Obesity / Premature Births in U.S.

Why have we made a virtue of premature birth? Is this health crisis something the U.S. can be proud of?

How many children and adults suffer lifelong serious impairment because preterm birth has become socially acceptable and is even considered to be “normal” or even a “blessing” ?

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Obesity before pregnancy linked to earliest preterm births, Stanford/Packard study finds.

Women who are obese before they become pregnant face an increased risk of delivering their babies before 28 weeks of pregnancy, a new study of nearly 1 million California births has found.

Women who are obese before they become pregnant face an increased risk of delivering a very premature baby, according to a new study of nearly 1 million California births. The findings from the Stanford University School of Medicine provide important clues as to what triggers extremely preterm births, specifically those that occur prior to 28 weeks of pregnancy. The study, published in the July issue of Paediatric and Perinatal Epidemiology, found no link between maternal obesity and premature births that happen between 28 and 37 weeks of the normal 40-week gestation period. The disparity suggests that premature birth may have different causes at different stages of pregnancy.

“Until now, people have been thinking about preterm birth as one condition, simply by defining it as any birth that happens at least three weeks early,” said Gary Shaw, DrPH, professor of pediatrics and lead author of the new study. “But it’s not as simple as that. Preterm birth is not one construct; gestational age matters.”

Preterm births affect one in nine pregnancies, or more than a half-million U.S. babies per year. Prematurity can lead to lifelong health problems, such as cerebral palsy, developmental delays and impaired vision or hearing. Babies born before 28 weeks of pregnancy are at especially high risk.

High U.S. prematurity rates prompted the 2011 launch of the March of Dimes Prematurity Research Center at Stanford University School of Medicine, the first of five such centers the March of Dimes has planned across the country. The new findings are a product of the center’s work.

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Isn’t this an extraordinary burden to place on a tiny, unfinished fetus?

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God “creates” premature babies so everyone can “be amazed” and instructed by his cruelty –

Understanding the role of a pregnant woman’s weight

The study, which examined nearly all California births between January 2007 and December 2009, was the largest ever to look for population-based links between maternal obesity and prematurity. To focus on spontaneous preterm births, the researchers excluded from analysis women who were pregnant with twins or other multiples, as well as women with illnesses previously linked to prematurity, such as diabetes, high blood pressure or pre-eclampsia. After these exclusions, the team had 989,697 births to analyze. Births were classified by gestational age, and many factors about the mothers were considered in the analysis, including body mass index, race/ethnicity, whether they were first-time mothers, educational attainment, when prenatal care began, source of health insurance, maternal age and maternal height.

For first-time mothers, obesity was linked with a substantial increase in risk of delivery before 28 weeks of pregnancy. The risk was highest at the earliest gestational ages and also at the highest levels of obesity. For instance, non-Hispanic, white first-time mothers in the most obese category were six times more likely than normal-weight women to deliver a baby between 20 and 23 weeks.

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High U.S. prematurity rates prompted the 2011 launch of the March of Dimes Prematurity Research Center at Stanford University School of Medicine, the first of five such centers the March of Dimes has planned across the country. The new findings are a product of the center’s work.

Obese women having their second or later child were also more likely to deliver very early than normal-weight women, though the risk was less pronounced than for first-time mothers.

“Ideally, as the American College of Obstetricians and Gynecologists has already recommended, women should embark upon a healthy diet and exercise program before becoming pregnant,” said study co-author Deirdre Lyell, MD, associate professor of obstetrics and gynecology and an obstetrician at Lucile Packard Children’s Hospital Stanford.

“Women who are obese should also consider meeting their obstetrician to discuss and understand the risks beyond those identified in this research,” Lyell added, noting that obesity has previously been shown to raise women’s risk of such pregnancy and delivery complications as gestational diabetes, preeclampsia and cesarean section.

In general, African-American women face a greater risk of preterm delivery than other populations, so the researchers were surprised to find that the effect of obesity on early preterm delivery was not explained by women’s racial/ethnic background. The finding indicates that there is something about obesity itself that can trigger early birth, which may or may not be associated with other factors, such as socioeconomic patterns, that put African-American women at greater risk.

Trying to solve the puzzle

“This is a clue that informs what sort of research we should try next,” Shaw said. For example, the researchers plan to investigate the role of increased inflammation from obesity because this factor cuts across racial backgrounds. “We believe the inflammatory process is contributing to preterm birth, particularly at earlier gestational ages,” he said. “We’re at the edge of trying to solve this puzzle.”

 

Information about Stanford’s Department of Pediatrics is available at http://pediatrics.stanford.edu.

 

 

 

 

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9 thoughts on “Obesity / Premature Births in U.S.

  1. Re ‘obesity is a choice’:

    True, it is – though if heredity and illness (hypothyroidism, for example) you a ‘crap hand’, that choice may well be ‘either be drastically overweight, or do something even more drastic to not be so, e.g eating ***carefully*** (serious-level dieting) and *lots* of exercise might get your BMI down to thirty or so – which is ‘overweight verging on obese’.

    In order to get it into the magical 18-25 range – one might well need to eat less than a thousand calories per day and develop an exercise addiction on top of ’embracing anorexia’.

    I’ve called the latter ‘controlled anorexia’ – as in one’s weight hasn’t gotten low enough to be considered the clinical version. Otherwise, no difference: the obsession with calories, the lowered body temperature (95.8 F), the lowered heart rate (50 while sitting) the lowered metabolism (1180 cal / day), falling blood pressure, extreme insomnia…

    Oh, and feeling guilty if you didnt devote ALL of your time and energy to becoming fashionably thin, also – even if you actually got nothing out of it beyond a few faint words of praise amid constant urging to tighten the noose further…

    Yes, you do have a choice – but that choice may well be a choice between two demons.

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  2. Of course, obesity is a choice. When you compare people in the US with people in the rest of the world, statistics point to people over there choosing to eat more.
    However, there is also the addiction component to over-eating. Because I am a person with an eating disorder, I have to watch myself so I do not fall back into old patterns. Food becomes a stim, the way it is for most obese people (ASDs are not the only people who stim).
    Some people are also metabolically more inclined towards obesity. That means that they must work much harder than the rest of us to remain under the limit.
    Since having babies is NOT a human right, and because humans are thought to be more than instinct (as if), we have an obligation to make half-way decent choices about changing life-patterns before becoming pregnant. This goes for the potential fathers as well, because sperm is influenced by general health.
    Physical laws are physical laws. Once we know something, we need to grow up and accept guilt/honor for making the choices we do.

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    • Yes; you understand and acknowledge that the “laws of nature” can’t be rewritten to suit each person. Tell that to an American? It’s a personal insult! They’ve been taught for generations now that the universe (for fundamentalists, the u = Jesus) exists for satisfying their private emotional needs, real or not. Now that school is starting again, parents are pulling children out of school for such “issues”: groups of parents are fighting each other and bullying teachers – and vice versa. No one seems to put the kids first…I truly think that psychological neoteny is so advanced that many “adults” have the cognitive capacity of 5-year olds. When I was in school in the 50s-60s it was NOTHING LIKE THIS so the contrast is mind-boggling.

      It pains me to see so many children that are damaged during gestation, are born premature or neglected, with real physical deficits, are being ‘swept under the rug” of Autism, so that “no one” (mother, father, doctor) needs to take a hard look at their own behavior. “God sent you a
      special child for a reason” – disgusting. Is god going to send nursing care, medical therapies and treatments, for the life time of the child and millions of dollars to pay for it? And what about the subjective experience of the child? People assume that if they can get a disabled person to smile – well – that’s all there is to human existence.

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  3. Just the fact that every health issue that I have where brushed off as being caused by my weight. A broken wrist was called a tendinitis for 10 years it took that I bugged my doc so offen that it finally prescribed the x ray. I got a problem with that constant dismissing and not running test because of the weight.

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    • I can’t figure out how you got from the content of the post – an article on obesity implications for premature birth – to it being about your medical history. Obesity does cause many health complications. I can’t offer any advice.

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  4. Obesity is not a choice , let’s ask the real question why so many woman have the tsh over 2.5 (wich is not medicamented until the 10 treshold) but just a 4 is infertility or miscarriage. And it is a factor for 80% of the premature baby. Also one of the only biological cause of add

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    • Obesity is a choice: The human body operates on the same Laws of physics, chemistry, thermodynamics, mechanics as any other living creature. Women are LIED TO by the diet fad – pill = medication industry because it keeps them in a cycle of $$$$$$$ forking over money for useless products. Doctors pander to childish people who want easy “miracle” excuses and fixes. Americans are emotionally infantile and will believe anything.

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      • Sadly I am a living proof that the belief of obesity is a choice is basically victim blaming techniques. Being blamed for the extra weight was a easy excuse to not run any test . I’m 38 now invalid for the rest of my life because the freaking pain management was never taken seriously. I got more hair on the chest than a normal male , yet I had to argue and prove my willingness and effort to eat well being active over and over again. Just to be dismissed and blamed for the obesity that was destroying my articulations. It took my daughter illness and staying with her all the time to get called out for my not eating enough, to be moving way to much and finally have a medical professional tell me that in logic and usual practice I’m a aberration.

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