Молодежный инновационный вестник

2415-7805

Федеральное государственное бюджетное образовательное учреждение высшего образования "Воронежский государственный медицинский университет имени Н.Н. Бурденко" Министерства здравоохранения Российской Федерации

10560

Conference Proceedings

Epidemiology of fat metabolism disorders in pregnant women in an obstetric hospital

Filonova

Нина Yrievna

nin.filonova@gmail.comhttps://orcid.org/0009-0000-3218-8480Filimonova

Ekaterina Sergeevna

katyunya.filimonova.02@mail.ruhttps://orcid.org/0009-0005-6928-6021Khodasevich

Ellina Valerievna

Candidate of Medical Sciences, Associate Professor  elina.hodasevich@yandex.ruhttps://orcid.org/0000-0002-2592-2592

Voronezh State Medical University named after N. N. Burdenko

30062025

1413740

28022025

25032025

2025

Introduction: Women's and children's health, as well as reproductive health, remain important topics in the healthcare system. The successful realization of a woman's reproductive potential depends on many factors, including metabolic balance, a healthy lifestyle, and genetic aspects. However, exogenous factors can negatively affect the process of fertilization and the course of pregnancy. One of the urgent problems is obesity, which affects the reproductive function and health of women. According to WHO, in 2022, 44% of women were overweight, which increases the risks to the health of the mother and fetus. Pre-pregnancy training, including normalization of body weight and rejection of bad habits, can reduce obstetric and perinatal risks. The aim of the study: was to determine the prevalence of obesity in obstetrichospitalpatientsand the frequencyof pre-pregnancy trainingamongwomenwithmetabolicdisorders. Materials and methods: A survey of 69 pregnant women in an obstetric hospital was conducted. The study included an analysis of exchange cards, birth history, and survey results. The participants were divided into groups by body mass index (BMI), and weight gain was assessed. Results: The average age of the participants was 29.4 years, the average BMI was 25.6 kg/m2. 39.1% of the patients were overweight or obese. Full-term pregnancies were more common in women without obesity. The average weight gain during pregnancy was 11.9 kg. 80.6% had planned pregnancies. Only 16.1% of the participants were tested for infections. Most of the women started taking vitamins, but the level of awareness about the need for comprehensive training was low. Conclusion: The studyrevealed a highproportion of overweightandobesepregnant women,whichhighlights the need for weightcontrolprograms.Obesity is associatedwith a lowchanceof full-termpregnancyand a highrisk of gestationaldiabetes.Despitethefactthatmanypregnant women are aware of the importance of planning, the level of preventiveexaminationsandtrainingwasinsufficient.Measures are neededtoraisehealthawarenessandprepareforpregnancy,especiallyamongoverweightwomen.

pregnancyobesitypre-pregnancy preparation

беременностьожирениепредгравидарная подготовка

Introduction. The health of women, children, and reproductive health has always remained an urgent topic in the healthcare system. There are many conditions predisposing to the successful realization of a woman's reproductive potential. Among the factors are the normal balance of metabolic processes, maintaining a healthy lifestyle for women, men, the father of the child, genetic and infectious factors, life history, and much more. At the same time, there are many non-permanent exogenous causes that change the process of fertilization, the normal course of pregnancy, and its outcome, so not all pregnancies proceed physiologically. One of the diseases that changes metabolic processes, having a negative impact on reproductive function, a woman's health is obesity [1]. An urgent problem in obstetrics is the current increase in the average body mass index for pregnant women (26.8%) and women planning pregnancy. According to WHO data for 2022, 44% of women aged 18 and over were overweight. According to statistics, the global incidence of obesity among pregnant women ranges from 12 to 28% and has no downward trend. Against the background of obesity and metabolic disorders, anovulation, infertility, and many other serious complications often develop, increasing the growth of subsequent maternal and fetal diseases, which affects the overall health of the population in the Russian Federation. [2] A number of measures that allow a woman and her partner to competently approach pregnancy planning, including normalization of body mass index, are called pre-pregnancy preparation [3]. The purpose of preventive measures is to improve the health of the mother and child, which reduces obstetric and perinatal risks. The chances of successful conception, pregnancy and the birth of a healthy child increase when partners give up bad habits and lifestyle modifications, normalize body weight, and take measures with the participation of a doctor to correct the level of sex hormones, eliminate vitamin and trace element deficiencies, and treat existing diseases [4].The aim of the study was to identify the prevalence of obesity in obstetric hospital patients and to determine the frequency and nature of the use of pre-pregnancy preparation for women with metabolic disorders.Materials and methods. A complete random survey was conducted of 69 pregnant women who were hospitalized in the Department of Pathology of pregnancy No. 3 at the time of the study. Exchange cards, birth histories, and survey results became the material for the study. The survey was conducted over 2 randomly selected business days between 11/28/2024 and 12/9/2024. The survey of pregnant women at the obstetric hospital included a study of the medical history, the course of pregnancy, and the nature of women's preparation for pregnancy. All pregnant women surveyed were divided into groups by body mass index (BMI). An assessment of the monthly weight gain in all groups was carried out in a comparative aspect.Inclusion criteria: consent to participate in the survey.Exclusion criteria: refusal to participate in the survey, incorrectly filled out questionnaires.The results of the study. The average age of all patients participating in the study was 29.47.2 years. The average BMI of the examined patients was 25.66.2 kg/m2. A total of 27 (39.1%) patients were obese and overweight, 9 (13%) were overweight, 9 (13%) had grade 1 obesity, 6 (8.7%) had grade 2 obesity, 1 (1.4%) had grade 3 obesity, and 4 (5.8%). The remaining 55.1% had a normal BMI. The average gestation period in the respondents was 36.12.5 weeks, full-term pregnancy (37 weeks or more) was observed in 32 patients without obesity (46%), 11 (14.1%) with obesity. 25 out of all the surveyed (36.8%) had their first pregnancy, and 1 IVF (1.4%). 31 (44.9% ) patients had their first labor, and 22 (31.9%) had a history of 3 or more births.Weight gain during the entire pregnancy ranged from 11.96.05 kg, 14 patients (20.3%) gained 15 kg or more. The average weight gain in non-obese patients with full-term pregnancy was 12.8 kg, the average weight gain in obese patients with full-term pregnancy was 10 kg. The average monthly weight gain was 33017 g in 23 people (33%), while the average weight gain in obese people was 24031 g in 8 people (12%). When assessing the exchange charts, a glucose tolerance test was performed in only 16 patients (23.1%), which revealed gestational diabetes in 4 respondents (5.8%), type 2 diabetes was observed in 1 patient (1.4%). 62 pregnant women answered the questionnaire correctly, where it was revealed that 50 (80.6%) had planned pregnancy, 12 (19.4%) - unplanned, and among non-obese women, 48.3% had planned pregnancies, 11.3% had unplanned pregnancies, 30.6% of obese patients had planned pregnancies, 6.5% had unplanned pregnancies, 57(91.9%) of respondents had self-induced pregnancies, 5 (8.1%) of patients had IVF, among women with With a normal body mass index, 51.6% became pregnant on their own, 1.6% with medical intervention, however, 38.7% of obese women became pregnant on their own, 6.5% did not become pregnant on their own., 22 (35.5%) had difficulties with pregnancy, 21% of non-obese women had difficulties, 41.9% did not, but 21% of obese women had difficulties, 16.1% did not. The average duration of infertility in 19 (30.6%) of the respondents was 2.80.3 years. 25 (40.3%) pregnant women were examined together with the father of the child during pregnancy planning, 37 (59.7%) were not examined at all. Non-obese women accounted for 24.2% of the surveyed, 38.7% of the untreated, and 16.1% of obese women, 19.4% of obese women were not examined. The survey was based on the diagnosis of various diseases: 10 (16.1%) of the respondents underwent an analysis to detect genital tract infections, 52 (83.9%) did not undergo this examination, while 6.5% of women without obesity passed this analysis, 60% did not pass, among obese women who passed the analysis was only 9.7%.When preparing women for pregnancy, the examination also assessed the results of 1) a general blood test in 26 (41.9%) of the respondents, non-obese women who passed the test accounted for 24.2%, obese 16.1%; 2) biochemical blood analysis in 42 (67.7%), non-obese women accounted for 14.5%, 48.4% did not pass, obese 9.7%, 25.8% did not pass; 42 (67.7%) patients gave up bad habits in preparation for pregnancy and subsequently during its onset, 20 (32.2%) They haven't given up their bad habits. Among women with a normal BMI, 43.5% refused, 19.4% could not refuse, among obese women, 24.2% refused, 11.3% could not refuse. Dietary changes during pregnancy occurred in 15 (24.2%), non-obese women with a change in diet accounted for 13%, 50% of the diet did not change, obese women 11.3%, unchanged - 11.3%. The diet included high-calorie foods, changes in the nature and type of heat treatment of food, the frequency of snacking, 24 (38.7%) of the respondents followed a diet, 21% of non-obese patients followed a diet, 42% did not follow a diet, among obese patients: 19.4% followed a diet, 24.2% did not. 5 (8.1%) people were vaccinated before pregnancy. The survey also examined the quality of drug pre-treatment: 22 (35.5%) people took vitamin D, 19.4% of non-obese patients took vitamin D, 45.1% did not take it, 16.1% took vitamin D with obesity, 17.7% did not take it. 23 people (37%) took iron supplements, and 25.8% of non-obese patients took the drugs, 38.7 did not take them, 11.3% took them among obese patients, and 22.6 did not take them. Folic acid was taken by 33 (53.2%), 35.5% of non-obese patients took it, 29% did not take it, 17.7% took it with obesity, 16.1% did not take it. 10 (16.1%) people jointly took folic acid, iron, vitamin D, iodine preparations 3 (4.8%), multivitamin complexes 6 (9,7%) ,1(1,62%) inositol, didrogesterone - 3 (4.9%). Conclusion. The proportion of overweight and obese pregnant women in a random BMI study in an obstetric hospital was 39.1%. This may indicate the need for additional weight control and obesity prevention programs among women of reproductive age. Full-term pregnancies are more common in women without obesity and less common in women with obesity, which highlights the link between weight and pregnancy outcomes. The study highlights the importance of body weight control in women of reproductive age to improve pregnancy outcomes. Obesity is associated with lower chances of full-term pregnancy and a higher risk of gestational diabetes. More than half of the pregnancies were planned, which indicates the increased responsibility of mothers in family planning and the importance of pre-pregnancy training. Nevertheless, the identified cases of difficulties in pregnancy, which occur more often with obesity, emphasize the importance of preventive examinations. Although many women underwent preventive examinations, more than 80% did not undergo infection screening. This may indicate a lack of awareness and accessibility of necessary medical services. Most of the patients started taking vitamins and medications to prepare for pregnancy, which is a positive development. However, only a few of them took the full range of necessary components, for example, the use of vitamins such as folic acid was common, but the use of other supplements such as vitamin D and iron supplements was significantly lower, especially among obese women. Although some patients changed their eating habits and gave up bad habits, more than one third of women continued to smoke, which can negatively affect the health of the mother and fetus. Since most of the study participants have already experienced childbirth, this may also influence their approach to pregnancy and their preparedness for potential complications. The results obtained indicate a low quality of preparation of the subjects for the onset of pregnancy, the presence of overweight in pregnant women, diabetes mellitus, and the lack of measures taken in the presence of weight abnormalities. The study group has a low level of awareness about the future quality of life of the child in case of impaired metabolic processes of the mother, as well as in the presence of bad habits, insufficient preparation for the onset of pregnancy. The study highlights the importance of body weight control in women of reproductive age to improve pregnancy outcomes. Obesity is associated with lower chances of full-term pregnancy and a higher risk of gestational diabetes.

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