Maternal Obesity Duration Of Labor And The Role Of Leptin
Download Maternal Obesity Duration Of Labor And The Role Of Leptin full books in PDF, epub, and Kindle. Read online free Maternal Obesity Duration Of Labor And The Role Of Leptin ebook anywhere anytime directly on your device. Fast Download speed and no annoying ads. We cannot guarantee that every ebooks is available!
| Author | : Sara Carlhäll |
| Publisher | : Linköping University Electronic Press |
| Total Pages | : 72 |
| Release | : 2018-05-03 |
| Genre | : Body mass index |
| ISBN | : 9176852806 |
Background: The prevalence of obesity substantially increases in pregnant women. Maternal obesity is associated with adverse maternal and neonatal outcomes. The increased risk for cesarean section present in obese women has been related to potential impaired uterine contractility. The mechanism that underlies this theory is not clear. In vitro studies have shown that leptin, produced by adipose tissue and the placenta, exerts an inhibitory effect on myometrial contractility. The aim of this thesis was to evaluate the labor process in relation to maternal body mass index (BMI) and the clinical role of leptin in this process. Material and Methods: Studies I-IV are cohort studies. The first two studies analyze the association between labor duration and maternal BMI based on data from the Perinatal Revision South register and the Swedish Pregnancy Register. Study I included 63,829 nulliparous women with a spontaneous onset of labor between 1995 and 2009. Study II included 15,259 nulliparous women with induced labor between 2014 and 2017. In study III, the maternal leptin levels during and after pregnancy were analyzed in 343 obese women with respect to their obesity class (I-III) and degree of gestational weight gain (GWG). In study IV, the association between the maternal leptin levels measured in active labor and duration of the active phase of labor was analyzed in 914 women. Results: The duration of spontaneous labor significantly increased with an increasing maternal BMI; however, the duration of the pushing phase was inversely related to BMI. Time in induced labor increased with maternal BMI; however, the differences between the BMI categories were more pronounced in the latent phase than the active phase. Leptin levels were higher in women with obesity class III than women with class I during and after pregnancy. The degree of GWG in obese women was not associated with maternal leptin. No significant association between maternal leptin and the duration of the active phase of labor was identified in the adjusted analyses. Conclusions: Nulliparous obese women have a higher risk for a prolonged duration of spontaneous and induced labor. This is important to consider prior to diagnosing labor arrest that results in a cesarean delivery. As maternal leptin levels are increased with the degree of obesity during pregnancy, future research on the association of high maternal leptin levels and the duration of labor is warranted.
| Author | : Sara Carlhäll |
| Publisher | : |
| Total Pages | : |
| Release | : 2018 |
| Genre | : |
| ISBN | : |
Background: The prevalence of obesity substantially increases in pregnant women. Maternal obesity is associated with adverse maternal and neonatal outcomes. The increased risk for cesarean section present in obese women has been related to potential impaired uterine contractility. The mechanism that underlies this theory is not clear. In vitro studies have shown that leptin, produced by adipose tissue and the placenta, exerts an inhibitory effect on myometrial contractility. The aim of this thesis was to evaluate the labor process in relation to maternal body mass index (BMI) and the clinical role of leptin in this process. Material and Methods : Studies I-IV are cohort studies. The first two studies analyze the association between labor duration and maternal BMI based on data from the Perinatal Revision South register and the Swedish Pregnancy Register. Study I included 63,829 nulliparous women with a spontaneous onset of labor between 1995 and 2009. Study II included 15,259 nulliparous women with induced labor between 2014 and 2017. In study III, the maternal leptin levels during and after pregnancy were analyzed in 343 obese women with respect to their obesity class (I-III) and degree of gestational weight gain (GWG). In study IV, the association between the maternal leptin levels measured in active labor and duration of the active phase of labor was analyzed in 914 women. Results: The duration of spontaneous labor significantly increased with an increasing maternal BMI; however, the duration of the pushing phase was inversely related to BMI. Time in induced labor increased with maternal BMI; however, the differences between the BMI categories were more pronounced in the latent phase than the active phase. Leptin levels were higher in women with obesity class III than women with class I during and after pregnancy. The degree of GWG in obese women was not associated with maternal leptin. No significant association between maternal leptin and the duration of the active phase of labor was identified in the adjusted analyses. Conclusions: Nulliparous obese women have a higher risk for a prolonged duration of spontaneous and induced labor. This is important to consider prior to diagnosing labor arrest that results in a cesarean delivery. As maternal leptin levels are increased with the degree of obesity during pregnancy, future research on the association of high maternal leptin levels and the duration of labor is warranted.
| Author | : Michael C. Henson |
| Publisher | : Springer Science & Business Media |
| Total Pages | : 352 |
| Release | : 2012-12-06 |
| Genre | : Science |
| ISBN | : 1461501571 |
The isolation of leptin in 1994 and its characterization as a factor influencing appetite, energy balance, and adiposity, immediately thrust the polypeptide into the rapidly growing body of literature centered on the physiology of obesity. The growing clinical awareness of obesity as a major health risk in developed societies dovetailed perfectly with any of a number of roles that leptin might play in this abenant physiological condition. Almost unnoticed amidst the excitement generated by early leptin publications was the suggestion that the "fat hormone" might also regulate a wide range of systems and events important to reproduction, including pubertal development, gonadal endocrinology, fettility, and pregnancy. Recognizing this potential, a relatively small cadre of researchers began to examine leptin specifically as a reproductive hormone, thus creating a new and fertile field of investigation. Interest in this area has since gained momentum and an increased number of participants have now made significant contributions to our understanding of many leptin-related mechanisms that are relevant to reproductive biology. Leptin and Reproduction is the first major volume to specifically address leptin as a reproductive hormone and closely examines the advances made in the short time since this field of interest developed. Preeminent researchers ti'om many of the subdisciplines working within this area present a welcomed compendium of the wealth of related literature and voice novel interpretations of cun'ent advances.
| Author | : Anna Ramö Isgren |
| Publisher | : Linköping University Electronic Press |
| Total Pages | : 97 |
| Release | : 2021-02-04 |
| Genre | : |
| ISBN | : 9179297471 |
Objectives: The overall aim of this thesis was to evaluate the impact of maternal body mass index (BMI) on obstetric and neonatal outcomes in adolescents as well as on treatment with oxytocin infusion during labor regarding cumulative oxytocin dose and plasma levels of oxytocin. Material and Methods: Studies I and II were nationwide Swedish register studies including 31,386 primiparous adolescents subdivided in BMI groups and obesity classes according to early pregnancy BMI. Additionally, 178,844 low-risk normal weight adult women, called “the standard women” were included for comparison with the adolescents in the different BMI groups. Study III was an observational study conducted at seven maternity wards in the southeast region of Sweden, including 1,097 nulliparous women with spontaneous start of labor receiving oxytocin infusion during labor. The study group was subdivided according to BMI on admission to the labor ward. Cumulative oxytocin dose was registered from the start of the oxytocin infusion until the neonate was born. Study IV was an observational pilot study conducted at the maternity ward in Linköping, including 40 women in term labor receiving oxytocin infusion during the first stage of labor. The women were subdivided into obese and non-obese categories according to BMI on admission to the labor ward. Serial peripheral venous blood samples were taken during oxytocin infusion in the first stage of labor. The plasma oxytocin concentrations were analyzed with ultra performance liquid chromatography - Orbitrap tandem mass spectrometry at the Department of Chemistry Biomedical Centre, Uppsala University. Results: Compared with their normal weight counterparts and compared with the standard women, overweight and obese adolescents had increased risks for adverse pregnancy and neonatal outcomes such as preeclampsia, stillbirth, post-term pregnancy, neonates large for gestational age and neonates with low Apgar score. In labor, compared with the normal weight adolescents, the overweight and obese adolescents had a decreased chance for a normal vaginal delivery (VD), increased risk for Cesarean section (CS) and postpartum hemorrhage (PPH). However, compared with the standard women, the overweight adolescents had increased chance for a normal VD, and decreased risk for instrumental VD, CS, obstetric anal sphincter injury (OASI) and PPH in VD. The obese adolescents had an increased risk for CS but a decreased risk for instrumental VD and OASI and they had the same chance for a normal VD and no increased risk for PPH in VD. The mean cumulative oxytocin dose increased in the BMI groups (normal weight 2278 [2748] mU, overweight 3108 [3839] mU and obese 4082 [4895] mU (p<0.0001)) and the mean maximum oxytocin infusion rate during the first stage of labor was higher in the obese group compared with the overweight group of women (15.5 [9.5] mU/min vs. 13.6 [9.1] mU/min (p<0.05)). When adjusting for birth weight, epidural analgesia, and cervical dilation at the start of oxytocin infusion, the statistically significant differences were no longer seen. The obese women had increased median levels of oxytocin in plasma at an oxytocin infusion rate of 3.3 mU/min compared with the non-obese women (19.55 ng/mL [IQR 10.61; 29.06 ng/mL] vs. 6.97 ng/mL [IQR 5.55; 13.70 ng/mL], p=0.016). Conclusions: There are several adverse obstetric and neonatal outcomes associated with overweight and obesity in adolescents. It is important for clinicians to be aware of these outcomes in maternal health care. Nevertheless, overweight adolescents seemed to have better labor outcomes compared with low-risk adults, which is useful knowledge when risk-assessments are made in the labor ward. In spontaneous onset of labor, the cumulative oxytocin dose and maximum oxytocin infusion rate were higher in women with obesity compared with lower BMI groups. One explanatory factor seems to be that women with obesity received the oxytocin infusion at an earlier cervical dilatation stage. Furthermore, obese women seemed to have higher levels of oxytocin in plasma at the beginning of the oxytocin infusion. The oxytocin-oxytocin receptor complex must be further investigated to gain more knowledge on how to optimize the treatment of obese women with oxytocin infusion during labor.
| Author | : Robert H Lustig |
| Publisher | : Springer Science & Business Media |
| Total Pages | : 411 |
| Release | : 2010-09-23 |
| Genre | : Medical |
| ISBN | : 1441970347 |
This volume will explore the epidemiology and the basic mechanisms of each of these prenatal phenomena, in an attempt to explain the role of the prenatal environment in promoting postnatal weight gain. This information will contribute to resolving the nature-nurture controversy. This information provides guidance to clinical practitioners involved in both prenatal and postnatal care. This volume further stimulates research into underlying mechanisms and prevention and treatment of this phenomenon.
| Author | : Matthew W. Gillman |
| Publisher | : Cambridge University Press |
| Total Pages | : 265 |
| Release | : 2012-07-19 |
| Genre | : Medical |
| ISBN | : 1107003962 |
Afflicting more than 300 million women across the globe, obesity has profound effects on health during pregnancy and on the wellbeing of the unborn child. In the face of such a challenging pandemic, this book reviews the latest research and provides up-to-date advice on clinical management. Maternal Obesity addresses the adverse effects of obesity among women of childbearing age, including infertility, medical complications, problems in labor, and adverse birth outcomes, and it reviews evidence that the obese mother's in utero environment has long-lasting influences on the health of the developing child. Chapters cover basic, clinical, and population perspectives, providing a range of valuable information from mechanistic insight through to public health and policy implications. Invaluable for obstetricians, gynaecologists, paediatricians, general and family physicians, subspecialists in obstetric and paediatric medicine, midwives, and dietitians, as well as researchers and public health policy makers seeking to tackle the burden of maternal obesity-related illness.
| Author | : Tursunjan Nurmamat |
| Publisher | : |
| Total Pages | : 196 |
| Release | : 2013 |
| Genre | : Adipose tissues |
| ISBN | : 9781303471124 |
Obesity is a major health concern, and the world is facing a global epidemic of obesity with increasing rates. It is considered a disease state in itself, but more importantly, it is also a major risk factor for other serious diseases including type II diabetes, hypertension, non-alcoholic fatty liver disease, and coronary heart disease. Currently, obesity affects more than one third of the women of reproductive age in the United States. Not only does obesity during pregnancy lead to increased maternal health concerns, it is linked to increases in adiposity and components of the metabolic syndrome in their offspring. Both human epidemiological studies and animal models of maternal obesity have provided strong evidence for the association of maternal overnutrition/obesity during pregnancy with abnormal fetal organ development, increased offspring adiposity and insulin resistance. However, the mechanisms mediating the alterations in offspring metabolic dysfunction born to obese mothers are yet to be elucidated. Leptin, a hormone mainly produced by adipocytes, is well-known for its effect on appetite control in the hypothalamus; however, recent studies suggest that it may also play important roles in the pituitary regulating body composition. This dissertation mainly focuses on the possible role of pituitary leptin signaling in mediating the phenotype of increased adult offspring adiposity and insulin resistance programmed by in utero exposure to maternal overnutrition/obesity. Further, we investigated the effect of an early pregnancy dietary intervention on both mothers and fetuses in a sheep model of maternal obesity in search of a potential intervention strategy for obese human pregnancies. In the first experiment, we evaluated the impact of maternal obesity on offspring weight gain, adiposity and insulin resistance during an ad libitum feeding trial in adulthood. We found that both male and female offspring of overnourished/obese mothers (MO) had increased appetite, weight gain, percentage body fat and insulin resistance compared with offspring born to control fed mothers (CON). Then, we evaluated the hormonal profiles of male offspring at necropsy at the end of the feeding trial, and further determined the role of leptin signaling utilizing relevant tissue samples from the male offspring. We confirmed that pituitary leptin signaling was reduced and was associated with down-regulation of the growth hormone (GH)/insulin-like growth factor 1 (IGF1) axis in MO offspring compared with CON offspring. In the second experiment, we have evaluated the effect of reducing maternal global food intake in obese pregnant ewes to a maintenance level at day 28 of gestation which is equivalent to ~day 50 in human pregnancy. The results of this study are consistent with the concept that reducing maternal diet of obese overfed ewes to requirements from early gestation can prevent subsequent alterations in fetal growth, adiposity and glucose-insulin dynamics. Given the relative importance of maternal metabolic parameters on offspring development in humans, and the similarities between our ovine model data and those from obese pregnancies in humans, we suggest that our model could potentially lead to a better understanding of the specific control mechanisms involved.
| Author | : Christos S. Mantzoros |
| Publisher | : Springer Science & Business Media |
| Total Pages | : 553 |
| Release | : 2007-11-16 |
| Genre | : Medical |
| ISBN | : 1592599850 |
International experts from world-renowned medical schools comprehensively review for practicing clinicians and scientists alike the latest understanding of the epidemiology, causation, and consequences of diabetes and obesity. The authors discuss in detail their diagnosis, clinical manifestations, complications, and best practices for diagnosis and treatment. They also review the history and epidemiology of these conditions, explain their genetics and pathophysiology, and illuminate their known mechanisms and interactions. State-of-the-art survey-chapters critique current approaches (lifestyle and pharmacological) to the treatment of these conditions.
| Author | : Andrea Dunaif |
| Publisher | : Springer Science & Business Media |
| Total Pages | : 361 |
| Release | : 2008-01-12 |
| Genre | : Medical |
| ISBN | : 1597451088 |
This volume includes the latest diagnostic criteria for PCOS and comprises the most up-to-date information about the genetic features and pathogenesis of PCOS. It critically reviews the methodological approaches and the evidence for various PCOS susceptibility genes. The book also discusses additional familial phenotypes of PCOS and their potential genetic basis. All four editors of this title are extremely prominent in the field of PCOS.
| Author | : National Research Council |
| Publisher | : National Academies Press |
| Total Pages | : 868 |
| Release | : 2010-01-14 |
| Genre | : Medical |
| ISBN | : 0309131138 |
As women of childbearing age have become heavier, the trade-off between maternal and child health created by variation in gestational weight gain has become more difficult to reconcile. Weight Gain During Pregnancy responds to the need for a reexamination of the 1990 Institute of Medicine guidelines for weight gain during pregnancy. It builds on the conceptual framework that underscored the 1990 weight gain guidelines and addresses the need to update them through a comprehensive review of the literature and independent analyses of existing databases. The book explores relationships between weight gain during pregnancy and a variety of factors (e.g., the mother's weight and height before pregnancy) and places this in the context of the health of the infant and the mother, presenting specific, updated target ranges for weight gain during pregnancy and guidelines for proper measurement. New features of this book include a specific range of recommended gain for obese women. Weight Gain During Pregnancy is intended to assist practitioners who care for women of childbearing age, policy makers, educators, researchers, and the pregnant women themselves to understand the role of gestational weight gain and to provide them with the tools needed to promote optimal pregnancy outcomes.
