Effect of pregravid obesity on perinatal outcomes in singleton pregnancies following in vitro fertilization and the weight-loss goals to reduce the risks of poor pregnancy outcomes: A retrospective cohort study

Liu, Lu; Wang, Hongmei; Zhang, Yang; Niu, Jinlei; Li, Zhongyuan; Tang, Rong

doi:10.1371/journal.pone.0227766

Cited by 24 publications

(25 citation statements)

References 39 publications

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“… 24 A reduction in pregravid BMI for overweight and obese women was associated with a significant reduction in caesarean deliveries. 25 …”

Section: Discussionmentioning

confidence: 99%

“…24 A reduction in pregravid BMI for overweight and obese women was associated with a significant reduction in caesarean deliveries. 25 Obesity adversely affects the maternal milieu by increasing the risk of gestational diabetes and hypertensive disease in pregnancy. 5 A previous study reported that abnormal weight did not affect pregnancy outcomes in women with PCOS that underwent frozen embryo transfer.…”

Section: Discussionmentioning

confidence: 99%

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

et al. 2021

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Objective To evaluate the effects of body mass index (BMI) in patients with polycystic ovary syndrome (PCOS) undergoing controlled ovarian stimulation (COS) with intrauterine insemination (IUI). Methods This 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. Results The 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. Conclusion Obese 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.

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“… 24 A reduction in pregravid BMI for overweight and obese women was associated with a significant reduction in caesarean deliveries. 25 …”

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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

et al. 2021

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“…In addition, women with pre-pregnancy obesity were more likely to give birth to infants with macrosomia. A study in China also showed that obesity was associated with an increased risk of macrosomia in ART singleton pregnancies ( 22 ). Other studies have shown increased risks of gestational hypertension, preeclampsia, gestational diabetes, and cesarean section in overweight or obese women who conceived through IVF ( 23 – 25 ), which is consistent with our research results.…”

Section: Discussionmentioning

confidence: 99%

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

et al. 2022

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ObjectiveTo study the association between pre-pregnancy body mass index (BMI) and adverse maternal and neonatal outcomes of singleton pregnancies after assisted reproductive technology (ART).MethodsThis hospital-based retrospective cohort study of women with live singleton births through ART in China from January 2015 to August 2020 included 3043 Chinese women. According to the latest BMI classification standard of Asian women, the women included in this study were classified as underweight (BMI <18.5 kg/m2), normal (BMI 18.5 to <23 kg/m2), overweight (BMI 23 to <27.5 kg/m2), and obese (BMI ≥27.5 kg/m2). We compared the risk of adverse outcomes of different pre-pregnancy BMI values of women with singleton pregnancies conceived through ART. We used Logistic regression analysis to estimate the associations between pre-pregnancy BMI and adverse perinatal and neonatal outcomes.ResultsOur findings showed that women who were overweight or obese before pregnancy through ART are more likely to have a cesarean section, gestational diabetes mellitus, gestational hypertension, and preeclampsia, regardless of whether confounding factors are adjusted. Moreover, pre-pregnancy obesity was more associated with a higher risk of these adverse outcomes than pre-pregnancy overweight. In addition, neonates from women who had obesity before pregnancy through ART were more likely to have macrosomia; adjusted odds ratios and 95% confidence intervals were 3.004 (1.693-5.330).ConclusionsOur research showed that women who had pre-pregnancy overweight or obesity with singleton pregnancies through ART were more likely to have a cesarean section, gestational diabetes mellitus, gestational hypertension, and preeclampsia. Moreover, neonates from women who had obesity before pregnancy were more likely to have macrosomia.

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“…In the present study, maternal HDP and fetal macrosomia were more likely to occur among younger women with high BMI. Liu et al 30 also reported that obesity might raise the risk of some poor prenatal outcomes through the development of GDM and HDP. Therefore, the fetus is more likely to be exposed to an adverse intrauterine environment, resulting in an increased incidence of fetal macrosomia and cesarean delivery, which, in turn, increases the risk of childhood and adult obesity.…”

Section: Main Findings and Interpretationsmentioning

confidence: 99%

“…Kort et al 31 showed that 10% weight loss could enhance LBR in overweight/obese women. Liu et al 30 also suggested a 10%-15% reduction in pre-pregnancy maternal BMI for obese women and a 5% reduction for overweight women to lower the incidence of prenatal outcomes. Based on the above evidence, younger women with elevated BMI should consider losing weight before pregnancy, but older women do not have to delay pregnancy to achieve weight loss as they need to balance against the risk of agerelated fertility decline.…”

Section: Main Findings and Interpretationsmentioning

confidence: 99%

Elevated body mass index impairs cumulative live birth rate and obstetric safety of younger women undergoing in-vitro fertilization/intracytoplasmic sperm injection treatment: A retrospective study

Huang

Xiong

et al. 2021

Preprint

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Objective: To evaluate the impact of elevated body mass index (BMI) on short- and long-term outcomes of in-vitro fertilization (IVF)/intracytoplasmic sperm injection (ICSI) treatments. Design: Retrospective cohort study. Setting: Teaching hospital. Population: Overall, 7229 patients undergoing IVF/ICSI fresh cycles and subsequent frozen embryo transfer cycles during 2014-2020. Methods: The patients were divided into normal (18.5–24.9 kg/m2) and high BMI (≥ 25 kg/m2) groups. Subgroup analyses were performed based on the boundary of 38 years old. Multivariate analysis was used to determine whether BMI was associated with live birth rate (LBR) or cumulative live birth rate (CLBR). Main Outcome Measure: Ovarian response, pregnancy outcomes, and safety for both mother and fetus. Results: For younger women (< 38y), CLBR was significantly reduced in the high BMI subgroup compared to the normal BMI control (73.7% vs 76.8%, p = 0.008) and was accompanied by fewer retrieved oocytes and available embryos. Meanwhile, the incidences of cesarean section (92.9% vs 87.1%, p < 0.001), hypertensive disorders of pregnancy (6.7% vs 3.1%, p < 0.001), fetal macrosomia (4.7% vs 2.8%, p = 0.002) and birth defects involving cleft lip and palate (0.4% vs 0.1%, p = 0.030) were significantly higher than the normal BMI group. However, no such differences were observed among older women (≥ 38y). Multivariate analysis revealed that high BMI was a risk factor for CLBR (OR = 0.837, 95% CI: 0.729–0.96). Conclusions: Elevated BMI has a greater adverse impact on younger women.

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Effect of pregravid obesity on perinatal outcomes in singleton pregnancies following in vitro fertilization and the weight-loss goals to reduce the risks of poor pregnancy outcomes: A retrospective cohort study

Cited by 24 publications

References 39 publications

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

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

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

Elevated body mass index impairs cumulative live birth rate and obstetric safety of younger women undergoing in-vitro fertilization/intracytoplasmic sperm injection treatment: A retrospective study

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