The prevalence and impact of overweight and obesity in an Australian obstetric population

Callaway, Leonie K.; Prins, Johannes B.; Chang, Allan; McIntyre, H. David

doi:10.5694/j.1326-5377.2006.tb00115.x

Cited by 522 publications

(449 citation statements)

References 21 publications

(24 reference statements)

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“…Similar findings were reported by Dietz et al even after adjustment for co-morbidity, such as GDM [30]. This finding is relevant considering the increasing rate of CS delivery [31] and obesity in many of the middle and high income countries [4,5], taking into account the significant morbidities in obese women who deliver by CS such as wound infection, endometritis, urinary tract infection and prolonged postpartum hospitalization [32,33]. …”

Section: Discussionsupporting

confidence: 80%

“…The prevalence of overweight and obesity is higher among women, with an estimated prevalence of 63% in the reproductive age group [3] and more than 50% among pregnant women [4]. Obesity in pregnancy is a recognized risk factor for many maternal and neonatal adverse outcomes including increased rate of cesarean section (CS), macrosomia, preeclampsia and gestational diabetes (GDM) [5-7]. …”

Section: Introductionmentioning

confidence: 99%

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The independent effects of maternal obesity and gestational diabetes on the pregnancy outcomes

et al. 2014

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BackgroundObesity and gestational diabetes (GDM) in pregnancy are recognized risk factors for adverse outcomes, including cesarean section (CS), macrosomia and preeclampsia. The aim of this study was to investigate the independent effect of GDM and obesity on the adverse pregnancy outcomes at term.MethodsA retrospective cohort of postpartum women, in King Khalid University Hospital, were stratified according to body mass index (obese ≥30 kg/m2, non-obese <30 kg/m2) and the results of GDM screening into the following groups, women with no obesity and no GDM (reference group), women with no obesity but with GDM, women with obesity but no GDM and women with both GDM and obesity. Adverse pregnancy outcomes included high birth weight, macrosomia, CS delivery and preeclampsia. Multiple logistic regression used to examine independent associations of GDM and obesity with macrosomia and CS.Results2701 women were included, 44% of them were obese and 15% had GDM. 63% of the women with GDM were obese. There was significant increase in the percentage of macrosomia, P < 0.001, high birth weight, P < 0.001, CS, P < 0.001 and preeclampsia, P < 0.001 in women with GDM and obesity compared to the reference group. Obesity increased the estimated risk of CS delivery, odds ratio (OR) 2.16, confidence intervals (CI) 1.74-2.67. The combination of GDM and obesity increased the risk of macrosomia OR 3.45, CI 2.05-5.81 and the risk of CS delivery OR 2.26, CI 1.65-3.11.ConclusionMaternal obesity and GDM were independently associated with adverse pregnancy outcomes. The combination of both conditions further increase the risk.

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Section: Discussionsupporting

confidence: 80%

Section: Introductionmentioning

confidence: 99%

The independent effects of maternal obesity and gestational diabetes on the pregnancy outcomes

et al. 2014

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“…Results from some earlier studies have shown an increased risk of preterm delivery in obese non-diabetic women,3 4 while others have reported the opposite association 2 5…”

Section: Discussionmentioning

confidence: 97%

Pre-pregnancy body mass index and the risk of adverse outcome in type 1 diabetic pregnancies: a population-based cohort study

et al. 2012

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ObjectiveTo assess the risk of perinatal complications in overweight and obese women with and without type 1 diabetes (T1DM).DesignProspective population-based cohort study.SettingThis study was based on data from the Swedish Medical Birth Registry from 1998 to 2007.Participants3457 T1DM and 764 498 non-diabetic pregnancies were included. T1DM was identified based on ICD code O24.0. Mothers were categorised according to pre-pregnancy body mass index (BMI: weight in kilograms per height in square metres) as normal weight (BMI 18.5–24.9), overweight (BMI 25–29.9) or obese (BMI ≥30). Only women with singleton pregnancies and with data on BMI were included.Primary/secondary outcomesThe primary outcome was large for gestational age (LGA: birth weight >90th percentile) infants. Secondary outcomes were major malformations, pre-eclampsia (PE), preterm delivery, perinatal mortality, delivery by Caesarean section and neonatal overweight. Logistic regression analysis was performed with normal weight non-diabetic women as the reference category and also within the diabetic cohort with normal weight type 1 diabetic women as the reference. The ORs were adjusted for ethnicity, maternal age, height, parity, smoking and chronic hypertension.Results35% of women with T1DM were overweight and 18% were obese, as compared with 26% and 11%, respectively, in non-diabetic pregnancies. The incidences of adverse outcome increased with greater BMI category. As compared with non-diabetic normal weight women, the adjusted OR for obese T1DM for LGA was 13.26 (95% CI 11.27 to 15.59), major malformations 4.11 (95% CI 2.99 to 5.65) and PE 14.19 (95% CI 11.50 to 17.50). T1DM was a significant effect modifier of the association between BMI and LGA, major malformations and PE (p<0.001).ConclusionHigh pre-pregnancy BMI is an important risk factor for adverse outcome in type 1 diabetic pregnancies. The combined effect of both T1DM and overweight or obesity constitutes the greatest risk. It seems prudent to strive towards normal pre-pregnancy BMI in women with T1DM.

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“…40 Whilst increasing maternal BMI is a well recognised risk factor for the development of gestational diabetes, 2, 41, 42 increasing BMI with normal glucose tolerance does not preclude the existence of metabolic abnormalities associated with increased fetal growth. 40 …”

Section: Discussionmentioning

confidence: 99%

Antenatal dietary and lifestyle advice for women who are overweight or obese and the effect on fetal growth and adiposity: the LIMIT randomised trial

Grivell

Yelland

Deussen

et al. 2015

BJOG

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Objective To report the influence of maternal overweight and obesity on fetal growth and adiposity and effects of an antenatal dietary and lifestyle intervention among these women on measures of fetal growth and adiposity as secondary outcomes of the LIMIT Trial. Design Randomised controlled trial. Setting Public maternity hospitals in metropolitan Adelaide, South Australia. Population Pregnant women with a BMI ≥25kg/m2, and singleton gestation between 10+0–20+0 weeks. Methods Women were randomised to Lifestyle Advice or continued Standard Care and offered two research ultrasound scans at 28 and 36 weeks gestation. Main Outcome Measures Ultrasound measures of fetal growth and adiposity. Results For each fetal body composition parameter, mean Z-scores were substantially higher when compared with population standards. Fetuses of women receiving Lifestyle Advice demonstrated significantly greater mean mid thigh fat mass, when compared with fetuses of women receiving Standard Care (Adjusted Difference in Means 0.17; 95% Confidence Intervals (CI) 0.02 to 0.32; p=0.0245). While subscapular fat mass increased between 28 and 36 weeks gestation in fetuses in both treatment groups, the rate of adipose tissue deposition slowed among fetuses of women receiving Lifestyle Advice, when compared with fetuses of women receiving Standard Care (p=0.0160). No other significant differences were observed. Conclusions These findings provide the first evidence of changes to fetal growth following an antenatal dietary and lifestyle intervention among women who are overweight or obese.

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The prevalence and impact of overweight and obesity in an Australian obstetric population

Cited by 522 publications

References 21 publications

The independent effects of maternal obesity and gestational diabetes on the pregnancy outcomes

The independent effects of maternal obesity and gestational diabetes on the pregnancy outcomes

Pre-pregnancy body mass index and the risk of adverse outcome in type 1 diabetic pregnancies: a population-based cohort study

Antenatal dietary and lifestyle advice for women who are overweight or obese and the effect on fetal growth and adiposity: the LIMIT randomised trial

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