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Elebishehy A, Ahmed MM, Aldahmash B, Mohamed MA, Shetaia AA, Khalifa SAM, Eldaim MAA, El-Seedi HR, Yosri N. Cymbopogon schoenanthus (L) extract ameliorates high fat diet-induced obesity and dyslipidemia via reducing expression of lipogenic and thermogenic proteins. Fitoterapia 2024; 175:105897. [PMID: 38479618 DOI: 10.1016/j.fitote.2024.105897] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2023] [Revised: 03/08/2024] [Accepted: 03/08/2024] [Indexed: 03/18/2024]
Abstract
Globally, obesity has become one of the major health problems. This study was conducted to evaluate the anti-obesity potential of Cymbopogon schoenanthus methanolic extract (CS) in rats. Fifty male Wistar rats of six to eight weeks old, 100-120 g body weight (BW) were randomly assigned into 5 groups (n = 10): The control group was fed a basal diet. CS-group was supplied with basal diet and orally given CS (200 mg/kg BW) for 12 weeks. HFD-group was fed a high-fat diet (HFD) for 18 weeks. HFD + CS-group was fed on HFD and CS HFD then CS-group was fed HFD for 12 weeks then shifted to basal diet and CS for another 6 weeks. Phytochemical analysis of CS indicated the presence of various terpenes and flavonoid compounds. Among the compounds characterized are quercetin, apigenin, luteolin, orientin, eudesmene, cymbopogonol, caffeic acid, coumaric acid, and linolenic acid. Supplementation of HFD significantly increased the body weight, levels of serum triacylglycerol, total cholesterol, very low-density lipoprotein, low-density lipo-protein (HDL), glucose, serum alanine aminotransferase (ALT) and aspartate aminotransferase (AST) activities. In addition, HFD up-regulated the protein expression of uncoupling protein (UCP)-1 in both brown and white adipose tissue; and the expression of hepatic mRNA of sterol regulatory element-binding protein (SREBP)-1c and SREBP-2. However, it decreased the serum level of HDL, and protein expression level of UCP-1 in both brown and white adipose tissue. Treatment of HFD-fed animals with CS extract either concurrently (HFD + CS-group), or after obesity induction (HFD then CS-group) significantly reversed all HFD-induced alterations in body weight; food intake; serum biochemical profile (including hyperglycemia, dyslipidemia); and tissue gene expressions. These results indicate that CS methanolic extract ameliorated HFD-induced obesity, serum biochemical, hepatic, and adipose tissue gene expression alterations. CS extract accomplished these effects mostly through its various identified bioactive compounds which have been proven to have anti-obesity and anti-diabetic activities.
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Affiliation(s)
- Asmaa Elebishehy
- Department of Chemistry, Faculty of Science, Menoufia University, Shebin El-Kom 31100107, Egypt
| | - Mohamed M Ahmed
- Department of Biochemistry and Chemistry of Nutrition, Faculty of Veterinary Medicine, University of Sadat City, Sadat City 32897, Menoufia, Egypt.
| | - Badr Aldahmash
- Zoology Department, College of Science, King Saud University, Riyadh, Saudi Arabia
| | | | - Aya A Shetaia
- Department of Chemistry, Faculty of Science, Menoufia University, Shebin El-Kom 31100107, Egypt
| | - Shaden A M Khalifa
- International Research Center for Food Nutrition and Safety, Jiangsu University, Zhenjiang 212013, China; Psychiatry and Neurology Department, Capio Saint Göran's Hospital, Sankt Göransplan 1, 112 19 Stockholm, Sweden
| | - Mabrouk Attia Abd Eldaim
- Department of Biochemistry and Chemistry of Nutrition, Faculty of Veterinary Medicine, Menoufia University, Shebeen Elkom, Menoufia, Egypt
| | - Hesham R El-Seedi
- Department of Chemistry, Faculty of Science, Islamic University of Madinah, Madinah 42351, Saudi Arabia.
| | - Nermeen Yosri
- Chemistry Department of Medicinal and Aromatic plants, Research Institute of Medicinal and Aro-matic plants (RIMAP), Beni-Suef University, Beni-Suef 62514, Egypt; China Light Industry Key Laboratory of Food Intelligent Detection & Processing, School of Food and Biological Engineering, Jiangsu University, Zhenjiang 212013, China
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Li YP, Li WJ, Hsieh WC, Chen LS, Yu CW. Impact of maternal body mass index on outcomes of singleton pregnancies after assisted reproductive technology: a 14-year analysis of the US Nationwide Inpatient Sample. BMC Pregnancy Childbirth 2023; 23:291. [PMID: 37101131 PMCID: PMC10131305 DOI: 10.1186/s12884-023-05620-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2022] [Accepted: 04/17/2023] [Indexed: 04/28/2023] Open
Abstract
BACKGROUND Obesity is increasing globally, which affects multiple human functions, including reproductive health. Many women with overweight and obesity of child-bearing years are treated with assisted reproductive technology (ART). However, the clinical impact of body mass index (BMI) on pregnancy outcomes after ART remains to be determined. Therefore, this population-based retrospective cohort study aimed to assess whether and how higher BMI affects singleton pregnancy outcomes. METHODS This study used the large nationally representative database of the US National Inpatient Sample (NIS), extracting data of women with singleton pregnancies who had received ART from 2005 to 2018. Diagnostic codes of the International Classification of Diseases, Ninth and Tenth edition (ICD-9 and ICD-10) were used to identify females admitted to US hospitals with delivery-related discharge diagnoses or procedures and secondary diagnostic codes for ART, including in vitro fertilization. The included women were further categorized into three groups based on BMI values < 30, 30-39, and ≥ 40 kg/m2. Univariate and multivariable regression analysis were conducted to assess the associations between study variables and maternal and fetal outcomes. RESULTS Data of totally 17,048 women were included in the analysis, which represented a population of 84,851 women in the US. Number of women in the three BMI groups were 15, 878 (BMI < 30 kg/m2), 653 (BMI 30-39 kg/m2), and 517 (BMI ≥ 40 kg/m2), respectively. The multivariable regression analysis revealed that, compared to BMI < 30 kg/m2, BMI 30-39 kg/m2 was significantly associated with increased odds for pre-eclampsia and eclampsia (adjusted OR = 1.76, 95% CI = 1.35, 2.29), gestational diabetes (adjusted OR = 2.25, 95% CI = 1.70, 2.98), and Cesarean delivery (adjusted OR = 1.36, 95% CI = 1.15, 1.60). Further, BMI ≥ 40 kg/m2 was associated with greater odds for pre-eclampsia and eclampsia (adjusted OR = 2.25, 95% CI = 1.73, 2.94), gestational diabetes (adjusted OR = 3.64, 95% CI = 2.80, 4.72), disseminated intravascular coagulation (DIC) (adjusted OR = 3.79, 95% CI = 1.47, 9.78), Cesarean delivery (adjusted OR = 1.85, 95% CI = 1.54, 2.23), and hospital stay ≥ 6 days (adjusted OR = 1.60, 95% CI = 1.19, 2.14). However, higher BMI was not significantly associated with greater risk of the fetal outcomes assessed. CONCLUSIONS Among US pregnant women who received ART, having a higher BMI level independently increases the risk for adverse maternal outcomes such as pre-eclampsia and eclampsia, gestational diabetes, DIC, longer hospital stays, and higher rates of Cesarean delivery, while risk is not increased for fetal outcomes.
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Affiliation(s)
- Yi-Ping Li
- Department of Obstetrics and Gynecology, Shin Kong Wu Ho-Su Memorial Hospital, No. 95 Wen Chang Road, Shih-Lin District, Taipei, 111, Taiwan
- Department of Obstetrics and Gynecology, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan
- School of Medicine, Fu-Jen Catholic University, New Taipei City, Taiwan
| | - Wei-Jiun Li
- Department of Obstetrics and Gynecology, Shin Kong Wu Ho-Su Memorial Hospital, No. 95 Wen Chang Road, Shih-Lin District, Taipei, 111, Taiwan
| | - Wen-Chi Hsieh
- Department of Obstetrics and Gynecology, Shin Kong Wu Ho-Su Memorial Hospital, No. 95 Wen Chang Road, Shih-Lin District, Taipei, 111, Taiwan
| | - Li-Shan Chen
- Department of Obstetrics and Gynecology, Shin Kong Wu Ho-Su Memorial Hospital, No. 95 Wen Chang Road, Shih-Lin District, Taipei, 111, Taiwan
| | - Cheng-Wei Yu
- Department of Obstetrics and Gynecology, Shin Kong Wu Ho-Su Memorial Hospital, No. 95 Wen Chang Road, Shih-Lin District, Taipei, 111, Taiwan.
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Awareness of link between obesity and breast cancer risk is associated with willingness to participate in weight loss intervention. Breast Cancer Res Treat 2022; 194:541-550. [PMID: 35751715 PMCID: PMC9244160 DOI: 10.1007/s10549-022-06546-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2021] [Accepted: 02/17/2022] [Indexed: 11/02/2022]
Abstract
PURPOSE To assess knowledge of obesity-associated cancer risk, self-awareness of BMI status, and willingness to engage in weight loss intervention in breast cancer survivors with overweight and obesity as a companion study for a novel weight loss program using a telehealth platform (NCT04855552). METHODS Breast cancer survivors with BMI ≥ 25 kg/m2 were surveyed to assess self-perception of BMI, knowledge of obesity-related cancer risk, and willingness to participate in weight loss programs. Multivariable logistic regression was used to assess factors associated with willingness to participate. RESULTS Of the 122 participants, 73 (59.8%) had BMI 25.0-29.9 kg/m2 (overweight) and 49 (40.2%) had BMI ≥ 30 (obesity). Patients with obesity were more likely to underestimate their BMI than those with overweight, 40.8% vs. 23.3% (p = 0.03). The majority (82.0%) indicated awareness that obesity increases breast cancer risk and 57.4% expressed interest in a weight loss program. Patients with knowledge of obesity-related breast cancer risk (91.4% willing vs. 69.2% not willing, p < 0.01) were more willing to participate in a weight loss program on univariable and multivariable analyses (p < 0.01). CONCLUSION Our results underscore the importance of raising patients' awareness of obesity-related health risks and individual BMI category. Future work in the development of better education and communication tools to improve awareness will likely improve the adoption rate of healthy lifestyles in at-risk patients.
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Lee SM, Versace VL, Obamiro K. Public Awareness of Bowel Cancer Risk Factors, Symptoms and Screening in Tasmania, Australia: A Cross-Sectional Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19031497. [PMID: 35162541 PMCID: PMC8835398 DOI: 10.3390/ijerph19031497] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/30/2021] [Revised: 01/24/2022] [Accepted: 01/25/2022] [Indexed: 02/01/2023]
Abstract
Tasmania has one of the highest bowel cancer incidence and death rates in the world. Public awareness of risk factors, symptoms, and early detection of bowel cancer is important for minimising the burden of disease. This study measured awareness levels of bowel cancer risk factors, symptoms and screening in Tasmania. An online survey of 3703 participants aged 18 years and older found that alcohol consumption, low physical activity levels, and having diabetes were the least known risk factors for bowel cancer. Over half of all participants were unaware the risk of bowel cancer increased with age, and 53 percent were not confident they would notice a bowel cancer symptom. Over a third of survey respondents did not know that screening commenced at the age of 50. The results indicate that a targeted campaign to increase bowel cancer awareness in Tasmania may help reduce the high rates of morbidity and mortality from the disease.
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Affiliation(s)
- Simone M. Lee
- Centre for Rural Health, University of Tasmania, Newnham, TAS 7248, Australia;
- Correspondence:
| | - Vincent L. Versace
- Deakin Rural Health, Deakin University, Warrnambool, VIC 3280, Australia;
| | - Kehinde Obamiro
- Centre for Rural Health, University of Tasmania, Newnham, TAS 7248, Australia;
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Body mass index of women in Bangladesh: comparing Multiple Linear Regression and Quantile Regression. J Biosoc Sci 2020; 53:247-265. [DOI: 10.1017/s0021932020000176] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
AbstractThis study explored the association between socio-demographic factors and the body mass index (BMI) of women of reproductive age (15–49 years) in Bangladesh. Data from the 2014 Bangladesh Demographic and Health Survey (BDHS-14) were analysed using Multiple Linear Regression (MLR) and Quantile Regression (QR) analyses. The study sample comprised 15,636 non-pregnant women aged 15–49. The mean BMI of the women was 22.35±4.12 kg/m2. Over half (56.75%) had a BMI in the normal range (18<BMI<25 kg/m2), and 18.50%, 20.00% and 4.75% were underweight (BMI≤18 kg/m2), overweight (25≤BMI<30 kg/m2) and obese (BMI≥30 kg/m2), respectively. The results of the MLR found that age, wealth index, urban/rural place of residence, geographical division, womenʼs educational status, husbandʼs educational status, womenʼs working status and total number of children ever born were significantly (p<0.001) associated with respondents’ mean BMI. The QR results showed different associations between socio-demographic factors and mean BMI, as well as a different conditional distribution of mean BMI. Overall, the results indicated that women with uneducated husbands, with little or no education and from less-affluent households from rural areas tended to be more underweight compared with women in other groups. The inter-relationship between the study womenʼs mean BMI and associated socio-demographic factors was assessed using QR analysis to identify the most vulnerable cohorts of women in Bangladesh.
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Remmert JE, Convertino AD, Roberts SR, Godfrey KM, Butryn ML. Stigmatizing weight experiences in health care: Associations with BMI and eating behaviours. Obes Sci Pract 2019; 5:555-563. [PMID: 31890246 PMCID: PMC6934430 DOI: 10.1002/osp4.379] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2019] [Revised: 10/02/2019] [Accepted: 10/07/2019] [Indexed: 12/12/2022] Open
Abstract
INTRODUCTION Individuals with overweight or obesity often experience stigmatizing weight-related interactions in health care, though how these experiences are associated with body mass index (BMI) and eating behaviour is unknown. This study had three aims: (a) characterize types and frequency of stigmatizing health care experiences, (b) assess relationships among BMI, eating behaviour, and stigmatizing experiences, and (c) examine whether internalized weight stigma mediates the relationship between stigmatizing experiences, weight, and eating behaviour. METHODS Adults (N = 85) enrolled in behavioural weight loss completed measures of stigmatizing health care experiences, weight bias internalization, eating behaviours, and BMI. Cross-sectional correlational and mediational analyses were conducted. RESULTS The majority (70.6%) of participants reported at least one stigmatizing health care experience in the past year. Greater amounts of stigmatizing experiences were associated with higher BMI (r = 0.32, P < .01) and greater uncontrolled (r = 0.22, P = .04) and emotional eating (r = 0.28, P < .01). Internalized weight stigma significantly mediated the relationship between stigmatizing experiences and maladaptive eating. CONCLUSION Experiences of health care weight stigma were associated with eating behaviour and BMI. Participants with a higher BMI or greater maladaptive eating behaviours may be more susceptible to stigmatizing experiences. Reducing internalized weight stigma and health care provider stigma may improve patient health outcomes.
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Affiliation(s)
- Jocelyn E. Remmert
- Center for Weight, Eating, and Lifestyle Science (WELL Center), College of Arts and SciencesDrexel UniversityPhiladelphiaPennsylvania
| | - Alexandra D. Convertino
- San Diego Joint Doctoral Program in Clinical PsychologySan Diego State University/University of CaliforniaSan DiegoCalifornia
| | - Savannah R. Roberts
- Joint Doctoral Program in Clinical and Developmental PsychologyUniversity of PittsburghPittsburghPennsylvania
| | - Kathryn M. Godfrey
- Center for Weight, Eating, and Lifestyle Science (WELL Center), College of Arts and SciencesDrexel UniversityPhiladelphiaPennsylvania
| | - Meghan L. Butryn
- Center for Weight, Eating, and Lifestyle Science (WELL Center), College of Arts and SciencesDrexel UniversityPhiladelphiaPennsylvania
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Abstract
Many countries tightly ration access to publicly funded fertility treatments such as in vitro fertilisation (IVF). One basis for excluding people from access to IVF is their body mass index. In this paper, I consider a number of potential justifications for such a policy, based on claims about effectiveness and cost-efficiency, and reject these as unsupported by available evidence. I consider an alternative justification: that those whose subfertility results from avoidable behaviours for which they are responsible are less deserving of treatment. I ultimately stop short of endorsing or rejecting such a justification, though highlight some reasons for thinking it is unlikely to be practicable.
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Affiliation(s)
- Rebecca C H Brown
- Oxford Uehiro Centre for Practical Ethics, University of Oxford, Suite 8 Littlegate House, 16-17 St Ebbes Street, OX1 1PT, Oxford, UK.
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Holliday CP, Holliday NP, Mulekar M. Women's perceptions of body mass index. Clin Obes 2019; 9:e12286. [PMID: 30302944 DOI: 10.1111/cob.12286] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/07/2018] [Revised: 08/19/2018] [Accepted: 08/26/2018] [Indexed: 11/30/2022]
Abstract
Women may not have an accurate perception of their own body weight and vary in understanding about healthy weight. The study's aim was to assess women's accuracy of their own body mass index (BMI), understanding of the healthiest body weight and opinion of the most attractive body figure. We surveyed 385 women (age, 19-77 years) attending our obstetrics and gynaecology clinics with an anonymous survey demonstrating a selection of Body Image Scale graphics to represent their current body, the healthiest body and the most attractive body. There was a significant positive correlation between Body Image Scale graphic selected and BMI (r = 0.80; P < 0.0001). The selected Body Image Scale graphic was accurate or within 1 graphic higher or lower than BMI in 88% of participants. The mean BMI of women accurately selecting the appropriate graphic (BMI, 29 ± 8 kg m-2 ) was significantly lower than that of women selecting the graphic lower than their BMI (BMI, 37 ± 7 kg m-2 ) but was significantly higher than those selecting a graphic higher than their BMI (BMI, 25 ± 4 kg m-2 ). For healthiest figure, 58% women selected a graphic representing overweight BMI and 2% women selected a graphic with Class 1 obesity. For most attractive figure, 48% women selected a graphic representing normal BMI, 49% women selected a graphic representing overweight BMI and 1% of women selected a graphic with Class 1 obesity. It is important to provide counselling about ideal weight, healthy lifestyle choices and consequences of obesity.
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Affiliation(s)
- C P Holliday
- Department of Obstetrics and Gynecology, University of South Alabama, Mobile, Alabama, United States
| | - N P Holliday
- Department of Obstetrics and Gynecology, University of South Alabama, Mobile, Alabama, United States
| | - M Mulekar
- Department of Mathematics and Statistics, University of South Alabama, Mobile, Alabama, United States
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Haggerty AF, Sarwer DB, Schmitz KH, Ko EM, Allison KC, Chu CS. Obesity and Endometrial Cancer: A Lack of Knowledge but Opportunity for Intervention. Nutr Cancer 2017; 69:990-995. [PMID: 28937804 PMCID: PMC6103650 DOI: 10.1080/01635581.2017.1359313] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
OBJECTIVE The causal link between obesity and endometrial cancer is well established; however obese women's knowledge of this relationship is unknown. Our objective was to explore patients' understanding of this relationship and assess the acceptability of a technology-based weight loss intervention. METHODS/MATERIALS Obese women with Type I endometrial cancer/hyperplasia were surveyed about their assessment of their body mass, knowledge of the relationship of obesity and endometrial cancer, and eating and activity habits. Interest in participation in an intervention also was assessed. RESULTS Eighty-one women with early stage (71.6% stage I) and grade (41.7% grade 1) disease completed the survey. The median BMI was 35.4 kg/m2 (IQR 32.2-43.5 kg/m2) and the average age was 59.3 (SD 11.1) yr. 76.25% of women were unable to categorize their BMI correctly and 86.9% of those incorrectly underestimated their BMI category. One-third (35.9%) were unaware of any association between obesity and endometrial cancer and 33.3% responded that obesity decreased or did not significantly increase the risk of endometrial cancer. 59% expressed interest in a weight loss intervention. CONCLUSIONS Endometrial cancer survivors with obesity underestimated their obesity and lacked knowledge regarding the link between obesity and endometrial cancer. However, the majority expressed interest in electronically delivered weight loss interventions.
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Affiliation(s)
- Ashley F. Haggerty
- Division of Gynecologic Oncology, University of Pennsylvania, 3400 Civic Center Blvd, Philadelphia, PA 19104
| | - David B. Sarwer
- College of Public Health, Temple University, 1101 W. Montgomery Avenue, Philadelphia PA, 19122
| | - Kathryn H. Schmitz
- Department of Public Health Sciences, Penn State College of Medicine, 500 University Drive Hershey, PA 17033
| | - Emily M. Ko
- Division of Gynecologic Oncology, University of Pennsylvania, 3400 Civic Center Blvd, Philadelphia, PA 19104
| | - Kelly C. Allison
- Department of Psychiatry, Center for Weight and Eating Disorders, 3535 Market St., Suite 3021, Philadelphia, PA 19104
| | - Christina S. Chu
- Division of Gynecology, Department of Surgical Oncology, Fox Chase Cancer Center, 333 Cottman Ave, Philadelphia, PA 19111
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Bodnar LM, Pugh SJ, Lash TL, Hutcheon JA, Himes KP, Parisi SM, Abrams B. Low Gestational Weight Gain and Risk of Adverse Perinatal Outcomes in Obese and Severely Obese Women. Epidemiology 2016; 27:894-902. [PMID: 27682365 PMCID: PMC5117438 DOI: 10.1097/ede.0000000000000535] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Our objective was to estimate associations between gestational weight gain z scores and preterm birth, neonatal intensive care unit admission, large- and small-for-gestational age birth, and cesarean delivery among grades 1, 2, and 3 obese women. METHODS We included singleton infants born in Pennsylvania (2003-2011) to grade 1 (body mass index 30-34.9 kg/m, n = 148,335), grade 2 (35-39.9 kg/m, n = 72,032), or grade 3 (≥40 kg/m, n = 47,494) obese mothers. Total pregnancy weight gain (kg) was converted to gestational age-standardized z scores. Multivariable Poisson regression models stratified by obesity grade were used to estimate associations between z scores and outcomes. A probabilistic bias analysis, informed by an internal validation study, evaluated the impact of body mass index and weight gain misclassification. RESULTS Risks of adverse outcomes did not substantially vary within the range of z scores equivalent to 40-week weight gains of -4.3 to 9 kg for grade 1 obese, -8.2 to 5.6 kg for grade 2 obese, and -12 to -2.3 kg for grade 3 obese women. As gestational weight gain increased beyond these z score ranges, there were slight declines in risk of small-for-gestational age birth but rapid rises in cesarean delivery and large-for-gestational age birth. Risks of preterm birth and neonatal intensive care unit admission were weakly associated with weight gain. The bias analysis supported the validity of the conventional analysis. CONCLUSIONS Gestational weight gain below national recommendations for obese mothers (5-9 kg) may not be adversely associated with fetal growth, gestational age at delivery, or mode of delivery.
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Affiliation(s)
- Lisa M. Bodnar
- Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA
- Department of Obstetrics, Gynecology, and Reproductive Sciences, School of Medicine, University of Pittsburgh, Pittsburgh, PA
- Magee-Womens Research Institute, Pittsburgh, PA
| | - Sarah J. Pugh
- Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA
| | - Timothy L. Lash
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA
| | - Jennifer A. Hutcheon
- Department of Obstetrics and Gynaecology, University of British Columbia, Vancouver, British Columbia, Canada
| | - Katherine P. Himes
- Department of Obstetrics, Gynecology, and Reproductive Sciences, School of Medicine, University of Pittsburgh, Pittsburgh, PA
- Magee-Womens Research Institute, Pittsburgh, PA
| | - Sara M. Parisi
- Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA
| | - Barbara Abrams
- Division of Epidemiology, University of California at Berkeley School of Public Health, Berkeley, CA
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Cardozo ER, Karmon AE, Gold J, Petrozza JC, Styer AK. Reproductive outcomes in oocyte donation cycles are associated with donor BMI. Hum Reprod 2015; 31:385-92. [PMID: 26677960 DOI: 10.1093/humrep/dev298] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2015] [Accepted: 11/06/2015] [Indexed: 12/13/2022] Open
Abstract
STUDY QUESTION When adjusting for recipient BMI, is donor body mass index (BMI) associated with IVF outcomes in donor oocyte IVF cycles? SUMMARY ANSWER Increasing oocyte donor BMI is associated with a reduction in clinical pregnancy and live birth rates. WHAT IS KNOWN ALREADY Increased BMI has been associated with suboptimal reproductive outcomes, particularly in assisted reproductive technology (ART) cycles. However, it remains unclear if this association implies an effect of BMI on oocyte quality and/or endometrial receptivity. STUDY DESIGN, SIZE, DURATION A retrospective cohort study of two hundred and thirty five consecutive fresh donor oocyte IVF cycles from 1 January 2007 through 31 December 2013 at the Massachusetts General Hospital (MGH) Fertility Center. PARTICIPANTS/MATERIALS, SETTING, METHODS Analyses included a total of 202 oocyte donors and 235 total cycles. Following adjustments for recipient BMI, the relationship between donor BMI (categorized into quartiles) and IVF outcomes was assessed. MAIN RESULTS AND THE ROLE OF CHANCE In the entire (anonymous and known) donor population, a reduced odds of clinical pregnancy (P-trend = 0.046) and live birth (P-trend = 0.06) was observed with increasing BMI quartile. Compared with quartile 1 (BMI 17.8-21.1), odds ratio (OR) (95% CI) of clinical pregnancy was 0.9 (0.4-2.0), 0.5 (0.2-1.1) and 0.5 (0.2-1.1), and OR of live birth was 1.1 (0.5-2.6), 0.6 (0.3-1.2) and 0.6 (0.3-1.2) for quartiles 2 through 4 respectively. In anonymous donors only, the odds of clinical pregnancy (P-trend = 0.02) and live birth (P-trend = 0.03) also declined as BMI quartile increased. Compared with quartile 1 (BMI 17.8-21.1), odds ratio (OR) (95% CI) of clinical pregnancy was 0.7 (0.3-1.7), 0.5 (0.2-1.1) and 0.4 (0.1-0.9), and OR of live birth was 0.9 (0.4-2.2), 0.5 (0.3-1.2) and 0.4 (0.2-1.1) for quartiles 2 through 4 respectively. LIMITATIONS, REASONS FOR CAUTION Limitations include the retrospective design, sample size and data from a single institution. Clinical application may not be limited to oocyte donors, though caution should be used prior to applying these principles to the general population. Data should not be interpreted to mean that all oocyte donors should be restricted to a BMI of less than 21.2 kg/m(2). WIDER IMPLICATIONS OF THE FINDINGS Following adjustments for the respective BMI of the oocyte donor and recipient, this study demonstrates an association of preconception BMI with subsequent IVF outcomes. The observations of this study are consistent with prior animal studies, suggest a possible effect of BMI at the oocyte level prior to fertilization and implantation, and warrant further investigation. STUDY FUNDING/COMPETING INTERESTS None.
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Affiliation(s)
- E R Cardozo
- Vincent Reproductive Medicine and IVF, Vincent Department of Obstetrics and Gynecology, Massachusetts General Hospital, Boston, MA 02114, USA Department of Obstetrics, Gynecology, and Reproductive Biology, Harvard Medical School, Boston, MA 02115, USA Present address: Vincent Reproductive Medicine and IVF, Vincent Department of Obstetrics and Gynecology, Massachusetts General Hospital, Yawkey 10A, 55 Fruit Street, Boston, MA 02114, USA
| | - A E Karmon
- Vincent Reproductive Medicine and IVF, Vincent Department of Obstetrics and Gynecology, Massachusetts General Hospital, Boston, MA 02114, USA Department of Obstetrics, Gynecology, and Reproductive Biology, Harvard Medical School, Boston, MA 02115, USA Present address: Vincent Reproductive Medicine and IVF, Vincent Department of Obstetrics and Gynecology, Massachusetts General Hospital, Yawkey 10A, 55 Fruit Street, Boston, MA 02114, USA
| | - J Gold
- Vincent Reproductive Medicine and IVF, Vincent Department of Obstetrics and Gynecology, Massachusetts General Hospital, Boston, MA 02114, USA Present address: Vincent Reproductive Medicine and IVF, Vincent Department of Obstetrics and Gynecology, Massachusetts General Hospital, Yawkey 10A, 55 Fruit Street, Boston, MA 02114, USA
| | - J C Petrozza
- Vincent Reproductive Medicine and IVF, Vincent Department of Obstetrics and Gynecology, Massachusetts General Hospital, Boston, MA 02114, USA Department of Obstetrics, Gynecology, and Reproductive Biology, Harvard Medical School, Boston, MA 02115, USA Present address: Vincent Reproductive Medicine and IVF, Vincent Department of Obstetrics and Gynecology, Massachusetts General Hospital, Yawkey 10A, 55 Fruit Street, Boston, MA 02114, USA
| | - A K Styer
- Vincent Reproductive Medicine and IVF, Vincent Department of Obstetrics and Gynecology, Massachusetts General Hospital, Boston, MA 02114, USA Department of Obstetrics, Gynecology, and Reproductive Biology, Harvard Medical School, Boston, MA 02115, USA Present address: Vincent Reproductive Medicine and IVF, Vincent Department of Obstetrics and Gynecology, Massachusetts General Hospital, Yawkey 10A, 55 Fruit Street, Boston, MA 02114, USA
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12
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Case AP, Hoyt AT, Canfield MA, Wilkinson AV. Periconceptional Risk Factors for Birth Defects among Younger and Older Teen Mothers. J Pediatr Adolesc Gynecol 2015; 28:263-70. [PMID: 26049938 DOI: 10.1016/j.jpag.2014.09.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2013] [Revised: 08/27/2014] [Accepted: 09/02/2014] [Indexed: 11/26/2022]
Abstract
STUDY OBJECTIVES We sought to determine whether selected periconceptional health behaviors that influence risk for birth defects differ between older and younger adolescents and whether pregnancy intention predicts more positive preconception health behaviors among teens. DESIGN AND PARTICIPANTS We analyzed interview responses from 954 adolescent control group participants from the National Birth Defects Prevention Study who delivered live infants during 1997-2007. MAIN OUTCOME MEASURES Adjusted odds ratios (aORs) and 95% confidence intervals (CIs) were calculated for factors of interest by age categories (13-15, 16-17, and 18 years, relative to 19 years). To construct a composite periconceptional behavior index, we summed the following healthy behaviors: nonsmoker, nondrinker, folic acid supplementation, and eating 5 or more servings of fruits and vegetables per day. RESULTS Analyses indicated that women in the youngest group (13-15 years of age) were more likely to be Hispanic (aOR 2.83, 95% CI 1.40-5.70) and less likely to engage in some unhealthy pregnancy-related behaviors compared with 19-year-olds, such as smoking (aOR 0.45, 95% CI 0.20-0.99) and being overweight or obese (aOR 0.32, 95% CI 0.16-0.61). However, they were also less likely to have taken periconceptional folic acid (aOR 0.44, 95% CI 0.21-0.90). About one-third of teen mothers indicated that their pregnancies had been intended. Among 18- and 19-year-olds, this predicted a higher mean value for the composite periconceptional behavior index (2.30 versus 1.94, P ≤ .01). CONCLUSIONS Teen mothers are not a homogeneous group. Each age subgroup presents varied demographic and behavioral factors that put them at varying levels of risk for birth defects. Furthermore, caregivers should not assume that teens do not plan pregnancies or that they need not be informed of the importance of periconceptional health.
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Affiliation(s)
- Amy P Case
- Texas Department of State Health Services, Austin, TX.
| | | | | | - Anna V Wilkinson
- The University of Texas School of Public Health, Austin Regional Campus & Michael and Susan Dell Center for Healthy Living, Austin, TX
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Beavis AL, Cheema S, Holschneider CH, Duffy EL, Amneus MW. Almost half of women with endometrial cancer or hyperplasia do not know that obesity affects their cancer risk. Gynecol Oncol Rep 2015; 13:71-5. [PMID: 26425728 PMCID: PMC4563798 DOI: 10.1016/j.gore.2015.07.002] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2015] [Revised: 07/02/2015] [Accepted: 07/06/2015] [Indexed: 11/06/2022] Open
Abstract
•A group of low income, largely Hispanic women demonstrated poor knowledge of the adverse reproductive effects of obesity. •53.5% of endometrial cancer/hyperplasia patients identified obesity as a risk factor for endometrial cancer. •32% of control patients identified obesity as a risk factor for endometrial cancer. •Physician discussion of overweight/obese diagnosis was predictive of this knowledge.
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Affiliation(s)
- Anna L. Beavis
- Department of Obstetrics and Gynecology, Olive View-UCLA Medical Center, 14445 Olive View Dr., Sylmar, CA 91342, United States
- Department of Obstetrics and Gynecology, David Geffen School of Medicine at UCLA, 10833 Le Conte Avenue, Room 951740, Los Angeles, CA 90095, United States
| | - Simrin Cheema
- Department of Obstetrics and Gynecology, Olive View-UCLA Medical Center, 14445 Olive View Dr., Sylmar, CA 91342, United States
| | - Christine H. Holschneider
- Department of Obstetrics and Gynecology, Olive View-UCLA Medical Center, 14445 Olive View Dr., Sylmar, CA 91342, United States
- Department of Obstetrics and Gynecology, David Geffen School of Medicine at UCLA, 10833 Le Conte Avenue, Room 951740, Los Angeles, CA 90095, United States
| | - Erin L. Duffy
- Department of Medicine Statistics Core, David Geffen School of Medicine at UCLA, 911 Broxton Ave., Los Angeles, CA 90024, United States
| | - Malaika W. Amneus
- Department of Obstetrics and Gynecology, Olive View-UCLA Medical Center, 14445 Olive View Dr., Sylmar, CA 91342, United States
- Department of Obstetrics and Gynecology, David Geffen School of Medicine at UCLA, 10833 Le Conte Avenue, Room 951740, Los Angeles, CA 90095, United States
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