Multiparity amongst women with a body mass index (BMI) ≥ 30 Kg/m2 is a common occurrence despite there being a known clear association with a decline in fecundity in women who are overweight or obese. These women, al...Multiparity amongst women with a body mass index (BMI) ≥ 30 Kg/m2 is a common occurrence despite there being a known clear association with a decline in fecundity in women who are overweight or obese. These women, also pose further concerns, as they are at increased risk of antenatal complications such as preeclampsia and gestational diabetes. Over the years, a number of different modalities of fertility treatments have been tried and tested in this cohort of women to find the optimal treatment to improve their reproductive capacity. There has been an exponential increase in knowledge and understanding towards managing patients with a raised BMI, particularly through assisted reproductive treatments. Although the efficacies of various forms of fertility treatments have been shown to be affected by a rise in BMI, there is yet to be a definitive understanding as to the optimal management of these patients. The literature supports weight loss alone as an effective intervention in improving the reproductive capacity of women with a raised BMI with unexplained infertility. Furthermore, if live birth rate is taken as the desired outcome measure, then ovarian drilling and in vitro fertilisation (IVF) treatment have been shown to yield the best results in overweight and obese patients when comparisons are drawn to other interventions such as natural conception and treatment with clomiphene citrate.展开更多
Objectives: Evaluation of change of cervicovaginal fluid (CVF) cytokines’ levels during pregnancy and its relation to incidence of preterm birth (PTB). Patients & Methods: Pregnant women with history of PTB and c...Objectives: Evaluation of change of cervicovaginal fluid (CVF) cytokines’ levels during pregnancy and its relation to incidence of preterm birth (PTB). Patients & Methods: Pregnant women with history of PTB and cervical length α (TNF-α) and interleukins (IL)-6 and -10 levels. Study outcomes included differences in cytokines’ levels between samples and groups. Results: Sample-I cytokines’ levels were significantly higher in study than control women. Cytokines’ levels in Sample-II were significantly higher in control, while were significantly lower in study women compared to Sample-I. Sixteen study women had PTB and had significantly higher CVF levels of IL-10 and TNF-α estimated in both samples than women had no PTB. Pregnancy duration was negatively correlated with maternal body mass index (BMI) and cytokines’ levels, while was positively correlated with inter-pregnancy interval (IPI). Cytokines’ levels were positively correlated with BMI and negatively correlated with IPI. Short IPI and high TNF-α levels are negative predictors for pregnancy duration. Conclusion: High BMI, short IPI and high CVF inflammatory cytokines’ levels negatively affect pregnancy duration especially in women with history of recurrent PTB. Early prophylactic CC for women at high-risk of SPTB can modulate local immune disturbance, reduce incidence of SPTB and prolong pregnancy duration.展开更多
目的探讨出生体重、出生方式、胎龄和母亲妊娠期代谢性疾病病史等生命早期因素与女生青春发动时相的关系。方法2019年3—12月采用分层整群抽样方法选取广州市3所小学2、3年级和3所中学7、8年级的女生进行乳房发育检查,并通过问卷调查收...目的探讨出生体重、出生方式、胎龄和母亲妊娠期代谢性疾病病史等生命早期因素与女生青春发动时相的关系。方法2019年3—12月采用分层整群抽样方法选取广州市3所小学2、3年级和3所中学7、8年级的女生进行乳房发育检查,并通过问卷调查收集学生的生命早期因素。采用多因素logistic回归法分析母亲妊娠期代谢性疾病史、出生体重、出生方式和胎龄与女生青春发动时相的关联。采用Bootstrap法对体重指数(body mass index,BMI)(Z值)在高出生体重(≥4000 g)与青春发动时相关系中的中介效应进行检验。结果共纳入1665例女生,其中280例(16.82%)判断为青春发动时相提前。多因素logistic回归分析显示,高出生体重与女生青春发动时相提前风险增高存在显著关联(OR=2.12,95%CI:1.19~3.66,P=0.008)。其余生命早期因素与青春发动时相的关联无统计学意义(P>0.05)。BMI(Z值)在出生体重与青春发动时相关系中的中介效应OR为1.25(95%CI:1.09~1.47),在高出生体重对青春发动时相提前总效应中占比29.33%。结论高出生体重与女生青春发动时相提前风险增高之间存在关联,超重/肥胖在其中发挥部分中介作用。展开更多
[目的]了解不同出生体重儿婴幼儿期身长、体重和体质指数(body mass index,BMI)的动态变化及营养不良、超重和肥胖的发生率.[方法]对2 547名婴幼儿0～30个月的体检资料进行统计分析,计算BMI值并采用身高别体重中位数百分比法来判定营养...[目的]了解不同出生体重儿婴幼儿期身长、体重和体质指数(body mass index,BMI)的动态变化及营养不良、超重和肥胖的发生率.[方法]对2 547名婴幼儿0～30个月的体检资料进行统计分析,计算BMI值并采用身高别体重中位数百分比法来判定营养不良、超重和肥胖.[结果]在0～30月中,巨大儿在各年龄的体重、身长和BMI均为3组之最,其次为正常出生体重儿,低出生体重儿处于最低水平.不同出生体重儿的超重和肥胖发生率在出生后头3个月呈上升趋势,于3个月时达到高峰.巨大儿组在出生后各年龄段的营养不良发生率在三组中处于最低水平,低出生体重儿组营养不良发生率在出生后第3年有明显上升趋势.[结论]宫内生长与儿童早期生长有密切的关系,在重视预防婴幼儿超重和肥胖的同时也要加强营养不良的预防.展开更多
目的根据美国医学研究院(Institute of Medicine,IOM)2009年指南标准,调查中国人群低危孕产妇孕前体质指数(body mass index,BMI)和孕期体重增加(gestational weight gain,GWG)及其与新生儿出生体重的关系。方法本研究采用多中心、大样...目的根据美国医学研究院(Institute of Medicine,IOM)2009年指南标准,调查中国人群低危孕产妇孕前体质指数(body mass index,BMI)和孕期体重增加(gestational weight gain,GWG)及其与新生儿出生体重的关系。方法本研究采用多中心、大样本的横断面调查的方法,在14个省市39家医院连续时间段分娩的孕产妇的112 485例资料中,选择无并发症、单胎、关键数据完整的28周后分娩的低危妊娠女性54 827例。分析产妇身高、孕前BMI、GWG等指标对出生体重的影响,并建立回归模型。结果孕前平均BMI为21.3 kg/m2,孕前BMI在正常范围的女性比例为77.2%,低体重女性比例为12.9%,超重为9.0%,肥胖为0.8%。平均GWG为(14±5)kg,根据IOM的标准,GWG总达标率仅45%,未达标者26%,超标者29%。出生体重与孕产妇身高、孕前BMI和GWG均有明显的正相关。结论中国城市孕产妇的身高、孕前BMI不同于其他国家,GWG控制不理想。建立符合中国人群特点的孕期营养咨询策略对于降低巨大儿和低体重儿具有重要意义。展开更多
文摘Multiparity amongst women with a body mass index (BMI) ≥ 30 Kg/m2 is a common occurrence despite there being a known clear association with a decline in fecundity in women who are overweight or obese. These women, also pose further concerns, as they are at increased risk of antenatal complications such as preeclampsia and gestational diabetes. Over the years, a number of different modalities of fertility treatments have been tried and tested in this cohort of women to find the optimal treatment to improve their reproductive capacity. There has been an exponential increase in knowledge and understanding towards managing patients with a raised BMI, particularly through assisted reproductive treatments. Although the efficacies of various forms of fertility treatments have been shown to be affected by a rise in BMI, there is yet to be a definitive understanding as to the optimal management of these patients. The literature supports weight loss alone as an effective intervention in improving the reproductive capacity of women with a raised BMI with unexplained infertility. Furthermore, if live birth rate is taken as the desired outcome measure, then ovarian drilling and in vitro fertilisation (IVF) treatment have been shown to yield the best results in overweight and obese patients when comparisons are drawn to other interventions such as natural conception and treatment with clomiphene citrate.
文摘Objectives: Evaluation of change of cervicovaginal fluid (CVF) cytokines’ levels during pregnancy and its relation to incidence of preterm birth (PTB). Patients & Methods: Pregnant women with history of PTB and cervical length α (TNF-α) and interleukins (IL)-6 and -10 levels. Study outcomes included differences in cytokines’ levels between samples and groups. Results: Sample-I cytokines’ levels were significantly higher in study than control women. Cytokines’ levels in Sample-II were significantly higher in control, while were significantly lower in study women compared to Sample-I. Sixteen study women had PTB and had significantly higher CVF levels of IL-10 and TNF-α estimated in both samples than women had no PTB. Pregnancy duration was negatively correlated with maternal body mass index (BMI) and cytokines’ levels, while was positively correlated with inter-pregnancy interval (IPI). Cytokines’ levels were positively correlated with BMI and negatively correlated with IPI. Short IPI and high TNF-α levels are negative predictors for pregnancy duration. Conclusion: High BMI, short IPI and high CVF inflammatory cytokines’ levels negatively affect pregnancy duration especially in women with history of recurrent PTB. Early prophylactic CC for women at high-risk of SPTB can modulate local immune disturbance, reduce incidence of SPTB and prolong pregnancy duration.
文摘目的探讨出生体重、出生方式、胎龄和母亲妊娠期代谢性疾病病史等生命早期因素与女生青春发动时相的关系。方法2019年3—12月采用分层整群抽样方法选取广州市3所小学2、3年级和3所中学7、8年级的女生进行乳房发育检查,并通过问卷调查收集学生的生命早期因素。采用多因素logistic回归法分析母亲妊娠期代谢性疾病史、出生体重、出生方式和胎龄与女生青春发动时相的关联。采用Bootstrap法对体重指数(body mass index,BMI)(Z值)在高出生体重(≥4000 g)与青春发动时相关系中的中介效应进行检验。结果共纳入1665例女生,其中280例(16.82%)判断为青春发动时相提前。多因素logistic回归分析显示,高出生体重与女生青春发动时相提前风险增高存在显著关联(OR=2.12,95%CI:1.19~3.66,P=0.008)。其余生命早期因素与青春发动时相的关联无统计学意义(P>0.05)。BMI(Z值)在出生体重与青春发动时相关系中的中介效应OR为1.25(95%CI:1.09~1.47),在高出生体重对青春发动时相提前总效应中占比29.33%。结论高出生体重与女生青春发动时相提前风险增高之间存在关联,超重/肥胖在其中发挥部分中介作用。
文摘[目的]了解不同出生体重儿婴幼儿期身长、体重和体质指数(body mass index,BMI)的动态变化及营养不良、超重和肥胖的发生率.[方法]对2 547名婴幼儿0～30个月的体检资料进行统计分析,计算BMI值并采用身高别体重中位数百分比法来判定营养不良、超重和肥胖.[结果]在0～30月中,巨大儿在各年龄的体重、身长和BMI均为3组之最,其次为正常出生体重儿,低出生体重儿处于最低水平.不同出生体重儿的超重和肥胖发生率在出生后头3个月呈上升趋势,于3个月时达到高峰.巨大儿组在出生后各年龄段的营养不良发生率在三组中处于最低水平,低出生体重儿组营养不良发生率在出生后第3年有明显上升趋势.[结论]宫内生长与儿童早期生长有密切的关系,在重视预防婴幼儿超重和肥胖的同时也要加强营养不良的预防.
文摘目的根据美国医学研究院(Institute of Medicine,IOM)2009年指南标准,调查中国人群低危孕产妇孕前体质指数(body mass index,BMI)和孕期体重增加(gestational weight gain,GWG)及其与新生儿出生体重的关系。方法本研究采用多中心、大样本的横断面调查的方法,在14个省市39家医院连续时间段分娩的孕产妇的112 485例资料中,选择无并发症、单胎、关键数据完整的28周后分娩的低危妊娠女性54 827例。分析产妇身高、孕前BMI、GWG等指标对出生体重的影响,并建立回归模型。结果孕前平均BMI为21.3 kg/m2,孕前BMI在正常范围的女性比例为77.2%,低体重女性比例为12.9%,超重为9.0%,肥胖为0.8%。平均GWG为(14±5)kg,根据IOM的标准,GWG总达标率仅45%,未达标者26%,超标者29%。出生体重与孕产妇身高、孕前BMI和GWG均有明显的正相关。结论中国城市孕产妇的身高、孕前BMI不同于其他国家,GWG控制不理想。建立符合中国人群特点的孕期营养咨询策略对于降低巨大儿和低体重儿具有重要意义。
