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Wednesday, 18 December 2013

Women's Health: Obesity and Congenital Abnormalities

A. Obesity is defined as a medical condition of excess body fat has accumulated overtime, while overweight is a condition of excess body weight relatively to the height. According to the Body Mass Index(BMI), a BMI between 25 to 29.9 is considered over weight, while a BMI of over 30 is an indication of obesity. According to the statistic, 68% of American population are either overweight or obese.

B. How do calculate your BMI index
BMI= weight (kg)/ height (m2)

C. Congenital Abnormalities is also known as congenital malformation, birth defect, defined as a abnormal condition at present of birth, including Down Syndrome (Trisomy 21), Neural Tube Defects, Congenital Heart Defects, Oral Facial Clefts, Limb Reduction Defects, etc.. According to statistic, affecting approximately 3% of newborns.

D. How Obesity associates with Congenital Abnormalities
1. According to the study of "[Obesity and pregnancy].[Article in French]" by Deruelle P., posted in PubMed, researchers wrote in abstract that Obesity during pregnancy increases the risk of complications for both the mother (gestational hypertension, diabetes mellitus) and the newborn (malformations and macrosomia). Deliveries are also more difficult with more c-section and failure in peridural analgesia. A specific organization supported by the perinatal network should improve the management of these women, especially for morbid obesity.

2. In the study of mothers enrolled in the National Birth Defects Prevention Study who had index pregnancies between October 1, 1997, and December 31, 2002., conducted by The University of Texas at Houston, posted in PubMed, researchers concluded that suggested a weak to moderate positive association of maternal obesity with 7 of 16 categories of birth defects and a strong inverse association with gastroschisis. The mechanisms underlying these associations are not yet understood but may be related to undiagnosed diabetes.

3. According to the study of "Maternal obesity and risk for birth defects" by Watkins ML, Rasmussen SA, Honein MA, Botto LD, Moore CA., posted in PubMed, researchers concluded that our study confirmed the previously established association between spina bifida and prepregnancy maternal obesity and found an association for omphalocele, heart defects, and multiple anomalies among infants of obese women. We also found an association between heart defects and multiple anomalies and being overweight before pregnancy. A higher risk for some birth defects is yet another adverse pregnancy outcome associated with maternal obesity. Obesity prevention efforts are needed to increase the number of women who are of healthy weight before pregnancy.

4. In the study of 169 infants with renal anomalies (renal agenesis [n = 41], obstructive defects [n = 117], and duplication defects [n = 11]) and 2763 infants without defects who were born in 1968-1980 in metropolitan Atlanta, after excluding mothers who reported diabetes, conducted by National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, posted in PubMed, researchers found that Women who are overweight/obese and experience subfertility may be more likely to have an infant with an obstructive renal anomaly. Further exploration of possible biologic mechanisms is needed.

5. According to the study of "Maternal obesity and morbid obesity: the risk for birth defects in the offspring" by Blomberg MI, Källén B., posted by PubMed, researchers found that The risk for a morbidly obese pregnant woman to have an infant with a congenital birth defect is small, but for society the association is important in the light of the ongoing obesity epidemic.

6. Etc.

E. Treatments of Obesity and Congenital Abnormalities
1. In a study of Healthy obese (n=12) and nonobese (n=12) women of childbearing age volunteered to participate. Each obese participant was matched to a nonobese participant and assigned an equivalent dose of folic acid per kilogram body weight. Folic acid was orally administered after a 6-hour fast, and blood samples were taken over a 10-hour period to evaluate pharmacokinetic parameters., conducted by University of Toronto, posted in PubMed, researchers found that the body tightly controls systemic exposure to folic acid, with 90% of the variability in AUC controlled by the dose per kilogram LBW. Periconceptional supplementation recommendations may need to be adjusted to account for LBW differences in the obese population.

2. According to the study of "Association of drug treatments in pregnant women with the risk of external ear congenital abnormalities in their offspring: a population-based case-control study" by Paput L, Bánhidy F, Czeizel AE., posted in PubMed, researchers found that Drug treatments are not important in the origin of isolated ear abnormalities. However, a higher risk of multiple ear abnormalities was found in children born to mothers with treatment of hydroxyethylrutosidea or antiepileptic drugs during pregnancy.

3. Etc.
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