Pre-pregnancy maternal obesity, macrosomia, and risk of stillbirth: A population-based study

Ikedionwu, Chioma; Dongarwar, Deepa; Yusuf, Korede K; Ibrahimi, Sahra; Salinas-Miranda, Abraham; Salihu, Hamisu M.

doi:10.1016/j.ejogrb.2020.06.004

Cited by 19 publications

(18 citation statements)

References 31 publications

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“…These risks, however, may not be the same for women of all ethnicities, all ages, all weights or parities. [26][27][28][29] Consequently the gestation at which a pregnancy is prolonged (and therefore the gestation at which her risk of stillbirth and adverse perinatal outcomes is considered unacceptably high) cannot logically be the same for all women. The Australian Department of Health's Pregnancy Care Guidelines affirms this notion and does not make any specific recommendation about timing of IOL other than it should 'be discussed' as an option when women are 'nearing prolonged pregnancy'.…”

Section: Discussionmentioning

confidence: 99%

“…‘Post‐dates’ and ‘post‐term’ indications for IOL are variably defined, although the rationale is widely accepted – to reduce the risk of stillbirth and adverse perinatal outcomes associated with a prolonged pregnancy. These risks, however, may not be the same for women of all ethnicities, all ages, all weights or parities 26–29 . Consequently the gestation at which a pregnancy is prolonged (and therefore the gestation at which her risk of stillbirth and adverse perinatal outcomes is considered unacceptably high) cannot logically be the same for all women.…”

Section: Discussionmentioning

confidence: 99%

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Five‐year trends in induction of labour in a large Australian metropolitan maternity service

Sullivan

Wilson

Beckmann

2022

Aust NZ J Obst Gynaeco

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Background:The World Health Organisation recommends that induction of labour (IOL) be performed only with a clear medical indication. Australian rates of IOL appear to be rising, with more than one-third of women having labour induced. This may reflect changing clinician and consumer perceptions of the benefits and potential harms of term IOL. Aims:To understand recent trends in the rates and indications for IOL. Materials and Methods: A retrospective cohort study was undertaken in a Level 6 maternity facility, in metropolitan South-East Queensland, Australia. Routinely collected data were gathered between 2015 and 2020. Exclusion criteria were multiple pregnancies, stillbirth and pre-labour rupture of membranes. Pre-labour rupture of membranes was excluded due to inability to assess if IOL for this indication was a true induction or augmentation of labour. Indications for induction were grouped into maternal, fetal, elective indications, 'post-dates' and decreased fetal movements (DFM). Rates of IOL and frequency of the various indications were compared over time. Results: About 46 530 livebirths occurred during the study period, with labour induced in 31.7%. The proportion of women undergoing IOL increased from 29.8% in 2015 to 33.4% in 2019 (P < 0.001). The proportion of inductions for DFM and elective indications increased over time, with a substantial decrease in 'post-dates' IOL. Conclusions: This large contemporary analysis of IOL trends in Australia has demonstrated rising rates and changing indications for IOL. There remain large knowledge gaps in areas such as care of women with DFM, definitions and management of 'post-term pregnancy', and the economic and service impacts of rising trends in the rate of IOL.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Five‐year trends in induction of labour in a large Australian metropolitan maternity service

Sullivan

Wilson

Beckmann

2022

Aust NZ J Obst Gynaeco

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“…Beyond these neonatal outcomes, stillbirth is more common in obese patients. Studies have demonstrated that the risk of stillbirth increases with BMI when adjusted for maternal age and race [16].…”

Section: Fertility In Individuals With Obesitymentioning

confidence: 99%

Obesity and reproduction

Armstrong

Berger

Al-Safi

2022

Current Opinion in Obstetrics &Amp; Gynecology

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Purpose of reviewThe objective of this review is to highlight the recent literature on how obesity affects reproductive capacity in men and women. Recent findingsThe relationship between fertility and obesity is complex and involves the hypothalamic-pituitary-ovarian axis, neuroendocrine systems and adipose tissue. The exact pathophysiology of how obesity lowers fertility rates is unknown, but is likely multifactorial involving anovulation, insulin resistance and alterations in gonadotropins. In addition, there is controversy on whether oocyte quality or endometrial receptivity plays a larger role in obese infertile women. Data on effects of bariatric surgery and weight loss on obese infertile men and women are mixed. SummaryObesity alters the hormonal profile, gonadotropin secretion, embryo development and in-vitro fertilization outcomes in both men and women.

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“…Do not only the repercussions of this complication affect women’s health but also extend across generations. In addition to some severe maternal obesity outcomes, including gestational diabetes, congenital fetal anomaly, miscarriage, dysfunctional labor, pre-eclampsia, and stillbirth [ 3 – 5 ], the long-term influences on offspring are a wake-up call. It is evident that obesity in pregnancy leads to an increased risk of obesity, coronary heart disease, stroke, asthma, type 2 diabetes, and neurodevelopmental disorders in children [ 6 ].…”

Section: Introductionmentioning

confidence: 99%

Barriers to weight management in pregnant mothers with obesity: a qualitative study on mothers with low socioeconomic background

Mehrabi

Ahmaripour

Jalali-Farahani

et al. 2021

BMC Pregnancy Childbirth

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Background Maternal obesity is a public health issue that could affect both women’s and children’s health. This qualitative study aimed to identify barriers to weight management of pregnant women with obesity and low socioeconomic backgrounds. Methods The current qualitative study has been conducted using a grounded theory approach by analyzing data collected from in-depth interviews with clients of Tehran’s public health care centers for prenatal care. The criteria for selecting participants were excessive weight gain during the first two trimesters of pregnancy, low socioeconomic status, and willingness to share their experiences. A semi-structured guide consisting of open-ended questions was asked in a private room. Open, axial, and selective coding were applied to the data. Findings Four main themes emerged from data, each of which has some subcategories: 1) personal factors (unpleasant emotions and feelings, personal tastes/hobbies, workload and responsibilities, and history of diseases), 2) pregnancy status (unintended and high-risk pregnancy), 3) interpersonal relationships and support (lack of a spouse’s support and unhealthy role modeling of relatives), 4) socio-cultural factors/influences (social norms and values, lack of access to health services, and unreliable information channels). Conclusions This study provides an overview of the barriers to the weight management of pregnant women from low socioeconomic backgrounds. The results could help develop appropriate health strategies for low socioeconomic women with obesity. Also, health care providers for this group of women could use these findings as a guide to consider their conditions and background.

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Pre-pregnancy maternal obesity, macrosomia, and risk of stillbirth: A population-based study

Cited by 19 publications

References 31 publications

Five‐year trends in induction of labour in a large Australian metropolitan maternity service

Five‐year trends in induction of labour in a large Australian metropolitan maternity service

Obesity and reproduction

Barriers to weight management in pregnant mothers with obesity: a qualitative study on mothers with low socioeconomic background

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