Obstetrics and Gynecology Commons^™

Maternal Obesity Reduces Placental Autophagy Marker Expression In Uncomplicated Pregnancies, Matthew Cohen, Emily Guo, Aidan Pucchio, Barbra De Vrijer, Trevor G Shepherd, Genevieve Eastabrook

Obstetrics & Gynaecology Publications

AIM: Obesity has been associated with changes in autophagy and its increasing prevalence among pregnant women is implicated in higher rates of placental-mediated complications of pregnancy such as pre-eclampsia and intrauterine growth restriction. Autophagy is involved in normal placentation, thus changes in autophagy may lead to impaired placental function and development. The aim of this study was to investigate the connection between obesity and autophagy in the placenta in otherwise uncomplicated pregnancies.

METHODS: Immunohistochemistry and western blot analysis were done on placental and omental samples from obese (body mass index [BMI] ≥30 kg/m

RESULTS: As pre-pregnancy BMI increased, there was …

Labour Progression In Obese Women: Are Women With Increased Body Mass Index Having Unnecessary Cesarean Sections?, Caroline Shenouda, Aloka Wijesooriya, Amanda Toufeili, Michael R Miller, Debbie Penava, Barbra De Vrijer

Obstetrics & Gynaecology Publications

OBJECTIVE: This study sought to determine whether obese pregnant women undergo cesarean sections without an adequate trial of labour. This may affect future birth and pregnancy outcomes.

METHODS: A retrospective analysis was done on 526 parturients at Victoria Hospital in London, Ontario. Women were categorized according to parity and pre-pregnancy body mass index (BMI; normal weight, BMI 18.5-24.9 kg/m

RESULTS: Obese class II and III primiparous women required an additional 1.62 and 2.67 hours (P = 0.012), respectively, to reach a dilation of 10 cm compared with their normal weight counterparts; obese class II and III multiparous women required an …

Clinical Significance Of A False Positive Glucose Challenge Test In Patients With A High Body Mass Index, A Borja, M Moretti, Nisha Lakhi

NYMC Faculty Publications

OBJECTIVE: To determine if there is an increased maternal or neonatal morbidity in overweight and obese patients with a false positive glucose challenge test (GCT). METHODS: Patients with a body mass index (BMI) >/=25.0 at registration were included in this prospective 36-month study. The study cohort consisted of patients with a false positive (FP) GCT, with two comparison cohorts: those with a (1) screen negative (SN) GCT result and (2) true positive (TP) GCT result. Risks were reported as odd ratios with 95% confidence intervals, with a P/=4000 g in the FP cohort, but this fell short of reaching statistical …

Risk Of Glucose Intolerance And Gestational Diabetes Mellitus In Relation To Maternal Habitual Snoring During Early Pregnancy., Chunfang Qiu, Wayne Lawrence, Bizu Gelaye, Lee Stoner, Ihunnaya O Frederick, Daniel A Enquobahrie, Tanya K Sorensen, Michelle A Williams

Articles, Abstracts, and Reports

BACKGROUND: Obstructive sleep apnea (OSA) or habitual snoring is known to be associated with impaired glucose tolerance and type 2 diabetes among both men and non-pregnant women. We examined the association of habitual snoring during early pregnancy with risk of impaired glucose tolerance (IGT) and gestational diabetes mellitus (GDM).

METHODS: A cohort of 1,579 women was interviewed during early pregnancy. We collected information about snoring frequency during early pregnancy. Results from screening and diagnostic tests for IGT and GDM were abstracted from medical records. Multivariate logistic regression models were fitted to estimate odds ratios (OR) and 95% confidence intervals (95% …

Achievement Test Performance In Children Conceived By Ivf, L. Mains, M. Zimmerman, J. Blaine, B. Stegmann, Amy Sparks, T. Ansley, Bradley Van Voorhis

Amy E.T. Sparks

BACKGROUND: Long-term follow-up studies of children conceived by IVF are limited. We examine academic performance on standardized tests [Iowa Tests of Basic Skills/Educational Development (ITBS/ITED)] of children conceived by IVF. METHODS: Parents of children 8-17 years of age at the onset of the study (March 2008) who were conceived by IVF at the University of Iowa Hospitals and Clinics and living in the state of Iowa were contacted by mail. Parents completed questionnaires on their child's health and education and parental education. ITBS/ITED scores from school grades 3-12 were obtained on IVF children and a group of anonymous children matched …

Obstetric Outcomes After In Vitro Fertilization In Obese And Morbidly Obese Women., Anuja Dokras, Lindsey Baredziak, Jill Blaine, Craig Syrop, Bradley Van Voorhis, Amy Sparks

Amy E.T. Sparks

OBJECTIVE: In addition to numerous health detriments caused by obesity, fertility and pregnancy success may also be compromised. The aims of this study were to compare the effects of obesity and morbid obesity on in vitro fertilization (IVF) outcomes. We also investigated the effects of obesity on obstetric outcomes after IVF treatment. METHODS: Retrospective study of women less than 38 years of age during their first fresh IVF cycle (January 1995 to April 2005). RESULTS: A total of 1,293 women were included in the study, with 236 obese women (body mass index [BMI] = 30-39.9) and 79 morbidly obese women …

Obstetric Outcomes After In Vitro Fertilization In Obese And Morbidly Obese Women., Anuja Dokras, Lindsey Baredziak, Jill Blaine, Craig Syrop, Bradley Van Voorhis, Amy Sparks

Bradley J Van Voorhis

OBJECTIVE: In addition to numerous health detriments caused by obesity, fertility and pregnancy success may also be compromised. The aims of this study were to compare the effects of obesity and morbid obesity on in vitro fertilization (IVF) outcomes. We also investigated the effects of obesity on obstetric outcomes after IVF treatment. METHODS: Retrospective study of women less than 38 years of age during their first fresh IVF cycle (January 1995 to April 2005). RESULTS: A total of 1,293 women were included in the study, with 236 obese women (body mass index [BMI] = 30-39.9) and 79 morbidly obese women …

Achievement Test Performance In Children Conceived By Ivf, L. Mains, M. Zimmerman, J. Blaine, B. Stegmann, Amy Sparks, T. Ansley, Bradley Van Voorhis

Bradley J Van Voorhis

BACKGROUND: Long-term follow-up studies of children conceived by IVF are limited. We examine academic performance on standardized tests [Iowa Tests of Basic Skills/Educational Development (ITBS/ITED)] of children conceived by IVF. METHODS: Parents of children 8-17 years of age at the onset of the study (March 2008) who were conceived by IVF at the University of Iowa Hospitals and Clinics and living in the state of Iowa were contacted by mail. Parents completed questionnaires on their child's health and education and parental education. ITBS/ITED scores from school grades 3-12 were obtained on IVF children and a group of anonymous children matched …

Sleep Disturbance, Cytokines, And Fatigue In Women With Ovarian Cancer., Lauren Clevenger, Andrew Schrepf, Desire Christensen, Koen De Geest, David Bender, Amina Ahmed, Michael Goodheart, Frank Penedo, David Lubaroff, Anil Sood, Susan Lutgendorf

Koen De Geest

Pro-inflammatory cytokines, such as interleukin-6 (IL-6), have been implicated in the underlying processes contributing to sleep regulation and fatigue. Despite evidence for sleep difficulties, fatigue, and elevations in IL-6 among women with ovarian cancer, the association between these symptoms and IL-6 has not been investigated. To address this knowledge gap, we examined relationships between sleep disturbance, fatigue, and plasma IL-6 in 136 women with ovarian cancer prior to surgery. These relationships were also examined in 63 of these women who were disease-free and not receiving chemotherapy one year post-diagnosis. At both time-points, higher levels of IL-6 were significantly associated with …

Obesity And Outcomes After Sacrocolpopexy, Catherine Bradley, K. Kenton, H. Richter, X. Gao, H. Zyczynski, A. Weber, I. Nygaard

Catherine S. Bradley

OBJECTIVE: The purpose of this study was to compare outcomes after sacrocolpopexy (SC) between obese and healthy-weight women. STUDY DESIGN: Baseline and postoperative data were analyzed from the Colpopexy And Urinary Reduction Efforts (CARE) randomized trial of SC with or without Burch colposuspension in stress continent women with stages II-IV prolapse. Outcomes and complications were compared between obese and healthy-weight women. RESULTS: CARE participants included 74 obese (body mass index >/=30 kg/m(2)), 122 overweight (25-29.9 kg/m(2)), and 125 healthy-weight (18.5-24.9 kg/m(2)) women, and 1 underweight (< 18.5 kg/m(2)) woman. Compared to healthy-weight women, obese women were younger (59.0 +/- 9.9 vs 62.1 +/- 10.3 yrs; P = .04), more likely to have stage II prolapse (25.7% vs 11.2%; P = .01), and had longer operative times (189 +/- 52 vs 169 +/- 58 min; P = .02). Two years after surgery, stress incontinence, prolapse, symptom resolution, and satisfaction did not differ between the obese and healthy-weight groups. CONCLUSION: Most outcomes and complication rates after SC are similar in obese and healthy-weight women.

Natural History Of Pelvic Organ Prolapse In Postmenopausal Women, Catherine Bradley, M. Zimmerman, Y. Qi, I. Nygaard

Catherine S. Bradley

OBJECTIVE: To describe the natural history of pelvic organ prolapse and risk factors for changes in vaginal descent in older women. METHODS: This 4-year prospective observational study included 259 postmenopausal women with a uterus enrolled at one Women's Health Initiative clinical site who completed at least two annual pelvic organ prolapse quantification (POP-Q) examinations. We calculated 1-year and 3-year incidence and resolution risks for prolapse (defined as maximal vaginal descent to or beyond the hymen) and estimated progression and regression rates (1 cm or greater and 2 cm or greater changes in maximal vaginal descent) and risk factors. RESULTS: Mean …

Sleep Disturbance, Cytokines, And Fatigue In Women With Ovarian Cancer., Lauren Clevenger, Andrew Schrepf, Desire Christensen, Koen De Geest, David Bender, Amina Ahmed, Michael Goodheart, Frank Penedo, David Lubaroff, Anil Sood, Susan Lutgendorf

David P Bender

Pro-inflammatory cytokines, such as interleukin-6 (IL-6), have been implicated in the underlying processes contributing to sleep regulation and fatigue. Despite evidence for sleep difficulties, fatigue, and elevations in IL-6 among women with ovarian cancer, the association between these symptoms and IL-6 has not been investigated. To address this knowledge gap, we examined relationships between sleep disturbance, fatigue, and plasma IL-6 in 136 women with ovarian cancer prior to surgery. These relationships were also examined in 63 of these women who were disease-free and not receiving chemotherapy one year post-diagnosis. At both time-points, higher levels of IL-6 were significantly associated with …

Body Mass Index And Cerclage Success, A. Suhag, Md, N. S. Seligman, Md, V. Berghella, Md

Department of Obstetrics and Gynecology Faculty Papers

Conclusions:

Among women with a cerclage, pre-pregnancy BMI was not a significant predictor of SPTB <35 weeks.

There was a non-significant trend toward increased rates of SPTB at all gestational age cutoffs.

Morbidly obese women consistently had worse outcomes than obese and normal/overweight women.

Compared to normal/overweight, GA at delivery decreases by 1 week for obese and 2 weeks for morbidly obese women.