The Effects of an Increasing Gradient of Maternal Obesity on Pregnancy Outcomes

Magann, Everett F.; Doherty, Dorota A.; Sandlin, Adam T.; Chauhan, S.P.; Morrison, J.C.

doi:10.1097/01.aoa.0000446296.50317.2d

Cited by 19 publications

(40 citation statements)

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“…A total of 20 articles (19 cohort studies and 1 case–control studies) involving 2 153 898 participants were included in this meta‐analysis. For obesity (including all obesity classes), 16 articles (15 cohort studies and 1 case–control studies) involving 1 308 888 participants met the inclusion criteria.…”

Section: Resultsmentioning

confidence: 99%

“…Of these studies, six were from Europe, five from Asia, three from North America and two from Oceania. For class I obesity, seven articles (all cohort studies) involving 641 997 participants were included. There were four studies conducted in Europe and one each in Asia, North America and Oceania.…”

Section: Resultsmentioning

confidence: 99%

“…There were four studies conducted in Europe and one each in Asia, North America and Oceania. For class III obesity, nine articles (all cohort studies) were included, involving 1 097 056 participants. There were four studies conducted in Europe, two in Asia, two in North America and one in Oceania.…”

Section: Resultsmentioning

confidence: 99%

See 2 more Smart Citations

Maternal prepregnancy obesity and the risk of shoulder dystocia: a meta‐analysis

Zhang

et al. 2017

BJOG

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

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Maternal prepregnancy obesity and the risk of shoulder dystocia: a meta‐analysis

Zhang

et al. 2017

BJOG

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“…25) [1], and similar trends have been observed worldwide. Maternal overweight/obesity is associated with pregnancy complications, such as stillbirth and birth injury, and increased risk of delivering both a growth-restricted and a large-for-gestational-age (LGA; .90th percentile) or macrosomic (.4000 g) baby [2][3][4][5]. Fetal overgrowth is associated with increased incidence of perinatal complications and development of obesity, diabetes, and cardiovascular disease in childhood and later in life [6].…”

Section: Introductionmentioning

confidence: 99%

Maternal Overweight Induced by a Diet with High Content of Saturated Fat Activates Placental mTOR and eIF2alpha Signaling and Increases Fetal Growth in Rats1

Gaccioli

White

Capobianco

et al. 2013

Biology of Reproduction

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The mammalian target of rapamycin (mTOR) and the eukaryotic initiation factor 2 (eIF2) signaling pathways control protein synthesis in response to nutrient availability. Moreover, mTOR is a positive regulator of placental nutrient transport and is involved in the regulation of fetal growth. We hypothesized that maternal overweight, induced by a diet with high saturated fat content, i) up-regulates placental mTOR activity and nutrient transport, resulting in fetal overgrowth; ii) inhibits phosphorylation of eIF2 at its alpha subunit (eIF2alpha); and iii) leads to placental inflammation. Albino Wistar female rats were fed a control or high-saturated-fat (HF) diet for 7 wk before mating and during pregnancy. At gestational day 21, the HF diet significantly increased maternal and fetal triglyceride, leptin, and insulin (but not glucose) levels and maternal and fetal weights, and placental weights trended to increase. Phosphorylated 4EBP1 (T37/46 and S65) was significantly higher, and phosphorylated rpS6 (S235/236) tended to increase, in the placentas of dams fed an HF diet, indicating an activation of mTOR complex 1 (mTORC1). Phosphorylation of AMPK and eIF2alpha was reduced in the HF diet group compared to the control. The expression and activity of placental nutrient transporters and lipoprotein lipase (LPL), as well as the activation of inflammatory pathways, were not altered by the maternal diet. We conclude that maternal overweight induced by an HF diet stimulates mTORC1 activity and decreases eIF2alpha phosphorylation in rat placentas. We speculate that these changes may up-regulate protein synthesis and contribute to placental and fetal overgrowth.

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“…2---4 Gestantes obesas têm risco aumentado de indução de trabalho de parto, trabalho de parto disfuncional, distocia de ombro, maior taxa de infecção em sítio cirúrgico, infecção urinária, endometrite e hemorragia pós-parto. 5 Obesidade materna está associada com aumentada dificuldade na feitura de anestesia em neuroeixo, 6 maior incidência de hipotensão arterial 7 e falha de intubação traqueal durante anestesia geral. 8 Os récem-nascidos das pacientes obesas estão sob maior risco de complicacões perinatais (baixo pH arterial, menor excesso de base, hipoglicemia e menores valores do índice de Apgar).…”

Section: Introductionunclassified

Controle perioperatório de gestante obesa mórbida submetida a parto cesariano sob anestesia geral – relato de caso

Benevides

Brandão

Lovera

2016

Brazilian Journal of Anesthesiology

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Pregnant woman in labor, 35 years of age, body mass index 59.8 kg/m(2). Caesarean section was indicated due to the presumed fetal macrosomia. The patient refused spinal anesthesia. She was placed in the ramp position with cushions from back to head to facilitate tracheal intubation. Another cushion was placed on top of the right gluteus to create an angle of approximately 15° to the operating table. Immediately before induction of anesthesia, asepsis was carried out and sterile surgical fields were placed. Anesthesia was induced in rapid sequence, with Sellick maneuver and administration of remifentanil, propofol, and succinilcolina. Intubation was performed using a gum elastic bougie, and anesthesia was maintained with sevoflurane and remifentanil. The interval between skin incision and fetal extraction was 21 minutes, with the use of a Simpson's forceps scoop to assist in the extraction. The patient gave birth to a newborn weighing 4850 g, with Apgar scores of 2 in the 1(st) minute (received positive pressure ventilation by mask for about 2 minutes) and 8 in the 5(th) minute. The patient was extubated uneventfully. Multimodal analgesia and prophylaxis of nausea and vomiting was performed. Mother and newborn were discharged on the 4(th) postoperative day.

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The Effects of an Increasing Gradient of Maternal Obesity on Pregnancy Outcomes

Cited by 19 publications

References 0 publications

Maternal prepregnancy obesity and the risk of shoulder dystocia: a meta‐analysis

Maternal prepregnancy obesity and the risk of shoulder dystocia: a meta‐analysis

Maternal Overweight Induced by a Diet with High Content of Saturated Fat Activates Placental mTOR and eIF2alpha Signaling and Increases Fetal Growth in Rats1

Controle perioperatório de gestante obesa mórbida submetida a parto cesariano sob anestesia geral – relato de caso

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