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Chapter 11 - Obesity and Metabolic Syndrome in Pregnancy

from Section II - Hormones and Gestational Disorders

Published online by Cambridge University Press:  09 November 2022

By
Kent L. R. Thornburg ,
Amy M. Valent ,
Nicole E. Marshall  and
Jonathan Q. Purnell
Edited by
Felice Petraglia ,
Mariarosaria Di Tommaso  and
Federico Mecacci
Felice Petraglia
Affiliation:
Università degli Studi, Florence
Mariarosaria Di Tommaso
Affiliation:
Università degli Studi, Florence
Federico Mecacci
Affiliation:
Università degli Studi, Florence
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Summary

Increasing numbers of women who are pregnant have a body mass index exceeding >30 kg/m2, the definition of obesity. The obese condition is associated with a number of adverse outcomes among mothers and offspring. Offspring are at greater risk for adult onset diseases, including obesity compared to babies born to women in the normal BMI category. The risk of mortality in offspring caused by ischemic heart disease increases linearly by three-fold between a BMI of 25 to 30 kg/m2. Women with obesity are less likely to breastfeed than normal weight women. An important aspect of the obese condition is an altered range of weight around which the body regulates appetite. The medical management of women who suffer obesity can include attention to a number of factors including lifestyle modifications. Importantly, eating a healthy diet during pregnancy has been shown to improve perinatal outcomes in women across the BMI spectrum.

Type
Chapter
Information
Hormones and Pregnancy
Basic Science and Clinical Implications
 , pp. 107 - 119
Publisher: Cambridge University Press
Print publication year: 2022

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References

Jones, DS, Podolsky, SH, and Greene, JA. The burden of disease and the changing task of medicine. The New England Journal of Medicine. 2012, 366:2333–2338.Google Scholar
(NCCDPHP) CsNCfCDPaHP. Chronic Diseases in America. In: (NCCDPHP) NCfCDPaHP, ed.: Center for Disease Control and Prevention, 2021.Google Scholar
Turnbaugh, PJ, Ley, RE, Mahowald, MA, et al. An obesity-associated gut microbiome with increased capacity for energy harvest. Nature. 2006, 444:1027–1031.Google Scholar
Hales, CM, Carroll, MD, Fryar, CD, et al. Prevalence of Obesity and Severe Obesity Among Adults: United States, 2017-2018. NCHS data brief 2020:1-8.Google Scholar
Barnes, AS. The epidemic of obesity and diabetes: Trends and treatments. Texas Heart Institute Journal. 2011, 38:142–144.Google Scholar
Percent of Adults Who Are Overweight/Obese. In: Global Sherpa, 2011.Google Scholar
Eriksson, J, Forsén, T, Tuomilehto, J, et al. Size at birth, childhood growth and obesity in adult life. International Journal of Obesity and Related Metabolic Disorders: Journal of the International Association for the Study of Obesity 2001, 25:735–740.Google Scholar
Rolland-Cachera, MF, Deheeger, M, Maillot, M, et al. Early adiposity rebound: Causes and consequences for obesity in children and adults. International Journal of Obesity. 2005, 30 Suppl (4):S11–S17.Google Scholar
Hales, CM, Fryar, CD, Carroll, MD, et al. Trends in obesity and severe obesity prevalence in US youth and adults by sex and age, 2007–2008 to 2015–2016. JAMA. 2018, 319:1723–1725.Google Scholar
Deputy, NP, Dub, B, and Sharma, AJ. Prevalence and trends in prepregnancy normal weight - 48 states, New York City, and District of Columbia, 2011–2015. MMWR Morbidity and Mortality Weekly Report. 2018, 66:1402–1407.CrossRefGoogle ScholarPubMed
Neeland, IJ, Poirier, P, and Després, JP. Cardiovascular and metabolic heterogeneity of obesity: Clinical challenges and implications for management. Circulation. 2018, 137:1391–1406.Google Scholar
ACOG Practice Bulletin No 156: Obesity in pregnancy. Obstetrics and Gynecology. 2015, 126:e112–e126.Google Scholar
Villamor, E, and Cnattingius, S. Interpregnancy weight change and risk of adverse pregnancy outcomes: A population-based study. Lancet. 2006, 368:1164–1170.Google Scholar
Harmon, KA, Gerard, L, Jensen, DR, et al. Continuous glucose profiles in obese and normal-weight pregnant women on a controlled diet: Metabolic determinants of fetal growth. Diabetes Care. 2011, 34:2198–2204.Google Scholar
Hedman, AM, Lundholm, C, Andolf, E, et al. Longitudinal plasma inflammatory proteome profiling during pregnancy in the Born into Life study. Scientific Reports. 2020, 10:17819.Google Scholar
Catalano, PM, and Shankar, K. Obesity and pregnancy: mechanisms of short term and long term adverse consequences for mother and child. BMJ (Clinical Research Ed.). 2017, 356:j1.Google Scholar
Davis, NL SA, and Goodman, DA. Pregnancy-Related Deaths: Data from 14 U.S. Maternal Mortality Review Committees, 2008–2017. Centers for Disease Control and Prevention, US Department of Health and Human Services, 2019.Google Scholar
Ende, HB, Lozada, MJ, Chestnut, DH, et al. Risk factors for atonic postpartum hemorrhage: A systematic review and meta-analysis. Obstetrics and Gynecology. 2021, 137:305–323.Google Scholar
Cnattingius, S, Villamor, E, Johansson, S, et al. Maternal obesity and risk of preterm delivery. JAMA. 2013, 309:2362–2370.Google Scholar
Aune, D, Saugstad, OD, Henriksen, T, et al. Maternal body mass index and the risk of fetal death, stillbirth, and infant death: A systematic review and meta-analysis. JAMA. 2014, 311:1536–1546.Google Scholar
Best, KE, Tennant, PW, Bell, R, et al. Impact of maternal body mass index on the antenatal detection of congenital anomalies. BJOG: An International Journal of Obstetrics and Gynaecology. 2012, 119:1503–1511.CrossRefGoogle ScholarPubMed
Pucci, A, and Batterham, RL. Endocrinology of the gut and the regulation of body weight and metabolism. In: Feingold, KR, Anawalt, B, Boyce, A, Chrousos, G, de Herder, WW, Dungan, K, et al., eds. Endotext. South Dartmouth, MA: MDText.com, Inc. 2000.Google Scholar
Barsh, GS, and Schwartz, MW. Genetic approaches to studying energy balance: Perception and integration. Nature Reviews Genetics. 2002, 3:589–600.CrossRefGoogle ScholarPubMed
Wallace, JM, Bhattacharya, S, and Horgan, GW. Weight change across the start of three consecutive pregnancies and the risk of maternal morbidity and SGA birth at the second and third pregnancy. PLoS ONE. 2017, 12:e0179589.Google Scholar
Peaceman, AM, Clifton, RG, Phelan, S, et al. Lifestyle interventions limit gestational weight gain in women with overweight or obesity: LIFE-Moms prospective meta-analysis. Obesity. 2018, 26:1396–1404.Google Scholar
Phelan, S, Clifton, RG, Haire-Joshu, D, et al. One-year postpartum anthropometric outcomes in mothers and children in the LIFE-Moms lifestyle intervention clinical trials. International Journal of Obesity. 2005, 2020(44):57–68.Google Scholar
Knowler, WC, Barrett-Connor, E, Fowler, SE, et al. Reduction in the incidence of type 2 diabetes with lifestyle intervention or metformin. New England Journal of Medicine. 2002, 346:393–403.Google Scholar
Tchang, BG, Kumar, RB, and Aronne, LJ. Pharmacologic treatment of overweight and obesity in adults. In: Feingold, KR, Anawalt, B, Boyce, A, Chrousos, G, de Herder, WW, Dungan, K. et al., eds. Endotext. South Dartmouth, MA: MDText.com, Inc. 2000.Google Scholar
Courcoulas, AP, King, WC, Belle, SH, et al. Seven-year weight trajectories and health outcomes in the Longitudinal Assessment of Bariatric Surgery (LABS) Study. JAMA Surgery. 2018, 153:427–434.Google Scholar
Benjamin, RH, Littlejohn, S, and Mitchell, LE. Bariatric surgery and birth defects: A systematic literature review. Paediatric and Perinatal Epidemiology. 2018, 32:533–544.Google Scholar
Neovius, M, Pasternak, B, Näslund, I, et al. Association of maternal gastric bypass surgery with offspring birth defects. JAMA. 2019, 322:1515–1517.Google Scholar
Elder, KA, and Wolfe, BM. Bariatric surgery: A review of procedures and outcomes. Gastroenterology. 2007, 132:2253–2271.Google Scholar
Kral, JG, Biron, S, Simard, S, et al. Large maternal weight loss from obesity surgery prevents transmission of obesity to children who were followed for 2 to 18 years. Pediatrics. 2006, 118:e1644–1649.Google Scholar
Smith, J, Cianflone, K, Biron, S, et al. Effects of maternal surgical weight loss in mothers on intergenerational transmission of obesity. The Journal of Clinical Endocrinology and Metabolism. 2009, 94:4275–4283.Google Scholar
Willmer, M, Berglind, D, Tynelius, P, et al. Children’s weight status, body esteem, and self-concept after maternal gastric bypass surgery. Surgery for Obesity and Related Eiseases: Official Journal of the American Society for Bariatric Surgery. 2015, 11:927–932.Google Scholar
Barisione, M, Carlini, F, Gradaschi, R, et al. Body weight at developmental age in siblings born to mothers before and after surgically induced weight loss. Surgery for Obesity and Related Diseases: Official Journal of the American Society for Bariatric Surgery. 2012, 8:387–391.Google Scholar
Willmer, M, Berglind, D, Sørensen, TI, et al. Surgically induced interpregnancy weight loss and prevalence of overweight and obesity in offspring. PLoS ONE. 2013, 8:e82247.Google Scholar
Guénard, F, Deshaies, Y, Cianflone, K, et al. Differential methylation in glucoregulatory genes of offspring born before vs. after maternal gastrointestinal bypass surgery. Proceedings of the National Academy of Sciences of the United States of America. 2013, 110:11439–11444.Google Scholar
Berglind, D, Müller, P, Willmer, M, et al. Differential methylation in inflammation and type 2 diabetes genes in siblings born before and after maternal bariatric surgery. Obesity. 2016, 24:250–261.Google Scholar
Svane, MS, Bojsen-Møller, KN, Martinussen, C, et al. Postprandial nutrient handling and gastrointestinal hormone secretion after Roux-en-Y gastric bypass vs sleeve gastrectomy. Gastroenterology. 2019, 156:1627–1641.e1.Google Scholar
Nohr, EA, Bech, BH, Davies, MJ, et al. Prepregnancy obesity and fetal death: A study within the Danish National Birth Cohort. Obstetrics and Gynecology. 2005, 106:250–259.Google Scholar
Ikedionwu, CA, Dongarwar, D, Yusuf, KK, et al. Pre-pregnancy maternal obesity, macrosomia, and risk of stillbirth: A population-based study. European Journal of Obstetrics, Gynecology, and Reproductive Biology. 2020, 252:1–6.Google Scholar
Marshall, NE, Guild, C, Cheng, YW, et al. Maternal superobesity and perinatal outcomes. American Journal of Obstetrics and Gynecology. 2012, 206(417):e1–6.Google Scholar
Beta, J, Khan, N, Khalil, A, et al. Maternal and neonatal complications of fetal macrosomia: Systematic review and meta-analysis. Ultrasound in Obstetrics & Gynecology: The Official Journal of the International Society of Ultrasound in Obstetrics and Gynecology. 2019, 54:308–318.Google Scholar
Desai, M, and Ross, MG. Fetal programming of adipose tissue: Effects of intrauterine growth restriction and maternal obesity/high-fat diet. Seminars in Reproductive Medicine. 2011, 29:237–245.Google Scholar
Kislal, S, Shook, LL, and Edlow, AG. Perinatal exposure to maternal obesity: Lasting cardiometabolic impact on offspring. Prenatal Diagnosis. 2020, 40:1109–11025.Google Scholar
Heslehurst, N, Vieira, R, Akhter, Z, et al. The association between maternal body mass index and child obesity: A systematic review and meta-analysis. PLoS Medicine. 2019, 16:e1002817.Google Scholar
Brumbaugh, DE, Tearse, P, Cree-Green, M, et al. Intrahepatic fat is increased in the neonatal offspring of obese women with gestational diabetes. The Journal of Pediatrics. 2013, 162:930–936.e1.Google Scholar
Cirulli, F, Musillo, C, and Berry, A. Maternal obesity as a risk factor for brain development and mental health in the offspring. Neuroscience. 2020, 447:122–135.Google Scholar
Basu, S, Haghiac, M, Surace, P, et al. Pregravid obesity associates with increased maternal endotoxemia and metabolic inflammation. Obesity. 2011, 19:476–482.Google Scholar
Breastfeeding and the use of human milk. Pediatrics. 2012;129:e827–841.Google Scholar
Marshall, NE, Lau, B, Purnell, JQ, et al. Impact of maternal obesity and breastfeeding intention on lactation intensity and duration. Maternal & Child Nutrition. 2019, 15:e12732.Google Scholar
Kugyelka, JG, Rasmussen, KM, and Frongillo, EA. Maternal obesity is negatively associated with breastfeeding success among Hispanic but not Black women. The Journal of Nutrition. 2004, 134:1746–1753.Google Scholar
Chapman, DJ, and Pérez-Escamilla, R. Maternal perception of the onset of lactation is a valid, public health indicator of lactogenesis stage II. The Journal of Nutrition. 2000, 130:2972–2980.CrossRefGoogle ScholarPubMed
Amir, LH, and Donath, S. A systematic review of maternal obesity and breastfeeding intention, initiation and duration. BMC Pregnancy and Childbirth. 2007, 7:9.CrossRefGoogle ScholarPubMed
Piercy, KL, and Troiano, RP. Physical activity guidelines for Americans from the US Department of Health and Human Services. Circulation Cardiovascular Quality and Outcomes. 2018, 11:e005263.Google Scholar
Agriculture USDo SU. Dietary Guidelines for Americans, 2020–2025. In: USDoHaH, ed. Vol. 9th Edition. 2020.Google Scholar
ACOG Committee opinion no. 548: Weight gain during pregnancy. Obstetrics and Gynecology. 2013, 121:210–212.Google Scholar
Voerman, E, Santos, S, Inskip, H, et al. Association of gestational weight gain with adverse maternal and infant outcomes. JAMA. 2019, 321:1702–1715.Google Scholar
Poston, L, Bell, R, Croker, H, et al. Effect of a behavioural intervention in obese pregnant women (the UPBEAT study): A multicentre, randomised controlled trial. The Lancet Diabetes & Endocrinology. 2015, 3:767–77.Google Scholar
Luppino, FS, de Wit, LM, Bouvy, PF, et al. Overweight, obesity, and depression: A systematic review and meta-analysis of longitudinal studies. Archives of General Psychiatry. 2010, 67:220–229.Google Scholar

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