit von Mutter und Fetus stark limitiert. Häufig verwendete Medikamente wie Betablocker, Kalziumkanalblocker, Antiarrhythmika und Antikoagulanzien müssen sehr vorsichtig und individualisiert gegeben werden; zu berücksichtigen sind dabei die aktuelle Schwangerschaftswoche und mögliche Komorbiditäten. Das unterstreicht die Notwendigkeit der interdisziplinären Evaluation durch einen Kardiologen und Gynäkologen. Die vorliegende Übersichtsarbeit fasst den aktuellen Wissensstand und die Behandlungsoptionen bei VHF während der Schwangerschaft zusammen. Des Weiteren wird ein vereinfachter Algorithmus für diese klinische Konstellation präsentiert.

Background Nutritional management in the dry period can alter body condition score (BCS) in dairy cows, a subjective measure of body fat. As such, differences in BCS during late-pregnancy not only mirror nutrient utilization by fat depots, but also can play important roles on the metabolic and hormonal environment. We investigated the association between cow BCS during late-pregnancy on developmental parameters and blood variables of neonatal calves. Forty-nine multiparous Holstein cows were retrospectively divided by prepartal BCS into normal BCS ≤3.25 (NormBCS; 3.02 ± 0.17, n = 30) or high BCS ≥3.75 (HighBCS; 3.83 ± 0.15, n = 19) groups. Plasma samples were collected from cows at − 10 d relative to parturition. Body weight, hip and wither height, hip width and body length were measured at birth and weekly through weaning (42 d of age) and until 9 weeks of age. Calf blood samples were collected from the jugular vein at birth (before receiving colostrum, 0 d), 24 h after first colostrum and at 7, 21, 42 and 50 d of age. The data were subjected to ANOVA using the mixed procedure of SAS. The statistical model included day, BCS, and their interactions. Results Dry matter intake (kg/d or % of body weight) during the last 4 weeks of pregnancy was lower (P ≤ 0.06) in HighBCS cows. Plasma concentrations of fatty acids, ceruloplasmin, and nitric oxide were greater overall (P P = 0.08) to have greater concentrations of reactive oxygen metabolites. Birth body weight was lower (P = 0.03) in calves born to dams with HighBCS. In addition, plasma concentrations of fatty acids, albumin and urea (P P = 0.04), hip and wither height, hip width, and body length, there was no difference (P > 0.05) in daily starter intake and average daily gain due to maternal BCS. Conclusions Overall, results highlight an association between BCS during late-gestation on in utero calf development and postnatal growth. A high maternal BCS during late-gestation was associated with lower calf body weights, which could be due to lower maternal intakes and a state of inflammation and metabolic stress.

Background/objectiveTo investigate the longitudinal development of maternal body weight and analyze the influence of obesity on obstetrics during more than two decades in Germany.Subjects/methodsData collected from the Federal state of Schleswig-Holstein (German Perinatal Survey) were analyzed with regard to the dynamics of maternal anthropometric variables (body weight, BMI) between 1995–7 and 2004–17. In total 335,511 mothers substantiated the presented study-collective. The statistical analysis was performed using IBM SPSS Statistics for Windows, Version 26.0. Armonk, NY.ResultsMaternal BMI advanced significantly over the study period. Among a rise in mean periconceptional body weight (67.6–72.0 kg), the segment of obese women increased disproportionately (in average 9.4–19.2%). Despite the observed trend to late giving birth (mean maternal age 1995: 29.3 vs. 30.7 years in 2017), it was not advanced maternal age but parity that influenced the continuous increase in maternal weight (mean maternal body weight 1995–7: primi- bi-, multiparae 67.4, 68.3 and 69.0 kg vs. 2004–17: primi- bi-, multiparae 70.0, 71.5 and 73.2 kg respectively).ConclusionObesity is a major problem on health issues in obstetrics. Advancing maternal BMI, increasing mother’s age and derived prenatal risks considerably complicate pregnancy and delivery. It has to be emphasized that its consequences do not end with delivery or childbed, but represent a livelong burden to the mother and their offspring. Hence, multimodal strategies to reduce/control periconceptional body weight are mandatory.

Background Insulin, leptin, and adiponectin regulate energy balance and may influence infant growth via their presence in human milk. Maternal body mass index has been associated with human milk insulin, leptin, and adiponectin concentrations, but results are inconsistent. Maternal serum hormone concentrations and fat mass may better characterize human phenotype and be more appropriate predictors of human milk insulin, leptin, and adiponectin. Research aim To examine the associations of human milk insulin, leptin, and adiponectin with their concentrations in maternal circulation and with maternal fat mass. Methods Insulin, leptin, and adiponectin were measured in serum and human milk at 1 month postpartum in 25 women. Total body fat mass and fat-free mass were measured using bioelectrical impedance analysis. Linear regression modeling was used to examine associations of serum hormone concentrations or fat mass with human milk insulin, leptin, and adiponectin after adjusting for covariates. Results Serum insulin ( p = .007), leptin ( p < .001), and adiponectin ( p < .001) were each associated with their respective concentrations in human milk. Fat mass was positively associated with insulin ( p = .005) and leptin ( p < .001), but not with adiponectin ( p = .65), in human milk. Conclusions Human milk insulin, leptin, and adiponectin were positively associated with their concentrations in serum, and human milk insulin and leptin were associated with maternal fat mass. Future research is needed to elucidate the role of human milk hormones in infant energy balance and growth.

Antecedentes: As taxas de obesidade continuam aumentando, principalmente entre as crianças. Estudos apontam a subestimação do peso corporal como principal fator para a não adesão aos comportamentos de perda de peso e, em crianças, bem como a subestimação do tamanho do corpo, a percepção percebida pelos pais sobre o peso de seus próprios filhos. é crucial para a manutenção principal do sobrepeso e obesidade. Assim, enfatiza-se que a percepção acurada da imagem corporal de crianças e pais é essencial para combater a alta prevalência de sobrepeso e obesidade na população infantil. Objetivo: Avaliar a concordância entre a autopercepção e a percepção materna do peso corporal das crianças e seu status de peso corporal. Métodos: Foram avaliadas 935 crianças de 6 a 10 anos e 922 mães. O status do peso corporal foi avaliado por meio de medidas de peso e altura e a percepção da imagem corporal por meio de software para Avaliação da Percepção Corporal Infantil. Resultados: Crianças classificadas como "baixo peso" ou "peso normal" demonstraram maior acurácia em suas percepções e tendência à superestimação em meninas cujo status de peso é "normal", enquanto crianças obesas ou com excesso de peso tendem a superestimar seu status de peso. As mães, por outro lado, subestimaram o status de peso dos filhos, independentemente do sexo do filho. Conclusão: As crianças apresentaram percepções mais precisas do que as mães em relação ao peso / tamanho corporal.

Congenital malformations are one of the leading causes of neonates and infants’ mortality and morbidity. The frequency of these congenital malformations varies in different populations. The objective of this study was to find out the prevalence and pattern of congenital malformations in a tertiary teaching hospital in Rabat, Morocco. This four-year retrospective descriptive study was conducted from January 2011 to December 2014. All newborns with congenital malformations diagnosed at birth were included. Mothers and newborn characteristics were analyzed using SPSS 13.0. A total of 706 newborns were noted to have congenital malformation. The prevalence rate was 1.02%. The mean maternal age was 28.8±7.2 years. The mean maternal body mass index was 28.1±6.9 kg/m2. 13.3% of the mothers had a history of abortion. The nervous system was the most affected system (19.4%) followed by the musculoskeletal system (14.2%), the chromosomal abnormalities (12.3%) and the genito-urinary system (10.8%). Males newborns (57.9%) had more congenital malformations than females (40.5%). The rates for live-births, fetal asphyxia and stillbirths were 75.2%, 7.2% and 17.3%, respectively. This retrospective study provides recent and detailed data about congenital malformations in a Moroccan region. The result from this study will contribute to the knowledge of congenital malformations in this particular area and hence the supportive preventive policy.

Introduction: The aim of this secondary analysis was to investigate the relationship between maternal body mass index (BMI) and fetal biometry, body composition, and velocity measurements at 28 and...

Background Bariatric procedures are on the rise. The risk of birth defects in pregnancies following such procedures may be increased (eg, due to nutrient deficiencies) or decreased (eg, due to decreased maternal body mass index, BMI). Methods We conducted a systematic literature review of the association between bariatric surgery and birth defects using Ovid MEDLINE and PubMed (1946-2017). Information was abstracted on study design, exposures, outcomes, covariates and estimates of association. Results Fifteen studies met our inclusion criteria: 14 evaluated the outcome of any birth defect, and one evaluated neural tube defects. Estimates of association between bariatric surgery and birth defects were available for nine studies and ranged from 0.6 to 1.9 (all 95% confidence intervals included 1.0). When studies were stratified by surgery type, there was no obvious pattern of association. When stratified by the approach used to account for BMI, positive associations were observed in studies that did not account for maternal prepregnancy BMI or used women with normal BMI as the reference group (range: 1.3-1.9). Estimates from studies that either matched or adjusted for prepregnancy BMI were closer to the null (range: 1.1-1.2) and studies that compared to morbidly obese women reported protective associations (range: 0.6-0.7). Conclusions Studies of the association between bariatric surgery and birth defects vary with respect to the surgical procedures included, birth defects ascertainment methods and approaches used to account for maternal BMI. Consequently, it is not possible to draw a conclusion regarding the association between bariatric surgery and birth defects. Additional studies are warranted.

OBJECTIVES: To evaluate whether women with a prior spontaneous preterm birth (SPTB) with a higher body mass index (BMI) have a lower risk of a shortened cervix in a subsequent pregnancy. STUDY DESIGN: A secondary analysis of the Maternal-Fetal Medicine Units Network RCT of omega-3 fatty acid supplementation for recurrent SPTB prevention. All women had ≥1 prior SPTB