overweight Archives - Revista Brasileira de Ginecologia e Obstetrícia
Summary
Rev Bras Ginecol Obstet. 2014;36(11):514-518
DOI 10.1590/S0100-720320140005007
To describe the epidemiologic and obstetric characteristics of women with recurrent miscarriages.
A descriptive and analytical study whose inclusion criterion was every woman that was attended at the clinic for recurrent miscarriage (loss group), between January 2006 and December 2010. Patients that did not live in Salvador, Bahia, Brazil, and those who were not reached by telephone or whose number was not included in the medical record were not included. The Control Group consisted of 204 pregnant women seen at the low-risk prenatal care unit between May 2007 and April 2008. Women who did not accept to be interviewed and those with obstetric risk were excluded from the Control Group. The analyzed variables were: age, education, occupation, marital status, alcohol consumption, body mass index, obstetric history and the gestational age when the losses occurred. The SPSS 18.0 program was used for statistical analysis. Means and standard deviations of continuous variables were compared using the Student's t-test and the frequencies of the nominal variables were compared by the χ2 test.
The mean age of women in the loss group was higher than in the Control Group (32.3±6.3 versus 26.5±6.4 years old, p<0.01). Consumption of alcoholic beverages predominated in the loss group (36.9 versus 22.1%, p=0.01), as well as marital status (93.2 versus 66.7% were married or living in a stable union, p<0.01). The pre-pregnancy body mass index was higher in the loss group (26.9 versus 23.5%, p<0.01). Regarding obstetric history, 103 women with recurrent miscarriage reported 334 pregnancies. Fifty-six of them had 2 or more miscarriages in the first quarter and in 31 of them, 2 or more pregnancies progressed to late abortions/extremely preterm infants.
Some risk factors were identified in women with recurrent losses, such as more advanced age and higher body mass index. These observations agree with more recent proposals regarding recurrent losses that consider the inclusion of losses in various gestational ages.
Summary
Rev Bras Ginecol Obstet. 2014;36(11):514-518
DOI 10.1590/S0100-720320140005007
To describe the epidemiologic and obstetric characteristics of women with recurrent miscarriages.
A descriptive and analytical study whose inclusion criterion was every woman that was attended at the clinic for recurrent miscarriage (loss group), between January 2006 and December 2010. Patients that did not live in Salvador, Bahia, Brazil, and those who were not reached by telephone or whose number was not included in the medical record were not included. The Control Group consisted of 204 pregnant women seen at the low-risk prenatal care unit between May 2007 and April 2008. Women who did not accept to be interviewed and those with obstetric risk were excluded from the Control Group. The analyzed variables were: age, education, occupation, marital status, alcohol consumption, body mass index, obstetric history and the gestational age when the losses occurred. The SPSS 18.0 program was used for statistical analysis. Means and standard deviations of continuous variables were compared using the Student's t-test and the frequencies of the nominal variables were compared by the χ2 test.
The mean age of women in the loss group was higher than in the Control Group (32.3±6.3 versus 26.5±6.4 years old, p<0.01). Consumption of alcoholic beverages predominated in the loss group (36.9 versus 22.1%, p=0.01), as well as marital status (93.2 versus 66.7% were married or living in a stable union, p<0.01). The pre-pregnancy body mass index was higher in the loss group (26.9 versus 23.5%, p<0.01). Regarding obstetric history, 103 women with recurrent miscarriage reported 334 pregnancies. Fifty-six of them had 2 or more miscarriages in the first quarter and in 31 of them, 2 or more pregnancies progressed to late abortions/extremely preterm infants.
Some risk factors were identified in women with recurrent losses, such as more advanced age and higher body mass index. These observations agree with more recent proposals regarding recurrent losses that consider the inclusion of losses in various gestational ages.
Summary
Rev Bras Ginecol Obstet. 2012;34(3):102-106
DOI 10.1590/S0100-72032012000300002
PURPOSE: To assess the prevalence of obstetric risk factors and their association with unfavorable outcomes for the mother and fetus. METHODS: A longitudinal, descriptive and analytical study was conducted on 204 pregnant women between May 2007 and December 2008. Clinical and laboratory assessments followed routine protocols. Risk factors included socio-demographic aspects; family, personal and obstetric history; high pre-gestational body mass index (BMI); excessive gestational weight gain and anemia. Adverse outcomes included pre-eclampsia (4.5%), gestational diabetes mellitus (3.4%), premature birth (4.4%), caesarian birth (40.1%), high birth weight (9.8%) and low birth weight (13.8%). RESULTS: The average age was 26±6.4 years; the mothers were predominantly non-white (84.8%), 51.8% had incomplete or complete secondary level schooling, 67.2% were in a stable marital relationship and 51.0% had a regular paid job; 63.7% were admitted to the prenatal clinic during the second trimester and 16.7% during the first, with 42.6% being primiparous. A past history of chronic hypertension was reported by 2.9%, pre-eclampsia by 9.8%, excessive gestational weight gain by 15.2% and former gestational diabetes mellitus by 1.0%. In the current pregnancy, elevated pre-gestational BMI was found in 34.6%; 45.5% presented with excessive gestational weight gain, 25.3% with anemia and 47.3% with dyslipidemia. Of the 17.5% of cases with altered blood glucose, gestational diabetes mellitus was confirmed in 3.4% and proteinuria occurred in 16.4% of all cases. Adverse maternal fetal outcomes included pre-eclampsia (4.5%), gestational diabetes mellitus (3.4%), premature birth (4.4%), caesarean birth (40.1%) and high and low birth weight (9.8% and 13.8%, respectively). Independent predictors of adverse maternal fetal outcomes were identified by Poisson multivariate regression analysis: pre-gestational BMI>25 kg/m² was a predictor for pre-eclampsia (RR=17.17; 95%CI 2.14-137.46) and caesarian operation (RR=1.79; 95%CI 1.13-2.85), previous caesarean was a predictor for present caesarean operation (RR=2.28; 95%CI 1.32-3.92) and anemia and high gestational weight gain were predictors for high birth weight (RR=3.38; 95%CI 1.41-8.14 and RR=4.68; 95%CI 1.56-14.01, respectively). CONCLUSION: Pre-gestational overweight/obesity, previous caesarean, excessive weight gain and anemia were major risk factors for pre-eclampsia, caesarean operations and high birth weight.
Summary
Rev Bras Ginecol Obstet. 2012;34(3):102-106
DOI 10.1590/S0100-72032012000300002
PURPOSE: To assess the prevalence of obstetric risk factors and their association with unfavorable outcomes for the mother and fetus. METHODS: A longitudinal, descriptive and analytical study was conducted on 204 pregnant women between May 2007 and December 2008. Clinical and laboratory assessments followed routine protocols. Risk factors included socio-demographic aspects; family, personal and obstetric history; high pre-gestational body mass index (BMI); excessive gestational weight gain and anemia. Adverse outcomes included pre-eclampsia (4.5%), gestational diabetes mellitus (3.4%), premature birth (4.4%), caesarian birth (40.1%), high birth weight (9.8%) and low birth weight (13.8%). RESULTS: The average age was 26±6.4 years; the mothers were predominantly non-white (84.8%), 51.8% had incomplete or complete secondary level schooling, 67.2% were in a stable marital relationship and 51.0% had a regular paid job; 63.7% were admitted to the prenatal clinic during the second trimester and 16.7% during the first, with 42.6% being primiparous. A past history of chronic hypertension was reported by 2.9%, pre-eclampsia by 9.8%, excessive gestational weight gain by 15.2% and former gestational diabetes mellitus by 1.0%. In the current pregnancy, elevated pre-gestational BMI was found in 34.6%; 45.5% presented with excessive gestational weight gain, 25.3% with anemia and 47.3% with dyslipidemia. Of the 17.5% of cases with altered blood glucose, gestational diabetes mellitus was confirmed in 3.4% and proteinuria occurred in 16.4% of all cases. Adverse maternal fetal outcomes included pre-eclampsia (4.5%), gestational diabetes mellitus (3.4%), premature birth (4.4%), caesarean birth (40.1%) and high and low birth weight (9.8% and 13.8%, respectively). Independent predictors of adverse maternal fetal outcomes were identified by Poisson multivariate regression analysis: pre-gestational BMI>25 kg/m² was a predictor for pre-eclampsia (RR=17.17; 95%CI 2.14-137.46) and caesarian operation (RR=1.79; 95%CI 1.13-2.85), previous caesarean was a predictor for present caesarean operation (RR=2.28; 95%CI 1.32-3.92) and anemia and high gestational weight gain were predictors for high birth weight (RR=3.38; 95%CI 1.41-8.14 and RR=4.68; 95%CI 1.56-14.01, respectively). CONCLUSION: Pre-gestational overweight/obesity, previous caesarean, excessive weight gain and anemia were major risk factors for pre-eclampsia, caesarean operations and high birth weight.
Summary
Rev Bras Ginecol Obstet. 2011;33(11):348-353
DOI 10.1590/S0100-72032011001100005
PURPOSE: To describe the obstetric outcome of women with overweight/obesity treated at the prenatal care clinic of a public maternity hospital in Rio de Janeiro. METHODS: A descriptive cross-sectional study which investigated 433 women (³20 years-old, without any chronic diseases) and their newborns treated at public hospitals in Rio de Janeiro. Information was collected from medical records and through interviews. The characteristics of mothers and newborns evaluated were divided into maternal (social habits, anthropometric measurements and clinical, obstetric, and prenatal care) and newborn groups (birth conditions). Data regarding the categories of nutritional status were analyzed using the odds ratio (OR) and 95% confidence interval (CI). RESULTS: The prevalence of overweight/obesity in this sample was 24.5% (n=106). There was an association between inadequate weight gain and the prevalence of overweight/obesity (OR 2.7, 95%CI 1.5-4.9, p<0.05). Overweight/obese women had an increased risk for preeclampsia (OR 3.3, 95%CI 1.1--9.9, p=0.03). Regarding birth conditions, mean birth weight was 3291.3 g (±455.2), with rates of low birth weight of 4.7% (n=5) and rates of macrosomia of 2.8% (n=3). CONCLUSIONS: There was an alarming prevalence of inadequate nutritional status before and during pregnancy, which may be associated with increased risk of perinatal morbidity and mortality. This suggests the need for nutritional monitoring of these pregnant women.
Summary
Rev Bras Ginecol Obstet. 2011;33(11):348-353
DOI 10.1590/S0100-72032011001100005
PURPOSE: To describe the obstetric outcome of women with overweight/obesity treated at the prenatal care clinic of a public maternity hospital in Rio de Janeiro. METHODS: A descriptive cross-sectional study which investigated 433 women (³20 years-old, without any chronic diseases) and their newborns treated at public hospitals in Rio de Janeiro. Information was collected from medical records and through interviews. The characteristics of mothers and newborns evaluated were divided into maternal (social habits, anthropometric measurements and clinical, obstetric, and prenatal care) and newborn groups (birth conditions). Data regarding the categories of nutritional status were analyzed using the odds ratio (OR) and 95% confidence interval (CI). RESULTS: The prevalence of overweight/obesity in this sample was 24.5% (n=106). There was an association between inadequate weight gain and the prevalence of overweight/obesity (OR 2.7, 95%CI 1.5-4.9, p<0.05). Overweight/obese women had an increased risk for preeclampsia (OR 3.3, 95%CI 1.1--9.9, p=0.03). Regarding birth conditions, mean birth weight was 3291.3 g (±455.2), with rates of low birth weight of 4.7% (n=5) and rates of macrosomia of 2.8% (n=3). CONCLUSIONS: There was an alarming prevalence of inadequate nutritional status before and during pregnancy, which may be associated with increased risk of perinatal morbidity and mortality. This suggests the need for nutritional monitoring of these pregnant women.
Summary
Rev Bras Ginecol Obstet. 2009;31(8):380-384
DOI 10.1590/S0100-72032009000800002
PURPOSE: to determine weight variation in women with different Body Mass Index (BMI) in use of trimestral injections of depot-medroxyprogesterone acetate (DMPA), and compare it to women users of a non-hormonal method. METHODS: retrospective study with the chart review of 226 DMPA users and 603 controls, users of DIU TCu380A. Women were distributed in categories, according to their initial BMI, as having normal weight (<25 kg/m²), overweight (25 to 29,9 kg/m²) and being obese (>30 kg/m²), and were followed-up for six years, with yearly measurements of weight and BMI. The statistic test ANOVA was used to measure the weight variation among the groups in each BMI category every year. RESULTS: the average age at the onset of the method employed was higher in the study group than in the controls, in all the BMI categories: 31.6±SD 7.1 X 27.4±SD 5.5 in the normal weight category (p<0.0001); 37.3±SD 6.8 X 29.2±SD 6.0 in the overweight category (p<0.0001); and 35.3±SD 6.4 X 29.7±SD 5.8 among obese women (p<0.0001). DMPA users showed weight increase as compared to the controls in the overweight category (p=0.0082); and the weight increase along the observation period was also higher among the DMPA users than among the controls, for the normal weight (p<0.0001) and overweight (p=0.0008) categories. In the obese group, there was no BMI variation between the groups, nor along the period during which they were using the method. CONCLUSIONS: there was no change in weight gain among DMPA users from the obese category. Prospective studies should be done with metabolic tests to establish the determining factors of weight gain in normal and overweight women.
Summary
Rev Bras Ginecol Obstet. 2009;31(8):380-384
DOI 10.1590/S0100-72032009000800002
PURPOSE: to determine weight variation in women with different Body Mass Index (BMI) in use of trimestral injections of depot-medroxyprogesterone acetate (DMPA), and compare it to women users of a non-hormonal method. METHODS: retrospective study with the chart review of 226 DMPA users and 603 controls, users of DIU TCu380A. Women were distributed in categories, according to their initial BMI, as having normal weight (<25 kg/m²), overweight (25 to 29,9 kg/m²) and being obese (>30 kg/m²), and were followed-up for six years, with yearly measurements of weight and BMI. The statistic test ANOVA was used to measure the weight variation among the groups in each BMI category every year. RESULTS: the average age at the onset of the method employed was higher in the study group than in the controls, in all the BMI categories: 31.6±SD 7.1 X 27.4±SD 5.5 in the normal weight category (p<0.0001); 37.3±SD 6.8 X 29.2±SD 6.0 in the overweight category (p<0.0001); and 35.3±SD 6.4 X 29.7±SD 5.8 among obese women (p<0.0001). DMPA users showed weight increase as compared to the controls in the overweight category (p=0.0082); and the weight increase along the observation period was also higher among the DMPA users than among the controls, for the normal weight (p<0.0001) and overweight (p=0.0008) categories. In the obese group, there was no BMI variation between the groups, nor along the period during which they were using the method. CONCLUSIONS: there was no change in weight gain among DMPA users from the obese category. Prospective studies should be done with metabolic tests to establish the determining factors of weight gain in normal and overweight women.
