Changes in maternal anthropometric measurements in the first postpartum month and associated factors

Osteopontin Levels in Maternal Serum, Cord Blood, and Breast Milk According to Gestational Diabetes Mellitus: A Case-Control Study

BACKGROUND/OBJECTIVES

The prevalence of gestational diabetes mellitus (GDM) is increasing, and GDM poses health risks for both mothers and newborns. This study investigated the association between GDM and two biomarkers, osteopontin (OPN) and betatrophin (ANGPTL8).

METHODS

This study involved face-to-face interviews with 165 participants-81 in the GDM group and 84 in the control group-to gather maternal-newborn data. Maternal serum OPN levels, along with cord serum OPN and ANGPTL8 levels, were measured at birth. OPN levels in breast milk were also measured between postnatal days 10-15. Statistical analysis included Student's t-test for comparing biomarker levels, chi-square tests for GDM incidence across OPN quartile levels, multiple logistic regression for assessing GDM frequency by OPN quartile levels, and the Pearson correlation coefficient to explore relationships between biomarker levels and maternal-newborn characteristics.

RESULTS

No significant differences in cord OPN or ANGPTL8 levels were detected between the groups. However, the OPN levels in maternal serum and breast milk were greater in the GDM group than in the control group. We found an association between increasing maternal serum and breast milk OPN levels in quartile groups and the risk of GDM. Additionally, there was a moderate correlation between cord OPN and both maternal serum OPN (r = 0.45) and breast milk OPN (r = 0.43).

CONCLUSIONS

The differences in OPN levels between the GDM and control groups suggest that OPN may reflect metabolic changes associated with GDM, possibly as a consequence of the condition itself or its treatment. Further research is necessary to validate these findings and uncover the underlying mechanisms involved.

Mental Health during the Interpregnancy Period and the Association with Pre-Pregnancy Body Mass Index and Body Composition: Data from the INTER-ACT Randomized Controlled Trial

Mental health problems and obesity are two common complications during pregnancy and postpartum. The preconception period is considered an appropriate period for prevention. Therefore, insights into interpregnancy mental health and the impact on weight and body composition are of interest to developing effective weight management strategies. The primary aim of this study is to assess the difference in women's mental health during the interpregnancy period and the association with pre-pregnancy body mass index (BMI) and body composition. The secondary aim is to study whether this association is affected by socio-demographic factors, interpregnancy interval and sleep. The study is a secondary analysis of the INTER-ACT e-health-supported lifestyle trial. Women were eligible if they had a subsequent pregnancy and mental health measurements at 6 weeks after childbirth and at the start of the next pregnancy (n = 276). We used univariate analyses to assess differences in mental health and performed regression analysis to assess their association with pre-pregnancy BMI and body composition at the start of the next pregnancy. Our results show a statistically significant increase in anxiety and depressive symptoms between 6 weeks after childbirth and the start of the next pregnancy (sSTAI-6 ≥ 40: +13%, p =≤ 0.001; GMDS ≥ 13: +9%, p = 0.01). Of the women who were not anxious at 6 weeks after childbirth (sSTAI < 40), more than one-third (39%) developed anxiety at the start of the next pregnancy (p =≤ 0.001). Regression analysis showed that sense of coherence (SOC-13) at the start of the next pregnancy was independently associated with women's pre-pregnancy BMI and fat percentage. We believe that the development of preconception lifestyle interventions that focus on both weight reduction and support in understanding, managing and giving meaning to stressful events (sense of coherence) may be of added value in optimizing women's preconception health.

Mental health after childbirth and the impact on postpartum weight retention and body composition. Data from the INTER-ACT randomized controlled trial

OBJECTIVE

To study the evolution of maternal mental health during the first year after childbirth in women with previous excessive gestational weight gain, and the relationship with postpartum weight retention and body composition.

METHODS

Anthropometric and mental health data of 505 women of the INTER-ACT RCT control group were collected and assessed using descriptive statistics and mixed model analyses.

RESULTS

At 6 weeks postpartum 28% of women reported depressive symptoms, 46% anxiety, 47% low sense of coherence and 48% low quality of life. From 6 weeks to 12 months postpartum there was a monthly increase (+0.38, p = .003) in anxiety and a monthly decrease (-0.39, p = .008) in quality of life. High levels of depressive symptoms at 6 weeks postpartum predicted higher body fat (+0.9%, p = .01) and higher waist circumference (+1.3 cm, p = .02) in the first year postpartum. High sense of coherence at 6 weeks postpartum predicted lower body fat (-0.8%, p = .01) the first year postpartum.

CONCLUSIONS

In women with a history of excessive gestational weight gain, the first year after childbirth is characterized by a high prevalence of mental health problems in which levels of anxiety and quality of life deteriorate over time. Moreover, high levels of depressive symptoms and low sense of coherence in the first weeks postpartum predict unfavourable body composition outcomes in the year after childbirth.