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      Overweight and obesity knowledge prior to pregnancy: a survey study

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          Abstract

          Background

          Overweight and obesity are associated with increased risk for pregnancy complications. Knowledge about increased risks in overweight and obese women could contribute to successful prevention strategies and the aim of this study is to assess current levels of knowledge in a pregnant population.

          Methods

          Cross sectional survey of 412 consecutive unselected women in early pregnancy in Brisbane, Australia: 255 public women attending their first antenatal clinic visit and 157 women at private maternal fetal medicine clinics undergoing a routine ultrasound evaluation prior to 20 weeks gestation. The cohort was stratified according to pre pregnancy BMI (< 25.0 or ≥ 25.0). The main outcome measure was knowledge regarding the risks of overweight and obesity in pregnancy.

          Results

          Over 75% of respondents identified that obese women have an increased risk of overall complications, including gestational diabetes and hypertensive disorders of pregnancy compared to women of normal weight. More than 60% of women asserted that obesity would increase the risk of caesarean section and less than half identified an increased risk of adverse neonatal outcomes. Women were less likely to know about neonatal complications (19.7% did not know about the effect of obesity on these) than maternal complications (7.4%). Knowledge was similar amongst women recruited at the public hospital and those recruited whilst attending for an ultrasound scan at a private clinic. For most areas they were also similar between women of lower and higher BMI, but women with BMI < 25.0 were less likely to know that obesity was associated with increased rate of Caesarean section than those with higher BMI (16.8% versus 4.5%, P < 0.001). Higher educational status was associated with more knowledge of the risks of overweight and obesity in pregnancy.

          Conclusions

          Many women correctly identify that overweight and obesity increases the overall risk of complications of pregnancy and childbirth. The increased risks of maternal complications associated with being obese are better known than the increased risk of neonatal complications. Maternal education status is a main determinant of the extent of knowledge and this should be considered when designing education campaigns.

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          Most cited references43

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          Clinical guidelines on the identification, evaluation, and treatment of overweight and obesity in adults: executive summary. Expert Panel on the Identification, Evaluation, and Treatment of Overweight in Adults.

          (1998)
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            Obesity, obstetric complications and cesarean delivery rate--a population-based screening study.

            This study was undertaken to determine whether obesity is associated with obstetric complications and cesarean delivery. A large prospective multicenter database was studied. Subjects were divided into 3 groups: body mass index (BMI) less than 30 (control), 30 to 34.9 (obese), and 35 or greater (morbidly obese). Groups were compared by using univariate and multivariable logistic regression analyses. The study included 16,102 patients: 3,752 control, 1,473 obese, and 877 morbidly obese patients. Obesity and morbid obesity had a statistically significant association with gestational hypertension (odds ratios [ORs] 2.5 and 3.2), preeclampsia (ORs 1.6 and 3.3), gestational diabetes (ORs 2.6 and 4.0), and fetal birth weight greater than 4000 g (ORs 1.7 and 1.9) and greater than 4500 g (ORs 2.0 and 2.4). For nulliparous patients, the cesarean delivery rate was 20.7% for the control group, 33.8% for obese, and 47.4% for morbidly obese patients. Obesity is an independent risk factor for adverse obstetric outcome and is significantly associated with an increased cesarean delivery rate.
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              Pregnancy complications and outcomes among overweight and obese nulliparous women.

              This study examined the associations between prepregnancy weight and the risk of pregnancy complications and adverse outcomes among nulliparous women. We conducted a population-based cohort study with 96,801 Washington State birth certificates from 1992 to 1996. Women were categorized by body mass index. Multivariate logistic regression was performed. The rate of occurrence of most of the outcomes increased with increasing body mass index category. Compared with lean women, both overweight and obese women had a significantly increased risk for gestational diabetes, preeclampsia, eclampsia, cesarean delivery, and delivery of a macrosomic infant. Among nulliparous women, not only prepregnancy obesity but also overweight increases the risk of pregnancy complications and adverse pregnancy outcomes.
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                Author and article information

                Journal
                BMC Pregnancy Childbirth
                BMC Pregnancy and Childbirth
                BioMed Central
                1471-2393
                2011
                21 November 2011
                : 11
                : 96
                Affiliations
                [1 ]School of Medicine, Royal Brisbane Clinical School, The University of Queensland, Brisbane, Australia
                [2 ]Department of Internal Medicine Research Unit, Royal Brisbane and Women's Hospital, Brisbane, Australia
                [3 ]Department of Maternity Services and Internal Medicine & Aged Care, Royal Brisbane and Women's Hospital, Brisbane, Australia
                [4 ]Department of Social Medicine, University of Bristol, Bristol, UK
                [5 ]Mater Children's Hospital, Brisbane, Australia
                [6 ]Departments of Endocrinology and Obstetric Medicine, Mater Health Services, Brisbane, Australia
                [7 ]Centre for Diabetes and Endocrine Research, The University of Queensland, Bribane, Australia
                [8 ]Department of Internal Medicine, Royal Brisbane and Women's Hospital, Brisbane, Australia
                Article
                1471-2393-11-96
                10.1186/1471-2393-11-96
                3240826
                22103736
                8d030196-097e-4ffe-948a-0674b6ee7258
                Copyright ©2011 Nitert et al; licensee BioMed Central Ltd.

                This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 9 September 2011
                : 21 November 2011
                Categories
                Research Article

                Obstetrics & Gynecology
                Obstetrics & Gynecology

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