No abstract

II-2

The effects of high or low gestational weight gain differ depending on maternal BMI and the outcome variable studied. Obese women may benefit from a low weight gain during pregnancy.

Objective To minimise obese women's total weight gain during pregnancy to less than 7 kg and to investigate the delivery and neonatal outcome.Design A prospective case-control intervention study.Setting Antenatal care clinics in the southeast region of Sweden.Population One hundred fifty-five pregnant women in an index group and one hundred ninety-three women in a control group.Methods An intervention programme with weekly motivational talks and aqua aerobic classes for obese pregnant women.Main outcome measures Weight gain in kilograms, delivery and neonatal outcome. ResultsThe index group had a significantly lower weight gain during pregnancy compared with the control group (P < 0.001). The women in the index group weighed less at the postnatal check-up compared with the weight registered in early pregnancy (P < 0.001). The percentage of women in the index group who gained less than 7 kg was greater than that of women in the control group who gained less than 7 kg (P = 0.003). The percentage of nulliparous women in this group was greater than that in the control group (P = 0.018). In addition, the women in the index group had a significantly lower body mass index at the postnatal check-up, compared with the control group (P < 0.001). There were no differences between the index group and the control group regarding birthweight, gestational age and mode of delivery. ConclusionThe intervention programme was effective in controlling weight gain during pregnancy and did not affect delivery or neonatal outcome.

The gestational weight gain limits for BMI categories determined in this large population-based cohort study from Swedish Medical Registers showed that a decreased risk of adverse obstetric and neonatal outcomes was associated with lower gestational weight gain limits than was earlier recommended, especially among obese women.

CEDERGREN, MARIE I. AND BENGT A.J. KÄ LLÉ N. Maternal obesity and infant heart defects. Obes Res. 2003; 11:1065-1071. Objective: This study determined whether obese women have an increased risk of cardiovascular defects in their offspring compared with average weight women. Research Methods and Procedures:In a case-control study, prospectively collected information was obtained from Swedish medical health registers. The study included 6801 women who had infants with a cardiovascular defect and, as controls, all delivered women (N ϭ 812,457) during the study period (1992 to 2001). Infants with chromosomal anomalies or whose mothers had pre-existing diabetes were excluded. Obesity was defined as BMI Ͼ29 kg/m 2 , and morbid obesity was defined as BMI Ͼ35 kg/m 2 . Comparisons were made with average weight women (BMI ϭ 19.8 to 26 kg/m 2 ). Results: In the group of obese mothers, there was an increased risk for cardiovascular defects compared with the average weight mothers [adjusted odds ratio (OR) ϭ 1.18; 95% CI, 1.09 to 1.27], which was slightly more pronounced for the severe types of cardiovascular defects (adjusted OR ϭ 1.23; 95% CI, 1.05 to 1.44). With morbid obesity, the OR for cardiovascular defects was 1.40 (95% CI, 1.22 to 1.64), and for severe cardiovascular defects, the OR was 1.69 (95% CI, 1.27 to 2.26). There was an increased risk for all specific defects studied among the obese women, but only ventricular septal defects and atrial septal defects reached statistical significance. Discussion: In this sample, a positive association was found between maternal obesity in early pregnancy and congenital heart defects in the offspring. A suggested explanation is undetected type 2 diabetes in early pregnancy, but other explanations may exist.

No abstract

No abstract