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BMC Pregnancy and Childbirth
Published in: BMC Pregnancy and Childbirth 1/2014

Open Access 01-12-2014 | Research article

Maternal obesity and fetal deaths: results from the Brazilian cross-sectional demographic health survey, 2006

Authors: Mariana Santos Felisbino-Mendes, Fernanda Penido Matozinhos, J Jaime Miranda, Eduardo Villamor, Gustavo Velasquez-Melendez

Published in: BMC Pregnancy and Childbirth | Issue 1/2014

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Abstract

Background

Obesity is highly related to negative reproductive health outcomes, but its relationship with spontaneous abortion and stillbirth remains to be understood, especially in transitioning economies. This study aimed to examine the relationship between obesity and spontaneous abortions and stillbirths in a representative sample of the Brazilian population.

Methods

Cross-sectional study using secondary data of Brazilian women of reproductive age (15–45 years old) from the National Demographic and Health Survey in 2006. Obesity was measured by body mass index (BMI), waist circumference (WC) and waist-to-height ratio (WHR). Logistic regression modeling of the survey data was used to evaluate the relationship between obesity and the study outcomes.

Results

The three obesity markers used were found to be strongly and positively associated with spontaneous abortion and stillbirth occurrence. In the adjusted models, there was strong evidence that for each unit increase in BMI (OR = 1.05; 95%CI: 1.02-1.08) and WHR (OR = 1.32; 95%CI: 1.03-1.69), the odds of having a spontaneous abortion was higher. In addition, compared to those of optimal weight, obese women were more likely to have negative outcomes. Maternal age, parity, skin color, educational level and household income were important covariates for adjustment. A sensitivity analysis among women who had only one pregnancy was also performed and showed similar results.

Conclusion

Obesity is potentially associated with an increased risk of spontaneous abortion and stillbirth in a representative sample of the Brazilian population. These findings are in accordance with previous studies and thus reinforce the need for obstetric care providers to counsel obese reproductive-age women regarding the risks, complications and importance of weight loss and weight control prior to pregnancy.
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Literature
1.
World Health Organization: Obesity: preventing and managing the global epidemic. Report of a WHO consultation. World Health Organ Tech Rep Ser. 2000, 894: 1-253.
2.
3.
Mendez MA, Monteiro CA, Popkin BM: Overweight exceeds underweight among women in most developing countries. Am J Clin Nutr. 2005, 81: 714-721.PubMed
4.
Balarajan Y, Villamor E: Nationally representative surveys show recent increases in the prevalence of overweight and obesity among women of reproductive age in Bangladesh, Nepal, and India. J Nutr. 2009, 139: 2139-2144. 10.3945/jn.109.112029.CrossRefPubMed
5.
Hillemeier MM, Weisman CS, Chuang C, Downs DS, McCall-Hosenfeld J, Camacho F: Transition to overweight or obesity among women of reproductive age. J Womens Health (Larchmt). 2011, 20: 703-710. 10.1089/jwh.2010.2397.CrossRef
6.
INSTITUTO BRASILEIRO DE GEOGRAFIA E ESTATÍSTICA/IBGE: Pesquisa de orçamentos familiares 2008–2009: análise da disponibilidade domiciliar de alimentos e do estado nutricional no Brasil. 2010, Rio de Janeiro: IBGE
7.
Yu CKH, Teoh TG, Robinson S: Obesity in pregnancy. RCOG. 2006, 113: 1117-1125.
8.
Metwally M, Li TC, Ledger WL: The impact of obesity on female reproductive function. Obes Rev. 2007, 8: 515-523. 10.1111/j.1467-789X.2007.00406.x.CrossRefPubMed
9.
Guelincky I, Devlieger R, Beckers K, Vansant G: Maternal obesity: pregnancy complications, gestational weigh gain and nutrition. Obes Rev. 2008, 9: 140-150. 10.1111/j.1467-789X.2007.00464.x.CrossRef
10.
Ramsay JE, Ferrell WR, Crawford L, Wallace AM, Greer IA, Sattar N: Maternal obesity is associated with dysregulation of metabolic, vascular, and inflammatory pathways. JCEM. 2002, 87: 4231-4237.PubMed
11.
Sen S, Carpenter AH, Hochstadt J, Huddleston JY, Kustanovich V, Reynolds A, Robert A: Nutrition, weight gain and eating behavior in pregnancy: a review of experimental evidence for long-term effects on the risk of obesity in offspring. Physiol Behav. 2012, 107: 138-145. 10.1016/j.physbeh.2012.04.014.CrossRefPubMed
12.
Subramanian SV, Ackerson LK, Smith GD, John NA: Association of maternal height with child mortality, anthropometric failure, and anemia in India. JAM. 2009, 301: 1691-1701. 10.1001/jama.2009.548.CrossRef
13.
Ozaltin E, Hill K, Subramanian SV: Association of maternal stature with offspring mortality, underweight, and stunting in low- to middle-income countries. JAMA. 2010, 303: 1507-1516. 10.1001/jama.2010.450.CrossRefPubMedPubMedCentral
14.
Cresswell JA, Campbell OMR, De Silva MJ, Filippi V: Effect of maternal obesity on neonatal death in Sub-Saharan Africa: multivariable analysis of 27 national datasets. Lancet. 2012, 380: 1325-1330. 10.1016/S0140-6736(12)60869-1.CrossRefPubMed
15.
Beck CC, Lopes AS, Pitanga FJG: Anthropometric indexes of overweight and obesity as predictors of lipid changes in adolescents. Rev Paul Pediatr. 2011, 29: 46-53. 10.1590/S0103-05822011000100008.CrossRef
16.
Hsieh SD, Muto T: Asian Perspectives and Evidence on Health Promotion and Education. Waist-to-height ratio is the best anthropometric index for screening the risk of obesity-related disorders. 2011, Tokyo: Springer, 358-363.
17.
Misra A, Wasir JS, Vikram NK: Waist circumference criteria for the diagnosis of abdominal obesity are not applicable uniformly to all populations and ethnic groups. Nutrition. 2005, 21: 969-976. 10.1016/j.nut.2005.01.007.CrossRefPubMed
18.
Brenner DR, Tepylo K, Eny KM, Cahill LE, El-Sohemy A: Comparison of body mass index and waist circumference as predictors of cardiometabolic health in a population of young Canadian adults. Diabetol Metab Syndr. 2010, 2: 28-10.1186/1758-5996-2-28.CrossRefPubMedPubMedCentral
19.
World Health Organization: Physical status: the use and interpretation of anthropometry. 1995, Geneva: World Health Organization, 36-Technical Report Series, 854
20.
Black RE, Allen LH, Bhutta ZA, Caulfield LE, de Onis M, Ezzati M, Mathers C, Rivera J: Maternal and child undernutrition: global and regional exposures and health consequences. Lancet. 2008, 371: 243-260. 10.1016/S0140-6736(07)61690-0.CrossRefPubMed
21.
Mosley WH, Chen LC: An analytical framework for the study of child survival in developing countries. Populat Dev Rev. 1984, 10: 25-45. Sup. Child Survival: Strategies for ResearchCrossRef
22.
West BT, Berglund P, Heeringa SG: A closer examination of subpopulation analysis of complex sample survey data. Stata J. 2008, 8: 520-531.
23.
Heeringa SG, West BT, Berglund PA: Applied survey data analysis. 2008, Boca Raton: Chapman Hall/CRC Press
24.
Villamor E, Cnattingius S: Interpregnancy weight change and risk of adverse pregnancy outcomes: a population-based study. Lancet. 2006, 368: 1164-1170. 10.1016/S0140-6736(06)69473-7.CrossRefPubMed
25.
Flenady V, Koopmans L, Middleton P, Froen JF, Smith GC, Gibbons K, Coory M, Gordon A, Ellwood D, McIntyre HD, Fretts R, Ezzati M: Major risks for stillbirth in high-income countries: a systematic review and meta-analysis. Lancet. 2011, 377: 1331-1340. 10.1016/S0140-6736(10)62233-7.CrossRefPubMed
26.
Nohr EA: Maternal obesity and neonatal mortality in an African setting. Lancet. 2012, 380: 1292-1293. 10.1016/S0140-6736(12)61181-7.CrossRefPubMed
27.
Lashen H, Fear K, Sturdee DW: Obesity is associated with increased risk of first trimester and recurrent miscarriage: matched case control study. Hum Reprod. 2004, 19: 1644-1646. 10.1093/humrep/deh277.CrossRefPubMed
28.
Rittenberg V, Seshadri S, Sunkara SK, Sobaleva S, Oteng-Ntim E, El-Thouky T: Effect of body mass index on IVF treatment outcome: an updated systematic review and meta-analysis. Reprod Biomed Online. 2011, 23: 421-439. 10.1016/j.rbmo.2011.06.018.CrossRefPubMed
29.
Boots C, Stephenson MD: Does obesity increase the risk of miscarriage in spontaneous conception: a systematic review. Semin Reprod Med. 2011, 29: 507-513. 10.1055/s-0031-1293204.CrossRefPubMed
30.
Cnattingius S, Berstrom R, Lipworth L, Kramer MS: Prepregnancy weight and the risk of adverse pregnancy outcomes. N Engl J Med. 1998, 338: 147-152. 10.1056/NEJM199801153380302.CrossRefPubMed
31.
Kristensen J, Vestergaard M, Wisborg K, Kesmodel U, Secher NJ: Pre-pregnancy weight and the risk of stillbirth and neonatal death. BJOG. 2005, 112: 403-408. 10.1111/j.1471-0528.2005.00437.x.CrossRefPubMed
32.
Hayes EK, Lechowicz A, Petrik JJ, Storozhuk Y, Paez-Parek S, Dai Q, Samjoo IA, Mansell M, Gruslin A, Holloway AC, Raha S: Adverse fetal and neonatal outcomes associated with a life-long high fat diet: role of altered development of the placental vasculature. PLoS One. 2012, 7: e33370-10.1371/journal.pone.0033370.CrossRefPubMedPubMedCentral
33.
Moran L, Tsagareli V, Norman R, Noakes M: Diet and IVF pilot study: short-term weight loss improves pregnancy rates in overweight⁄obese women undertaking IVF. Aust N Z J Obstet Gynaecol. 2011, 51: 455-459. 10.1111/j.1479-828X.2011.01343.x.CrossRefPubMed
34.
Chen Z, Du J, Shao L, Zheng L, Wu M, Ai M, Zhang Y: Prepregnancy body mass index, gestational weight gain, and pregnancy outcomes in China. Int J Gynecol Obstet. 2010, 109: 41-44. 10.1016/j.ijgo.2009.10.015.CrossRef
35.
Stone JL, Lockwood CJ, Berkowitz GS, Alvarez M, Lapinski R, Berkowitz RL: Risk factors for severe preeclampsia. Obstet Gynecol. 1994, 83: 357-361.PubMed
36.
Rocha VZ, Libby P: Obesity, inflammation, and atherosclerosis. Nat Rev Cardiol. 2009, 6: 399-409. 10.1038/nrcardio.2009.55.CrossRefPubMed
37.
Schmidt MI, Duncan BB, Silva GA, Menezes AM, Monteiro CA, Barreto SM, Chor D, Menezes PR: Chronic non-communicable diseases in Brazil: burden and current challenges. Lancet. 2011, 377: 1949-1961. 10.1016/S0140-6736(11)60135-9.CrossRefPubMed
Metadata
Title
Maternal obesity and fetal deaths: results from the Brazilian cross-sectional demographic health survey, 2006
Authors
Mariana Santos Felisbino-Mendes
Fernanda Penido Matozinhos
J Jaime Miranda
Eduardo Villamor
Gustavo Velasquez-Melendez
Publication date
01-12-2014
Publisher
BioMed Central
Published in
BMC Pregnancy and Childbirth / Issue 1/2014
Electronic ISSN: 1471-2393
DOI
https://doi.org/10.1186/1471-2393-14-5

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