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Obesity and labor

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https://www.readbyqxmd.com/read/28936902/maternal-obesity-is-associated-with-chorioamnionitis-and-earlier-indicated-preterm-delivery-among-expectantly-managed-women-with-preterm-premature-rupture-of-membranes
#1
Emily E Hadley, Andrea Discacciati, Maged M Costantine, Mary B Munn, Luis D Pacheco, George R Saade, Giuseppe Chiossi
OBJECTIVE: To determine the association between maternal obesity and delivery due to chorioamnionitis prior to labor onset, among expectantly managed women with preterm premature rupture of membranes (pPROM). METHODS: This was a secondary analysis of a multicenter randomized trial of magnesium sulfate versus placebo to prevent cerebral palsy or death among offspring of women with anticipated delivery at 24-31-week gestation. After univariable analysis, Cox proportional hazard evaluated the association between maternal obesity and chorioamnionitis, while Laplace regression investigated how obesity affects the gestational age at delivery of the first 20% of women developing the outcome of interest...
September 22, 2017: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28889657/the-physiologic-pattern-of-normal-labor-progression
#2
Jun Zhang, Tao Duan
The escalating frequency of obstetric interventions such as oxytocin augmentation and cesarean delivery has raised concerns to practitioners and the public. While maternal consequences of cesarean section are well recognized by obstetricians, the impact of cesarean birth on child health has come under the spot light in recent years. Mounting evidence is linking cesarean birth with childhood allergic disorders, such as asthma, childhood obesity and neurodevelopmental disorders (Cho CE, et al. Am J Obstet Gynecol 2013;208:249-54...
September 10, 2017: BJOG: An International Journal of Obstetrics and Gynaecology
https://www.readbyqxmd.com/read/28886213/prospective-study-of-the-effect-of-maternal-body-mass-index-on-labor-progress-in-nulliparous-women-in-egypt
#3
Ahmed M Maged, Doaa S Belal, Heba M Marie, Hamsa Rashwan, Suzy Abdelaziz, Amir A Gabr, Ahmed R Elzayat
OBJECTIVE: To evaluate the impact of maternal body mass index (BMI, calculated as weight in kilograms divided by the square of height in meters) on labor progress in nulliparous women. METHODS: The present prospective cohort study enrolled primigravidae admitted to Kasr Al Ainy hospital, Cairo University, Egypt, during active labor between February 1, 2016, and February 28, 2017. Patients were classified into three equal groups using their BMI at admission: underweight (<18...
September 8, 2017: International Journal of Gynaecology and Obstetrics
https://www.readbyqxmd.com/read/28861414/continuous-spinal-anesthesia-for-obstetric-anesthesia-and-analgesia
#4
REVIEW
Ivan Veličković, Borislava Pujic, Charles W Baysinger, Curtis L Baysinger
The widespread use of continuous spinal anesthesia (CSA) in obstetrics has been slow because of the high risk for post-dural puncture headache (PDPH) associated with epidural needles and catheters. New advances in equipment and technique have not significantly overcome this disadvantage. However, CSA offers an alternative to epidural anesthesia in morbidly obese women, women with severe cardiac disease, and patients with prior spinal surgery. It should be strongly considered in parturients who receive an accidental dural puncture with a large bore needle, on the basis of recent work suggesting significant reduction in PDPH when intrathecal catheters are used...
2017: Frontiers in Medicine
https://www.readbyqxmd.com/read/28851241/obesity-s-impact-on-intrapartum-electronic-fetal-monitoring
#5
Brian Brocato, David Lewis, Madhuri Mulekar, Susan Baker
OBJECTIVE: The objective of this study is to evaluate the impact maternal obesity has on the percentage of unmonitored electronic fetal monitoring (EFM). STUDY DESIGN: Women undergoing induction of labor at term were categorized into three groups: Group 1 (body mass index (BMI) < 30 kg/m(2)), Group 2 (30 < BMI < 40 kg/m(2)), and Group 3 (BMI ≥ 40 kg/m(2)). External EFM tracings were reviewed from the time of induction of labor until amniotomy; the percentage of time off of EFM was calculated...
September 17, 2017: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28810235/obesity-as-a-conditioning-factor-for-high-altitude-diseases
#6
Rocío San Martin, Julio Brito, Patricia Siques, Fabiola León-Velarde
Obesity, a worldwide epidemic, has become a major health burden because it is usually accompanied by an increased risk for insulin resistance, diabetes, hypertension, cardiovascular diseases, and even some kinds of cancer. It also results in associated increases in healthcare expenditures and labor and economic consequences. There are also other fields of medicine and biology where obesity or being overweight play a major role, such as high-altitude illnesses (acute mountain sickness, hypoxic pulmonary hypertension, and chronic mountain sickness), where an increasing relationship among these two morbid statuses has been demonstrated...
2017: Obesity Facts
https://www.readbyqxmd.com/read/28800658/spontaneous-labor-onset-and-outcomes-in-obese-women-at-term
#7
Antonina I Frolova, Judy J Wang, Shayna N Conner, Methodius G Tuuli, George A Macones, Candice L Woolfolk, Alison G Cahill
No abstract text is available yet for this article.
August 11, 2017: American Journal of Perinatology
https://www.readbyqxmd.com/read/28780659/preconception-counseling-for-women-with-cardiac-disease
#8
REVIEW
Mark A Clapp, Sarah N Bernstein
All providers who care for reproductive-aged women with cardiac disease should assess these patients' desires and plans for pregnancy at every encounter. For those considering pregnancy, preconception counseling, often performed by a maternal-fetal medicine specialist, can help patients understand the potential implications of pregnancy on their health and estimate the risks of an adverse cardiac event prior to conceiving. There are cardiac conditions, such as pulmonary hypertension and aortic stenosis, in which pregnancy may be contraindicated given the high morbidity and mortality; there are tools available to help quantify a patient's risk...
September 2017: Current Treatment Options in Cardiovascular Medicine
https://www.readbyqxmd.com/read/28757105/-double-balloon-catheter-compared-to-vaginal-dinoprostone-for-cervical-ripening-in-obese-women-at-term
#9
J Grange, J Dimet, M Vital, A Le Thuaut, G Ducarme
OBJECTIVE: To compare the efficacy of a double-balloon catheter versus vaginal prostaglandin E2 (dinoprostone) for cervical ripening in obese patients with unfavorable cervix at term. METHODS: The study had an open-label, prospective combined with retrospective, observational design. From January 2013 until May 2016, a prospective cohort study of 46 women with pre-pregnancy BMI>30kg/m(2), live singleton term fetuses (>37 weeks) in vertex presentation and unfavorable cervix (Bishop score<6), who underwent labor induction for conventional indications using a double-balloon catheter...
July 27, 2017: Gynecologie, Obstetrique, Fertilite & Senologie
https://www.readbyqxmd.com/read/28729012/evidence-that-children-born-at-early-term-37-38-6-7-weeks-are-at-increased-risk-for-diabetes-and-obesity-related-disorders
#10
Dorit Paz Levy, Eyal Sheiner, Tamar Wainstock, Ruslan Sergienko, Daniella Landau, Asnat Walfisch
BACKGROUND: Prematurity is known to be associated with high rates of endocrine and metabolic complications in the offspring. Offspring born early term (37-38 6/7 weeks' gestation) were also shown to exhibit long-term morbidity resembling that of late preterm, in several health categories. OBJECTIVE: We aimed to determine whether early term delivery impacts on the long-term endocrine and metabolic health of the offspring. STUDY DESIGN: A population-based cohort analysis was performed, including all term singleton deliveries occurring from 1991 through 2013 at a single regional tertiary medical center...
July 18, 2017: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28727889/clinical-assessment-of-uterine-contractions
#11
REVIEW
Wayne R Cohen
The assessment of uterine contractions is important in clinical decision-making, but the precise role for appraising contractions remains controversial. Four clinical approaches to assessing contractions are available: manual palpation; intrauterine pressure determination; external tocodynamometry; and electrohysterography. Palpation is inexpensive and harmless but requires the constant bedside presence of a trained observer. Intrauterine pressure measurement is considered the most sensitive and specific technique, and has become the standard by which other methods are judged; however, its quantitative measurements are not always precise or reproducible...
July 20, 2017: International Journal of Gynaecology and Obstetrics
https://www.readbyqxmd.com/read/28726455/a-developmental-perspective-on-the-link-between-parents-employment-and-children-s-obesity
#12
Robert Crosnoe, Rachel Dunifon
Despite public concerns about the negative implications of the increased labor force participation of mothers for child development, decades of research have revealed few risks and some benefits. One potential risk-a consistently observed association between maternal employment and childhood obesity-offers a window into how some dimensions of family health may be undermined by work in an economic and policy context that is not family friendly. The purpose of this article is to identify ways that a developmental perspective can enrich the literature on how children's weight may be related to the work experiences of both mothers and fathers across diverse populations, a literature that heretofore has been dominated by economic and demographic perspectives, focused almost solely on women, and largely ignored racial/ethnic variation...
July 2017: American Psychologist
https://www.readbyqxmd.com/read/28690864/surgical-site-infections-after-cesarean-delivery-epidemiology-prevention-and-treatment
#13
REVIEW
Tetsuya Kawakita, Helain J Landy
Cesarean delivery (CD) is one of the most common procedures performed in the United States, accounting for 32% of all deliveries. Postpartum surgical site infection (SSI), wound infection and endometritis is a major cause of prolonged hospital stay and poses a burden to the health care system. SSIs complicate a significant number of patients who undergo CD - 2-7% will experience sound infections and 2-16% will develop endometritis. Many risk factors for SSI have been described. These include maternal factors (such as tobacco use; limited prenatal care; obesity; corticosteroid use; nulliparity; twin gestations; and previous CD), intrapartum and operative factors (such as chorioamnionitis; premature rupture of membranes; prolonged rupture of membranes; prolonged labor, particularly prolonged second stage; large incision length; subcutaneous tissue thickness > 3 cm; subcutaneous hematoma; lack of antibiotic prophylaxis; emergency delivery; and excessive blood loss), and obstetrical care on the teaching service of an academic institution...
2017: Maternal Health, Neonatology and Perinatology
https://www.readbyqxmd.com/read/28683786/grandmothers-perspectives-on-the-changing-context-of-health-in-india
#14
Solveig A Cunningham, Susannah D Gloor, Shailaja S Patil
BACKGROUND: The prevalence of obesity and other chronic diseases is increasing in India and around the world. As globalization and social changes are believed to be at the root of these epidemiological changes, these factors must be better understood. This study engaged older adults to gain an important perspective on globalization and health. METHODS: A free-list instrument and a structured survey were developed and used to gather data on changes in diet, activity, and women's roles from ten grandmothers in rural India...
July 7, 2017: BMC Research Notes
https://www.readbyqxmd.com/read/28677406/tropomyosin-receptor-kinase-b-agonist-7-8-dihydroxyflavone-improves-mitochondrial-respiration-in-placentas-from-obese-women
#15
Calais S Prince, Alina Maloyan, Leslie Myatt
Maternal obesity negatively impacts the placenta, being associated with increased inflammation, decreased mitochondrial respiration, decreased expression of brain-derived neurotrophic factor (BDNF), and its receptor, tropomyosin receptor kinase B (TRKB). TRKB induction by 7,8-dihydroxyflavone (7,8-DHF) improves energy expenditure in an obesity animal model. We hypothesized that TRKB activation would improve mitochondrial respiration in trophoblasts from placentas of obese women. Placentas were collected from lean (pre-pregnancy BMI < 25) and obese (pre-pregnancy BMI > 30) women at term following cesarean section delivery without labor...
January 1, 2017: Reproductive Sciences
https://www.readbyqxmd.com/read/28670545/gestational-weight-gain-and-pregnancy-outcomes-in-relation-to-body-mass-index-in-asian-indian-women
#16
Balaji Bhavadharini, Ranjit Mohan Anjana, Mohan Deepa, Gopal Jayashree, Subramanyam Nrutya, Mahadevan Shobana, Belma Malanda, Arivudainambi Kayal, Anne Belton, Kurian Joseph, Kurian Rekha, Ram Uma, Viswanathan Mohan
AIM: The aim of the study was to compare the weight gain during pregnancy (using Institute of Medicine guidelines) among Asian Indians across different body mass index (BMI) categories (using World Health Organization Asia Pacific BMI cut points) and to compare the pregnancy outcomes in each of the different BMI categories. METHODOLOGY: Retrospective records of 2728 pregnant women attending antenatal clinics and private maternity centers in Chennai, South India, from January 2011 to January 2014 were studied...
July 2017: Indian Journal of Endocrinology and Metabolism
https://www.readbyqxmd.com/read/28649037/the-dynamic-effects-of-obesity-on-the-wages-of-young-workers
#17
Joshua C Pinkston
This paper considers effects of body mass on wages in the years following labor market entry. The preferred models allow current wages to be affected by both past and current body mass, as well as past wages, while also addressing the endogeneity of body mass. I find that a history of severe obesity has a large negative effect on the wages of white men. White women face a penalty for a history of being overweight, with some evidence of additional penalties that begin above the threshold for severe obesity. Furthermore, the effects of past wages on current wages imply that past body mass has additional, indirect effects on wages, especially for white women...
June 8, 2017: Economics and Human Biology
https://www.readbyqxmd.com/read/28645121/effect-of-obesity-on-gestational-and-perinatal-outcomes
#18
Sônia Regina Cabral Madi, Rosa Maria Rahmi Garcia, Vandrea Carla de Souza, Renato Luís Rombaldi, Breno Fauth de Araújo, José Mauro Madi
Purpose To assess the impact of pre-pregnancy obesity (body mass index [BMI] ≥ 30 kg/m(2)) on the gestational and perinatal outcomes. Methods Retrospective cohort study of 731 pregnant women with a BMI ≥ 30 kg/m(2) at the first prenatal care visit, comparing them with 3,161 women with a BMI between 18.5 kg/m(2) and 24.9 kg/m(2). Maternal and neonatal variables were assessed. Statistical analyses reporting the demographic features of the pregnant women (obese and normal) were performed with descriptive statistics followed by two-sided independent Student's t tests for the continuous variables, and the chi-squared (χ(2)) test, or Fisher's exact test, for the categorical variables...
July 2017: Revista Brasileira de Ginecologia e Obstetrícia
https://www.readbyqxmd.com/read/28578171/nonmedically-indicated-induction-in-morbidly-obese-women%C3%A2-is-not-associated-with-an-increased-risk-of-cesarean%C3%A2-delivery
#19
Tetsuya Kawakita, Sara N Iqbal, Chun-Chih Huang, Uma M Reddy
BACKGROUND: The prevalence of morbid obesity (body mass index ≥40 kg/m(2)) in women aged 20-39 years was 7.5% in 2009 through 2010. Morbid obesity is associated with an increased risk of stillbirth compared with normal body mass index, especially >39 weeks' gestation. The data regarding increased risk of cesarean delivery associated with nonmedically indicated induction of labor compared to expectant management in morbidly obese women are limited. OBJECTIVE: We sought to compare the cesarean delivery rate of nonmedically indicated induction of labor with expectant management in morbidly obese women without other comorbidity...
May 31, 2017: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28528810/titration-of-intravenous-oxytocin-infusion-for-postdate-induction-of-labor-across-body-mass-index-groups
#20
Angela B Maeder, Susan C Vonderheid, Chang G Park, Aleeca F Bell, Barbara L McFarlin, Catherine Vincent, C Sue Carter
OBJECTIVE: To evaluate whether oxytocin titration for postdate labor induction differs among women who are normal weight, overweight, and obese and whether length of labor and birth method differ by oxytocin titration and body mass index (BMI). DESIGN: Retrospective cohort study. SETTING: U.S. university-affiliated hospital. PARTICIPANTS: Of 280 eligible women, 21 were normal weight, 134 were overweight, and 125 were obese at labor admission...
May 18, 2017: Journal of Obstetric, Gynecologic, and Neonatal Nursing: JOGNN
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