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Maternal weight gain is associated with pregnancy complications, including gestational diabetes mellitus, pre-eclampsia, gestational hypertension, preterm birth, macrosomia, and development of obesity in newborn baby.
Here we have analyzed data set containing 272 participants, among these participants 22% were lost as they did not come for follow up leading to 211 participants
The study aimed to analyze factors affecting the gestational outcomes .The factors we considered are demographics, maternal fat assessment, lifestyle, nutrition, previous pregnancies outcomes and medical conditions. The data also includes pregnancy outcomes like type of delivery, newborn condition after birth ,pregnancy complications like Preeclampsia.
Obstetric ultrasound was performed with a maternal epigastric fat measurement conducted in all included cases. Two assessments were performed: the epigastric maternal visceral adipose tissue (preperitoneal m-VAT) and the epigastric maternal subcutaneous adipose tissue (preperitoneal m-SAT). Cases included before 20 weeks had an additional periumbilical fat assessment performed; this included: the periumbilical maternal visceral adipose tissue and the periumbilical maternal subcutaneous adipose tissue
Visceral fat and subcutaneous fat are both types of belly fat. Visceral fat is belly fat found deep within your abdominal cavity. It surrounds important organs, including your stomach, liver and intestines. It’s different than subcutaneous fat, which is fat just below your skin. Visceral fat is actually more dangerous to your health. Diet and exercise are the best ways to prevent the buildup of visceral fat.
Subcutaneous abdominal fat thickness (SCFT) is important for predisposition to metabolic and cardiovascular diseases. Pregnant women with thicker SCFT may be susceptible to the development of metabolic complications of pregnancy, such as gestational diabetes mellitus (GDM) and hypertension, as well as risk of future metabolic and cardiovascular disease.
Abnormally high deposition of visceral adipose tissue is known as visceral obesity.
Data Analysis
Firstly we have analyzed patients with pre eclampsia, as it is a serious condition during pregnancy.
Preeclampsia is a complication of pregnancy some women get after the 20th week of pregnancy or after giving birth. Preeclampsia is diagnosed when high blood pressure (140/90 mm Hg or higher) occurs together with one or more of the following after 20 weeks pregnancy: protein in the urine – determined by analysis of a urine sample. swelling and fluid in the feet hands and face.
Symptoms
Excess protein in urine (proteinuria) or other signs of kidney problems.
Decreased levels of platelets in blood (thrombocytopenia)
Increased liver enzymes that indicate liver problems.
Severe headaches.
Changes in vision, including temporary loss of vision, blurred vision or light sensitivity.
First chart shows participants in different BMI category vs pre eclampsia. Second chart we can see for the Preeclampsia patients, WHR is higher. Third chart we can see as the visceral fat increases more cases of pre eclampsia are observed. BMI and WHR are significant risk factors for development of gestational diabetes and insulin resistance.
From the scatter plot we can see there is a positive correlation between preperitoneal subcutaneous fat and mean SBP ,pre eclampsia is highlighted in black color
Hypoglycemia is the condition in which blood glucose level is lower than recommended level, from the chart we can see around 37% hypoglycemic patients are having preeclampsia condition. Low blood sugar can lead to a rise in blood pressure. This happens when the body responds to low blood sugar levels by releasing adrenaline. This hormone causes your heart rate to increase and arteries to constrict, which can raise blood pressure levels.
Cesarean Vs Vaginal delivery:
A vaginal delivery is the safest and most common type of childbirth. Vaginal deliveries account for about 68% of all births in the United States. Most medical organizations and obstetricians recommend a vaginal delivery unless there is a medical reason for a C-section.
The first chart shows that participants with more substances used are undergoing more cesarean than vaginal delivery. The consumption of alcohol/tobacco/drugs we have generalized as substances used.
Second chart shows that participants with more maternal waist circumference are undergoing more cesarean than vaginal delivery.Â
Next chart shows maternal weight gain and delivery mode. We can see that participants with more weight gain are undergoing more cesarean delivery than vaginal delivery.
 Increased maternal abdominal subcutaneous fat thickness is associated with increased cesarean delivery
We can see from the chart that participants having more subcutaneous fat are undergoing more cesarean delivery.
From the next bar chart we can see among Gestational diabetes patients around 32 % have undergone cesarean delivery.
From the last chart we can see that around 39% of participants with hypoglycemia have undergone cesarean delivery.
Newborn score: For obtaining newborn score , we have considered newborn airway aspiration, Apgar Score 1 and 5 minute ,Intubation , pediatric resuscitation maneuvers and Meconium in labor.
Neonatal resuscitation is defined as the set of interventions at the time of birth to support the establishment of breathing and circulation. Efficient resuscitation at birth can save a huge percentage of newborn’s life.
Newborn resuscitation Vs Maternal BP chart shows that more than 75% of newborns who underwent resuscitation, their mothers were hypertensive-Stage1,Stage2 or Hypertensive crisis. We have filtered out babies who have undergone resuscitation in the first chart
From BMI Vs Newborn score chart, we can see obese and overweight mothers are having more number of extra care babiesÂ
From the Delivery mode Vs Newborn score chart we can see that among cesarean delivery babies there are more extra care babies than vaginal delivery.
In the last chart, Lifestyle factors we have scored based on the number of substances they have used, if they are having only one substance used like consuming alcohol or more than one substance used ,we have counted and obtained lifestyle scores.
From the Lifestyle Vs Newborn score chart we can see people with lesser substance use have a lesser number of extra care babies. Participants who have used all three substances have more extra care babies.
Conclusion:
Maternal abdominal subcutaneous fat thickness (SCFT) measured by ultrasound at the fetal morphology scan is a better predictor than BMI of mode of delivery and other pregnancy outcomes. Losing subcutaneous fat can be a slow process. It involves making combined changes to your diet and physical activity routines.
We observed that women who experienced complications during pregnancy had greater levels of maternal visceral fat, especially gestational diabetes, which was linked to metabolic risk factors including insulin resistance and arterial blood pressure. Among the participants with excess fat or higher waist to hip ratio , more number of pre-eclampsia cases are observed.
In order to avoid excess visceral fat ,it is advisable to follow healthy eating habits & lifestyle.
Reference