body mass index Archives - Revista Brasileira de Ginecologia e Obstetrícia
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2013;35(12):536-540
DOI 10.1590/S0100-72032013001200002
PURPOSE: To evaluate weight retention 12 months postpartum and factors associated among women who had received prenatal care at Health Care Centers in Porto Alegre, southern Brazil. METHODS: Pregnant women in the last trimester were identified at 20 Health Care Centers. Socioeconomic, demographic and anthropometrics data were obtained. Six and 12 months after delivery, the women received home visits for anthropometric measures. The gestational weight gain was defined by pre-pregnancy Body Mass Index (BMI). Weight retention was defined as the difference between pre-gestational weight and weight at postpartum. Data were analyzed using McNemar's Test, ANOVA with Bonferroni correction and multiple linear regression. RESULTS: Of the 715 pregnant women recruited, 545 were assessed 12 months after delivery. Women were more likely to be overweight 12 months postpartum compared to the pre-pregnancy period (52.9 versus 36.7%) and weight retention during the 12 months postpartum was more than 10 kg in 30.7% of the women. Weight retention in the postpartum period was higher among women who were overweight (9.9±7.7 kg) compared to those who were of normal weight during the pre-pregnancy period (7.6±6.2 kg). Pre-pregnancy BMI, gestational weight gain, and maternal age were associated with gestational weight retention 12 months postpartum (p<0.001). CONCLUSION: Adequate prenatal care is necessary to minimize the adverse effects of excessive weight gain during pregnancy on women's health.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2013;35(12):536-540
DOI 10.1590/S0100-72032013001200002
PURPOSE: To evaluate weight retention 12 months postpartum and factors associated among women who had received prenatal care at Health Care Centers in Porto Alegre, southern Brazil. METHODS: Pregnant women in the last trimester were identified at 20 Health Care Centers. Socioeconomic, demographic and anthropometrics data were obtained. Six and 12 months after delivery, the women received home visits for anthropometric measures. The gestational weight gain was defined by pre-pregnancy Body Mass Index (BMI). Weight retention was defined as the difference between pre-gestational weight and weight at postpartum. Data were analyzed using McNemar's Test, ANOVA with Bonferroni correction and multiple linear regression. RESULTS: Of the 715 pregnant women recruited, 545 were assessed 12 months after delivery. Women were more likely to be overweight 12 months postpartum compared to the pre-pregnancy period (52.9 versus 36.7%) and weight retention during the 12 months postpartum was more than 10 kg in 30.7% of the women. Weight retention in the postpartum period was higher among women who were overweight (9.9±7.7 kg) compared to those who were of normal weight during the pre-pregnancy period (7.6±6.2 kg). Pre-pregnancy BMI, gestational weight gain, and maternal age were associated with gestational weight retention 12 months postpartum (p<0.001). CONCLUSION: Adequate prenatal care is necessary to minimize the adverse effects of excessive weight gain during pregnancy on women's health.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2013;35(11):511-515
DOI 10.1590/S0100-72032013001100006
PURPOSE: To evaluate the incidence of maternal and fetal repercussions and glycemic control in women with Gestational Diabetes Mellitus (GDM) using a fasting glucose of 85 mg/dL in the first trimester as a cut-off point and to correlate it with risk factors. METHODS: The medical records of pregnant women followed in the outpatient antenatal high-risk service (PNAR) of HRAN from January 2011 to March 2012 were reviewed and those women diagnosed with GDM were selected for contact and for prenatal card verification. We collected data of age, parity, fasting glucose during the first quarter, the value of the Oral Glucose Tolerance Test (OGTT), Body Mass Index (BMI), mode of delivery, form of control, effects and fetal risk factors for GDM. Statistical analysis was performed using the PSPP 0.6.2 software and consisted of descriptive analysis of frequencies, χ2 test for categorical variables, Student's t-test for independent samples, and Pearson test for correlations, with the level of significance set at 5%. RESULTS: From 408 pregnant women enrolled, 105 were diagnosed with GDM and 71 had complete records or answered to the contact in order to provide the missing information. The GDM-fasting <85 (fasting glucose <85 mg/dL at the first prenatal visit, in the first trimester) group consisted of 29 (40.8%) women and the GDM-fasting >85 (fasting glucose >85 mg/dL at the first prenatal visit, in the first trimester) consisted of 42 (59.1%) women. It was observed that few patients (five in the GDM-fasting <85 group and three in the GDM-fasting >85 group) had no risk factors for GDM. There was a major need for control with insulin in patients of the GDM-fasting >85 group. There was no significant difference related to fetal impact or mode of delivery between the groups. CONCLUSIONS: The first trimester fasting glycemia, with a cut-off value of 85 mg/dL alone or associated with risk factors, does not seem to be a good single predictor of the maternal-fetal effects of GDM.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2013;35(11):511-515
DOI 10.1590/S0100-72032013001100006
PURPOSE: To evaluate the incidence of maternal and fetal repercussions and glycemic control in women with Gestational Diabetes Mellitus (GDM) using a fasting glucose of 85 mg/dL in the first trimester as a cut-off point and to correlate it with risk factors. METHODS: The medical records of pregnant women followed in the outpatient antenatal high-risk service (PNAR) of HRAN from January 2011 to March 2012 were reviewed and those women diagnosed with GDM were selected for contact and for prenatal card verification. We collected data of age, parity, fasting glucose during the first quarter, the value of the Oral Glucose Tolerance Test (OGTT), Body Mass Index (BMI), mode of delivery, form of control, effects and fetal risk factors for GDM. Statistical analysis was performed using the PSPP 0.6.2 software and consisted of descriptive analysis of frequencies, χ2 test for categorical variables, Student's t-test for independent samples, and Pearson test for correlations, with the level of significance set at 5%. RESULTS: From 408 pregnant women enrolled, 105 were diagnosed with GDM and 71 had complete records or answered to the contact in order to provide the missing information. The GDM-fasting <85 (fasting glucose <85 mg/dL at the first prenatal visit, in the first trimester) group consisted of 29 (40.8%) women and the GDM-fasting >85 (fasting glucose >85 mg/dL at the first prenatal visit, in the first trimester) consisted of 42 (59.1%) women. It was observed that few patients (five in the GDM-fasting <85 group and three in the GDM-fasting >85 group) had no risk factors for GDM. There was a major need for control with insulin in patients of the GDM-fasting >85 group. There was no significant difference related to fetal impact or mode of delivery between the groups. CONCLUSIONS: The first trimester fasting glycemia, with a cut-off value of 85 mg/dL alone or associated with risk factors, does not seem to be a good single predictor of the maternal-fetal effects of GDM.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2013;35(9):413-420
DOI 10.1590/S0100-72032013000900006
PURPOSE: To characterize and compare clinical, anthropometric and biochemical-metabolic variables in patients with polycystic ovary syndrome (PCOS), stratified according to body mass index (BMI). METHODS: A cross-sectional study conducted on 78 women aged 18 to 45 years with a clinical diagnosis of PCOS by the Rotterdam criteria. Patients were stratified according to BMI. The variables analyzed were: age, marital status, physical inactivity, menstrual irregularity, blood pressure (BP), anthropometric measurements, lipid profile, fasting glucose, and hormone measurements. To compare the variables between the different BMI values we used analysis of variance and the Kruskal-Wallis test. The level of significance was set at 5% for all tests. RESULTS: The patients had a mean age of 26.3 years, 79.5% of them were sedentary and 68% had hyperandrogenism. Waist circumference, waist/hip ratio, waist/height ratio and percentage of body fat were higher in the obese group. The markers of cardiovascular risk (CVR - fasting glucose, systolic and diastolic BP and LDL-cholesterol) were directly proportional to BMI, whereas HDL-cholesterol and SHBG were inversely related to BMI. CONCLUSION: The presence of markers of CVR factors increased proportionally to BMI, indicating that the metabolic profile of obese women with PCOS is more unfavorable than that of non-obese patients.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2013;35(9):413-420
DOI 10.1590/S0100-72032013000900006
PURPOSE: To characterize and compare clinical, anthropometric and biochemical-metabolic variables in patients with polycystic ovary syndrome (PCOS), stratified according to body mass index (BMI). METHODS: A cross-sectional study conducted on 78 women aged 18 to 45 years with a clinical diagnosis of PCOS by the Rotterdam criteria. Patients were stratified according to BMI. The variables analyzed were: age, marital status, physical inactivity, menstrual irregularity, blood pressure (BP), anthropometric measurements, lipid profile, fasting glucose, and hormone measurements. To compare the variables between the different BMI values we used analysis of variance and the Kruskal-Wallis test. The level of significance was set at 5% for all tests. RESULTS: The patients had a mean age of 26.3 years, 79.5% of them were sedentary and 68% had hyperandrogenism. Waist circumference, waist/hip ratio, waist/height ratio and percentage of body fat were higher in the obese group. The markers of cardiovascular risk (CVR - fasting glucose, systolic and diastolic BP and LDL-cholesterol) were directly proportional to BMI, whereas HDL-cholesterol and SHBG were inversely related to BMI. CONCLUSION: The presence of markers of CVR factors increased proportionally to BMI, indicating that the metabolic profile of obese women with PCOS is more unfavorable than that of non-obese patients.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2012;34(10):442-446
DOI 10.1590/S0100-72032012001000002
PURPOSE: To evaluate the prevalence of common mental disorders in women diagnosed with polycystic ovary syndrome as compared with paired controls without this syndrome. METHODS: Cross-sectional study with a Control Group examining women between the ages of 18 and 30 who did not use antidepressants and who sought the Gynecology Service of the researched sites. For every woman diagnosed with the polycystic ovary syndrome, another with the same age, educational status and presence or absence of sexual partners was sought without this diagnosis. In total, 166 patients agreed to participate, consisting of 95 diagnosed with polycystic ovary syndrome and 71 in the Control Group. The diagnosis of polycystic ovary syndrome was made by the presence of two from three criteria: oligomenorrhea or amenorrhea, clinical or biochemical hyperandrogenism and polycystic ovaries on transvaginal ultrasound, following exclusion of patients with Cushing's syndrome, congenital adrenal hyperplasia, and androgen-secreting tumors. Weight and height were measured to calculate the body mass index. The Self-Reporting Questionnaire, which evaluated 20 items, was used as an indicator of common mental disorders. A χ² analysis stratified by the category of body mass index was used to compare the prevalence of common mental disorders, between the groups of women with and without the polycystic ovary syndrome. RESULTS: There were no significant differences in age, education, presence of sexual partners, ethnicity, socioeconomic status, use of psychiatric medication, and search for consultation in mental health between the studied groups. The prevalence of obese women with indications of common mental disorders was significantly higher in women with polycystic ovary syndrome than in the Control Group. In the group with healthy body mass index, the incidence of common mental disorders was statistically significant different between women with polycystic ovary syndrome and normal controls (p=0.008). CONCLUSIONS: Women with diagnosis of this disease have an almost three-fold increased likelihood of common mental disorders as compared with those without polycystic ovary syndrome. Although obesity is often observed in polycystic ovary syndrome, even women with a healthy body mass index have an increased risk of psychiatric comorbidity.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2012;34(10):442-446
DOI 10.1590/S0100-72032012001000002
PURPOSE: To evaluate the prevalence of common mental disorders in women diagnosed with polycystic ovary syndrome as compared with paired controls without this syndrome. METHODS: Cross-sectional study with a Control Group examining women between the ages of 18 and 30 who did not use antidepressants and who sought the Gynecology Service of the researched sites. For every woman diagnosed with the polycystic ovary syndrome, another with the same age, educational status and presence or absence of sexual partners was sought without this diagnosis. In total, 166 patients agreed to participate, consisting of 95 diagnosed with polycystic ovary syndrome and 71 in the Control Group. The diagnosis of polycystic ovary syndrome was made by the presence of two from three criteria: oligomenorrhea or amenorrhea, clinical or biochemical hyperandrogenism and polycystic ovaries on transvaginal ultrasound, following exclusion of patients with Cushing's syndrome, congenital adrenal hyperplasia, and androgen-secreting tumors. Weight and height were measured to calculate the body mass index. The Self-Reporting Questionnaire, which evaluated 20 items, was used as an indicator of common mental disorders. A χ² analysis stratified by the category of body mass index was used to compare the prevalence of common mental disorders, between the groups of women with and without the polycystic ovary syndrome. RESULTS: There were no significant differences in age, education, presence of sexual partners, ethnicity, socioeconomic status, use of psychiatric medication, and search for consultation in mental health between the studied groups. The prevalence of obese women with indications of common mental disorders was significantly higher in women with polycystic ovary syndrome than in the Control Group. In the group with healthy body mass index, the incidence of common mental disorders was statistically significant different between women with polycystic ovary syndrome and normal controls (p=0.008). CONCLUSIONS: Women with diagnosis of this disease have an almost three-fold increased likelihood of common mental disorders as compared with those without polycystic ovary syndrome. Although obesity is often observed in polycystic ovary syndrome, even women with a healthy body mass index have an increased risk of psychiatric comorbidity.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2012;34(7):304-309
DOI 10.1590/S0100-72032012000700003
PURPOSE: To evaluate the impact of body mass index (BMI) at the beginning of pregnancy and weight gain on pregnancy outcome so that this measure can be implemented and valued by prenatal care health services. METHOD: Cross-sectional population-based study of all births in the only two hospitals in Rio Grande city (Brazil), in 2007. Among the 2,557 mothers interviewed, it was possible to calculate BMI in only 1,117. The Stata 11 software was used for data analysis. Logist regression was applied to the outomes involving diabetes mellitus, premature labor and cesarean section. Regarding birth weight, data were adjusted by multinomial logistic regression using as base category the group of 2,500 to 4,000 g. The level of significance was set at p-value <0.05 in a two-tailed test. RESULTS: There was no increased risk of hypertension or diabetes in patients in the different groups of BMI and weight gain. The risk of preterm delivery was evident in the group with a weight gain ≤8 kg (p<0.05). Regarding the route of delivery, it was observed that the higher the BMI in early pregnancy (p=0.001) and the greater the weight gain during pregnancy (p=0.004), the greater the risk of surgical delivery, which reached 11% in the group of obese mothers (p=0.004) and 12% in the group with a weight gain ≥17 kg (p=0.001). The weight of the newborns was influenced by BMI and weight gain, and the higher the BMI in early pregnancy and the gestational weight gain, the greater the risk of macrosomia. CONCLUSION: The monitoring of BMI and weight gain during pregnancy is a low cost and useful procedure for the establishment of nutritional interventions aimed at reducing maternal and fetal risks.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2012;34(7):304-309
DOI 10.1590/S0100-72032012000700003
PURPOSE: To evaluate the impact of body mass index (BMI) at the beginning of pregnancy and weight gain on pregnancy outcome so that this measure can be implemented and valued by prenatal care health services. METHOD: Cross-sectional population-based study of all births in the only two hospitals in Rio Grande city (Brazil), in 2007. Among the 2,557 mothers interviewed, it was possible to calculate BMI in only 1,117. The Stata 11 software was used for data analysis. Logist regression was applied to the outomes involving diabetes mellitus, premature labor and cesarean section. Regarding birth weight, data were adjusted by multinomial logistic regression using as base category the group of 2,500 to 4,000 g. The level of significance was set at p-value <0.05 in a two-tailed test. RESULTS: There was no increased risk of hypertension or diabetes in patients in the different groups of BMI and weight gain. The risk of preterm delivery was evident in the group with a weight gain ≤8 kg (p<0.05). Regarding the route of delivery, it was observed that the higher the BMI in early pregnancy (p=0.001) and the greater the weight gain during pregnancy (p=0.004), the greater the risk of surgical delivery, which reached 11% in the group of obese mothers (p=0.004) and 12% in the group with a weight gain ≥17 kg (p=0.001). The weight of the newborns was influenced by BMI and weight gain, and the higher the BMI in early pregnancy and the gestational weight gain, the greater the risk of macrosomia. CONCLUSION: The monitoring of BMI and weight gain during pregnancy is a low cost and useful procedure for the establishment of nutritional interventions aimed at reducing maternal and fetal risks.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2012;34(2):74-79
DOI 10.1590/S0100-72032012000200006
PURPOSE: To analyze the prevalence of insulin resistance, according to different biochemical and anthropometric measurements in women with polycystic ovary syndrome. METHODS: A total of 189 patients with polycystic ovary syndrome were retrospectively analyzed. Insulin resistance diagnosis was performed using fasting insulin, HOMA-IR, QUICKI, insulin sensibility index and glucose/fasting insulin ratio. Body mass index and lipid accumulation product were used. Data were analyzed statistically by descriptive statistics, ANOVA, Tukey post-test, and Pearson's correlation. RESULTS: The polycystic ovary syndrome patients had a mean age of 24.9±5.2 and a mean body mass index of 31.8±7.6. The percentage of obese patients was 57.14%. Among the methods of insulin resistance investigation, the insulin sensibility index was the technique that most detected (56.4%) the presence of insulin resistance in women with polycystic ovary syndrome. The insulin resistance was detected in 87% of obese patients. The fasting glucose/fasting insulin ratio and insulin sensibility index were strongly correlated with lipid accumulation product. CONCLUSION: The prevalence of insulin resistance varied according to the method used, and it was greater the higher the body mass index. Lipid accumulation product was also related to insulin resistance.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2012;34(2):74-79
DOI 10.1590/S0100-72032012000200006
PURPOSE: To analyze the prevalence of insulin resistance, according to different biochemical and anthropometric measurements in women with polycystic ovary syndrome. METHODS: A total of 189 patients with polycystic ovary syndrome were retrospectively analyzed. Insulin resistance diagnosis was performed using fasting insulin, HOMA-IR, QUICKI, insulin sensibility index and glucose/fasting insulin ratio. Body mass index and lipid accumulation product were used. Data were analyzed statistically by descriptive statistics, ANOVA, Tukey post-test, and Pearson's correlation. RESULTS: The polycystic ovary syndrome patients had a mean age of 24.9±5.2 and a mean body mass index of 31.8±7.6. The percentage of obese patients was 57.14%. Among the methods of insulin resistance investigation, the insulin sensibility index was the technique that most detected (56.4%) the presence of insulin resistance in women with polycystic ovary syndrome. The insulin resistance was detected in 87% of obese patients. The fasting glucose/fasting insulin ratio and insulin sensibility index were strongly correlated with lipid accumulation product. CONCLUSION: The prevalence of insulin resistance varied according to the method used, and it was greater the higher the body mass index. Lipid accumulation product was also related to insulin resistance.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2011;33(10):310-314
DOI 10.1590/S0100-72032011001000007
PURPOSE: to evaluate the effect of hormone replacement therapy (HT) on the weight on perimenopausal women as well as the effect of different treatment regimens on this parameter. METHODS: a retrospective study of 139 women with menopause for less than 2 years, who were monitored with periodical visits in our department. We compared two groups: women who started HT (n=89) with women who had no hormonal treatment (n=50) and in the two groups, we evaluated the changes in body weight over a 1-year period. In the first group, we assessed the same parameter as a function of different treatment regimens: estrogen alone versus estrogen combined with progestin and standard dose versus low dose. The SPSS® program was used for statistical analysis, with the level of significance set at p<0.05. RESULTS: the groups were similar with respect to demographic and baseline characteristics; weight gain was higher in the untreated group (434 vs 76 g), but the difference observed was not significant (p = 0.406); among HT users, those taking estrogen alone had an increased weight gain compared to women taking estrogen with progestin (775 vs 24 g), although no statistically significant difference was observed and the same applied when comparing the dose initially prescribed (92 vs 49 g). CONCLUSIONS: despite the common belief about weight gain associated with HT, the results of the present study seem to contradict this point, with no additional weight gain beyond that normally associated with this period in a woman´s life.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2011;33(10):310-314
DOI 10.1590/S0100-72032011001000007
PURPOSE: to evaluate the effect of hormone replacement therapy (HT) on the weight on perimenopausal women as well as the effect of different treatment regimens on this parameter. METHODS: a retrospective study of 139 women with menopause for less than 2 years, who were monitored with periodical visits in our department. We compared two groups: women who started HT (n=89) with women who had no hormonal treatment (n=50) and in the two groups, we evaluated the changes in body weight over a 1-year period. In the first group, we assessed the same parameter as a function of different treatment regimens: estrogen alone versus estrogen combined with progestin and standard dose versus low dose. The SPSS® program was used for statistical analysis, with the level of significance set at p<0.05. RESULTS: the groups were similar with respect to demographic and baseline characteristics; weight gain was higher in the untreated group (434 vs 76 g), but the difference observed was not significant (p = 0.406); among HT users, those taking estrogen alone had an increased weight gain compared to women taking estrogen with progestin (775 vs 24 g), although no statistically significant difference was observed and the same applied when comparing the dose initially prescribed (92 vs 49 g). CONCLUSIONS: despite the common belief about weight gain associated with HT, the results of the present study seem to contradict this point, with no additional weight gain beyond that normally associated with this period in a woman´s life.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2011;33(7):164-169
DOI 10.1590/S0100-72032011000700008
PURPOSE: to analyze the gait propulsion force and relate it to changes in the dimensions of the feet and to the influence on the quality of life of pregnant women. METHODS: two groups were studied, a control (C) one consisting of 20 non-pregnant women and a group of 13 pregnant women investigated during the three gestational trimesters (Gfirst, Gsecond, Gthird). The groups were subjected to an initial assessment; evaluation of gait propulsion force using the force platform (Bertec); measurement of foot length and width; assessment of perimetry by the figure eight method; and assessment of quality of life using the World Health Organization Quality of Life Instrument Bref (Whoqol-bref). The Mann-Whitney test was used to evaluate differences between group C and Gfirst, the Friedman test was used to determine differences between Gfirst, Gsecond and Gthird, and the Wilcoxon test was applied to significant cases. The level of significance was set at 5%. RESULTS: There was an increase in body mass (10.5 kg) and ankle edema (2.4 cm) during pregnancy. There was a decrease of gait propulsion force (10% of body mass) and an increase of mediolateral sway (10% of body mass) compared to Control Group. There was a reduced quality of life among pregnnat women, especially in the physical domain. CONCLUSIONS: Gait disorders occur during pregnancy, which can increase the risk of falls and musculoskeletal discomfort, which may affect the quality of life of pregnant wome
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2011;33(7):164-169
DOI 10.1590/S0100-72032011000700008
PURPOSE: to analyze the gait propulsion force and relate it to changes in the dimensions of the feet and to the influence on the quality of life of pregnant women. METHODS: two groups were studied, a control (C) one consisting of 20 non-pregnant women and a group of 13 pregnant women investigated during the three gestational trimesters (Gfirst, Gsecond, Gthird). The groups were subjected to an initial assessment; evaluation of gait propulsion force using the force platform (Bertec); measurement of foot length and width; assessment of perimetry by the figure eight method; and assessment of quality of life using the World Health Organization Quality of Life Instrument Bref (Whoqol-bref). The Mann-Whitney test was used to evaluate differences between group C and Gfirst, the Friedman test was used to determine differences between Gfirst, Gsecond and Gthird, and the Wilcoxon test was applied to significant cases. The level of significance was set at 5%. RESULTS: There was an increase in body mass (10.5 kg) and ankle edema (2.4 cm) during pregnancy. There was a decrease of gait propulsion force (10% of body mass) and an increase of mediolateral sway (10% of body mass) compared to Control Group. There was a reduced quality of life among pregnnat women, especially in the physical domain. CONCLUSIONS: Gait disorders occur during pregnancy, which can increase the risk of falls and musculoskeletal discomfort, which may affect the quality of life of pregnant wome