The relationship between body mass index in late pregnancy and fetomaternal blood flow parameters: A prospective cross-sectional study
The relationship between body mass index in late pregnancy and fetomaternal blood flow parameters: A prospective cross-sectional study
Aim: To evaluate a possible relationship between body mass index and fetomaternal blood flow parameters in women with termpregnancy.Material and Methods: This study was performed on pregnant women undergoing routine third trimester ultrasound scans. Womenwere divided into four groups [underweight (< 18.5 kg/m2), normal weight (18.5–24.9 kg/m2), overweight (25-29.9 kg/m2) andobese (≥30 kg/m2)]. The uterine artery (UtA), umbilical artery (UA) and middle cerebral artery (MCA) were examined using colorDoppler according to the standard protocols. The systole/diastole (S/D) ratio, pulsatility index (PI), and resistance index (RI) valuesof UtA, UA and MCA were recorded.Results: All Doppler findings were found to be similar among normal weight, overweight and obese women. There was apositive correlation between UtA-RI and maternal BMI (r=0.350; p
___
- 1. Ertan AK, Taniverdi HA. Doppler Sonography in Obstetrics. Donald School J Ultrasound Obstet Gynecol 2013;7:128-48.
- 2. Bhide A, Acharya G, Bilardo CM, , et al. ISUOG practice guidelines: use of Doppler ultrasonography in obstetrics. Ultrasound Obstet Gynecol 2013;41:233-9.
- 3. Committee Opinion. Weight gain during pregnancy. ACOG Obstet Gynecol 2013;121:210-2.
- 4. Kushner RF, Kahan S. Introduction: The State of Obesity in 2017. Med Clin North Am 2018;102:1-11.
- 5. Khadaee Gh, Saeidi M. Increases of Obesity and Overweight in Children: an Alarm for Parents and Policymakers. Int J Pediatr 2016;4:1591-601.
- 6. Cedergren MI. Maternal obesity and the risk of adverse pregnancy outcome. Obstet Gynecol 2004;103:219- 24.
- 7. Mrema D, Lie RT, Østbye T, et al. The association between pre pregnancy body mass index and risk of preeclampsia: a registry based study from Tanzania. BMC Pregnancy Childbirth 2018;18:56.
- 8. World Health Organization: Physical Status: The use and interpretation of anthropometry. Geneva. Switzerland: World Health Organization 1995. WHO Technical Report Series.
- 9. Hadlock FP, Harrist RB, Sharman RS, et al. Estimation of fetal weight with the use of head, body and femur measurements, a prospective study. Am J Obstet Gynecol 1985;151:333-7.
- 10. Gomez O, Figueras F, Fernadez S, , et al. Reference ranges for uterine artery mean pulsatility index at 11- 41 weeks of gestation. Ultrasound Obstet Gynaecol 2008;32:128-32.
- 11. Acharya G, Wilsgaard T, Berntsen GK, et al. Reference ranges for serial measurements of umbilical artery Doppler indices in the second half of pregnancy. Am J Obstet Gynecol 2005;192:937-44.
- 12. Bahlmann F, Reinhard I, Krummenauer F, et al. Blood flow velocity waveforms in the fetal middle cerebral artery in a normal population: reference values from 18 weeks to 42 weeks of gestation. J Perinat Med 2002;30:490-501.
- 13. Lenth, R.V. (2006). Java Applets for Power and Sample Size [Computer software] http://www.stat.uiowa. edu/~rlenth/Power. access date 22.04.2019.
- 14. Leddy MA, Power ML, Schulkin J. The impact of maternal obesity on maternal and fetal health. Rev Obstet Gynecol 2008;1:170-8.
- 15. Baeten JM, Bukusi EA, Lambe M. Pregnancy complications and outcomes among overweight and obese nulliparous women. Am J Public Health 2001;91:436-40.
- 16. Peixoto AB, Rodrigues da Cunha Caldas TM, Godoy Silva TA, et al. Assessment of ultrasound and Doppler parameters in the third trimester of pregnancy as predictors of adverse perinatal outcome in unselected pregnancies. Ginekol Pol 2016;87:510-5.
- 17. Arrue M, García M, Rodriguez-Bengoa MT, et al. Do low-risk nulliparous women with abnormal uterine artery Doppler in the third trimester have poorer perinatal outcomes? A longitudinal prospective study on uterine artery Doppler in low-risk nulliparous women and correlation with pregnancy outcomes. J Matern Fetal Neonatal Med 2017;30:877-80.
- 18. Chalouhi SE, Salafia C, Mikhail M, et al. Maternal body mass index does not affect neonatal umbilical artery blood gas parameters. J Pregnancy 2013;2013:654817.
- 19. Sarno L, Maruotti GM, Saccone G, et al. Maternal body mass index influences umbilical artery Doppler velocimetry in physiologic pregnancies. Prenat Diagn 2015;35:125-8.
- 20. Rosario FJ, Kanai Y, Powell TL, et al. Increased placental nutrient transport in a novel mouse model of maternal obesity with fetal overgrowth. Obesity (Silver Spring) 2015;23:1663-70.
- 21. Howell KR, Powell TL. Effects of maternal obesity on placental function and fetal development. Reproduction 2017;153:97-108.
- 22. Huang L, Liu J, Feng L, et al. Maternal prepregnancy obesity is associated with higher risk of placental pathological lesions. Placenta 2014;35:563-9.
- 23. Sewell MF, Huston-Presley L, Amini SB, et al. Body mass index: a true indicator of body fat in obese gravidas. J Reprod Med 2007;52:907-11.
- 24. Hauner H. Secretory factors from human adipose tissue and their functional role. The Proceedings of the Nutrition Society 2005;64:163-9.
- 25. Lappas M. Markers of endothelial cell dysfunction are increased in human omental adipose tissue from women with pre-existing maternal obesity and gestational diabetes. Metabolism 2014;63:860-73.
- 26. Aye IL, Lager S, Ramirez VI, et al. Increasing maternal body mass index is associated with systemic inflammation in the mother and the activation of distinct placental inflammatory pathways. Biol Reprod 2014;90:129.
- 27. Monaghan C, Binder J, Thilaganathan B, et al. Perinatal Loss at Term: The Role of Uteroplacental and Fetal Doppler Assessment. Ultrasound Obstet Gynecol 2018;52:72-7.
- 28. Sebire NJ, Jolly M, Harris JP, et al. Maternal obesity and pregnancy outcome: a study of 287,213 pregnancies in London. Int J Obes Relat Metab Disord 2001;25:1175-82.