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      Obesidad pregestacional y alteraciones del parto Translated title: Pregestational obesity and birth alterations

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          Abstract

          RESUMEN Objetivo . Establecer la asociación entre obesidad pregestacional y el riesgo de alteraciones del parto. Diseño. Estudio de cohortes retrospectivo. Institución. Hospital Central “Dr. Urquinaona”, Maracaibo, Venezuela. Métodos . Resultante obstétrica de pacientes según índice de masa pregestacional -obesidad (grupo A), sobrepeso (grupo B) y peso normal (grupo C)- atendidas entre enero y diciembre de 2021. Principales medidas de estudio. Duración del embarazo y duración, tipo y alteraciones del parto. Resultados . Se atendió 2,250 partos durante el periodo de estudio, de los cuales se seleccionó 226 gestantes para el análisis. La mayoría de gestantes (60,5%) fueron asignadas al grupo A, 47 (20,8%) al grupo B y 41 (17,5%) al grupo C. Las gestantes del grupo A presentaron una mayor probabilidad de cesárea (razón de probabilidad (RP) 1,76; intervalo de confianza del 95% (IC95%), 1,03 a 2,98), de parto prolongado (RP 2,09; IC95%, 1,23 a 3,53) y de embarazo prolongado (RP 2,30; IC95%, 1,32 a 4,01) comparadas con las embarazadas del grupo C. Las gestantes del grupo B no mostraron diferencias estadísticamente significativas en la frecuencia de las variables obstétricas comparado con las gestantes del grupo C (p = ns). Conclusión . Existió asociación significativa entre la obesidad pregestacional y el riesgo de alteraciones del parto.

          Translated abstract

          ABSTRACT Objective : To establish the association between pregestational obesity and the risk of birth alterations. Design: Retrospective cohort study. Institution: Hospital Central "Dr. Urquinaona", Maracaibo, Venezuela. Methods : Obstetric outcome of patients according to pregestational mass index -obese (group A), overweight (group B), and normal weight (group C)- attended between January and December 2021. Main study measures: Duration of pregnancy and duration, type and alterations of delivery. Results : A total of 2,250 deliveries were attended during the study period, of which 226 pregnant women were selected for analysis. The majority of the pregnant women (60.5%) were assigned to group A, 47 (20.8%) to group B, and 41 (17.5%) to group C. Pregnant women in group A had a higher probability of cesarean section (odds ratio (OR) 1.76; 95% confidence interval (95%CI), 1.03 - 2.98), prolonged labor (OR 2.09; 95%CI, 1.23 - 3.53) and prolonged pregnancy (OR 2.30; 95%CI, 1.32 - 4.01) compared to pregnant women in group C. The pregnant women in group B did not show statistically significant differences in the frequency of obstetric variables compared to the pregnant women in group C (p = ns). Conclusion : There was a significant association between pregestational obesity and the risk of birth alterations.

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          Obesity and gynaecological and obstetric conditions: umbrella review of the literature

          Objective To study the strength and validity of associations between adiposity and risk of any type of obstetric or gynaecological conditions. Design An umbrella review of meta-analyses. Data sources PubMed, Cochrane database of systematic reviews, manual screening of references for systematic reviews or meta-analyses of observational and interventional studies evaluating the association between adiposity and risk of any obstetrical or gynaecological outcome. Main outcomes Meta-analyses of cohort studies on associations between indices of adiposity and obstetric and gynaecological outcomes. Data synthesis Evidence from observational studies was graded into strong, highly suggestive, suggestive, or weak based on the significance of the random effects summary estimate and the largest study in the included meta-analysis, the number of cases, heterogeneity between studies, 95% prediction intervals, small study effects, excess significance bias, and sensitivity analysis with credibility ceilings. Interventional meta-analyses were assessed separately. Results 156 meta-analyses of observational studies were included, investigating associations between adiposity and risk of 84 obstetric or gynaecological outcomes. Of the 144 meta-analyses that included cohort studies, only 11 (8%) had strong evidence for eight outcomes: adiposity was associated with a higher risk of endometrial cancer, ovarian cancer, antenatal depression, total and emergency caesarean section, pre-eclampsia, fetal macrosomia, and low Apgar score. The summary effect estimates ranged from 1.21 (95% confidence interval 1.13 to 1.29) for an association between a 0.1 unit increase in waist to hip ratio and risk endometrial cancer up to 4.14 (3.61 to 4.75) for risk of pre-eclampsia for BMI >35 compared with <25. Only three out of these eight outcomes were also assessed in meta-analyses of trials evaluating weight loss interventions. These interventions significantly reduced the risk of caesarean section and pre-eclampsia, whereas there was no evidence of association with fetal macrosomia. Conclusions Although the associations between adiposity and obstetric and gynaecological outcomes have been extensively studied, only a minority were considered strong and without hints of bias.
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            Long-term consequences of obesity on female fertility and the health of the offspring.

            Obesity has reached near epidemic levels among reproductive age women with a myriad of consequences. Obesity adversely affects the maternal milieu by creating conditions that decrease fertility and increase the risk of gestational diabetes, hypertensive disease in pregnancy, fetal growth abnormalities and congenital anomalies. The effects of obesity are not limited to pregnancy. Indeed, beyond the immediate postpartum period, obese women maintain a higher prevalence of insulin resistance and cardiovascular disease. In this article, we will review the pathophysiology underlying the effects of obesity on fertility, pregnancy outcome and health status of offspring. The purpose of this review is to outline proposed models responsible for the short-term and long-term consequences of obesity on fertility and offspring development, and identify knowledge gaps where additional research is needed.
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              Does prepregnancy weight change have an effect on subsequent pregnancy health outcomes? A systematic review and meta‐analysis

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                Author and article information

                Journal
                rgo
                Revista Peruana de Ginecología y Obstetricia
                Rev. peru. ginecol. obstet.
                Sociedad Peruana de Obstetricia y Ginecología (Lima, , Peru )
                2304-5132
                April 2023
                : 69
                : 2
                : 00003
                Affiliations
                [1] Maracaibo Venezuela orgnameHospital Central "Dr. Urquinaona"
                [5] Maracaibo orgnameUniversidad del Zulia orgdiv1Facultad de Medicina Venezuela
                [7] Maracaibo orgnameHospital Central "Dr. Urquinaona" Venezuela
                [2] Maracaibo orgnameHospital Central "Dr. Urquinaona" Venezuela
                [6] Florida orgnameSanitas Medical Center, Coral Springs EE. UU
                [3] Maracaibo orgnameUniversidad del Zulia orgdiv1Facultad de Medicina Venezuela
                [4] Maracaibo orgnameUniversidad del Zulia orgdiv1Facultad de Medicina Venezuela
                Article
                S2304-51322023000200003 S2304-5132(23)06900200003
                10.31403/rpgo.v69i2510
                74f0657a-2f0f-4d3b-99d5-e23727b6a48a

                This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

                History
                : 25 August 2022
                : 20 January 2023
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 25, Pages: 0
                Product

                SciELO Peru

                Categories
                Artículos Originales

                Maternal obesity,Obstetric labor complications,Índice de masa corporal,Obesidad materna,Complicaciones del trabajo de parto,Body mass index

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