The association of pre-pregnancy body mass index and risk of pre-eclampsia

Background: Preeclampsia is a pregnancy-related condition characterized by new-onset hypertension and proteinuria. Preeclampsia is responsible for 20% to 80% of mortality among pregnant in developing countries. Preeclampsia may cause prematurity and fetal growth restriction. It is the most serious complication affecting 2-8% of all pregnancies. The mortality and morbidity rates among the babies of pre-eclampsia mothers is five times higher than that among babies born to healthy mothers. Objective: To find the association between pre-pregnancy Body Mass Index (BMI) and gestational weight gain with incidence of pre-eclampsia.Methods: Cross sectional Observational study was conducted among 140 cases. The study was conducted after obtaining approval from the ethics committee.Results: In this study, in 27.9% of cases overweight, and in 12.1% of cases obesity were seen. In 60.7% of cases severe preeclampsia, and 39.3% of cases mild preeclampsia was reported. Preeclampsia had no significant association with age, marital life, parity, but had a significant association with liquor, birth weight, and NICU admission.Conclusions: Pre pregnancy weight and Gestational weight gain were associated with high risk of preeclampsia.

Intervenciones psicoeducativas para reducir factores psicosociales y controlar el peso en mujeres embarazadas s / Psychoeducational interventions to control weight gain in pregnant women / Intervenções psicoeducativas para reduzir fatores psicossociais e controle de peso em mulheres grávida

Objetivo: identificar las intervenciones psicoeducativas (IP) dirigidas a reducir factores psicosociales (ansiedad, depresión, estrés, imagen corporal, autoestima y apoyo social) y controlar el aumento de peso en mujeres embarazadas. Método: revisión sistemática de ensayos clínicos aleatorizados y estudios cuasi-experimentales consultado en las bases de datos de PubMed, Academic Search Complete, Medline, Web of Science, Ovid, ScienceDirect, Wiley Online Library y Scopus. Resultados: se incluyeron 4 estudios publicados entre el 2000 y 2016. Las IP que incluyen algún componente psicoeducativo como: psicoterapia, entrevista motivacional, establecimiento de objetivos y resolución de problemas junto con asesoramiento en conductas como alimentación saludable y actividad física, tienen un efecto significativo en disminuir la depresión y ansiedad, y a la vez mejoran el control del peso gestacional. Las IP dirigidas al estrés, autoestima, imagen corporal y apoyo social no mostraron efecto significativo para mejorar estas condiciones ni para el control de peso gestacional. Conclusión: se debe considerar componentes psicoeducativos, aunado con terapias complementarias para reducir los factores psicológicos y GPG. Se necesitan más investigaciones para identificar la detección de estos síntomas.

Objective: Identify psychoeducational interventions (PI) aimed at reducing psychosocial factors (anxiety, depression, stress, body image, self-esteem and social support) and controlling weight gain in pregnant women. Method: Systematic review of randomized clinical trials and quasi-experimental studies consulted in the databases of PubMed, Academic Search Complete, Medline, Web of Science, Ovid, ScienceDirect, Wiley Online Library and Scopus. Results: We include four studies published between el 2000 y 2016. The PIs that include some psychoeducational component such as: psychotherapy, motivational interview, goal setting and problem solving together with counseling on behaviors such as healthy eating and physical activity, have a significant effect in reducing depression and anxiety, and at the same time improve the control of gestational weight. The PIs aimed at stress, self-esteem, body image and social support showed no significant effect to improve these conditions or for the control of gestational weight. Conclusion: psychoeducational components should be considered, combined with complementary therapies to reduce psychological factors and GPG. More research is needed to identify the detection of these symptoms.

Objetivo: Identificar intervenções psicoeducativas (IP) voltadas à redução de fatores psicossociais (ansiedade, depressão, estresse, imagem corporal, autoestima e suporte social) e controle do ganho de peso em gestantes. Método: Revisão sistemática de ensaios clínicos randomizados e estudos quase-experimentais consultados nas bases de datos de PubMed, Academic Search Complete, Medline, Web of Science, Ovid, ScienceDirect, Wiley Online Library e Scopus. Resultados: Quatro estudos publicados entre 2000 e 2016. IP incluindo um componente psicoeducacional como incluído: psicoterapia, entrevista motivacional, estabelecimento de metas e resolução de problemas, juntamente com conselhos sobre comportamentos, como alimentação saudável e atividade física, têm um efeito significativo na diminuição depressão e ansiedade e, ao mesmo tempo, melhorar o controle do peso gestacional. Os IPs voltados ao estresse, autoestima, imagem corporal e suporte social não apresentaram efeito significativo para melhorar essas condições ou para o controle do peso gestacional. Conclusão: os componentes psicoeducacionais devem ser considerados, combinados com terapias complementares para reduzir fatores psicológicos e GPG. Mais pesquisas são necessárias para identificar a detecção desses sintomas.

New outpatient mode based on mobile internet for pregnancy nutrition / 医疗卫生装备

Objective To explore a new outpatient mode for pregnancy nutrition to adapt to digital hospital.Methods The outpatient management mode and methods were analyzed for pregnancy nutrition.A new outpatient mode combining the technologies of mobile internet and remote monitoring was developed with consideration on standardization,and the effect of the new mode was discussed on pregnancy nutrition outpatient.Results Mobile internet technology and remote monitoring technology contributed to enhancing the efficiency of pregnancy nutrition outpatient,and facilitated the nutrition service of common pregnant women as well as the precision and individualized nutrition management of high-risk ones such as those with gestational diabetes mellitus.Conclusion The new outpatient mode enhances the doctor's efficiency and pregnancy care,and thus is worthy promoting practically.

Relationships between maternal pre-pregnancy body mass index, pregnancy weight gain and gestational diabetes / 中国基层医药

Objective To analyze the association between pre-pregnancy body mass index,pregnancy weight gain and gestational diabetes(GDM).Methods The pre-pregnancy body mass index,pregnancy weight gain and the incidence data of 345 gestational diabetes with full-term primiparae were analyzed.Results The GDM ratio of low-weight,ideal weight group,over-weight was 2.78％,2.96％,16.04％,respectively over-weight GDM pregnancy was significantly higher than the ideal weight group( x2 =4.269,P ＜0.05),and GDM over-weight before pregnancy was significantly higher than the low weight group the incidence of GDM,the difference was statistically significant( x2 =17.299,P ＜0.01 ) ;Pregnant women in different pregnancy weight gain A( ＜ 11.0kg),B( 11.0 ～ 17.9kg),C( 18.0～24.9kg),D(≥25.0kg) range,the GDM were 0％,1.75％,6.60％,11.02％,that GDM of A,B,C,D group were statistically different( P ＜ 0.05 ).Rate of weight gain during pregnancy on pregnancy size was proportional to the impact of diabetes.Conclusion Pre-pregnancy body mass index,pregnancy weight gain had clinical significance in evaluation of gestational diabetes.

Relação entre cuidado pré-natal, fatores maternos e peso da criança ao nascer / Relationship between prenatal care, maternal factors and childs weight at birth

Introdução: A assistência pré-natal é importantíssima tanto para a evolução da gravidez quanto para o bem-estar da mãe, sendo o cuidado nutricional um promissor aliado para a otimização do crescimento fetal. Objetivo: Nesse estudo, objetivou-se analisar características maternas, gestacionais e do parto e relacioná-las com o estado nutricional pré-gestacional e com o peso da criança ao nascer, de mães usuárias do SUS. Métodos: Foi realizado um estudo transversal retrospectivo com 173 nascidos vivos de gravidez única. Resultados: Os resultados mostraram elevada prevalência de sobrepeso/obesidade pré-gestacional e sua associação com nascimento de recém-nascidos macrossômicos e maior número de partos cesáreos. Conclusão: A idade materna elevada e o grande número de filhos tidos em gestações anteriores contribuíram para essa prevalência, reforçando a importância da realização do pré-natal e da avaliação do estado nutricional pré-gestacional.

Introduction: The prenatal managing is important both for the development of pregnancy as the mother?s well being, being the nutritional care a promising ally to optimize fetal growth. Objective: This study aimed to examine maternal characteristics, pregnancy and childbirth and correlate them with nutritional status before pregnancy and the child?s weight at birth of mothers from SUS. Methods: This is a retrospective cross-sectional study with 173 live born in singleton pregnancies. Results: The results showed high prevalence of pre-pregnancy overweight / obesity and its relation with the birth of macrosomic newborns and greater number of cesarean deliveries. Conclusion: The increased maternal age and the high number of children from former pregnancies contributed to this prevalence, reinforcing the importance of prenatal exam and the nutritional evaluation before pregnancy.

A Study of the Pregnancy Weight Gains of Noncomplicated Primiparas and Multiparas / 대한주산의학회잡지

OBJECTIVE: To establish the biweekly standard values of pregnancy weight gains for primiparas and multiparas, and to investigate the influence of prepregnancy body mass index on biweekly weight gain during pregnancy. METHODS: We analyzed the biweekly weight gain data from 536 primiparas and 114 multiparas who had noncomplicated singleton term pregnancy. Data was categorized according to parity and body mass index (BMI). RESULTS: Biweekly weight gain was significantly different among prepregnancy BMI groups from the 15th week but was not different between primiparas and multiparas. CONCLUSION: To prevent a lot of complications which may be associated with abnormal weight gain during pregnancy, more careful prenatal care according to the prepregnancy BMI groups is needed. To establish the Korean standard value for antenatal weight gain, a nationwide multicenter study is needed.

A study of the monthly weight gains of noncomplicated pregnancies among 20s, early and late 30s / 대한산부인과학회지

OBJECTIVE: To calculate monthly weight gains during pregnancy among 20s, early and late 30s, and to investigate the influence of age groups on monthly weight gains. METHODS: We analyzed the monthly weight gain data from 892 women who had visited before 20 weeks of gestation and had healthy singleton term pregnancy. Data was categorized in three groups according to age (20s, early and late 30s). RESULTS: The monthly weight gain tables among 20s, early and late 30s have been determined. Monthly weight gain was not significantly different among three age groups. CONCLUSION: Although statistically insignificant among three age groups, more cautious prenatal care according to the monthly weight gain-gestational month tables for each age group is needed to prevent complications which may be associated with abnormal weight gain during pregnancy.

A study of the biweekly weight gains of noncomplicated pregnancies / 대한산부인과학회지

OBJECTIVE: To establish the standard values for proper antenatal weight gain, biweekly mean weight gains, standard deviations were calculated from the 5th to the 42nd gestational week and their percentiles were determined. And the influence of prepregnancy body mass index and/or parity on biweekly weight gain was investigated. METHODS: We analyzed the biweekly weight gain data from 910 women who had noncomplicated singleton term pregnancy. Data was categorized in three groups according to body mass index (BMI). RESULTS: The biweekly weight gain table has been determined and 'Sigmoid(S) shaped' weight gain curves were presented. Primipara and multipara have significantly less weight gain than nullipara beyond the 25th weeks. Biweekly weight gain was significantly different among prepregnancy BMI groups from the 13th week. CONCLUSION: More careful prenatal care according to the biweekly weight gain-gestational week tables is needed to prevent a lot of complications which may be associated with abnormal weight gain during pregnancy. To establish Korean standard value for antenatal weight gain, a nationwide multicenter study is needed.

Maternal Nutritional Status at the End of Pregnancy,and Correlation among Pregnancy Weight Gain,Birth Weight and Serum Leptin Levels

The necessity of adequate pregnancy weight gain for optimal pregnancy outcome has been recognized. However, the specific components of pregnancy weight gain that might be critical for fetal growth and development have not been elucidated clearly. The purpose of this study was to investigate the correlation of pregnancy weight gain and birth weight with serum leptin levels in women delivered newborns. The subjects were recruited from K university hospital. The subject's characteristic data (age 32.1+/-4.3 y, gestational age 39.5+/-1.1wk, pre-pregnancy weight 58.0+/-8.6 kg, pregnancy weight gain 12.7+/-5.5 kg, newborn's birth weight 3.5+/-0.5 kg) were gathered. Maternal dietary assessment was carried out at the end of pregnancy. After delivery, blood samples were collected from 20 mother-newborn pairs. Serum levels of various lipids and leptin were analyzed. Maternal daily consumption of iron, zinc, folate were lower than the RDA of each nutrient and index of nutritional quality was less than 1 showing that the quality of maternal diet was low. The levels of serum leptin of mothers and infants were 10.2+/-6.7 ng/ ml and 1.7+/-0.6 ng/ml, respectively. The serum leptin concentrations of male infants (1.9+/-0.7 ng /ml) were not different from that of females (1.7+/-0.5 ng/ml). A negative correlation was found between the maternal pre-pregnant BMI and weight gain during pregnancy (r=-0.54, p<0.05). There was a positive correlation between the pregnancy weight gain and the newborn's birth weight (r = 0.59, p<0.01). There were also positive correlation between newborn's birth weight and newborn's serum leptin levels (r =0.57, p<0.01). No correlations were found between maternal serum leptin levels and that of newborn's. Efforts should be made to attain adequate diet and weight gain during the pregnancy to reduce the likelihood of low or over birth weight of newborns.

A Study of the Monthly Weight Gains of Noncomplicated Pregnancies / 대한주산의학회잡지

OBJECTIVE: Mean weight gains, standard deviations were calculated for each gestational months and the 10th, 25th, 50th, 75th, and 90th percentiles were determined. And the influence of prepregnancy body mass index and/or parity on monthly weight gain was investigated. METHODS: We analyzed the monthly weight gain data from 876 women who had healthy sigleton term pregnancy in Han-il Hospital(Jul 2001-Jun 2002). Data were categorized in three groups according to the prepregnancy body mass index. RESULTS: The monthly weight gain table has been determined and 'Sigmoid(S) shaped' monthly weight gain curve was presented. Primipara and multipara have less weight gain than nullipara in the 5th and the 7th-11th months. Monthly weight gains adjusted for parity and age were significantly different among prepregnancy body mass index groups from the 4th month. CONCLUSIONS: More careful prenatal care according to the monthly weight gain-gestational month tables is needed to prevent a lot of complications which may be associated with abnormal weight gain during pregnancy.

Prepregnancy weight, maternal weight gain, and birth weight

BACKGROUND: Low birth weight and high birth weight are closely related to perinatal complications. The purpose of this study is to estimate the association of prepregnancy weight, maternal weight gain and infant birth weight. METHODS: The effect on birth weight in 724 live births after 38~42 weeks gestation was studied at Taegu Medical Center, between January, 1997, and August, 1998. Pregnant women with hypertension, diabetes mellitus, multiple pregnancy and drug abuse were excluded because of their possible influence on birth weight. To study the effect on infant birth weight, multiple regression analysis was carried out. RESULTS: We evaluated 724 pregnant women and their babies. Mean prepregnancy weight was 52.2+/-.9kg, mean maternal weight gain was 13.0+/-.6kg, and mean BMI(Body Mass Index) was 20.5+/-2.5kg/m(2). Mean gestational age was 278+/-7.3days and mean birth weight was 3,320.5+/-405.2gm. Correlation coefficient between birth weight and prepregnancy weight was 0.347(p<0.01), and maternal weight gain was 0.248(p<0.01), and BMI(Body Mass Index) was 0.261(p<0.01). Birth weight was significantly correlated with prepregnancy weight(p<0.01) and maternal weight gain(p<0.01), but prepregnancy weight was not significantly correlated with maternal weight gain(p<0.05). Prepregnancy weight had most apparent influence on birth weight. CONCLUSIONS: Prepregnancy weight and maternal weight gain was positively related to birth weight. These results suggest that there are good effects of properly controlling prepregnancy weight and maternal weight gain in pregnant women and their babies.