Association Between Pre-Pregnancy Body Mass Index and Maternal and Neonatal Outcomes of Singleton Pregnancies After Assisted Reproductive Technology

Sun, Hanxiang; Liu, Yang; Huang, Shijia; Liu, Xiaosong; Li, Guohua; Du, Qiaoling

doi:10.3389/fendo.2021.825336

Cited by 6 publications

(9 citation statements)

References 39 publications

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“…The authors concluded that women with overweight or obesity who had ART for a singleton pregnancy were significantly more likely to have a cesarean section, gestational diabetes mellitus, gestational hypertension, and preeclampsia. Furthermore, neonates born to mothers with obesity were more likely to have macrosomia [ 15 ]. Despite querying different population, the findings of Sun et al are generally in line with those of the present analysis.…”

Section: Discussionmentioning

confidence: 99%

“…Moreover, recent studies suggested that women with obesity who had ART for a singleton pregnancy were more likely to have a cesarean section, gestational diabetes mellitus, gestational hypertension, and preeclampsia [ 15 , 16 ]. However, the evidence on the clinical impact of high BMI on various maternal and child-health outcomes in women receiving ART is not sufficient and remains to be clarified, particularly in a nationwide cohort.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Impact of maternal body mass index on outcomes of singleton pregnancies after assisted reproductive technology: a 14-year analysis of the US Nationwide Inpatient Sample

Li²,

Hsieh³

et al. 2023

BMC Pregnancy Childbirth

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Background Obesity is increasing globally, which affects multiple human functions, including reproductive health. Many women with overweight and obesity of child-bearing years are treated with assisted reproductive technology (ART). However, the clinical impact of body mass index (BMI) on pregnancy outcomes after ART remains to be determined. Therefore, this population-based retrospective cohort study aimed to assess whether and how higher BMI affects singleton pregnancy outcomes. Methods This study used the large nationally representative database of the US National Inpatient Sample (NIS), extracting data of women with singleton pregnancies who had received ART from 2005 to 2018. Diagnostic codes of the International Classification of Diseases, Ninth and Tenth edition (ICD-9 and ICD-10) were used to identify females admitted to US hospitals with delivery-related discharge diagnoses or procedures and secondary diagnostic codes for ART, including in vitro fertilization. The included women were further categorized into three groups based on BMI values < 30, 30–39, and ≥ 40 kg/m2. Univariate and multivariable regression analysis were conducted to assess the associations between study variables and maternal and fetal outcomes. Results Data of totally 17,048 women were included in the analysis, which represented a population of 84,851 women in the US. Number of women in the three BMI groups were 15, 878 (BMI < 30 kg/m2), 653 (BMI 30–39 kg/m2), and 517 (BMI ≥ 40 kg/m2), respectively. The multivariable regression analysis revealed that, compared to BMI < 30 kg/m2, BMI 30–39 kg/m2 was significantly associated with increased odds for pre-eclampsia and eclampsia (adjusted OR = 1.76, 95% CI = 1.35, 2.29), gestational diabetes (adjusted OR = 2.25, 95% CI = 1.70, 2.98), and Cesarean delivery (adjusted OR = 1.36, 95% CI = 1.15, 1.60). Further, BMI ≥ 40 kg/m2 was associated with greater odds for pre-eclampsia and eclampsia (adjusted OR = 2.25, 95% CI = 1.73, 2.94), gestational diabetes (adjusted OR = 3.64, 95% CI = 2.80, 4.72), disseminated intravascular coagulation (DIC) (adjusted OR = 3.79, 95% CI = 1.47, 9.78), Cesarean delivery (adjusted OR = 1.85, 95% CI = 1.54, 2.23), and hospital stay ≥ 6 days (adjusted OR = 1.60, 95% CI = 1.19, 2.14). However, higher BMI was not significantly associated with greater risk of the fetal outcomes assessed. Conclusions Among US pregnant women who received ART, having a higher BMI level independently increases the risk for adverse maternal outcomes such as pre-eclampsia and eclampsia, gestational diabetes, DIC, longer hospital stays, and higher rates of Cesarean delivery, while risk is not increased for fetal outcomes.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Impact of maternal body mass index on outcomes of singleton pregnancies after assisted reproductive technology: a 14-year analysis of the US Nationwide Inpatient Sample

Li²,

Hsieh³

et al. 2023

BMC Pregnancy Childbirth

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show abstract

“…Various studies have reported similar findings, so Jagan et al in 2020 (Jagan, et al, 2020) and Doherty et al, in 2006 (Doherty, et al, 2006) reported an increased risk of both gestational hypertension and pre-eclampsia in the control group and obese group). Maternal age as a factor risk factor for pregnancy outcomes, such as gestational diabetes mellitus, preeclampsia, and premature delivery is shown in previous studies (Sun, et al, 2022;Wei, et al, 2015;Vinturache, et al, 2014). Despite that, Claramonte et al, in their study reported that maternal age was associated with a high risk of cesarean section, and gestational diabetes (Claramonte, et al, 2019).…”

Section: Discussionmentioning

confidence: 92%

Evaluation of Preeclampsia Risk in Gestational Weight Gain

Baftiu

Abazaj

Ali

et al. 2022

ESJ

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Background: The incidence of obesity worldwide has increased over the last 20 years. The increase in obesity in maternal pregnancy is causing a major challenge to obstetrics practices. The aimed study was to evaluate gestational weight gain as a risk for preeclampsia in pregnant women. Methods: This cross-sectional study was conducted on 2756 pregnant women with gestational age≥37 weeks. The selection of women was categorized into two groups, 1528 normal-weight women with BMI less than 25kg/m2 and 1228 pregnant women with BMI over 25kg/m2. SPSS software version 26.0 was used to analyze data. Multivariate logistic regression described the relation of weight change to pregnancy course and outcomes. Results: A comparison between study groups appears an increase in antepartum complications in obese weight women. Besides that, arterial hypertension, pre-eclampsia, and gestational diabetes were more frequent in obese weight women compared to normal-weight women obese women. The incidence of cesarean was highest in obese women statistically significant difference from normal women with a p-value <0.005. In addition, maternal obese pregnancies were at twice the risk for delivery of infants who were macrosomia with higher odds (OR = 3.1, 95%CI = [1.09-5.8]). In perinatal outcomes, the difference in mean birth weight of the babies among normal and obese women was statistically significant (p<0.05). Conclusion: As we saw from the results of this study obesity during pregnancy was associated with pregnancy complications. To optimize all complications to maternal and fetus, weight gains during the pregnancy must be controlled and appropriate. Furthermore, studies are recommended to explore the maternal obesity complication and risk factors that influence obesity to minimize the adverse negative effect of this risk.

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“…[4,5] Although the conclusions of various studies are different, multiple studies have shown that overweight/obesity has an adverse effect on IVF pregnancy outcomes and increases maternal and fetal complications. [6,7] To evaluate the final outcome of a patient assisted fertility cycle, it is necessary to consider both the fresh transfer cycle and the subsequent frozen-thawed embryo transfer (ET) cycle. The cumulative live birth rate (CLBR), as an evaluation indicator for a complete oocyte retrieval cycle, has more practical significance for patients than the previous clinical pregnancy rate and delivery rate.…”

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

The effect of female body mass index on cumulative live birth rate in women undergoing in vitro fertilization according to age

Ma,

Li,

Ouyang

et al. 2024

Medicine

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The aim of this study was to explore the impact of female body mass index (BMI) on cumulative live birth rates (CLBR) in patients treated with in vitro fertilization (IVF) and embryo transfer. A total of 2377 patients who visited the Reproductive Medical Center, Luoyang Maternal and Child Health Hospital from January 2015 to December 2021. The patients underwent the first IVF cycles. According to female BMI, patients were divided into 3 groups, group A: BMI ≤ 18.5 kg/m2 (underweight), group B: BMI: 18.5 to 24.0 kg/m2 (normal), group C: BMI ≥ 24.0 kg/m2 (overweight/obesity). Patient basic parameters and clinical outcomes were compared among these 3 groups. Multivariate logistic regression analysis was used to explore the impact of BMI on CLBR. In all treatment cycles, patients’ basic parameters were significantly different among 3 BMI groups. Age of underweight patient was younger than patients in the other 2 groups (28.45 ± 5.32 vs 29.89 ± 5.00 vs 30.74 ± 5.40; P = .000). In addition, number of oocytes retrieved was also significantly higher in group A (11.25 ± 5.97 vs 11.07 ± 5.49 vs 10.52 ± 5.02; P = .000). CLBR in these 3 groups were 66.40%, 65.98%, and 59.14%, respectively. In logistic analysis, overweight/obesity was associated with CLBR in young patients (aOR = 0.822, 95% CI: 0.817–0.957, P = .000). However, in the cycles of older patients, the effect of overweight/obesity on the CLBR was not significant (aOR = 0.986, 95% CI: 0.903–1.027, P > .05). Overweight/obesity is a predictor for CLBR in younger patients (<35 years old), but not in advanced age patients undergoing their first IVF/intracytoplasmic sperm injection treatment cycles.

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Association Between Pre-Pregnancy Body Mass Index and Maternal and Neonatal Outcomes of Singleton Pregnancies After Assisted Reproductive Technology

Cited by 6 publications

References 39 publications

Impact of maternal body mass index on outcomes of singleton pregnancies after assisted reproductive technology: a 14-year analysis of the US Nationwide Inpatient Sample

Impact of maternal body mass index on outcomes of singleton pregnancies after assisted reproductive technology: a 14-year analysis of the US Nationwide Inpatient Sample

Evaluation of Preeclampsia Risk in Gestational Weight Gain

The effect of female body mass index on cumulative live birth rate in women undergoing in vitro fertilization according to age

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