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Obesity and Socioeconomic Disparities

Rethinking Causes and Perinatal Care

The Journal of Perinatal & Neonatal Nursing: April/June 2019 - Volume 33 - Issue 2 - p E1
doi: 10.1097/JPN.0000000000000414
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CE TEST QUESTIONS

JPNN0419A

General Purpose Statement: To present a literature review that examines new concepts in obesity and its associations with socioeconomic disparities, along with individual and population-targeted nursing actions to ameliorate obesity-related perinatal morbidities.

Learning Objectives/Outcomes: After completing this continuing education activity, you should be able to:

  1. Recall the background information helpful for understanding the effects of obesity on perinatal health.
  2. Identify the biophysical and biochemical factors that affect obesity and its perinatal effects.
  3. Summarize the societal and biological risks that obesity poses to perinatal health.
  1. Which of the following groups of women has the highest age-adjusted prevalence of obesity?
    1. Hispanic
    2. non-Hispanic white
    3. non-Hispanic black
  2. During pregnancy, obesity increases the risk for
    1. placental abruption.
    2. acrodysesthesia.
    3. placenta previa.
  3. During the intrapartum period, obesity increases the risk for
    1. nuchal cord.
    2. shoulder dystocia.
    3. breech presentation.
  4. Which of the following measurements do perinatal researchers use to define obesity at the first prenatal visit?
    1. body mass index (BMI)
    2. biophysical profile
    3. waist circumference
  5. Brown adipose tissue
    1. produces more hormones than white adipose tissue.
    2. secretes endocrine, paracrine, and autocrine signals.
    3. is a protective factor during cold exposure.
  6. Which of the following molecules improves insulin sensitivity, stimulates fatty acid oxidation and glucose uptake in skeletal muscle, stimulates appetite, and reduces energy expenditure?
    1. factor D
    2. adiponectin
    3. acylation stimulating protein
  7. Which of the following molecules changes the balance between fibrinogenesis and fibrinolysis and contributes to atherosclerosis?
    1. interleukin-6
    2. tumor necrosis factor
    3. plasminogen activator inhibitor
  8. Endocrine changes in utero, including increased cortisol production and decreased production of insulin and growth hormone, program the child for
    1. stroke.
    2. hypertension.
    3. hypothyroidism.
  9. At least a 30% increase in a child's risk for developing adult obesity has been associated with in utero exposure to maternal
    1. smoking.
    2. alcoholism.
    3. caffeine ingestion.
  10. Adipose tissue cytokines increase a chronic, low-level inflammation that stimulates
    1. satiety.
    2. hyperphagia.
    3. energy harvesting.
  11. Research cited in the article describes how consumption of obesogenic foods relates to elevated BMI and larger waist circumferences because women use it as a
    1. means of promoting fetal growth.
    2. less costly nutrition alternative.
    3. stress-coping mechanism.
  12. A systematic review of 16 cross-sectional studies found consistent associations between short sleep and higher consumption of
    1. high-fat foods.
    2. more fruit.
    3. cereal.
  13. A multinational literature review of food prices and diet quality found that people with reduced incomes stretched food dollars by increasing their consumption of
    1. protein shakes.
    2. processed foods.
    3. sugary beverages.
  14. Research cited in the article reported that infants of women who had pregestational obesity are at risk for
    1. early introduction of juices.
    2. prolonged exclusive breastfeeding.
    3. substitution of cow's milk for formula.
  15. Because of the high rate of uterine atony with postpartum hemorrhage associated with obesity, the author recommends active management of the third stage of labor with
    1. delaying cord clamping.
    2. expediting placental detachment.
    3. withholding of oxytocic medication.
  16. The chronic, systemic inflammation associated with adipose dysfunction increases risk for which of the following postpartum complications?
    1. mastitis
    2. hemorrhage
    3. deep vein thrombosis
  17. After delivery, women with obesity and gestational diabetes
    1. have sustained high blood glucose levels.
    2. remain at increased risk for future type 2 diabetes.
    3. have a return of blood glucose levels to normal at 6 weeks postpartum.
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