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This volume will explore the epidemiology and the basic mechanisms of each of these prenatal phenomena, in an attempt to explain the role of the prenatal environment in promoting postnatal weight gain. This information will contribute to resolving the nature-nurture controversy. This information provides guidance to clinical practitioners involved in both prenatal and postnatal care. This volume further stimulates research into underlying mechanisms and prevention and treatment of this phenomenon.
As women of childbearing age have become heavier, the trade-off between maternal and child health created by variation in gestational weight gain has become more difficult to reconcile. Weight Gain During Pregnancy responds to the need for a reexamination of the 1990 Institute of Medicine guidelines for weight gain during pregnancy. It builds on the conceptual framework that underscored the 1990 weight gain guidelines and addresses the need to update them through a comprehensive review of the literature and independent analyses of existing databases. The book explores relationships between weight gain during pregnancy and a variety of factors (e.g., the mother's weight and height before pregnancy) and places this in the context of the health of the infant and the mother, presenting specific, updated target ranges for weight gain during pregnancy and guidelines for proper measurement. New features of this book include a specific range of recommended gain for obese women. Weight Gain During Pregnancy is intended to assist practitioners who care for women of childbearing age, policy makers, educators, researchers, and the pregnant women themselves to understand the role of gestational weight gain and to provide them with the tools needed to promote optimal pregnancy outcomes.
The increasing prevalence of preterm birth in the United States is a complex public health problem that requires multifaceted solutions. Preterm birth is a cluster of problems with a set of overlapping factors of influence. Its causes may include individual-level behavioral and psychosocial factors, sociodemographic and neighborhood characteristics, environmental exposure, medical conditions, infertility treatments, and biological factors. Many of these factors co-occur, particularly in those who are socioeconomically disadvantaged or who are members of racial and ethnic minority groups. While advances in perinatal and neonatal care have improved survival for preterm infants, those infants who do survive have a greater risk than infants born at term for developmental disabilities, health problems, and poor growth. The birth of a preterm infant can also bring considerable emotional and economic costs to families and have implications for public-sector services, such as health insurance, educational, and other social support systems. Preterm Birth assesses the problem with respect to both its causes and outcomes. This book addresses the need for research involving clinical, basic, behavioral, and social science disciplines. By defining and addressing the health and economic consequences of premature birth, this book will be of particular interest to health care professionals, public health officials, policy makers, professional associations and clinical, basic, behavioral, and social science researchers.
This text addresses the need for a book specifically aimed at obstetric anesthesia and covers topics such as pulmonary, cardiac renal, hepatic, hematologic, neurologic, endocrine and other diseases. The real anesthetic challenge arises when patients present to Labor and Delivery with unusual or complicated medical problems and, in recent years, a few of the larger institutions have developed an Obstetric Anesthesiology Consultation Service to prepare for the management of these patients. While most pregnant women who present to Labor and Delivery require anesthetic intervention, they typically meet the anesthesiologist for the first time in labor. Since the majority of laboring women are healthy without significant comorbidities, this does not present much of a challenge to the anesthesiologist and the anesthetic management tends to be straight-forward with favorable outcomes. However, using this new model, the anesthesiologist has the opportunity to discuss the various treatment modalities and potentially suggest diagnostic testing to be performed prior to delivery, similar to the pre-operative testing that is done in other surgical environments.
Obesity and Obstetrics, Second Edition, brings together experts to examine the issues and challenges of obesity and obstetrics, also discussing how obesity affects fertility, reproduction and pregnancy. Beginning with the worldwide epidemic of obesity, chapters then go on to review obesity and hyperglycemia of pregnancy, management of labor, interventions to improve care during pregnancy, and long-term impact of maternal obesity. - Provides an essential reference on the significant risk of complications during pregnancy, including early pregnancy loss, recurrent miscarriage and fetal developmental abnormalities - Builds foundational knowledge on how maternal obesity predisposes offspring to obesity, highlighting that the prevention of childhood obesity begins during pregnancy - Assembles critically evaluated chapters focused on obesity and obstetrics to meet the practical needs of obstetricians, endocrinologists and general practitioners
The delivery of high quality and equitable care for both mothers and newborns is complex and requires efforts across many sectors. The United States spends more on childbirth than any other country in the world, yet outcomes are worse than other high-resource countries, and even worse for Black and Native American women. There are a variety of factors that influence childbirth, including social determinants such as income, educational levels, access to care, financing, transportation, structural racism and geographic variability in birth settings. It is important to reevaluate the United States' approach to maternal and newborn care through the lens of these factors across multiple disciplines. Birth Settings in America: Outcomes, Quality, Access, and Choice reviews and evaluates maternal and newborn care in the United States, the epidemiology of social and clinical risks in pregnancy and childbirth, birth settings research, and access to and choice of birth settings.
Maternal-fetal medicine has evolved over the last three decades to become a well-established discipline. The current understanding of maternal physiology and pathophysiology has allowed us to obtain more accurate diagnoses and to provide more effective treatments of medical, surgical, and obstetrical maternal complications. More importantly, the fetus has become a distinct individual whose in utero environment has become much more accessible to study, diagnose, and treatment. Clinical Maternal-Fetal Medicine addresses the pathophysiology, diagnosis, and treatment of common medical and obstetrical maternal complications and fetal complications. It provides a concise and timely review of clinically relevant topics in this discipline. The textbook is a comprehensive reference covering the wide range of disciplines that make up maternal-fetal medicine.
Obesity is a continuing issue around the world and in many contexts. The growing number of obese people is an increasing concern for those in the medical profession, and obesity can pose specific challenges in relation to fertility and pregnancy. Patients who are obese require specific considerations and knowledge. Bringing together experts from a variety of specialties to examine the issues and challenges of obesity, this book discusses how obesity affects fertility, reproduction, and pregnancy. Beginning with an exploration of the epidemiology of obesity, further chapters focus on specific issues related to obesity and both male and female reproduction, the complications of obesity during pregnancy and labour, and the long term effects of obesity. This is the most comprehensive resource to examine the topic of obesity and reproductive issues, making it invaluable for medical students, professionals, and researchers in public policy and medicine. - Comprehensive examination of fertility issues arising from male and female obesity - Clinical knowledge and expertise given to the subjects - In-depth examination through 47 chapters of a growing, but often overlooked, issue in fertility and pregnancy
There is no longer any doubt that the inherited genetic constitution of the individual has a large influence on the entire life cycle, from human fetal development and pre- and postnatal growth to subsequent health status. However, growing evidence suggests that this predisposition is not rigid, but that early genetic imprinting, caused by exposure to a diverse spectrum of nutrients, macromolecules, microbial agents and other cellular or soluble components present in the external environment, is also of importance. According to this concept of the developmental origins of adult diseases, intrauterine and early life events play an important role in the etiology of human diseases: there seems to exist a critical 'window of opportunity' in the human infant before and during pregnancy, and up to 24 months of age. Altered exposure to different environmental agents during this critical period may determine the nature of responses in the perinatal period, and the expression of specific disease states in later life. The papers presented in this publication thus focus on the impact of perinatal growth, nutrition, environmental microflora, and host immune responses on the outcome of health and disease in later life.