Abnormal maternal body mass index and obstetric and neonatal outcome

Objective.?The objective of this study is to examine the effects of abnormal maternal body mass index (BMI), either underweight or severe or morbid obesity (BMI >35), on obstetrical and neonatal outcomes.

Methods.?A three-year period (2.007–2.009) observational retrospective study was carried out in Granada (Spain). Women were categorized by first ten weeks of pregnancy BMI, according to World Health Organization (WHO) into three groups: underweight (<18.5), normal (20–24.9), and severe or morbid obese (>35). Obstetrical and neonatal outcomes were evaluated using normal group as reference after suitable adjustments for confounding factors.

Results.?3.016 patients out of 12.781 single births were included. Maternal BMI classified 168 women (5.5 %) as underweight, 2.597 (86.1%) as normal, and 251 (8.3%) as severe or morbidly obese. As compared to normal women, underweight women were younger, and class II or III obese showed higher parity and higher incidence of hypertension disorders and Diabetes Mellitus. After controlling for these confounders, underweight women showed increased adjusted risk of oligohydramnios and low birth weight babies, and severe or morbidly obese women had an increased adjusted risk of Streptococcus Group B colonization, induction of labour, elective and emergency cesarean section, fetal macrosomia, fetal acidosis at birth, and perinatal mortality.

Conclusions.?Severe or morbid obesity were associated with an increased risk of adverse perinatal outcome and mortality and should be managed as high-risk pregnancies.     

肥胖型与非肥胖型多囊卵巢患者的内分泌特点及临床治疗方案分析

目的分析肥胖型与非肥胖型多囊卵巢综合征（PCOS）患者的内分泌、代谢特征及相应的治疗方案。方法根据患者体重指数将2009年1月至2012年5月于我院就诊的86例多囊卵巢综合征患者分为肥胖组与非肥胖组，对比分析两组患者糖耐量受损、胰岛素抵抗、胰岛素曲线下面积，及其给予的治疗方案。结果肥胖组患者胰岛素抵抗率明显高于非肥胖组患者，有胰岛素抵抗的患者联合用药比单用药效果更明显，且各项指标差异均有统计学意义（P〈0．05）。结论肥胖型患者大多数存在胰岛素抵抗，非肥胖型患者亦有相当患者存在胰岛素抵抗，联合用药比单用药效果更明显。     

Managing patients with obesity in the post COVID-19 world: Time to sharpen the saw

The clash of the dual pandemics – COVID-19 and obesity (Chua et al., 2020) [1], threatens to exponentially increase the rates of obesity, which is a risk factor for severe COVID-19 and death (Garg et al., 2020; Peng et al., 2020; Wu et al., 2020; Kass et al., 2020) [[2], [3], [4], [5]]. We need to urgently find solutions to halt this vicious circle. Where do we begin?Our patients – who are often our best teachers. In my clinical practice, I have observed disparate responses among my patients in response to the pandemic. This highlighted the importance of understanding the factors underlying motivation and provided important clues on what clinicians can do to help our patients create a virtuous circle towards positive health outcomes.     

安徽省部分地区农村老年人肥胖现状及影响因素

目的了解安徽省农村老年人肥胖现状及影响因素，并探讨其与慢性病的关系，为提高安徽省农村老年人健康生活质量提供依据。方法采用分层随机整群抽样的方法，对751名60岁以上老年人进行问卷调查和身高、体重等指标的测量。结果在有效的743份问卷中，BMI法测量有52名肥胖者，占总人数的7．0％，其中女性多于男性（P〈0．05）；WHR法测量有551名腹型肥胖者，占总人数的74．2％，女性高于男性（P〈0．05），70～75岁达到高峰；单因素χ^2检验分析显示，性别、经济来源、家人外出务工情况、吸烟、甜食为肥胖的主要影响因素；同时，肥胖者高血压、胆囊炎／胆结石的患病率明显高于正常体重者（P〈0．05）。结论安徽省部分地区农村老年肥胖尤其是腹型肥胖现状十分严峻，实施防治肥胖的干预措施是必要的。     

The 1999 Neuroendocrine Workshop on Food Intake, Energy Metabolism and Obesity, San Diego, CA, USA, 9–11 June 1999

The recent American Endocrine Society Annual Workshop was attended by over 125 students, senior investigators and Fellows. The workshop focused on the latest developments in central nervous system (CNS) mechanisms (mainly peptidergic) that influence food intake and energy expenditure, and the biological consequences of altered energy states on reproduction.