| Efecto del IMC materno sobre la evolución del embarazo y el peso del recién nacido |
Effect of maternal body mass index on pregnancy outcome and newborn weight.
Yazdani S, Yosofniyapasha Y, Nasab BH, Mojaveri MH, Bouzari Z.
Department of Anesthesia, Babol University of Medical Sciences, Babol, Iran. bahmanh2002@yahoo.com.
BMC Res Notes. 2012 Jan 17;5:34.
Abstract
BACKGROUND: Maternal obesity has been associated with adverse pregnancy outcomes, such as pre-eclampsia, eclampsia, pre- and post-term delivery, induction of labor, macrosomia, increased rate of caesarean section, and post-partum hemorrhage. The objective of this study was to determine the effect of maternal Body Mass Index (BMI) on pregnancy outcomes. METHODS: 1000 pregnant women were enrolled in the study. In order to explore the relationship between maternal first trimester Body Mass Index and pregnancy outcomes, participants were categorized into five groups based on their first trimester Body Mass Index. The data were analyzed using Pearson Chi-square tests in SPSS 18. Differences were considered significant if p < 0.05. RESULTS: Women with an above-normal Body Mass Index had a higher incidence of pre-eclampsia, induction of labor, caesarean section, pre-term labor, and macrosomia than women with a normal Body Mass Index (controls). There was no significant difference in the incidence of post-term delivery between the control group and other groups. CONCLUSION: Increased BMI increases the incidence of induction of labor, caesarean section, pre-term labor and macrosomia. The BMI of women in the first trimester of pregnancy is associated with the risk of adverse pregnancy outcome
http://www.biomedcentral.com/content/pdf/1756-0500-5-34.pdf
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| Obesidad materna y complicaciones del parto después de la inducción del parto en embarazo prolongado |
Maternal obesity and labour complications following induction of labour in prolonged pregnancy.
Arrowsmith S, Wray S, Quenby S.
Department of Cellular and Molecular Physiology, Institute of Translational Medicine, University of Liverpool, Crown Street, Liverpool, UK.s.arrowsmith@liv.ac.uk
BJOG. 2011 Apr;118(5):578-88. doi: 10.1111/j.1471-0528.2010.02889.x. Epub 2011 Jan 26.
Abstract
OBJECTIVE: To investigate the effect of maternal obesity on mode of delivery following induction of labour (IOL) for prolonged pregnancy and subsequent intrapartum and neonatal complications. DESIGN: Retrospective (historical) cohort study.SETTING: Liverpool Women's Hospital NHS Foundation Trust, UK. POPULATION: A total of 29, 224 women with singleton pregnancies between 2004 and 2008 of whom 3076 had a prolonged pregnancy (defined as ≥290 days or 41(+3) weeks of gestation) and received IOL. METHODS: Kruskal-Wallis test, chi-square test and multivariable logistic regression. MAIN OUTCOME MEASURES: Mode of delivery and risk of delivery and neonatal complications in obese verses non-obese women following IOL. RESULTS: Obese women had a significantly higher rate of IOL ending in caesarean section compared with women of normal weight following IOL (38.7% versus 23.8% primiparous; 9.9% versus 7.9% multiparous women, respectively); however, length of labour, incidence of postpartum haemorrhage and third-degree tear, rate of low cord blood pH, low Apgar scores and shoulder dystocia were similar in all body mass index categories. Complications included a higher incidence of fetal macrosomia and second-degree, but not third-degree, tear in primiparous women. CONCLUSIONS: Higher maternal body mass index at booking is associated with an increased risk of prolonged pregnancy and increased rate of IOL. Despite this, more than 60% of obese primiparous and 90% of multiparous women with prolonged pregnancies who were induced achieved vaginal delivery and labour complications in the obese women with prolonged pregnancies were largely comparable to those of normal weight women with prolonged pregnancies. Our data suggest that IOL for prolonged pregnancy in obese women is a reasonable and safe management option.
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3085126/pdf/bjo0118-0578.pdf
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| Obesidad materna y evolución del embarazo |
Maternal obesity and pregnancy outcome.
Michlin R, Oettinger M, Odeh M, Khoury S, Ophir E, Barak M, Wolfson M, Strulov A.
Department of Obstetrics and Gynecology, Western Galilee Medical Center, Nahariya, Israel. meting@naharia.health.gov.il
Isr Med Assoc J.2000 Jan;2(1):10-3.
Abstract
BACKGROUND: Obesity, a common condition in developed countries, is recognized as a threat to health. OBJECTIVES: To describe the distribution of weight in pregnant women and evaluate the influence of obesity on pregnancy outcome in a high parity northern Israeli population.
METHODS: The study included 887 women who gave birth in the Western Galilee Medical Center during the period August to November 1995. The patients were classified as underweight, normal weight, overweight, or obese according to body mass index. Maternal demographic, obstetric, and perinatal variables were compared. A control group of 167 normal weight women were matched with the obese group for maternal age, parity, and gestational age. RESULTS: Obese mothers had a higher incidence of gestational diabetes and pregnancy-induced hypertension compared to normal weight mothers (5.4% vs. 1.8%, and 7.2% vs. 0.6% respectively, P < 0.01), a higher rate of labor induction (20.4% vs. 10.2%, P < 0.01), and a higher cesarean section rate (19.6% vs. 10.8%, P < 0.05). There was also a significant difference in the prevalence of macrosomia in the offspring (16.8% vs. 8.4%, P < 0.05). CONCLUSION: Obese pregnant women are at high risk for complications during delivery and therefore need careful pre-conception and prenatal counseling, as well as perinatal management.
http://www.ima.org.il/imaj/ar00jan-3.pdf |
| Examinando el efecto de la obesidad materna sobre la evolución de la inducción del parto en pacientes con pre eclampsia |
Examining the effect of maternal obesity on outcome of labor induction in patients with preeclampsia.
Robinson CJ, Hill EG, Alanis MC, Chang EY, Johnson DD, Almeida JS.
Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, Medical University of South Carolina, Charleston, South Carolina 29425, USA. robinscj@musc.edu
Hypertens Pregnancy. 2010;29(4):446-56.
Abstract
OBJECTIVE: The objective of this investigation was to evaluate the effect of maternal obesity, as measured by prepregnancy body mass index (BMI), on the mode of delivery in women undergoing indicated induction of labor for preeclampsia. STUDY DESIGN: Following Institutional Review Board (IRB) approval, patients with preeclampsia who underwent an induction of labor from 1997 to 2007 were identified from a perinatal information database, which included historical and clinical information. Data analysis included bivariable and multivariable analyses of predictor variables by mode of delivery. An artificial neural network was trained and externally validated to independently examine predictors of mode of delivery among women with preeclampsia.RESULTS: Six hundred and eight women met eligibility criteria and were included in this investigation. Based on multivariable logistic regression (MLR) modeling, a 5-unit increase in BMI yields a 16% increase in the odds of cesarean delivery. An artificial neural network trained and externally validated confirmed the importance of obesity in the prediction of mode of delivery among women undergoing labor induction for preeclampsia.
CONCLUSION: Among patients who are affected by preeclampsia, obesity complicates labor induction. The risk of cesarean delivery is enhanced by obesity, even with small increases in BMI. Prediction of mode of delivery by an artificial neural network performs similar to MLR among patients undergoing labor induction for preeclampsia.
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3192401/pdf/nihms244750.pdf |
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