Pre-pregnancy overweight and obesity prevalence and relation to maternal and perinatal outcomes.

OBJECTIVE: To identify the prevalence of pre-pregnancy overweight/obesity in pregnant women and its relationship with socio-demographic factors and to describe the maternal and perinatal outcomes in a Barcelona hospital (Spain). METHOD: A descriptive cross-association study, with retrospective data collection, was performed Barcelona Hospital. The data of 5447 pregnant women who delivered at >=23 weeks of gestation were included. Body Mass Index (BMI) data were categorised into World Health Organization classifications. p values <.05 (two-tailed) were considered significant. Logistic regression models were performed. RESULTS: The prevalence of pre-pregnancy obesity was 8.4% and 18.9% for overweight. Gestational diabetes was more frequent in pre-pregnancy overweight/obesity (OR 1.92: 95% CI 1.54-2.40 and OR 3.34: 95% CI 2.57-4.33), as were preeclampsia (OR 2.08: 95% CI 1.55-2.79 and OR 3.35: 95% CI 2.38-4.71), induction of labour (OR 1.19: 95% CI 1.02-1.38 and OR 1.94: 95% CI 1.57-2.10), caesarean section (OR 1.41: 95% CI 1.21-1.65 and OR 2.68: 95% CI 2.18-3.29), prematurity (OR 1.28: 95% CI 1-1.65 and OR 1.79: 95% CI 1.32-2.44) and macrosomia (OR 1.87: 95% CI 1.43-2.46 and OR 2.03: 95% CI 1.40-2.93). CONCLUSIONS: One in four pregnant women had pre-pregnancy overweight or obesity. This study shows the relationship between pre-pregnancy overweight or obesity with adverse maternal and perinatal outcomes.

Effectiveness of a Step Counter Smartband and Midwife Counseling Intervention on Gestational Weight Gain and Physical Activity in Pregnant Women With Obesity (Pas and Pes Study): Randomized Controlled Trial.

BACKGROUND: Women who are pregnant and have obesity and excessive gestational weight gain (GWG) present a higher risk of maternal and perinatal complications. The use of mobile apps and a wristband during pregnancy may contribute to promoting healthy lifestyles and, thus, improving maternal and neonatal health. OBJECTIVE: This study aims to evaluate the effectiveness of a complex digital health intervention, using a smartband and app with midwife counseling, on GWG and physical activity (PA) in women who are pregnant and have obesity and analyze its impact on maternal and perinatal outcomes. In addition, we aim to study the frequency of use, usability, and satisfaction with the mobile apps used by the women in the intervention group. METHODS: A parallel, 2-arm, randomized controlled trial was conducted. A total of 150 women who were pregnant and had obesity were included. The intervention group received a complex combined digital intervention. The intervention was delivered with a smartband (Mi Band 2) linked to the app Mi Fit to measure PA and the Hangouts app with the midwife to provide personal health information. The control group received usual care. The validated Spanish versions of the International Physical Activity Questionnaire-Short Form and the System Usability Scale were used. Satisfaction was measured on a 1- to 5-point Likert scale. RESULTS: We analyzed 120 women, of whom 30 (25%) were withdrawn because of the COVID-19 pandemic. The median GWG in the intervention group was 7.0 (IQR 4-11) kg versus 9.3 (IQR 5.9-13.3) kg in the control group (P=.04). The adjusted mean GWG per week was 0.5 (95% CI 0.4-0.6) kg per week in the control group and 0.3 (95% CI 0.3-0.4) kg per week in the intervention group (df=0.1, 95% CI -0.2 to 0.03; P=.008). During the 35 and 37 gestational weeks, women in the intervention group had higher mean PA than women in the control group (1980 metabolic equivalents of tasks-minutes per week vs 1386 metabolic equivalents of tasks-minutes per week, respectively; P=.01). No differences were observed between the study groups in the incidence of maternal and perinatal outcomes. In the intervention group, 61% (36/59) of the women who were pregnant used the smartband daily, and 75% (44/59) evaluated the usability of the Mi Fit app as excellent. All women in the intervention group used the Hangouts app at least once a week. The mean of the satisfaction scale with the health counseling app and midwife support was 4.8/5 (SD 0.6) points. CONCLUSIONS: The use of a complex mobile health intervention was associated with adequate GWG, which was lower in the intervention group than in the control group. In addition, we observed that the intervention group had increases in PA. No differences were observed in maternal perinatal complications. TRIAL REGISTRATION: ClinicalTrials.gov NCT03706872; https://www.clinicaltrials.gov/ct2/show/NCT03706872.

Pre-pregnancy overweight and obesity prevalence and relation to maternal and perinatal outcomes.

OBJECTIVE: To identify the prevalence of pre-pregnancy overweight/obesity in pregnant women and its relationship with socio-demographic factors and to describe the maternal and perinatal outcomes in a Barcelona hospital (Spain). METHOD: A descriptive cross-association study, with retrospective data collection, was performed Barcelona Hospital. The data of 5447 pregnant women who delivered at >=23 weeks of gestation were included. Body Mass Index (BMI) data were categorised into World Health Organization classifications. p values <.05 (two-tailed) were considered significant. Logistic regression models were performed. RESULTS: The prevalence of pre-pregnancy obesity was 8.4% and 18.9% for overweight. Gestational diabetes was more frequent in pre-pregnancy overweight/obesity (OR 1.92: 95% CI 1.54-2.40 and OR 3.34: 95% CI 2.57-4.33), as were preeclampsia (OR 2.08: 95% CI 1.55-2.79 and OR 3.35: 95% CI 2.38-4.71), induction of labour (OR 1.19: 95% CI 1.02-1.38 and OR 1.94: 95% CI 1.57-2.10), caesarean section (OR 1.41: 95% CI 1.21-1.65 and OR 2.68: 95% CI 2.18-3.29), prematurity (OR 1.28: 95% CI 1-1.65 and OR 1.79: 95% CI 1.32-2.44) and macrosomia (OR 1.87: 95% CI 1.43-2.46 and OR 2.03: 95% CI 1.40-2.93). CONCLUSIONS: One in four pregnant women had pre-pregnancy overweight or obesity. This study shows the relationship between pre-pregnancy overweight or obesity with adverse maternal and perinatal outcomes.

New care challenges: detection of anxiety in pregnant women at risk. / Nuevos retos en los cuidados: detección de la ansiedad en la gestante de riesgo.

Pregnancy is considered a period of well-being and happiness in a woman's life. However, these expectations are occasionally disrupted by maternal and/or foetal problems, and situations of vulnerability develop. The evidence suggests that pregnancy-related anxiety is strongly associated with adverse maternal and child outcomes such as pospartum depression, premature birth, low birth weight, and health and mental development problems in childhood. On the other hand, it is evident that obstetric and perinatal complications increase the risk of pospartum anxiety and depression while anxiety levels increase as the gestational risk increases. Current recommendations about the care and treatment of mental health problems in women during pregnancy and up to one year after delivery are aimed at recognition, evaluation, care and treatment, ensuring continuity of care. The aim of this study was to recognise anxiety in pregnant women at risk, from the definition of model cases, in order to enhance critical thinking in both health professionals and pregnant women and thus improve the care of these patients.

Efectividad de una intervención digital compleja en los hábitos alimentarios de gestantes con obesidad preconcepcional / Effectiveness of a complex digital intervention on eating habits in pregnant women with pre-pregnancy obesity

Objetivo: Evaluar la efectividad de una intervención digital compleja, en gestantes con obesidad, con la provisión de consejos sobre hábitos alimentarios y el soporte virtual de una matrona a través de una app, respecto a los hábitos alimentarios, así como analizar el grado de satisfacción global con la intervención digital. Métodos: Se realizó un ensayo clínico paralelo aleatorizado con dos brazos 1:1 con grupo intervención (GI) y grupo control (GC). Se incluyeron 150 gestantes con obesidad preconcepcional. Ambos grupos recibieron el control prenatal habitual. La intervención en el GI fue el uso de una pulsera de actividad y la recepción de consejos sobre hábitos alimentarios mediante una app, y el soporte virtual de una matrona. Se utilizó el «Cuestionario de hábitos alimentarios para pacientes con sobrepeso y obesidad» en una escala Likert de 1 a 5. Las pruebas estadísticas fueron bilaterales y se evaluaron a un nivel α de 0,05. Los análisis se realizaron con SPSS v. 25 y SAS v. 9.4.Resultados: Se analizaron 110 (73,3 % del total) mujeres. En el GI la puntuación media de los hábitos alimentarios fue mayor que en el GC (3,49 ± 0,36 vs. 3,35 ± 0,41; p= 0,056), pero no se observaron diferencias estadísticamente significativas. En el GI, la puntuación media del consumo del tipo de alimentos fue mayor que en el GC (3,49 ± 0,78 vs. 3,18 ± 0,71; p= 0,019). El grado de satisfacción global fue de 4,76 ± 0,6 puntos de media. Conclusiones: El uso de una intervención digital compleja fue efectivo en la mejora del consumo del tipo de alimentos respecto a las gestantes que solo recibieron el control prenatal habitual. (AU)

Objective: To assess the effectiveness of a complex digital health intervention, in pregnant women with obesity, by means of an app for advice eating habits and a virtual midwife’s support, regarding their eating habits, and also to analyze the global satisfaction with digital intervention.Methods: A parallel randomized clinical trial with two arms 1:1 with intervention group (IG) and control group (CG) was conducted. 150 pregnant women with pre-pregnancy obesity were included. Both groups received usual prenatal care. The intervention, in the IG, was delivered with smartband and an app providing advice about eating habits and with a virtual midwife to support women. The validated «Questionnaire of eating habits for patients with overweight and obesity» was administrated and measured using a 1-to-5-point Likert scale. Statistical tests were two-sided and evaluated at an α level of 0.05. Analyzes were performed with SPSS v. 25 and SAS v. 9.4.Results: 110 (73.3% of the total) women were analyzed. In the IG, the mean score for eating habits was higher than in the CG (3.49 ± 0.36 versus 3.35 ± 0.41; p=0.056), but no statistically significant differences were observed. In the IG, the mean score for the intake of the type of food was higher than in the CG (3.49 ± 0.78 versus 3.18 ± 0.71; p=0.019). The mean of global satisfaction was 4.76 ± 0.6 points. Conclusions: The use of a complex digital intervention was effective in improving the intake of the type of food compared to pregnant women who only received usual prenatal care. (AU)

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Nuevos retos en los cuidados: detección de la ansiedad en la gestante de riesgo / New care challenges: detection of anxiety in pregnant women at risk

Aunque el embarazo se considera un periodo de bienestar y felicidad en la vida de la mujer, en ocasiones estas expectativas se ven alteradas por problemas a nivel materno o fetal, generándose situaciones de vulnerabilidad. La evidencia indica que la ansiedad en el embarazo está fuertemente asociada con resultados maternos e infantiles adversos como depresión posparto, parto prematuro, bajo peso al nacer y problemas de salud y desarrollo mental en la infancia. Por otra parte, se evidencia que las complicaciones obstétricas y perinatales incrementan el riesgo de ansiedad y depresión posparto, y que los niveles de ansiedad aumentan conforme lo hace el riesgo gestacional. Las recomendaciones actuales acerca del cuidado y el tratamiento de los problemas de salud mental en las mujeres durante el embarazo y hasta un año después del parto están dirigidas al reconocimiento, evaluación, cuidado y tratamiento, asegurando la continuidad asistencial. El objetivo de este artículo se centra en el reconocimiento de la ansiedad en la gestante de riesgo, a partir de la definición de casos modelo, con el fin de potenciar el pensamiento crítico tanto en los profesionales sanitarios como en las gestantes y mejorar, de este modo, el cuidado de estas pacientes

Pregnancy is considered a period of well-being and happiness in a woman's life. However, these expectations are occasionally disrupted by maternal and/or foetal problems, and situations of vulnerability develop. The evidence suggests that pregnancy-related anxiety is strongly associated with adverse maternal and child outcomes such as pospartum depression, premature birth, low birth weight, and health and mental development problems in childhood. On the other hand, it is evident that obstetric and perinatal complications increase the risk of pospartum anxiety and depression while anxiety levels increase as the gestational risk increases. Current recommendations about the care and treatment of mental health problems in women during pregnancy and up to one year after delivery are aimed at recognition, evaluation, care and treatment, ensuring continuity of care. The aim of this study was to recognise anxiety in pregnant women at risk, from the definition of model cases, in order to enhance critical thinking in both health professionals and pregnant women and thus improve the care of these patients