Maternal Obesity and Its Associated Factors and Outcomes in Klang Valley, Malaysia: Finding from National Obstetric Registry

@#Introduction: Maternal obesity presents significant health risks to mothers and their fetuses. This study aimed to determine the proportion, associated factors and outcomes of maternal obesity among pregnant women in Klang Valley, Malaysia. Methods: A retrospective cross-sectional study was conducted between January 2018 and March 2018 using secondary data from the Malaysian National Obstetric Registry (NOR) for the year 2015. All pregnant women with first-trimester booking at 12 weeks and below that were registered with the NOR and met the inclusion and exclusion criteria were included in the study. Descriptive statistics and multiple logistic regression analysis were used. Data were analysed using SPSS version 22.0. A total of 2113 respondents were included in this study to determine the proportion, associated factors and outcomes of maternal obesity. Regarding the univariate and multivariate analyses, respondents were classified into two groups: normal and obese. The obese group comprised overweight and obese mothers. The underweight group was excluded in the subsequent analysis. Results: Out of the 2113 respondents, 7.1% were underweight, 41.7% were of normal weight, 28.6% were overweight, 15.9% were in obese class I, 4.6% were in obese class II, and 2.1% were in obese class III according to the WHO (1995) reference. However, when the MOH (2003) cutoff point was used, there was a marked increase in the proportion of respondents in the overweight categories by 2.7% and obesity class I by 12.8%. The Indian (AdjOR 2.06, 95% CI: 1.11, 3.83, p=0.021) and Malay (AdjOR 1.75, 95% CI: 1.02, 3.00, p=0.040) ethnicities, as well as both multiparity (AdjOR 1.46, 95% CI: 1.23, 1.73, p <0.001) and grand multiparity (AdjOR 2.41, 95% CI: 1.78, 3.26, p <0.001), were significantly associated with maternal obesity. There were significant association between maternal obesity with hypertensive disorder in pregnancy (p=0.025), caesarean section delivery (p=0.002) and macrosomic infant (p <0.001). Conclusion: The identification of risk factors for maternal obesity is important to facilitate intervention programmes focused on improving the pregnancy outcomes for a high-risk group of women.

Maternal obesity and its determinants: A neglected issue?

@#Maternal obesity is a global public health concern that affects every aspect of maternity care. It affects the short-term and long-term health of the mother and her offspring. Obese pregnant mothers are at an increased risk of developing complications during antenatal, intrapartum, and postnatal periods. Maternal complications include gestational diabetes mellitus, hypertensive disorder in pregnancy, pre-eclampsia and eclampsia, increased rate of cesarean delivery, pulmonary embolism, and maternal mortality; fetal complications include congenital malformation, stillbirth, and macrosomia. Moreover, both mother and infant are at an increased risk of developing subsequent non-communicable diseases and cardiovascular problems later in life. Several factors are associated with the likelihood of maternal obesity, including sociodemographic characteristics, obstetric characteristics, knowledge, and perception of health-promoting behavior. Gaining a sound understanding of these factors is vital to reaching the targets of Sustainable Developmental Goal 3—to reduce global maternal mortality and end preventable deaths of children under 5 years of age—by 2030. It is essential to identify pregnant women who are at risk of maternal obesity in order to plan and implement effective and timely interventions for optimal pregnancy outcomes. Importantly, maternal obesity as a significant pregnancy risk factor is largely modifiable.

Understanding Dieting and Previous Weight Loss Attempts among Overweight and Obese Participants: Insights into My Body Is Fit and Fabulous at Work Program / 가정의학회지

BACKGROUND: A qualitative study providing an in-depth exploration of people's view and the increasing burden of overweight and obesity is required. This study aimed to explore the understanding of dieting and previous experiences on weight loss attempts among overweight and obese government employees in Kelantan, Malaysia, prior to recruitment into the intervention program. METHODS: Thirteen focus group discussions involving 129 participants from a weight-loss intervention program were conducted within the first 1 month of recruitment. These discussions were moderated by two trained researchers in the Malay language and assisted by an interview guide. They were audio-recorded and transcribed verbatim. A thematic analysis was performed, and codes and themes from each discussion were constructed. RESULTS: The participants understood dieting with various meanings, including skipping meals and removing rice from daily diets. They applied numerous methods to lose weight and achieved various outcomes. Health and appearance, social support, and compliance with current trends were the factors motivating these participants to lose weight. Their determination to lose weight was limited by lack of self-control and motivation, experiences of unpleasant effects, influence on weight, and environmental and health factors. CONCLUSION: Real-life weight loss experiences and perceptions provided relevant insights into current weight loss management strategies. Some of these issues and misunderstandings should be emphasized in weight loss strategies during health promotion.

coexistence of dual form of malnutrition in a sample of rural Malaysia

The co-existence of under and over nutrition might be influenced by a marked shift in dietary and lifestyle practices of people in developing countries. This study aims to identify the factors associated with the occurrence of a dual form of malnutrition in the same households in a rural district in Peninsular Malaysia. This study was conducted in two phases. The first phase involved a survey of 223 mother-child pairs that fit the required criteria [223 non-pregnant, non-lactating mothers aged 18 to 55 years old and 223 children aged 2 to 12 years old]. Anthropometric indices: Weight-for-age Z score [WAZ] /= 25 kg/m2 was used to measure overweight status among mothers. The results showed that the prevalence of overweight mother/underweight child [OWM/UWC] pairs was 66 [29.6%], and that the prevalence of normal weight mother/normal weight child [NWM/NWC] pairs was 34 [15.2%]. The second phase of the study involved a case-control comparison of the 66 OWM/UWC pairs and the 34 NWM/NWC pairs. A pre-tested questionnaire was used to gather socio-economic-demographic data, whereas food frequency questionnaire was used to assess diet diversity. The results indicated that 61.0% of the children were underweight and 61.4% were stunted, whereas the prevalence of overweight and obesity in women were 35% and 17%, respectively. The study did not report any association between the dual burden of malnutrition and household size, number of children, educational level of the mother, total income, income per capita, and food expenditure. The only association reported was with household type [OR: 5.01; 95% CI; 63, 15.34; P = 0.005]. In general, the total diet diversity score of both types of mother-child pairs was low. Compared with overweight mothers, normal weight mothers had a higher diet diversity score for at least six food groups and for the total diet diversity score, although these differences were not significant. The clustering of dual forms of malnutrition in the same household poses big challenges for food intervention programs. Although, this study cannot make an inference for the whole population, the results shed light on a serious public health issue that must be addressed