Obesity Archives - Revista Brasileira de Ginecologia e Obstetrícia

  • Original Article09-01-2018

    Urinary Incontinence and Quality of Life in Female Patients with Obesity

    Revista Brasileira de Ginecologia e Obstetrícia. 2018;40(9):534-539

    Abstract

    Original Article

    Urinary Incontinence and Quality of Life in Female Patients with Obesity

    Revista Brasileira de Ginecologia e Obstetrícia. 2018;40(9):534-539

    DOI 10.1055/s-0038-1670626

    Views210

    Abstract

    Objective

    To analyze the prevalence of urinary incontinence (UI) in female patients with an indication for bariatric surgery, to investigate the potential risk factors and the impact on quality of life.

    Methods

    A cross-sectional study with female patients with obesity. The evaluation consisted of a structured interview, a specific study form and quality of life questionnaires. The Poisson regression was performed to identify independent risk factors related to UI.

    Results

    A total of 221 patients were enrolled; 118 of the study participants (53.4%) reported UI episodes. Mixed UI (MUI), stress UI (SUI) only, and urgency UI (UUI) only were reported by 52.5% (62), 33.9% (40) , and 13.5% (16) of these patients respectively. The prevalence of UI was increased by 47% among the women who had given birth vaginally and by 34% of the women who had entered menopause. Vaginal delivery and menopause were identified as independent risk factors related to UI. The mean International Consultation on Incontinence Questionnaire - Short Form (ICIQ-SF) score was 9.36 ± 4.9. The severity of symptoms was considered moderate in 53.3% (63) of the patients with UI.

    Conclusion

    Urinary incontinence impacts quality of life negatively, and the prevalence of UI is high among obese patients. In the present study, vaginal delivery and menopause were independently associated with UI.

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    This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
  • Original Article05-01-2018

    A Long-term Estrogen Deficiency in Ovariectomized Mice is Associated with Disturbances in Fatty Acid Oxidation and Oxidative Stress

    Revista Brasileira de Ginecologia e Obstetrícia. 2018;40(5):251-259

    Abstract

    Original Article

    A Long-term Estrogen Deficiency in Ovariectomized Mice is Associated with Disturbances in Fatty Acid Oxidation and Oxidative Stress

    Revista Brasileira de Ginecologia e Obstetrícia. 2018;40(5):251-259

    DOI 10.1055/s-0038-1666856

    Views245

    Abstract

    Objective

    The aim of this work was to evaluate the changes caused by estrogen deficiency in lipid metabolism.

    Methods

    This study encompassed direct measurements of plasma biochemical analyses, liver lipid contents, and assessments of the mitochondrial β-oxidation capacity as well as an evaluation of the liver redox status in an animal model of estrogen deficiency.

    Results

    When compared with control mice, the livers of ovariectomized (OVX) mice presented considerable accretions in their lipid contents, which were accompanied by increased levels of lipid peroxidation in liver homogenates andmitochondria from OVX groups and decreased reduced glutathione (GSH) contents. In isolated mitochondria, estrogen deficiency inhibited mitochondrial β-oxidation of fatty acids irrespective of their chain length. The liver mitochondrial and peroxisomal H2O2 generations in OVX mice were increased. Additionally, the activities of all antioxidant enzymes assessed were decreased.

    Conclusion

    These data provide one potential explanation for the increased susceptibility to metabolic diseases observed after menopause.

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    This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
  • Original Article04-01-2018

    Effectiveness of Metformin in the Prevention of Gestational Diabetes Mellitus in Obese Pregnant Women

    Revista Brasileira de Ginecologia e Obstetrícia. 2018;40(4):180-187

    Abstract

    Original Article

    Effectiveness of Metformin in the Prevention of Gestational Diabetes Mellitus in Obese Pregnant Women

    Revista Brasileira de Ginecologia e Obstetrícia. 2018;40(4):180-187

    DOI 10.1055/s-0038-1642632

    Views281

    Abstract

    Objective

    To assess the effectiveness of metformin in the incidence of gestational diabetes mellitus (GDM) in obese pregnant women attending a public maternity hospital in Joinville, Santa Catarina, Brazil.

    Methods

    Randomized clinical trial including obese pregnant women with a body mass index (BMI) ≥ 30 kg/m2, divided into two groups (control and metformin). Both groups received guidance regarding diet and physical exercise. The participants were assessed at two moments, the first at enrollment (gestational age ≤ 20) and the second at gestational weeks 24-28. The outcomes assessed were BMI and gestational diabetes mellitus (GDM) diagnosis. The data distribution was assessed with the Friedman test. For all the analytical models, the p-values were considered significant when lower than 0.05. The absolute risk reduction was also estimated.

    Results

    Overall, 164 pregnant women were assessed and further divided into 82 participants per group. No significant difference was observed in BMI variation between the control and metformin groups (0.9 ± 1.2 versus 1.0 ± 0.9, respectively, p = 0.63). Gestational diabetes mellitus was diagnosed in 15.9% (n = 13) of the patients allocated to the metformin group and 19.5% (n = 16) of those in the control group (p = 0.683). The absolute risk reduction was 3.6 (95% confidence interval 8.0- 15.32) in the group treated with metformin, which was not significant.

    Conclusion

    Metformin was not effective in reducing BMI and preventing GDM in obese pregnant women.

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    This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
  • Original Article01-01-2018

    Body Mass Index Changes during Pregnancy and Perinatal Outcomes – A Cross-Sectional Study

    Revista Brasileira de Ginecologia e Obstetrícia. 2018;40(1):11-19

    Abstract

    Original Article

    Body Mass Index Changes during Pregnancy and Perinatal Outcomes – A Cross-Sectional Study

    Revista Brasileira de Ginecologia e Obstetrícia. 2018;40(1):11-19

    DOI 10.1055/s-0037-1608885

    Views222

    Abstract

    Objective

    To evaluate the relation between changes the body mass index (BMI) percentile, reflected in the Atalah curve, and perinatal outcomes.

    Methods

    A cross-sectional study with 1,279 women was performed. Data regarding gestational weight, sociodemographic characteristics and perinatal outcomes were collected through medical charts, prenatal card and interviews in the postpartum period. Women could be classified according to the Atalah curve in the following categories: low weight, adequateweight, overweight, and obese. The BMIwas calculated at the first and at the last prenatal care visits, and these values were compared.

    Results

    An increase in the BMI category according to the Atalah classification occurred in 19.9% of pregnant women, and an increase of 3.4, 5.8 and 6.4 points of BMI were found for women respectively classified in the adequate weight, overweight and obese categories at the first prenatal visit. Women with high school education presented a lower chance of increasing their BMI (odds ratio [OR] 0:47 [0.24- 0.95]). Women who evolved with an increase in the the Atalah classification were associated with cesarean section (OR 1.97-2.28), fetalmacrosomia (OR 4.13-12.54) and large for gestational age newborn (OR 2.88-9.83).

    Conclusion

    Pregnant women who gained enough weight to move up in their BMI classification according to the Atalah curve had a higher chance of cesarean section and macrosomia. Women classified as obese, according to the Atalah curve, at the first prenatal visit had a high chance of cesarean section and delivering a large for gestational age newborn.

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    This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
  • Short Communication12-01-2017

    Nutritional Counseling Promotes Changes in the Dietary Habits of Overweight and Obese Adolescents with Polycystic Ovary Syndrome

    Revista Brasileira de Ginecologia e Obstetrícia. 2017;39(12):692-696

    Abstract

    Short Communication

    Nutritional Counseling Promotes Changes in the Dietary Habits of Overweight and Obese Adolescents with Polycystic Ovary Syndrome

    Revista Brasileira de Ginecologia e Obstetrícia. 2017;39(12):692-696

    DOI 10.1055/s-0037-1607458

    Views208

    Abstract

    Objective

    To evaluate the effects of nutritional counseling on the dietary habits and anthropometric parameters of overweight and obese adolescentswith polycystic ovary syndrome (PCOS).

    Methods

    This was a prospective, longitudinal and auto-controlled study. Thirty adolescents aged 13-19 years-old, diagnosed with PCOS received nutritional counseling and were followed-up for 6 months. After the follow-up period, the results were evaluated through body weight, body mass index (BMI) and waist circumference (WC).

    Results

    Sixty-percent of the adolescents adhered to the nutritional counseling and, of these, 50% lost weight. Adolescents who lost weight changed their dietary habits by adopting hypocaloric diets and eating more meals per day, as per nutritional counseling. The waist circumference (WC) decreased significantly, although the body weight decreased non-significantly after adoption of a hypocaloric diet.

    Conclusion

    Although there was no significant weight loss, there was a considerable reduction in theWCassociated with hypocaloric diets and with eating a greater number of meals per day.

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    This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
  • Original Article07-01-2017

    Effect of Obesity on Gestational and Perinatal Outcomes

    Revista Brasileira de Ginecologia e Obstetrícia. 2017;39(7):330-336

    Abstract

    Original Article

    Effect of Obesity on Gestational and Perinatal Outcomes

    Revista Brasileira de Ginecologia e Obstetrícia. 2017;39(7):330-336

    DOI 10.1055/s-0037-1603826

    Views145

    Abstract

    Purpose

    To assess the impact of pre-pregnancy obesity (body mass index [BMI] ≥30 kg/m2) on the gestational and perinatal outcomes.

    Methods

    Retrospective cohort study of 731 pregnant women with a BMI ≥30 kg/m2 at the first prenatal care visit, comparing them with 3,161 women with a BMI between 18.5 kg/m2 and 24.9 kg/m2. Maternal and neonatal variables were assessed. Statistical analyses reporting the demographic features of the pregnant women (obese and normal) were performed with descriptive statistics followed by two-sided independent Student’s t tests for the continuous variables, and the chi-squared (χ2) test, or Fisher’s exact test, for the categorical variables. We performed a multiple linear regression analysis of newborn body weight based on the mother’s BMI, adjusted by maternal age, hyperglycemic disorders, hypertensive disorders, and cesarean deliveries to analyze the relationships among these variables. All analyses were performed with the R (R Foundation for Statistical Computing, Vienna, Austria) for Windows software, version 3.1.0. A value of p < 0.05 was considered statistically significant.

    Results

    Obesity was associated with older age [OR 9.8 (7.8-12.2); p < 0.01], hyperglycemic disorders [OR 6.5 (4.8-8.9); p < 0.01], hypertensive disorders [OR 7.6 (6.1-9.5); p < 0.01], caesarean deliveries [OR 2.5 (2.1-3.0); p < 0.01], fetal macrosomia [OR 2.9 (2.3-3.6); p < 0.01] and umbilical cord pH [OR 2.1 (1.4-2.9); p < 0.01). Conversely, no association was observed with the duration of labor, bleeding during labor, Apgar scores at 1 and 5 minutes after birth, gestational age, stillbirth and early neonatal mortality, congenital malformations, and maternal and fetal injury.

    Conclusion

    We observed that pre-pregnancy obesity was associated with maternal age, hyperglycemic disorders, hypertension syndrome, cesarean deliveries, fetal macrosomia, and fetal acidosis.

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    This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
    Effect of Obesity on Gestational and Perinatal Outcomes
  • Original Article08-01-2015

    Sleep quality in overweight pregnant women

    Revista Brasileira de Ginecologia e Obstetrícia. 2015;37(8):359-365

    Abstract

    Original Article

    Sleep quality in overweight pregnant women

    Revista Brasileira de Ginecologia e Obstetrícia. 2015;37(8):359-365

    DOI 10.1590/SO100-720320150005415

    Views129

    PURPOSE:

    To compare sleep quality of overweight versus normal weight women in the second and third trimesters of pregnancy.

    METHODS:

    A cross-sectional study involving 223 women with 14 or more weeks of pregnancy, 105 of them overweight (pre-pregnancy body mass index - BMI - ≥25.0 kg/m2) and 118 of normal weight (BMI 18.5-24.9 kg/m2), attending the prenatal care clinic. The Brazilian version of the Pittsburgh Sleep Quality Index (PSQI-BR) questionnaire was used to evaluate sleep quality. The Student t-test and the chi-square test were used to compare differences between groups and a p value <0.05 was considered statistically significant.

    RESULTS:

    Most of the participants (67.7%) were poor sleepers (total score >5); this proportion was significantly higher among overweight (80/105) versus normal weight (67/118) women (76.2 versus 56.8%, p=0,004). During the second trimester, this difference did not reach statistical significance (72.5 versus 53.7%, respectively, p=0.06) but mean total PSQI-BR scores were significantly higher among overweight participants (7.0±3.8 versus 5.5±3.2, p=0.02). In the 2nd trimester, overweight women also had higher scores for sleep latency (1.4±1.0 versus 1.0±0.9, p=0.02) and subjective sleep quality (1.3±0.8 versus 0.8±0.8, p=0.02). In the third trimester, the proportion of women with poor sleep quality was significantly higher in the overweight group, but did not reach statistical significance (79.6 versus 60.8%, p=0.06). During this period, total mean scores were similar for women with and without excess weight (9.4±4.2 versus 8.3±4.6, p=0.2). However, overweight women had higher mean scores for sleep disturbance (2.3±0.7 versus 2.0±0.8, p=0.04).

    CONCLUSION:

    Overweight women had a poorer sleep quality than normal weight women in the second and third trimesters of pregnancy.

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    This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
  • Original Article07-01-2015

    Blockade of AT1 receptor of Angiotensin II reduces the number of antral follicles in female rats with obesity induced by cafeteria diet

    Revista Brasileira de Ginecologia e Obstetrícia. 2015;37(7):302-307

    Abstract

    Original Article

    Blockade of AT1 receptor of Angiotensin II reduces the number of antral follicles in female rats with obesity induced by cafeteria diet

    Revista Brasileira de Ginecologia e Obstetrícia. 2015;37(7):302-307

    DOI 10.1590/S0100-720320150005352

    Views93

    PURPOSE:

    To evaluate the follicular development of female Wistar rats with obesity induced by the cafeteria diet, submitted to the administration of losartan (LOS), an antagonist of the AT1 receptor of Angiotensin II.

    METHODS:

    At weaning (21 days of age), female Wistar rats were randomly divided, into two groups: control (CTL) that received standard chow and cafeteria (CAF) that received a cafeteria diet, a highly palatable and highly caloric diet. At 70 days of age, at the beginning of the reproductive age, animals of the CAF group were subdivided into two groups (n=15/group): CAF, that received water, and CAF+LOS, that received LOS for 30 days. The CTL group also received water by gavage. At 100 days of age, the animals were euthanized and body weight (BW) as well as the retroperitoneal, perigonadal and subcutaneous fat weights were analyzed. The right ovaries were isolated for counting the number of primary, secondary, antral and mature follicles. Plasma levels of FSH, LH, prolactin and progesterone hormones were analyzed. The results were expressed as mean±standard error of the mean. Data were analyzed statistically by one-way ANOVA followed by the Newman-Keuls post-test (p<0.05).

    RESULTS:

    BW and fat weight, as well as the number of antral follicles, were higher in the CAF group compared to the CTL group. However, FSH and LH levels were lower in CAF animals compared to CTL animals. LOS administration attenuated the reduction of FSH and LH levels. Progesterone and PRL levels were similar among groups.

    CONCLUSION:

    LOS could improve follicular development in obese females and could be used as an adjunctive drug in the treatment of infertility associated with obesity.

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    This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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