Gestational Weight - Smart-phone Calculator: A Case Study of Pregnant Women in India | Chapter 11 | Advancement and New Understanding in Medical Science Vol. 1

Pregnancy is an anabolic state with increased nutritional requirements to support the growth and metabolism of maternal and fetal tissues, nutrient storage in the fetus, and preparation of maternal tissues for lactation. International IOM 2009 recommendations for gestational weight gain during pregnancy are highly contested in Asia by Indians and East-Asian scholars (China, Korea, Japan etc..). They even use "Asian adapted" overweight and obese classifications (e.g. obesity ≥ 27.5 kg/m² instead of 30 kg/m²). The study investigates the possibilities of establishing quickly a Smart-Phone calculator for Optimal Gestational Weight Gain, especially for Indian Pregnant women.

Four years ago we demonstarted that if we chose as perequisite rationale that the maternal optimal gestational weight in term pregnancies (optGWG) is to have Appropriate for Gestational Age (AGA) term newborns (by definition 80% of a neonatal population, with 10% of SGA -small for gestational age- as well as 10% of LGA -Large for gestational age-), there is an association with maternal PRE-pregnancy Body Mass Index (ppBMI), and that this association is a linear curve (y= ax+b).

We propose then an alternative solution for Indian scientists/epidemiologists to confirm in the Indian population our preceding findings and establish in India their specific linear equation knowing the specific SGA-LGA definitions of term newborns in India.

It will be easy to make this linear equation accessible everywhere on smartphones for health workers and women themselves. The Indian calculator will give therefore indispensable councils since the beginning of pregnancy to each pregnant woman, and should be useful also for the great "Indian diaspora" around the planet (e.g. Mauritius, Trinidad and Tobago, Fiji, French overseas territories and others), where obesity is a huge rising problem in this community. The study concluded that we could lower probably the rate of low-birthweights babies in lean women (by higher GWG than the international IOM 2009 recommendations) by using the Indian Calculator.

Author(s) Details:

Pierre-Yves Robillard,
Service de Néonatologie, Centre Hospitalier Universitaire Sud Réunion, La Réunion, France and Centre d’Etudes Périnatales Océan Indien (CEPOI), Centre Hospitalier Universitaire Sud Réunion, La Réunion, France.

Please see the link here: https://stm.bookpi.org/ANUMS-V1/article/view/13022

A Retrospective Analysis on the Urgent Need to Optimize Gestation Weight in Overweight/Obese Women to Lower Maternal-Fetal Morbidities: 59000 Singleton Term Pregnancies | Chapter 1 | Advancement and New Understanding in Medical Science Vol. 1

Objective: This study primarily focuses on examining the criticalities of optimizing gestational weight for obese women to reduce fatal morbidities. We retrospectively did a simulation applying the optimal gestational weight gain (optGWG) equation (that we proposed in 2018) on our population, and observed if its effect on maternal/fetal morbidities in singleton term pregnancies (≥37 weeks).

Design: This is a Retrospective observational study.

Setting: The setting for this study was in a single large tertiary maternity unit in Reunion Island, Indian Ocean, overseas French department.

Population or Sample: All consecutive singleton births delivered at the Centre Hospitalier Universitaire Hospitalier Sud Reunion's maternity was the chosen population for this study. A standardized epidemiological perinatal database was used here.

Methods: This study employed mathematical simulation on a 19-year historical cohort (2001-2019)'. Data was presented as numbers and proportions for categorical variables and as mean and Standard Deviation (SD) for continuous ones.

Main Outcome Measures: Five Maternal/fetal morbidities were measured for this study.

Results: Beginning with overweight women, and enlarging the effect with the rise of different obesities (class I to III) and considering maternal pre- pregnancy BMI (ppBMI), individualized counselling women on their GWG (optimal gestational weight gain, optGWG) lowers significantly maternal/ fetal morbidities: in a logistic regression model among overweight/obese women, with the outcome optGWG, several morbidities have a negative coefficient as independent factors: cesarean-section, birthweight ≥ 4000 g, term preeclampsia, lowering the effect of rising maternal ppBMI per increment of 5 kg/m² (coefficient -0.13), all p < 0.001. Dietary and lifestyle interventional studies have reduced GWG by 0.7kg or 3.7kg and had no effect on other pregnancy and birth outcomes including GDM, PE, PIH, LGA and macrosomic infants.

We propose as a prediction to be verified in future prospective studies that a follow-up and counselling since the first prenatal visit should also lower gestational diabetes mellitus rates.

Conclusion: We may have significant health (and cost) benefits by lowering c-section rates, term preeclampsia, macrosomic babies and LGA babies in overweight/obese women and low-birthweight babies in lean women. We may have much to win from reducing weight gain during pregnancy in overweight/obese women. It is urgent to verify and establish in all continents the specific linear curve of optGWG for each geographic/ethnic area.

Author(s) Details:

Pierre-Yves Robillard,
Service de Néonatologie, Centre Hospitalier Universitaire Sud Réunion, Saint-Pierre Cedex, La Réunion, France and Centre d'Etudes Périnatales Océan Indien (CEPOI), Centre Hospitalier Universitaire Sud Réunion, Saint-Pierre Cedex, La Réunion, France.

Gustaaf Dekker,
Department of Obstetrics & Gynaecology, University of Adelaide, Robinson Institute, Lyell McEwin Hospital, Australia.

Malik Boukerrou,
Centre d’Etudes Périnatales Océan Indien (CEPOI), Centre Hospitalier Universitaire Sud Réunion, Saint-Pierre Cedex, La Réunion, France and Service de Gynécologie et Obstétrique, Centre Hospitalier Universitaire Sud Réunion, BP 350, 97448 Saint-Pierre Cedex, La Réunion, France.

Brahim Boumahni,
Service de Neonatologie, Centre Hospitalier Universitaire Sud Reunion, Saint-Pierre Cedex, La Reunion, France.

Thomas C Hulsey,
Department of Epidemiology, School of Public Health, West Virginia University, Morgantown WV, USA.

Marco Scioscia,
Department of Obstetrics and Gynaecology, Policlinico of Abano Terme, Abano Terme (PD), Italy.

Please see the link here: https://stm.bookpi.org/ANUMS-V1/article/view/12998