Pregnancy Rates And Cost Per Pregnancy Improve Linked To Weight Loss Intervention

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Main Category: Pregnancy / Obstetrics
Also Included In: Obesity / Weight Loss / Fitness
Article Date: 09 May 2012 - 11:00 PDT


At the 19th European Congress on Obesity in Lyon, France, the annual meeting of the European Association for the Study of Obesity, Dr Kyra Sim from The Boden Institute of Obesity, Nutrition, Exercise and Eating Disorders at the University of Sydney in Australia presented a new study, which shows that weight loss intervention in obese women who undergo fertility treatment substantially improves their chance of pregnancy and other health indicators, whilst also saving substantial costs per achieved pregnancy.

The study is the first to evaluate the economic value of the impact of women's weight loss strategies on fertility treatment. The randomized controlled trial involved 49 women aged 37 years or younger, with an average BMI of = 30 kg/m2, who were in an assisted reproductive technology program.

The researchers randomized 27 women to a 12-week intervention, consisting of a very-low-energy diet for the first six weeks, after which the women went on a low-energy diet combined with a weekly group multidisciplinary program. The other 22 women in the control group received recommendations for weight loss and the same printed material. The researchers measured multiple parameters at baseline and at 12 weeks. Follow up was at 12 months to confirm whether a pregnancy had occurred.

The findings demonstrated the women in the intervention group registered an average weight loss of 6.6 kg, with a 9 cm waistline reduction compared with those in the control group who lost 1.8 kg on average with a 1 cm reduction in waist circumference. The results also showed that pregnancy rates were significantly improved amongst those in the intervention group with 48% compared to 14% in the control group.

The number of assisted reproductive cycles needed to become pregnant was also less amongst the intervention group, together with a decline in maternal and fetal risk factors. The researchers also noted that the intervention group showed metabolic, hormonal and psychological improvements. The intervention saved US$9360 (AU$9,035 - EUR€6,900 - GBP5865) per pregnancy.

Dr Sim states that the study highlights the significance of implementing a program of preconception weight management together with providing specific information about the maternal and fetal risks of obesity in pregnancy, and concludes:

"A weight-loss intervention, incorporating dietary, exercise and behavioral components, is associated with significantly better pregnancy and economic outcomes in a group of obese women undergoing assisted reproductive technology."

Written By Petra Rattue
Copyright: Medical News Today
Not to be reproduced without permission of Medical News Today

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Child size, birth weight not affected by the use of drugs HIV during pregnancy

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Main Category: HIV / AIDS
Also Included In: Pregnancy / Obstetrics;  Pediatrics / Children's Health
Article Date: 03 May 2012 - 2:00 PDT

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Infants born to women who used the anti-HIV drug tenofovir as part of an anti-HIV drug regimen during pregnancy do not weigh less at birth and are not of shorter length than infants born to women who used anti-HIV drug regimens that do not include tenofovir during pregnancy, according to findings from a National Institutes of Health network study. However, at 1 year of age, children born to the tenofovir-treated mothers were slightly shorter and had slightly smaller head circumference - about 1 centimeter each, on average - than were infants whose mothers did not take tenofovir.

The study authors described the findings as reassuring, noting that the study did not identify any serious safety concerns during pregnancy for tenofovir. In combination with other anti-HIV drugs, tenofovir is the first line of treatment for adults with HIV. The researchers called for additional studies to follow the children as they grow and develop, to identify any potential long term effects of the treatment.

The study was undertaken because earlier studies had shown laboratory animals exposed to tenofovir in the womb were smaller at birth than were their unexposed peers.

Because of its safety and effectiveness, many women who have HIV take the drug for their health, often before they become pregnant. Similarly, because the drug is so effective for adult use and because there have been no problems reported in human infants related to their mother's use of tenofovir, many physicians will prescribe it for pregnant women, both to safeguard the women's health and to prevent the virus from being passed on to their infants. However, before the current research, the drug had not been specifically studied for its potential effects on infants whose mothers took it during pregnancy.

"Physicians treating pregnant women for HIV face a dilemma: do they continue treating a pregnant woman with a drug that is highly effective for adults but which has not been studied for its effects on infants, or do they switch the woman to another therapy, which may not be as effective and well-tolerated?" said first author George K. Siberry, M.D., of the Pediatric, Adolescent and Maternal AIDS Branch of the NIH's Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), the NIH institute that conducted the study. "Our findings indicate that tenofovir does not affect the growth of the fetus."

Over the seven years of the study, the number of participants being treated with tenofovir increased sharply, the study authors noted. In 2003, 14 percent of mothers in the study had been prescribed the drug, compared with 43 percent in 2010.

"The priority has been to treat mothers and prevent an infant's infection," said co-author Paige L. Williams, Ph.D., of the Harvard School of Public Health, Boston. "However, it's important to monitor the effects of these drugs on the infant."

The research was conducted as part of the Pediatric HIV/AIDS Cohort Study (PHACS), which is supported by the NICHD, the National Institute of Allergy and Infectious Diseases, the National Institute on Drug Abuse, the National Institute of Mental Health, the National Institute on Deafness and other Communication Disorders, the National Heart, Lung, and Blood Institute, the National Institute of Neurological Disorders and Stroke, and the National Institute on Alcohol Abuse and Alcoholism.

Dr. Siberry and Dr. Williams collaborated with colleagues at the State University of New York Downstate, Brooklyn; University of Miami School of Medicine; Indiana University School of Medicine, Indianapolis; Harvard; and the NICHD.

Their findings appear online in the journal AIDS.

The study included 2,000 U.S. infants born to HIV-positive mothers between 2003 and 2010. The researchers collected data for the infants' size relative to their gestational age (time they had spent in the womb), their birth weight, length at birth, and the circumference of their head. The researchers recorded similar measurements when the child was 1 year old.

They found that mothers taking tenofovir in combination with other anti-HIV medications and mothers on anti-HIV drug combinations that did not include tenofovir gave birth to infants who were smaller, on average, than infants born to HIV-negative mothers. However, they did not find significant differences between infants from the two groups of HIV-positive mothers.

The tenofovir-exposed infant's smaller average size and head circumference at one year of age suggests tenofovir could have a delayed effect on growth. Further research on this and other classes of anti-HIV drugs is ongoing in the PHACS.

"Overall, this study produced reassuring information regarding the use of tenofovir," said Dr. Siberry. "Although further research is needed, on balance, our findings favor the use of tenofovir in pregnancy to ensure good outcomes in the mother and prevent transmission of HIV to the infant."

Article adapted by Medical News Today from original press release. Click 'references' tab above for source.
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Obese weight or insufficient may cause risks during pregnancy

Main category: pregnancy and obstetrics
Also included in: Obesity / weight loss / Fitness;  High blood pressure
Article Date: April 22, 2012 - 0: 00 PDT

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Obese women are at risk of problems during pregnancy, labour and complications to the baby's health. A new study of over 3000 pregnant women confirms and also revealed that in underweight also has specific complications.

Researchers at the University Hospital Virgen de las Nieves in Granada, have identified risk during pregnancy specifically related to obesity and compared to underweight women to confirm that extreme thinness also carries a risk.

"Pregnancy, obesity is linked to hypertension, gestational diabetes, preterm labour, macrosomy of the fetus and unexplained death during labour" Sebastián Manzanares, the first author of the study says to SINC. "Nevertheless, it is still little information concerning the link between low birth weight and perinatal complications.

The study, published in the Journal of maternal-fetal and neonatal medicine, includes a sample of 3 016, 168 (5.5%) with extreme thinness, 2,597 (86.1%) pregnant women with a normal weight and 251 (8.3%) being severely obese or morbidly.

The results show that obese mothers have a higher risk of developing high blood pressure, diabetes mellitus and colonization with Group B Streptococcus. For these women, it is also more common to induce labour, or undergo a caesarean or emergency. It is also more common for macrosomy or acidosis occurs at birth, or for the baby to die before she was born.

In addition, insufficient weight women are more prone to oligohydramnios (reduced in the amount of amniotic fluid) and their underweight infants. The incidence of women in labour prematurely or late was not significantly different from the mass of the mother.

"Mothers severely or morbidly obese have a higher risk of perinatal mortality and negative results and must therefore be informed on weight loss and how to recognize the warning signs of possible complications" Manzanares highlights. "Nevertheless, this group, and underweight women, must be considered"high risk"."

Chubbier babies

The new study shows that infants of mothers severely or morbidly obese are larger. In addition, the risk of fetal macrosomy is 2.3 times more important in this group compared to women with normal weight.

For authors "these results justify the need for evaluation before pregnancy and it could be a convincing argument for the change of weight". "The study shows an increased risk for severe or morbid obesity and underweight women also," concludes Manzanares.

Article adapted by Medical News Today news release original. Click on "References" tab over the source.
Visit our pregnancy / obstetrics section for the latest news on this subject. Sebastián Manzanares Galán, Ángel Santalla Hernández, Irene vico Zúñiga, Mr. Setefilla López Criado and Alicia Pineda Lloréns José Luis Vallejo de Gallo. Index abnormal maternal body mass and obstetrical and neonatal outcomes. The Journal of maternal-fetal and neonatal medicine, 1-5, marzo de 2012.
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