- Email: [email protected]
544: The relation between birthweight and metabolic syndrome in Japanese population
Academic Issues, etc
www.AJOG.org
Poster Session IV
and satisfying work environments and decrease staff turnover and vacancy. 0002-9378/$ – see front matter • doi:10.1016/j.ajog.2009.10.408
544 The relation between birthweight and metabolic syndrome in Japanese population Shinji Katsuragi1, Chizuko Kamiya2, Keiko Ueda2, Kaoru Yamanaka2, Reiko Neki2, Jun Yoshimatsu1, Tomoaki Ikeda2 1
National Cardiovascular Center, Department of Perinatology, Suita, Osaka, Japan, 2National Cardiovascular Center, Suita, Osaka, Japan
OBJECTIVE: There are few studies in Japan of diseases caused by nutritional dysfunction and environmental factors during growth. We investigated the relationship between birthweight and metabolic syndrome, a risk factor for cardiovascular dysfunction. STUDY DESIGN: The relationship between birthweight and the following parameters was investigated in 1241 subjects aged 40-69 years (males 521, females 720): waist 90 cm (males) and 80 cm (females), blood pressure (SBP/DBP 130/85 mm Hg and/or current use of antihypertensives), fasting blood glucose 110 mg/dl and/or current use of insulin or oral diabetes medication, triglyceride 150 mg/dl and/or current use of cholesterol-lowering medication, HDL cholesterol ⬍40 mg/dl. Subjects were classified based on birthweight in the maternal notebook (⬍2500, 2500-3500, ⬍3500 g) and on the examinee’s memory (“light”, “medium” and “heavy” body weight). RESULTS: The maternal notebook correlated well with the examinee memory (r⫽0.73; p⬍0.025). “Light” body weight was a risk for hypertension (OR 2.0; 95%CI 1.02-4.09), hypertriglyceridemia (OR 3.0; 95%CI 1.06-9.77), low HDL cholesterol (OR 3.80; 95%CI 1.08-4.09) in females when controlling for age, BMI, smoking, alcohol, menopause. The percentage of “light”, “medium” and “heavy” females fulfilling the glucose criteria was 14.1%, 11.6% and 4.8%, respectively. CONCLUSION: Females with a light birthweight had greater risk for metabolic syndrome than heavy ones for blood pressure, HDL-cholesterol, and glucose level. These phenomena were not observed in males. 0002-9378/$ – see front matter • doi:10.1016/j.ajog.2009.10.409
545 Withdrawn 0002-9378/$ – see front matter • doi:10.1016/j.ajog.2009.10.410
Absolute risk percentage of birthweight outcomes by gestational weight gain categories stratified by pre-pregnancy BMI for women giving birth in Missouri, 1995-2004 CONCLUSION: Our results indicate lower optimal gestational weight
gain ranges than are recommended by the Institute of Medicine (IOM), especially for overweight and obese women. Given the high prevalence of overweight and obesity among women of reproductive age in the United States, IOM guidelines need to be revisited and revised. 0002-9378/$ – see front matter • doi:10.1016/j.ajog.2009.10.411
547 Pneumonia during pregnancy: radiological characteristics, predisposing factors, and pregnancy outcomes Lior Raichel1, Vitaliy Romanyuk2, Ruslan Sergienko3, Arnon Wiznitzer1, Eyal Sheiner1
546 Association between gestational weight gain and optimal infant birthweight outcomes in women of varying pre-pregnancy body size Thomas Myles1, Megan Campise2, Nupur Kittur2, Terry Leet3 1
Saint Louis University, Department of Ob/Gyn/Women’s Health, St. Louis, Missouri, 2Saint Louis University, School of Public Health, St. Louis, Missouri, 3Saint Louis University, St. Louis, Missouri
OBJECTIVE: To identify the gestational weight gain range associated with the lowest combined risk of low birthweight and macrosomia for women of varying pre-pregnancy Body Mass Index (BMI). STUDY DESIGN: We conducted a large population-based cohort study using Missouri birth certificate data from 1995-2004. The eligibility criteria were first-time mothers aged 16 years who delivered full-term (37 or more weeks of gestation), live, singleton infants as Missouri residents. The primary exposure was gestational weight gain and the primary outcomes were low birthweight and macrosomia. Pre-pregnancy BMI category was used to stratify the study population. Adjusted relative risks and 95% confidence intervals were calculated using log binomial regression. These were used to determine the specific ranges of gestational weight gain associated with optimal birthweight outcomes with minimized risk for low birthweight infants and macrosomia. RESULTS: The optimal gestational weight gain ranges for minimal risk of low birthweight and macrosomia are as follows; 15-18.9 kg for underweight women, 9-12.9 kg for normal weight women, 1-6.9 kg for overweight women and no gain for obese women. These ranges held true even after adjusting for significant confounders.
1 Soroka University Medical Center, Obstetrics and Gynecology, Beer-Sheva, Israel, 2Soroka University Medical Center, Radiology, Beer Sheva, Israel, 3Ben-Gurion University, Epidemiology, Israel
OBJECTIVE: To establish radiological characteristics and pregnancy out-
comes of patients hospitalized due to pneumonia during pregnancy. STUDY DESIGN: A population-based study comparing all pregnancies
of women with and without pneumonia was conducted. The diagnosis of pneumonia was confirmed by chest radiograph. Multivariable logistic regression models were constructed in order to control for confounders. RESULTS: During the study period there were 181,765 deliveries, of which 160 patients were hospitalized due to pneumonia. The most common site of pneumonia was the left lower lobe (53.4%), followed by the right lower lobe (26.3%), and right middle lobe (8.3%); 9.8% were complicated with pleural effusion. Using a multivariable analysis, pneumonia was significantly associated with placental abruption (OR⫽4.2; 95% CI 1.9-9.1), intrauterine growth restriction (IUGR; OR⫽3.7; 95% CI 2.1-6.6), previous cesarean deliveries (OR⫽2.6; 95% CI 1.8-3.7), and severe preeclampsia (OR⫽2.6; 95% CI 1.2-5.7). Patients with pneumonia were more likely to have preterm deliveries (PTD, ⬍37 weeks) (35.6% vs. 7.7%, p⬍0.001), cesarean deliveries (54.4% vs. 12.8%, p⬍0.001), low Apgar scores at 1 and 5 minutes (26.3% vs. 5.9%, p⬍0.001 and 10.6% vs. 2.6%, p⬍0.001; respectively) and perinatal mortality (7.5% vs. 1.3%, p⬍0.001). Using two multiple logistic regression models with PTD and perinatal mortality as the outcome variables, controlling for confounders such as placental ab-
Supplement to DECEMBER 2009 American Journal of Obstetrics & Gynecology
S203
www.AJOG.org
Poster Session IV
and satisfying work environments and decrease staff turnover and vacancy. 0002-9378/$ – see front matter • doi:10.1016/j.ajog.2009.10.408
544 The relation between birthweight and metabolic syndrome in Japanese population Shinji Katsuragi1, Chizuko Kamiya2, Keiko Ueda2, Kaoru Yamanaka2, Reiko Neki2, Jun Yoshimatsu1, Tomoaki Ikeda2 1
National Cardiovascular Center, Department of Perinatology, Suita, Osaka, Japan, 2National Cardiovascular Center, Suita, Osaka, Japan
OBJECTIVE: There are few studies in Japan of diseases caused by nutritional dysfunction and environmental factors during growth. We investigated the relationship between birthweight and metabolic syndrome, a risk factor for cardiovascular dysfunction. STUDY DESIGN: The relationship between birthweight and the following parameters was investigated in 1241 subjects aged 40-69 years (males 521, females 720): waist 90 cm (males) and 80 cm (females), blood pressure (SBP/DBP 130/85 mm Hg and/or current use of antihypertensives), fasting blood glucose 110 mg/dl and/or current use of insulin or oral diabetes medication, triglyceride 150 mg/dl and/or current use of cholesterol-lowering medication, HDL cholesterol ⬍40 mg/dl. Subjects were classified based on birthweight in the maternal notebook (⬍2500, 2500-3500, ⬍3500 g) and on the examinee’s memory (“light”, “medium” and “heavy” body weight). RESULTS: The maternal notebook correlated well with the examinee memory (r⫽0.73; p⬍0.025). “Light” body weight was a risk for hypertension (OR 2.0; 95%CI 1.02-4.09), hypertriglyceridemia (OR 3.0; 95%CI 1.06-9.77), low HDL cholesterol (OR 3.80; 95%CI 1.08-4.09) in females when controlling for age, BMI, smoking, alcohol, menopause. The percentage of “light”, “medium” and “heavy” females fulfilling the glucose criteria was 14.1%, 11.6% and 4.8%, respectively. CONCLUSION: Females with a light birthweight had greater risk for metabolic syndrome than heavy ones for blood pressure, HDL-cholesterol, and glucose level. These phenomena were not observed in males. 0002-9378/$ – see front matter • doi:10.1016/j.ajog.2009.10.409
545 Withdrawn 0002-9378/$ – see front matter • doi:10.1016/j.ajog.2009.10.410
Absolute risk percentage of birthweight outcomes by gestational weight gain categories stratified by pre-pregnancy BMI for women giving birth in Missouri, 1995-2004 CONCLUSION: Our results indicate lower optimal gestational weight
gain ranges than are recommended by the Institute of Medicine (IOM), especially for overweight and obese women. Given the high prevalence of overweight and obesity among women of reproductive age in the United States, IOM guidelines need to be revisited and revised. 0002-9378/$ – see front matter • doi:10.1016/j.ajog.2009.10.411
547 Pneumonia during pregnancy: radiological characteristics, predisposing factors, and pregnancy outcomes Lior Raichel1, Vitaliy Romanyuk2, Ruslan Sergienko3, Arnon Wiznitzer1, Eyal Sheiner1
546 Association between gestational weight gain and optimal infant birthweight outcomes in women of varying pre-pregnancy body size Thomas Myles1, Megan Campise2, Nupur Kittur2, Terry Leet3 1
Saint Louis University, Department of Ob/Gyn/Women’s Health, St. Louis, Missouri, 2Saint Louis University, School of Public Health, St. Louis, Missouri, 3Saint Louis University, St. Louis, Missouri
OBJECTIVE: To identify the gestational weight gain range associated with the lowest combined risk of low birthweight and macrosomia for women of varying pre-pregnancy Body Mass Index (BMI). STUDY DESIGN: We conducted a large population-based cohort study using Missouri birth certificate data from 1995-2004. The eligibility criteria were first-time mothers aged 16 years who delivered full-term (37 or more weeks of gestation), live, singleton infants as Missouri residents. The primary exposure was gestational weight gain and the primary outcomes were low birthweight and macrosomia. Pre-pregnancy BMI category was used to stratify the study population. Adjusted relative risks and 95% confidence intervals were calculated using log binomial regression. These were used to determine the specific ranges of gestational weight gain associated with optimal birthweight outcomes with minimized risk for low birthweight infants and macrosomia. RESULTS: The optimal gestational weight gain ranges for minimal risk of low birthweight and macrosomia are as follows; 15-18.9 kg for underweight women, 9-12.9 kg for normal weight women, 1-6.9 kg for overweight women and no gain for obese women. These ranges held true even after adjusting for significant confounders.
1 Soroka University Medical Center, Obstetrics and Gynecology, Beer-Sheva, Israel, 2Soroka University Medical Center, Radiology, Beer Sheva, Israel, 3Ben-Gurion University, Epidemiology, Israel
OBJECTIVE: To establish radiological characteristics and pregnancy out-
comes of patients hospitalized due to pneumonia during pregnancy. STUDY DESIGN: A population-based study comparing all pregnancies
of women with and without pneumonia was conducted. The diagnosis of pneumonia was confirmed by chest radiograph. Multivariable logistic regression models were constructed in order to control for confounders. RESULTS: During the study period there were 181,765 deliveries, of which 160 patients were hospitalized due to pneumonia. The most common site of pneumonia was the left lower lobe (53.4%), followed by the right lower lobe (26.3%), and right middle lobe (8.3%); 9.8% were complicated with pleural effusion. Using a multivariable analysis, pneumonia was significantly associated with placental abruption (OR⫽4.2; 95% CI 1.9-9.1), intrauterine growth restriction (IUGR; OR⫽3.7; 95% CI 2.1-6.6), previous cesarean deliveries (OR⫽2.6; 95% CI 1.8-3.7), and severe preeclampsia (OR⫽2.6; 95% CI 1.2-5.7). Patients with pneumonia were more likely to have preterm deliveries (PTD, ⬍37 weeks) (35.6% vs. 7.7%, p⬍0.001), cesarean deliveries (54.4% vs. 12.8%, p⬍0.001), low Apgar scores at 1 and 5 minutes (26.3% vs. 5.9%, p⬍0.001 and 10.6% vs. 2.6%, p⬍0.001; respectively) and perinatal mortality (7.5% vs. 1.3%, p⬍0.001). Using two multiple logistic regression models with PTD and perinatal mortality as the outcome variables, controlling for confounders such as placental ab-
Supplement to DECEMBER 2009 American Journal of Obstetrics & Gynecology
S203