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Bear AP, Bennett WL, Katz J, Lee KH, Chowdhury AI, Bari S, El Arifeen S, Gurley ES. Associations of hypertension and antenatal care-seeking with perinatal mortality: A nested case-control study in rural Bangladesh. PLoS One 2024; 19:e0287622. [PMID: 39037995 PMCID: PMC11262631 DOI: 10.1371/journal.pone.0287622] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2023] [Accepted: 07/08/2024] [Indexed: 07/24/2024] Open
Abstract
Maternal hypertension may be an underrecognized but important risk factor for perinatal death in low resource settings. We investigated the association of maternal hypertension and perinatal mortality in rural Bangladesh. This nested, matched case-control study used data from a 2019 cross-sectional survey and demographic surveillance database in Baliakandi, Bangladesh. We randomly matched each pregnancy ending in perinatal death with five pregnancies in which the neonate survived beyond seven days based on maternal age, education, and wealth quintile. We estimated associations of antenatal care-seeking and self-reported hypertension with perinatal mortality using conditional logistic regression and used median and interquartile ranges to assess the mediation of antenatal care by timing or frequency. Among 191 cases and 934 matched controls, hypertension prevalence was 14.1% among cases and 7.7% among controls. Compared with no diagnosis, the probability of perinatal death was significantly higher among women with a pre-gestational hypertension diagnosis (OR 2.90, 95% CI 1.29, 6.57), but not among women with diagnosis during pregnancy (OR 1.68, 95% CI 0.98, 2.98). We found no association between the number of antenatal care contacts and perinatal death (p = 0.66). Among women with pre-gestational hypertension who experienced a perinatal death, 78% had their first antenatal contact in the sixth or seventh month of gestation. Hypertension was more common among rural women who experience a perinatal death. Greater effort to prevent hypertension prior to conception and provide early maternity care to women with hypertension could improve perinatal outcomes in rural Bangladesh.
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Affiliation(s)
- Allyson P. Bear
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United Stated of America
| | - Wendy L. Bennett
- Division of General Internal Medicine, Department of Medicine, Johns Hopkins School of Medicine, Baltimore, Maryland, United Stated of America
| | - Joanne Katz
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United Stated of America
| | - Kyu Han Lee
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United Stated of America
| | - Atique Iqbal Chowdhury
- Division of Maternal and Child Health, International Centre for Diarrheal Disease Research, Bangladesh, Dhaka, Bangladesh
| | - Sanwarul Bari
- Division of Maternal and Child Health, International Centre for Diarrheal Disease Research, Bangladesh, Dhaka, Bangladesh
| | - Shams El Arifeen
- Division of Maternal and Child Health, International Centre for Diarrheal Disease Research, Bangladesh, Dhaka, Bangladesh
| | - Emily S. Gurley
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United Stated of America
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Hong E, Kang Y. Lifestyle Factors Influencing Metabolic Syndrome after Adjusting for Socioeconomic Status and Female Reproductive Health Indicators: A National Representative Survey in Korean Pre- and Postmenopausal Women. Healthcare (Basel) 2024; 12:821. [PMID: 38667583 PMCID: PMC11050311 DOI: 10.3390/healthcare12080821] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2024] [Revised: 04/07/2024] [Accepted: 04/09/2024] [Indexed: 04/28/2024] Open
Abstract
Metabolic syndrome (MetS) is increasing markedly among postmenopausal women. Although studies suggest multiple risk factors for its development, few have investigated changes in socioeconomic status (SES), female reproductive health indicators (menarche age, experience of pregnancy, delivery, breastfeeding, and postmenopausal status), and lifestyle factors. This study investigated lifestyle factors affecting MetS prevalence among pre- and post-menopausal women after adjusting for SES and female reproductive health indicators. Data from the Korea National Health and Nutrition Examination Survey VII (2016-2018) on 2856 pre- and postmenopausal women aged 40-59 years were analyzed. Differences in SES (e.g., age, education, and household income), female reproductive health indicators (e.g., age of menarche and menopause), and lifestyle (e.g., total calorie intake, fats, and proteins, percentage of energy from carbohydrates, fats, and proteins, smoking, physical activity, and obesity) between MetS and non-MetS groups were calculated by performing χ2 or t-tests. Consequently, current smoking, physical inactivity, overweight, and obesity were significantly associated with increased MetS after adjusting for SES and female reproductive health indicators using logistic regression analysis. Hence, health policies and programs focusing on modifiable MetS risk factors-encouraging healthy eating habits, smoking cessation, and regular exercise-must be formulated to prevent the development of MetS in pre- and postmenopausal women.
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Affiliation(s)
- Eunyoung Hong
- Sustainable Health Research Institute, College of Nursing, Gyeongsang National University, Jinju 52828, Republic of Korea;
| | - Youngmi Kang
- East-West Nursing Research Institute, College of Nursing Science, Kyung Hee University, Seoul 02447, Republic of Korea
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Lee JS, Choi ES, Lee H, Son S, Lee KS, Ahn KH. Machine learning analysis for the association between breast feeding and metabolic syndrome in women. Sci Rep 2024; 14:4138. [PMID: 38374105 PMCID: PMC10876622 DOI: 10.1038/s41598-024-53137-6] [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: 03/07/2023] [Accepted: 01/29/2024] [Indexed: 02/21/2024] Open
Abstract
This cross-sectional study aimed to develop and validate population-based machine learning models for examining the association between breastfeeding and metabolic syndrome in women. The artificial neural network, the decision tree, logistic regression, the Naïve Bayes, the random forest and the support vector machine were developed and validated to predict metabolic syndrome in women. Data came from 30,204 women, who aged 20 years or more and participated in the Korean National Health and Nutrition Examination Surveys 2010-2019. The dependent variable was metabolic syndrome. The 86 independent variables included demographic/socioeconomic determinants, cardiovascular disease, breastfeeding duration and other medical/obstetric information. The random forest had the best performance in terms of the area under the receiver-operating-characteristic curve, e.g., 90.7%. According to random forest variable importance, the top predictors of metabolic syndrome included body mass index (0.1032), medication for hypertension (0.0552), hypertension (0.0499), cardiovascular disease (0.0453), age (0.0437) and breastfeeding duration (0.0191). Breastfeeding duration is a major predictor of metabolic syndrome for women together with body mass index, diagnosis and medication for hypertension, cardiovascular disease and age.
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Affiliation(s)
- Jue Seong Lee
- Department of Pediatrics, Korea University College of Medicine, Korea University Anam Hospital, Seoul, South Korea
| | - Eun-Saem Choi
- Department of Obstetrics and Gynecology, Korea University College of Medicine, Korea University Anam Hospital, 73 Goryeodae-ro, Seongbuk-gu, Seoul, 02841, South Korea
| | - Hwasun Lee
- Department of Biostatistics, Korea University College of Medicine, Seoul, South Korea
| | - Serhim Son
- Department of Biostatistics, Korea University College of Medicine, Seoul, South Korea
| | - Kwang-Sig Lee
- AI Center, Korea University College of Medicine, Korea University Anam Hospital, 73 Goryeodae-ro, Seongbuk-gu, Seoul, 02841, South Korea.
| | - Ki Hoon Ahn
- Department of Obstetrics and Gynecology, Korea University College of Medicine, Korea University Anam Hospital, 73 Goryeodae-ro, Seongbuk-gu, Seoul, 02841, South Korea.
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Musa IR, Osman OE, Adam I. The association between parity and hypertension: a cross-sectional, community-based study. Front Cardiovasc Med 2023; 10:1247244. [PMID: 37937292 PMCID: PMC10626486 DOI: 10.3389/fcvm.2023.1247244] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2023] [Accepted: 10/13/2023] [Indexed: 11/09/2023] Open
Abstract
Background The available data on the association between parity and hypertension are inconclusive. This study was conducted to investigate the prevalence of hypertension and its association with parity among adult Sudanese women. Methods A multi-stage sampling survey was conducted in four villages in the River Nile State in Sudan between July and September 2022. The World Health Organization's three-level stepwise questionnaire was used to gather the participants' sociodemographic characteristics (age, sex, marital status, parity, educational level, occupation, obstetric history, family history of hypertension, weight and height). Regression analyses were performed. Results A total of 408 women were recruited. The median [measured in terms of interquartile range (IQR)] age was 45.0 years (33.0-55.7 years). A linear regression analysis revealed a significant association between parity and diastolic blood pressure (coefficient, 0.60; P = 0.011). The prevalence of hypertension (55.9%) increased with parity and ranged from 43.7% to 74.9%. In the multivariate analyses, increasing age (adjusted odds ratio [AOR], 1.03; 95% confidence interval [CI], 1.02-1.05), increasing parity (AOR, 1.09; 95% CI, 1.01-1.19), family history of hypertension (AOR, 1.79; 95% CI, 1.15-2.77), and increasing body mass index (AOR, 1.09; 95% CI, 1.05-1.13) were associated with hypertension. In women of ages ≥ 50 years, increasing parity was significantly associated with hypertension (AOR, 1.15; 95% CI, 1.2-1.29). Para > 5 (AOR, 2.73; 95% CI, 1.11-6.73) was associated with hypertension. Conclusion A high prevalence of hypertension was found among Sudanese women, and that parity at 5 or more is linked to hypertension.
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Affiliation(s)
- Imad R. Musa
- Department of Medicine, Royal Commission Hospital at AL Jubail Industrial City, Al Jubail, Saudi Arabia
| | - Osman E. Osman
- Faculty of Medicine, Alneelain University, Khartoum, Sudan
| | - Ishag Adam
- Department of Obstetrics and Gynecology, Unaizah College of Medicine and Medical Sciences, Qassim University, Unaizah, Saudi Arabia
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Bear AP, Bennett WL, Katz J, Lee KH, Chowdhury AI, Bari S, El Arifeen S, Gurley ES. Self-reported diabetes or hypertension diagnoses and antenatal care among child-bearing women in rural Bangladesh: A cross-sectional study. PLOS GLOBAL PUBLIC HEALTH 2023; 3:e0002175. [PMID: 37708098 PMCID: PMC10501644 DOI: 10.1371/journal.pgph.0002175] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/02/2022] [Accepted: 08/08/2023] [Indexed: 09/16/2023]
Abstract
Health care systems in low- and middle-income countries may not meet the needs of pregnant women where the burden of diabetes and hypertension is rapidly increasing. We asked recently pregnant women about ever having been screened for or diagnosed with hypertension or diabetes and their ANC-seeking experiences in a cross-sectional survey. We used chi-squared tests and logistic regression to test the associations between self-reported coverage of hypertension and diabetes screening, diagnoses, and elements of ANC by age, wealth, educational attainment, and gravidity. Among 4,692 respondents, for hypertension, 97% reported having been screened and 10% of screened women reported a diagnosis. Women 30-39 years of age (aOR 3.02, 95% CI 2.00, 4.56) or in the top wealth quintile (aOR 1.70, 95% CI 1.18, 2.44) were more likely to be diagnosed with hypertension compared to reference groups. Any hypertension diagnosis was associated with reporting four or more antenatal care contacts (44% vs. 35%, p < 0.01), blood pressure measurements (85% vs. 79%, p < 0.01), and urine tests (71% vs. 61%, p < 0.01) conducted during ANC visits. For diabetes, 46% of respondents reported having been screened and 3% of screened women reported a diagnosis. Women 30-39 years of age were more likely to be diagnosed with diabetes (aOR 8.19, 95% CI 1.74, 38.48) compared to the reference group. Any diabetes diagnosis was associated with reporting four or more ANC contacts (48% vs. 36%, p = 0.04) and having blood testing during pregnancy (83% vs. 66%, p < 0.01). However, the frequency and quality of ANC was below the national guidelines among all groups. Focused efforts to ensure that women receive the recommended number of ANC contacts, coupled with improved compliance with ANC guidelines, would improve awareness of hypertension and diabetes among women in Bangladesh.
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Affiliation(s)
- Allyson P. Bear
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States of America
| | - Wendy L. Bennett
- Department of Medicine, Division of General Internal Medicine, Johns Hopkins School of Medicine, Baltimore, Maryland, United States of America
| | - Joanne Katz
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States of America
| | - Kyu Han Lee
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States of America
| | - Atique Iqbal Chowdhury
- Division of Maternal and Child Health, International Centre for Diarrheal Disease Research, Bangladesh, Dhaka, Bangladesh
| | - Sanwarul Bari
- Division of Maternal and Child Health, International Centre for Diarrheal Disease Research, Bangladesh, Dhaka, Bangladesh
| | - Shams El Arifeen
- Division of Maternal and Child Health, International Centre for Diarrheal Disease Research, Bangladesh, Dhaka, Bangladesh
| | - Emily S. Gurley
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States of America
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Ou YJ, Lee JI, Huang SP, Chen SC, Geng JH, Su CH. Association between Menopause, Postmenopausal Hormone Therapy and Metabolic Syndrome. J Clin Med 2023; 12:4435. [PMID: 37445470 DOI: 10.3390/jcm12134435] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2023] [Revised: 06/17/2023] [Accepted: 06/26/2023] [Indexed: 07/15/2023] Open
Abstract
(1) Background: We aimed to explore the associations between menopause, postmenopausal hormone therapy, and metabolic syndrome in a large community-based group of Asian women. (2) Methods: This is a cross-sectional study in which we enrolled women aged 30 to 70 years with sufficient information about menopausal status from the Taiwan Biobank. The definition for metabolic syndrome used in this study aligns with the Bureau of Health Promotion's (Taiwan) proposed definition. (3) Results: A total of 17,460 women were recruited. The postmenopausal group had a higher metabolic syndrome prevalence (30% vs. 14%) and 1.17 times higher odds ratio (OR) than the premenopausal group (95% confidence interval [CI] = 1.02 to 1.33). Regarding the types of menopause, surgical menopause was associated with metabolic syndrome (OR = 1.40; 95% CI = 1.20 to 1.63); however, natural menopause was not associated with metabolic syndrome. Interestingly, postmenopausal hormone therapy was associated with a lower risk of metabolic syndrome in the women with natural menopause (OR = 0.79; 95% CI = 0.70 to 0.89), but not in those with surgical menopause. (4) Conclusions: Our results suggest that menopause is associated with an increased prevalence of metabolic syndrome, while postmenopausal hormone therapy is associated with a lower prevalence of metabolic syndrome in women with natural menopause.
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Affiliation(s)
- Ying-Ju Ou
- Department of Pharmacy, Kaohsiung Medical University Hospital, Kaohsiung 80756, Taiwan
- Department of Pharmacology, Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 80756, Taiwan
| | - Jia-In Lee
- Department of Psychiatry, Kaohsiung Medical University Hospital, Kaohsiung 80756, Taiwan
| | - Shu-Pin Huang
- Department of Urology, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung 80756, Taiwan
- Graduate Institute of Clinical Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 80756, Taiwan
| | - Szu-Chia Chen
- Department of Internal Medicine, Kaohsiung Municipal Siaogang Hospital, Kaohsiung Medical University, Kaohsiung 81267, Taiwan
- Department of Internal Medicine, Division of Nephrology, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung 80756, Taiwan
- Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 80756, Taiwan
- Research Center for Environmental Medicine, Kaohsiung Medical University, Kaohsiung 80756, Taiwan
| | - Jiun-Hung Geng
- Department of Urology, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung 80756, Taiwan
- Graduate Institute of Clinical Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 80756, Taiwan
- Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 80756, Taiwan
- Research Center for Environmental Medicine, Kaohsiung Medical University, Kaohsiung 80756, Taiwan
- Department of Urology, Kaohsiung Municipal Siaogang Hospital, Kaohsiung Medical University, Kaohsiung 81267, Taiwan
| | - Chia-Hung Su
- Department of Surgery, Kaohsiung Municipal Siaogang Hospital, Kaohsiung 81267, Taiwan
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Li J, Chongpison Y, Amornvit J, Chaikittisilpa S, Santibenchakul S, Jaisamrarn U. Association of reproductive factors and exogenous hormone use with distal sensory polyneuropathy among postmenopausal women in the United States: results from 1999 to 2004 NHANES. Sci Rep 2023; 13:9274. [PMID: 37286578 DOI: 10.1038/s41598-023-35934-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2022] [Accepted: 05/25/2023] [Indexed: 06/09/2023] Open
Abstract
Postmenopausal status is a risk factor for distal sensory polyneuropathy-the most common type of peripheral neuropathy. We aimed to investigate associations between reproductive factors and history of exogenous hormone use with distal sensory polyneuropathy among postmenopausal women in the United States using data from the National Health and Nutrition Examination Survey 1999-2004, and to explore the modifying effects of ethnicity on these associations. We conducted a cross-sectional study among postmenopausal women aged ≥ 40 years. Women with a history of diabetes, stroke, cancer, cardiovascular disease, thyroid disease, liver disease, weak or failing kidneys, or amputation were excluded. Distal sensory polyneuropathy was measured using a 10-g monofilament test, and a questionnaire was used to collect data on reproductive history. Multivariable survey logistic regression was used to test the association between reproductive history variables and distal sensory polyneuropathy. In total, 1144 postmenopausal women aged ≥ 40 years were included. The adjusted odds ratios were 8.13 [95% confidence interval (CI) 1.24-53.28] and 3.18 (95% CI 1.32-7.68) for age at menarche < 11 years and time since menopause > 20 years, respectively, which were positively associated with distal sensory polyneuropathy; adjusted odds ratios were 0.45 for the history of breastfeeding (95% CI 0.21-0.99) and 0.41 for exogenous hormone use (95% CI 0.19-0.87) were negatively associated. Subgroup analysis revealed ethnicity-based heterogeneity in these associations. Age at menarche, time since menopause, breastfeeding, and exogenous hormone use were associated with distal sensory polyneuropathy. Ethnicity significantly modified these associations.
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Affiliation(s)
- Jiayu Li
- Department of Obstetrics and Gynecology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - Yuda Chongpison
- Center of Excellence in Biostatistics, Research Affairs, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.
- The Skin and Allergy Research Unit, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.
| | - Jakkrit Amornvit
- Division of Neurology, Department of Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
- King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok, Thailand
| | - Sukanya Chaikittisilpa
- Menopause Research Group, Department of Obstetrics and Gynecology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - Somsook Santibenchakul
- Family Planning and Reproductive Health Unit, Department of Obstetrics and Gynecology, Faculty of Medicine, Chulalongkorn University, Rama 4 Road, Bangkok, 10330, Thailand.
| | - Unnop Jaisamrarn
- Department of Obstetrics and Gynecology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
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Faramarzi E, Somi MH, Tutunchi H, Almaspour H, Sanaie S, Asemani S. The association of parity number with multimorbidity and polypharmacy among Iranian women in the Azarcohort: a cross-sectional study. BMC Womens Health 2023; 23:295. [PMID: 37264361 DOI: 10.1186/s12905-023-02434-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2022] [Accepted: 05/13/2023] [Indexed: 06/03/2023] Open
Abstract
OBJECTIVE We aimed to study the association of parity number with multimorbidity (MM) and polypharmacy among women in the Azar cohort population. PATIENTS & METHODS This cross-sectional investigation was based on data from the Azar Cohort Study. Information regarding demographics, personal habits, physical activity level, medical and reproductive history, and anthropometric measurements of 8,290 females (35-70 years) were evaluated. Ordinal logistic and logistic regression analyses were conducted to assess for associations of parity number with multimorbidity (MM), polypharmacy, chronic disease, and abdominal obesity. RESULTS More educated participants and people in the fifth quintile of the Wealth Score Index were less likely to have a higher parity number. With increasing parity numbers, the prevalence of MM, polypharmacy, hypertension, cardiovascular disease, fatty liver disease, stroke, rheumatoid diseases, chronic obstructive pulmonary disease, and cancers tended to rise. Moreover, we found that increasing parity numbers (especially when ≥ 5) enhanced the odds of abdominal obesity, waist-to-hip ratio ≥ 0.85, and waist-to-height ratio ≥ 0.5; these significant associations were more obvious in parity numbers ≥ 9 and WHtR ≥ 0.5. CONCLUSION The parity number is associated with MM and polypharmacy in Iranian women enrolled in the Azar Cohort Study. Further studies exploring the pathways (biological, social, and environmental) underlying these relationships will provide clues for preventing morbidity and premature mortality among susceptible andhighly parous women.
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Affiliation(s)
- Elnaz Faramarzi
- Liver and Gastrointestinal Diseases Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Mohammd Hossein Somi
- Liver and Gastrointestinal Diseases Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Helda Tutunchi
- Endocrine Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Hanieh Almaspour
- Student Research Committee, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Sarvin Sanaie
- Research Center for Integrative Medicine in Aging, Aging Research Institute, Tabriz University of Medical Sciences, Tabriz, Iran.
| | - Sanaz Asemani
- Student Research Committee, Tabriz University of Medical Sciences, Tabriz, Iran.
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Rahmati M, Saei Ghare Naz M, Azizi F, Ramezani Tehrani F. Parity and hypertension risk in couples: does number of parity matter: findings from Tehran Lipid and Glucose Study. BMC Public Health 2023; 23:474. [PMID: 36907869 PMCID: PMC10010040 DOI: 10.1186/s12889-023-15397-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2022] [Accepted: 03/07/2023] [Indexed: 03/14/2023] Open
Abstract
BACKGROUND AND AIMS As reported, hypertension (HTN) plays a leading role in explaining mortality worldwide, but it still has many confounding factors. This study explored whether the number of parity and age matters for HTN among couples from the Tehran Lipid and Glucose Study (TLGS). METHODS This study was conducted on 2851 couples from TLGS. All the variables were collected based on the standard protocol. The participants were categorized into four and five categories according to the number of parity (childless, one, two, three, or more parities) and age (18-30y, 30-40y, 40-50y, 50-60y, and 60-70y), respectively. Spline regression models via log link function for the binary outcome and linear link function for continuous outcomes were applied to evaluate the effect of interaction term age and parity categories on the desired outcome. RESULTS Among the total of 2851 pairs, 2.3% had no child, 9.5% had 1 child, 38.4% had 2 children, and 49.8% had ≥ 3 children. The adjusted risk (95% CI) of HTN in females aged 40-50y with 1 child, 2 and ≥ 3 children compared to no child were 1.14(1.04, 1.26), 1.05(1.01, 1.10), 1.12(1.07, 1.17), respectively (p < 0.05). Moreover, in those aged 50-60y with 2 and ≥ 3 children, the risk of HTN significantly increased by 4%. In females aged 60-70y with ≥ 3 children compared to those without children, the risk of HTN increased by 2%. For males aged 30-40y with 2 children compared to the no child group, the adjusted risk of HTN increased by 17%, while for those with ≥ 3 children in the same age group, this risk significantly decreased by 13%. Moreover, in males aged 30-40y with 2 children, risk ratio of HTN increased by 17%, but in males with ≥ 3 children, it decreased by 13% and in those in the same groups but aged 40-50y the risk increased by 6% and 11%, respectively. CONCLUSION Our findings suggest that gender, childlessness, having one child, and multi-parity had different impacts on HTN. Further research is needed to confirm our findings.
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Affiliation(s)
- Maryam Rahmati
- Reproductive Endocrinology Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Marzieh Saei Ghare Naz
- Reproductive Endocrinology Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
| | - Fereidoun Azizi
- Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Fahimeh Ramezani Tehrani
- Reproductive Endocrinology Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Bawahab MA, Abbas KS, Maksoud WMAE, Abdelgadir RS, Altumairi K, Alqahtani AR, Alzahrani HA, Bhat MJ. Factors Affecting Weight Reduction after Intragastric Balloon Insertion: A Retrospective Study. Healthcare (Basel) 2023; 11:healthcare11040600. [PMID: 36833134 PMCID: PMC9957044 DOI: 10.3390/healthcare11040600] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2022] [Revised: 02/11/2023] [Accepted: 02/16/2023] [Indexed: 02/19/2023] Open
Abstract
BACKGROUND AND OBJECTIVES Intragastric balloon (IGB) is a safe option for obesity management. However, studies determining the factors influencing the procedure's outcomes are scarce. Therefore, our goal was to determine the factors affecting weight reduction after IGB insertion. MATERIALS AND METHODS This retrospective study included 126 obese patients who underwent IGB treatment using the ORBERA® Intragastric Balloon System. Patients' records were retrieved; and demographic data, initial body mass index (BMI), complications, compliance with both diet and exercise programs, and percentage of excess weight reduction were recorded. RESULTS The study included 108 female (85.7%) and 18 male (14.3%) patients. The mean age was 31.7 ± 8.1 years. The percentage of excess weight loss (EWL) was 55.8 ± 35.7%. The mean weight loss was 13.01 ± 7.51 kg. A significant association was found between EWL and age, initial weight, initial body mass index, and the number of pregnancies. No major complications were observed. However, the balloon had to be removed early in two patients (1.59%) due to its rupture and in two other patients (1.59%) due to severe gastritis. CONCLUSIONS IGB therapy is a safe and effective option for obesity management, associated with low rates of complications. The EWL after IGB insertion is significantly higher among older patients, those with a relatively low initial body mass index, those with a longer duration of IGB insertion, and female patients with less parity. Larger prospective studies are needed to support our results.
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Affiliation(s)
- Mohammed A. Bawahab
- Surgery Department, Faculty of Medicine, King Khalid University, P.O. Box 641, Abha 61421, Saudi Arabia
| | - Khaled S. Abbas
- Surgery Department, Faculty of Medicine, King Khalid University, P.O. Box 641, Abha 61421, Saudi Arabia
| | - Walid M. Abd El Maksoud
- Surgery Department, Faculty of Medicine, King Khalid University, P.O. Box 641, Abha 61421, Saudi Arabia
- Correspondence: ; Tel.: +966-543128555
| | - Reem S Abdelgadir
- General Surgery, Abha International Private Hospital, Abha 62521, Saudi Arabia
| | | | - Awadh R. Alqahtani
- Surgery Department, Faculty of Medicine, King Saud University, Riyadh 11461, Saudi Arabia
| | - Hassan A. Alzahrani
- Surgery Department, Faculty of Medicine, King Khalid University, P.O. Box 641, Abha 61421, Saudi Arabia
| | - Muneer Jan Bhat
- Anesthesia, Surgery Department, Faculty of Medicine, King Khalid University, Abha 61421, Saudi Arabia
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Association of hypertension with infection and inflammation in a setting of disadvantage in rural India. J Hum Hypertens 2022; 36:1011-1020. [PMID: 34535756 DOI: 10.1038/s41371-021-00609-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2021] [Revised: 08/28/2021] [Accepted: 09/08/2021] [Indexed: 01/09/2023]
Abstract
We assessed the association of hypertension with markers of inflammation and infection in a rural and disadvantaged Indian population. In a case-control study, we age- and gender-matched 300 cases with hypertension to 300 controls without hypertension. Blood pressure was measured according to a strict protocol. We measured markers of inflammation and infection including serum high-sensitivity C-reactive protein (hs-CRP), blood lymphocyte count, serum homocysteine, tooth loss, overcrowding and exposure to fecal contamination. Multivariable conditional logistic regression was used to determine their association with hypertension. Median serum hs-CRP was 42% greater in cases than controls, while median serum homocysteine was 10% greater. In multivariable conditional logistic regression, elevated homocysteine (OR 1.75, 95% CI 1.09-2.82), greater lymphocyte count (OR 1.49, 95% CI 1.01-2.01) and exposure to fecal contamination, defined as a distance from the field used for toilet purposes to the household of ≤50 m (OR 2.38, 95% CI 1.07-5.29), were independently associated with hypertension in this rural population. In separate analyses for each gender, elevated hs-CRP (OR 2.62, 95% CI 1.04-6.58) was associated with hypertension in men, whereas edentulism (OR 4.75, 95% CI 1.62-13.96) was associated with greater odds of hypertension in women. Our findings demonstrate specific associations between hypertension and markers of inflammation and infection including hs-CRP, homocysteine, lymphocyte count, edentulism and exposure to fecal contamination. Thus, strategies aimed at reducing inflammation and infection may reduce the burden of hypertension in such settings of disadvantage in rural India.
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Sun MH, Wen ZY, Wang R, Gao C, Yin JL, Chang YJ, Wu QJ, Zhao YH. Parity and Metabolic Syndrome Risk: A Systematic Review and Meta-Analysis of 15 Observational Studies With 62,095 Women. Front Med (Lausanne) 2022; 9:926944. [PMID: 35903312 PMCID: PMC9314745 DOI: 10.3389/fmed.2022.926944] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2022] [Accepted: 06/20/2022] [Indexed: 11/16/2022] Open
Abstract
Background Epidemiological studies have provided inconsistent evidence of the association between parity and metabolic syndrome (MetS) risk. We conducted this first systematic review and meta-analysis to comprehensively and precisely quantify this topic. Methods Comprehensive searches of PubMed, Embase, and the Web of Science databases were conducted to identify observational studies of the association between parity and MetS risk up to 30 January 2022. Study inclusion, data extraction, and quality assessment were checked and reviewed by two investigators independently. Random-effects models were applied to estimate pooled odds ratios (ORs) and 95% CIs. This study has been registered with PROSPERO. Results Two high-quality cohorts and thirteen medium-quality cross-sectional studies involving 62,095 women were finally included. Compared with the nulliparous, the pooled OR of MetS for the ever parity was 1.31 (95% CI = 0.91–1.88, I2 = 72.6%, n = 3). Compared with the lowest parity number, the pooled OR of MetS for the highest parity number was 1.38 (95% CI = 1.22–1.57, I2 = 60.7%, n = 12). For the dose-response analysis, the pooled OR of MetS for each increment of one live birth was 1.12 (95% CI = 1.05–1.19, I2 = 78.6%, n = 6). These findings were robust across subgroups and sensitivity analyses. No evidence of heterogeneity between subgroups was indicated by meta-regression analyses. Conclusion The findings suggested that parity was associated with an increased risk of MetS. A sufficient number of large prospective cohort studies are required to fully verify our findings. Systematic Review Registration [https://www.crd.york.ac.uk/PROSPERO/], identifier [CRD42022307703].
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Affiliation(s)
- Ming-Hui Sun
- Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, Shenyang, China
- Clinical Research Center, Shengjing Hospital of China Medical University, Shenyang, China
- Key Laboratory of Precision Medical Research on Major Chronic Disease, Shengjing Hospital of China Medical University, Shenyang, China
| | - Zhao-Yan Wen
- Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, Shenyang, China
- Clinical Research Center, Shengjing Hospital of China Medical University, Shenyang, China
- Key Laboratory of Precision Medical Research on Major Chronic Disease, Shengjing Hospital of China Medical University, Shenyang, China
| | - Ran Wang
- Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, Shenyang, China
- Clinical Research Center, Shengjing Hospital of China Medical University, Shenyang, China
- Key Laboratory of Precision Medical Research on Major Chronic Disease, Shengjing Hospital of China Medical University, Shenyang, China
| | - Chang Gao
- Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, Shenyang, China
- Clinical Research Center, Shengjing Hospital of China Medical University, Shenyang, China
- Key Laboratory of Precision Medical Research on Major Chronic Disease, Shengjing Hospital of China Medical University, Shenyang, China
| | - Jia-Li Yin
- Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, Shenyang, China
- Clinical Research Center, Shengjing Hospital of China Medical University, Shenyang, China
- Key Laboratory of Precision Medical Research on Major Chronic Disease, Shengjing Hospital of China Medical University, Shenyang, China
| | - Yu-Jiao Chang
- Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, Shenyang, China
- Clinical Research Center, Shengjing Hospital of China Medical University, Shenyang, China
- Key Laboratory of Precision Medical Research on Major Chronic Disease, Shengjing Hospital of China Medical University, Shenyang, China
| | - Qi-Jun Wu
- Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, Shenyang, China
- Clinical Research Center, Shengjing Hospital of China Medical University, Shenyang, China
- Key Laboratory of Precision Medical Research on Major Chronic Disease, Shengjing Hospital of China Medical University, Shenyang, China
- Department of Obstetrics and Gynecology, Shengjing Hospital of China Medical University, Shenyang, China
- *Correspondence: Qi-Jun Wu,
| | - Yu-Hong Zhao
- Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, Shenyang, China
- Clinical Research Center, Shengjing Hospital of China Medical University, Shenyang, China
- Key Laboratory of Precision Medical Research on Major Chronic Disease, Shengjing Hospital of China Medical University, Shenyang, China
- Yu-Hong Zhao,
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Chechko N, Dukart J, Tchaikovski S, Enzensberger C, Neuner I, Stickel S. The Expectant Brain-Pregnancy Leads to Changes in Brain Morphology in the Early Postpartum Period. Cereb Cortex 2021; 32:4025-4038. [PMID: 34942007 PMCID: PMC9476604 DOI: 10.1093/cercor/bhab463] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2021] [Revised: 10/12/2021] [Accepted: 11/15/2021] [Indexed: 11/15/2022] Open
Abstract
There is growing evidence that pregnancy may have a significant impact on the maternal brain, causing changes in its structure. To investigate the patterns of these changes, we compared nulliparous women (n = 40) with a group of primiparous women (n = 40) and multiparous mothers (n = 37) within 1–4 days postpartum, using voxel-based and surface-based morphometry (SBM). Compared with the nulliparous women, the young mothers showed decreases in gray matter volume in the bilateral hippocampus/amygdala, the orbitofrontal/subgenual prefrontal area, the right superior temporal gyrus and insula, and the cerebellum. These pregnancy-related changes in brain structure did not predict the quality of mother–infant attachment at either 3 or 12 weeks postpartum nor were they more pronounced among the multiparous women. SBM analyses showed significant cortical thinning especially in the frontal and parietal cortices, with the parietal cortical thinning likely potentiated by multiple pregnancies. We conclude that, compared with the brain of nulliparous women, the maternal brain shows widespread morphological changes shortly after childbirth. Also, the experience of pregnancy alone may not be the underlying cause of the adaptations for mothering. As regards the exact biological function of the changes in brain morphology, longitudinal research will be needed to draw any definitive conclusions.
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Affiliation(s)
- Natalia Chechko
- Department of Psychiatry, Psychotherapy and Psychosomatics, Medical Faculty, RWTH Aachen, Aachen 52074, Germany.,Institute of Neuroscience and Medicine, JARA-Institute Brain Structure Function Relationship (INM 10), Research Center Jülich, Jülich 52428, Germany.,Institute of Neuroscience and Medicine, Brain & Behavior (INM-7), Research Center Jülich, Jülich 52428, Germany
| | - Jürgen Dukart
- Institute of Neuroscience and Medicine, Brain & Behavior (INM-7), Research Center Jülich, Jülich 52428, Germany.,Institute of Systems Neuroscience, Medical Faculty, Heinrich Heine University Düsseldorf, Düsseldorf 40225, Germany
| | - Svetlana Tchaikovski
- Department of Gynecology and Obstetrics, Medical Faculty, RWTH Aachen, Aachen 52074, Germany
| | - Christian Enzensberger
- Department of Gynecology and Obstetrics, Medical Faculty, RWTH Aachen, Aachen 52074, Germany
| | - Irene Neuner
- Department of Psychiatry, Psychotherapy and Psychosomatics, Medical Faculty, RWTH Aachen, Aachen 52074, Germany.,Institute of Neuroscience and Medicine, JARA-Institute Brain Structure Function Relationship (INM 10), Research Center Jülich, Jülich 52428, Germany
| | - Susanne Stickel
- Department of Psychiatry, Psychotherapy and Psychosomatics, Medical Faculty, RWTH Aachen, Aachen 52074, Germany.,Institute of Neuroscience and Medicine, JARA-Institute Brain Structure Function Relationship (INM 10), Research Center Jülich, Jülich 52428, Germany
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Moazzeni SS, Asgari S, Azizi F, Hadaegh F. Live birth/parity number and the risk of incident hypertension among parous women during over 13 years of follow-up. J Clin Hypertens (Greenwich) 2021; 23:2000-2008. [PMID: 34657376 PMCID: PMC8630610 DOI: 10.1111/jch.14369] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2021] [Revised: 08/30/2021] [Accepted: 09/15/2021] [Indexed: 12/14/2022]
Abstract
The effect of live birth/parity number on incident hypertension was investigated among Iranian parous women aged 30–70 years. The study population included 2188 normotensive women who were enrolled in 1999–2001. They were followed for incident hypertension (based on JNC 7 report) by 3‐year intervals up to April 2018. Multivariable Cox proportional hazard models, adjusted for a wide set of potential hypertension risk factors, reproductive factors, and pregnancy complications, were applied to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) of the number of parity/live birth(s) for incident hypertension. Additionally, as a sensitivity analysis, age‐scale Cox regression was also done. During a median follow‐up of 13.5 years, 935 incident hypertension have occurred. Compared to those with two live births, the participants who had 3 and ≥4 live births were at higher risk of hypertension development by the HRs of 1.25 [95% CI: 1.02–1.55] and 1.39 [1.12–1.72], respectively, in the full‐adjusted model. Moreover, each additional live birth increased the risk of hypertension by a HR of 1.06 [95%CI: 1.02–1.11]. Results of parity number were also similar. Considering age as time scale also did not change the results generally. The authors found a significant interaction between live birth/parity number and age groups; the adverse effect of higher live birth/parity numbers on hypertension development was mainly found among those aged < 50 years. To sum up, compared to the live birth/parity number of two, Iranian women with ≥3 live birth/parity had a higher risk of incident hypertension; the issue was more prominent among younger mothers.
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Affiliation(s)
- Seyyed Saeed Moazzeni
- Prevention of Metabolic Disorders Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Samaneh Asgari
- Prevention of Metabolic Disorders Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Fereidoun Azizi
- Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Farzad Hadaegh
- Prevention of Metabolic Disorders Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Eslami E, Mohammad Alizadeh Charandabi S, Farshbaf Khalili A, Asghari Jafarabadi M, Mirghafourvand M. The effect of a lifestyle training package on physical activity and nutritional status in obese and overweight pregnant women: A randomized controlled clinical trial. Int J Nurs Pract 2021; 28:e12992. [PMID: 34313366 DOI: 10.1111/ijn.12992] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2017] [Revised: 03/02/2021] [Accepted: 06/24/2021] [Indexed: 11/28/2022]
Abstract
AIM The aim of this study was to determine the effect of a lifestyle training package that consisted of a 60- to 90-min session of group training, educational booklet and text messages on physical activity and nutritional status in obese and overweight pregnant women. METHODS In this randomized controlled trial, 140 obese or overweight women (gestational age: 16-20 weeks) covered by health centres in Tehran, Iran, were equally randomized into two parallel groups using block randomization and stratified by the body mass index. Participants completed the Food Frequency Questionnaire and International Physical Activity Questionnaire at baseline and fourth and eighth weeks after intervention. Participants were 38 obese and 102 overweight women who were later followed-up. RESULTS After the intervention, the mean weekly intake of the vegetable and fruit subgroups was significantly higher; and intake of fats and oils and the confections subgroups were significantly lower in the intervention compared with the control group (p < 0.05). Although physical activity was higher in the intervention group, 8 weeks after the intervention, this difference was not statistically significant (p > 0.05). CONCLUSIONS The training package appears to offer a suitable strategy for adjusting the intake of the recommended food subgroups in obese and overweight pregnant women.
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Affiliation(s)
- Elham Eslami
- Department of Midwifery, Faculty of Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Sakineh Mohammad Alizadeh Charandabi
- Social Determinants of Health Research Center, Nursing and Midwifery Faculty, Midwifery Department, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Azizeh Farshbaf Khalili
- Physical Medicine and Rehabilitation Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Mohammad Asghari Jafarabadi
- Department of Statistics and Epidemiology, School of Medicine, Zanjan University of Medical Sciences, Zanjan, Iran.,Center for the development of interdisciplinary research in Islamic sciences and health sciences, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Mojgan Mirghafourvand
- Social Determinants of Health Research Center, Nursing and Midwifery Faculty, Midwifery Department, Tabriz University of Medical Sciences, Tabriz, Iran
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The role of multiparity and maternal age at first pregnancy in the association between early menarche and metabolic syndrome among middle-aged and older women. ACTA ACUST UNITED AC 2021; 28:1004-1011. [PMID: 34183563 DOI: 10.1097/gme.0000000000001809] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To analyze whether maternal age at first pregnancy and parity are mediators of the association between early menarche and metabolic syndrome in a sample of middle-aged and older women. METHODS Cross-sectional study of 428 women (40 to 80 y), who had experienced a pregnancy in their lifetime, was performed between 2014 and 2016. Age at first pregnancy, parity, and early menarche were self-reported. Metabolic syndrome was assessed using the criteria described by the National Cholesterol Education Program's Adult Treatment Panel III. The association between metabolic syndrome and early menarche was assessed by logistic regression analysis. The mediating role of age at first pregnancy and multiparity in the relationship between early menarche and metabolic syndrome was assessed through mediation analysis, adjusted for covariates. RESULTS According to adjusted logistic regression models, early menarche was associated with higher odds of prevalent metabolic syndrome (OR: 2.26; 95% CI: 1.15-4.46). Mediation analysis showed a significant direct effect of early menarche on metabolic syndrome (β: 0.808; 95% CI: 0.107-1.508). Of the two mediators tested, age at first pregnancy was significant (β: 0.065; 95% CI: 0.004-0.221), ie, participants with and without early menarche differ, on average, by 0.879 SDs in the log odds of MetS (total effect), of which 0.065 SDs (8%), on average, would be attributable to the effect of early menarche on age at first pregnancy (indirect effect), which, in turn, affects MetS. CONCLUSIONS Age at first pregnancy may partially contribute to the association between early menarche and metabolic syndrome among middle-aged and older women who had experienced a pregnancy over their lifetime.
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Zhang X, Lou H, Tang X, Chen X. Socio-demographic characteristics and outcomes of pregnant women who delivered prior to and after the termination of the one-child policy in China: a comparative study. BMC Pregnancy Childbirth 2021; 21:318. [PMID: 33882886 PMCID: PMC8061051 DOI: 10.1186/s12884-021-03740-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2020] [Accepted: 03/16/2021] [Indexed: 01/25/2023] Open
Abstract
Background The new Chinese fertility policy has recently received widespread public attention. However, there are few studies available on the comprehensive epidemiology of maternal and infant health with respect to the characteristic changes of childbearing women. In the study, we compared the maternal characteristics and pregnancy outcomes at different time points according to policy adjustments, accessed the possible relationship among these factors, and evaluated the impacts of these policies for medical and policy assistance. Methods This was a retrospective study. Data were collected from three representative hospitals in Zhejiang Province using stratified random sampling. The annual number of births, and maternal and child healthcare levels were the determining factors of sampling. Women who gave birth in November of 2012, 2014, and 2016 were recruited in accordance with the time of the change in the fertility policy, and we explored the differences in maternal socio-demographic characteristics, delivery mode and pregnancy outcomes. Results A total of 11,718 women were recruited, including 3480, 4044, and 4194 in November of 2012, 2014, and 2016, respectively. The proportions of multiparous women, women who aged ≥35 years, who received higher education, who had previous cesarean sections (CS), and who delivered in a high level hospital increased over time. In 2016, multipara accounted for 49.12, 14.47% were aged ≥35 years, nearly half of women had previous CS and delivered in a provincial hospital, 41.73% gave birth by CS, and 31.62% suffered pregnancy complications. The results of multiple logistic regression mode showed CS risk decreased significantly in 2014 (ORadj = 0.62; 95% CI, 0.55–0.67) relative to 2012, and risks of pregnancy complications (ORadj = 2.30; 95% CI, 1.86–2.83) and multiple births (ORadj = 3.25; 95% CI, 2.19–4.83) only increased in 2016 compared to 2012. Conclusions Some pregnancy outcomes increased as several key characteristics of childbearing women changed after China ended its “one-child” policy. This suggests that policy providers and medical staff need to strengthen healthcare in a consistent fashion regarding changes in birth policy.
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Affiliation(s)
- Xiaohui Zhang
- Department of women's health, Women's Hospital, School of Medicine, Zhejiang University, Xueshi Road 1, Hangzhou, Zhejiang, 310006, P.R. China.
| | - Haifeng Lou
- Women's Hospital, School of Medicine, Zhejiang University, Xueshi Road 1, Hangzhou, Zhejiang, 310006, P.R. China
| | - Xuejuan Tang
- Department of women's health, Jiaxing Maternal and Child Health Hospital, Jia Xing, Zhonghuan Eastern Road, 2468, Zhejiang, P.R. China
| | - Xiaoli Chen
- Department of pathology, Women's Hospital, School of Medicine, Zhejiang University, Xueshi Road 1, Hangzhou, Zhejiang, 310006, P.R. China
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18
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Longitudinal changes in HDL-cholesterol concentration are associated with different risk factors in primiparous and nulliparous young women: The NHLBI Growth and Health Study (NGHS). J Clin Lipidol 2021; 15:488-499. [PMID: 33875403 DOI: 10.1016/j.jacl.2021.03.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2020] [Revised: 03/10/2021] [Accepted: 03/10/2021] [Indexed: 02/06/2023]
Abstract
BACKGROUND Previous studies report that first pregnancy is associated with persistent decreases in HDL-cholesterol (HDL-C) concentrations. OBJECTIVE This study evaluated factors associated with declines in HDL-C concentration in parous and nulliparous young women. METHODS This study leverages data from African-American and white women from the NHLBI Growth and Health Study. Parity-related changes in lipids, BMI and percent body fat were assessed longitudinally. A subset of primiparous and nulliparous women with paired lipid measurements were analyzed regarding changes in HDL-C concentrations. RESULTS Among 870 women in longitudinal analyses, African-American women had higher parity (p<0.0001), with baseline measurements of each parity group being similar. HDL-C concentration decreased significantly and remained lower after the first pregnancy, while BMI and percent body fat increased with increasing parity. In the subset of 401 women, HDL-C concentration decreased among primiparous women (-4.81 ± 0.93 mg/dl), with no overall change in nulliparous (p = 0.003). In both groups, greater HDL-C concentration declines were independently associated with higher initial HDL-C concentration and greater increases in BMI (both p<0.0001). Among primiparous women, younger delivery age (p = 0.0001) and birth control use (p = 0.004) were associated with greater HDL-C concentration decline. Nulliparous white women's HDL-C concentration increased over time, with no change in African-American women (p = 0.008); no racial difference was seen in primiparous women. CONCLUSION Persistent decreases in HDL-C concentration were associated with the first pregnancy, and were greater with higher initial HDL-C concentration. Racial differences in HDL-C concentration emerged over time in nulliparous women, but not primiparous women. Potential impacts of these findings on women's long-term cardiometabolic health should be evaluated.
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Shi M, Zhou X, Zheng C, Pan Y. The association between parity and metabolic syndrome and its components in normal-weight postmenopausal women in China. BMC Endocr Disord 2021; 21:8. [PMID: 33413314 PMCID: PMC7792174 DOI: 10.1186/s12902-020-00674-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/30/2020] [Accepted: 12/22/2020] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Studies analyzing the association between parity and normal-weight metabolic syndrome (MetS) in postmenopausal women of normal weight remain limited, this study aimed to explore the association between parity and MetS among Chinese normal-weight postmenopausal women. METHODS In total, 776 normal-weight undiagnosed type 2 diabetes postmenopausal women who visited the Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University for a routine health check-up between 1 January 2017 and 31 December 2019 were included in the cross-sectional study. All individuals had fully completed information records encompassing standardized electronic medical records, physical examinations, and biochemical measurements. Metabolic health was defined as fewer than 2 parameters of the MetS were present, in combination with normal weight. Continuous variables which were normally distributed were expressed as means and standard deviation. Comparisons among normally distributed continuous variables were made using one-way ANOVA while that among non-normal distribution parameters were made using Kruskal-Wallis. The association between parity and MetS was analyzed using multivariate logistic regression. All of the analyses were performed with SPSS statistical software (Version 23.0, SPSS, Inc., Chicago, IL, USA) and the statistical software package EmpowerStats ( http://www.empowerstats.com , X&Y Solutions, Inc., Boston, MA). RESULTS After adjusting for potential confounding factors including hip circumference, parity was failed to show a significantly relationship with MetS in normal-weight women(P=0.054). Women with a higher parity (≥3) had an increased OR of abdominal obesity, while the OR (95% CI) of the parity 3 group was 2.06 (1.13, 3.77) and that of the parity ≥4 group was 3.08(1.42, 6.66) the P for trend was 0.002 after adjusting for potential confounding factors. No significant differences were detected for other metabolic disorders including high levels of triglycerides (TG), blood pressure, fasting plasma glucose (FPG), and decreased high-density lipoprotein cholesterol (HDL-C) in different parity groups. CONCLUSIONS Higher parity was not associated with a higher risk of MetS in normal weight Chinese postmenopausal women. As for the components of MetS, only waist circumference was associated with multiparity even after controlling for hip circumference.
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Affiliation(s)
- Mengte Shi
- Department of Endocrinology, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, No. 109, Xueyuanxi Road, Wenzhou, Zhejiang, 325000, China
| | - Xinhe Zhou
- Department of Endocrinology, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, No. 109, Xueyuanxi Road, Wenzhou, Zhejiang, 325000, China
| | - Chao Zheng
- Department of Endocrinology, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, No. 109, Xueyuanxi Road, Wenzhou, Zhejiang, 325000, China.
- The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, People's Republic of China.
| | - Youjin Pan
- Department of Endocrinology, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, No. 109, Xueyuanxi Road, Wenzhou, Zhejiang, 325000, China.
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20
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Jasienska G. Costs of reproduction and ageing in the human female. Philos Trans R Soc Lond B Biol Sci 2020; 375:20190615. [PMID: 32951546 PMCID: PMC7540952 DOI: 10.1098/rstb.2019.0615] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/20/2020] [Indexed: 12/27/2022] Open
Abstract
Evolutionary theories of ageing point to reproduction as a significant factor to consider when asking why ageing occurs and why there is inter-individual variation in its progression. Reproduction in human females is costly, in terms of energy, nutrients and metabolic adjustments. Thus, it is expected that women who experienced high reproductive effort resulting from multiple reproductive events will age faster. However, the evidence for long-term negative effects of reproduction is not conclusive. The lack of understanding of whether there are trade-offs between reproduction and ageing in women is partly due to methodological challenges. The costs of reproduction are often calculated based only on parity, while other elements contributing to these costs (e.g. breastfeeding, timing of reproduction) are neglected, which may significantly underestimate the total costs and obscure the all-important inter-individual variation in such costs. Costs must be evaluated in relation to individual characteristics, including developmental conditions, nutritional status and social support that a mother receives during reproduction. Furthermore, ageing and health must be assessed based on comprehensive markers rather than arbitrarily assembled variables. Finally, longitudinal rather than cross-sectional studies and new statistical approaches are needed to reveal how much of a decline in health and progressing ageing can actually be attributed to past reproductive processes. This article is part of the theme issue 'Evolution of the primate ageing process'.
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Affiliation(s)
- Grazyna Jasienska
- Department of Environmental Health, Faculty of Health Sciences, Jagiellonian University Medical College, Krakow, Poland
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21
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Pineda B, Pertusa C, Panach L, Tarín JJ, Cano A, García-Pérez MÁ. Polymorphisms in genes involved in T-cell co-stimulation are associated with blood pressure in women. Gene 2020; 754:144838. [PMID: 32525043 DOI: 10.1016/j.gene.2020.144838] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2019] [Revised: 05/06/2020] [Accepted: 06/01/2020] [Indexed: 02/07/2023]
Abstract
In recent years, conclusive data have emerged on a relationship between immune system, especially the T-cell, and blood pressure (BP). The objective of the present study was to determine the association between BP and four polymorphisms in CD80, CD86, CD28 and CTLA4 genes that code for key proteins in the T-cell co-stimulation process, in a female cohort. To that end, an association study in a cohort of 934 women over 40 years old from two hospitals was done. Raw data showed a significant association between the SNP rs1129055 of CD86 gene and BP. Analyzing this association against inheritance patterns, higher SBP (p < 0.000) and DBP (p = 0.005) values were observed in AA than in GG/GA genotype subjects in the largest sample cohort (Hospital 1). In multivariate linear regression studies, with adjustment for presumed independent predictors of BP, the SNP of the CD86 gene remained a predictor of SBP (p = 0.001) and DBP (p = 0.006), as did the SNP rs867234 of the CD80 gene for DBP (p < 0.000), both resisting the Bonferroni correction for multiple comparisons. As conclusion, we report a robust association between the SNP rs1129055 of CD86 gene and BP. The SNP rs867234 of CD80 gene was also shown to be a strong predictor of DBP.
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Affiliation(s)
- Begoña Pineda
- Research Foundation, INCLIVA Institute of Health Research, 46010 Valencia, Spain
| | - Clara Pertusa
- Research Foundation, INCLIVA Institute of Health Research, 46010 Valencia, Spain
| | - Layla Panach
- Research Foundation, INCLIVA Institute of Health Research, 46010 Valencia, Spain
| | - Juan J Tarín
- Department of Cellular Biology, Functional Biology and Physical Anthropology, University of Valencia, 46100 Burjassot, Spain
| | - Antonio Cano
- Department of Pediatrics, Obstetrics and Gynecology, University of Valencia, 46010 Valencia, Spain
| | - Miguel Ángel García-Pérez
- Research Foundation, INCLIVA Institute of Health Research, 46010 Valencia, Spain; Department of Genetics, University of Valencia, 46100 Burjassot, Spain.
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22
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Tørris C, Bjørnnes AK. Duration of Lactation and Maternal Risk of Metabolic Syndrome: A Systematic Review and Meta-Analysis. Nutrients 2020; 12:E2718. [PMID: 32899507 PMCID: PMC7551509 DOI: 10.3390/nu12092718] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2020] [Revised: 08/29/2020] [Accepted: 09/03/2020] [Indexed: 12/16/2022] Open
Abstract
Cardiovascular disease (CVD) is the leading cause of death of women across all ages, and targeting modifiable risk factors, such as those comprised in metabolic syndrome (MetS) (e.g., waist circumference, lipid profile, blood pressure, and blood glucose), is of great importance. An inverse association between lactation and CVD has been suggested, and lactation may decrease the risk of MetS. This systematic review and meta-analysis examined how lactation may affect the development and prevalence of MetS in women. A literature search was performed using Cinahl, Embase, Web of Science, and PubMed. A total of 1286 citations were identified, and finally, ten studies (two prospective and eight cross-sectional) were included. Seven studies (two prospective and five cross-sectional) revealed associations between lactation and MetS, suggesting that breastfeeding might prevent or improve metabolic health and have a protective role in MetS prevention. This protective role might be related to the duration of lactation; however, a lack of controlling for potential confounders, such as parity, might inflict the results. The pooled effect was non-conclusive. Additional research is required to further explore the duration of lactation and its potential role in improving or reversing MetS and its components.
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Affiliation(s)
- Christine Tørris
- Health Sciences, Oslo Metropolitan University, 0130 Oslo, Norway;
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Moosazadeh M, Takezaki T, Saeedi M, Kheradmand M. Association between gravidity and risk of metabolic syndrome: Results of Tabari cohort study. Diabetes Metab Syndr 2020; 14:843-847. [PMID: 32559733 DOI: 10.1016/j.dsx.2020.04.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2019] [Revised: 04/06/2020] [Accepted: 04/06/2020] [Indexed: 11/21/2022]
Abstract
BACKGROUND AND AIMS The purpose of the present study was to investigate the association of gravidity and age at first pregnancy with metabolic syndrome in a large-scale, population-based cohort study in Iran. METHODS The present secondary analysis was conducted on a subset of the population (5739 women with at least one pregnancy) enrolled in the Tabari cohort study. Reproductive history was collected using a structured questionnaire. The relationship of gravidity and age at first pregnancy with metabolic syndrome and its components was analyzed using the logistic regression model. RESULTS The results showed that after adjustment for confounding variables, the odds of having metabolic syndrome was not significantly associated with age at first pregnancy (P = 0.269) and gravidity (P = 0.504). However, there was an association between hypertension and age at first pregnancy (OR = 0.32, 95% CI = 0.12-0.82; P = 0.03). Additionally, waist circumference was also associated with gravidity (OR = 2.17, 95% CI = 1.37-3.35). CONCLUSION As the findings indicated, age at first pregnancy and gravidity were not associated with the odds of having metabolic syndrome. However, a relationship was found between first pregnancy at the age of >35 years and the decreased risk of hypertension. Gravidity was also found to be a dose-dependent risk factor for increased waist circumference.
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Affiliation(s)
- Mahmood Moosazadeh
- Health Science Research Center, Addiction Institute, Mazandaran University of Medical Sciences, Sari, Iran
| | - Toshiro Takezaki
- Department of International Islands and Community Medicine, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan
| | - Majid Saeedi
- Department of Pharmaceutics, School of Pharmacy, Mazandaran University of Medical Sciences, Sari, Iran
| | - Motahareh Kheradmand
- Health Science Research Center, Addiction Institute, Mazandaran University of Medical Sciences, Sari, Iran.
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24
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Studnicki J, Fisher JW, Reardon DC, Craver C, Longbons T, Harrison DJ. Pregnancy Outcome Patterns of Medicaid-Eligible Women, 1999-2014: A National Prospective Longitudinal Study. Health Serv Res Manag Epidemiol 2020; 7:2333392820941348. [PMID: 32844103 PMCID: PMC7416150 DOI: 10.1177/2333392820941348] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2020] [Revised: 06/02/2020] [Accepted: 06/02/2020] [Indexed: 01/10/2023] Open
Abstract
Introduction: The number and outcomes of pregnancies experienced by a woman are
consequential determinants of her health status. However, there is no
published research comparing the patterns of subsequent pregnancy outcomes
following a live birth, natural fetal loss, or induced abortion. Objectives: The objective of this study was to describe the characteristic patterns of
subsequent pregnancy outcomes evolving from each of three initiating outcome
events (birth, induced abortion, natural fetal loss) occurring in a Medicaid
population fully insured for all reproductive health services. Methods: We identified 7,388,842 pregnancy outcomes occurring to Medicaid-eligible
women in the 17 states which paid for abortion services between 1999-2014.
The first known pregnancy outcome for each woman was marked as the index
outcome which assigned each woman to one of three cohorts. All subsequent
outcomes occurring up to the fifth known pregnancy were identified. Analyses
of the three index outcome cohorts were conducted separately for all
pregnancy outcomes, three age bands (<17, 17-35, 36+), and three
race/ethnicity groups (Hispanic, Black, White). Results: Women with index abortions experienced more lifetime pregnancies than women
with index births or natural fetal losses and were increasingly more likely
to experience another pregnancy with each subsequent pregnancy. Women whose
index pregnancy ended in abortion were also increasingly more likely to
experience another abortion at each subsequent pregnancy. Both births and
natural fetal losses were likely to result in a subsequent birth, rather
than abortion. Women with natural losses were increasingly more likely to
have a subsequent birth than women with an index birth. All age and
racial/ethnic groups exhibited the characteristic pattern we have described
for all pregnancy outcomes: abortion is associated with more subsequent
pregnancies and abortions; births and fetal losses are associated with
subsequent births. Other differences between groups are, however, apparent.
Age is positively associated with the likelihood of a birth following an
index birth, but negatively associated with the likelihood of a birth
following an index abortion. Hispanic women are always more likely to have a
birth and less likely to have an abortion than Black or White women, for all
combinations of index outcome and the number of subsequent pregnancies.
Similarly, Black women are always more likely to have an abortion and less
likely to experience a birth than Hispanic or White women. Conclusion: Women experiencing repeated pregnancies and subsequent abortions following an
index abortion are subjected to an increased exposure to hemorrhage and
infection, the major causes of maternal mortality, and other adverse
consequences resulting from multiple separation events.
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Affiliation(s)
| | | | | | | | | | - Donna J Harrison
- American Association of Pro-Life Obstetricians and Gynecologists, Eau Claire, MI, USA
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25
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Lee Y, Lee HN, Kim SJ, Koo J, Lee KE, Shin JE. Higher parity and risk of metabolic syndrome in Korean postmenopausal women: Korea National Health and Nutrition Examination Survey 2010-2012. J Obstet Gynaecol Res 2018; 44:2045-2052. [PMID: 30058110 DOI: 10.1111/jog.13766] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2018] [Accepted: 06/29/2018] [Indexed: 01/17/2023]
Abstract
AIM We sought to examine whether parity is associated with higher incidence of metabolic syndrome in postmenopausal women. METHODS We conducted a cross-sectional study on 4098 Korean postmenopausal women by using nationally representative data from the Korea National Health and Nutrition Examination Survey 2010-2012. Multivariate logistic regression was performed to evaluate the relationship between parity and metabolic syndrome, with adjustment for potential confounding variables. RESULTS The rate of metabolic syndrome was significantly higher with increasing number of parity, with dose-response relationship in univariate analysis (P <0.001). In addition, higher parity (≥3 live births) was associated with more prevalence of all components of metabolic syndrome compared with two live births (parity 2 vs 3 vs ≥4: 5.5 vs 12.1 and 14.4%, respectively; P < 0.001). However, after adjusting for demographic, socioeconomic, lifestyle and reproductive factors, we found that only higher parity was significantly associated with metabolic syndrome compared with two live births, and failed to show a dose-dependent relationship (parity 2 vs 3 vs ≥4: odds ratio 1 vs 1.404 vs 1.379, respectively; P = 0.043). We also proved that among the components of metabolic syndrome, only waist circumference had a significant positive relationship with parity in a multivariable adjusted model (parity 2 vs 3 vs ≥4: odds ratio 1 vs 1.559 vs 1.656, respectively; P < 0.001). CONCLUSION Higher parity was independently associated with a higher risk of metabolic syndrome in postmenopausal women.
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Affiliation(s)
- Young Lee
- Department of Obstetrics and Gynecology, College of Medicine, The Catholic University of Korea, Seoul, South Korea
| | - Hae Nam Lee
- Department of Obstetrics and Gynecology, College of Medicine, The Catholic University of Korea, Seoul, South Korea
| | - Sa Jin Kim
- Department of Obstetrics and Gynecology, College of Medicine, The Catholic University of Korea, Seoul, South Korea
| | - Jahyun Koo
- Department of Obstetrics and Gynecology, College of Medicine, The Catholic University of Korea, Seoul, South Korea
| | - Kyung Eun Lee
- Department of Obstetrics and Gynecology, College of Medicine, The Catholic University of Korea, Seoul, South Korea
| | - Jae Eun Shin
- Department of Obstetrics and Gynecology, College of Medicine, The Catholic University of Korea, Seoul, South Korea
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26
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Prevalence of metabolic syndrome in Bangladesh: a systematic review and meta-analysis of the studies. BMC Public Health 2018; 18:308. [PMID: 29499672 PMCID: PMC5833131 DOI: 10.1186/s12889-018-5209-z] [Citation(s) in RCA: 50] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2017] [Accepted: 02/23/2018] [Indexed: 11/10/2022] Open
Abstract
Background Metabolic syndrome (MS) is a cluster of health problems that set the stage for serious health conditions and places individuals at higher risk of cardiovascular disease, diabetes and stroke. The worldwide prevalence of MS in the adult population is on the rise and Bangladesh is no exception. According to some epidemiological study, MS is highly prevalent in Bangladesh and has increased dramatically in last few decades. To provide a clear picture of the current situation, we conducted a systematic review and meta-analysis with an objective to assess the prevalence of metabolic syndrome among the Bangladeshi population using data already published in the scientific literature. Methods We searched MEDLINE, EMBASE and PubMed and manually checked references of all identified relevant publications that described the prevalence of MS in Bangladesh. Random effects meta-analysis was used to pool the prevalence. Heterogeneity was explored using formal tests and subgroup analyses. Study quality and publication bias was also explored. Results Electronic and grey literature search retrieved 491 potentially relevant papers. After removing duplicates, reviewing titles and abstracts and screening full texts, 10 studies were finally selected. Most of the studies were conducted in rural populations and study participants were mostly females. The weighted pooled prevalence of metabolic syndrome regardless of gender and criteria used to define metabolic syndrome, was 30.0% with high heterogeneity observed. Weighted pooled prevalence of metabolic syndrome is higher in females (32%) compared to males (25%) though not statistically significant (p = 0.434). Prevalence was highest (37%) when Modified NCEP ATP III criteria was used to define MS, while it was lowest (20%) when WHO criteria was used. In most cases, geographical area (urban/rural) was identified as a source of heterogeneity between the studies. Most of the studies met study quality assessment criteria’s except adequate sample size criteria and evidence of small study effect was also detected. Conclusions The prevalence of metabolic syndrome is high and rising in Bangladesh. Strategies aimed at primary prevention are required to mitigate a further increase in the prevalence and for the reduction of the morbidity and mortality associated with metabolic syndrome. Electronic supplementary material The online version of this article (10.1186/s12889-018-5209-z) contains supplementary material, which is available to authorized users.
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Rosendaal NTA, Alvarado B, Wu YY, Velez MP, da Câmara SMA, Pirkle CM. Adolescent Childbirth Is Associated With Greater Framingham Risk Scores for Cardiovascular Disease Among Participants of the IMIAS (International Mobility in Aging Study). J Am Heart Assoc 2017; 6:e007058. [PMID: 29092844 PMCID: PMC5721784 DOI: 10.1161/jaha.117.007058] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2017] [Accepted: 09/11/2017] [Indexed: 11/21/2022]
Abstract
BACKGROUND Previous studies observe associations between lifetime parity and cardiovascular disease, but relatively fewer investigate age at first childbirth (AFB). Herein, we examine the association of AFB with a summary cardiovascular risk measure (Framingham Risk Score [FRS]). METHODS AND RESULTS As part of the IMIAS (International Mobility in Aging Study), data were collected in 2012 among 1047 women, aged 65 to 74 years, from Canada, Albania, Colombia, and Brazil. FRSs were calculated to describe cardiovascular risk profiles, and linear regression analyses were performed, adjusting for early life and socioeconomic variables. Women with an AFB of <20 years were compared with women with an AFB of 20 to 24, 25 to 29, and ≥30 years, as well as nulliparous women. We also compared FRS between combinations of AFB and parity categories: nulliparous women, parity 1 to 3 combined with AFB <20 years, parity ≥4 with AFB <20 years, parity 1 to 3 with AFB ≥20 years, and parity ≥4 with AFB ≥20 years. Women with an AFB of <20 years had a higher mean FRS compared with all other AFB groups. Compared with the lowest AFB risk group (25-29 years), women with an AFB of <20 years had a 5.8-point higher mean FRS (95% confidence interval, 3.4-8.3 points). Nulliparous women presented the lowest mean FRS in all analyses. The analysis comparing combinations of AFB and parity categories showed no meaningful differences in FRS between women who had 1 to 3 childbirths and those who had ≥4 childbirths within the stratum of AFB <20 years, and in the stratum of AFB ≥20 years. CONCLUSIONS Our analyses suggest that nulliparity and AFB, rather than increasing parity, drive the association with cardiovascular disease risk.
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Affiliation(s)
| | - Beatriz Alvarado
- Department of Public Health Sciences, Queen's University, Kingston, Ontario, Canada
| | - Yan Yan Wu
- Office of Public Health Studies, University of Hawai'i at Mānoa, Honolulu, HI
| | - Maria P Velez
- Department of Public Health Sciences, Queen's University, Kingston, Ontario, Canada
- Department of Obstetrics and Gynecology, Queen's University, Kingston, Ontario, Canada
| | - Saionara M Aires da Câmara
- Faculty of Health Sciences of Trairí, Universidade Federal do Rio Grande do Norte, Santa Cruz, Rio Grande do Norte, Brazil
| | - Catherine M Pirkle
- Office of Public Health Studies, University of Hawai'i at Mānoa, Honolulu, HI
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Szostak-Węgierek D, Waśkiewicz A, Piotrowski W, Stepaniak U, Pająk A, Kwaśniewska M, Nadrowski P, Niklas A, Puch-Walczak A, Drygas W. Metabolic syndrome and its components in Polish women of childbearing age: a nationwide study. BMC Public Health 2017; 18:15. [PMID: 28705231 PMCID: PMC5508652 DOI: 10.1186/s12889-017-4564-5] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2017] [Accepted: 07/04/2017] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Abnormal body mass and related metabolic disorders may affect female reproductive health. The purpose of the study was to determine the prevalence of underweight, overweight, obesity, lipid and glucose metabolism disorders, hypertension, and metabolic syndrome, among Polish women of childbearing age. METHODS One thousand five hundred eighty-eight non-pregnant Polish women of childbearing age (20-49 years) who participated in the Multi-Centre National Population Health Examination Survey (WOBASZ II study) in 2013-2014, were assigned to 3 age groups: 20-29 years (n = 403), 30-39 years (n = 600) and 40-49 years (n = 585). Measurements of weight, height, waist circumference, blood pressure, blood lipids, and blood glucose were taken. For statistical analysis, the Kruskal-Wallis, Chi-Square, and Cohran-Armitage tests were used. RESULTS Of the participants, 4.3% were determined to be underweight, 25.2% were overweight, 15% were obese, and 53.1% had abdominal obesity. With age, the prevalence of both excessive body mass and abdominal obesity tended to increase, and that of underweight to decrease. Frequency of hypercholesterolemia and hypertriglyceridemia found in the whole group were 50% and 12.6% respectively, and also tended to rise with age. Low serum HDL-cholesterol (high density lipoprotein cholesterol) levels were found in 15.1% of the participants. Prevalence of impaired fasting glucose in the whole group was 8.2% and tended to increase with age. Diabetes was found in 1.2% of the participants and its prevalence also tended to rise with age, at the borderline of significance. Frequency of arterial hypertension and metabolic syndrome in the whole group was 15.7% and 14.1% respectively and both tended to increase with age. CONCLUSIONS Overweight and obesity, especially of abdominal type, and the related metabolic abnormalities are common in Polish women of childbearing age. Their prevalence tends to increase with age. Underweight is relatively common in the youngest age group.
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Affiliation(s)
- Dorota Szostak-Węgierek
- Department of Human Nutrition, Faculty of Health Sciences, Medical University of Warsaw, Erazma Ciołka 27, 01-445 Warsaw, Poland
| | - Anna Waśkiewicz
- Department of Epidemiology, Cardiovascular Disease Prevention and Health Promotion, Institute of Cardiology, Warsaw, Poland
| | - Walerian Piotrowski
- Department of Epidemiology, Cardiovascular Disease Prevention and Health Promotion, Institute of Cardiology, Warsaw, Poland
| | - Urszula Stepaniak
- Deparment of Epidemiology and Population Studies, Institute of Public Health, Faculty of Health Sciences, Jagiellonian University Medical College, Crakow, Poland
| | - Andrzej Pająk
- Deparment of Epidemiology and Population Studies, Institute of Public Health, Faculty of Health Sciences, Jagiellonian University Medical College, Crakow, Poland
| | - Magdalena Kwaśniewska
- Department of Social and Preventive Medicine, Medical University of Lodz, Lodz, Poland
| | - Paweł Nadrowski
- 3rd Department of Cardiology, Upper Silesian Centre of Cardiology, Medical University of Silesia, Katowice, Poland
| | - Arkadiusz Niklas
- Department of Hypertension, Angiology, and Internal Medicine, University of Medical Sciences, Poznan, Poland
| | - Aleksandra Puch-Walczak
- Department of Arterial Hypertension and Diabetology, Medical University of Gdansk, Gdansk, Poland
| | - Wojciech Drygas
- Department of Epidemiology, Cardiovascular Disease Prevention and Health Promotion, Institute of Cardiology, Warsaw, Poland
- Department of Social and Preventive Medicine, Medical University of Lodz, Lodz, Poland
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29
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Association between maternal age at childbirth and metabolic syndrome in postmenopausal women: Korea National Health and Nutrition Examination Survey 2010 to 2012. Menopause 2017; 24:196-202. [DOI: 10.1097/gme.0000000000000740] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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30
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Vladutiu CJ, Siega-Riz AM, Sotres-Alvarez D, Stuebe AM, Ni A, Tabb KM, Gallo LC, Potter JE, Heiss G. Parity and Components of the Metabolic Syndrome Among US Hispanic/Latina Women: Results From the Hispanic Community Health Study/Study of Latinos. CIRCULATION-CARDIOVASCULAR QUALITY AND OUTCOMES 2016; 9:S62-9. [PMID: 26908862 DOI: 10.1161/circoutcomes.115.002464] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
BACKGROUND Physiological adaptations occurring across successive pregnancies may increase the risk of adverse cardiovascular health outcomes in later life. METHODS AND RESULTS The association between parity and metabolic syndrome was examined among 7467 Hispanic/Latina women of diverse backgrounds, aged 18 to 74 years, who participated in the Hispanic Community Health Study/Study of Latinos (HCHS/SOL) from 2008 to 2011. Metabolic syndrome components were defined according to American Heart Association/National Heart, Lung, and Blood Institute criteria and included abdominal obesity, elevated triglycerides, low high-density lipoprotein cholesterol, high blood pressure, and elevated fasting glucose. Logistic regression models estimated odds ratios (ORs) adjusting for sociodemographic, behavioral, and reproductive characteristics. At HCHS/SOL baseline, women reported none (21.1%), 1 (19.9%), 2 (25.7%), 3 (18.6%), 4 (8.8%), and ≥ 5 (5.9%) live births. When compared with women with 1 birth, those with 4 births had the highest odds of abdominal obesity (OR, 2.0; 95% confidence interval, 1.5-2.8) and overall metabolic syndrome (OR, 1.4; 95% confidence interval, 1.0-2.0) and those with ≥ 5 births had the highest odds of low high-density lipoprotein cholesterol (OR, 1.5; 95% confidence interval, 1.2-2.0) and elevated fasting glucose (OR, 1.6; 95% confidence interval, 1.1-2.4), after adjusting for age, background, education, marital status, income, nativity, smoking, physical activity, menopause, oral contraceptive use, hormone therapy, and field center. Further adjustment for percent body fat attenuated these associations. No associations were observed between parity and elevated triglycerides or high blood pressure. CONCLUSIONS Higher parity is associated with an increased prevalence of selected components of the metabolic syndrome among Hispanic/Latina women in the US. High parity among Hispanics/Latinas with a high prevalence of abdominal obesity suggests high risk for metabolic dysregulation.
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Affiliation(s)
- Catherine J Vladutiu
- From the Department of Obstetrics and Gynecology, School of Medicine, (C.J.V., A.M.S.), Department of Epidemiology, Gillings School of Global Public Health (C.J.V., A.M.S.-R., G.H.), Department of Nutrition, Gillings School of Global Public Health (A.M.S.-R.), Collaborative Studies Coordinating Center, Department of Biostatistics, Gillings School of Global Public Health (D.S.-A., A.N.), Department of Maternal and Child Health, Gillings School of Global Public Health (A.M.S.), University of North Carolina, Chapel Hill; School of Social Work, University of Illinois at Urbana-Champaign (K.M.T.); Department of Psychology, San Diego State University, CA (L.C.G.); and Department of Obstetrics and Gynecology, University of Miami Miller School of Medicine, FL (J.E.P.).
| | - Anna Maria Siega-Riz
- From the Department of Obstetrics and Gynecology, School of Medicine, (C.J.V., A.M.S.), Department of Epidemiology, Gillings School of Global Public Health (C.J.V., A.M.S.-R., G.H.), Department of Nutrition, Gillings School of Global Public Health (A.M.S.-R.), Collaborative Studies Coordinating Center, Department of Biostatistics, Gillings School of Global Public Health (D.S.-A., A.N.), Department of Maternal and Child Health, Gillings School of Global Public Health (A.M.S.), University of North Carolina, Chapel Hill; School of Social Work, University of Illinois at Urbana-Champaign (K.M.T.); Department of Psychology, San Diego State University, CA (L.C.G.); and Department of Obstetrics and Gynecology, University of Miami Miller School of Medicine, FL (J.E.P.)
| | - Daniela Sotres-Alvarez
- From the Department of Obstetrics and Gynecology, School of Medicine, (C.J.V., A.M.S.), Department of Epidemiology, Gillings School of Global Public Health (C.J.V., A.M.S.-R., G.H.), Department of Nutrition, Gillings School of Global Public Health (A.M.S.-R.), Collaborative Studies Coordinating Center, Department of Biostatistics, Gillings School of Global Public Health (D.S.-A., A.N.), Department of Maternal and Child Health, Gillings School of Global Public Health (A.M.S.), University of North Carolina, Chapel Hill; School of Social Work, University of Illinois at Urbana-Champaign (K.M.T.); Department of Psychology, San Diego State University, CA (L.C.G.); and Department of Obstetrics and Gynecology, University of Miami Miller School of Medicine, FL (J.E.P.)
| | - Alison M Stuebe
- From the Department of Obstetrics and Gynecology, School of Medicine, (C.J.V., A.M.S.), Department of Epidemiology, Gillings School of Global Public Health (C.J.V., A.M.S.-R., G.H.), Department of Nutrition, Gillings School of Global Public Health (A.M.S.-R.), Collaborative Studies Coordinating Center, Department of Biostatistics, Gillings School of Global Public Health (D.S.-A., A.N.), Department of Maternal and Child Health, Gillings School of Global Public Health (A.M.S.), University of North Carolina, Chapel Hill; School of Social Work, University of Illinois at Urbana-Champaign (K.M.T.); Department of Psychology, San Diego State University, CA (L.C.G.); and Department of Obstetrics and Gynecology, University of Miami Miller School of Medicine, FL (J.E.P.)
| | - Andy Ni
- From the Department of Obstetrics and Gynecology, School of Medicine, (C.J.V., A.M.S.), Department of Epidemiology, Gillings School of Global Public Health (C.J.V., A.M.S.-R., G.H.), Department of Nutrition, Gillings School of Global Public Health (A.M.S.-R.), Collaborative Studies Coordinating Center, Department of Biostatistics, Gillings School of Global Public Health (D.S.-A., A.N.), Department of Maternal and Child Health, Gillings School of Global Public Health (A.M.S.), University of North Carolina, Chapel Hill; School of Social Work, University of Illinois at Urbana-Champaign (K.M.T.); Department of Psychology, San Diego State University, CA (L.C.G.); and Department of Obstetrics and Gynecology, University of Miami Miller School of Medicine, FL (J.E.P.)
| | - Karen M Tabb
- From the Department of Obstetrics and Gynecology, School of Medicine, (C.J.V., A.M.S.), Department of Epidemiology, Gillings School of Global Public Health (C.J.V., A.M.S.-R., G.H.), Department of Nutrition, Gillings School of Global Public Health (A.M.S.-R.), Collaborative Studies Coordinating Center, Department of Biostatistics, Gillings School of Global Public Health (D.S.-A., A.N.), Department of Maternal and Child Health, Gillings School of Global Public Health (A.M.S.), University of North Carolina, Chapel Hill; School of Social Work, University of Illinois at Urbana-Champaign (K.M.T.); Department of Psychology, San Diego State University, CA (L.C.G.); and Department of Obstetrics and Gynecology, University of Miami Miller School of Medicine, FL (J.E.P.)
| | - Linda C Gallo
- From the Department of Obstetrics and Gynecology, School of Medicine, (C.J.V., A.M.S.), Department of Epidemiology, Gillings School of Global Public Health (C.J.V., A.M.S.-R., G.H.), Department of Nutrition, Gillings School of Global Public Health (A.M.S.-R.), Collaborative Studies Coordinating Center, Department of Biostatistics, Gillings School of Global Public Health (D.S.-A., A.N.), Department of Maternal and Child Health, Gillings School of Global Public Health (A.M.S.), University of North Carolina, Chapel Hill; School of Social Work, University of Illinois at Urbana-Champaign (K.M.T.); Department of Psychology, San Diego State University, CA (L.C.G.); and Department of Obstetrics and Gynecology, University of Miami Miller School of Medicine, FL (J.E.P.)
| | - JoNell E Potter
- From the Department of Obstetrics and Gynecology, School of Medicine, (C.J.V., A.M.S.), Department of Epidemiology, Gillings School of Global Public Health (C.J.V., A.M.S.-R., G.H.), Department of Nutrition, Gillings School of Global Public Health (A.M.S.-R.), Collaborative Studies Coordinating Center, Department of Biostatistics, Gillings School of Global Public Health (D.S.-A., A.N.), Department of Maternal and Child Health, Gillings School of Global Public Health (A.M.S.), University of North Carolina, Chapel Hill; School of Social Work, University of Illinois at Urbana-Champaign (K.M.T.); Department of Psychology, San Diego State University, CA (L.C.G.); and Department of Obstetrics and Gynecology, University of Miami Miller School of Medicine, FL (J.E.P.)
| | - Gerardo Heiss
- From the Department of Obstetrics and Gynecology, School of Medicine, (C.J.V., A.M.S.), Department of Epidemiology, Gillings School of Global Public Health (C.J.V., A.M.S.-R., G.H.), Department of Nutrition, Gillings School of Global Public Health (A.M.S.-R.), Collaborative Studies Coordinating Center, Department of Biostatistics, Gillings School of Global Public Health (D.S.-A., A.N.), Department of Maternal and Child Health, Gillings School of Global Public Health (A.M.S.), University of North Carolina, Chapel Hill; School of Social Work, University of Illinois at Urbana-Champaign (K.M.T.); Department of Psychology, San Diego State University, CA (L.C.G.); and Department of Obstetrics and Gynecology, University of Miami Miller School of Medicine, FL (J.E.P.)
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Suliga E, Kozieł D, Cieśla E, Rębak D, Głuszek S. Factors Associated with Adiposity, Lipid Profile Disorders and the Metabolic Syndrome Occurrence in Premenopausal and Postmenopausal Women. PLoS One 2016; 11:e0154511. [PMID: 27128677 PMCID: PMC4851395 DOI: 10.1371/journal.pone.0154511] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2015] [Accepted: 04/14/2016] [Indexed: 12/16/2022] Open
Abstract
The aim of the study was the assessment of the dependencies between a woman’s menopausal status and adiposity, lipid profile and metabolic syndrome occurrence, as well as finding out whether the correlations between the socio-demographic profile and lifestyle elements and adiposity, lipid profile and the risk of MetS are the same before and after menopause. A cross-sectional study was carried out on 3636 women, aged between 40–59, which involved a questionnaire interview, anthropometric measurements and fasting blood samples, on the basis of which the concentration of triglycerides, cholesterol and glucose was estimated. Before menopause, a greater adiposity (BMIβ = 0.08; %BFβ = 0.07; WCβ = 0.06) was characteristic for women living in a stable relationship than for single women. Women who smoked in the past were characterized by a higher BMI (β = 0.09) and WC (β = 0.06) in comparison with women who have never smoked, while after menopause a greater adiposity (%BFβ = 0.12) and a worse lipid profile (TCβ = 0.08; LDLβ = 0.07; HDLβ = -0.05; TGβ = 0.14) were present in women currently smoking, in comparison to women who have never smoked. After menopause, in women who had two or more children, a greater adiposity (BMIβ = 0.07 and 0.09; %BFβ = 0.05 and 0.07) and a higher risk of MetS (OR = 1.22, 95%CI: 1.03–1.44) was observed compared to nulliparous women, than before menopause. In women with a higher level of education, the risk of MetS after menopause was significantly lower compared with women with a lower level of education (OR = 0.74, 95%CI: 0.61–0.90). Physical activity after menopause had a higher influence on the decrease in the women’s adiposity (BMIβ = -0.11 v. -0.06; %BFβ = -0.11 v. -0.06; WCβ = -0.14 v. -0.08), than before menopause. In women not undergoing hormone replacement therapy, some of the socio-demographic factors and lifestyle elements affected adiposity, lipid profile and the risk of MetS differently before and after menopause, which requires verification through long-term research.
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Affiliation(s)
- Edyta Suliga
- Department of the Prevention of Alimentary Tract Diseases, The Institute of Nursing and Midwifery, Faculty of Health Sciences, Jan Kochanowski University, Kielce, Poland
- * E-mail:
| | - Dorota Kozieł
- Department of Surgery and Surgical Nursing with the Scientific Research Laboratory, The Institute of Medical Sciences, Faculty of Health Sciences, Jan Kochanowski University, Kielce, Poland
| | - Elżbieta Cieśla
- Department of Developmental Age Research, Institute of Public Health, Faculty of Health Sciences, Jan Kochanowski University, Kielce, Poland
| | - Dorota Rębak
- Department of Surgery and Surgical Nursing with the Scientific Research Laboratory, The Institute of Medical Sciences, Faculty of Health Sciences, Jan Kochanowski University, Kielce, Poland
| | - Stanisław Głuszek
- Department of Surgery and Surgical Nursing with the Scientific Research Laboratory, The Institute of Medical Sciences, Faculty of Health Sciences, Jan Kochanowski University, Kielce, Poland
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Feresu SA, Wang Y, Dickinson S. Relationship between maternal obesity and prenatal, metabolic syndrome, obstetrical and perinatal complications of pregnancy in Indiana, 2008-2010. BMC Pregnancy Childbirth 2015; 15:266. [PMID: 26475596 PMCID: PMC4609050 DOI: 10.1186/s12884-015-0696-8] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2015] [Accepted: 10/06/2015] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Obesity is a serious medical condition affecting more than 30% of Indiana, and 25% of Unites States pregnant women. Obesity is related to maternal complications, and significantly impacts the health of pregnant women. The objective of this study was to describe the relationship between maternal complications and pre-pregnancy maternal weight. METHODS Using logistic regression models, we analyzed 2008 to 2010 birth certificate data, for 255,773 live births abstracted from the Indiana Vital Statistics registry. We examined the risk of reproductive factors, obstetrical complications and perinatal (intrapartum) complications for underweight, healthy weight, overweight and obese women for this population. RESULTS Women who received prenatal care were more likely to be obese [adjusted odds ratio (AOR) = 1.82 (1.56-2.13)]. While women with parity of zero (0) were less likely to be obese [AOR = 0.89, 95% CI (0.86-0.91)]. Women giving birth to twins [AOR = 1.25, 95% CI (1.17- 1.33)], women delivering by Caesarian section [AOR = 2.31, 95% CI ( 2.26-2.37)], and women who previously had a Caesarian section [AOR = 1.95, 95% CI (1.88-2.02)] were more likely to be obese. There was evidence of metabolic like complication in this population, due to obesity. Obesity was significantly associated with obstetrical conditions of the metabolic syndrome, including pre-pregnancy diabetes, gestational diabetes, pre-pregnancy hypertension, pregnancy-induced hypertension and eclampsia [AOR = 5.12, 95% CI (4.47-5.85); AOR = 3.87, 95% CI (3.68-4.08); AOR = 7.66, 95% CI (6.77-8.65); AOR = 3.23, 95% CI (3.07-3.39); and AOR = 1.77, 95% CI (1.31-2.40), respectively. Maternal obesity modestly increased the risk of induction, epidural, post-delivery bleeding, and prolonged labor [AOR = 1.26, 95% CI (1.23-1.29); AOR = 1.15, 95% CI (1.13-1.18); AOR = 1.20, 95% CI (1.12-1.28); and AOR = 1.44, 95% CI (1.30-1.61)], respectively. Obese women were less likely to have blood transfusions [AOR = .74, 95% CI (0.58-96)], vaginal tears [AOR = 0.51, 95% CI (0.44-0.59)], or infections [AOR = 86, 95% CI (0.80-0.93)]. CONCLUSIONS Our results suggest that maternal obesity in Indiana, like other populations in the USA, is associated with high risks of maternal complications for pregnant women. Pre-pregnancy obesity prevention efforts should focus on targeting children, adolescent and young women, if the goal to reduce the risk of maternal complications related to obesity, is to be reached.
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Affiliation(s)
- Shingairai A Feresu
- Epidemiology and Biostatistics Track, School of Health Systems and Public Health, University of Pretoria, 5-10 H.W. Snyman Building, 31 Bophelo Road, Gezina, 0031, Pretoria, South Africa.
- School of Health Sciences, College of Health Sciences, Walden University, 155 Fifth Ave. South, Suite 100, Minneapolis, MN, 55401, USA.
| | - Yi Wang
- Department of Statistics, Indiana University, Indiana Statistical Consulting Center, 309 N Park Ave, Bloomington, IN, 47405, USA.
| | - Stephanie Dickinson
- Department of Statistics, Indiana University, Indiana Statistical Consulting Center, 309 N Park Ave, Bloomington, IN, 47405, USA.
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Berggren EK, Presley L, Amini SB, Hauguel-de Mouzon S, Catalano PM. Are the metabolic changes of pregnancy reversible in the first year postpartum? Diabetologia 2015; 58:1561-8. [PMID: 25957777 PMCID: PMC4703315 DOI: 10.1007/s00125-015-3604-x] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/20/2015] [Accepted: 04/02/2015] [Indexed: 02/07/2023]
Abstract
AIMS/HYPOTHESIS Maternal metabolic alterations are essential to achieve healthy pregnancy outcomes, but increasing maternal parity may be associated with long-term metabolic dysfunction risk. As existing data are limited by study design, our aim was to employ robust metabolic measures to determine whether or not physiological pregnancy alterations in maternal metabolic function persist at 1 year postpartum. METHODS We evaluated 21 healthy women, of whom 11 had an interval pregnancy (IP) and assessment at preconception, during pregnancy and 1 year postpartum, and 10 had no IP and assessment at baseline and a 1 year interval. Assessment measures included body composition, insulin sensitivity and response, and basal metabolic rate. For each measure, IP vs no IP and time intervals within each group were compared using nonparametric analyses, reporting median (IQR). RESULTS IP and no IP women were similar at enrolment, and no IP women had similar metabolic profiles at enrolment and the 1 year interval. IP women exhibited expected metabolic changes during pregnancy compared with preconception. In IP women, preconception and postpartum measures, including fat mass (20.7 [13.7-37.4] kg vs 18.4 [13.8-41.3] kg; p = 0.2), total insulin response (AUC 11,459 [9,230-13,696] pmol/ml × min vs 11,522 [5,882-17,404] pmol/ml × min; p = 0.9), insulin sensitivity (0.12 [0.06-0.13] mg [kg fat-free mass (FFM)](-1) min(-1) vs 0.11 [0.10-0.15] mg [kg FFM](-1) min(-1); p = 0.1) and basal metabolic rate (0.092 [0.092-0.105] kJ min(-1) FFM vs 0.096 [0.088-0.096] kJ min(-1) FFM; p = 0.5), were similar. CONCLUSIONS/INTERPRETATION Our findings suggest pregnancy might not irreversibly alter maternal metabolic profile, measured at preconception through to 1 year postpartum. This result might be explained by a return to pre-pregnancy weight.
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Affiliation(s)
- Erica K Berggren
- Department of Reproductive Biology, Case Western Reserve University/MetroHealth Medical Center, Center for Reproductive Health, 2500 MetroHealth Drive, Cleveland, OH, 44109, USA,
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Wu J, Xu G, Shen L, Zhang Y, Song L, Yang S, Yang H, Yuan J, Liang Y, Wang Y, Wu T. Parity and risk of metabolic syndrome among Chinese women. J Womens Health (Larchmt) 2015; 24:602-7. [PMID: 26172999 DOI: 10.1089/jwh.2014.5134] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Studies regarding the effects of parity on metabolic syndrome in later life have produced conflicting results. The purpose of this study was to explore the association between parity and the risk of metabolic syndrome and its components in a population of Chinese women. METHODS A cross-sectional study was performed in a total of 13,358 women (mean age 61.5 years) with at least one live birth from the Dongfeng-Tongji cohort study. Each woman completed baseline questionnaires and received baseline examination, including a physical examination and laboratory tests. Participants were categorized into four groups according to parity (one, two, three, four or more live births). The metabolic syndrome was defined according to the International Diabetes Foundation criteria. Logistic regression was conducted to examine the association between parity and metabolic syndrome, with adjustment of potential confounders. RESULTS In this study sample, the prevalence of metabolic syndrome was 38.6% (5,156 of 13,358). After adjusting for demographic, lifestyle, and reproduction-related factors, women with two, three, or four or more live births had 1.18 times (95% confidence interval [CI], 1.05-1.32), 1.44 times (95% CI, 1.24-1.67), and 1.52 times (95% CI, 1.26-1.83), respectively, higher odds of having metabolic syndrome compared with those with one live birth. Furthermore, parity showed a positive association with waist circumference and a negative association with high-density lipoprotein cholesterol. CONCLUSIONS Multiparity was associated with increasing risk of metabolic syndrome independent of main covariates in this population of Chinese women. The findings suggested that multiparity may be a risk factor for metabolic syndrome.
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Affiliation(s)
- Jing Wu
- 1 MOE Key Lab of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology , Wuhan, China .,2 Department of Maternal and Child Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology , Wuhan, China
| | - Guiqiang Xu
- 1 MOE Key Lab of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology , Wuhan, China .,2 Department of Maternal and Child Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology , Wuhan, China
| | - Lijun Shen
- 1 MOE Key Lab of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology , Wuhan, China .,2 Department of Maternal and Child Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology , Wuhan, China
| | - Yanmei Zhang
- 1 MOE Key Lab of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology , Wuhan, China .,2 Department of Maternal and Child Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology , Wuhan, China
| | - Lulu Song
- 1 MOE Key Lab of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology , Wuhan, China .,2 Department of Maternal and Child Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology , Wuhan, China
| | - Siyi Yang
- 1 MOE Key Lab of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology , Wuhan, China .,2 Department of Maternal and Child Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology , Wuhan, China
| | - Handong Yang
- 3 Dongfeng General Hospital, Dongfeng Motor Corporation and Hubei University of Medicine , Shiyan, China
| | - Jing Yuan
- 1 MOE Key Lab of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology , Wuhan, China
| | - Yuan Liang
- 4 Department of Social Medicine, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology , Wuhan, China
| | - Youjie Wang
- 1 MOE Key Lab of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology , Wuhan, China .,2 Department of Maternal and Child Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology , Wuhan, China
| | - Tangchun Wu
- 1 MOE Key Lab of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology , Wuhan, China
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