The influence of pre-gestational nutritional status on mother-newborn pair outcomes
Influência do estado nutricional pré-gestacional no desfecho do binômio mãe-bebê
Palavras-chave:
Estado Nutricional, Baixo Peso, Obesidade, Recém-NascidoResumo
Introduction: Abnormal pregestational and gestational maternal nutritional status is an undeniable health problem which can result in gestational changes and interfere in fetal and maternal health conditions. Objective: To analyze the influence of pre-pregnancy nutritional status on mother-newborn pair outcomes. Methods: This is an observational, analytical, and cross-sectional study carried out in a public Maternity Hospital in Joinville, SC, Brazil. A total of 1,670 puerperal women were interviewed and classified according to BMI. The outcomes evaluated were: cesarean delivery, Gestational Diabetes Mellitus, Pregnancy-induced Hypertension, small for Gestational age newborns, large for gestational age newborns, premature birth, low weight at birth and admission to the neonatal intensive care unit. Results: Low-weight pregnant women had a higher risk of cesarian delivery. Overweight and obese patients had a greater chance of GDM, with the odds ranging from 1.5 to 7.2 times, and PIH with the odds ranging from 1.7 to 4.6 times. Conclusion: Low-weight pregnant women have a higher chance of cesarian delivery. Meanwhile, overweight and all classes of obesity in pregnancy progressively increase the risk of GDM and PIH.
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ALANIS, M. C., GOODNIGHT, W. H, HILL, E. G., et al. Maternal super-obesity (body mass index ≥ 50) and adverse pregnancy outcomes. Acta Obstetricia et Gynecologica Scandinavica. V.89, n. 7, p. 924-930. Jul. 2010.
AYE I.L., LAGER S., RAMIREZ V.I., 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. V. 90, n. 6. Jun. 2014.
BARBOUR, L.A. Metabolic Culprits in Obese Pregnancies and Gestational Diabetes Mellitus: Big Babies, Big Twists, Big Picture: The 2018 Norbert Freinkel Award Lecture. Diabetes Care. v. 42, n. 5, p. 718-726, 2019.
BARROS, Denise Cavalcante de et al. Avaliação nutricional antropométrica de gestantes brasileiras: uma revisão sistemática, Rev. Brasi. Saúde Matern. Infant., v. 8, ed. 4, p. 363-376, dezembro 2008.
BEN-HAROUSH, A.; YOGEV, Y.; HOD, M. Epidemiology of gestational diabetes mellitus and its association with Type 2 diabetes. Diabetic Medicine. Tel Aviv, v. 2, n. 2, p. 103–113, jan. 2004.
BRASIL. Ministério da Saúde. Secretaria de Atenção à Saúde. Departamento de Ações Programáticas Estratégicas. Gestação de alto risco: manual técnico. 5 ed. Brasília – DF: 2012, 302 p.
BRASIL. Ministério da Saúde. Conselho Nacional de Saúde. Resolução nº 466, de 12 de dezembro de 2012. Dispõe sobre diretrizes e normas regulamentadoras de pesquisas envolvendo seres humanos. Diário Oficial da República Federativa do Brasil, Brasília, DF. Disponível em: https://bvsms.saude.gov.br/bvs/saudelegis/cns/2013/res0466_12_12_2012.html. Acesso em: 10 jun. 2020.
BRASIL. Ministério da Saúde. Cadernos de Atenção Básica: Atenção ao pré-natal de baixo risco. 1 ed. Revista. Ministério da Saúde: Brasília, 2013.
BRASIL. Organização Pan-Americana da Saúde. Ministério da Saúde. Tratamento do diabetes mellitus gestacional no Brasil. OPAS: Brasília, 2019.
BROWN, J. et al. Lifestyle interventions for the treatment of women with gestational diabetes. Cochrane Database of Systematic Reviews. n. 5, 2017.
CAMPOS, A. P. S. Dor neonatal: conhecimento, atitude e prática da equipe de enfermagem. Brazilian Journal of Pain. v. 1, n. 4. 2018.
CATALANO P.M, SHANKAR K. Obesity and pregnancy: mechanisms of short term and long term adverse consequences for mother and child. BMJ. V. 8, 2017.
CHEN, C.-N.; CHEN, H.-S.; HSU, H.-C. Maternal Prepregnancy Body Mass Index, Gestational Weight Gain, and Risk of Adverse Perinatal Outcomes in Taiwan: A Population-Based Birth Cohort Study. Int. J. environ. res. public health (Online), v. 17, n. 4, 2020.
CIDADE, Denise Gomes. Obesidade e sobrepeso pré-gestacionais: Prevalência e complicações obstétricas e perinatais. 2011. Dissertação (Mestrado) - Faculdade de Medicina de Botucatu, [S. l.], 2011.
CRANE, J. M.G.; MURPHY, P.; BURRAGE, L.; HUTCHENS, D.Maternal and Perinatal Outcomes of Extreme Obesity in Pregnancy. Journal of Obstetrics and Gynaecology Canada. V. 35, n. 7, p. 606–611. 2013.
CZARNOBAY S.A, KROLL C., SCHULTZ L.F, MALINOVSKI J., MASTROENI S. S. B. S., MASTROENI M.F. Predictors of excess birth weight in Brazil: a systematic review. Jornal de Pediatria. v. 95, n. 2, p. 128-154, Rio de Janeiro: 2019.
DAVIS, A. M. Collateral Damage: Maternal Obesity During Pregnancy Continues to Rise. Obstetrical and Gynecological Survey. V. 75, n. 1, p. 39-49. 2020.
FERNANDES, D. C. et al . Relação entre o estado nutricional pré-gestacional e o tipo de processamento de alimentos consumidos por gestantes de alto risco. Revista Brasileira Saude Materno Infantil, Recife , v. 19, n. 2, p. 351-361, June 2019.
FRANCISQUETI et al. Estado nutricional materno na gravidez e sua influência no crescimento fetal. Revista. Simbio-Logias, V.5, n.7, Dez-2012.
GUIMARÃES, Eliete Albano de Azevedo et al . Prevalência e fatores associados à prematuridade em Divinópolis, Minas Gerais, 2008-2011: análise do Sistema de Informações sobre Nascidos Vivos. Epidemiol. Serv. Saúde, Brasília , v. 26, n. 1, p. 91-98, jan. 2017.
GUNDERSON, E. P. Childbearing and obesity in women: weight before, during, and after pregnancy. Obstetrics and gynecology clinics of North America. v. 36, n. 2 p. 317-332, 2009.
HADLOCK F.P, HARRIST R.B, MARTINEZ-POYER J. In utero analysis of fetal growth: a sonographic weight standard. Radiology. v.181, n. 1, p. 129-133, 1991.
HIERONIMUS, B., ENSENAUER, R. Influence of maternal and paternal pre-conception overweight/obesity on offspring outcomes and strategies for prevention. European Journal Clinical Nutrition. 2021.
HIRSHBERG, A.; SRINIVAS, S. K. Epidemiology of maternal morbidity and mortality. Seminars in Perinatology. V. 41, n. 6. P. 332-337. Oct. 2017.
IBGE – Instituto Brasileiro de Geografia e Estatística. Pesquisa nacional de saúde : 2019 : atenção primária à saúde e informações antropométricas. Rio de Janeiro, 2020.
IOM. Institute of Medicine; NRC. National Research Council. Weight gain during pregnancy: reexamining the guidelines. The National Academies Press. Washington, DC: 2009.
KELLY N.M, KEANE J.V, GALLIMORE R.B, BICK D., TRIBE R.M. Neonatal weight loss and gain patterns in cesarean section born infants: integrative systematic review. Matern Child Nutr. n. 2, v. 16, 2019.
LECORGUILLÉ M, JACOTA M, DE LAUZON-GUILLAIN B, FORHAN A, CHEMINAT M, et al. An association between maternal weight change in the year before pregnancy and infant birth weight: ELFE, a French national birth cohort study. PLOS Medicine. v. 16, n. 8, 2019.
LEWANDOWSKA, M.; WIECKOWSKA, B.; SAJDAK, S. Pre-Pregnancy Obesity, Excessive Gestational Weight Gain, and the Risk of Pregnancy-Induced Hypertension and Gestational Diabetes Mellitus. Journal of Clinical Medicine. v. 9, n. 6, 2020.
LIU, L., MA, Y., WANG, N. et al. Maternal body mass index and risk of neonatal adverse outcomes in China: a systematic review and meta-analysis. BMC Pregnancy Childbirth. V. 19, n. 105, 2019.
MASTROENI, M. F., CZARNOBAY, S. A., KROLL, C. et al. The Independent Importance of Pre-pregnancy Weight and Gestational Weight Gain for the Prevention of Large-for Gestational Age Brazilian Newborns. Matern Child Health J. v. 21, p. 705–714, 2017.
MELENDEZ-GONZALEZ, C.V et al . Relación entre el índice de masa corporal bajo previo al embarazo y el riesgo de parto prematuro. Ginecol. obstet. Méx., Ciudad de México , v. 85, n. 9, p. 589-594, 2017.
METSÄLÄ, J. et al. Risk of Pregnancy Complications in Relation to Maternal Prepregnancy Body Mass Index: Population-Based Study from Finland 2006-10. Paediatr Perinat Epidemiol, v. 30, n. 1, p. 28–37, 2016.
NOWAK, M. et al. The relationship between pre-pregnancy BMI, gestational weight gain and neonatal birth weight: a retrospective cohort study. Ginekol Pol, v. 90, n. 1, p. 50–54, 2019.
OLIVEIRA, L. P. M et. al. Índice de massa corporal obtido por medidas autorreferidas para a classificação do estado antropométrico de adultos: estudo de validação com residentes no município de Salvador, estado da Bahia, Brasil. Epidemiologia e Serviços de Saúde, v. 21, n. 2, p. 325-332, abr-jun 2012.
PILEGGI, V., OLADAPO, O., CAVENAGUE DE SOUZA, H., et al. Maternal BMI at the time of birth and selected risk factors associated with severe neonatal outcomes: A secondary analysis of the WHO Better Outcomes in Labour Difficulty (BOLD) project. British Journal of Nutrition, v. 124, n. 10, p.1086-1092, 2020.
RAMONIENĖ, G. et al. Maternal obesity and obstetric outcomes in a tertiary referral center. Medicina (Lithuania), v. 53, n. 2, p. 109–113, 2017.
REECE, E. A.; LEGUIZAMÓN, G.; WIZNITZER, A. Gestational diabetes: the need for a common ground. The Lancet. v. 373, n. 9677, p.1789–1797, Maio 2009.
SAINI A., RIZVI, S. M; GUPTA, A., Hostile turf: Higher maternal body mass index and neonatal intensive care unit admission risk. Journal of Clinical Neonatology. v. 7, n. 4, p. 213 – 216, 2018.
SBD. Sociedade Brasileira de Diabetes. Diretrizes da Sociedade Brasileira de Diabetes (2019-2020). São Paulo: SBD, 2020.
SCHNEIDER, L. et al. Evaluation of neonatal and obstetric outcomes according to increased or decreased body mass index of the pregnant woman. Obesity Medicine, v. 14, 2019.
SHAW, G.M. et al BMI and preterm birth risk. Paediatr Perinat Epidemiol. V. 28, p. 302-311, 2014.
SHORT, V. L. et al. The Relationship between Body Mass Index in Pregnancy and Adverse Maternal, Perinatal, and Neonatal Outcomes in Rural India and Pakistan. Am J Perinatol, v. 35, n. 9, p. 844–851, 2018.
SILVA, F. P.; SOUZA, R.T., CECATTI, J.G. et al. Role of Body Mass Index and gestational weight gain on preterm birth and adverse perinatal outcomes. Science Report. V. 9, n. 13093. 2019.
SILVA, S. L et al. Classificação antropométrica de gestantes: comparação entre cinco métodos diagnósticos utilizados na América Latina. Revista Panamericama de Salud Pública. v. 41; e. 85. 2017.
SUK, D., KWAK T., KHAWAR N., VANHORN S., SALAFIA C. M., GUDAVALLI M.B., NARULA P. Increasing maternal body mass index during pregnancy increases neonatal intensive care unit admission in near and full-term infants. The Journal of Maternal-Fetal & Neonatal Medicine. v.29, n. 20, p.3249-3253.
TAVARES, B. B; TRESSO, B.D. Índice de massa corporal associado às caractéristicas das puérperas e dos neonatos. Revista Cuidarte. v. 10; n. 2. 2019.
TOMEO C.A, RICH-EDWARDS J.W, MICHELS K.B, BERKEY C.S, HUNTER D.J, FRAZIER A.L, WILLETT W.C, BUKA S.L. Reproducibility and validity of maternal recall of pregnancy-related events. Epidemiology. V. 10, n. 6, p. 774-777, Nov.1999.
VARELA, M. J. et al. Pregestational overweight/obesity are associated with C-section and with LGA newborn in women attended in the public health system in Chile between 2015-2017*. Placenta, v. 83, n. 2019, p. e94, 2019.
VITOLO, Márcia Regina. Nutrição: Da Gestação ao Envelhecimento. Ed. Rubio, 2015.
XIONG, C., ZHOU, A., CAO, Z. et al. Association of pre-pregnancy body mass index, gestational weight gain with cesarean section in term deliveries of China. Scientific Reports 6, n. 37168, 2016.
YOGEV, Y.; VISSER, G. H. A. Obesity, gestational diabetes and pregnancy outcome. Seminars in Fetal and Neonatal Medicine, v. 14, n. 2, p. 77–84, abr. 2009.
ZAMBONATO, Ana Maria Krusser; PINHEIRO, Ricardo Tavares; HORTA, Bernardo Lessa; TOMASI, Elaine. Fatores de risco para nascimento de crianças pequenas para idade gestacional. Revista de Saúde Pública, São Paulo, v. 38, n. 1, p. 24-9, fev. 2004.
ZHANG Y.P et al. Risk Factors for Preterm Birth in Five Maternal and Child Health Hospitals in Beijing. Plos One. V. 7, n. 12. 2012.
ZHOU Y, ZHANG Y, SUN Y, ZHANG D. Association of Cesarean Birth with Body Mass Index Trajectories in Adolescence. Int J Environ Res Public Health. v. 17, n. 6, 2020.
WHO. World Health Organization. Obesity: preventing and managing the global epidemic. Report of a WHO Consultation of Obesity. Geneva. World Health Organization: 1997.
WHO. World Health Organization. de Onis M, Onyango AW, Borghi E, Siyam A, Nishida C, Siekmann J. Development of a WHO growth reference for school-aged children and adolescents. Bulletin of the World Health Organization 2007. Geneva. World Health Organization: n. 85. p. 660-667. 2007.
