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      Prevalence of Metabolic Syndrome Markers among Women at 1-year Postpartum as per Prepregnancy Body Mass Index Status: A Longitudinal Study

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          Abstract

          Introduction:

          Maternal body composition (BC) changes during lactation. Increased prepregnancy obesity is associated with poor obstetric outcomes. The aim was to study changes in maternal BC postpartum (PP) to 1-year PP with reference to their prepregnancy body mass index (BMI) status.

          Methods:

          The study design was a 1-year follow-up study. Sixty-five apparently healthy primiparous women (28.6 ± 3.4 years delivered full-term infants) were randomly selected from December 2010 to June 2013 and postclassified on the basis of their prepregnancy BMI status. Anthropometry, sociodemographic status, physical activity, diet, clinical examination, biochemical tests, and BC at total body (dual energy X-ray absorptiometry, GE, Lunar DPX) were collected using standardized protocols.

          Results:

          Forty-one women were classified in Group A with normal prepregnancy BMI (20.4 ± 2.0 kg/m 2) and 24 women in Group B with overweight/obese (OW/OB) prepregnancy BMI (26.1 ± 1.9 kg/m 2). At 1 year, 75% of women returned to normal BMI in Group A, whereas all 100% of women from Group B remained in OW category at 1-year PP. Nearly 43% of Group B women showed the presence of at least two metabolic syndrome risk factors as compared to 36% in Group A at 1 year.

          Conclusion:

          Women with OW/OB prepregnancy BMI accumulated higher visceral fat with a higher prevalence of metabolic risk factors at 1-year PP. Our study underlines the importance of maintaining BMI status in reference range in reproductive years.

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          Most cited references24

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          Combined associations of prepregnancy body mass index and gestational weight gain with the outcome of pregnancy.

          Although both maternal prepregnancy body mass index (BMI) and gestational weight gain (GWG) may affect birth weight, their separate and joint associations with complications of pregnancy and delivery and with postpartum weight retention are unclear. We aimed to investigate the combined associations of prepregnancy BMI and GWG with pregnancy outcomes and to evaluate the trade-offs between mother and infant for different weight gains. Data for 60892 term pregnancies in the Danish National Birth Cohort were linked to birth and hospital discharge registers. Self-reported total GWG was categorized as low ( or=20 kg). Adjusted associations of prepregnancy BMI and GWG with outcomes of interest were estimated by logistic regression analyses. High and very high GWG added to the associations of high prepregnancy BMI with cesarean delivery and were strongly associated with high postpartum weight retention. Moreover, greater weight gains and high maternal BMI decreased the risk of growth restriction and increased the risk of the infant's being born large-for-gestational-age or with a low Apgar score. Generally, low GWG was advantageous for the mother, but it increased the risk of having a small baby, particularly for underweight women. Heavier women may benefit from avoiding high and very high GWG, which brings only a slight increase in the risk of growth restriction for the infant. High weight gain in underweight women does not appear to have deleterious consequences for them or their infants, but they may want to avoid low GWG to prevent having a small baby.
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            Childbearing and obesity in women: weight before, during, and after pregnancy.

            Weight gain and the development of obesity during midlife are strong independent predictors of cardiovascular disease, particularly among women, as well as the metabolic syndrome, type 2 diabetes, and early mortality. Primiparity and maternal body size before pregnancy affect long-term postpartum weight retention and the development of obesity among women of reproductive age. As a modifiable risk factor, body weight during the preconception, prenatal, and postpartum periods may present critical windows to implement interventions to prevent weight retention and the development of overweight and obesity in women of childbearing age.
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              Risk of adverse pregnancy outcomes by prepregnancy body mass index: a population-based study to inform prepregnancy weight loss counseling.

              To estimate the absolute risks of adverse maternal and perinatal outcomes based on small differences in prepregnancy body mass (eg, 10% of body mass or 10-20 pounds).
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                Author and article information

                Journal
                Indian J Endocrinol Metab
                Indian J Endocrinol Metab
                IJEM
                Indian Journal of Endocrinology and Metabolism
                Medknow Publications & Media Pvt Ltd (India )
                2230-8210
                2230-9500
                Sep-Oct 2017
                : 21
                : 5
                : 703-709
                Affiliations
                [1]Pediatric Growth and Endocrine Unit, Hirabai Cowasji Jehangir Medical Research Institute, Jehangir Hospital, Pune, Maharashtra, India
                [1 ]Department of Paediatric Endocrinology, Royal Manchester Children's Hospital, Manchester, UK
                Author notes
                Address for correspondence: Dr. Anuradha V. Khadilkar, Growth and Endocrine Unit, Hirabai Cowasji Jehangir Medical Research Institute, Old Building Basement, Jehangir Hospital, 32, Sassoon Road, Pune - 411 001, Maharashtra, India. E-mail: anuradhavkhadilkar@ 123456gmail.com
                Article
                IJEM-21-703
                10.4103/ijem.IJEM_145_17
                5628540
                0053b419-4e0a-4d36-9703-779efbc7deb2
                Copyright: © 2017 Indian Journal of Endocrinology and Metabolism

                This is an open access article distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 3.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as the author is credited and the new creations are licensed under the identical terms.

                History
                Categories
                Original Article

                Endocrinology & Diabetes
                android fat,body composition,dual energy x-ray absorptiometry,insulin resistance

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