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Maternal Body Mass Index (maternal + body_mass_index)
Selected AbstractsHbA1c levels in non-diabetic Dutch children aged 8,9 years: the PIAMA birth cohort studyDIABETIC MEDICINE, Issue 2 2009H. Jansen Abstract Aim, Glycated haemoglobin (HbA1c) is considered the best index of glycaemic control in established diabetes. It may also be useful in the diagnosis of diabetes and as a screening tool. Little is known about the distribution of HbA1c in healthy children and its predictors. The aim of this study is to describe the distribution of HbA1c in non-diabetic Dutch children aged 8,9 years and to investigate potential associations of HbA1c in this group. Methods HbA1c was measured in 788 non-diabetic children aged 8,9 years participating in the PIAMA birth cohort study. Data on parents and children were collected prospectively by questionnaires. Weight, height and waist and hip circumference of the children were measured when blood samples were taken. Results, Mean (sd) HbA1c was 4.9 ± 0.33%, range 3.5,6.0%. HbA1c was significantly higher in boys (4.9 ± 0.31 vs. 4.9 ± 0.33%) and in children of mothers with gestational diabetes (5.0 ± 0.37 vs. 4.9 ± 0.32%). We found a significant inverse association between HbA1c and haemoglobin (regression coefficient: ,0.169 (95% CI ,0.221 to ,0.118), P < 0.001). HbA1c was not significantly associated with age, body mass index, waist circumference, parental diabetes or maternal body mass index. Conclusions, We found no significant relation between known risk factors for Type 2 diabetes and HbA1c at age 8,9 years. Moreover, there was a significant inverse association between haemoglobin and HbA1c. These results suggest that HbA1c may not only reflect the preceding blood glucose levels, but seems to be determined by other factors as well. [source] First-trimester fetal heart rate in mothers with opioid addictionADDICTION, Issue 7 2010Maximilian Schmid ABSTRACT Aim To investigate the difference in fetal heart rate of opioid-dependent mothers compared to non-dependent mothers in the first trimester of pregnancy. Design The data of 74 consecutive singleton pregnancies of mothers enrolled in a maintenance programme for opioid-dependent women was matched to 74 non-exposed singleton pregnancies by maternal age, crown,rump length, smoking status, ethnic background and mode of conception. Measurement Fetal heart rate measured as part of first-trimester screening by Doppler ultrasound between 11+0 and 13+6 gestational weeks was compared retrospectively. Findings The mean fetal heart rate in opioid-dependent mothers was 156.0 beats per minute (standard deviation 7.3) compared to 159.6 (6.5) in controls. The difference in fetal heart rate was significant (P = 0.02). There was a significant difference in mean maternal body mass index (P = 0.01) but not in mean nuchal translucency (P = 0.3), gestational age (0.5), fetal gender (P = 0.3) and parity (P = 0.3) between both groups. Fifty-five per cent (41 of 74) of cases were taking methadone, 30% (22 of 74) buprenorphine and 15% (11 of 74) were taking slow-release morphines throughout the pregnancy. Conclusions In fetuses of opioid-dependent mothers a decreased fetal heart rate can already be observed between 11+0 and 13+6 gestational weeks. The effect of opioid intake needs to be taken into consideration when interpreting fetal heart rate in opioid-dependent mothers at first-trimester screening. [source] Impact of maternal body mass index on obstetric outcomeJOURNAL OF OBSTETRICS AND GYNAECOLOGY RESEARCH (ELECTRONIC), Issue 5 2007Meenakshi T. Sahu Abstract Aim:, The purpose of the present study was to correlate effect of maternal body mass index (BMI) on obstetric outcome. The studies conducted so far are from Western developed countries and there is a paucity of data from developing countries. Methods:, A prospective evaluation was carried out of 380 women in one unit of a tertiary care teaching hospital in North India from May 2005 to June 2006 on the effect of maternal BMI on pregnancy outcome. BMI was calculated as weight (kg) divided by height (m2). BMI was used to characterize women as lean (BMI < 19.8 kg/m2), normal (BMI 19.9,24.9 kg/m2), overweight (BMI 25,29.9 kg/m2) or obese (,30 kg/m2). Results:, Forty-six women (12.1%) out of 380 were underweight, 99 (26.1%) were overweight, 30 (7.9%) were obese and the remaining 205 (53.9%) had normal BMI. Anemia (P = 0.02) and low birthweight (P = 0.008) was significantly present among lean women. Obese women had a significant risk for gestational diabetes (P = 0.0004), pre-eclampsia (P = 0.004), cesarean delivery (P = 0.01) and macrosomia (P = 0.02). Conclusion:, Both lean and obese women carry a risk for adverse pregnancy outcome, therefore pregnant women should maintain a normal BMI to achieve a healthy pregnancy outcome. [source] Ultrasound screening for fetal aneuploidy using soft markers in the overweight and obese gravida,PRENATAL DIAGNOSIS, Issue 9 2010Lily J. Tsai Abstract Objective To determine the completion rate of ultrasound surveys for aneuploidy markers by maternal body mass index (BMI). Methods A retrospective review of ultrasounds on midtrimester singleton pregnancies was performed. Subjects were grouped as normal, overweight (BMI 25,29.9 kg/m2), and obese: class I (30,34.9 kg/m2), class II (35,39.9 kg/m2), and class III (, 40 kg/m2). Examinations with visualization of at least seven of eight markers were considered complete. Results Of 14 353 ultrasounds reviewed, 5690 patients were eligible: 43% normal, 29% overweight, 27% obese. Completion rates differed significantly between groups (64% normal, 64% overweight, 61% class I, 55% class II, 47% class III, p < 0.001). The screen positive rates (,1 marker) differed significantly overall (16% normal, 13% overweight, 15% class I, 12% class II, 10% class III, p < 0.02), but not for complete examinations (p = 0.42). Conclusions Since completion rates for ultrasound aneuploidy screening are inversely related to maternal obesity, obese women are underscreened. Copyright © 2010 John Wiley & Sons, Ltd. [source] Prenatal diagnosis of orofacial clefts, National Birth Defects Prevention Study, 1998,2004,PRENATAL DIAGNOSIS, Issue 9 2009Candice Y. Johnson Abstract Objective The aims of this study were to determine how frequently orofacial clefts were diagnosed prenatally and to investigate factors associated with prenatal diagnosis. Methods We included 2298 mothers from the National Birth Defects Prevention Study, each of whom gave birth to a child with an orofacial cleft, and assessed associated factors using logistic regression. Results The frequencies of prenatal diagnosis for cleft lip and palate, cleft lip only, and cleft palate only were 33.3%, 20.3%, and 0.3%, respectively. Among cases with cleft lip with or without cleft palate, cleft type, geographic location, maternal body mass index, household income, year of infant's birth, and presence of multiple birth defects were significantly associated with receiving a prenatal diagnosis. Conclusion In the majority of infants with orofacial clefts, a prenatal diagnosis was not made. Receiving a prenatal diagnosis was significantly associated with several infant and maternal characteristics. Copyright © 2009 John Wiley & Sons, Ltd. [source] Increased maternal BMI is associated with an increased risk of minor complications during pregnancy with consequent cost implicationsBJOG : AN INTERNATIONAL JOURNAL OF OBSTETRICS & GYNAECOLOGY, Issue 11 2009FC Denison Objective, To investigate the effect of maternal body mass index (BMI) on minor complications, associated additional medication use during pregnancy and the consequent cost implications. Design, Retrospective analysis of case notes. Setting, Labour wards, tertiary referral hospital, Royal Infirmary Edinburgh, UK. Population, Six hundred and fifty-one women with a singleton pregnancy over four separate time periods in 2007 and 2008. Methods, Descriptive statistics, univariate and multivariate logistic regression analysis and cost analysis using standard techniques and inflation indices. Main outcome measures, Minor complications, use of medications during pregnancy and consequent incremental costs from the perspective of the National Health Service (NHS). Results, 42.4% of women were overweight or obese (BMI , 25 kg/m2). Higher BMI during the first trimester (BMI , 30 kg/m2 compared with BMI < 25 kg/m2) was associated with an increased risk of minor complications including symphysis pubis dysfunction (OR 3.97; 95% CI 2.19,7.18), heartburn (OR 2.65; 95% CI 1.42,4.94) and chest infection (OR 8.71; 95% 2.20,34.44) and with drugs used to treat these complications including Gaviscon (OR 3.52; 95% CI 1.78,6.96). The mean incremental (additional) NHS costs per woman for treating minor complications increased with maternal BMI were £15.45/woman, £17.64/woman and £48.66/woman for BMI < 25 kg/m2, BMI , 25 to <30 kg/m2 and BMI , 30 kg/m2 respectively. Conclusions, Increased maternal BMI is associated with increased risk of developing minor complications during pregnancy; use of medications associated with treating these conditions and has significant NHS costs. [source] Poor uterine contractility in obese womenBJOG : AN INTERNATIONAL JOURNAL OF OBSTETRICS & GYNAECOLOGY, Issue 3 2007J Zhang Objective, The aim of the study was to elucidate the reason for the high rate of caesarean section in obese women. We examined the following hypotheses: (1) obese women have a high incidence of complications related to poor uterine contractility,caesarean section for dysfunctional labour and postpartum haemorrhage. 2) The myometrium from obese women has less ability to contract in vitro. Design, First, a clinical retrospective analysis of data from 3913 completed singleton pregnancies was performed. Secondly, in a prospective study the force, frequency and intracellular [Ca2+] flux of spontaneously contracting myometrium were related to the maternal body mass index. Setting, Liverpool Women's Hospital and University of Liverpool. Population, The clinical study involved all women who delivered in one hospital in 2002. The in vitro study myometrial biopsies were obtained from 73 women who had elective caesarean section at term. Results, Maternal obesity carried significant risk of caesarean section in labour that was highest for delay in the first stage of labour (OR 3.54). The increased risk of caesarean section in obese women largely occurred in women with normal- and not with high-birthweight infants. Obese women delivering vaginally had increased risk of prolonged first stage of labour and excessive blood loss. Myometrium from obese women contracted with less force and frequency and had less [Ca2+] flux than that from normal-weight women. Conclusions, We suggest that these findings indicate that obesity may impair the ability of the uterus to contract in labour. [source] New postnatal urinary incontinence: obstetric and other risk factors in primiparaeBJOG : AN INTERNATIONAL JOURNAL OF OBSTETRICS & GYNAECOLOGY, Issue 2 2006CMA Glazener Objective, To identify obstetric and other risk factors for urinary incontinence that occurs during pregnancy or after childbirth. Design, Questionnaire survey of women. Setting, Maternity units in Aberdeen (Scotland), Birmingham (England) and Dunedin (New Zealand). Population, A total of 3405 primiparous women with singleton births delivered during 1 year. Methods, Questionnaire responses and obstetric case note data were analysed using multivariate analysis to identify associations with urinary incontinence. Main outcome measures, Urinary incontinence at 3 months after delivery first starting in pregnancy or after birth. Results, The prevalence of urinary incontinence was 29%. New incontinence first beginning after delivery was associated with older maternal age (oldest versus youngest group, OR 2.02, 95% CI 1.35,3.02) and method of delivery (caesarean section versus spontaneous vaginal delivery, OR 0.28, 95% CI 0.19,0.41). There were no significant associations with forceps delivery (OR 1.18, 95% CI 0.92,1.51) or vacuum delivery (OR 1.16, 95% CI 0.83,1.63). Incontinence first occurring during pregnancy and still present at 3 months was associated with higher maternal body mass index (BMI > 25, OR 1.68, 95% CI 1.16,2.43) and heavier babies (birthweight in top quartile, OR 1.56, 95% CI 1.12,2.19). In these women, caesarean section was associated with less incontinence (OR 0.39, 95% CI 0.27,0.58) but incontinence was not associated with age. Conclusions, Women have less urinary incontinence after a first delivery by caesarean section whether or not that first starts during pregnancy. Older maternal age was associated with new postnatal incontinence, and higher BMI and heavier babies with incontinence first starting during pregnancy. The effect of further deliveries may modify these findings. [source] Diet in late pregnancy and glucose-insulin metabolism of the offspring 40 years laterBJOG : AN INTERNATIONAL JOURNAL OF OBSTETRICS & GYNAECOLOGY, Issue 7 2000A. W. Shiell Statistician Objective To determine how diets of women in pregnancy influence the glucose-insulin metabolism of their offspring in adult life. Design A follow up study of men and women born during 1948,1954 whose mothers had taken part in a survey of diet in late pregnancy. Setting Aberdeen, Scotland. Population One hundred and sixty-eight men and women born in the Aberdeen Maternity Hospital. Main outcome measure Plasma glucose and insulin concentrations, fasting and after a standard oral glucose challenge. Results The offspring of women who had high intakes of fat and protein in late pregnancy had a reduced plasma insulin increment between fasting and 30 min with a 7.0% decrease in increment (P= 0.007) per 10 g increase in protein intake and a 4.9% decrease (P= 0.002) per 10 g increase in fat intake. This was independent of the mother's body mass index or weight gain in pregnancy. A low maternal body mass index in early or late pregnancy was associated with a raised fasting plasma insulin concentration with a decrease of 2.4% (P= 0.05) per 1 kg/m2 increase of maternal body mass. Conclusion High intakes of protein and fat during pregnancy may impair development of the fetal pancreatic beta cells and lead to insulin deficiency in the offspring. The offspring of thin mothers tend to be insulin resistant. [source] | ||||||||||