Pregnancy Body Mass Index Research Articles

Portable HEPA filter air cleaner use during pregnancy and children's body mass index at two years of age: The UGAAR randomized controlled trial.

Gestational exposure to particulate matter (PM) air pollution may increase the risk of childhood obesity, but the impact of reducing air pollution during pregnancy on obesity-related outcomes in childhood has not been examined. To assess the impact of reducing gestational PM exposure on body mass index (BMI) at two years of age. In this single-blind, parallel group randomized controlled trial in Ulaanbaatar Mongolia, we randomly assigned 540 pregnant women to receive 1-2 portable high efficiency particulate air (HEPA) filter air cleaners or no air cleaners. We measured height and weight when children were a mean age of 23.8months. Our primary outcome was age- and sex-specific BMI z-score based on the World Health Organization 2007 Growth Charts. Secondary outcomes included age- and sex-specific weight z score, overweight/obesity (defined as BMI z-score>2.00), and catch-up growth (defined using various cut-offs to identify children with relatively low birth weight for sex and gestational age and relatively high age- and sex-specific weight in childhood). We imputed missing outcome data using multiple imputation with chained equations and our primary analysis was by intention to treat (ITT). We estimated intervention effects on continuous and binary outcomes using linear and logistic regression, respectively. After excluding known miscarriages, still births, and neonatal deaths our analysis included 480 children (235 control and 245 intervention). The mean (SD) child BMI z score was 0.79 (1.0); 9.8% of children were overweight or obese. The mean BMI z score of children who were randomly assigned to the intervention group was 0.16-units lower (95% CI: -0.35, 0.04) than children in the control group. The intervention was also associated with reductions in overweight/obesity (odds ratio=0.59; 95% CI: 0.31, 1.12). Catch-up growth occurred less frequently in the intervention group, but effect estimates varied depending on the specific definition of catch-up growth and confidence intervals consistently spanned no effect. We found that the use of portable air cleaners during pregnancy was associated with improvements in obesity-related outcomes, although some effect estimates lacked precision. Reducing PM exposure during pregnancy may lead to improvements in cardiometabolic health in childhood.

The mediating role of gestational diabetes mellitus in the associations of maternal prepregnancy body mass index with neonatal birth weight.

BackgroundBoth prepregnancy obesity and gestational diabetes mellitus (GDM) have been linked to adverse neonatal birth weight. However, the mediating role of GDM between prepregnancy obesity and neonatal birth weight is unclear.MethodThe cohort study included 17 260 singleton pregnant women and their newborns. Participants' demographic characteristics, disease history, family history of the disease, and the perinatal outcomes were recorded. The association between maternal prepregnancy body mass index (BMI) status and small for gestational age (SGA) or large for gestational age (LGA) neonates was analyzed using logistic regressions, before and after adjusting for covariates and GDM. The potential mediation of GDM on the association between prepregnancy BMI and adverse birth weight was examined.ResultMultivariate logistic regression demonstrated that prepregnancy underweight women were more likely to deliver SGA neonates compared to those who had normal weights, whereas prepregnancy obese pregnant women were more likely to have LGA neonates. The RMediation analyses illustrated that the mediation effect of GDM on the maternal prepregnancy BMI (continuous variable) and the risk of SGA was not significant, whereas the association between prepregnancy BMI and LGA was statistically mediated by GDM (95%CI of a*b: 0.009‐0.051). The Iacobacci (2012) method indicated that the impact of maternal prepregnancy overweight (Zmediation = 2.418, P = .015) and obesity (Zmediation = 2.165, P = .030) on LGA was partially mediated by GDM, with an indirect effect of 16.3% and 13.1%, respectively.ConclusionPrepregnancy BMI was observed to be associated with SGA and LGA. The association of prepregnancy overweight and obesity with LGA was found to be partially mediated by GDM.

Exploring the intensity, barriers and correlates of physical activity In Iranian pregnant women: a cross-sectional study

ObjectivesTo determine the intensity, barriers and correlates of physical activity (PA) in Iranian pregnant women.MethodsThis cross-sectional study was carried out with 300 eligible pregnant women referred to the Ilam health...

The Impact of Gestational Weight Gain on the Risks of Adverse Maternal and Infant Outcomes among Normal BMI Women with High Triglyceride Levels during Early Pregnancy.

A high maternal triglyceride (mTG) level during early pregnancy is linked to adverse pregnancy outcomes, but the use of specific interventions has been met with limited success. A retrospective cohort study was designed to investigate the impact of gestational weight gain (GWG) on the relationship between high levels of mTG and adverse pregnancy outcomes in normal early pregnancy body mass index (BMI) women. The patients included 39,665 women with normal BMI who had a singleton pregnancy and underwent serum lipids screening during early pregnancy. The main outcomes were adverse pregnancy outcomes, including gestational hypertension, preeclampsia, gestational diabetes, cesarean delivery, preterm birth, and large or small size for gestational age (LGA or SGA) at birth. As a result, the high mTG (≥2.05mM) group had increased risks for gestational hypertension ((Adjusted odds ratio (AOR), 1.80; 95% CI, 1.46 to 2.24)), preeclampsia (1.70; 1.38 to 2.11), gestational diabetes (2.50; 2.26 to 2.76), cesarean delivery (1.22; 1.13 to 1.32), preterm birth (1.42, 1.21 to 1.66), and LGA (1.49, 1.33 to 1.68) compared to the low mTG group, after adjustment for potential confounding factors. Additionally, the risks of any adverse outcome were higher in each GWG subgroup among women with high mTG than those in the low mTG group. High mTG augmented risks of gestational hypertension, preeclampsia, preterm birth, and LGA among women with 50th or greater percentile of GWG. Interestingly, among women who gained less than the 50th percentile of GWG subgroups, there was no relationship between high mTG level and risks for those pregnancy outcomes when compared to low mTG women. Therefore, weight control and staying below 50th centile of the suggested GWG according to gestational age can diminish the increased risks of adverse pregnancy outcomes caused by high mTG during early pregnancy.

Depth of spinal needle insertion and its associated factors among patients who underwent surgery under spinal anesthesia

BackgroundLumbar puncture is a difficult medical skill and used by anesthetists for administering local anesthetics to the subarachnoid space. Prior knowledge of how far the needle needs to be inserted from skin to the subarachnoid space distance (SSD) has a paramount role to guide spinal needle placement and reduce complications related to lumbar puncture. Therefore, we aimed to determine the depth of spinal needle insertion and its associated factors among patients who underwent surgery under spinal anesthesia. MethodsAn institutional based cross-sectional study design was conducted among 274 patients who underwent surgery under spinal anesthesia. Following very successful lumbar puncture procedure, the distance from skin entry point to the tip of the spinal needle was measured. The data were entered into an Epi data version 4.3.1 and exported to SPSS software version 20 for analysis. Descriptive analysis, simple linear and multiple linear regression analysis were used. Then, in order to assess the correlation of depth of spinal needle insertion with other independent variables Pearson's correlation coefficient (r) was applied. ResultsTwo hundred seventy four patients comprising 112 (40.8%) male and 162 (59.1%) female were included in the study with a mean height, weight and body mass index (BMI) of 1.63 m, 62.9 kg, and 23.9 kg/m2 respectively. The mean distance from skin to the subarachnoid space was 5.13 ± 0.69 cm ranging from 3.5 to 7.1 cm. Pregnancy, weight and BMI had statistically significant effect on the mean SSD (p < 0.001, p < 0.001 and p = 0.014) respectively. ConclusionsThe distance from the skin to the subarachnoid space was differed among individuals. The SSD was affected by individuals’ pregnancy status, BMI and weight. Hence, to minimize complications, these factors should be taken into consideration at the time of spinal needle insertion.

English

BACKGROUND World health organization (WHO) declares obesity as a pandemic issue, having high prevalence in females, especially in the childbearing age than in males. Pregnancies complicated by obesity has been identified as early as 1945. Prepregnancy obesity endangers both maternal and fetal well-being. Increasing body mass index (BMI) is associated with increased adverse obstetric and fetal outcomes. Pre-pregnancy obesity and excessive gestational weight gain are parts of maternal obesity during pregnancy. Prenatal maternal obesity and excessive gestational weight gain also improve placental nutrition transfer to the developing foetus and foetal development. The purpose of this study was to evaluate the association between early pregnancy BMI and maternal complications as well as labour outcome. METHODS A prospective observational study comprising 250 antenatal women with singleton uncomplicated pregnancies, booked at Narayan Hospital, Rohtas, South Bihar within the first 12 weeks of gestation were selected for the study. The following inclusion and exclusion criteria were considered. With the help of a predesigned questionnaire, basic information including weight and height was collected in the first check up and BMI was calculated accordingly. BMI was calculated using the formula weight (kg)/height 2 (m2). RESULTS The mean age of mothers was 25.98 ± 3.92 years. Mothers who underwent caesarean section had BMI of 27.36 ± 5.768 and for normal vaginal delivery mothers it was 27.94 ± 6.076, whereas for mother who had undergone forceps delivery, BMI was 30.60 ± 3.864 whereas for other assisted vaginal delivery it was 29.75 ± 7.246. There is mild correlation of BMI of mother to the birth weight of baby. On applying regression analysis, we found mild correlation with R square 0.134. There was no correlation of BMI of mother to the hospital stay of their children. CONCLUSIONS We concluded that however statistically there is no significant association between obesity and numerous maternal and perinatal risks in obese pregnant women but it poses a considerable challenge to the obese patient in successful completion of pregnancy. KEYWORDS Obesity, BMI, Pregnancy Outcome, NICU, Mode of Delivery

Maternal body mass index in pregnancy and mental disorders in adult offspring: a record linkage study in Aberdeen, Scotland

Maternal obesity in pregnancy predicts offspring psychopathology risk in childhood but it remains unclear whether maternal obesity or underweight associate with adult offspring mental disorders. We examined longitudinally whether maternal body mass index (BMI) in pregnancy predicted mental disorders in her offspring and whether the associations differed by offspring birth year among 68,571 mother–child dyads of Aberdeen Maternity and Neonatal Databank, Scotland. The offspring were born 1950–1999. Maternal BMI was measured at a mean 15.7 gestational weeks and classified into underweight, normal weight, overweight, moderate obesity and severe obesity. Mental disorders were identified from nationwide registers carrying diagnoses of all hospitalizations and deaths in Scotland in 1996–2017. We found that maternal BMI in pregnancy was associated with offspring mental disorders in a time-dependent manner: In offspring born 1950–1974, maternal underweight predicted an increased hazard of mental disorders [Hazard Ratio (HR) = 1.74; 95% Confidence Interval (CI) = 1.01–3.00)]. In offspring born 1975–1999, maternal severe obesity predicted increased hazards of any mental (HR 1.60; 95% CI 1.08–2.38) substance use (HR 1.91; 95% CI 1.03–3.57) and schizophrenia spectrum (HR 2.80; 95% CI 1.40–5.63) disorders. Our findings of time-specific associations between maternal prenatal BMI and adult offspring mental disorders may carry important public health implications by underlining possible lifelong effects of maternal BMI on offspring psychopathology.

Gestational weight gain and pregnancy outcomes: Findings from North Indian pregnancy cohort

Despite the high prevalence of inadequate gestational weight gain (GWG) and adverse pregnancy outcomes, very few studies have addressed the association between GWG and pregnancy outcomes in South Asia. Our objectives were to estimate the prevalence of GWG during the second and third trimesters within, below and above the Institute of Medicine (IOM) guidelines, and to estimate the effect of the rate and adequacy of GWG on gestational age at the time of delivery, weight, length, length‐for‐age z‐score (LAZ), weight‐for‐length z‐score (WLZ) and adverse pregnancy outcomes, namely prematurity, small‐for‐gestational age (SGA), low birth weight (LBW), stunting and wasting at birth. We analysed data from the intervention group of the Women and Infants Integrated Interventions for Growth Study (WINGS), which is an ongoing individually randomized factorial design study. Of the 1332 women analysed, 40.2% [95% confidence interval (CI) 37.5 to 42.8] had GWG below the IOM guidelines. For every 100‐g/week increase in GWG, birth weight increased by 61 g, birth length by 0.16 cm, LAZ score by 0.08 SD, WLZ score by 0.14 SD, and gestational age at birth by 0.48 days. Women with GWG below the IOM guidelines had a higher relative risk of adverse pregnancy outcomes (44% for LBW, 27% for SGA, 32% for stunting and 42% for wasting at birth) than women who had GWG within the IOM guidelines, except for prematurity. The association between GWG and LAZ scores at birth was modified by early pregnancy body mass index (BMI). GWG is a strong predictor of newborn anthropometric outcomes and duration of gestation but not prematurity.

Influence of intrauterine growth status on aortic intima-media thickness and aortic diameter in near-term fetuses: a comparative cross-sectional study.

Intrauterine undernutrition may lead to fetal vascular programming. We compared abdominal aortic intima-media thickness (aIMT) and aortic diameter (aD) between appropriate for gestational age (AGA) and growth-restricted fetuses (GRF). We recruited 136 singleton fetuses at 34-37 weeks of gestation from Fetal Medicine Unit of Aga Khan University Hospital, Karachi (January-November 2017). Subjects were classified as AGA (n = 102) and GRF (n = 34) using INTER-GROWTH 21st growth reference and standard ultrasound protocol. Their far- and near-wall aIMT and aD were compared after adjustment of maternal age, first-trimester body mass index, fetal gender, hypertension and hyperglycemia in pregnancy. As the severity of growth restriction increased in GRF, aIMT and aD showed an increasing and a decreasing trend, respectively. Both far- and near-wall aIMT in GRF [(adj. β = 0.082, 95% confidence interval [CI] 0.042-0.123) and (adj. β = 0.049, 95% CI 0.010-0.089)] were significantly greater with reference to AGA fetuses. GRF subgroup analysis into small for gestational age (SGA) fetuses and intrauterine growth restricted (IUGR) revealed highly significant difference between AGA and IUGR for far (0.142mm, P-value < 0.001) and near-wall aIMT (0.115mm, P-value < 0.001) and marginally significant aD difference (0.51mm, P-value 0.05). These findings suggest that the extent of fetal aortic remodelling is influenced by the severity of growth restriction. Hence, the targeted interventions for the cardiovascular health promotion of IUGR and SGA born neonates are desirable during early childhood, particularly in set ups with high prevalence of low birth weight babies.

Impact of High Pre-Pregnancy Body Mass Index on Pregnancy Outcome Among Women Residing in Urban North-West Delhi, India

ObjectivesThere is emerging evidence regarding the association of maternal overweight/obesity with an array of pregnancy-related complications and adverse pregnancy outcome. The present study aimed to evaluate the impact of higher pre- pregnancy body mass index (BMI) on pregnancy outcomes of women belonging to the upper socio-economic strata of North West Delhi. MethodsAn observational longitudinal study was conducted among 312 pregnant women attending the private antenatal clinics in North-West, Delhi, India during July 2018 to March 2020. Only women with pre-pregnancy BMI: >18.5kg/m2 who belonged to upper socio-economic strata and with confirmed singleton pregnancies were included in study. All the eligible subjects were enrolled at ≤ 16th week of their pregnancies and further stratified on basis of pre-pregnancy BMI criteria for the Asian-Indians,2009 i.e.,: normal weight;18.5–22.9kg/m2 (n:90), overweight; 23–24.9 kg/m2 (n = 90) and obese; ≥25 kg/m2 (n = 132). The primary outcome of study was macrosomia (birth weight: >3.5kg). Secondary outcomes were gestational diabetes mellitus (GDM), hypothyroid, pre-eclampsia (PE), pre-term birth (PTB), cesarean section (CS), neonatal intensive care unit (NICU) admission, miscarriage and still birth. Mixed and fixed-effects logistic regression analysis was performed with normal weight category women as a reference group. ResultsIncidence of adverse pregnancy outcome increased as pre-pregnancy BMI increases. Obese and overweight women had greater risk of undergoing CS (OR: 0.97, 95% CI: 0.9–1.05) and delivering a macrosomic neonate (OR = 2.36, 95% CI: 0.38–14.81 and OR = 1.03, 95% CI: 0.18–5.82) than normal weight women. Neonates of obese (OR: 1.30, 95%, CI:0.67–2.52) and overweight (OR: 1.33, 95% CI: 0.67–2.66) women had a higher risk of NICU admissions. ConclusionsData indicated detrimental effect of higher pre-pregnancy BMI for both mother and as well as the neonate. It would be prudent to strive for normal pre-pregnancy BMI to reduce the likelihood of adverse pregnancy outcome and lay a healthy foundation for an offspring. Funding SourcesThe financial assistance for present study was provided by the University Grant Commission (UGC), Government of India, under Junior/Senior Fellow Scheme.

Pre-pregnancy Diet Quality Is Associated With Lowering the Risk of Offspring Obesity and Underweight: Finding From a Prospective Cohort Study

Abstract Objectives To examine the association between maternal diet quality before pregnancy and childhood BMI in offspring. Methods We included 1936 mothers with 3391 children from the Australian Longitudinal Study on Women's Health (ALSWH) and the Mothers and their Children's Health study (MatCH). Maternal diet was assessed using a semi-quantitative and validated 101-item food-frequency questionnaire (FFQ). We used the healthy eating index (HEI-2015) score to explore maternal diet quality before pregnancy. Children over 2 years of age were categorized as underweight, normal, overweight, and obese based on age and sex-specific BMI classifications for children. Multinomial logistic regression with cluster-robust standard errors was used for analyses. Results Greater adherence to maternal diet quality before pregnancy was associated with a lower risk of offspring underweight after adjustment for potential confounders, highest vs lowest quartile (RRR = 0.68, 95% CI: 0.49, 0.96). Higher adherence to pre-pregnancy diet quality was also inversely associated with the risk of offspring obesity (RRR = 0.49, 95% CI: 0.24, 0.98). This association was, however, slightly attenuated by pre-pregnancy body mass index (BMI) in the full adjusted model. No significant association was observed between pre-pregnancy diet quality and offspring overweight. Conclusions This study suggests that better adherence to maternal diet quality before pregnancy is associated with a reduced risk of childhood underweight and obesity. Funding Sources The ALSWH is funded by the Australian Government Department of Health. MatCH is funded by the National Health and Medical Research Council (NHMRC) project grant. Dereje Gete is supported by the University of Queensland Research Training Scholarship. Gita Mishra holds the Australian Health and Medical Research Council Principal Research Fellowship.

Associations of Tryptophan, Docosahexaenoic Acid (DHA), and Vitamin D With Sleep Quality and Depression During Pregnancy

ObjectivesDuring pregnancy women are at increased risk of poor sleep quality and depression. Serotonin and melatonin are compounds that are involved in regulation of sleep and mood. Several nutrients are involved in the synthesis of these compounds, including tryptophan, docosahexaenoic acid (DHA), and vitamin D. Studies exploring associations between these nutrients and sleep, as well as mood, have been largely limited to the general population, showing mixed results. The aim of this study was to assess the associations of dietary intake of these nutrients with sleep quality and depression in pregnant women. MethodsParticipants enrolled in the Understanding Pregnancy Signals and Infant Development (UPSIDE) Study (n = 253) were included in this analysis if they completed dietary, sleep and depression assessments during the 2nd trimester. Dietary and supplement intake were measured using 24-hour dietary recalls. The NCI method was used to estimate usual intake. Sleep quality was measured with the Pittsburgh Sleep Quality Index (PSQI). Depressive symptoms were measured with the Edinburgh Postnatal Depression Scale (EPDS). Multivariable linear regression was conducted to estimate the associations between nutrients and sleep/depression, adjusting for age, race/ethnicity, parity, education, early pregnancy body mass index, smoking status, energy and macronutrient intake. ResultsThe NCI adjusted mean intakes of tryptophan, DHA, and vitamin D were 1.02 ± 0.11 g/day, 0.13 ± 0.11g/day, and 19.74 ± 21.80 mcg/day, respectively. Mean PSQI score was 6.15 ± 3.39, where higher scores indicated worse sleep quality, and mean EPDS score was 5.84 ± 4.77, where higher scores indicated increased severity of depressive symptoms. Tryptophan intake was inversely associated with EPDS scores (b = –15.23, 95%CI: –26.75, –3.72). The associations between DHA, vitamin D, and depression were not significant. The selected nutrients were not associated with PSQI scores. ConclusionsIn this study, higher tryptophan intake was associated with lower depressive symptoms among pregnant women during the second trimester. Additional research on the relationship between tryptophan intake and maternal mental health during pregnancy is warranted. Funding SourcesNIH, Mae Stone Goode Foundation, Wynne Family Foundation.

Effect of Maternal Prepregnancy/Early-Pregnancy Body Mass Index and Pregnancy Smoking and Alcohol on Congenital Heart Diseases: A Parental Negative Control Study.

BackgroundCongenital heart diseases (CHDs) are the most common congenital anomaly. The causes of CHDs are largely unknown. Higher prenatal body mass index (BMI), smoking, and alcohol consumption are associated with increased risk of CHDs. Whether these are causal is unclear.Methods and ResultsSeven European birth cohorts, including 232 390 offspring (2469 CHD cases [1.1%]), were included. We applied negative exposure paternal control analyses to explore the intrauterine effects of maternal BMI, smoking, and alcohol consumption during pregnancy, on offspring CHDs and CHD severity. We used logistic regression, adjusting for confounders and the other parent's exposure and combined estimates using a fixed‐effects meta‐analysis. In adjusted analyses, maternal overweight (odds ratio [OR], 1.15 [95% CI, 1.01–1.31]) and obesity (OR, 1.12 [95% CI, 0.93–1.36]), compared with normal weight, were associated with higher odds of CHD, but there was no clear evidence of a linear increase in odds across the whole BMI distribution. Associations of paternal overweight, obesity, and mean BMI were similar to the maternal associations. Maternal pregnancy smoking was associated with higher odds of CHD (OR, 1.11 [95% CI, 0.97–1.25]) but paternal smoking was not (OR, 0.96 [95% CI, 0.85–1.07]). The positive association with maternal smoking appeared to be driven by nonsevere CHD cases (OR, 1.22 [95% CI, 1.04–1.44]). Associations with maternal moderate/heavy pregnancy alcohol consumption were imprecisely estimated (OR, 1.16 [95% CI, 0.52–2.58]) and similar to those for paternal consumption.ConclusionsWe found evidence of an intrauterine effect for maternal smoking on offspring CHDs, but no evidence for higher maternal BMI or alcohol consumption. Our findings provide further support for the importance of smoking cessation during pregnancy.

BMI Trajectories During the First 2 Years, and Their Associations With Infant Overweight/Obesity: A Registered Based Cohort Study in Taizhou, China

Objective: The purpose of this study was to identify trajectories of body mass index (BMI) in toddlers from birth to 2 years old and examine their association with infantile overweight/obesity.Methods: Data were collected from 19,054 children born in any hospital or community healthcare center in Taizhou, China from 2018 to 2019 with at least three BMI measurements after birth. The Latent Class Growth Mixture Model was used to identify distinct BMI trajectories during the first 2 years of infants. Multiple logistic regression models were conducted to explore the associated factors of different BMI trajectories, and log-binomial regression was performed to assess the association between the trajectories and overweight/obesity.Results: Three heterogeneous BMI trajectories were identified and labeled as “lower” (36.21%, n = 6,899), “middle” (53.15%, n = 10,128) and “upper” (10.64%, n = 2,027), respectively. Several characteristics of infants and their corresponding mothers were found to be correlated with infant BMI trajectories, including infant sex, mode of delivery and weight at birth, as well as maternal parity, early pregnancy BMI and status of gestational diabetes mellitus. Furthermore, compared with those in the lower trajectory, infants in the middle [prevalence ratio (PR) = 2.63, 95% confidence interval (95%CI) = 2.17–2.63] or upper (PR = 2.98, 95%CI = 1.51–2.98) trajectory groups were prone to be overweight/obesity at their final observation.Conclusion: Heterogeneous BMI trajectories were observed in our study. Characteristics of both infants and their corresponding mothers could be potential determinants of infant growth. Moreover, infants in the middle and upper trajectory groups were more likely to suffer overweight/obesity.

Fetal Growth Disorders and Influence of Maternal Adiposity

Introduction: Infant birth weight is recognized as the leading indicator of health among infants and affects a wide range of subsequent outcomes later in life. The incidence of neonates with high birth weight has increased in recent years. Many studies in the past have revealed that high birth weight is associated with neonatal morbidity and mortality and associated with complications in later life. These complications include shoulder dystocia, birth trauma, asphyxia, and neonatal deaths. In the later life these neonates have high risk for obesity, hypertension, diabetes mellitus and cancer. High pre-pregnancy body mass index (BMI) has been reported as a well-established risk factors for adverse pregnancy outcomes. Despite the high prevalence of maternal obesity in the gulf region, only a few studies in this regard have been published. Methods: A retrospective service evaluation was conducted at a secondary hospital to evaluate the effect of pre-pregnancy BMI on neonatal birth weight. 950 women were randomly selected from women delivered at or more than 37 weeks gestation and grouped on the basis of pregnancy BMI as group A-BMI 18.5–24.9 kg/m2, group-B- BMI 25–29.9 kg/m2 and group C-BMI >30 kg/m2. Infants were grouped according to birth weight as low birth weight(<2500 g), normal birth weight (2500–3999 g), and high birth weight >4000g and correlation was studied with maternal body mass index. Chi square test was used for statistical evaluation using Medcal online software. Results: In the study group, 34.43% women had normal body mass index, 37.21 % women were overweight and 28.36 % were obese. In group A, 6.50% and 4.64 % infants were with low and high birth weight, respectively. In group B, 4.3% and 5.73 % were with low and high birth weight, respectively. In group C, 4.51% and 20.33 % infants were with low and high birth weight, respectively. In comparison to women with normal BMI, low birth weight infants in group B (OR-0.922, 95% CI- 0.327–1.275) and group C (OR- 0.679, 95% CI-0.682–1.572) were not statistically significant. High birth weight infants in group B (OR- 1.2482, 95% CI- 0.3270 to 1.2756, p = 0.2080) and group C (OR-5.230, 95% CI-2.875–9.512, p= < 0.0001) were positively correlated with pre-pregnancy BMI. Pre-pregnancy overweight and obesity increased the risk of high birth weight (OR- 1.248 and 5.230 respectively). The results were statistically significant in obese women (p=< 0.0001). Conclusion: Women with pre-pregnancy overweight and obesity have higher likelihood of high birth weight in infants. Pre-pregnancy weight loss is the key to reduce maternal and fetal complications. Early pregnancy booking and antenatal fetal surveillance is recommended for all women with high body mass index.

Predictors of pregnancy after intrauterine insemination in women with polycystic ovary syndrome.

ObjectiveTo evaluate the effects of body mass index (BMI) in patients with polycystic ovary syndrome (PCOS) undergoing controlled ovarian stimulation (COS) with intrauterine insemination (IUI).MethodsThis retrospective study evaluated couples with PCOS undergoing COS and IUI. The relationship between cumulative IUI pregnancy outcomes and BMI, treatment cycles, treatment schemes, number of dominant follicles, endometrial thickness, infertility duration and type of infertility was analysed.ResultsThe study evaluated 831 IUI cycles in 451 couples with PCOS. Compared with normoweight women, overweight and obese women required more human menopausal gonadotropin (hMG) doses and more days of COS. Gestational diabetes mellitus occurred more frequently in the obese group than in the other BMI groups. The clinical pregnancy and live birth rates in the hMG, clomiphene citrate (CC) + hMG and letrozole (LE) + hMG groups were significantly higher than those in the CC and LE groups. The clinical pregnancy rate was higher in the secondary infertility group compared with the primary infertility group.ConclusionObese women might require more hMG doses and more days of COS to overcome the effects of weight. As BMI increases, the incidence of gestational diabetes might also increase. The number of cycles and type of infertility may have a predictive value for pregnancy outcomes.

Maternal Health Outcomes and Male Partner Involvement Among HIV Infected Women in Rural South Africa.

This study aimed to investigate the association between Male Partner Involvement (MPI) and maternal health outcomes among women attending Prevention of Mother-to-Child Transmission of HIV (PMTCT) services in rural South Africa. The association between Male Partner Participation in the main study (MPP) and maternal health outcomes among these women was also investigated. The study utilized data collected from 535 HIV infected women in a randomized controlled trial between 2015 and 2016. Maternal health outcome data (delivery mode, pregnancy systolic and diastolic blood pressure, pregnancy body mass index, pregnancy CD4 count, and pregnancy viral load) were collected from the women's antenatal record forms accessed from the primary healthcare facilities. Bivariate and multivariable logistic regression models were used to estimate the association between socio-demographic characteristics of the women, MPI, and MPP with maternal health outcomes. The mean age of the women was 29.03years (SD = 5.89). No significant associations were found between MPI and any of the maternal health outcomes contrary to what was hypothesized. Both the bivariate and multivariate analysis indicated a significant association between MPP and higher pregnancy viral load, contrary to the study hypothesis. Insignificant associations were found between MPP and both pregnancy CD4 count and pregnancy blood pressure. The only significant association between maternal health outcomes and socio-demographic characteristics, was between educational attainment and higher pregnancy CD4 count in both the bivariate and multivariate analysis. The study showed no significant support for MPI in improving maternal health outcomes of women in PMTCT in rural South Africa. Future studies should include additional maternal health outcomes for investigation.

Association of maternal body mass index with intellectual disability risk

ObjectivesThe study aimed to investigate the association between maternal body mass index (BMI) in early pregnancy and children’s intellectual disability (ID) risk in the absence of chromosomal disorders, neurofibromatosis and...

Hypertensive Disorders during Pregnancy (HDP), Maternal Characteristics, and Birth Outcomes among Japanese Women: A Hokkaido Study.

Hypertension during pregnancy causes a greater risk of adverse birth outcomes worldwide; however, formal evidence of hypertensive disorders during pregnancy (HDP) in Japan is limited. We aimed to understand the association between maternal characteristics, HDP, and birth outcomes. In total, 18,833 mother-infant pairs were enrolled in the Hokkaido study on environment and children’s health, Japan, from 2002 to 2013. Medical records were used to identify hypertensive disorders and birth outcomes, namely, small for gestational age (SGA), SGA at full term (term-SGA), preterm birth (PTB), and low birth weight (LBW). The prevalence of HDP was 1.9%. Similarly, the prevalence of SGA, term-SGA, PTB, and LBW were 7.1%, 6.3%, 7.4%, and 10.3%, respectively. The mothers with HDP had increased odds of giving birth to babies with SGA (2.13; 95% Confidence Interval (CI): 1.57, 2.88), PTB (3.48; 95%CI: 2.68, 4.50), LBW (3.57; 95%CI: 2.83, 4.51) than normotensive pregnancy. Elderly pregnancy, low and high body mass index, active and passive smoking exposure, and alcohol consumption were risk factors for different birth outcomes. Therefore, it is crucial for women of reproductive age and their families to be made aware of these risk factors through physician visits, health education, and various community-based health interventions.

Pre-Pregnancy Diet Quality Is Associated with Lowering the Risk of Offspring Obesity and Underweight: Finding from a Prospective Cohort Study.

Maternal diet plays a critical role in epigenetic changes and the establishment of the gut microbiome in the fetus, which has been associated with weight outcomes in offspring. This study examined the association between maternal diet quality before pregnancy and childhood body mass index (BMI) in offspring. There were 1936 mothers with 3391 children included from the Australian Longitudinal Study on Women’s Health (ALSWH) and the Mothers and their Children’s Health (MatCH) study. Maternal dietary intakes were assessed using a semi-quantitative and validated 101-item food-frequency questionnaire (FFQ). The healthy eating index (HEI-2015) score was used to explore preconception diet quality. Childhood BMI was categorized as underweight, normal, overweight, and obese based on sex and age-specific BMI classifications for children. Multinomial logistic regression with cluster-robust standard errors was used for analyses. Greater adherence to maternal diet quality before pregnancy was associated with a lower risk of offspring being underweight after adjustment for potential confounders, highest vs. lowest quartile (relative risk ratio (RRR) = 0.68, 95% confidence interval (CI): 0.49, 0.96). Higher adherence to preconception diet quality was also inversely linked with the risk of childhood obesity (RRR = 0.49, 95% CI: 0.24, 0.98). This association was, however, no longer significant after adjusting for pre-pregnancy BMI. Sodium intake was significantly associated with decreased risk of childhood overweight and obesity (RRR = 0.18, 95% CI: 0.14, 0.23) and (RRR = 0.21, 95% CI: 0.17, 0.26), respectively. No significant association was detected between preconception diet quality and offspring being overweight. This study suggests that better adherence to maternal diet quality before pregnancy is associated with a reduced risk of childhood underweight and obesity.