Obese Pregnant Women Research Articles

Adverse Fetomaternal Outcomes in Obese Pregnant Women with Gestational Hypertension

Objective: To determine the incidence of adverse fetomaternal outcomes of gestational hypertension in pregnant obese women. Methodology: The six-month descriptive observational study at Liaqat Memorial Hospital, Kohat, with 127obesepregnantwomenaged15-45.Participantswere selectedbasedonsingletonpregnancy more than 24 weeks gestation according to scan or LMP and a blood pressure of >140/90 mmHg on two different occasions without proteinuria, or a single reading of BP of 160/110mmHg with a BMI over 30 kg/m². Baseline data (maternal age, parity, BMI gestational age, education, socioeconomic status, family income, and residence) were collected. Fetomaternal complications were recorded by following up the patients till delivery. Results: The study included obese pregnant women with an average age of 33.2± 1.5 years and a mean BMI of 31.2 ± 5.6. Most participants had a median parity of 3, with a majority belonging to urban areas (51.1%) , having middle socioeconomic status (48.8% ). The adverse fetal outcomes ranged from preterm birth (16.4%),fetal growth restriction (12.6%),fetal hypoxia (8.9%)andlastlyperinataldeath(5.2%).Theadversematernaloutcomeswerepostpartumhemorrhage (16.4%), placental abruption (8.3%) , ecclempsia (7.2%) , HELLPsyndrome (4.1%) and maternal mortality (3.1%). Adverse maternal and fetal outcomes preterm labor postpartum hemorrhage, eclampsia, and placental abruption, fetal growth restriction and intrauterine fetal death outcomes being significantly higher in moderate gestational hypertension compared to mild gestational hypertension p=0.023, p=0.030, p=0.020, p=0.011, p=0.035 and p=0.022) respectively and adverse outcome placental abruption, eclampsia, and fetal growth restriction being significantly higher in class II obesity when compared to class I (p value= p=0.045 p=0.041 p=0.038)respectively Conclusion: Adverse fetomaternal outcomes are significantly affected by the severity of gestational hypertension andclass of obesity.Prenatal identification ofrisk factors in these women couldlowermaternal and fetal morbidity and mortality rates, underscoring the importance of an effective prenatal care system. Keywords: Obesity, Maternal Health, Fetal Growth Retardation, Pre- Eclampsia, Premature Birth

Analysis of Endothelin-1 (ET-1) Levels in the Urine of Non-Obese Pregnant Women and Obese Pregnant Women

Analysis of Endothelin-1 (ET-1) Levels in the Urine of Non-Obese Pregnant Women and Obese Pregnant Women

Pregnancy in obese women and mechanisms of increased cardiovascular risk in offspring.

Pregnancy complicated by maternal obesity contributes to an increased cardiovascular risk in offspring, which is increasingly concerning as the rates of obesity and cardiovascular disease are higher than ever before and still growing. There has been much research in humans and preclinical animal models to understand the impact of maternal obesity on offspring health. This review summarizes what is known about the offspring cardiovascular phenotype, describing a mechanistic role for oxidative stress, metabolic inflexibility, and mitochondrial dysfunction in mediating these impairments. It also discusses the impact of secondary postnatal insults, which may reveal latent cardiovascular deficits that originated in utero. Finally, current interventional efforts and gaps of knowledge to limit the developmental origins of cardiovascular dysfunction in offspring of obese pregnancy are highlighted.

Relationship between serum 25-hydroxyvitamin D level and preeclampsia components and metabolic parameters among overweight and obese pregnant women

Background: Studies have shown that vitamin D deficiency can be related to the occurrence of preeclampsia. Objective: The present study was conducted with the aim of determining the relationship between the serum level of 25-hydroxyvitamin D and preeclampsia and its related risk factors among obese or overweight pregnant women. Methods: This cross-sectional-analytical study was conducted on 83 pregnant women referring to comprehensive health service centers in Makoo city. Anthropometric indices and biochemical factors including vitamin D serum level, glycemic indices and lipid parameters were investigated in these women. In addition, the food intake of the participants was evaluated using an FFQ. Results: The results showed that there is a direct correlation between vitamin D serum level and dietary fat level (r=0.269, p=0.007) and high-density lipoprotein (HDL-C) (r=0.478, p<0.0001). Also, there was an inverse correlation between serum vitamin D level and pre-pregnancy body mass index (r=-0.625, p<0.0001), systolic blood pressure (r=-0.592, p<0.0001), diastolic blood pressure (r=-0.592, p<0.0001), fasting blood sugar (FBS) (r=-0.511, p<0.0001), proteinuria (r=-0.422, p<0.0001), triglyceride (TG) ( r=-0.225, p=0.020), total cholesterol (TC) (r=-0.428, p<0.0001) and low-density lipoprotein (LDL-C) (r=-0.602, p<0.0001). Conclusion: There is a direct relationship between dietary fat intake and serum vitamin D level. There is also a positive correlation between serum levels of this vitamin and serum HDL-C. On the other hand, there is an inverse relationship between the serum level of this vitamin and systolic blood pressure, degree of proteinuria, pre-pregnancy body mass index and FBS, TC and LDL-C.

Postpartum cardiac reverse remodeling is reflected in urine proteome

Abstract Background The impact of postpartum cardiac reverse remodeling (RR) on urinary proteome, particularly in pregnant women with cardiovascular risk (CVR) factors who show long-term increased risk of cardiovascular disease and mortality is unknown. Purpose To profile the urinary proteome in pregnant women with/without CVR factors to identify proteins associated with postpartum RR. Methods Our study included a prospective cohort of 32 healthy and 27 obese and/or hypertensive and/or diabetic pregnant women who underwent transthoracic echocardiography, pulse-wave-velocity, and urine collection at the 3rd trimester and 6-months postpartum. Shotgun HPLC-MS/MS profiled proteins. Generalized linear mixed-effects models were used to identify associations between urinary proteins and left ventricle mass (LVM), a surrogate of RR. Results The presence of at least one CVR factor was associated with worse LVM RR. We identify 6 (alpha-galactosidase A [GLA], sialate O-acetylesterase [SIAE], trans-golgi network integral membrane protein 2 [TGOLN2], sortilin [SORT1], desmoglein-2 [DSG2] and neuroblast differentiation-associated protein [AHNAK]) and 11 (serotransferrin [TF], inter-α-trypsin inhibitor heavy chain 4 [ITIH4], complement C3 [C3], transketolase [TKT], fibronectin [FN1], ubiquitin-like modifier-activating enzyme 1 [UBA1], cell division control protein 42 homolog [CDC42], glutathione s-transferase P1 [GSTP1], sodium/potassium-transporting ATPase subunit alpha-1 [ATP1A1], ADP-ribosylation factor 1 [ARF1] and pro-cathepsin H [CTSH]) proteins associated with high and low LVM regression, respectively. These proteins were functionally linked with insulin-like growth factor (IGF) transport and uptake regulation by IGF binding-proteins, platelet activation, signaling and aggregation and the immune system’s activity. The concentration of IGF-1 in urine samples was associated with low LVM regression after delivery. Conclusions Urine proteome reflects postpartum cardiac RR. Specifically, eight urine proteins (GSTP1, ARF1, FN1, SORT1, SIAE, GLA, ITIH4 and DGS2) show clinical value in identifying women at higher risk for incomplete postpartum RR. In addition, the association between IGF and postpartum LVM regression was validated.

Trophoblast-specific overexpression of adiponectin receptor 2 causes fetal growth restriction in pregnant mice.

Maternal obesity in pregnancy is strongly associated with complications such as fetal overgrowth and infants of obese mothers have an increased risk to develop obesity, diabetes, and cardiovascular disease later in life. However, the underlying mechanisms are not well established. Circulating levels of adiponectin are low in obese pregnant women and maternal circulating adiponectin is negatively associated with birth weight. We have reported that normalizing maternal adiponectin in obese pregnant mice prevents placental dysfunction, fetal overgrowth, and programming of offspring cardio-metabolic disease. However, the mechanistic link between maternal adiponectin, placental function, and fetal growth remains to be established. We hypothesized that trophoblast-specific overexpression of the adiponectin receptor 2 (Adipor2) in healthy pregnant mice inhibits placental mTORC1 signaling and nutrient transport, resulting in fetal growth restriction. Using lentiviral transduction of blastocysts with a mammalian gene expression lentiviral vector for up-regulation of Adipor2 (Adipor2-OX), we achieved a ~ 3-fold increase in placenta Adipor2 mRNA levels and a 2-fold increase of the ADIPOR2 protein in the trophoblast plasma membrane. Placenta-specific Adipor2-OX increased placental peroxisome proliferator-activated receptor-α phosphorylation, ceramide synthase expression and ceramide concentrations. Furthermore, Adipor2-OX inhibited placental mTORC1 signaling and reduced invivo placental transport of glucose and amino acids. Lastly, Adipor2-OX reduced fetal weight by 11%. These data provide mechanistic evidence that placental Adipor2 signaling directly affects fetal growth. We propose that low circulating adiponectin in maternal obesity causes fetal overgrowth and programs the offspring for cardio-metabolic disease mediated by a direct effect on placental function.

Effects of Maternal Obesity on Oxidative Parameters in Maternal and Cord Blood Samples.

Aim The purpose of this study was to analyze oxidative stress parameters in maternal and cord blood samples from both obese and nonobese women. Methods Our study included 30 obese and 35 nonobese pregnant women aged 18-40. We analyzed and compared oxidative stress parameters, including thiol/disulfide balance markers (native thiol, total thiol, and disulfide), albumin, ischemia-modified albumin (IMA), myeloperoxidase (MPO), catalase, ceruloplasmin, and intracellular glutathione levels. Results The comparison of maternal blood oxidative stress parameters between obese and nonobese pregnant women showed significantly higher levels of disulfide, catalase (kU/L), and ceruloplasmin (U/L) in the obese group (p = 0.005, p = 0.001, p < 0.001, respectively). Similarly, in cord blood, disulfide (µmol/L), IMA, catalase (kU/L), and (U/L) levels were significantly higher in the obese group (p < 0.001, p = 0.049, p < 0.001, p = 0.023, respectively), while albumin levels were significantly higher in the nonobese group (p = 0.003). Conclusions Our results suggest a strong association between maternal obesity and increased oxidative stress in both mothers and their offspring. Elevated oxidative stress levels may contribute to adverse maternal and fetal clinical outcomes. Therefore, we conclude that maintaining healthy weight control during reproductive age is crucial for ensuring maternal and fetal well-being.

Prediction of fetal growth restriction in obese women

Objective. To develop a way of prediction of fetal growth restriction in the first trimester of pregnancy in obese women. Materials and methods. 85 obese pregnant women at 6–9 weeks of gestation took part in the study. Obesity was determined by body mass index, as squared height (m)-to-weight (kg) ratio, with a BMI 30 kg/m2. In the blood serum of all patients the level of total copper (Cuvol.) was determined by the colorimetric method, and ceruloplasmin (CP) by of V.S. Kamyshnikov`s method and the percentage of free copper (Cufree) was calculated. The free copper index was calculated using the formula: Cufree = (Cuvol. – (ceruloplasmin · 3)) / Cuvol. · 100, where Cufree is the percentage of free copper in the blood serum, %; Cuob. – content of total copper in blood serum, µmol/l; CP – content of ceruloplasmin in blood serum, mg/l; 3 – conversion factor. All pregnant women were divided into two groups depending on the percentage of free copper: group A – pregnant women with obesity and free copper content 25 % (n = 26); group B – obese pregnant women with a percentage of free copper 25 %, (n = 59). The control group consisted of 20 pregnant women with normal body weight. Results. Among the studied groups, in pregnant women with obesity statistically significant differences in the content of total copper (p = 0.013), and the percentage of free copper (p = 0.041) were revealed. In the group of pregnant women with a free copper content 25 % chronic placental insufficiency occurred 1.5 times more frequently and fetal growth restriction syndrome was 6.4 times more frequent than in the group of patients with a free copper content of 25 %. Conclusion. The free copper level, determined in the first trimester of pregnancy equal to 25% or more, can be considered as a predictor of fetal growth restriction in obese pregnant women.

Critical Threshold of Average Weekly Weight Gain in Overweight Pregnant Women During the Second and Third Trimesters: A Strategy to Prevent Macrosomia.

The study aimed to obtain more evidence on the association of gestational weight gain and pre-pregnancy body mass index (BMI) with macrosomia. The data on 5409 live births delivered at Peking Union Medical College Hospital from July 2020 to June 2022 were collected. Group analyses were performed according to the presence or absence of macrosomia. Multivariable binary logistic regression and incidence heatmaps was used to analyze the related factors of macrosomia. The following variables were significantly associated with macrosomia: overweight (odds ratio [OR]: 2.24, 95% confidence interval [CI]: 1.62-3.10), obesity (OR: 4.56, 95% CI: 2.93-6.98), excessive gestational weight gain (OR: 2.39, 95% CI: 1.67-3.43), gestational age at delivery at 39-41weeks (OR: 3.83, 95% CI: 2.56-5.95), gestational age at delivery over 41weeks (OR: 7.88, 95% CI: 4.37-14.19), education level of junior college or below (OR: 1.95, 95% CI: 1.19-3.09), and multipara (OR: 1.62, 95% CI: 1.09-2.42). "v" represents the mean weekly weight gain during the second and third trimesters. A higher v value increased the risk of macrosomia by 2.6-fold (95% CI: 1.37-4.89, P = 0.003). Compared to normal weight women, after adjustment for different pre-pregnancy BMI subgroups, overweight pregnant women had higher weekly weight gain in the second and third trimesters (OR: 4.57, 95% CI: 2.27-9.10, P < 0.001). Obese pregnant women had higher average weekly weight gain during the second and third trimesters, and the OR value for macrosomia was 11.33 (95% CI: 4.95-25.18, P < 0.001). To reduce the incidence of macrosomia in overweight pregnant women, v = 0.32 could be considered the critical threshold of average weekly weight gain in these women in the second and third trimesters of pregnancy. Pre-pregnancy BMI and weight gain during pregnancy are closely related to macrosomia. The introduction of average weekly weight gain values in the second and third trimesters of pregnancy probably help pregnant women minimizing adverse pregnancy-related outcomes.

Metformin versus Low Dose Aspirin In Prevention of Hypertensive Disorders in Pregnant Obese Women

Metformin versus Low Dose Aspirin In Prevention of Hypertensive Disorders in Pregnant Obese Women

Expression levels of ACE and ACE2 in the placenta and white adipose tissue of lean and obese pregnant women

Background This study evaluated the expression of ACE and ACE2 in the placenta and white adipose tissue in lean and obese women, and correlated their levels with anthropometric, clinical, and laboratory parameters, and tissue count of inflammatory cells. Methods A cross-sectional analytical study was performed with 49 pregnant women and their respective newborns. Samples of placenta and adipose tissue were used for measuring mRNA expression for ACE and ACE2 through qRT-PCR. Inflammatory cell counting was performed through conventional microscopy. Results An increase in ACE expression and a decrease in ACE2 were observed in the placenta and adipose tissue of women with obesity. ACE2 levels showed a negative correlation with pre-pregnancy BMI and total cholesterol. Conclusion Maternal obesity can modulate the expression of RAS components in the placenta and white adipose tissue, with ACE2 correlated with pre-pregnancy BMI and total cholesterol.

Higher sweet beverage consumption was associated with increased gestational weight gain and birth weight: A Chinese cohort study

Diet during pregnancy is crucial to maternal metabolism and fetal development, so exploring the most potent food risk factor could improve maternal and child health. In this study, we investigated the diet and lifestyle of 833 healthy pregnant women in the second trimester from November 2020 to August 2021. Based on the Tianjin Antenatal Care System in China, we followed up with these women and recorded their gestational weight gain (GWG) and newborn birth weight. We conducted a dietary survey through FFQ based on the food groups recommended by the Chinese Dietary Guidelines and included common ultra-processed foods. We collected 219 semi-quantitative FFQs and 614 self-reported FFQs for analysis. According to the consumption frequency of 12 food groups, 4 dietary patterns were extracted by principal component analysis. We analyzed the associations of food energy, consumption frequency, and dietary patterns with GWG and birth weight, especially GWG in the first and second trimesters (f-GWG). The results showed that f-GWG was positively correlated with food energy. Beverage consumption was associated with f-GWG (r = 0.288, P = .026) in obese pregnant women. A dietary pattern that favors high consumption of ultra-processed foods (fried foods, baked desserts, and sweet beverages) was associated with increased GWGs. Non-obesity women with high consumption of baked desserts and sweet beverages had higher GWGs (P < .05). After adjusting for confounding factors (including total energy, physical activity, and sleep quality), only sweet beverage consumption was associated with f-GWG (β 0.498, 95%CI 0.153-0.843) and birth weight (β 0.124, 95%CI 0.009-0.240). Sweet beverage consumption is a key adjustable risk factor for prenatal care.

Pregnancy-Associated Plasma Protein-A and Free β-Human Chorionic Gonadotrophin in Relation with Oxidative Stress in Obese Pregnant Women: A Clinical Cross-Sectional Study.

Background: The pathophysiological mechanism underlying pregnancy complications is not entirely known. Although it is currently impossible to predict the occurrence of redox imbalance, it is possible to identify women with a high or medium risk of developing this disease prior to a negative outcome by non-invasive diagnostic methods. The Aim: This study aimed to examine the possible role of the parameter of oxidative stress (OS) measured in early pregnancy in the screening/treatment of obesity and its complications during pregnancy. Methods: This research was designed as a prospective observational cross-sectional clinical study which included 40 non-obese and 31 obese pregnant women between 11 and 13 g.w. who were managed in the Department of Obstetrics, University Clinical Center Kragujevac in Serbia. We collected anthropometric and clinical indicators, maternal and pregnancy factors, and measured prooxidative parameters from blood samples. Results: We observed significantly increased levels of the superoxide anion radical, hydrogen peroxide and the index of lipid peroxidation in the Obese group in comparison with the Non-Obese group and significantly decreased bioavailability of nitrites in the Obese group in comparison with the Non-Obese group. Conclusions: The determination of systemic parameters of OS in early pregnancy could be a good methodological approach in the screening/treatment of obesity during pregnancy and this approach should be followed for the screening of endothelial dysfunction in pregnancy which needs further monitoring and/or treatment.

Abstract P415: The Current Cardiac Disease in Pregnancy -II Risk Score as a Predictor of Pregnancy Morbidity is Not Affected by Maternal Obesity

Cardiovascular disease (CVD) is the most common cause of death in adults over 40 years of age. CVD remains a common cause of death in pregnancy and within the first-year post-partum, and Black women have higher cardiovascular risk during pregnancy than White women. There are several established mortality and morbidity prediction models for maternal cardiac complications including the Cardiac Disease in Pregnancy (CARPREG) risk score. CARPREG-II is the newest risk score which uses ten criteria to predict maternal cardiac complications. However, the only study to validate the CARPREG-II risk score had a large sample size with only 15% of patients with obesity (body mass index (BMI) &gt;30 kg/m2). Obesity and increased obesity class are known risks factors for pregnancy related morbidity and mortality. Thus, the validity of CARPREG-II risk score as a predictor of cardiovascular risks and pregnancy outcomes in women with cardiac disease and obesity remains unknown. Therefore, the goals of our study were to assess the validity of the CARPREG-II score in Black and White women as a predictor of risk for cardiovascular morbidity and mortality in obese pregnant women and determine if obesity influences CARPREG-II score and pregnancy morbidity and mortality. For this study, we completed an IRB-approved retrospective chart review of 232 pregnant adult Black and White women who received care at the University of Mississippi Medical Center (UMMC) from January 2013 - 2020. We completed a CARPREG-II risk score and compared morbidity in patients with normal BMI (18-24.9 kg/m2), overweight (25-29.9 kg/m2), obesity class I (30-34.9 kg/m2), obesity class II (35-39.9 kg/m2), and obesity class III (&gt;40 kg/m2). By race, the majority of White women were categorized as overweight; whereas the majority of Black women were categorized as obesity class II or III (p=0.0016). Although frequency of BMI category differed by race, CARPREG-II score did not differ as BMI increased in Black or White women, and obesity class did not influence CARPREG-II risk score. Our data indicate that Black women were more likely to have increased obesity, but obesity class did not influence CARPREG-II score. The lack of association between obesity class and CARPREG-II risk score indicate that the current CARPREG-II assessment is not an appropriate risk assessment tool for pregnant obese women and additional studies/tools are warranted to determine cardiovascular risks in pregnant obese women.

Incidence of excessive gestational weight gain among overweight and obese women.

To determine the incidence of excessive gestational weight gain (GWG) among overweight and obese pregnant women, its associated factors, and pregnancy outcomes. A total of 355 overweight or obese singleton pregnant women who received antenatal care and delivered at Siriraj Hospital were included. Data, including obstetric characteristics, weight gain, and pregnancy outcomes, were extracted from medical records. GWG was categorized according to the Institute of Medicine recommendation. Comparisons were made between individuals with inadequate, normal, and excessive GWG. Logistic regression analysis was performed to determine independent associated factors for excessive GWG. Majority of the women were overweight (68.7%), 38.9% were nulliparous, and mean pre-pregnancy body mass index was 28.9 kg/m2. Excessive GWG was observed in 53% of the women. Women with excessive GWG had significantly higher weight gain in every trimester. Risk of excessive GWG increased in women ≤30 years of age, while gestational diabetes (GDM) significantly decreased the risk. Women with excessive GWG had a significantly higher primary cesarean section rate. Both women with normal and excessive GWG showed higher rate of having large for gestational age (LGA) infants (P=0.003). Maternal age of ≤30 years significantly increased the risk of excessive GWG (adjusted odds ratio [OR], 1.91; 95% confidence interval [95% CI], 1.11-3.27) and GDM significantly decreased this risk (adjusted OR, 0.40; 95% CI, 0.24-0.67). The incidence of excessive GWG among overweight and obese women was 53%. Maternal age of ≤30 years significantly increased this risk while women with GDM were at significantly decreased risk. Rates of primary cesarean section and fetal LGA significantly increased in women with excessive GWG.

The Effect of a Self-Efficacy-Based Dietary Intervention on Weight Gain Control in Obese and Overweight Pregnant Women: A Quasi-Experimental Pretest-Posttest Design Study

Background: The increasing incidence of obesity among women of childbearing age has raised concerns regarding the associated maternal and neonatal complications. Excessive gestational weight gain in overweight and obese pregnant women is related to various perinatal complications, including hypertensive disorders, gestational diabetes mellitus, and cesarean deliveries. Objectives: The aim of this study was to investigate the impact of self-efficacy-based psychological training on controlling excessive weight gain in overweight and obese pregnant women. Methods: A quasi-experimental pretest-posttest design was employed, involving 141 pregnant women with a gestational age range of 16 - 24 weeks, who were attending healthcare centers in Dezful city, Iran. Participants were randomly assigned to either the intervention (n = 69) or control group (n = 71), with the intervention group receiving one month of psychological training in self-efficacy as an educational intervention. The intervention incorporated self-efficacy strategies, including step-by-step progression, learning from vicarious experience, using verbal persuasion, physiological arousal, and mindfulness training to improve self-efficacy regarding eating behaviors. Results: The intervention group demonstrated a significant improvement in weight gain control within the recommended range compared to the control group. Self-efficacy scores increased from 54.43 ± 11.28 to 62.54 ± 7.49 in the intervention group. Additionally, the study found that the intervention group exhibited improved self-efficacy in eating behaviors, particularly in the sub-scales of availability, social pressure, negative emotion, positive emotion, and physical discomfort. Conclusions: This study highlights the effectiveness of using self-efficacy strategies in managing weight gain during pregnancy among overweight and obese women. The findings suggest the potential benefits of mindfulness-based eating awareness training for pregnant women. The study emphasizes the need for tailored interventions to empower pregnant women in managing gestational weight gain, particularly those with pre-pregnancy obesity.

Investigation of Gasdermin-D and Pannexin-1 in Omental Adipose and Placental Tissues in Obese Pregnant Women

Investigation of Gasdermin-D and Pannexin-1 in Omental Adipose and Placental Tissues in Obese Pregnant Women

Impact of obesity on the perinatal vaginal environment and bacterial microbiome: effects on birth outcomes.

Introduction. Lactobacillus species predominate the human vagina and are associated with positive vaginal health, including an acidic pH (<4.5). The prevalence of vaginal Lactobacilli increases with increased oestrogen due to increased glycogen production within the vagina. Lactobacilli produce lactic acid, thereby lowering vaginal pH, preventing growth of other bacteria, and lowering microbial diversity. Lower placental oestrogen levels in obese pregnant women could dampen the mechanism to initiate this process, which may be associated with vaginal dysbiosis and unfavourable pregnancy outcomes.Hypothesis. We hypothesize that oestrogen and glycogen levels will be lower, vaginal pH will be higher, and vaginal microbiome diversity will be greater during pregnancy in obese and overweight women compared to healthy weight women.Aim. Pregnancy complications (e.g. preterm birth) are more common in overweight and obese women. If vaginal dysbiosis plays a role, and quantifiable predictors of this increased risk can be determined, these measures could be used to prospectively identify women at risk for pregnancy complications early in pregnancy.Methodology. Vaginal samples were collected at 10-14, 18-24, 26-30, and 34-37 weeks gestation and at delivery from 67 pregnant participants (23 healthy weight, 22 overweight, 22 obese). A blood sample to quantify serum oestrogen was collected at 10-14 weeks. Vaginal samples were collected to test vaginal pH using pH paper, glycogen abundance using fluorometry, and the vaginal microbiome using 16S rRNA amplicon sequencing.Results. Vaginal pH was higher in obese participants compared to healthy weight participants (P=<0.001). Vaginal glycogen levels increased over time in obese participants (P=0.033). The vaginal bacterial alpha diversity was higher in obese participants compared to healthy weight participants (P=0.033). The relative abundances of Peptoniphilus and Anaerococcus were increased in overweight and obese participants, as well as in complicated pregnancies, at 10-14 weeks gestation.Conclusion. The relative abundance of specific vaginal bacteria, like Peptoniphilus and Anaerococcus, in early pregnancy could predict pregnancy outcomes. Our goal is to use the information gathered in this pilot study to further determine the feasibility of assessing the vaginal environment during pregnancy to identify women at risk for negative pregnancy and birth outcomes in the context of a larger study.

Correlation between Obesity and Pregnancy Outcomes, Miscarriage, and Mode of Delivery

&lt;p&gt;&lt;strong&gt;Introduction: &lt;/strong&gt;The obesity pandemic is a source of problems in both developed countries. The obesity is associated with complications before and during pregnancy and even infant death. The study aims to find out the issue of obesity among women of reproductive age, particularly concerning its impact on maternal and fetal outcomes during pregnancy.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;This is a cross-sectional observational study using secondary data with medical records taken at Sebelas Maret University Hospital (UNS Hospital). Subjects were obese pregnant women who gave birth at UNS Hospital. Data from 284 single births were added maternal parameters, obstetric parameters, and newborn parameters were taken and then analyzed univariately, and bivariate analysis was carried out using the Kruskall-Wallis test and the Spearman test for comparison and correlation of each variable.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;This study finds lower incidences of postdate pregnancy and instrumental deliveries among obese mothers, but a higher rate of emergency cesarean sections. Newborn anthropometric measurements increase with maternal BMI, indicating a direct association between maternal obesity and newborn health (p = 0.001), while APGAR scores show no significant differences among maternal BMI groups. The findings underscore the importance of addressing maternal obesity to improve both maternal and newborn health outcomes.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;The research indicates a correlation between maternal BMI, maternal obstetric characteristics, newborn anthropometric measurements, and APGAR scores. This suggests that interventions aimed at promoting healthy maternal BMI, beginning before conception, continuing throughout pregnancy, and extending into the post-pregnancy period, could potentially improve newborn health outcomes and give long-term health benefits.&lt;/p&gt;

Balance in obese and normal weight pregnant women: A longitudinal study

IntroductionPregnancy's physiological changes and weight gain can decrease balance control, increasing the risk of falls and impacting quality of life. The effect of obesity on balance control in pregnant women needs further investigation. ObjectiveInvestigate the effect of obesity during pregnancy on center of pressure (COP) control under sensory disturbances at different gestational age. MethodsThe COP (95% ellipse area, mean velocity and total length) of 23 pregnant women classified as normal weight (CG: n = 12) and obese (OG: n = 11) was evaluated at three gestational-age week times (T1 = 16th, T2 = 24th, T3 = 32nd week) on a force platform on standing position (SP) and under three disturbances: 1) visual disturbance (eyes closed), 2) proprioceptive disturbance (over an unstable surface) and, 3) vestibular disturbance (head movement). A mixed ANOVA (3 repeated measures vs. 2 groups) and LSD post-hoc was applied to examine main effects and interactions. Effect sizes were assessed using generalized eta squared (η2). ResultsAs main effect, in SP, COP area increased from T2 to T3 for both groups (P = 0.021, η2 = 0.193). One interaction was observed, under visual disturbance, the area increased from T2 to T3 only in the CG group (P = 0.020, η2 = 0.195). ConclusionThe progression of pregnancy negatively impacts postural stability throughout its course. Visual disturbance only affected the balance of the CG. Hence, obesity combined with pregnancy does not appear to alter COP variables.