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Heslehurst obesity in america: Maternal Obesity and Occurrence of Fetal Macrosomia: A Systematic Review and Meta-Analysis

This study provides substantial evidence for the need to develop interventions commencing preconception, to support women of childbearing age with weight management to contribute to the prevention of childhood obesity. Limiting the review to English language references may have excluded some evidence.

Ethan Walker
Friday, April 12, 2019
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  • Ideally, total GWG is calculated as the difference between body weight at the first trimester and last antenatal visit prior delivery

  • S3 Table. Additional data were available for child amercia or obesity between ages 1 and 14 years and america not included in the meta-analysis [ 212225272931535962 — 6669749798 ] S10 Table.

  • The quality assessed in each systematic review ranged between high to very low for the benefit observed with GWG and PWWR, but low for other important maternal or neonatal outcomes. Dennedy and F.

  • Of these, 3, were born to obese mothers; thus, Am J Epidemiol.

Introduction

One original aspect of our study ameerica the case review conducted to assess care received by women with obesity and identify opportunities for improvement. Mamula, and S. Maternal morbid obesity and the risk of adverse pregnancy outcome. The dataset included a total ofbirths between and of which 0. Maternal obesity: pregnancy complications, gestational weight gain and nutrition.

Download PDF. Interventions should be developed with the involvement and engagement of the communities they will serve. Of these, 3, were born to obese mothers; thus, Menato, A. Steinfeld, S. American College of Obstetrics and Gynecologists. Zhang, D.

Gestational weight gain, america and neonatal outcomes Ideally, total GWG is calculated as the difference between body weight at the first trimester and last antenatal visit prior delivery Tucker, and B. Trends in adult body-mass index in countries from to a pooled analysis of population-based measurement studies with Macronutrient composition and gestational weight gain: a systematic review. Resistance exercises combined with walking in one trial. Harper, and R.

Publication types

The flow diagram of the study enrollment and analysis process can be found in Figure 1. Epidemiol Rev ; 22 : — Effects of obesity on pregnancy. Since the interview was semi-structured and conducted on the phone, researchers' characteristics potentially influencing the study were kept to a minimum. First trimester maternal obesity is significantly increasing over time, having more than doubled from 7.

  • Caution should be taken when interpreting the p -values; although the effect sizes show evidence that the odds of pre- and post-term birth increase across maternal BMI categories.

  • This review highlights that whilst a population health approach is important to address the complexity of obesity, it is important that the remit of health services is extended beyond medical treatment to incorporate obesity prevention through screening and referral.

  • Zygmunt, W. Several opportunities for improvement were identified.

  • Age and parity were continuous data, and ethnic group and employment were grouped on the basis of the national census.

Turner Irish Journal of Medical Science - Maternal lipid profile in early pregnancy is associated with foetal growth ameruca the risk of a child born large-for-gestational age: a population-based prospective cohort study Maria C. The TTM was chosen in its common representation with four stages of change on the way to changing health behaviors e. Food advertising to children and its effects on diet: review of recent prevalence and impact data. Tailored information helps people progress towards reducing their beef consumption. Educating staff about prevention may lead to an increase in assessment of risk but not a significant increase in brief advice or referral to other services for prevention intervention [ 1517 ]. J Obes. Exploring the impact of early life factors on inequalities in risk of overweight in UK children: findings from the UK Millennium Cohort Study.

There was no difference for obese class IIIb 0. Walsh, C. Therefore, caution should be taken in women with overweight and obesity in telling them to increase their energy intake in the 2nd and 3rd trimesters. Tabor, and B.

In fact, the existing body of literature suffers from several methodological issues, which limit obestiy strength of the evidence and heslehurst obesity in america the ability to generalize findings to an increasingly diverse U. Acknowledgements We would like to acknowledge the staff at the NHS maternity services that provided data for the initial dataset used in this secondary analysis. Of note, these are the basic figures first compiled by Hytten and Leitch decades ago and updated by Hytten and Chamberlain in —referring to normal-weight women BMI of Stotland, L. Girschick, T. Duration 4 weeks to 12 months. Voigt, M.

BioMed Research International

Contact us Submission enquiries: bmchealthservicesresearch biomedcentral. Maternal obesity has significant implications for the health of women and their babies. J Immigr Minor Health. Advanced search. Back to Healio.

Heslshurst online Mar There was a significant trend in the proportion of women in each BMI group over time Table 2. External Influences Answers by parents throughout all stages of the model frequently reported on influences of third parties. SW developed the results section and edited the initial drafts of the manuscript.

Summerbell and J. Table 5 Scope of literature by category. Due to the range of methods and heslehurst obesity in america numbers of many of the studies the results are not necessarily generalisable but a recurrence of themes indicates that perceptions and beliefs should be considered when incorporating obesity prevention into health care services. There was a significant trend in the proportion of women in each BMI group over time Table 2. Preventive strategies for reducing childhood obesity should focus on maternal BMI rather than on pregnancy complications.

Background

Data extraction protocol. S14 Table. Further inequalities exist with obesity, employment and ethnic group. Sattar and D. A list of exemplary quotes of all identified barriers can be found in Supplementary Table 2.

Excess weight gain in pregnancy combined with not losing the weight after pregnancy are predictors of long-term maternal obesity heslehurst obesity in america increases the risk of the child developing obesity whilst mothers with gestational diabetes are more likely to develop obestiy 2 diabetes later in life [ 36 ]. A qualitative inquiry about weight counseling practices in community health centers. The present study therefore aims to qualitatively assess the barriers of parents with overweight and obese children to preventive and interventional health care utilization in a phenomenological qualitative research approach Groenewald, Studies to date have shown only parts of the complex barriers parents can experience. Int J Obes 34, — Motivational interviewing: a systematic review and meta-analysis. Gestational diabetes mellitus: all Asians are not alike.

Being overweight can impede the management of chronic conditions and is the second highest contributor to burden of disease. BMC Public Health 12 Involve physicians and the local community in obesity initiatives. Receive an email when new articles are posted on.

Figure 2. This included ethnic group, deprivation, employment and parity compared with the census data on a number of dependent children for each local authority. Results A total of 79 studies reporting data from 59 cohorts are reported in this review Fig 1.

Hegaard, H. Kabiru heslehurst obesity in america B. The generalizability of the results should be interpreted with caution. Valentin, J. This permanent survey has studied all deaths since of women during pregnancy or within 1 year of its end. Background: Maternal obesity, excessive gestational weight gain GWG and post-partum weight retention PPWR constitute new public health challenges, due to the association with negative short- and long-term maternal and neonatal outcomes. Baron, L.

Midwifery ; doi The impact of maternal BMI status on pregnancy outcomes with immediate short-term obstetric resource implications: im meta-analysis. Topics from this paper. This might indicate an additional barrier to change that the interviewed parents of this study were not aware of and that might be addressed in individualized counseling sessions. Lutfiyya MN, et al.

Associated Data

Further inequalities heslehurst obesity in america with obesity, employment and ethnic group. Food advertising to children and its effects on diet: review of recent prevalence and impact data. The complete list of identified barriers can be found in Figure 2. BMJ Open 4 :e The primary aim of analysis was to determine the main factors in delivering adult obesity prevention within a health setting.

PLoS Med. BMJ Open 4 :e In addition to a long-standing focus on both childhood and adult obesity, there has been more recent concern relating to maternal obesity. The authors thank Irena Schank and Sebastian Martin Benito for their assistance during the study's administration. This paper is dedicated to her memory.

Google Scholar. Further papers were highlighted through a manual search of the reference lists. Acknowledgements Not applicable. Disclosure : Heslehurst reports no relevant financial disclosures. Reimagining obesity in a JAMA theme issue on obesity. The adjusted results of the logistic regression analysis for demographic predictors of maternal BMI groups are shown in Table 4.

Forty-nine maternity units 32 NHS Trusts were sampled as they reported collecting all data items required for the study electronically. Barriers to action are the factors mentioned by parents who are aware of the problem but are not adequately taking action against it. Specialist health visitor-led weight management intervention in primary care: exploratory evaluation.

Fernandez, and W. Mizutani, T. Diet is associated with greater reduction of the risks of GDM, pregnancy-induced hypertension and preterm birth, compared with any other intervention. Stuart, and M. Essential medical statistics.

  • Further, the infants were at higher risk of having birth trauma, of needing resuscitation, and of having an Apgar score less than seven at five minutes of life [ 5 ]. A total ofinfants were large for gestational age

  • What childhood obesity prevention programmes work?

  • The two vignettes in supplementary material briefly illustrate some of these factors. Ten years of confidential inquiries into maternal deaths in France, —

  • The derived barriers were grouped into the stages of change according to the TTM; hence, the final model of perceived barriers to behavior change was derived.

  • Health Monit. European Congress on Obesity.

  • Has PDF. More Filters.

Definition of term birth. Obesuty, Heslehurst obesity in america. Obey, J. Individual or group sessions on diet and PA; goals setting, self-monitoring, pedometer, telephone call. Devlieger, K. Postpartum weight retention and inter-pregnancy obesity 3132 Type 2 diabetes Long-term vascular dysfunction 14 The year incidence of overweight and major weight gain in US adults.

Heslehurst obesity in america hardship which includes food insecurity during childhood has also been found to increase the risk of excessive GWG during pregnancy and later in life [62]. Nutrition, exercise or combined diet and PA interventions. View at: Google Scholar T. An overview of mortality and sequelae of preterm birth from infancy to adulthood. View at: Google Scholar W.

Background

Early life predictors of preschool overweight and obesity: a case-control study in Sri Lanka. KorsKelly R. Maternal overweight and obesity and the risk of congenital anomalies: a systematic review and meta-analysis.

Identifying modifiable factors related to the health care provide to women with obesity might produce a more positive effect. Obesity: the gateway obrsity ill health - an EASO position statement on a rising public heslehurst obesity in america, clinical and scientific challenge in Europe. We have added evidence to the need for pregnancy-related research and practice to consider all obesity classes separately; obesity is a heterogeneous population as not all obesity classes have same level of risk or care requirements. Lauszus, J. Delivery varied between individual or group sessions, conducted either at home or at a center. The two vignettes in supplementary material briefly illustrate some of these factors. The optimal amount of weight gain or loss during pregnancy that would minimize maternal and fetal complications remains a topic of discussion 64 — 68and there is a need to examine the tailoring of interventions to the severity of maternal obesity.

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Walsh, C. Chu, W. Morin, A. Common pitfalls in analysis and interpretation. Clausen, N. Maternal diet has been shown to influence DNA methylation patterns in offspring, but research in humans is limited

Robinson, S. Despite the above limitations, some clear conclusions can be made concerning the type and dose of interventions. Correspondence to Monica Saucedo. Prevalence of obesity and trends in the distribution of body mass index among US adults, Table 3 Summary of effects of lifestyle interventions on gestational weight gain and postpartum weight loss. Strengths Several strengths characterised our study.

The absolute risk of post-term birth increased monotonically as BMI category ameriac 4. Bottone et al. Although the quality of evidence remain low, the available evidence suggests that antenatal multi-component lifestyle interventions are also effective in reducing the risk of macrosomia and neonatal respiratory distress syndrome in women with overweight and obesity 3. Perales et al. Ingardia, J.

Related Content

S2 Table. Independent and combined effects of maternal prepregnancy body mass index and gestational weight gain on offspring growth at 0—3 years of age. Analysis of categorical outcomes The primary outcome was childhood obesity. Thank you for visiting nature.

Lancet Diabetes Endocrinol. Both supporting people who are currently overweight to attain modest weight loss as well as preventing further increases in weight may eventually see a decrease in overall rates of obesity and a reduction in the rates of chronic diseases [ 6 ] and therefore a decrease in associated costs [ 7 ]. A study by Eli et al. Screening: Studies excluded due to duplicate cohort data. Reimagining obesity in a JAMA theme issue on obesity. Nurs Outlook.

  • Efficacy of physical activity interventions in post-natal populations: systematic review, meta-analysis and content coding of behaviour change techniques.

  • The statistical analyses were conducted using dosresmeta [ 15 ] and metafor [ 19 ] packages for R version 3. Sensitivity analyses for linear and nonlinear meta-analyses did not show any 1 study to be substantially influencing the overall direction of association, effect size, statistical significance, or heterogeneity S14 — S17 Tables.

  • Article Google Scholar 7.

  • Secular trends in cardiovascular disease risk factors according to body mass index in US adults.

  • The studies involving human participants were reviewed and approved by Ethics committee of the medical faculty of the Eberhard Karls University of Tuebingen. The size of the data markers indicates the weight assigned to each study in the meta-analysis.

Has PDF. Health services are a complex system, constituted of a range of people, processes, activities, settings and structures. Global prevalence and trends of overweight and obesity among preschool children. Footnotes Funding.

Growth of children at high risk of obesity during the first 6 y of life: implications for prevention. A list of exemplary quotes of all identified barriers can be found in Supplementary Table 2. Obesity and reproduction. No multicollinearity was present between the predictor variables, and therefore all were included in the final regression model. Along with the individual risks to mother and child, there is an increased demand for services and a requirement for more specialised services to support woman and baby both during and after the birth [ 182630313334 ]. European Congress on Obesity. Limiting the review to English language references may have excluded some evidence.

Introduction

Child Health 50— Lutfiyya MN, et al. Google Scholar 23 Department of Health. The English Indices of Deprivation.

  • Kornosky, K. This type of research must include effective methods for overcoming implementation challenges in diverse, under-resourced communities and should be made available to practitioners and professional organizations through the adoption of effective communication and dissemination strategies.

  • Effectiveness of an intervention in increasing the provision of preventive care by community mental health services: a non-randomized, multiple baseline implementation trial. A network analysis of the causal attributions for obesity in children and adolescents and their parents.

  • Smith, J. BMJ :e

Academic Editor: Francesco Saverio Papadia. Combined associations of prepregnancy body mass index and gestational weight gain with the outcome of pregnancy. Clin Endocrinol Oxf. Structured intensive programs using cognitive-behavioral techniques in individual or group setting are effective in achieving realistic goals in an adequate time frame

There were increased odds for the overall obese women to be living in the most deprived quintile compared with the least deprived quintile, and when the subgroups of obesity were explored, the relationship with deprivation was seen to increase as the america of obesity increased. The quality score of studies ranged from 3 to 8; no studies were rated low quality, 26 medium quality, and 53 high quality S6 Table. Full size image. Childhood overweight and obesity: maternal perceptions of the time for engaging in child weight management. Protection of the Child and Evaluation of Physical and Mental Health Although action was taken, parents reported on limiting changes and not talking to their children about the measures taken in order to protect their mental health. Statistics on obesity, physical activity and diet: England, January

Lancet — Goodman, J. The duration of the interventions was 11 days to 36 months. Not surprisingly, more intensive and expensive interventions with more frequent human interaction seem to be more effective than brief once or twice interventions or brochure- based advice. A secondary data analysis of 13 maternity units in England with information onsingleton live births between and

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Story, and J. Morin, A. Maternal BMI and preterm birth: a systematic review hewlehurst the literature with meta-analysis. It is also unknown how many providers are recommending smartphone apps for weight management in pregnancy, and what barriers exist to their use, especially among lower-income patients, patients of color, and non-English-speaking patients in the United States. Cooper, and K.

Kemper KA. Crippa A, Orsini N. Table 1. Keywords: readiness to change, parental role, obesity, overweight, children. You will receive an email when new content is published. Heslehurst, N.

Lederman and A. In Sweden, two-thirds of women weigh more than their pre-pregnancy weight at 6 months postpartum 59 and, in the U. Brynhildsen, A. The STOP Obesity Alliance tool kit has many other examples of how to begin and continue these necessary conversations [35].

Report of the Commission on Ending Childhood Obesity. S4 Table. S14 Table. Meta-analysis in clinical trials. Schmied et al.

Also, there is limited evidence on the effectiveness of interventions in tackling maternal obesity, and further research is required to identify ways to halt the yearly accelerating rise in obesiy obesity incidence in England. Data extraction All articles were reviewed and divided into the categories described above. Little attention has been given to the preconception period among obesity prevention interventions to date; attention to this period may help to address the complex early-life inequalities associated with obesity development. A variety of studies showed the effect of motivational interviewing to enhance commitment and further readiness to change Hettema et al.

When multiple studies reported data from the same cohort, 3 authors NH, ZA, and RV selected which to include using a priority list based on study characteristics: all data required for meta-analysis present, a greater number of maternal BMI categories, child ages not combined, larger sample size, and adjusted analyses. Details of included studies as reported in the original papers. S2 Table. Obes Rev.

Google Scholar. Jain, C. Table 2 The United States of America Institute of Medicine Recommendations for total weight gain during pregnancy, by pre-pregnancy body mass index.

Sydney; Harris M, Lloyd J. Or giving her just one piece. Capitalising on opportunities for early-life prevention of obesity is a priority for public health, global health, and clinical practice.

The following statements were examples:. Care 26— Relationships of body composition and liver fat content with insulin resistance in obesity-matched adolescents and adults. Version 5. HMSO: London, What did the researchers do and find? We included primary studies as well as literature reviews.

Salsberry and P. Areas where the majority of reviews were marked down included not adequately describing excluded studies and statistical tests, and not providing a clinical consensus statement. Mozas et al.

  • Han, K.

  • Similarly in services delivering general community health care, despite the presence of risk factors and an openness by clients to receive preventive advice, community health staff do not deliver opportunistic prevention, particularly in relation to diet [ 817 ].

  • Although there america a plethora of information available in the literature regarding the contribution of maternal obesity, both preexisting and due to excessive gestational weight gain, to fetal macrosomia, the exact effect size of this relationship remains imprecise [ 421 — 40 ]. Three recent review studies showed that exercise-alone interventions, while effective in some Asian and European studies, have generally not been shown to be effective at preventing excessive GWG in U.

  • Shults, S.

  • J Epidemiol.

The odds of moderate preterm birth were significantly increased for all obesity classes except IIIa; the greatest effect size was for obesity class IIIb: 1. Lawlor, G. Figure 4. Carstensen, and V.

Click here for additional data file. Motivational interviewing: a systematic review and meta-analysis. The interview guideline consisted of 25 open main questions with up to seven side questions each for deepening the respective topic see Supplementary Table 1. Related Papers.

Siega-Riz, D. Natl Vital Stat. Stat Med. Results Thirty studies met the inclusion criteria Figure 1. Accepted : 25 September Delivery varied between individual or group sessions, conducted either at home or at a center. BMJ :e

Stat Med. Boulet, H. Semin Reprod Med.

The delivery of preventive care to clients of community health services. Motivational interviewing: a systematic review and meta-analysis. Metrics details. If the adjusted ORs and CIs were not available, the respective unadjusted parameters were derived from the data.

High-quality evidence that interventions reduced the risk of cesarean section RR 0. View at: Google Scholar F. Hellerstedt, I. Correspondence to Monica Saucedo. Stella et al. Brennand, D.

Heslehurst obesity in america then explored the extent to which any association was explained by maternal pre-pregnancy or early-pregnancy BMI. Examinations and hslehurst should also be done by the pediatrician in the parents' eyes, i. Early-life intervention to prevent childhood obesity is a priority for public health, global health, and clinical practice. Excess weight gain in pregnancy combined with not losing the weight after pregnancy are predictors of long-term maternal obesity and increases the risk of the child developing obesity whilst mothers with gestational diabetes are more likely to develop type 2 diabetes later in life [ 36 ]. Analysis commenced with an examination of intervention type, sample size, setting and duration.

The adjusted results of the logistic regression analysis for demographic predictors of maternal BMI groups are shown in Table 4. Meta-regression explored maternal and child clinical, socio-demographic, behavioural, and study design factors, yet only child age and the continent of study significantly contributed towards heterogeneity between studies. The increasing rates of maternal obesity supports previous research carried out in the UK at the individual maternity unit level, 8910 although the actual proportions vary. Geneva: World Health Organization. When maternal BMI was reported in a continuous form, the reported study-specific linear trends odds ratios [ORs] for continuous BMI were used assuming linearity. Table 1 Scope of literature by category. Similar results were obtained within a community mental health setting, concluding that even when clinical guidelines explicitly direct clinicians to incorporate preventive care into interactions, rates of care given around issues such as fruit and vegetable intake or physical activity remain low [ 16 ].

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Preventing excessive gestational weight gain: a systematic review of interventions. Results from the French National Perinatal Surveys. Cedergren MI. Madan, J. The association between maternal obesity and fetal overgrowth may well represent the first opportunity through which obese mothers can modify the intergenerational obesity cycle and result in healthier, happier families.

Andreasen, M. Richter, K. Tabor, and B. Measuring multiple deprivation at the small-area level. Confounding, causality, and confusion: the role of intermediate variables in interpreting observational studies in obstetrics. The full texts of articles that were felt to be potentially relevant were obtained.

Figure 2. Environ Health Perspect. Excess weight gain in pregnancy combined with not losing the weight after pregnancy are predictors of long-term maternal obesity and increases the heslehurst obesity in america of the child developing obesity whilst mothers with gestational diabetes are more likely to develop type 2 diabetes later in life [ 36 ]. The disadvantage of many of the survey based studies was the reliance on self-reported weight and height. Obesity has been shown to reduce quality-adjusted life expectancy [ 5 ].

There was also a significantly increased Ij for maternal underweight and borderline significance for overweight categories. Results There was a J-shaped association between the absolute risk of extreme, very and moderate preterm birth and BMI category, with the greatest effect size for extreme preterm. In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript. Abenhaim, R. Maternal overweight and obesity and the risk of congenital anomalies: a systematic review and meta-analysis.

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Healio News Endocrinology Obesity. CINAHL and Medline searches using the same search terms produced articles which on screening appeared to hold relevant studies. This included ethnic group, deprivation, employment and parity compared with the census data on a number of dependent children for each local authority. SD and FS performed the analysis. Midwifery ; doi Importantly it should be acknowledged that systems are often nested within other systems with their own dynamics at play.

  • Nutrition, exercise or combined diet and PA interventions. Duncan, L.

  • Linearity was not rejected for either measure when analysed separately S8 Table.

  • Does obesity increase the risk of miscarriage in spontaneous conception: a systematic review.

  • Nevertheless, a recent meta-analysis showed that self-reported weight of women of reproductive age differs only slightly from direct measures [ 35 ].

Fig 2. Concerning barriers to action, parents in the present study were missing concrete ideas as well as contact persons with which practical problems and barriers obesith be discussed. This study is the first to describe a nationally representative maternal obesity research data set in England. Obesity: why be concerned? View 3 excerpts, references background. Studies to date have shown only parts of the complex barriers parents can experience. Innovative care for chronic conditions: building blocks for action: global report.

Methods A secondary data analysis of 13 maternity units in England with information onsingleton live births between and Kargili, N. Journal overview. Hauger, L.

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