Obese Pregnant Women Research Articles

The effect of obesity on oxidative stress parameters in pregnant women

Objective: In recent years, there has been a growing public concern about obesity, since it is known to reduce fertility in women and increase the duration of conception. Maternal obesity is also related to adverse pregnancy outcomes affected by placental malfunction. Therefore, in this study, we aimed to compare levels of oxidative stress between obese women and women of normal weight in the second trimester.
 
 Method: We assessed lipid peroxidation by measuring the thiobarbituric acid reactive species (TBARS), as well as the antioxidant defense system by measuring the activity of superoxide dismutase (SOD), glutathione peroxidase (GPx) and catalase (CAT) enzymes in 50 obese women (body mass index, BMI:36.60±4.95) and 51 women of normal weight (BMI:24.51±3.47).
 
 Results: Increased lipid peroxidation and SOD enzyme activity were determined in obese pregnant women when compared to women of normal weight. Also, we found a significantly positive correlation (r:0.286, p:0.0435) between BMI and TBARS level as well as a significantly negative correlation (r: -0.421, p:0.002) between TBARS level and SOD enzyme activity. No significant difference was observed between the two groups in CAT and GPx enzymes activities.
 
 Conclusion: Although increased SOD enzyme activity indicates that the antioxidant defense system is activated to deal with increased production of reactive oxygen species, maternal obesity is induced by oxidative stress via increased lipid peroxidation. Hence, maternal-obesity-induced oxidative stress in the second trimester should be followed up by clinicians since it may cause oxidative damage in the placenta during pregnancy.

Influence of gestational weight gain on the nutritional status of offspring at birth and at 5 years of age

ObjectiveTo determine the influence of pre-pregnancy maternal BMI and increases in maternal weight during pregnancy on perinatal and child outcomes at birth and at 5 years. Research design/settingA prospective cohort study was conducted between November 2016 and December 2021. The participants were a total of 115 women-child dyads, selected from among pregnant women receiving routine prenatal care in different health centres belonging to 2 health districts. Follow-ups were conducted with the women during pregnancy and with their children during the 10 days after birth and at 5 years. FindingsThe total weight gain during pregnancy is influenced by an inadequate pre-pregnancy BMI (0.03; 95 % CI, 0.004 – 0.25; P=.001) and a greater increase in maternal BMI during the first and second term of pregnancy. A greater increase in BMI during pregnancy was associated with higher breastfeeding rates both in the short term (1.21; 95 % CI, 1.01–1.44; P = 0.04) and the long term (12 months: 1.30; 95 % CI, 1.02 – 1.67; P = 0.04; 24 months: 1.30; 95 % CI, 1.02 – 1.69; P = 0.04). No links were found between gains in maternal weight and the weight of the newborn, nor between maternal weight and/or pre-pregnancy BMI with the nutritional status of the child. Key conclusionsAfter studying these results, it was concluded that promoting and implementing health and education policies focused on enhancing maternal nutritional status is essential to improve the nutritional status of children. Implications for practiceHealthy gestational weight gain (GWG) is an important issue to be addressed by the midwife in primary care, both in the preconception period and throughout pregnancy.As a result, it is important that the midwife is trained and has the appropriate resources and tools to work with pregnant women individually and collectively. In addition to paying attention to overweight and obese pregnant women, the midwife should also pay attention to women with a normal BMI, as they seem to have greater difficulty in maintaining a healthy weight gain.Another line of intervention to be addressed is breastfeeding (BF), where the midwife should be the main point of reference from the beginning of this process, taking into account the relationship between BMI and BF.

The Investigation of Maternal Perception, Body Perception, Distress Level and Fear of Chilbirth in Maternal Obesity Pregnancy

Purpose: In this study, it was aimed to examine the relationship between maternal obesity and maternal perception, body perception, distress level and fear of childbirth in pregnant women. 
 Methods: The data of this descriptive-correlational study were obtained by Self-perception Scale of Pregnant Women (SSPW), Tilburg Pregnancy Distress Scale (TGSS), and The Wijma Delivery Expectancy/Experience Questionnaire A Version (W-DEQ/ A Version).
 Results: 54.1% of pregnant women were obese according to BMI. 89.6% of the pregnant women reported that they paid attention to adequate and balanced nutrition during pregnancy, and 21.6% of them did regular exercise during pregnancy. A statistically significant difference was found between the presence of obesity in pregnant women and the median score of the Tillburg Pregnancy Distress Scale (p=0,004). There was a significant, positive and low correlation between the median BMI score of the pregnant women and the SSPW (rs=0.146, p=0.017) and the median body perception score (rs=0.158, p=0.010). 
 Conclusion: There was no statistically significant difference between the presence of obesity in pregnant women and SSPW, maternal perception, body perception, presence of distress and fear of childbirth. Health care professionals should plan pregnancy, regulate weight gain during pregnancy, and provide nutrition and exercise training for women in the risk group. In Maternal obesity pregnancy, risk factors should be identified at an early stage and a multidisciplinary approach should be followed.

The Efficacy and Safety of Myo-inositol Supplementation for the Prevention of Gestational Diabetes Mellitus in Overweight and Obese Pregnant Women: A Systematic Review and Meta-Analysis.

Myo-inositol has emerged as one of the preventive therapies for the development of gestational diabetes mellitus in at-risk populations. This systematic review and meta-analysis was conducted to determine the efficacy and safety of myo-inositol in decreasing the incidence of gestational diabetes in overweight and obese pregnant women. This meta-analysis was conducted using the standard Cochrane methodology and reported in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) 2020 guidelines. Inclusion criteria were randomized controlled trials (RCTs) that enrolled overweight and obese pregnant women and used myo-inositol supplementation. The primary outcome was the incidence of gestational diabetes mellitus at 24-28 weeks. Secondary outcomes included cesarean section rate, the incidence of pregnancy-induced hypertension, macrosomia and preterm delivery. Risk ratios (RRs) and 95% confidence intervals (CIs) were used for dichotomous data. Six RCTs were included. Compared to standard micronutrient supplementation, standard dose of myo-inositol (4 g) may reduce the incidence of GDM (RR 0.54; CI [0.30, 0.96]; n = 887 women), but the certainty of evidence is low to very low. With low-dose myo-inositol however, evidence is uncertain about its benefit on the incidence of gestational diabetes mellitus in overweight and obese women with RR 0.71; CI [0.14, 3.50]. No adverse effects were noted. For the secondary outcomes, standard dose myo-inositol appears to reduce the incidence of pregnancy-induced hypertension and preterm delivery, but the certainty of evidence is low to very low. Current evidence is uncertain on the potential benefit of myo-inositol supplementation in overweight and obese pregnant women. While studies show that 4 g myo-inositol per day may decrease the incidence of GDM, pregnancy-induced hypertension and pre-term birth with no associated risk of serious adverse events, the certainty of evidence is low to very low. Future high-quality trials may provide more compelling evidence to support practice recommendations.

Perbedaan Karakteristik Demografi dan Klinis Ibu Hamil Overweight dan Obesitas Tipe I


 
 
 
 Indonesia is also experiencing a nutritional transition, namely increased overweight and obesity. This trend has a big impact on both mothers and the babies born. There has been no research that reveals differences in the demographic and clinical characteristics of overweight and obese pregnant women, so appropriate management cannot be carried out according to the characteristics of pregnant women. The aim of this study is to explain the differences in demographic and clinical characteristics of overweight and obese type 1 pregnant woman in Kediri City.. This research uses a comparative analytical design. The research was conducted at nine Kediri City health centers, namely Campurejo, Banjarmlati, Pesantren I, Pesantren II, North Region City, South Region City, Ngletih, and Mrican health centers, from June to August 2023. The research population in June was composed of third-trimester pregnant women (102 pregnant women). Determining the sample using a simple random sampling technique, 86 pregnant women were obtained and divided into groups, namely overweight (n = 59) and type 1 obesity (n = 27). The research inclusion criteria include willingness to be a respondent, age 20–35 years, having ANC at least once in the first trimester and once in the second trimester, LILA > 23.5 cm, BMI > 25, and the exclusion criteria is pregnancy with comorbidities. Data analysis in this study used the Mann-Whitney, Fisher Exact, and Chi-Square tests with a significance value of 0.05 using SPSS 26. The research results showed that in the demographic characteristics of the overweight group compared to obesity type I, there were differences in age (p < 0.001), family history of obesity (p = 0.007), and there were no differences in education level (p = 0.0617), employment status (p = 0.096), income level (0.0353), and family support score (p = 0.587). Data on clinical characteristics in the overweight group compared to obesity type I showed differences in the history of hormonal contraceptive use (p = 0.049) and diet (p = 0.035), but there were no differences in gestational age (p = 0.157) or parity (p = 0.530). The differences in demographic and clinical characteristics between the two groups can be used as a reference for service providers so that pregnant women can control weight gain according to their body mass index.
 
 
 
 

Efecto del embarazo y el parto en la musculatura perineal de mujeres con obesidad. Un estudio de cohorte longitudinal

ObjectiveEvaluating the changes of the perineal muscles in primigravid women with obesity (BMI≥30) and to compare the progress with primigravid women in normal BMI range. MethodsA prospective longitudinal cohort study was carried out. The pregnant women were studied at three moments: at 12 weeks’ gestation, at 34 weeks’ gestation and at 12 weeks after delivery. During the ckeck-up, perinometric measurements were taken to determine basal tone (BT), maximum contractile force (FMax) and applied forced (AF). In addition, the Oxford test (MOS) was used. General statistical mixed models were used for the statistical study. ResultsFifty nulliparous pregnant women (25 with BMI≥30 and 25 with BMI<25) were recruited at the beginning of the study and 39 completed the entire study. Basal tone (BT) was 4.62±0.24 Nw at the beginning of pregnancy and decreased to 4.18±0.26 Nw after delivery. Contractile capacity was 5.56±0.79 Nw at week 12 and increased to 6.34±1.24 Nw after delivery. When comparing the FCMax at week 12 in obese vs. normal weight pregnant women, values of 5.51±87 Nw vs. 5.61±0.71 Nw were observed (P=.941). Postpartum values were 6.72±1.17 Nw vs. 5.95±1.21 Nw (P=.024), higher in the obese population. ConclusionsThere is an increase in contractile strength (Fmax) at 12 weeks postpartum in order to counteract the significant decrease in basal tone (BT). The body has compensatory mechanisms that allow recovery after 3 months postpartum, with greater muscle strength in obese patients.

Effect of pregnancy and childbirth on perineal musculature in women with obesity. A longitudinal cohort study

ObjectiveEvaluating the changes of the perineal muscles in primigravid women with obesity (BMI ≥ 30) and to compare the progress with primigravid women in normal BMI range. MethodsA prospective longitudinal cohort study was carried out. The pregnant women were studied at three moments: at 12 weeks' gestation, at 34 weeks' gestation and at 12 weeks after delivery. During the ckeck-up, perinometric measurements were taken to determine basal tone (BT), maximum contractile force (FMax) and applied forced (AF). In addition, the Oxford test (MOS) was used. General statistical mixed models were used for the statistical study. ResultsFifty nulliparous pregnant women (25 with BMI ≥ 30 and 25 with BMI < 25) were recruited at the beginning of the study and 39 completed the entire study. Basal tone (BT) was 4.62 ± 0.24 Nw at the beginning of pregnancy and decreased to 4.18 ± 0.26 Nw after delivery. Contractile capacity was 5.56 ± 0.79 Nw at week 12 and increased to 6.34 ± 1.24 Nw after delivery. When comparing the FCMax at week 12 in obese VS normal weight pregnant women, values of 5.51 ± 87 Nw vs. 5.61 ± 0.71 Nw were observed (P = .941). Postpartum values were 6.72 ± 1.17 Nw vs 5.95 ± 1.21 Nw (P = .024), higher in the obese population. ConclusionsThere is an increase in contractile strength (Fmax) at 12 weeks postpartum in order to counteract the significant decrease in basal tone (BT). The body has compensatory mechanisms that allow recovery after 3 months postpartum, with greater muscle strength in obese patients.

A longitudinal study on the effect of obesity upon circulating renin-angiotensin system in normal pregnancy

Background and aimsObesity is the most common health issue in women of reproductive age, which profoundly affects maternal-fetal health. Despite progress in understanding key inflammatory and metabolic changes, the pathogenesis of the cardiovascular phenotype of obese pregnant women remains to be fully understood. This study aimed at: (i) evaluating the changes of the renin-angiotensin system (RAS) throughout pregnancy in obese vs normal weight (control) women, and (ii) evaluating the presence of any associations between maternal hemodynamic status and RAS changes. Methods and resultsThirty-eight normal weight and nineteen obese pregnant women were included. Clinical assessment, blood samples and maternal hemodynamic evaluation were performed at 12, 20, 30, and 36 weeks, while ultrasound assessment was scheduled at 20, 30, and 36 weeks of gestation. Measurements of sFlt-1, PlGF, Angiotensinogen, Renin, AngII, Ang1-7, ACE and ACE2 were performed by ELISA. Our data show that normotensive obese women had lower placental blood supply, as assessed by UV-Q and UV-Q/EFW, as compared to controls, and significantly higher levels of AngII and AngII/Ang1-7 ratio, which were inversely related to placental blood supply. ConclusionsOur study shows for the first time that normotensive obese women exhibited a significant progressive increase of AngII and AngII/Ang1-7 throughout pregnancy, which were inversely related to placental blood supply as assessed by UV-Q and UV-Q/EFW. Our data shed light on the early changes in pregnant obese women and suggest that RAS dysregulation is a prerequisite rather than a consequence of hypertensive disorders of pregnancy and other maternal neonatal complications.

B-cell-activating factor (BAFF) and platelet-activating factor (PAF) in pregnancies complicated by maternal obesity and diabetes: a preliminary study

Objective In pregnancies complicated by maternal obesity and diabetes, a disruption in inflammatory mediators occurs, resulting in endothelial microvascular dysfunction, oxidative stress, tissue damage, and maternal and feto-neonatal complications. To outline this proinflammatory status, an innovative approach is represented by the measurement of proinflammatory cytokines. Among these biomarkers, B-cell-activating factor (BAFF) and platelet-activating factor (PAF) play a key role in metabolic regulation, immune response to infections, tissue homeostasis, and “food-related inflammation.” The aim of the present study is to investigate the blood expression of BAFF and PAF in a cohort of pregnant women affected by obesity and diabetes compared with a control group of healthy pregnant women. Methods A prospective longitudinal cohort study has been conducted on pregnant women referred to Fondazione Policlinico Universitario Gemelli IRCCS in Rome. For each pregnant woman, a capillary sample was collected with a swab in three different consecutive evaluations carried out in the three trimesters of pregnancy. Results A total of 77 pregnant women have been enrolled. No significant differences in BAFF and PAF levels were longitudinally observed between groups. Focusing on the exposed group, in the third trimester of pregnancy, both PAF and BAFF levels were lower than the basal time. Among the selected group of patients who developed Gestational Diabetes, only PAF values were longitudinally lower when compared to other groups. The multivariate analysis showed that BAFF levels were positively correlated with thyroid-stimulating hormone levels. No macrosomia, no shoulder dystocia, no major perineal lacerations at birth, and no intrauterine growth restriction were observed in the whole population. Conclusions This study supports the involvement of metabolic and proinflammatory biomarkers in the mechanisms related to pregnancy complications. Improving a good metabolic environment for obese and diabetic pregnant women could break the vicious cycle connecting inflammation, oxidative stress, and metabolic disorders.

Obesity in prenatal medicine: a game changer?

Obesity is recognized by the World Health Organization (WHO) as a disease in its own right. Moreover, obesity is an increasingly concerning public health issue across the world and its prevalence is rising amongst women of reproductive age. The fertility of over-weight and obese women is reduced and they experience a higher rate of miscarriage. In pregnant women obesity not only increases the risk of antenatal complications, such as preeclampsia and gestational diabetes, but also fetal abnormalities, and consequently the overall feto-maternal mortality. Ultrasound is one of the most valuable methods to predict and evaluate pregnancy complications. However, in overweight and obese pregnant women, the ultrasound examination is met with several challenges, mainly due to an impaired acoustic window. Overall obesity in pregnancy poses special challenges and constraints to the antenatal care and increases the rate of pregnancy complications, as well as complications later in life for the mother and child.

Fetal cortical development and neurosonographic findings in obese pregnant women: a case control study from a tertiary hospital.

To investigate the effect of obesity on fetal cortical development. This prospective cross-sectional study was conducted with 91 pregnant women. Fetal neurosonography scans were performed in the third trimester, and according to body mass index (BMI) values, the patients were evaluated in two groups: obese (BMI ≥ 30kg/m2) and normal weight (BMI < 30kg/m2). During neurosonography, fetal insular depth and Sylvian fissures, parieo-occipital and cingulate fissure depth, frontal lobe length, and the sizes of the corpus callosum and cavum septum pellucidum were measured using a transvaginal approach. Fetal cortical development and Sylvian fissure operculization were graded. The number of patients with grade 2 fetal cortical development was significantly higher among the pregnant women in the obese group compared to the normal weight group (n = 17, 41.5% and n = 8, 16.0%, respectively; p = 0.007). In the obese group, the number of pregnant women with grade 4 or below fetal Sylvian fissure operculization was significantly higher (n = 13, 31.7%), and the number of those with grade 9 or above operculization was significantly lower (n = 1, 2.5%) (p = 0.003). The fetal insular depth, frontal lobe anterior-posterior diameter, cingulate fissure depth, and corpus callosum thickness were lower in the obese group, albeit with no significant difference. Parieto-occipital depth significantly decreased in the obese group [6.8 (6) mm)] compared to the control group [10.5 (7.2) mm)] (p = 0.008). The fetal Sylvian fissure ratio and the cavum septum pellucidum ratio were found to be similar between the groups. The data obtained from this study showed that obesity caused fetal cortical changes in pregnant women.

The effects of exercise intervention on complications and pregnancy outcomes in pregnant women with overweight or obesity: A systematic review and meta-analysis.

Being overweight or obese is closely related to adverse pregnancy outcomes and harms both pregnant women and neonates, increasing complications during pregnancy and leading to adverse pregnancy outcomes. Consequently, a meta-analysis was done to investigate exercise therapy impact on the complications and outcomes of pregnant women who are obese or overweight. The computer system searched PubMed, Cochrane Library, Wanfang, EMBASE, and CNKI databases. The search duration extended from the database establishment until October 2022. A thorough search was carried out for pertinent studies investigating exercise therapy impact on pregnancy complications and outcomes in obese or overweight pregnant women. The heterogeneity test was carried out using Cochrane Q and Chi-square tests. The combined findings from the meta-analysis were examined for reliability and robustness using sensitivity and publication bias analyses. All statistics used RevMan 5.3 software. This meta-analysis included data from 8026 patients from 22 randomized controlled trials. The results demonstrated that exercise therapy might successfully decrease the incidence of gestational diabetes mellitus (GDM) (odds ratio [OR] = 0.85, 95% confidence interval [CI]: 0.74-0.96, P = .01) and macrosomia (OR = 0.78, 95% CI: 0.68-0.89, P < .001), and control weight gain during pregnancy (SMD = -0.2, 95% CI: -0.31 to -0.08, P < .001). Exercise therapy can control weight gain during pregnancy, lower the incidence of GDM and the macrosomia rate, and improve adverse pregnancy outcomes.

Fetal abdominal obesity and the ensuing adverse perinatal outcomes in older obese pregnant women with or without obesity and with normal glucose tolerance

To investigate whether the increased risk of fetal abdominal obesity (FAO) is present in the older (≥ 35 years) and/or obese (≥ body mass index 25 kg/m2) women with normal glucose tolerance, we reviewed medical record of 6721 singleton pregnancy. At 24–28 gestational weeks (GW), fetal abdominal overgrowth was assessed by the fetal abdominal overgrowth ratios (FAORs) of the ultrasonographically estimated gestational age (GA) of abdominal circumference per actual GA by the last menstruation period, estimated GA of biparietal diameter or femur length, respectively. FAO was defined as FAOR ≥ 90th percentile. Compared to young and non-obese women, older women showed significantly higher FAORs irrespective of obesity and the prevalence of FAO in older and non-obese women was significantly higher (11.8% vs. 8.6%, p < 0.05). The odds ratio for large for gestational age at birth were 3.06(1.96–4.77, p < 0.005), 1.47(1.16–1.86, p < 0.005) and 2.82(1.64–4.84, p < 0.005) in young and obese, older and non-obese, and older and obese women, respectively. The odds ratio for primary cesarean delivery in older and non-obese women was 1.33 (1.18–1.51, p < 0.005). An increased risk of FAO at 24–28 GW and subsequent adverse perinatal outcomes have been observed in the older women with or without obesity, compared to younger and non-obese women, despite normal glucose tolerance.

Comparison of cesarean delivery rates after 3 methods of cervical ripening among obese women at or after 41 weeks – Secondary analysis of two French randomized controlled trials: MAGPOP and CYTOPRO

ObjectiveTo compare cesarean rates and maternal and neonatal morbidity according to the cervical ripening method used among obese pregnant women requiring induction of labor at or after 41 weeks of gestation. DesignA secondary analysis of two multicenter randomized controlled trials conducted in French maternity units between 2015 and 2018. Participants336 women with a body mass index ≥30 kg/m2, a pregnancy ≥41 weeks, and an induction of labor requiring cervical ripening. InterventionsCervical ripening with a PGE2 dinoprostone pessary (Propess®), or low-dose vaginal PGE1 (misoprostol) or a double-balloon catheter. Measurements and findingsThe rates of cesarean delivery did not differ significantly according to the cervical ripening method (PGE2 pessary vs PGE1, RR: 1.18, 95% CI: 0.80–1.75; PGE2 pessary vs double balloon catheter: RR, 0.88, 95% CI: 0.60–1.29), p = 0.52; double balloon catheter vs PGE1, RR: 1.34, 95% CI: 0.77–2.32, p = 0.29). More oxytocin was required for women from the double-balloon group compared to those from both the PGE1 and PGE2 pessary groups (respectively, RR: 1.31, 95% CI: 1.08–1.58, p = 0.005; RR: 1.17, 95% CI: 1.03–1.32, p = 0.01). The risk of perineal tears or episiotomy was significantly lower for women induced with the PGE2 pessary than with PGE1 (0.85; 95% CI: 0.74–0.99), p = 0.03). Key conclusions and implications for practiceNo cervical ripening method was associated with a lower cesarean rate in obese women who required cervical ripening from 41 weeks. Further trials are required among obese women to determine the cervical ripening method most efficacious for reducing the cesarean rate.

Role of body mass index in pregnancy outcomes after emergency cerclage for cervical insufficiency in singleton pregnant patients

BackgroundThe study aims were to analyze pregnancy outcomes after the use of emergency cerclage in patients with different BMIs.MethodsA total of 76 singleton pregnant patients who underwent emergency cerclage at a tertiary comprehensive hospital in China between Jan 2017 and Dec 2021 were retrospectively divided into an obesity group of 37 patients with BMIs ≥ 28 kg/m2 and a non-obesity group of 39 patients with BMIs < 28 kg/m2. The medical records of patients were reviewed and all relevant clinical data were further collected into an itemized data spreadsheet for various analyses.ResultsEmergent cerclage, along with amnioreduction if needed, could be safely performed on both obese and non-obese pregnant women with a dilated external cervix (> 1 cm), which effectively prolonged the gestational week up to ≥ 25 weeks. Obese gravidae had shorter suture-to-delivery intervals and mean pregnancy lengths but more spontaneous preterm births before 37 weeks, and a lower live birth rate (P < 0.05). Logistic regression analysis revealed that BMI, how many times cerclages have been performed during pregnancy (frequency of cerclage) and bacterial vaginosis, aerobic vaginitis and vulvovaginal candidiasis (vaginal microecology) were significantly correlated with fetal loss (P < 0.05), while rank correlation analysis established a negative correlation between BMI values and the suture-to-delivery interval (P = 0.031).ConclusionsPregnant cervical insufficiency patients with BMIs > 28 kg/m2 may ill-serve the gestational outcomes and suture-to-delivery interval after their emergent cerclage. Additionally, BMI, frequency of cerclage and vaginal microecology accounted for higher fetal loss in patients who underwent emergency cerclage.

O48 - The changing landscape of obesity in pregnant women in Victoria

O48 - The changing landscape of obesity in pregnant women in Victoria

Prediction of cesarean delivery in class III obese nulliparous women: An externally validated model using machine learning.

class III obese women, are at a higher risk of cesarean section during labor, and cesarean section is responsible for increased maternal and neonatal morbidity in this population. the objective of this project was to develop a method with which to quantify cesarean section risk before labor. this is a multicentric retrospective cohort study conducted on 410 nulliparous class III obese pregnant women who attempted vaginal delivery in two French university hospitals. We developed two predictive algorithms (a logistic regression and a random forest models) and assessed performance levels and compared them. the logistic regression model found that only initial weight and labor induction were significant in the prediction of unplanned cesarean section. The probability forest was able to predict cesarean section probability using only two pre-labor characteristics: initial weight and labor induction. Its performances were higher and were calculated for a cut-point of 49.5% risk and the results were (with 95% confidence intervals): area under the curve 0.70 (0.62,0.78), accuracy 0.66 (0.58, 0.73), specificity 0.87 (0.77, 0.93), and sensitivity 0.44 (0.32, 0.55). this is an innovative and effective approach to predicting unplanned CS risk in this population and could play a role in the choice of a trial of labor versus planned cesarean section. Further studies are needed, especially a prospective clinical trial. French state funds "Plan Investissements d'Avenir" and Agence Nationale de la Recherche.

PO6_03. Do lower blood pressure cut-offs in obese pregnant women identify women at greater risk of adverse maternal and perinatal outcomes? A secondary analysis of upbeat data

PO6_03. Do lower blood pressure cut-offs in obese pregnant women identify women at greater risk of adverse maternal and perinatal outcomes? A secondary analysis of upbeat data

Hemoglobin Levels, Anemia, and Their Associations with Body Mass Index among Pregnant Women in Hail Maternity Hospital, Saudi Arabia: A Cross-Sectional Study.

The level of association between hemoglobin level/anemia and obesity during pregnancy is not yet fully understood. A cross-sectional study was conducted in Hail Maternity Hospital in northern Saudi Arabia from March to May 2023 to assess the associations between hemoglobin levels, anemia, and obesity among pregnant women. Reproductive history was gathered through a questionnaire. Body mass index (BMI) was calculated/computed from the women's weight and height. Linear and binary regression analyses were performed. A total of 334 pregnant women were enrolled. The median (interquartile range (IQR)) age and parity were 33.2 (27.4-37.8) years and 3 (1-5), respectively. Of the 334 women, 52 (15.6%) were normal weight, while 87 (26.0%) were overweight and 195 (58.4%) were obese. In the multiple linear regression, parity (coefficient = -0.121, p = 0.001) and BMI (coefficient = 0.030, p = 0.006) were negatively associated with the hemoglobin level. Ninety-nine (26.9%) women had anemia. In the multivariate analysis, primiparity (adjusted odds ratio (AOR) = 0.54, 95% confidence interval (CI) = 0.30-0.97), increasing BMI (AOR = 0.93, 95% CI = 0.89-0.97), and obesity (AOR = 0.31, 95% CI = 0.16-0.61) were associated with decreased ORs of anemia. Increasing parity was associated with increased ORs of anemia (AOR = 1.18, 95% CI = 1.05-1.32). Being overweight was not associated with anemia (AOR = 0.56, 95% CI = 0.27-1.16). In the current study, a high hemoglobin level and lower prevalence of anemia were observed among obese pregnant women.

Assessment of Maternal Abdominal Subcutaneous Fat Thickness (Sft) Measured by Ultrasound as an Independent Predictor of Adverse Pregnancy Outcomes

Introduction: Obese pregnant women are at increased risk for a variety of maternal and perinatal complications. The maternal risks related to obesity include Gestational Diabetes mellitus, Preeclampsia, increased caesarean sections. The fetes is at risk of stillbirth, preterm birth and congenital anomalies. This study focuses on the use of Maternal abdominal subcutaneous fat thickness (SFT) as a surrogate measure for central obesity as measured by ultrasound, and determining its efficacy compared to BMI in predicting obesity related pregnancy complications. Objective: To measure mid-trimester SFT in antenatal women and establish SFT as an independent predictor of obesity related adverse pregnancy outcomes Methods: This was a prospective cohort study. 150 pregnant women between 20-40 years of age were recruited. Demographic data of each participant was collected from the OPD. USG for abdominal subcutaneous fat thickness (SFT) was done at 18-22 wks period of gestation. The participants were followed up to labour. Adverse pregnancy outcomes and their correlation with the SFT measured was studied. Results: There was significant positive correlation between BMI and SFT (r=0.591, p&lt;0.001) .A positive correlation was noticed between BMI and adverse pregnancy outcomes such as PIH, GDM , preterm birth , postdates and NICU admissions. SFT independently showed a positive correlation with the above parameters. The mean SFT among women without PIH was 11.45 mm, and with PIH was 16.48 mm[p &lt;0.001].Mean SFT were 11.68mm and 16.24 mm among the ladies without and with GDM respectively[p&lt;0.001]. The mean SFT for term pregnancies was 12.06 mm whereas the mean SFT for preterm births was 14.21 showing positive correlation between SFT and preterm birth. SFT also showed positive correlation with need for NICU admission for neonates [ SFT avg being 11.72mm and 14.94 mm in the 2 groups]. A comparative analysis was done between BMI and SFT regarding their correlation to the various outcomes. SFT showed higher correlation coefficients for these variables than BMI, with lower p values suggesting more statistical significance. Conclusion: BMI showed a positive correlation with adverse pregnancy outcomes in mother as well as fetes, SFT showed greater and more statistically significant correlation for adverse outcomes. Thus it was concluded that SFT is a better independent predictor of obesity related adverse pregnancy outcomes.