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DOI: 10.1055/s-0035-1557868
Prevalence and Associated Risk Factors for Obesity During Pregnancy Over Time
Zeitliche Untersuchung von Adipositasprävalenz und assoziierten Risikofaktoren während der SchwangerschaftPublikationsverlauf
received 22. April 2015
revised 23. Juni 2015
accepted 15. Juli 2015
Publikationsdatum:
07. Oktober 2015 (online)
![](https://www.thieme-connect.de/media/gebfra/201509/lookinside/thumbnails/10-1055-s-0035-1557868_gf958-1.jpg)
Abstract
Objective: The increasing prevalence of obesity is having an impact on morbidity worldwide. Since young mature women are equally affected by the general increase in weight, the aim of the study was to evaluate the prevalence of obesity together with associated maternal risk factors, complications during pregnancy, and fetal outcomes in a local cohort for the years 2006 and 2011. Study Design: Maternal and fetal records of women who delivered at the University of Würzburg, with a 5-year interval (2006 and 2011) between investigations, were retrospectively analyzed. Descriptive statistics included prevalence of obesity, maternal weight gain, as well as several complications during pregnancy and fetal characteristics. The association between maternal or fetal complications and extent of maternal obesity was analyzed. Results: Our analysis included 2838 mothers with singleton pregnancies who delivered in 2006 (n = 1293) or 2011 (n = 1545) in our department. We found that neither pre-pregnancy body mass index (23.77 ± 4.85 vs. 24.09 ± 5.10 kg/m2, p = 0.25) nor weight gain (14.41 ± 5.77 vs. 14.78 ± 5.65 kg; p = 0.09) increased significantly over time. But the majority of all overweight (71 %) or obese (60.4 %) mothers gained more weight than generally recommended. The prevalence of gestational diabetes, gestational hypertension, and preeclampsia increased significantly and was associated with high pre-pregnancy body mass index, as was delivery by cesarean section. However, obesity was not associated with prolonged pregnancy and did not seem to negatively affect fetal outcome. Conclusion: There is a trend to increasing weight gain during pregnancy, and the majority of mothers, especially those with a high pre-pregnancy body mass index, exceeded the weight gain recommendations. Associated risk factors such as gestational diabetes, hypertension, and delivery by cesarean section are increasing.
Zusammenfassung
Einleitung: Die steigende Prävalenz adipöser Menschen führt weltweit zu einer relevanten Morbidität, die auch junge Frauen im geschlechtsreifen Alter betrifft. Damit gerät der Themenkomplex Adipositas und assoziierte Komplikationen auch in Hinblick auf die Versorgung schwangerer Frauen in den Fokus. Das Ziel dieser Arbeit war es deshalb, die Adipositasprävalenz und hiermit assoziierte maternale und fetale Risikofaktoren zwischen 2006 und 2011 in einem lokalen Kollektiv zu untersuchen. Material und Methoden: Die retrospektive Analyse umfasste alle maternalen und fetalen Daten von Patientinnen, die 2006 und 2011 an der Universitäts-Frauenklinik Würzburg von einem Einling entbunden wurden. Die deskriptive Statistik umfasste die Prävalenz von Adipositas und Gewichtszunahme, sowie maternale Risikofaktoren, Schwangerschaftskomplikationen und fetales Outcome. Weiterhin wurde eine Assoziation von maternalen und fetalen Komplikationen in Abhängigkeit vom Grad der Adipositas untersucht. Ergebnisse: Unsere Analyse umfasste 2838 Patientinnen mit Einlingsgraviditäten, die in den Jahren 2006 (n = 1293) und 2011 (n = 1545) an der Universitätsklinik Würzburg entbunden haben. Es zeigte sich, dass weder der initiale BMI (23,77 ± 4,85 vs. 24,09 ± 5,10 kg/m2, p = 0,25) noch die Gewichtszunahme während der Schwangerschaft (14,41 ± 5,77 vs. 14,78 ± 5,65 kg; p = 0,09) zwischen 2006 und 2011 signifikant anstiegen. Die Mehrheit der übergewichtigen (71 %) oder adipösen (60,4 %) Patientinnen überstieg die empfohlene Gewichtszunahme. Die Prävalenz von adipositasassoziierten Erkrankungen wie Gestationsdiabetes, präexistenter Hypertonus sowie Präeklampsie stiegen signifikant an und waren mit einem hohen initialen Body-Mass-Index assoziiert. Während Übergewichtigkeit nicht mit einer Terminüberschreitung assoziiert war, wurden adipöse Patientinnen signifikant häufiger per Sectio caesarea entbunden. Das Geburtsgewicht war 2011 signifikant höher als 2006, wobei keine signifikanten Änderungen im fetalen Outcome dargestellt werden konnten. Schlussfolgerung: Es gibt einen Trend zu vermehrter Gewichtszunahme während der Schwangerschaft. Assoziierte Risikofaktoren wie Gestationsdiabetes, Hypertonus und Kaiserschnittentbindung sind erhöht.
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References
- 1 Ogden CL, Carroll MD, Kit BK et al. Prevalence of obesity among adults: United States, 2011-2012. NCHS Data Brief 2013; (131) 1-8
- 2 Mensink GB, Schienkiewitz A, Haftenberger M et al. [Overweight and obesity in Germany: results of the German Health Interview and Examination Survey for Adults (DEGS1)]. Bundesgesundheitsblatt, Gesundheitsforschung, Gesundheitsschutz 2013; 56: 786-794
- 3 Flegal KM, Carroll MD, Kit BK et al. Prevalence of obesity and trends in the distribution of body mass index among US adults, 1999–2010. JAMA 2012; 307: 491-497
- 4 Cedergren MI. Maternal morbid obesity and the risk of adverse pregnancy outcome. Obstet Gynecol 2004; 103: 219-224
- 5 American College of Obstetricians and Gynecologists. ACOG Committee opinion no. 549: obesity in pregnancy. Obstet Gynecol 2013; 121: 213-217
- 6 Sullivan EL, Grove KL. Metabolic imprinting in obesity. Forum Nutr 2010; 63: 186-194
- 7 Oken E, Rifas-Shiman SL, Field AE et al. Maternal gestational weight gain and offspring weight in adolescence. Obstet Gynecol 2008; 112: 999-1006
- 8 Rasmussen KM, Catalano PM, Yaktine AL. New guidelines for weight gain during pregnancy: what obstetrician/gynecologists should know. Curr Opin Obstet Gynecol 2009; 21: 521-526
- 9 Rasmussen KM, Yaktine AL eds. Weight Gain during Pregnancy: reexamining the Guidelines. Washington (DC): The National Academies Collection, Reports funded by National Institutes of Health; 2009
- 10 Ogden CL, Carroll MD, Kit BK et al. Prevalence of childhood and adult obesity in the United States, 2011–2012. JAMA 2014; 311: 806-814
- 11 Chu SY, Callaghan WM, Kim SY et al. Maternal obesity and risk of gestational diabetes mellitus. Diabetes Care 2007; 30: 2070-2076
- 12 Baeten JM, Bukusi EA, Lambe M. Pregnancy complications and outcomes among overweight and obese nulliparous women. Am J Public Health 2001; 91: 436-440
- 13 Balsells M, Garcia-Patterson A, Gich I et al. Ultrasound-guided compared to conventional treatment in gestational diabetes leads to improved birthweight but more insulin treatment: systematic review and meta-analysis. Acta Obstet Gynecol Scand 2014; 93: 144-151
- 14 Langer O. Glycemic targets for the optimal treatment of GDM. Clin Obstet Gynecol 2013; 56: 788-802
- 15 Jeyabalan A. Epidemiology of preeclampsia: impact of obesity. Nutr Rev 2013; 71 (Suppl. 01) S18-S25
- 16 Salihu HM, De La Cruz C, Rahman S et al. Does maternal obesity cause preeclampsia? A systematic review of the evidence. Minerva Ginecol 2012; 64: 259-280
- 17 Crane SS, Wojtowycz MA, Dye TD et al. Association between pre-pregnancy obesity and the risk of cesarean delivery. Obstet Gynecol 1997; 89: 213-216
- 18 Yu Z, Han S, Zhu J et al. Pre-pregnancy body mass index in relation to infant birth weight and offspring overweight/obesity: a systematic review and meta-analysis. PloS one 2013; 8: e61627
- 19 Palatianou ME, Simos YV, Andronikou SK et al. Long-term metabolic effects of high birth weight: a critical review of the literature. Horm Metab Res 2014; 46: 911-920
- 20 Ronnberg AK, Ostlund I, Fadl H et al. Intervention during pregnancy to reduce excessive gestational weight gain—a randomised controlled trial. BJOG 2015; 122: 537-544
- 21 Quinlivan JA, Julania S, Lam L. Antenatal dietary interventions in obese pregnant women to restrict gestational weight gain to Institute of Medicine recommendations: a meta-analysis. Obstet Gynecol 2011; 118: 1395-1401
- 22 Streuling I, Beyerlein A, Rosenfeld E et al. Physical activity and gestational weight gain: a meta-analysis of intervention trials. BJOG 2011; 118: 278-284
- 23 Allen R, Rogozinska E, Sivarajasingam P et al. Effect of diet- and lifestyle-based metabolic risk-modifying interventions on preeclampsia: a meta-analysis. Acta Obstet Gynecol Scand 2014; 93: 973-985
- 24 Muktabhant B, Lumbiganon P, Ngamjarus C et al. Interventions for preventing excessive weight gain during pregnancy. Cochrane Database Syst Rev 2012; (4) CD007145