jueves, 7 de mayo de 2015

Obesidad neonatal/Neonatal obesity

Evolución perinatal de los infantes de término de las madres con sobrepeso y obesidad. Un estudio de cohorte de base poblacional en Canadá
Perinatal outcomes of maternal overweight and obesity in term infants: a population-based cohort study in Canada.
Vinturache AE, McDonald S, Slater D, Tough S.
Sci Rep. 2015 Mar 20;5:9334. doi: 10.1038/srep09334.
The objective of this study was to assess the impact of increased pre-pregnancy maternal body mass index (BMI) on perinatal outcomes in term, singleton pregnancies who received prenatal care in community-based practices. The sample of 1996 infants included in the study was drawn from the All Our Babies Study, a prospective pregnancy cohort from Calgary. Multivariable logistic regression explored the relationship between the main outcomes, infant birth weight, Apgar score, admission to neonatal intensive care (NICU) and newborn duration of hospitalization, and BMI prior to pregnancy. Approximately 10% of the infants were macrosoms, 1.5% had a low Apgar score (<7 at 5 min), 6% were admitted to intensive care and 96% were discharged within 48 h after delivery. Although the infants of overweight and obese women were more likely to have increased birth weight as compared to infants of normal weight women, there were no differences in Apgar score, admission to NICU, or length of postnatal hospital stay among groups. This study suggests that in otherwise healthy term, singleton pregnancies, obesity does not seem to increase the risk of severe fetal impairment, neonatal admission to intensive care or duration of postnatal hospitalization.
Inicio de la lactancia. Impacto de la obesidad en un estudio Canadiense perinatal de cohorte
Breastfeeding initiation: impact of obesity in a large Canadian perinatal cohort study.
Verret-Chalifour J, Giguère Y, Forest JC, Croteau J, Zhang P, Marc I.
PLoS One. 2015 Feb 6;10(2):e0117512. doi: 10.1371/journal.pone.0117512. eCollection 2015.
OBJECTIVE: To evaluate incidence of breastfeeding initiation according to maternal pre-pregnancy body mass index (BMI) in "Grossesse en Santé", a large prospective birth cohort in Quebec City. METHODS: Breastfeeding initiation in the post-partum period, pre-pregnancy BMI, sociodemographic determinants and obstetrical and neonatal factors were collected from years 2005 to 2010 in 6592 women with single pregnancies. Prenatal non-intention to breastfeed was documented in a subgroup of the cohort (years 2009-2010). Log-binomial regression analyses were performed to assess relative risk (RR) of non-initiation of breastfeeding between maternal BMI categories in models including pre- and post-natal determinants, after exclusion of variables with a mediating effect. RESULTS: Twenty percent (20%) of obese women did not initiate breastfeeding in the post-natal period at hospital compared to 12% for normal weight women. Compared with those having a normal pre-pregnancy BMI, obese women had a higher risk of non-initiation of breastfeeding (RRunadj 1.69, 95% CI 1.44-1.98), even after adjustment for prenatal and sociodemographic factors (RRadj 1.26, 95% CI 1.08-1.46). Furthermore, the risk of non-initiation of breastfeeding in obese women still remained higher after introduction of per- and post-natal factors (RR 1.22, 95% CI 1.04-1.42). The prenatal non-intention to breastfeed was strongly associated with the non-initiation of breastfeeding for all categories of BMI. CONCLUSION: Maternal obesity is associated with a two-fold rate of non-initiation of breastfeeding. Considering the benefits of breastfeeding and the increasing obesity rate, adapted interventions and specialized support should target both pre- and immediate post-natal periods in this population.
La obesidad inducida por sobrealimentación neonatal empeora la hiper reactividad e inflamación de la vía aérea
Obesity induced by neonatal overfeeding worsens airway hyperresponsiveness and inflammation.
Ye Z, Huang Y, Liu D, Chen X, Wang D, Huang D, Zhao L, Xiao X.
PLoS One. 2012;7(10):e47013. doi: 10.1371/journal.pone.0047013. Epub 2012 Oct 8.
BACKGROUND:Obesity is a risk factor for the development of certain respiratory diseases, and neonatal overfeeding results in an early onset ofobesity in adulthood. However, the influence of neonatal overfeeding on respiratory diseases has rarely been studied. Therefore, this paper is aimed at investigating the effect of neonatal overfeeding on airway responsiveness and inflammation.METHODOLOGY/PRINCIPAL FINDINGS: The neonatal overfeeding was induced by reducing litter size to three pups per litter (small litter, SL) in contrast to the normal litter size with ten pups per litter (NL) on postnatal day 3 (P3) in male ICR mice. On P21, mice were weaned to standard chow diet. Airway responsiveness to methacholine was measured either on P21 or P150. Total and classified inflammatory cells in bronchoalveolar lavage fluid (BALF) were counted, lung inflammatory cells were evaluated through staining with hematoxylin & eosin and F4/80 immunohistochemistry; lung fibrosis was evaluated through staining with Masson and α-SAM immunohistochemistry. Leptin levels in serum were measured by RIA; TNF-α levels in serum and BALF were quantified by ELISA; mRNA levels of TNF-α, CTGF and TGF-β1 in lung tissues were measured using real-time PCR. Mice from SL exhibited accelerated body weight gain, impaired glucose tolerance and hyperleptinemia. Enhanced airway responsiveness to methacholine was observed in SL mice on P150, but not on P21. Pulmonary inflammation was evident in SL mice on P150, as reflected by inflammatory cells especially macrophages around bronchi and interstitium. BALF and serum TNF-α levels and lung TNF-α mRNA expression were significantly increased in SL mice on P150. More collagen accumulated surrounding the bronchi on P150; lung mRNA levels of TGF-β1 and CTGF were also increased on P150. CONCLUSION: In addition to inducing a variety of metabolic defects, neonatal overfeeding enhanced lung inflammation, which may lead to airway remodeling and airway hyperresponsiveness in adulthood.
Los efectos de la dieta prenatal y consejos de estilo de vida para las mujeres que tienen sobrepeso u obesidad en la salud neonatal : el ensayo aleatorio LIMIT.
The effects of antenatal dietary and lifestyle advice for women who are overweight or obese on neonatal health outcomes: the LIMIT randomised trial.
Dodd JM1,2, McPhee AJ3, Turnbull D4, Yelland LN5,6,7, Deussen AR8, Grivell RM9,10, Crowther CA11,12, Wittert G13, Owens JA14, Robinson JS15; LIMIT Randomised Trial Group.
BMC Med. 2014 Oct 13;12(1):163. doi: 10.1186/s12916-014-0163-9.
Anestesia y Medicina del Dolor
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