Physical Activity and Excess Weight in Pregnancy Have Independent and Unique Effects on Delivery and Perinatal Outcomes

Morgan, Kelly; Rahman, Muhammad Azizur; Hill, Rebecca; Zhou, Shang‐Ming; Bijlsma, Gunnar; Khanom, Ashrafunnesa; Lyons, Ronan A.; Brophy, Sinéad

doi:10.1371/journal.pone.0094532

Cited by 28 publications

(45 citation statements)

References 44 publications

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“…Other studies have found out similar higher incidence of macrosomia. 28,[31][32][33][34] In the present study it was found that increased NICU admissions for stabilisation of the newborn of cases was found when compared to the control group (22% vs 10%) (p = 0.012). Majority of this admission (12% of 22%) was due to fetal distress.…”

Section: Discussionmentioning

confidence: 74%

Maternal and fetal outcomes of obese pregnant women: a prospective cohort study

John

Mahendran²

2017

Int J Reprod Contracept Obstet Gynecol

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Background: Obesity in Indian women had increased from 10.6% to 14.8% in India. Mothers who are overweight or obese during pregnancy and childbirth cause significant antenatal, intrapartum, postpartum and also neonatal complications. The present study aimed to explore various maternal and fetal outcomes influenced by maternal obesity. The objective was to find the effect of obesity on maternal and perinatal outcome among obese pregnant women compared to those of normal weight.Methods: The study was conducted in antenatal women attending antenatal outpatient department of CSI rainy multispecialty hospital located in North Chennai of South India. Consecutive sampling method was followed to include 50 cases and 50 controls. Analysis was done with IBM SPSS v.21.0. Chi square test was applied to find difference between proportions. For comparison of means independent t-test and ANOVA was applied. Pearson's correlation was done to find association between maternal BMI and birth weight.Results: Sixteen (32%) cases developed gestational diabetes mellitus during their antenatal period and 19 (38%) developed gestational hypertension. 10% underwent in emergency caesarean section and in 28% cases elective caesarean section was done. The proportion of cases who developed ante partum complications including gestational diabetes mellitus, gestational hypertension and preeclampsia were higher than in control groups (p value = 0.03,0.00,0.004 respectively). The need for induction of labour and caesarean section was found to be higher in cases than in controls (p = 0.014,0.03 respectively). Increased NICU admissions for stabilization of the newborn among cases was higher than control group (p = 0.012).Conclusions: It was clearly evident from the present study that maternal obesity had adverse maternal and fetal outcomes. Maternal obesity was strongly associated with antenatal complications like gestational diabetes mellitus, gestational hypertension, preeclampsia and increase in need for induction of labour and operative interference.

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Section: Discussionmentioning

confidence: 74%

Maternal and fetal outcomes of obese pregnant women: a prospective cohort study

John

Mahendran²

2017

Int J Reprod Contracept Obstet Gynecol

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“…Analyses were performed throughout to explore the influence of methodological decisions, such as using unadjusted data and Asian-specific BMI categories. The conversion of categorical BMI was necessary due to limited reporting of directly comparable obesity categories: 17 studies combined data for obesity classes I-III (19,34,35,38,(42)(43)(44)(48)(49)(50)(51)(52)(53)(54)(55)(56)(57), three reported obesity classes I-III separately (58)(59)(60), four combined obesity classes I and II (20,41,61,62), six combined classes II and III (39,40,(63)(64)(65)(66), seven had further inconsistent noncomparable categories such as combining overweight and obese (36,37,(67)(68)(69)(70)(71), and two studies did not define their BMI categories (21,72). The possible groups to combine for categorical analyses would have been further reduced when applying additional analysis criteria such as the gestational age stratification, definition of the reference BMI group, etc.…”

Section: Discussionmentioning

confidence: 99%

Maternal body mass index and post‐term birth: a systematic review and meta‐analysis

et al. 2017

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SummaryPost‐term birth is a preventable cause of perinatal mortality and severe morbidity. This review examined the association between maternal body mass index (BMI) and post‐term birth at ≥42 and ≥41 weeks' gestation. Five databases, reference lists and citations were searched from May to November 2015. Observational studies published in English since 1990 were included. Linear and nonlinear dose–response meta‐analyses were conducted by using random effects models. Sensitivity analyses assessed robustness of the results. Meta‐regression and sub‐group meta‐analyses explored heterogeneity. Obesity classes were defined as I (30.0–34.9 kg m−2), II (35.0–39.9 kg m−2) and III (≥40 kg m−2; IIIa 40.0–44.9 kg m−2, IIIb ≥ 45.0 kg m−2). Searches identified 16,375 results, and 39 studies met the inclusion criteria (n = 4,143,700 births). A nonlinear association between maternal BMI and births ≥42 weeks was identified; odds ratios and 95% confidence intervals for obesity classes I–IIIb were 1.42 (1.27–1.58), 1.55 (1.37–1.75), 1.65 (1.44–1.87) and 1.75 (1.50–2.04) respectively. BMI was linearly associated with births ≥41 weeks: odds ratio is 1.13 (95% confidence interval 1.05–1.21) for each 5‐unit increase in BMI. The strength of the association between BMI and post‐term birth increases with increasing BMI. Odds are greatest for births ≥42 weeks among class III obesity. Targeted interventions to prevent the adverse outcomes associated with post‐term birth should consider the difference in risk between obesity classes.

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“…These properties make it particularly suitable for monitoring both child and adult PA. Its reliability and validity have been extensively assessed. 27 30 The GeneActiv contains sufficient memory to store up to 60 days of data when sampling at 10 Hz frequency, or 7 days at 100 Hz. When activated, the GeneActiv continuously tracks and stores activity information whether or not it is worn.…”

Section: Methodsmentioning

confidence: 99%

Classification of accelerometer wear and non-wear events in seconds for monitoring free-living physical activity

et al. 2015

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ObjectiveTo classify wear and non-wear time of accelerometer data for accurately quantifying physical activity in public health or population level research.DesignA bi-moving-window-based approach was used to combine acceleration and skin temperature data to identify wear and non-wear time events in triaxial accelerometer data that monitor physical activity.SettingLocal residents in Swansea, Wales, UK.Participants50 participants aged under 16 years (n=23) and over 17 years (n=27) were recruited in two phases: phase 1: design of the wear/non-wear algorithm (n=20) and phase 2: validation of the algorithm (n=30).MethodsParticipants wore a triaxial accelerometer (GeneActiv) against the skin surface on the wrist (adults) or ankle (children). Participants kept a diary to record the timings of wear and non-wear and were asked to ensure that events of wear/non-wear last for a minimum of 15 min.ResultsThe overall sensitivity of the proposed method was 0.94 (95% CI 0.90 to 0.98) and specificity 0.91 (95% CI 0.88 to 0.94). It performed equally well for children compared with adults, and females compared with males. Using surface skin temperature data in combination with acceleration data significantly improved the classification of wear/non-wear time when compared with methods that used acceleration data only (p<0.01).ConclusionsUsing either accelerometer seismic information or temperature information alone is prone to considerable error. Combining both sources of data can give accurate estimates of non-wear periods thus giving better classification of sedentary behaviour. This method can be used in population studies of physical activity in free-living environments.

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Physical Activity and Excess Weight in Pregnancy Have Independent and Unique Effects on Delivery and Perinatal Outcomes

Cited by 28 publications

References 44 publications

Maternal and fetal outcomes of obese pregnant women: a prospective cohort study

Maternal and fetal outcomes of obese pregnant women: a prospective cohort study

Maternal body mass index and post‐term birth: a systematic review and meta‐analysis

Classification of accelerometer wear and non-wear events in seconds for monitoring free-living physical activity

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