Maternal obesity, duration of labor and the role of leptin

Maternal obesity, duration of labor and the role of leptin
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.

Leptin and Reproduction

Leptin and Reproduction
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.

Polycystic Ovary Syndrome

Polycystic Ovary Syndrome
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.

Weight Gain During Pregnancy

Weight Gain During Pregnancy
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.

Handbook of Life Course Health Development

Handbook of Life Course Health Development
Author: Neal Halfon
Publisher: Springer
Total Pages: 667
Release: 2017-11-20
Genre: Medical
ISBN: 3319471430

This book is open access under a CC BY 4.0 license. ​This handbook synthesizes and analyzes the growing knowledge base on life course health development (LCHD) from the prenatal period through emerging adulthood, with implications for clinical practice and public health. It presents LCHD as an innovative field with a sound theoretical framework for understanding wellness and disease from a lifespan perspective, replacing previous medical, biopsychosocial, and early genomic models of health. Interdisciplinary chapters discuss major health concerns (diabetes, obesity), important less-studied conditions (hearing, kidney health), and large-scale issues (nutrition, adversity) from a lifespan viewpoint. In addition, chapters address methodological approaches and challenges by analyzing existing measures, studies, and surveys. The book concludes with the editors’ research agenda that proposes priorities for future LCHD research and its application to health care practice and health policy. Topics featured in the Handbook include: The prenatal period and its effect on child obesity and metabolic outcomes. Pregnancy complications and their effect on women’s cardiovascular health. A multi-level approach for obesity prevention in children. Application of the LCHD framework to autism spectrum disorder. Socioeconomic disadvantage and its influence on health development across the lifespan. The importance of nutrition to optimal health development across the lifespan. The Handbook of Life Course Health Development is a must-have resource for researchers, clinicians/professionals, and graduate students in developmental psychology/science; maternal and child health; social work; health economics; educational policy and politics; and medical law as well as many interrelated subdisciplines in psychology, medicine, public health, mental health, education, social welfare, economics, sociology, and law.

Obesity and Diabetes

Obesity and Diabetes
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.

The Genetics of Obesity

The Genetics of Obesity
Author: Claude Bouchard
Publisher: CRC Press
Total Pages: 262
Release: 1994-03-28
Genre: Medical
ISBN: 9780849348808

This book provides a comprehensive compilation of the evidence available regarding the role of genetic differences in the etiology of human obesities and their health and metabolic implications. It also identifies the most promising research areas, methods, and strategies for use in future efforts to understand the genetic basis of obesities and their consequences on human health. Leading researchers in their respective fields present contributed chapters on such topics as etiology and the prevalence of obesities, nongenetic determinants of obesity and fat topography, and animal models and molecular biological technology used to delineate the genetic basis of human obesities. A major portion of the book is devoted to human genetic research and clinical observations encompassing adoption studies, twin studies, family studies, single gene effects, temporal trends and etiology heterogeneity, energy intake and food preference, energy expenditure, and susceptibility to metabolic derangements in the obese state. Future directions of research in the field are covered in the book as well.

Nutrition, Microbiota and Noncommunicable Diseases

Nutrition, Microbiota and Noncommunicable Diseases
Author: Julio Plaza-Díaz
Publisher: MDPI
Total Pages: 416
Release: 2021-01-20
Genre: Science
ISBN: 3039369164

Health is defined as “the state of the organism when it functions optimally without evidence of disease”. Surprisingly, the words “microbes” or “microorganism” are missing in this definition. The regulation of gut microbiota is mediated by an enormous quantity of aspects, such as microbiological factors, host characteristics, diet patterns, and environmental variables. Some protective, structural, and metabolic functions have been reported for gut microbiota, and these functions are related to the regulation of homeostasis and host health. Host defense against pathogens is, in part, mediated through gut microbiota action and requires intimate interpretation of the current microenvironment and discrimination between commensal and occasional bacteria. The present Special Issue provides a summary of the progress on the topic of intestinal microbiota and its important role in human health in different populations. This Special Issue will be of great interest from a clinical and public health perspective. Nevertheless, more studies with more samples and comparable methods are necessary to understand the actual function of intestinal microbiota in disease development and health maintenance.

Maternal-Fetal Nutrition During Pregnancy and Lactation

Maternal-Fetal Nutrition During Pregnancy and Lactation
Author: Michael E. Symonds
Publisher: Cambridge University Press
Total Pages: 217
Release: 2010-01-28
Genre: Family & Relationships
ISBN: 0521887097

With the aim to improve clinicians' understanding of the important effects nutrition can have on maternal health and fetal and neonatal development, Maternal-Fetal Nutrition During Pregnancy and Lactation defines the nutritional requirements with regard to the stage of development and growth, placing scientific developments into clinical context.