Perinatal outcomes in nutritionally monitored obese pregnant women: a randomized clinical trial.

BACKGROUND: Although obesity in pregnancy continues to be associated with ongoing health problems, many clinicians have been reluctant to place nondiabetic, obese, pregnant women on a monitored, calorie-appropriate nutritional regimen for fear of fetal growth restriction, low birth weight, or starvation ketosis. METHODS: A total of 257 patients were enrolled in the randomized study, with a loss-to-follow-up rate of 9.73%. Patients were assigned randomly to either the control (unmonitored) group (n=116), consisting of conventional prenatal dietary management, or to the study (monitored) group (n=116), which was prescribed a balanced nutritional regimen and were asked to record in a diary all of the foods eaten during each day. Women were eligible for the study if they were pregnant with a single fetus between 12 and 28 weeks of gestation and had a prepregnancy body mass index of more than 30 kg/m2. The primary outcome was to compare perinatal outcomes in the control vs the study groups. The secondary measure was to compare outcomes in adherent and nonadherent patients in the study group. RESULTS: Omnibus MANOVA showed statistically significant differences between the study and control groups regarding 3 variables: (1) gestational hypertension, p < .46; (2) mother's last weight before delivery, p < .001; and (3) mother's 6-week postpartum weight, p < .001. Patients gaining 15 pounds or more during their pregnancy showed statistically significant differences between the groups for 8 variables. CONCLUSION: Obese pregnant women may be placed on a healthy, well-balanced, monitored nutritional program during their antepartum course without adverse perinatal outcomes.

Perceived musculoskeletal symptoms among dental students in the clinic work environment.

Musculoskeletal symptoms are a major concern among dental practitioners. Dental students perform the same clinical tasks as dentists in private practice, yet only recently has scientific evidence suggested a relationship between the tasks and musculoskeletal symptoms. This study investigates the clinical tasks that place students at physical risk and the relationship between the tasks and musculoskeletal symptoms. Student perceptions of physical symptoms were established with a questionnaire identifying variables on general health, tasks, physical demands, workload and environment. A total of 61% (358/590) reported that during the past year they experienced musculoskeletal symptoms related to work at dental school (second year (n = 212), third year (n = 201) and fourth year (n = 177)). Of those students, the neck represented 48%, shoulder 31%, back 44% and hands 20% (p < 0.001). Third year students reported the highest occurrence of symptoms in every body area (p < 0.001). Third and fourth year students reported significant relationships between the occurrence of symptoms and equipment utilisation, work efficiency and general health. Further studies are recommended to evaluate types and levels of potential risk factors. A total of 75% of dental practitioners are at risk for developing work-related musculoskeletal disorders. Results from this study have found that dental students were no exception. Third year dental students reported the highest level of musculoskeletal symptoms with the prevalence of pain in the neck, shoulder and lower back.