• Are there sex differences in Fetal Abdominal Subcutaneous Tissue (FAST) measurements?

      Farah, Nadine; Stuart, Bernard; Harrold, Emily; Fattah, Chro; Kennelly, Mairead; Turner, Michael J; UCD School of Medicine and Medical Science, Coombe Women and Infants University, Hospital, Dublin 8, Ireland. nadine.farah@ucd.ie (2012-02-01)
      OBJECTIVE: To determine if Fetal Abdominal Subcutaneous Tissue (FAST) measurements using antenatal ultrasound differ between male and female fetuses. STUDY DESIGN: Women who had an ultrasound examination for fetal growth between 20 and 40 weeks gestation were studied. Women with diabetes mellitus were excluded. The fetal anterior abdominal subcutaneous tissue was measured on the anterior abdominal wall in millimetres anterior to the margins of the ribs, using magnification at the level of the abdominal circumference. The fetal sex was recorded after delivery. RESULTS: A total of 557 fetuses were measured, 290 male and 267 female. The FAST measurements increased with gestational age. The FAST increased at the same rate for both male and female fetuses and at any given week there was no sex difference. CONCLUSIONS: The increased fat composition in females reported after birth was not found in abdominal wall subcutaneous fat measurements using ultrasound during pregnancy. Antenatal centile charts for FAST do not need to be based on sex.
    • Body Mass Index (BMI) in women booking for antenatal care: comparison between selfreported and digital measurements.

      Fattah, Chro; Farah, Nadine; O'Toole, Fiona; Barry, Sinead; Stuart, Bernard; Turner, Michael J; UCD School of Medicine and Medical Science, Coombe Women and Infants University, Hospital, Dublin, Ireland. (2012-02-01)
      OBJECTIVE: We set out to compare measurement of Body Mass Index (BMI) with selfreporting in women early in pregnancy. STUDY DESIGN: We studied 100 women booking for antenatal care in the first trimester with a normal ongoing pregnancy. Selfreported maternal weight and height were recorded and the Body Mass Index was calculated. Afterwards maternal weight and height were digitally measured and actual BMI was calculated. RESULTS: If selfreporting is used for BMI classification, we found that 22% of women were classified incorrectly when BMI was measured. 12% of the women who were classified as having a normal selfreported BMI were overweight and 5% classified as overweight were obese. Similar findings have been reported outside pregnancy. CONCLUSIONS: These findings have implications for clinical practice, and for research studies exploring the relationship between maternal adiposity and pregnancy complications.
    • Body Mass Index and spontaneous miscarriage.

      Turner, Michael J; Fattah, Chro; O'Connor, Norah; Farah, Nadine; Kennelly, Mairead; Stuart, Bernard; UCD Centre for Human Reproduction, Coombe Women and Infants University Hospital, , Dublin 8, Ireland. michael.turner@ucd.ie (2012-02-01)
      OBJECTIVE: We compared the incidence of spontaneous miscarriage in women categorised as obese, based on a Body Mass Index (BMI) >29.9 kg/m(2), with women in other BMI categories. STUDY DESIGN: In a prospective observational study conducted in a university teaching hospital, women were enrolled at their convenience in the first trimester after a sonogram confirmed an ongoing singleton pregnancy with fetal heart activity present. Maternal height and weight were measured digitally and BMI calculated. Maternal body composition was measured by advanced bioelectrical impedance analysis. RESULTS: In 1200 women, the overall miscarriage rate was 2.8% (n=33). The mean gestational age at enrolment was 9.9 weeks. In the obese category (n=217), the miscarriage rate was 2.3% compared with 3.3% in the overweight category (n=329), and 2.3% in the normal BMI group (n=621). There was no difference in the mean body composition parameters, particularly fat mass parameters, between those women who miscarried and those who did not. CONCLUSIONS: In women with sonographic evidence of fetal heart activity in the first trimester, the rate of spontaneous miscarriage is low and is not increased in women with BMI>29.9 kg/m(2) compared to women in the normal BMI category.
    • Correlation between birth weight and maternal body composition.

      Kent, Etaoin; O'Dwyer, Vicky; Fattah, Chro; Farah, Nadine; O'Connor, Clare; Turner, Michael J; UCD Centre for Human Reproduction, Coombe Women and Infants University Hospital, Dublin, Ireland. ekent@rcsi.ie (2013-01)
      To estimate which maternal body composition parameters measured using multifrequency segmental bioelectric impedance analysis in the first trimester of pregnancy are predictors of increased birth weight.
    • Maternal leptin and body composition in the first trimester of pregnancy.

      Fattah, Chro; Barry, Sinead; O'connor, Norah; Farah, Nadine; Stuart, Bernard; Turner, Michael J; UCD Centre for Human Reproduction, Coombe Women and Infants University Hospital, , Dublin, Ireland. (2012-02-01)
      BACKGROUND: Leptin is produced mainly by adipocytes. Levels are increased in women with obesity and during pregnancy. Increased levels are also associated with pregnancy complications such as, pre-eclampsia and gestational diabetes mellitus. OBJECTIVE: We studied what component of body composition correlated best with maternal leptin in the first trimester of pregnancy and, whether maternal leptin correlated better with visceral fat rather than fat distributed elsewhere. SUBJECTS AND METHODS: Women were recruited in the first trimester. Maternal adiposity was measured using body mass index and advanced bioelectrical impedance analysis. Maternal leptin was measured using an enzyme-linked immunosorbent assay technique. RESULTS: Of the 100 subjects studied, the mean leptin concentration was 37.7 ng/ml (range: 2.1-132.8). Leptin levels did not correlate with gestational age in the first trimester, maternal age, parity or birth weight. Serum leptin correlated positively with maternal weight and body mass index, and with the different parameters of body composition. On multiple regression analysis, serum leptin correlated with visceral fat but not fat distributed elsewhere. CONCLUSIONS: Visceral fat is the main determinant of circulating maternal leptin in the first trimester of pregnancy. This raises the possibility that maternal leptin in early pregnancy may be a marker for the development of metabolic syndrome, including diabetes mellitus.
    • Maternal weight and body composition in the first trimester of pregnancy.

      Fattah, Chro; Farah, Nadine; Barry, Sinead C; O'Connor, Norah; Stuart, Bernard; Turner, Michael J; UCD Centre for Human Reproduction, Coombe Women and Infants University Hospital, , Dublin, Ireland. (2012-02-01)
      OBJECTIVE: Previous studies on weight gain in pregnancy suggested that maternal weight on average increased by 0.5-2.0 kg in the first trimester of pregnancy. This study examined whether mean maternal weight or body composition changes in the first trimester of pregnancy. DESIGN: Prospective observational study. POPULATION: We studied 1,000 Caucasian women booking for antenatal care in the first trimester of pregnancy. SETTING: Large university teaching hospital. METHODS: Maternal height and weight were measured digitally in a standardized way and Body Mass Index (BMI) was calculated. Maternal body composition was measured using segmental multifrequency Bioelectrical Impedance Analysis (BIA). Sonographic examination confirmed the gestational age and a normal ongoing singleton pregnancy in all subjects. MAIN OUTCOME MEASURES: Maternal weight, maternal body composition. RESULTS: The mean BMI was 25.7 kg/m(2) and 19.0% of the women were in the obese category (> or =30.0 kg/m(2)). Cross-sectional analysis by gestational age showed that there was no change in mean maternal weight, BMI, total body water, fat mass, fat-free mass or bone mass before 14 weeks gestation. CONCLUSIONS: Contrary to previous reports, mean maternal weight and mean body composition values remain unchanged in the first trimester of pregnancy. This has implications for guidelines on maternal weight gain during pregnancy. We also recommend that calculation of BMI in pregnancy and gestational weight gain should be based on accurate early pregnancy measurements, and not on self-reported or prepregnancy measurements.
    • Miscarriage after sonographic confirmation of an ongoing pregnancy in women with moderate and severe obesity.

      O'Dwyer, Vicky; Monaghan, Bernadette; Fattah, Chro; Farah, Nadine; Kennelly, Mairead M; Turner, Michael J; UCD Centre for Human Reproduction, Coombe Women and Infants University Hospital, Dublin, Ireland. vicky.odwyer@ucd.ie (2012)
      To compare the incidence of spontaneous miscarriage in women with moderate to severe obesity to that in women with a normal BMI after sonographic confirmation of the foetal heart rate in the first trimester.
    • The risk of caesarean section in obese women analysed by parity.

      O'Dwyer, Vicky; Farah, Nadine; Fattah, Chro; O'Connor, Norah; Kennelly, Mairead M; Turner, Michael J; UCD Centre for Human Reproduction, Coombe Women and Infants University Hospital, , Dublin 8, Ireland. vicky.odwyer@ucd.com (2012-02-01)
      OBJECTIVE: This study looked at the association between caesarean section (CS) and Body Mass Index (BMI) in primigravidas compared with multigravidas. STUDY DESIGN: We enrolled women at their convenience, in the first trimester after an ultrasound examination confirmed an ongoing pregnancy. Weight and height were measured digitally and BMI calculated. After delivery, clinical details were again collected from the Hospital's computerised database. RESULTS: Of the 2000 women enrolled, there were 50.4% (n=1008) primigravidas and 49.6% (n=992) multigravidas. Of the 2000 8.5% were delivered by elective CS and 13.4% were delivered by emergency CS giving an overall rate of 21.9%. The overall CS rate was 30.1% in obese women compared with 19.2% in the normal BMI category (p<0.001). In primigravidas the increase in CS rate in obese women was due to an increase in emergency CS (p<0.005) and in multigravidas the increase was due to an increase in elective CS (p<0.01). In obese primigravidas 20.6% had an emergency section for fetal distress. In obese multigravidas 17.2% had a repeat elective CS. CONCLUSION: The influence of maternal obesity on the increase in CS rates is different in primigravidas compared with multigravidas.