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AlAnnaz WAA, Gouda ADK, Abou El-Soud FA, Alanazi MR. Obesity Prevalence and Its Impact on Maternal and Neonatal Outcomes among Pregnant Women: A Retrospective Cross-Sectional Study Design. NURSING REPORTS 2024; 14:1236-1250. [PMID: 38804427 PMCID: PMC11130889 DOI: 10.3390/nursrep14020094] [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: 02/19/2024] [Revised: 05/10/2024] [Accepted: 05/15/2024] [Indexed: 05/29/2024] Open
Abstract
BACKGROUND The escalating prevalence of obesity in women of reproductive age raises concerns about its impact on maternal and fetal health during pregnancy. This study aimed to thoroughly assess how obesity affects pregnancy and neonatal outcomes among Saudi pregnant women. METHODS In a retrospective cross-sectional study, we analyzed 8426 pregnant women who delivered at King Fahad National Guard Hospital in Riyadh in 2021. Of these, 3416 had obesity, and 341 of them, meeting the inclusion criteria, were selected. Maternal and neonatal outcomes were compiled using a structured questionnaire and extracted from the hospital's "Best Care" data-based registration system. RESULTS The findings highlighted that 40.5% of pregnant women were classified as obese, with almost half falling into obesity class II based on BMI. Obesity correlated significantly with adverse maternal outcomes like gestational diabetes and increased rates of cesarean deliveries. Additionally, maternal obesity was linked to unfavorable fetal outcomes, including higher rates of newborn intensive care unit admissions, lower APGAR scores at 1 min, and a greater likelihood of macrosomia. CONCLUSIONS This study underscores the important impact of maternal obesity on both maternal and fetal health during pregnancy. Addressing this high-risk condition demands targeted educational programs for women of reproductive age focusing on BMI control, dietary adjustments, and lifestyle modifications to mitigate obesity-related complications during pregnancy.
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Affiliation(s)
- Wejdan Abdullah A. AlAnnaz
- College of Nursing, King Saud Bin Abdul Aziz University for Health Sciences (KSAU-HS), Riyadh 14611, Saudi Arabia; (W.A.A.A.); (A.D.K.G.); (F.A.A.E.-S.)
- King Abdullah International Medical Research Center, Riyadh 11481, Saudi Arabia
- Ministry of the National Guard—Health Affairs, Riyadh 11426, Saudi Arabia
| | - Amel Dawod Kamel Gouda
- College of Nursing, King Saud Bin Abdul Aziz University for Health Sciences (KSAU-HS), Riyadh 14611, Saudi Arabia; (W.A.A.A.); (A.D.K.G.); (F.A.A.E.-S.)
- King Abdullah International Medical Research Center, Riyadh 11481, Saudi Arabia
- Ministry of the National Guard—Health Affairs, Riyadh 11426, Saudi Arabia
- Maternal and Newborn Health Nursing, Faculty of Nursing, Cairo University, Giza 11562, Egypt
| | - Faiza Ahmed Abou El-Soud
- College of Nursing, King Saud Bin Abdul Aziz University for Health Sciences (KSAU-HS), Riyadh 14611, Saudi Arabia; (W.A.A.A.); (A.D.K.G.); (F.A.A.E.-S.)
- King Abdullah International Medical Research Center, Riyadh 11481, Saudi Arabia
- Ministry of the National Guard—Health Affairs, Riyadh 11426, Saudi Arabia
| | - Mona R Alanazi
- College of Nursing, King Saud Bin Abdul Aziz University for Health Sciences (KSAU-HS), Riyadh 14611, Saudi Arabia; (W.A.A.A.); (A.D.K.G.); (F.A.A.E.-S.)
- King Abdullah International Medical Research Center, Riyadh 11481, Saudi Arabia
- Ministry of the National Guard—Health Affairs, Riyadh 11426, Saudi Arabia
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Alotaibi EA, AlHaidar AM, Alotaibi SA, Alshehri NA, Alotaibi RA, Bashumeel YY, Nassar R, Batais MA. Assessment of Thyroid Dysfunction Among Pregnant Women With Pre-Existing Diabetes Mellitus or Gestational Diabetes Mellitus. Cureus 2023; 15:e44390. [PMID: 37779813 PMCID: PMC10541241 DOI: 10.7759/cureus.44390] [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] [Accepted: 08/29/2023] [Indexed: 10/03/2023] Open
Abstract
Objective This study investigates the prevalence and risk of thyroid disturbances in pregnant women with pre-existing diabetes mellitus (DM) or gestational diabetes mellitus (GDM) in a tertiary hospital setting in Riyadh, SA. This research's findings may help identify potential risk factors associated with thyroid disturbances during pregnancy and facilitate early diagnosis for at-risk pregnant women. Subjects and methods A retrospective cross-sectional study was conducted at an endocrinology clinic between October 2018 and December 2021 to evaluate the electronic records of pregnant women with DM or GDM who had documented normal thyroid function before pregnancy. Results Three hundred ninety-six files that met the selection criteria were deeply investigated and analyzed. The analysis showed that 378 (95.5%) patients were of Saudi nationality, and the mean age in years ± SD for the selected patients was 34.23 ± 5.468. The prevalence of obesity was 63.7%, with a mean body mass index (BMI) of 32.78 ± 6.78 kg/m2. The patients in this study were categorized into three groups based on their type of DM: 57 were diagnosed with type 1 DM (14.4%), 120 with type 2 DM (30.3%), and 219 with GDM (55.3%). The study identified 43 patients (10.85%) with subclinical hypothyroidism and 74 (18.69%) with hypothyroidism. Among the remaining patients, thyroid function was within the normal range for 264 (66.67%). The study also identified eight patients (2.02%) with subclinical hyperthyroidism and seven (1.77%) with hyperthyroidism. The prevalence of thyroid dysfunction was reported at 33.4%, with most of the dysfunction observed in the GDM group (20.7%). By comparison, the type 1 DM and type 2 DM groups presented a lower prevalence of thyroid dysfunction, accounting for only 4.1% and 8.6%, respectively. Conclusions Hypothyroidism, both clinical and subclinical, is more prevalent among patients with GDM than individuals with type 1 and type 2 DM. Research suggests a greater risk of developing hypothyroidism in patients with an increased BMI and among those older during pregnancy.
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Affiliation(s)
- Eman A Alotaibi
- Department of Family and Community Medicine, Unaizah College of Medicine and Medical Sciences, Qassim University, Unaizah, SAU
| | | | - Shahad A Alotaibi
- College of Medicine, Sulaiman Al Rajhi University, Al Bukayriah, SAU
| | - Norah A Alshehri
- Department of Family and Community Medicine, College of Medicine, King Saud University, Riyadh, SAU
| | - Raghad A Alotaibi
- College of Medicine, Sulaiman Al Rajhi University, Al Bukayriah, SAU
| | - Yaser Y Bashumeel
- Research, Endocrine and Oncology Division, Department of Surgery, Tulane University School of Medicine, New Orleans, USA
| | - Reema Nassar
- College of Medicine, Omdurman Islamic University, Khartoum, SDN
| | - Mohammed A Batais
- Family Medicine, Diabetes & Chronic Disease Management, King Khalid University Hospital, Riyadh, SAU
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Alamri SH, Abdeen GN. Maternal Nutritional Status and Pregnancy Outcomes Post-bariatric Surgery. Obes Surg 2022; 32:1325-1340. [PMID: 35165854 PMCID: PMC8933294 DOI: 10.1007/s11695-021-05822-y] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2021] [Revised: 11/21/2021] [Accepted: 11/22/2021] [Indexed: 11/30/2022]
Abstract
Obesity in childbearing women leads to pregnancy-related complications such as gestational diabetes mellitus, pregnancy-associated hypertensive disorders, and macrosomia. Weight loss helps reduce these complications. Studies show bariatric surgery reduces obesity-related complications during and after pregnancy. However, bariatric surgery might be associated with adverse outcomes, such as low birth weight and small-for-gestational-age infants. In addition, several studies suggest pregnancy occurring less than a year post-bariatric surgery adversely affects pregnancy outcomes and causes micronutrients deficiency since the dramatic weight loss occurs in the first year. These adverse outcomes may lead to nutritional malabsorption, such as anemia and low vitamin B12 and folic acid levels. The review aims to overview obesity-related complications during pregnancy and the benefits and risks of bariatric surgery on pregnancy outcomes and maternal nutrition status.
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Affiliation(s)
- Sara H Alamri
- Department of Community Health Science, Clinical Nutrition, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia.,Department of Clinical Nutrition Services, King Abdulaziz Medical City, King Saud bin Abdulaziz University for Health Sciences, King Abdullah International Medical Research Center, Riyadh, Saudi Arabia
| | - Ghalia N Abdeen
- Department of Community Health Science, Clinical Nutrition, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia. .,Strategic Center for Diabetes Research, College of Medicine, King Saud University, Riyadh, Saudi Arabia.
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Melisse B, van Furth EF, de Beurs E. Eating disorder examination questionnaire (EDE-Q): validity and norms for Saudi nationals. Eat Weight Disord 2022; 27:139-150. [PMID: 33751466 DOI: 10.1007/s40519-021-01150-3] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/08/2020] [Accepted: 02/09/2021] [Indexed: 01/17/2023] Open
Abstract
PURPOSE The aim of this study was to develop an Arabic version of the EDE-Q and to assess its psychometric properties and utility as a screener in the Saudi population. An additional aim was to establish EDE-Q norms for Saudis. METHOD EDE-Q data were collected in a convenience sample of the Saudi community (N = 2690), of which a subset was also subjected to the EDE interview (N = 98). Various models for the factor structure were evaluated on their fit by CFA. With ROC analysis, the AUC was calculated to test how well the EDE-Q discriminated between Saudis at high and low risk for eating disorders. RESULTS The original four factor model of the EDE-Q was not supported. Best fit was found for a three factor model, including the weight/shape concern scale, dietary restraint scale and eating concern scale. The ROC analysis showed that the EDE-Q could accurately discriminate between individuals at high and low risk for an eating disorder according to the EDE interview. Optimal cut off of 2.93 on the global score yielded a sensitivity of 82% and specificity of 80%. EDE-Q scores were fairly associated with BMI. DISCUSSION Psychometric characteristics of the Saudi version of the EDE-Q were satisfactory and results support the discriminant and convergent validity. Severity level of eating disorder pathology can be determined by the EDE-Q global score. Global scores were high compared to what is found in Western community samples, leading to high prevalence estimates for Saudis at high risk for eating disorders. LEVEL OF EVIDENCE Not applicable, empirical psychometric study.
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Affiliation(s)
- Bernou Melisse
- Novarum Center for Eating Disorders and Obesity, Jacob Obrechtstraat 92, 1071 KR, Amsterdam, the Netherlands. .,GGZ Rivierduinen, Sandifortdreef 18, 2333 ZZ, Leiden, the Netherlands.
| | - Eric F van Furth
- GGZ Rivierduinen, Sandifortdreef 18, 2333 ZZ, Leiden, the Netherlands.,Department of Psychiatry, Leiden University Medical Center, Albinusdreef 2, 2333 ZA, Leiden, the Netherlands
| | - Edwin de Beurs
- Research Department, Arkin Mental Health Institute, Klaprozenweg 111, 1033 NN, Amsterdam, the Netherlands.,Section Clinical Psychology, Leiden University, Wassenaarseweg 52, 2333 AK, Leiden, the Netherlands
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Impact of maternal pre-pregnancy body mass index on maternal, fetal and neonatal adverse outcomes in the worldwide populations: A systematic review and meta-analysis. Obes Res Clin Pract 2021; 15:536-545. [PMID: 34782256 DOI: 10.1016/j.orcp.2021.10.005] [Citation(s) in RCA: 60] [Impact Index Per Article: 20.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2021] [Revised: 10/25/2021] [Accepted: 10/29/2021] [Indexed: 12/25/2022]
Abstract
OBJECTIVE Systematic review and meta-analysis conducted to investigate the effect of stratified pre-pregnancy maternal body mass index on twenty maternal and fetal/neonatal adverse outcomes. METHODS PubMed, Google Scholar, Medline, Embase, Web of Science databases were searched from inception till July 11, 2020. Cohort studies were included. The pooled odds ratio with 95% confidence interval was reported considering the random effect and the quality effect model. The sub-group analysis and meta-regression were conducted for BMI cut-offs, geographical region, source of BMI, and sample size. RESULTS Overall, 86 studies representing 20,328,777 pregnant women were included in this meta-analysis. Our study reveals that overweight and obese mothers are at increased odds of cesarean delivery, elective cesarean delivery, emergency cesarean delivery, gestational diabetes, gestational hypertension, induction of labor, postpartum hemorrhage, pre-eclampsia, pre-term premature rupture of membrane, and the fetuses/neonates of overweight and obese mothers are at increased risk of admission in the newborn intensive care unit, APGAR scores less than 7 at 5 min, large for gestational age, macrosomia, extreme pre-term birth in pregnant mothers compared with standard BMI mothers. However, the underweight mothers showed increased odds for small for gestational age infant and pre-term birth, whereas obese mothers were at higher risk for post-term birth and stillbirths. The subgroup and meta-regression analyses have shown the impact of BMI cut-offs, geographical region, source of BMI, and sample size on several maternal, fetal/neonatal adverse outcomes. CONCLUSION The meta-analysis confirmed the association of elevated pre-pregnancy maternal BMI with higher odds of adverse maternal and fetal/neonatal outcomes.
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Alhabeeb H, Baradwan S, Kord-Varkaneh H, Tan SC, Low TY, Alomar O, Salem H, Al-Badawi IA, Abu-Zaid A. Association between body mass index and urinary tract infection: a systematic review and meta-analysis of observational cohort studies. Eat Weight Disord 2021; 26:2117-2125. [PMID: 33423153 DOI: 10.1007/s40519-020-01101-4] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/10/2020] [Accepted: 12/19/2020] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND AND OBJECTIVE Very few studies have investigated the relationship between body mass index (BMI) and risk of urinary tract infection (UTI), and conclusions from these available studies have been inconsistent. To resolve this inconsistency, we performed a systematic review and meta-analysis to precisely examine the association between BMI and UTI. METHODS This meta-analysis was performed based on the PRISMA recommendations. PubMed, Web of Science, Scopus, Embase, and Google Scholar databases were searched for all published observational studies that reported the risk of UTI based on BMI categories up to March 2020. RESULTS Fourteen (n = 14) articles comprising 19 studies in different populations met our inclusion criteria. The overall analysis showed a significant increased risk of UTI in subjects affected by obesity vs. individuals without obesity (RR = 1.45; 95% CI: 1.28 - 1.63; I2 = 94%), and a non-significant increased risk of UTI in subjects who were overweight (RR = 1.03; 95% CI: 0.98 - 1.10; I2 = 49.6%) and underweight (RR = 0.99; 95% CI: 0.81 - 21; I2 = 0.0%) when compared to subjects who had normal weight. In the stratified analysis, we showed that obesity increased the risk of UTI in females (RR = 1.63; 95% CI: 1.38 - 1.93) and in subjects below 60 years old (RR = 1.53; 95% CI: 1.33 - 1.75). CONCLUSION This systematic review and meta-analysis recognized a significant relationship between BMI and incidence of UTI in obese vs. non-obese subjects, as well as in females and in individuals below 60 years old.
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Affiliation(s)
- Habeeb Alhabeeb
- Clinical Research, King Fahad Medical City, Riyadh, Saudi Arabia
| | - Saeed Baradwan
- Department of Obstetrics and Gynecology, HealthPlus Fertility and Women's Health Center, Jeddah, Saudi Arabia
| | - Hamed Kord-Varkaneh
- Department of Clinical Nutrition and Dietetics, Student Research Committee, Faculty of Nutrition and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Shing Cheng Tan
- UKM Medical Molecular Biology Institute, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Teck Yew Low
- UKM Medical Molecular Biology Institute, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Osama Alomar
- Department of Obstetrics and Gynecology, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia
| | - Hany Salem
- Department of Obstetrics and Gynecology, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia
| | - Ismail Abdulrahman Al-Badawi
- Department of Obstetrics and Gynecology, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia
| | - Ahmed Abu-Zaid
- Department of Pharmacology, College of Graduate Health Sciences, University of Tennessee Health Science Center, Memphis, TN, USA. .,College of Medicine, Alfaisal University, Riyadh, Saudi Arabia.
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Maternal Prepregnancy Weight and Pregnancy Outcomes in Saudi Women: Subgroup Analysis from Riyadh Mother and Baby Cohort Study (RAHMA). BIOMED RESEARCH INTERNATIONAL 2021; 2021:6655942. [PMID: 33869631 PMCID: PMC8034996 DOI: 10.1155/2021/6655942] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/10/2020] [Revised: 03/07/2021] [Accepted: 03/13/2021] [Indexed: 01/22/2023]
Abstract
The objectives of this study were to estimate the prevalence of prepregnancy overweight/obesity and underweight among Saudi mothers and to determine the adverse pregnancy outcomes associated with them. Methods. This is a subgroup analysis from a Riyadh mother and baby cohort study. Participants were divided into four groups according to prepregnancy BMI. Participants with normal BMI were the reference group. Groups were compared in relation to pregnancy-related obstetric, as well as fetal and neonatal complications. A regression model was used to control for covariates, and adjusted odds ratios (AOR) with 95% Confidence Intervals (95% CI) were calculated. Results. A total of 7,029 women were included, 29.7% had normal BMI, 33.3% were overweight, 34.8% were obese, and 2.2% were underweight. Obesity was associated with increased odds of gestational diabetes (AOR 2.07, 95% CI 1.73-2.47), hypertensive events in pregnancy (AOR 2.33, 95% CI 1.19-3.91), induction of labour (IOL) (AOR 1.40, 95% CI, 1.19-1.65), failed IOL (AOR 2.13, 95% CI 1.40-3.25), and delivery by emergency caesarean section (CS) (AOR 1.67, 95% CI 1.39-2.01). Infants of obese women had increased odds of macrosomia (AOR 3.73, 95% CI 2.33-5.98). Overweight women had increased odds of CS delivery (AOR 1.25, 95% CI 1.03-1.5) and failed IOL (AOR 1.69, 95% CI 1.09-2.60). Underweight women had increased odds of delivering a low birth weight (LBW) infant (AOR 2.49, 95% CI, 1.58-3.92). Conclusion. The prevalence of prepregnancy overweight and obesity is very high in Saudi Arabia. Prepregnancy obesity is associated with GDM and hypertensive events inpregnancy, IOL, failed IOL, and CS delivery. Infants of obese mothers were at higher risk of macrosomia, while underweight women were at increased risk of delivering LBW infants.
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Fallatah AM, AlNoury A, Fallatah EM, Nassibi KM, Babatin H, Alghamdi OA, Tarabaih BY, Abduljabbar HS. Obesity Among Pregnant Women in Saudi Arabia: A Retrospective Single-Center Medical Record Review. Cureus 2021; 13:e13454. [PMID: 33728225 PMCID: PMC7934212 DOI: 10.7759/cureus.13454] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/20/2021] [Indexed: 12/25/2022] Open
Abstract
Background Obesity in Saudi Arabia is on the rise, especially among females who are more likely to suffer from obesity in the reproductive age group than males in the adult age group. Biologically, pregnancy can increase women's weight and put them at greater risk for adverse obstetric outcomes. Objectives To find the prevalence of obesity among pregnant women and their obstetric outcomes. Methods This retrospective study was conducted on pregnant women who delivered between January 2013 and May 2018 at the obstetrics clinic of King Abdulaziz University Hospital (KAUH), Jeddah, Saudi Arabia. A datasheet was formed to collect data from the medical records of these pregnant women. The analysis was done using the Statistical Package for Social Sciences (SPSS), version 26 (IBM SPSS Statistics, Armonk, NY). A p-value of < 0.05 was used to calculate statistical significance. Results A total of 9,095 pregnant women delivered during that period. Of those women, a total of 2,235 were found to be obese, and 1,842 were included in the study. A total of 1,130 women were categorized under Class I obesity, 458 were categorized under Class II obesity, and 254 were categorized under Class III obesity. The majority of the sample were Saudis (72.3%) and young adults (90.8%) with 1,672 cases. The average age was 31.7 (standard deviation (SD): 5.9). Twenty percent of the sample had preterm newborns, while the majority (62.4%) ended up with cesarean delivery. Advanced age, multipara, and cesarean delivery were statistically significant with adverse pregnancy outcomes (p < 0.05). Conclusion As demonstrated in this study, obesity among females in Saudi Arabia has increased over the past decade. Hence, this puts them at higher risk of developing adverse pregnancy outcomes, as pregnancy physiologically results in additional weight gain. Proper antenatal counseling, health education, and a comprehensive plan prior to conception are highly recommended.
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Affiliation(s)
- Anas M Fallatah
- Medicine, College of Medicine, King Abdulaziz University, Jeddah, SAU
| | - AlRayan AlNoury
- Obstetrics and Gynecology, East Jeddah Hospital, Jeddah, SAU
| | - Enas M Fallatah
- Medicine, College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Jeddah, SAU
| | - Khalid M Nassibi
- Medicine, College of Medicine, King Abdulaziz University, Jeddah, SAU
| | - Hussam Babatin
- Medicine, College of Medicine, King Abdulaziz University, Jeddah, SAU
| | - Omar A Alghamdi
- Medicine, College of Medicine, King Abdulaziz University, Jeddah, SAU
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Al-Rifai RH, Abdo NM, Paulo MS, Saha S, Ahmed LA. Prevalence of Gestational Diabetes Mellitus in the Middle East and North Africa, 2000-2019: A Systematic Review, Meta-Analysis, and Meta-Regression. Front Endocrinol (Lausanne) 2021; 12:668447. [PMID: 34512543 PMCID: PMC8427302 DOI: 10.3389/fendo.2021.668447] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/16/2021] [Accepted: 07/30/2021] [Indexed: 12/16/2022] Open
Abstract
UNLABELLED Women in the Middle East and North Africa (MENA) region are burdened with several risk factors related to gestational diabetes mellitus (GDM) including overweight and high parity. We systematically reviewed the literature and quantified the weighted prevalence of GDM in MENA at the regional, subregional, and national levels. Studies published from 2000 to 2019 reporting the prevalence of GDM in the MENA region were retrieved and were assessed for their eligibility. Overall and subgroup pooled prevalence of GDM was quantified by random-effects meta-analysis. Sources of heterogeneity were investigated by meta-regression. The risk of bias (RoB) was assessed by the National Heart, Lung, and Blood Institute's tool. One hundred and two research articles with 279,202 tested pregnant women for GDM from 16 MENA countries were included. Most of the research reports sourced from Iran (36.3%) and Saudi Arabia (21.6%), with an overall low RoB. In the 16 countries, the pooled prevalence of GDM was 13.0% (95% confidence interval [CI], 11.5-14.6%, I2 , 99.3%). Nationally, GDM was highest in Qatar (20.7%, 95% CI, 15.2-26.7% I2 , 99.0%), whereas subregionally, GDM was highest in Gulf Cooperation Council (GCC) countries (14.7%, 95% CI, 13.0-16.5%, I2 , 99.0%). The prevalence of GDM was high in pregnant women aged ≥30 years (21.9%, 95% CI, 18.5-25.5%, I2 , 97.1%), in their third trimester (20.0%, 95% CI, 13.1-27.9%, I2 , 98.8%), and who were obese (17.2%, 95% CI, 12.8-22.0%, I2 , 93.8%). The prevalence of GDM was 10.6% (95% CI, 8.1-13.4%, I2 , 98.9%) in studies conducted before 2009, whereas it was 14.0% (95% CI, 12.1-16.0%, I2 , 99.3%) in studies conducted in or after 2010. Pregnant women in the MENA region are burdened with a substantial prevalence of GDM, particularly in GCC and North African countries. Findings have implications for maternal health in the MENA region and call for advocacy to unify GDM diagnostic criteria. SYSTEMATIC REVIEW REGISTRATION PROSPERO CRD42018100629.
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Affiliation(s)
- Rami H. Al-Rifai
- Institute of Public Health, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates
- *Correspondence: Rami H. Al-Rifai,
| | - Noor Motea Abdo
- Institute of Public Health, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates
| | - Marília Silva Paulo
- Institute of Public Health, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates
| | - Sumanta Saha
- Department of Community Medicine, R. G. Kar Medical College, Kolkata, India
| | - Luai A. Ahmed
- Institute of Public Health, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates
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Alshakhs F, Alharthi H, Aslam N, Khan IU, Elasheri M. Predicting Postoperative Length of Stay for Isolated Coronary Artery Bypass Graft Patients Using Machine Learning. Int J Gen Med 2020; 13:751-762. [PMID: 33061545 PMCID: PMC7537993 DOI: 10.2147/ijgm.s250334] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2020] [Accepted: 08/10/2020] [Indexed: 11/23/2022] Open
Abstract
Purpose Predictive analytics (PA) is a new trending approach in the field of healthcare that uses machine learning to build a prediction model using supervised learning algorithms. Isolated coronary artery bypass grafting (iCABG), an open-heart surgery, is commonly performed in the treatment of coronary heart disease. Aim The aim of this study was to develop and evaluate a model to predict postoperative length of stay (PLoS) for iCABG patients using supervised machine learning techniques, and to identify the features with the highest contribution to the model. Methods This is a retrospective study that uses historic data of adult patients who underwent isolated CABG (iCABG). After initial data pre-processing, data imputation using the kNN method was applied. The study used five prediction models using Naïve Bayes, Decision Tree, Random Forest, Logistic Regression and k Nearest Neighbor algorithms. Data imbalance was managed using the following widely used methods: oversampling, undersampling, "Both", and random over-sampling examples (ROSE). The features selection process was conducted using the Boruta method. Two techniques were applied to examine the performance of the models, (70%, 30%) split and cross-validation, respectively. Models were evaluated by comparing their performance using AUC and other metrics. Results In the final dataset, six distinct features and 621 instances were used to develop the models. A total of 20 models were developed using R statistical software. The model generated using Random Forest with "Both" resampling method and cross-validation technique was deemed the best fit (AUC=0.81; F1 score=0.82; and recall=0.82). Attributes found to be highly predictive of PLoS were pulmonary artery systolic, age, height, EuroScore II, intra-aortic balloon pump used, and complications during operation. Conclusion This study demonstrates the significance and effectiveness of building a model that predicts PLoS for iCABG patients using patient specifications and pre-/intra-operative measures.
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Affiliation(s)
- Fatima Alshakhs
- Department of Health Information Management & Technology, College of Public Health, Imam Abdulrahman Bin Faisal University, Dammam 34221-4237, Saudi Arabia
| | - Hana Alharthi
- Department of Health Information Management & Technology, College of Public Health, Imam Abdulrahman Bin Faisal University, Dammam 34221-4237, Saudi Arabia
| | - Nida Aslam
- Department of Computer Science, College of Computer Science and Information Technology, Imam Abdulrahman Bin Faisal University, Dammam 34221-4237, Saudi Arabia
| | - Irfan Ullah Khan
- Department of Computer Science, College of Computer Science and Information Technology, Imam Abdulrahman Bin Faisal University, Dammam 34221-4237, Saudi Arabia
| | - Mohamed Elasheri
- Department of Cardiac Surgery, Saud Albabtain Cardiac Centre, Dammam 32245, Saudi Arabia
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Fallatah AM, Babatin HM, Nassibi KM, Banweer MK, Fayoumi MN, Oraif AM. Maternal and Neonatal Outcomes among Obese Pregnant Women in King Abdulaziz University Hospital: A Retrospective Single-Center Medical Record Review. Med Arch 2020; 73:425-432. [PMID: 32082014 PMCID: PMC7007626 DOI: 10.5455/medarh.2019.73.425-432] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
Abstract
Intoruction: Pregnancy results in different physiological changes to the pregnant body resulting in weight gain. This added weight can result in poor pregnancy outcomes in obese women. Aim: To assess the adverse maternal and neonatal outcomes among obese pregnant women. Methods: This is a retrospective record review conducted on obese pregnant women who delivered in the last five years attending King Abdulaziz University Hospital, Jeddah, Saudi Arabia. Therefore, for analysis we used the following; 1- descriptive analysis, 2- Chi-square test, Pearson correlation, independent t-test, and one-way ANOVA to test the difference in obese and adverse pregnancy outcomes. Advance statistics such as binary, and multinomial logistic regression were used to examine the relationship between obesity and all adverse pregnancy outcomes. Results: A total of 1037 obese pregnant women were enrolled in our study including 620 (59.8%) obese in class I (30-34.9), 262 (25.3%) obese in class II (35-39.9), and 155 (14.9%) obese in class III (40). About 74.73% of the population were Saudis. The average age was 31.96 (5.79) years. Out of 1037 obese pregnant women, 449 did develop undesired antepartum outcomes, while 729 and 163 had adverse neonatal, and postpartum outcomes. Antepartum variables such as preeclampsia, gestational diabetes mellitus, impaired glucose tolerance test, antiphospholipid syndrome, premature rupture of membranes, placenta previa, anemia, urinary tract infection, and oligohydramnios, and rate of Cesarean section were significantly associated with obesity (P<0.05). Postpartum variables such as vaginal laceration, perianal laceration, postpartum hemorrhage, and endometritis were also significantly associated with obesity (P<0.05). Moreover, adverse neonatal outcomes such as low APGAR scores at 1 and 5 minutes, birthweight, gestational age, admission to neonatal intensive care unit, intrauterine fetal death, and neonatal death, were significant significantly associated with obesity (P<0.05). Conclusion: As our study demonstrated, maternal obesity resulted in adverse outcomes for the mother and fetus. Hence, to yield a better outcome for these women and their offspring, periconceptional counseling, conducting health education, and comprehensive plan prior to their pregnancy should be enforced.
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Affiliation(s)
- Anas M Fallatah
- Faculty of Medicine, King Abdulaziz University, Jeddah, Kingdom of Saudi Arabia
| | - Hussam M Babatin
- Faculty of Medicine, King Abdulaziz University, Jeddah, Kingdom of Saudi Arabia
| | - Khalid M Nassibi
- Faculty of Medicine, King Abdulaziz University, Jeddah, Kingdom of Saudi Arabia
| | - Mazen K Banweer
- Faculty of Medicine, Jeddah University, Jeddah, Kingdom of Saudi Arabia
| | - Mohammad N Fayoumi
- Faculty of Medicine, King Abdulaziz University, Jeddah, Kingdom of Saudi Arabia
| | - Ayman M Oraif
- Department of Obstetrics and Gynecology, King Abdulaziz University Hospital, Jeddah, Kingdom of Saudi Arabia
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12
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Al-Otaibi H, Hussein N, Mustafa H, Al-Mudaires N. Obesity, gestational weight gain, and polyunsaturated fatty acids profile in pregnant Saudi women. Bioinformation 2020; 16:493-500. [PMID: 32884215 PMCID: PMC7452740 DOI: 10.6026/97320630016493] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2020] [Revised: 05/25/2020] [Accepted: 05/26/2020] [Indexed: 12/11/2022] Open
Abstract
Obesity and excessive gestational weight gain (GWG) are associated with a deficiency of essential fatty acids, affecting maternal health during and after pregnancy. Therefore, it is of interest to identify the associations of pre-pregnancy body mass index (BMI) and GWG with lipid profiles in Saudi women after giving birth. Hence, a cross-sectional study of 238 pregnant women aged 20-40 years was conducted at the King Abdul Aziz Hospital, in Al-Ahsa Governorate-Saudi Arabia. Thus, socio-demographic and anthropometric data were collected using a structured questionnaire. Poly-unsaturated fatty acids (PUFAs), saturated fatty acids (SFAs), and monounsaturated fatty acids (MUFAs) levels were assessed from blood samples collected after the women gave birth. The participants generally consumed diets low in omega-3 and omega-6 PUFAs and high in SFAs and MUFAs. Among them, 51% had university degrees, only 20.4% were employed, and 50% had pre-pregnancy overweight/obesity. Women with overweight/obesity had a higher omega-6 to omega-3 PUFA ratio than women with normal weight. Overweight, obesity, and excessive GWG were not associated with higher levels of total n-3 PUFAs, docosahexaenoic acid, and α-linolenic acid but were associated with higher levels of total n-6 PUFAs and linoleic acid. Women with obesity had significantly higher SFA and MUFA levels than women with normal weight, whereas women with excessive GWG were twice as likely to have higher SFA levels than women with adequate GWG. We show that a higher pre-pregnancy BMI and excessive GWG were significantly associated with abnormal lipid profiles in Saudi women after giving birth. We believe that future studies will help explore these associations in detail.
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Affiliation(s)
- Hala Al-Otaibi
- Department of Food Sciences and Nutrition, College of Agriculture and Food Sciences, King Faisal University, Al-Ahsa, Saudi Arabia
| | - Nahed Hussein
- Faculty of Specific Education, Ain Shams University, Cairo, Egypt
| | - Hani Mustafa
- King Abdul Aziz Hospital, National Guard Health Affairs, Al-Ahsa, Saudi Arabia
| | - Norah Al-Mudaires
- Department of Physical Education, College of Education, King Faisal University, Al-Ahsa, Saudi Arabia
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13
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Al-Rifai RH, Ali N, Barigye ET, Al Haddad AHI, Al-Maskari F, Loney T, Ahmed LA. Maternal and birth cohort studies in the Gulf Cooperation Council countries: a systematic review and meta-analysis. Syst Rev 2020; 9:14. [PMID: 31948468 PMCID: PMC6964097 DOI: 10.1186/s13643-020-1277-0] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/21/2019] [Accepted: 01/10/2020] [Indexed: 02/11/2023] Open
Abstract
BACKGROUND We systematically reviewed and chronicled exposures and outcomes measured in the maternal and birth cohort studies in the Gulf Cooperation Council (GCC) countries and quantitatively summarized the weighted effect estimates between maternal obesity and (1) cesarean section (CS) and (2) fetal macrosomia. METHODS We searched MEDLINE-PubMed, Embase, Cochrane Library, Scopus, and Web of Science electronic databases up to 30 June 2019. We considered all maternal and birth cohort studies conducted in the six GCC countries (Bahrain, Kuwait, Oman, Qatar, Saudi Arabia, and United Arab Emirates (UAE)). We categorized cohort studies on the basis of the exposure(s) (anthropometric, environmental, medical, maternal/reproductive, perinatal, or socioeconomic) and outcome(s) (maternal or birth) being measured. Adjusted weighted effect estimates, in the form of relative risks, between maternal obesity and CS and fetal macrosomia were generated using a random-effects model. RESULTS Of 3502 citations, 81 published cohort studies were included. One cohort study was in Bahrain, eight in Kuwait, seven in Qatar, six in Oman, 52 in Saudi Arabia, and seven in the UAE. Majority of the exposures studied were maternal/reproductive (65.2%) or medical (39.5%). Birth and maternal outcomes were reported in 82.7% and in 74.1% of the cohort studies, respectively. In Saudi Arabia, babies born to obese women were at a higher risk of macrosomia (adjusted relative risk (aRR), 1.15; 95% confidence interval (CI), 1.10-1.20; I2 = 50%) or cesarean section (aRR, 1.21; 95% CI, 1.15-1.26; I2 = 62.0%). Several cohort studies were only descriptive without reporting the magnitude of the effect estimate between the assessed exposures and outcomes. CONCLUSIONS Cohort studies in the GCC have predominantly focused on reproductive and medical exposures. Obese pregnant women are at an increased risk of undergoing CS delivery or macrosomic births. Longer-term studies that explore a wider range of environmental and biological exposures and outcomes relevant to the GCC region are needed. SYSTEMATIC REVIEW REGISTRATION PROSPERO CRD42017068910.
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Affiliation(s)
- Rami H. Al-Rifai
- Institute of Public Health, College of Medicine and Health Sciences, United Arab Emirates University, P.O. Box 15551, Al Ain, United Arab Emirates
| | - Nasloon Ali
- Institute of Public Health, College of Medicine and Health Sciences, United Arab Emirates University, P.O. Box 15551, Al Ain, United Arab Emirates
| | - Esther T. Barigye
- Institute of Public Health, College of Medicine and Health Sciences, United Arab Emirates University, P.O. Box 15551, Al Ain, United Arab Emirates
| | - Amal H. I. Al Haddad
- Institute of Public Health, College of Medicine and Health Sciences, United Arab Emirates University, P.O. Box 15551, Al Ain, United Arab Emirates
| | - Fatima Al-Maskari
- Institute of Public Health, College of Medicine and Health Sciences, United Arab Emirates University, P.O. Box 15551, Al Ain, United Arab Emirates
| | - Tom Loney
- College of Medicine, Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai, United Arab Emirates
| | - Luai A. Ahmed
- Institute of Public Health, College of Medicine and Health Sciences, United Arab Emirates University, P.O. Box 15551, Al Ain, United Arab Emirates
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14
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Nguyen TMT, Steane SE, Moritz KM, Akison LK. Prenatal alcohol exposure programmes offspring disease: insulin resistance in adult males in a rat model of acute exposure. J Physiol 2019; 597:5619-5637. [PMID: 31595508 DOI: 10.1113/jp278531] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2019] [Accepted: 09/26/2019] [Indexed: 12/12/2022] Open
Abstract
KEY POINTS Prenatal alcohol exposure has the potential to affect fetal development and programme chronic disease in offspring. Previous preclinical models typically use high, chronic doses of alcohol throughout pregnancy to examine effects on offspring, particularly on the brain and behaviour. In this study we use a rat model of moderate, acute, prenatal alcohol exposure to determine if this can be detrimental to maintenance of glucose homeostasis in adolescent and adult offspring. Although female offspring were relatively unaffected, there was evidence of insulin resistance in 6-month-old male offspring exposed to prenatal alcohol, suggestive of a pre-diabetic state. This result suggests that even a relatively low-dose, acute exposure to alcohol during pregnancy can still programme metabolic dysfunction in a sex-specific manner. ABSTRACT Alcohol consumption is highly prevalent amongst women of reproductive age. Given that approximately 50% of pregnancies are unplanned, alcohol has the potential to affect fetal development and programme chronic disease in offspring. We examined the effect of an acute but moderate prenatal alcohol exposure (PAE) on glucose metabolism, lipid levels and dietary preference in adolescent and/or adult rat offspring. Pregnant Sprague-Dawley rats received an oral gavage of ethanol (1 g kg-1 maternal body weight, n = 9 dams) or an equivalent volume of saline (control, n = 8 dams) at embryonic days 13.5 and 14.5. PAE resulted in a blood alcohol concentration of 0.05-0.06% 1 h post-gavage in dams. Fasting blood glucose concentration was not affected by PAE in offspring at any age, nor were blood glucose levels during a glucose tolerance test (GTT) in 6-month-old offspring (P > 0.5). However, there was evidence of insulin resistance in PAE male offspring at 6 months of age, with significantly elevated fasting plasma insulin (P = 0.001), a tendency for increased first phase insulin secretion during the GTT and impaired glucose clearance following an insulin challenge (P = 0.007). This was accompanied by modest alterations in protein kinase B (AKT) signalling in adipose tissue. PAE also resulted in reduced calorie consumption by offspring compared to controls (P = 0.04). These data suggest that a relatively low-level, acute PAE programmes metabolic dysfunction in offspring in a sex-specific manner. These results highlight that alcohol consumption during pregnancy has the potential to affect the long-term health of offspring.
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Affiliation(s)
- Tam M T Nguyen
- School of Biomedical Sciences, The University of Queensland, St Lucia, QLD, Australia
| | - Sarah E Steane
- School of Biomedical Sciences, The University of Queensland, St Lucia, QLD, Australia
| | - Karen M Moritz
- School of Biomedical Sciences, The University of Queensland, St Lucia, QLD, Australia.,Child Health Research Centre, The University of Queensland, South Brisbane, QLD, Australia
| | - Lisa K Akison
- School of Biomedical Sciences, The University of Queensland, St Lucia, QLD, Australia.,Child Health Research Centre, The University of Queensland, South Brisbane, QLD, Australia
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15
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Najafi F, Hasani J, Izadi N, Hashemi-Nazari SS, Namvar Z, Mohammadi S, Sadeghi M. The effect of prepregnancy body mass index on the risk of gestational diabetes mellitus: A systematic review and dose-response meta-analysis. Obes Rev 2019; 20:472-486. [PMID: 30536891 DOI: 10.1111/obr.12803] [Citation(s) in RCA: 79] [Impact Index Per Article: 15.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/30/2018] [Revised: 10/10/2018] [Accepted: 10/11/2018] [Indexed: 12/16/2022]
Abstract
This study was conducted to investigate the effect of the prepregnancy BMI on the risk of gestational diabetes mellitus (GDM). Five electronic databases, including PubMed, Scopus, Embase, Web of Science, and Google Scholar, were searched for literature published until 1 January 2018. The two-stage, random effect meta-analysis was performed to compare the dose-response relationship between BMI and GDM. As well as studies with categorized BMI, studies that treat BMI as a continuous variable were analysed. A total of 33 observational studies with an overall sample size of 962 966 women and 42 211 patients with GDM were included in analysis. The pooled estimate of GDM risk in the underweight, overweight, and obese pregnant women was 0.68, 2.01, and 3.98 using the adjusted OR and 0.34, 1.52, and 2.24 using the adjusted RR. The GDM risk increased 4% per unit of increase in BMI with both the crude and adjusted OR/RR models. Also, the risk of GDM increased 19% with the crude model and 14% with the adjusted model. The existence of dose-response relationship between the pre-pregnancy BMI and GDM can strengthen the scientific background for vigorous public health interventions for the control of pre-pregnancy BMI as well as the weight gain during pregnancy.
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Affiliation(s)
- Farid Najafi
- Department of Epidemiology, Research Center for Environmental Determinants of Health (RCEDH), Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Jalil Hasani
- Torbat Jam Faculty of Medical Sciences, Torbat Jam, Iran
| | - Neda Izadi
- Student Research Committee, Department of Epidemiology, School of Public Health and Safety, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Seyed-Saeed Hashemi-Nazari
- Safety Promotion and Injury Prevention Research Center, Department of Epidemiology, School of Public Health and Safety, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Zahra Namvar
- Student Research Committee, Department of Environmental Health Engineering, School of Public Health and Safety, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Samira Mohammadi
- Health Education and Health Promotion, Social Development & Health Promotion Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Masoud Sadeghi
- Medical Biology Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran
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16
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Subki AH, Algethami MR, Baabdullah WM, Alnefaie MN, Alzanbagi MA, Alsolami RM, Abduljabbar HS. Prevalence, Risk Factors, and Fetal and Maternal Outcomes of Hypertensive Disorders of Pregnancy: A Retrospective Study in Western Saudi Arabia. Oman Med J 2018; 33:409-415. [PMID: 30210720 DOI: 10.5001/omj.2018.75] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
Objectives We sought to estimate the prevalence of hypertensive disorders of pregnancy (HDP) in Saudi Arabia as well as the risk factors of HDP, and maternal and fetal outcomes. Methods We retrospectively evaluated the medical records of 9493 women who delivered at King Abdulaziz University Hospital, a tertiary care center, between January 2015 and June 2017. All cases of HDP were included. Results We identified 224 pregnant women with HDP in our patient cohort, giving a prevalence of 2.4%. Their mean age was 31.3±6.7 years, with an average gravidity of 4.0 and average parity of 3.0. The most prevalent subtype of HDP was preeclampsia (54.9%) while 29.5% of the women had gestational hypertension, and 8.0% had eclampsia. The prevalence of subtypes of HDP differed significantly with gravidity, and mean age differed significantly with HDP subtype. Personal and family histories of preeclampsia and the presence of diabetes were more prevalent in women with preeclampsia and gestational hypertension; however, only the difference in diabetes prevalence was significant. The overall prevalence of maternal complications was 9.4% and the prevalence of maternal mortality was 1.3%. Multigravid women and women with chronic hypertension were at increased risk of prematurity compared to other pregnant women, but not significantly. Conclusions The prevalence of HDP was relatively low in our cohort. However, to prevent harmful impacts on both the mother and fetus, screening for this disorder is recommended early in pregnancy.
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Affiliation(s)
- Ahmed Hussein Subki
- Department of Obstetrics and Gynecology, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Mohammed Ridha Algethami
- Department of Obstetrics and Gynecology, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Wejdan Mohammad Baabdullah
- Department of Obstetrics and Gynecology, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Majed Nasser Alnefaie
- Department of Obstetrics and Gynecology, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Mashael Abdullah Alzanbagi
- Department of Obstetrics and Gynecology, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Rawan Marzooq Alsolami
- Department of Obstetrics and Gynecology, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Hassan S Abduljabbar
- Department of Obstetrics and Gynecology, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
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17
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Vinturache AE, Winn A, Tough SC. Recall of Prenatal Counselling Among Obese and Overweight Women from a Canadian Population: A Population Based Study. Matern Child Health J 2018; 21:2092-2101. [PMID: 28721648 DOI: 10.1007/s10995-017-2324-x] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Objective The objective of this study was to evaluate the recall of prenatal counselling received among overweight and obese women in primary care settings. Methods A sample of 1996 women with singleton, term deliveries and pre-pregnancy BMI >18.5 kg/m2 were identified from the All Our Babies pregnancy cohort. Information on socio-demographic characteristics and women's experiences with prenatal counselling on nutrition, vitamin and mineral supplements, exercise, weight gain, employment, alcohol and drug use, and smoking during pregnancy were collected through questionnaires administered at <25 weeks and 34-36 weeks gestation. Multivariable logistic regression analyses explored the associations between pre-pregnancy BMI and the domains of prenatal counselling, controlling for confounders. Results Women reported high levels of comfort asking questions and satisfaction with their health care provider. Women reported getting information about nutrition (69.3%), weight gain (67.8%), exercise (64.4%), vitamins and minerals supplementation (86.1%). Obese women (211, 10.6%) were more likely than normal weight women (1313, 65.8%) to be Caucasian (p = 0.004), less educated (p = 0.001), and to have been born or lived in Canada for at least 5 years (p = 0.01). There was no difference in the prenatal advice received on nutrition, weight gain and exercise in pregnancy between obese, overweight, and normal weight women. Conclusions for Practice Pre-pregnancy BMI did not appear to influence the recall of prenatal counselling women receive in community health care centers. Given the importance of nutrition and weight gain during pregnancy, and guidelines for weight gain based on pre-pregnancy BMI, there are missed opportunities in knowledge exchange between women and providers in the prenatal period.
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Affiliation(s)
- Angela E Vinturache
- Department of Paediatrics, Cumming School of Medicine, University of Calgary, 3330 Hospital Drive NW, Calgary, AB, T2N 4N1, Canada.
| | - Anika Winn
- Faculty of Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Canada
| | - Suzanne C Tough
- Department of Paediatrics, Cumming School of Medicine, University of Calgary, 3330 Hospital Drive NW, Calgary, AB, T2N 4N1, Canada.,Department of Community of Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Canada
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18
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Zutshi A, Santhosh J, Sheikh J, Naeem F, Al-Hamedi A, Khan S, Al-Said E. Implications of Early Pregnancy Obesity on Maternal, Fetal and Neonatal Health: Retrospective cohort study from Oman. Sultan Qaboos Univ Med J 2018; 18:e47-e53. [PMID: 29666681 DOI: 10.18295/squmj.2018.18.01.008] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2017] [Revised: 11/08/2017] [Accepted: 01/07/2018] [Indexed: 11/16/2022] Open
Abstract
Objectives This study aimed to determine the prevalence of early pregnancy obesity among Omani women and to review maternal antenatal complications, intrapartum and postpartum events and neonatal complications among such women in comparison to women of normal weight. Methods This retrospective cohort study included 2,652 pregnant Omani women who delivered at the Royal Hospital, Muscat, Oman, between November 2011 and April 2012. The patients' electronic medical records were reviewed for antenatal, intrapartum and postpartum data. Body mass index was measured during the first trimester (≤12 gestational weeks) and classified according to the World Health Organization categories. Maternal and neonatal complications were compared between obese women and those of normal weight. Obstetric outcomes in uncomplicated pregnancies were also compared. Results In the study cohort, there were 901 (34%) obese women and 912 (34.4%) women of normal weight; of these, 440 (48.8%) and 672 (73.7%) had uncomplicated pregnancies, respectively. Obese women had a significantly increased incidence of gestational diabetes (relative risk [RR]: 2.23; 95% confidence interval [CI]: 1.70-2.92; P <0.01), gestational hypertension (RR: 3.04; 95% CI: 1.63-5.65; P <0.01), Caesarean delivery (RR: 1.48; 95% CI: 1.08-2.03; P <0.01), postpartum haemorrhage (RR: 2.10; 95% CI: 1.11-4.10; P = 0.01) and fetal macrosomia (RR: 2.71; 95% CI: 1.21-6.09; P <0.01). Conclusion Approximately one-third of the studied Omani women were obese. These women had a significantly increased risk of various maternal antenatal complications, intrapartum and postpartum events and neonatal complications.
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Affiliation(s)
- Anita Zutshi
- Department of Obstetrics & Gynaecology, Royal Hospital, Muscat, Oman
| | - Jayasree Santhosh
- Department of Obstetrics & Gynaecology, Royal Hospital, Muscat, Oman
| | - Julie Sheikh
- Department of Obstetrics & Gynaecology, Royal Hospital, Muscat, Oman
| | - Fareeha Naeem
- Department of Obstetrics & Gynaecology, Royal Hospital, Muscat, Oman
| | - Ahmed Al-Hamedi
- Family & Community Medicine Residency Programme, Oman Medical Specialty Board, Muscat, Oman
| | - Shahla Khan
- Department of Obstetrics & Gynaecology, Royal Hospital, Muscat, Oman
| | - Eishthiag Al-Said
- Department of Obstetrics & Gynaecology, Royal Hospital, Muscat, Oman
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19
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Virgo S, Gon G, Cavallaro FL, Graham W, Woodd S. Who delivers where? The effect of obstetric risk on facility delivery in East Africa. Trop Med Int Health 2017. [DOI: 10.1111/tmi.12910] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Sandra Virgo
- Faculty of Epidemiology and Population Health; London School of Hygiene & Tropical Medicine; London UK
| | - Giorgia Gon
- Faculty of Epidemiology and Population Health; London School of Hygiene & Tropical Medicine; London UK
| | - Francesca L. Cavallaro
- Faculty of Epidemiology and Population Health; London School of Hygiene & Tropical Medicine; London UK
| | - Wendy Graham
- Faculty of Epidemiology and Population Health; London School of Hygiene & Tropical Medicine; London UK
| | - Susannah Woodd
- Faculty of Epidemiology and Population Health; London School of Hygiene & Tropical Medicine; London UK
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20
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Heslehurst N, Vieira R, Hayes L, Crowe L, Jones D, Robalino S, Slack E, Rankin J. Maternal body mass index and post-term birth: a systematic review and meta-analysis. Obes Rev 2017; 18:293-308. [PMID: 28085991 PMCID: PMC5324665 DOI: 10.1111/obr.12489] [Citation(s) in RCA: 38] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2016] [Revised: 09/27/2016] [Accepted: 11/14/2016] [Indexed: 01/28/2023]
Abstract
Post-term birth is a preventable cause of perinatal mortality and severe morbidity. This review examined the association between maternal body mass index (BMI) and post-term birth at ≥42 and ≥41 weeks' gestation. Five databases, reference lists and citations were searched from May to November 2015. Observational studies published in English since 1990 were included. Linear and nonlinear dose-response meta-analyses were conducted by using random effects models. Sensitivity analyses assessed robustness of the results. Meta-regression and sub-group meta-analyses explored heterogeneity. Obesity classes were defined as I (30.0-34.9 kg m-2 ), II (35.0-39.9 kg m-2 ) and III (≥40 kg m-2 ; IIIa 40.0-44.9 kg m-2 , IIIb ≥ 45.0 kg m-2 ). Searches identified 16,375 results, and 39 studies met the inclusion criteria (n = 4,143,700 births). A nonlinear association between maternal BMI and births ≥42 weeks was identified; odds ratios and 95% confidence intervals for obesity classes I-IIIb were 1.42 (1.27-1.58), 1.55 (1.37-1.75), 1.65 (1.44-1.87) and 1.75 (1.50-2.04) respectively. BMI was linearly associated with births ≥41 weeks: odds ratio is 1.13 (95% confidence interval 1.05-1.21) for each 5-unit increase in BMI. The strength of the association between BMI and post-term birth increases with increasing BMI. Odds are greatest for births ≥42 weeks among class III obesity. Targeted interventions to prevent the adverse outcomes associated with post-term birth should consider the difference in risk between obesity classes.
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Affiliation(s)
- N. Heslehurst
- Institute of Health and SocietyNewcastle UniversityNewcastle upon TyneUK
| | - R. Vieira
- Institute of Health and SocietyNewcastle UniversityNewcastle upon TyneUK
| | - L. Hayes
- Institute of Health and SocietyNewcastle UniversityNewcastle upon TyneUK
| | - L. Crowe
- Institute of Health and SocietyNewcastle UniversityNewcastle upon TyneUK
| | - D. Jones
- Institute of Health and SocietyNewcastle UniversityNewcastle upon TyneUK
| | - S. Robalino
- Institute of Health and SocietyNewcastle UniversityNewcastle upon TyneUK
| | - E. Slack
- Institute of Health and SocietyNewcastle UniversityNewcastle upon TyneUK
| | - J. Rankin
- Institute of Health and SocietyNewcastle UniversityNewcastle upon TyneUK
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21
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Albawardi NM, Jradi H, Al-Hazzaa HM. Levels and correlates of physical activity, inactivity and body mass index among Saudi women working in office jobs in Riyadh city. BMC WOMENS HEALTH 2016; 16:33. [PMID: 27323844 PMCID: PMC4915164 DOI: 10.1186/s12905-016-0312-8] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/18/2015] [Accepted: 06/17/2016] [Indexed: 11/05/2022]
Abstract
Background Physical inactivity is among the leading risk factors for non-communicable diseases. Saudi Arabia has just begun to address physical inactivity as recent studies have shown an alarming prevalence of insufficiently physically active adults. Saudi women are identified as among the most overweight/obese and least active worldwide. With an increase in the number of women in office based jobs, the risk of physical inactivity is likely to increase. Identifying the level and correlates for high BMI and physical inactivity in Saudi women will help to plan more effective public health strategies. The aim of this study is to assess the level of physical activity, inactivity and body mass index among Saudi women working in office based jobs in Riyadh city and identify the correlates for overweight, obesity and low physical activity. Methods A cross- sectional study was conducted on 420 Saudi women aged 18 to 58 years working in office based jobs in eight worksites in Riyadh, Saudi Arabia. Body mass index was determined using weight and height measurements and physical activity was assessed based on a validated self-administered questionnaire. Results The majority of the subjects were overweight or obese (58.3 %). Overweight/obesity was associated with increased age, lower income and with those working in the public versus private sector. More than half of the sample (52.1 %) were insufficiently physically active. Participants working seven or more hours per day and those working in private versus public sector were significantly associated with low physical activity. Conclusion This study identified Saudi women working in office based jobs as a high risk group for overweight, obesity and physical inactivity. As sedentary jobs may compound the risk for obesity and physical inactivity, this may support the use of workplace health programs to reduce sitting time and promote physical activity as a viable public health initiative.
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Affiliation(s)
- Nada M Albawardi
- Prince Sultan Center for Special Education Support Services, Po Box 75246, Riyadh, 11578, Saudi Arabia.
| | - Hoda Jradi
- Community and Environmental Health, College of Public Health and Health Informatics, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
| | - Hazzaa M Al-Hazzaa
- Emeritus Professor and Former Director of Pediatric Exercise Physiology Research Laboratory, King Saud University, Riyadh, Saudi Arabia
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22
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Wahabi H, Fayed A, Esmaeil S, Alzeidan R, Elawad M, Tabassum R, Hansoti S, Magzoup ME, Al-Kadri H, Elsherif E, Al-Mandil H, Al-Shaikh G, Zakaria N. Riyadh Mother and Baby Multicenter Cohort Study: The Cohort Profile. PLoS One 2016; 11:e0150297. [PMID: 26937965 PMCID: PMC4777404 DOI: 10.1371/journal.pone.0150297] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2015] [Accepted: 02/11/2016] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVES To assess the effects of non-communicable diseases, such as diabetes, hypertension and obesity, on the mother and the infant. METHODS A multicentre cohort study was conducted in three hospitals in the city of Riyadh in Saudi Arabia. All Saudi women and their babies who delivered in participating hospitals were eligible for recruitment. Data on socio-demographic characteristics in addition to the maternal and neonatal outcomes of pregnancy were collected. The cohort demographic profile was recorded and the prevalence of maternal conditions including gestational diabetes, pre-gestational diabetes, hypertensive disorders in pregnancy and obesity were estimated. FINDINGS The total number of women who delivered in participating hospitals during the study period was 16,012 of which 14,568 women participated in the study. The mean age of the participants was 29 ± 5.9 years and over 40% were university graduates. Most of the participants were housewives, 70% were high or middle income and 22% were exposed to secondhand smoke. Of the total cohort, 24% were married to a first cousin. More than 68% of the participants were either overweight or obese. The preterm delivery rate was 9%, while 1.5% of the deliveries were postdate. The stillbirth rate was 13/1000 live birth. The prevalence of gestational diabetes was 24% and that of pre-gestational diabetes was 4.3%. The preeclampsia prevalence was 1.1%. The labour induction rate was 15.5% and the cesarean section rate was 25%. CONCLUSION Pregnant women in Saudi Arabia have a unique demographic profile. The prevalence of obesity and diabetes in pregnancy are among the highest in the world.
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Affiliation(s)
- Hayfaa Wahabi
- Chair of Evidence Based Health Care and Knowledge Translation, College of Medicine, King Saud University, Riyadh, Saudi Arabia
- Department of Community and Family Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Amel Fayed
- Department of Biostatistics, High Institute of Public Health, Alexandria University, Alexandria, Egypt
- College of Medicine, Princess Nourah Bint Abdulrahman University, Riyadh, Saudi Arabia
| | - Samia Esmaeil
- Chair of Evidence Based Health Care and Knowledge Translation, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Rasmieh Alzeidan
- Chair of Evidence Based Health Care and Knowledge Translation, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Mamoun Elawad
- Department of Obstetrics and Gynecology, King Fahad Medical City, Riyadh, Saudi Arabia
| | - Rabeena Tabassum
- Department of Obstetrics and Gynecology, King Fahad Medical City, Riyadh, Saudi Arabia
| | - Shehnaz Hansoti
- Department of Obstetrics and Gynecology, King Fahad Medical City, Riyadh, Saudi Arabia
| | - Mohie Edein Magzoup
- Department of Medical Education, College of Medicine, King Saud Bin Abdul-Aziz University for Health Sciences, Riyadh, Saudi Arabia
| | - Hanan Al-Kadri
- Department of Medical Education, College of Medicine, King Saud Bin Abdul-Aziz University for Health Sciences, Riyadh, Saudi Arabia
- Department of Obstetrics and Gynecology, King Abdul Aziz Medical City, Riyadh, Saudi Arabia
| | - Elham Elsherif
- Department of Obstetrics and Gynecology, King Abdul Aziz Medical City, Riyadh, Saudi Arabia
| | - Hazim Al-Mandil
- Department of Obstetrics and Gynecology, King Khaled University Hospital, Riyadh, Saudi Arabia
| | - Ghadeer Al-Shaikh
- Department of Obstetrics and Gynecology, King Khaled University Hospital, Riyadh, Saudi Arabia
| | - Nasria Zakaria
- Department of Medical Informatics and E-Learning Unit, Medical Education Department, King Saud University, Riyadh, Saudi Arabia
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23
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Al-Hakmani FM, Al-Fadhil FA, Al-Balushi LH, Al-Harthy NA, Al-Bahri ZA, Al-Rawahi NA, Al-Dhanki MS, Masoud I, Afifi N, Al-Alawi A, Padmakumar H, Kurup PJ. The Effect of Obesity on Pregnancy and its Outcome in the Population of Oman, Seeb Province. Oman Med J 2016; 31:12-7. [PMID: 26816564 DOI: 10.5001/omj.2016.03] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
OBJECTIVES The World Health Organization estimated that in 2011 worldwide 1.6 billion adults were overweight, and 400 million were obese. The obesity epidemic is a documented phenomenon and Oman is no exception. The aim of this study was to determine the effect of obesity on pregnancy and its prenatal and neonatal outcomes. METHODS A prospective cohort study was carried out among pregnant Omani women attending antenatal clinics in their first trimester in the Seeb province of Muscat, Oman. RESULTS A total of 700 pregnant women were enrolled in the study and were categorized according to their body mass index: 245 (35%) were normal weight, 217 (31%) were overweight, and 238 (34%) were obese. The relative risk (RR) of cesarean section among obese women compared to women of normal weight was 2.1 (95% confidence interval (CI) 1.2-3.2) and of overweight women was 1.4 (95% CI 0.9-2.3). The risk of elective cesarean section increased to 7.5 (95% CI 1.7-32.8) in obese women and was statistically significant in the obese group. In this study, 100 women (15.7%) developed gestational diabetes (11.8% of normal weight women, 17.8% of overweight women, and 17.9% of obese women). Miscarriages were more common among obese women 11.9% (n = 27) compared to the normal weight and overweight groups (6.7% and 9.4%, respectively). There was a weak yet statistically significant correlation between birth weight and body mass index. The risk of macrosomia was significantly higher in obese women compared to normal weight women. To evaluate the sensitivity of the oral glucose challenge test (OGCT), the oral glucose tolerance test (OGTT) was measured in 203 participants (29%) who had a normal OGCT result. It was found that 14.5% of overweight women and 13.5% of normal weight women had an abnormal OGTT result even when their OGCT result was normal. CONCLUSIONS Obesity is associated with an increased risk of cesarean section (especially elective cesarean), gestational hypertension, macrosomia, and miscarriage. It also increases the risk of gestational diabetes.
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Affiliation(s)
- Fatma M Al-Hakmani
- Directorate General of Health Services, Governorate of Muscat, Ministry of Health, Oman
| | - Faiza A Al-Fadhil
- Directorate General of Health Services, Governorate of Muscat, Ministry of Health, Oman
| | - Lamia H Al-Balushi
- Directorate General of Health Services, Governorate of Muscat, Ministry of Health, Oman
| | - Norah A Al-Harthy
- Directorate General of Health Services, Governorate of Muscat, Ministry of Health, Oman
| | - Zakiya A Al-Bahri
- Directorate General of Health Services, Governorate of Muscat, Ministry of Health, Oman
| | - Naama A Al-Rawahi
- Directorate General of Health Services, Governorate of Muscat, Ministry of Health, Oman
| | - Manal S Al-Dhanki
- Directorate General of Health Services, Governorate of Muscat, Ministry of Health, Oman
| | - Imrana Masoud
- Directorate General of Health Services, Governorate of Muscat, Ministry of Health, Oman
| | - Nahal Afifi
- Directorate General of Health Services, Governorate of Muscat, Ministry of Health, Oman
| | - Aisha Al-Alawi
- Directorate General of Health Services, Governorate of Muscat, Ministry of Health, Oman
| | - Harikumar Padmakumar
- Directorate General of Health Services, Governorate of Muscat, Ministry of Health, Oman
| | - Padmamohan J Kurup
- Directorate General of Health Services, Governorate of Muscat, Ministry of Health, Oman
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24
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Caldas MC, Serrette JM, Jain SK, Makhlouf M, Olson GL, McCormick DP. Maternal morbid obesity: financial implications of weight management. Clin Obes 2015; 5:333-41. [PMID: 26434773 DOI: 10.1111/cob.12116] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/10/2015] [Revised: 08/01/2015] [Accepted: 08/19/2015] [Indexed: 11/30/2022]
Abstract
The objective of this study was to evaluate health outcomes and costs of pregnancies complicated by extreme maternal obesity (class III obesity, body mass index ≥ 40). We conducted a retrospective case-control descriptive study comparing extremely obese women (cases) and their infants with randomly selected controls. Health outcomes were obtained from the medical records and costs from billing data. Total costs for each mother-infant dyad were calculated. Compared with 85 controls, the 82 cases experienced higher morbidity, higher costs and prolonged hospital stay. However, 26% of cases maintained or lost weight during pregnancy, whereas none of the controls maintained or lost weight during pregnancy. When mother/infant dyads were compared on costs, case subjects who maintained or lost weight experienced lower costs than those who gained weight. Neonatal intensive care consumed 78% of total hospital costs for infants of the obese women who gained weight, but only 48% of costs for infants of obese women who maintained or lost weight. For extremely obese women, weight management during pregnancy was achievable, resulted in healthier neonatal outcomes and reduced perinatal healthcare costs.
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Affiliation(s)
- M C Caldas
- Department of Pediatrics, University of Texas Medical Branch, Galveston, TX, USA
| | - J M Serrette
- Department of Pediatrics, University of Texas Medical Branch, Galveston, TX, USA
| | - S K Jain
- Department of Pediatrics, University of Texas Medical Branch, Galveston, TX, USA
| | - M Makhlouf
- Department of Obstetrics and Gynecology, University of Texas Medical Branch, Galveston, TX, USA
| | - G L Olson
- Department of Obstetrics and Gynecology, University of Texas Medical Branch, Galveston, TX, USA
| | - D P McCormick
- Department of Pediatrics, University of Texas Medical Branch, Galveston, TX, USA
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25
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Gaudet L, Ferraro ZM, Wen SW, Walker M. Maternal obesity and occurrence of fetal macrosomia: a systematic review and meta-analysis. BIOMED RESEARCH INTERNATIONAL 2014; 2014:640291. [PMID: 25544943 PMCID: PMC4273542 DOI: 10.1155/2014/640291] [Citation(s) in RCA: 167] [Impact Index Per Article: 16.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/25/2014] [Accepted: 11/09/2014] [Indexed: 12/15/2022]
Abstract
OBJECTIVE To determine a precise estimate for the contribution of maternal obesity to macrosomia. DATA SOURCES The search strategy included database searches in 2011 of PubMed, Medline (In-Process & Other Non-Indexed Citations and Ovid Medline, 1950-2011), and EMBASE Classic + EMBASE. Appropriate search terms were used for each database. Reference lists of retrieved articles and review articles were cross-referenced. METHODS OF STUDY SELECTION All studies that examined the relationship between maternal obesity (BMI ≥30 kg/m(2)) (pregravid or at 1st prenatal visit) and fetal macrosomia (birth weight ≥4000 g, ≥4500 g, or ≥90th percentile) were considered for inclusion. TABULATION, INTEGRATION, AND RESULTS Data regarding the outcomes of interest and study quality were independently extracted by two reviewers. Results from the meta-analysis showed that maternal obesity is associated with fetal overgrowth, defined as birth weight ≥ 4000 g (OR 2.17, 95% CI 1.92, 2.45), birth weight ≥4500 g (OR 2.77,95% CI 2.22, 3.45), and birth weight ≥90% ile for gestational age (OR 2.42, 95% CI 2.16, 2.72). CONCLUSION Maternal obesity appears to play a significant role in the development of fetal overgrowth. There is a critical need for effective personal and public health initiatives designed to decrease prepregnancy weight and optimize gestational weight gain.
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Affiliation(s)
- Laura Gaudet
- University of Ottawa, Faculty of Medicine, 451 Smyth Road, Ottawa, ON, Canada K1H 8M5
- Division of Maternal-Fetal Medicine, Department of Obstetrics, Gynecology & Newborn Care, The Ottawa Hospital, 501 Smyth Road, Ottawa, ON, Canada K1H 8L6
- Ottawa Hospital Research Institute, Ottawa, ON, Canada K1H 8L6
| | - Zachary M. Ferraro
- Division of Maternal-Fetal Medicine, Department of Obstetrics, Gynecology & Newborn Care, The Ottawa Hospital, 501 Smyth Road, Ottawa, ON, Canada K1H 8L6
- Healthy Active Living and Obesity (HALO) Research Group, Children's Hospital of Eastern Ontario, 401 Smyth Road, Ottawa, ON, Canada K1H 8L1
| | - Shi Wu Wen
- Ottawa Hospital Research Institute, Ottawa, ON, Canada K1H 8L6
| | - Mark Walker
- University of Ottawa, Faculty of Medicine, 451 Smyth Road, Ottawa, ON, Canada K1H 8M5
- Division of Maternal-Fetal Medicine, Department of Obstetrics, Gynecology & Newborn Care, The Ottawa Hospital, 501 Smyth Road, Ottawa, ON, Canada K1H 8L6
- Ottawa Hospital Research Institute, Ottawa, ON, Canada K1H 8L6
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26
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Shaban MM, Bassiouny YA, Elzahaby IM, Hassan AA. Body mass index and labour outcome in Egyptian women. J OBSTET GYNAECOL 2013; 34:248-50. [PMID: 24294988 DOI: 10.3109/01443615.2013.844113] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
We conducted a cross-sectional descriptive study to evaluate the impact of body mass index (BMI) on maternal medical disorders, progress of labour, mode of delivery and neonatal outcome in Cairo University hospital between September 2012 and March 2013. A total of 574 parturients were divided into two groups: group A with a BMI < 30 and group B with a BMI ≥ 30. A statistically significant difference was found in favour of group B, regarding medical disorders, especially gestational hypertension and pre- eclampsia (p < 0.001), caesarean deliveries (p < 0.001) and neonatal birth weight (p = 0.001). There was no difference regarding gestational age at delivery, progress of labour (cervical dilatation, cervical effacement, duration of first and second stage of labour) and neonatal outcome (Apgar score at 1 and 5 min and neonatal deaths). Our conclusion is that increased maternal BMI is associated with an increased incidence of medical disorders during pregnancy, caesarean section rate and fatal macrosomia.
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Affiliation(s)
- M M Shaban
- Department of Obstetrics and Gynaecology, Faculty of Medicine, Cairo University , Egypt
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27
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The independent effects of second hand smoke exposure and maternal body mass index on the anthropometric measurements of the newborn. BMC Public Health 2013; 13:1058. [PMID: 24209496 PMCID: PMC4226006 DOI: 10.1186/1471-2458-13-1058] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2013] [Accepted: 11/07/2013] [Indexed: 12/19/2022] Open
Abstract
Background Exposure to tobacco smoke during pregnancy, whether as active smoking or by exposure to secondhand smoke (SHS), is associated with adverse pregnancy outcomes including low birth weight (LBW) and small for gestational age infants due to the effect of tobacco on the anthropometric measurements of the newborn. This effect might be masked by maternal obesity as it increases fetal weight. The objectives of this study were to estimate the independent effects of maternal exposure to SHS and maternal body mass index (BMI) on the anthropometric measurements and on the prevalence of macrosomia and LBW among term infants. Methods Data were collected from women in the postnatal ward following delivery. Participants were stratified into six groups based on the BMI (underweight <18 kg/m2, non-obese 18–29.9 kg/m2, and obese ≥30 kg/m2) and the SHS exposure status (exposed and non- exposed), to examine the independent effects of BMI and SHS on infants’ anthropometry. Multiple regression analysis was used to explore the independent associations between the six groups and the risk of delivering a macrosomic or LBW infant. Results Infants of women exposed to SHS had significantly reduced anthropometric measurements compared to infants of unexposed women. The odds of delivering a macrosomic baby increased to 9-fold for women with BMI of ≥30 kg/m2 compared to non-obese women; odds ratio (OR) 9.18, 95% Confidence Interval (CI) (1.01, 9.37); p = 0.04, this risk was attenuated to 1.5-fold in women exposed to SHS, OR 1.53, 95% CI (1.19, 12.1); p < 0.0001. The odds of delivering an LBW infant were more than doubled in underweight women compared to non-obese women, OR 2.15, 95% CI (1.001, 4.57); p = 0.034, and were further increased to almost 3-fold for women who were exposed to SHS, OR 2.71, 95% CI (1.82,4.045); p = 0.02. Conclusion Exposure to SHS was associated with reduced anthropometric measurements of the newborn and increased rate of LBW infants, irrespective of maternal BMI. Maternal obesity was associated with increased risk of delivering a macrosomic infant; conversely maternal underweight was associated with increased risk of delivering an LBW infant.
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28
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Wang Z, Wang P, Liu H, He X, Zhang J, Yan H, Xu D, Wang B. Maternal adiposity as an independent risk factor for pre-eclampsia: a meta-analysis of prospective cohort studies. Obes Rev 2013; 14:508-21. [PMID: 23530552 DOI: 10.1111/obr.12025] [Citation(s) in RCA: 61] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2012] [Revised: 01/11/2013] [Accepted: 01/12/2013] [Indexed: 01/18/2023]
Abstract
Studies investigating the association between maternal adiposity and risk of pre-eclampsia showed contradictory results. Therefore, we performed a meta-analysis of prospective cohort studies to estimate the effect of maternal adiposity on pre-eclampsia. We reviewed 1,286 abstracts and finally included 29 prospective cohort studies with 1,980,761 participants and 67,075 pre-eclampsia events. We pooled data with a random-effects model, and obtained risk estimates for five predetermined bodyweight groups: low, normal-weight (reference), overweight, obese and severely obese. In the cohort studies that unadjusted for pre-eclampsia risk factors, the pooled unadjusted relative risks (RR) with 95% confidence intervals (95%CI) for pre-eclampsia of overweight, obese and severely obese women were 1.58 (95% CI 1.44-1.72, P < 0.001), 2.68 (95% CI 2.39-3.01, P < 0.001) and 3.12 (95% CI 2.24-4.36, P < 0.001), respectively. In those cohorts that adjusted for pre-eclampsia risk factors, the pooled unadjusted RRs for pre-eclampsia of overweight, obese and severely obese women were 1.70 (95% CI 1.60-1.81, P < 0.001), 2.93 (95% CI 2.58-3.33, P < 0.001) and 4.14 (95% CI 3.61-4.75, P < 0.001), respectively. Sensitivity analysis showed maternal adiposity was associated with increased risk of pre-eclampsia in both nulliparous and multiparas women. In conclusion, overweight or obese pregnant women have a substantially increased risk of pre-eclampsia, and maternal adiposity is an independent risk factor of pre-eclampsia.
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Affiliation(s)
- Z Wang
- Department of Obstetrics, Maternal and Children Health's Hospital, Weifang, China
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29
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Mehrabi E, Kamalifard M, Yavarikia P, Ebrahimi Mameghani M. The Relation between Early Pregnancy Anthropometric Indices among Primiparous Women and Macrosomia. J Caring Sci 2012; 1:153-8. [PMID: 25276690 DOI: 10.5681/jcs.2012.022] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2011] [Accepted: 03/06/2012] [Indexed: 11/17/2022] Open
Abstract
INTRODUCTION The prevalence of obesity is increasing in both developed and developing nations. Body mass index (BMI) is the most common index for obesity assessment and its relation with most complications among non-pregnant and pregnant women is known. However, no study has evaluated the relation between abdominal obesity and macrosomia among pregnant women. METHODS In this prospective study, anthropometric indices including weight, height, and waist circumference (WC) of 1140 nulliparous pregnant women during their first trimester of pregnancy (6(th)-10(th) weeks) were measured by the researcher. According to the classification of the World Health Organization, women with BMI > 25 kg/m(2) were considered as overweight or obese. Abdominal obesity was defined as WC ≥ 88 cm. Finally, mothers were followed up and fetal macrosomia was recorded in a checklist. Data was analyzed in SPSS15. RESULTS The results showed that 77.5% of women aged 20-35 years and 92.7% were housewives. The mean (SD) values of BMI and WC were 24.32 (4.08) kg/m(2) and 81.84 (9.25) cm, respectively. The prevalence of overweight (BMI = 25-29.9 kg/m(2)) and obesity (BMI > 29.9 kg/m) was 27.6% and 8.8%, respectively. Abdominal obesity based on WC was found in 34.8% of the subjects. CONCLUSION Findings of this study revealed obesity in over one third of nulliparous pregnant women during their first trimester. Moreover, the high prevalence of macrosomia, in these women confirmed the importance of maternal education about obesity-related complications in order to change their lifestyle and prevent obesity.
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Affiliation(s)
- Esmat Mehrabi
- PhD Student of Reproductive Health, Shahid Beheshti University, Tehran, Iran And Lecturer, Department of Midwifery, Islamic Azad University, Tabriz, Iran
| | - Mahin Kamalifard
- MSc, Instructor, Department of Midwifery, Faculty of Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Parisa Yavarikia
- MSc, Instructor, Department of Midwifery, Faculty of Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Mehrangiz Ebrahimi Mameghani
- PhD, Assistant Professor, Department of Nutrition, Nutrition Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
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30
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Chigbu CO, Aja LO. Obesity in pregnancy in southeast Nigeria. Ann Med Health Sci Res 2011; 1:135-40. [PMID: 23209967 PMCID: PMC3507115] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2011] [Revised: 10/07/2011] [Accepted: 12/22/2011] [Indexed: 10/30/2022] Open
Abstract
BACKGROUND Obesity in pregnancy has continued to attract global attention due to its contribution to maternal morbidity and mortality. However, this attention appears to be concentrated on developed countries with little or no attention to developing countries, resulting in very little statistics from developing countries on the subject matter. OBJECTIVES To determine the prevalence and characteristics of obesity during pregnancy, in South-east Nigeria. METHOD Women who registered for antenatal care in their first trimester of pregnancy were interviewed and requisite data collected. Fischer exact test, t-test and bivariate correlation analysis were carried out as appropriate at the 95% confidence level. P-values less than 0.05 were considered significant. RESULTS A total of 3,167 pregnant women were recruited. The prevalence of obesity in pregnancy was 10.7%. Obesity was significantly more prevalent amongst women residing in urban areas. Only 15.1% of participants knew their pre-pregnancy weight. Education, employment, parity and age did not have significant relations with obesity in pregnancy. CONCLUSION Obesity in pregnancy exists in appreciable proportion in south-eastern Nigeria and majority of women in this setting do not know their pre-pregnancy weights. There is need to begin to consider obesity in pregnancy as a problem that does exist in resource-poor settings and specific guidelines on the management of obese pregnant women in resource-poor settings would be needed. Nigerian women need to be encouraged to check their weights periodically especially before planning pregnancy.
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Affiliation(s)
- CO Chigbu
- Department of Obstetrics and Gynecology, University of Nigeria Teaching Hospital, Enugu, Nigeria,Correspondence: Dr. C.O. Chigbu, E-mail: Phone Number:+2348037027137
| | - LO Aja
- Department of Obstetrics and Gynecology, University of Nigeria Teaching Hospital, Enugu, Nigeria
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