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Staimez LR, Dutta A, Beyh YS, Gupta R, Noule HK, Sapna V, Deepa K, Stein AD, Narayan KV, Prabhakaran D, Kalpana B, Prabhakaran P. Pancreatic Beta Cell Function in Infants Varies by Maternal Weight. Metabolites 2024; 14:208. [PMID: 38668336 PMCID: PMC11052198 DOI: 10.3390/metabo14040208] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2024] [Revised: 03/19/2024] [Accepted: 03/25/2024] [Indexed: 04/28/2024] Open
Abstract
The Asian Indian Beta Cell function (ABCs) in Infants Study examined the associations of maternal weight on infant pancreatic beta cell function across 7 months postpartum. Pregnant women aged 18-35 years were recruited in Hyderabad, India. Women were classified by first trimester weight as underweight (UW), BMI < 18.5 kg/m2; normal weight (NW), BMI 18.5-22.9 kg/m2; or overweight (OW), BMI 23.0 through <28.5 kg/m2. At age > 7 months, infants had an oral glucose tolerance test (OGTT, 1.75 g glucose/kg bodyweight) following a 3 h fast. Infant blood samples were assayed for C-peptide and glucose. Infant beta cell function (HOMA2-B; disposition index, DI) and insulin resistance (HOMA2-IR) were compared across maternal weight groups. Mothers (UW n = 63; NW n = 43; OW n = 29) had similar age at delivery and second trimester 50 g glucose challenge test results. Cord HOMA2-B values were 51% greater for IUW (83.5, SD 55.2) and 44% greater for IOW (79.9, SD 60.8) vs. INW (55.4, SD 51.5), forming a U-shaped relationship between maternal weight and HOMA2-B. No qualitative differences in HOMA2-IR were found at birth. However, at 7 months postpartum, HOMA2-IR changed most within IUW (-64% median reduction) and changed the least in IOW (-7% median reduction). At seven months postpartum, DI was higher in IUW vs. the other groups (geometric mean IUW 1.9 SD 2.5; INW 1.3 SD 2.6 or vs. IOW mean 1.2 SD 3.7), reflecting a +49% difference in DI. Evidence from this study illustrates adaptations in the pancreatic functional response of infants associated with the maternal nutritional environment.
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Affiliation(s)
- Lisa R. Staimez
- Emory Global Diabetes Research Center, Woodruff Health Sciences Center, Emory University, Atlanta, GA 30322, USA; (Y.S.B.)
- Hubert Department of Global Health, Rollins School of Public Health, Emory University, 1518 Clifton Rd NE, Atlanta, GA 30322, USA
| | - Anubrati Dutta
- Centre for Chronic Disease Control, New Delhi 110016, Delhi, India; (A.D.); (R.G.); (D.P.); (P.P.)
| | - Yara S. Beyh
- Emory Global Diabetes Research Center, Woodruff Health Sciences Center, Emory University, Atlanta, GA 30322, USA; (Y.S.B.)
| | - Ruby Gupta
- Centre for Chronic Disease Control, New Delhi 110016, Delhi, India; (A.D.); (R.G.); (D.P.); (P.P.)
| | - Hari Krishna Noule
- Centre for Chronic Disease Control, New Delhi 110016, Delhi, India; (A.D.); (R.G.); (D.P.); (P.P.)
- Share India, MediCiti Institute for Medical Sciences, Medchal 501401, Telangana, India; (V.S.); (B.K.)
- Administrative Staff College of India, Hyderabad 500034, Telanaga, India
| | - Vyakaranam Sapna
- Share India, MediCiti Institute for Medical Sciences, Medchal 501401, Telangana, India; (V.S.); (B.K.)
| | - Kothapally Deepa
- Share India, MediCiti Institute for Medical Sciences, Medchal 501401, Telangana, India; (V.S.); (B.K.)
| | - Aryeh D. Stein
- Hubert Department of Global Health, Rollins School of Public Health, Emory University, 1518 Clifton Rd NE, Atlanta, GA 30322, USA
| | - K.M. Venkat Narayan
- Emory Global Diabetes Research Center, Woodruff Health Sciences Center, Emory University, Atlanta, GA 30322, USA; (Y.S.B.)
- Hubert Department of Global Health, Rollins School of Public Health, Emory University, 1518 Clifton Rd NE, Atlanta, GA 30322, USA
| | - Dorairaj Prabhakaran
- Centre for Chronic Disease Control, New Delhi 110016, Delhi, India; (A.D.); (R.G.); (D.P.); (P.P.)
- Public Health Foundation of India, Gurgaon 110030, Haryana, India
| | - Basany Kalpana
- Share India, MediCiti Institute for Medical Sciences, Medchal 501401, Telangana, India; (V.S.); (B.K.)
| | - Poornima Prabhakaran
- Centre for Chronic Disease Control, New Delhi 110016, Delhi, India; (A.D.); (R.G.); (D.P.); (P.P.)
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Bashir M, Fagier Y, Ahmed B, C Konje J. An overview of diabetes mellitus in pregnant women with obesity. Best Pract Res Clin Obstet Gynaecol 2024; 93:102469. [PMID: 38359580 DOI: 10.1016/j.bpobgyn.2024.102469] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2023] [Revised: 01/02/2024] [Accepted: 02/05/2024] [Indexed: 02/17/2024]
Abstract
Rates of obesity are increasing world-wide with an estimated 1billion people projected to be obese by 2030 if current trends remain unchanged. Obesity currently considered one of the most significant associated factors of non-communicable diseases poses the greatest threat to health. Diabetes mellitus is an important metabolic disorder closely associated with obesity. It is therefore expected that with the increasing rates of obesity, the rates of diabetes in pregnancy will also be rising. This disorder may pre-date pregnancy (diagnosed or undiagnosed and diagnosed for the first time in pregnancy) or may be of onset in pregnancy. Irrespective of the timing of onset, diabetes in pregnancy is associated with both fetal and maternal complications. Outcomes are much better if control is maximised. Early diagnosis, multidisciplinary care and tailored management with optimum glycaemic control is associated with a significant reduction in not only pregnancy complications but long-term consequences on both the mother and offspring. This review brings together the current understanding of the pathogenesis of the endocrine derangements that are associated with diabetes in pregnancy how screening should be offered and management including pre-pregnancy care and the role of newer agents in management.
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Affiliation(s)
- Mohammed Bashir
- Qatar Metabolic Institute, Hamad Medical Corporation, Doha, Qatar; Endocrinology, Weill Cornell Medicine, Doha, Qatar.
| | - Yassin Fagier
- Women's Clinical Management Group, Sidra Medicine, Doha, Qatar
| | - Badreldeen Ahmed
- Feto Maternal Centre, Al Markhiya Street, Doha, Qatar; Obstetrics and Gynaecology, Weill Cornell Medicine, Doha, Qatar; Obstetrics and Gynaecology, Qatar University, Doha, Qatar
| | - Justin C Konje
- Feto Maternal Centre, Al Markhiya Street, Doha, Qatar; Obstetrics and Gynaecology, Weill Cornell Medicine, Doha, Qatar; Obstetrics and Gynaecology, University of Leicester, UK
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Arora P, Aeri BT. High pre-pregnancy body mass index and gestational weight gain among women belonging to upper SES from Delhi, India. Eur J Obstet Gynecol Reprod Biol X 2023; 20:100258. [PMID: 37942027 PMCID: PMC10628650 DOI: 10.1016/j.eurox.2023.100258] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2023] [Revised: 10/14/2023] [Accepted: 10/20/2023] [Indexed: 11/10/2023] Open
Abstract
Background and objective With increase in prevalence of obesity and an increasing trend in the birth of macrosomic infants, Institute of Medicine (IOM) guidelines pertaining to optimal gestational weight gain (GWG) required for positive pregnancy outcome were revised in 1990 and 2009. Since, in the Indian scenario, no recommendations exist for optimum GWG for obese (OB) and overweight (OW) women, we assessed the pattern of GWG w.r.t Institute of Medicine (IOM), 2009 among the subjects with different body mass index (BMI). Study design Present data were a part of a longitudinal observational study wherein, 312 pregnant women (≤12th week of gestation) attending private antenatal clinics were followed till term and their weight was monitored regularly at pre-determined intervals i.e., 12th-14th, 18th-20th, 24th-26th, 30th-32nd, 36th + week of gestation and compared w.r.t IOM guidelines 2009. Results 66.37 %, 57.89 % and 11.69 % of OB, OW and normal weight (NW) subjects respectively had weight gain exceeding their GWG limits. About 5 %,10.53 %, 33.77 % of OB, OW and NW subjects respectively had gained weight less than GWG limits (p = 0.000***). Conclusion An increase in GWG inadequacy with increase in BMI and pronounced variations in GWG among OB and OW subjects underscore the necessity to monitor GWG especially among the subjects with high BMI.
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Affiliation(s)
- Priyanka Arora
- Department of Food and Nutrition, Institute of Home Economics, University of Delhi, F-4, Hauz Khas Enclave, Delhi
| | - Bani Tamber Aeri
- Department of Food and Nutrition, Institute of Home Economics, Delhi University, F-4, Hauz Khas Enclave, New Delhi, India
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Mahesh PA, Kaleem Ullah M, Parthasarathi A. Allergic sensitization to foods in India and other Low-Middle-income countries. Clin Exp Allergy 2023. [PMID: 36825760 DOI: 10.1111/cea.14300] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2022] [Revised: 01/06/2023] [Accepted: 02/05/2023] [Indexed: 02/25/2023]
Abstract
Food allergy is an important cause of morbidity, significantly affecting the quality of life of the sufferer. Most food allergy research has been undertaken in high-income countries. Here, we summarize literature regarding food allergy in India and other low-middle-income countries (LMIC). We provide summaries of self-reported adverse food reactions and food sensitization in these regions by reviewing published community-based studies of prevalence, burden, and risk factors. We identified 2 community-based studies of food allergy prevalence in Karnataka, India, which estimate that food allergy affects just 0.14% of children and 1.2% of adults. The overall prevalence of allergic sensitization to 'any' food was 26.5% in adults and 19.1% in children by serum-specific IgE; but only 4.48% in children by skin prick test. We identified a further 28 studies in other LMICs, mainly from China but also Turkey, South Africa, Ghana, Mexico, Brazil, Thailand, Philippines, and Korea. The overall prevalence of allergic sensitization to 'any' food ranged from 0.11% to 16.8% in children using serum-specific IgE and 0.14% to 9.6% in children by skin prick test. The questionnaires and skin prick testing materials used and number of allergens tested varied significantly between studies. Other than Karnataka, there is no information on prevalence of food sensitization and probable food allergy in the community in India. Similar lack of information is noted among the majority of the 136 LMICs. Where community-based studies have been undertaken, there is wide variation in the prevalence and patterns of food sensitization across different LMICs, at least partly due to variations in study methodology. International collaboration is required in order to formally assess food allergy prevalence and burden across representative samples from multiple LMICs.
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Affiliation(s)
- Padukudru Anand Mahesh
- Department of Respiratory Medicine, Special Interest Group, Environment and Respiratory Diseases, JSS Medical College, JSSAHER, Mysore, Karnataka, India
| | - Mohammed Kaleem Ullah
- Centre for Excellence in Molecular Biology and Regenerative Medicine (A DST-FIST Supported Center), Department of Biochemistry (A DST-FIST Supported Department), JSS Medical College, JSSAHER, Karnataka, Mysore, India.,Division of Infectious Disease and Vaccinology, School of Public Health, University of California, Berkeley, California, USA
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McAuliffe FM. Impact of pregnancy on long-term health: Advances in postpregnancy care-An opportunity to improve long-term maternal health. Int J Gynaecol Obstet 2023; 160 Suppl 1:4-6. [PMID: 36635076 DOI: 10.1002/ijgo.14536] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Affiliation(s)
- Fionnuala M McAuliffe
- UCD Perinatal Research Centre, School of Medicine, National Maternity Hospital, University College Dublin, Dublin, Ireland.,FIGO Committee on Impact of Pregnancy on Long-Term Health, FIGO, London, UK
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Jacob CM, Inskip HM, Lawrence W, McGrath C, McAuliffe FM, Killeen SL, Divakar H, Hanson M. Acceptability of the FIGO Nutrition Checklist in Preconception and Early Pregnancy to Assess Nutritional Status and Prevent Excess Gestational Weight Gain: A Study of Women and Healthcare Practitioners in the UK. Nutrients 2022; 14:nu14173623. [PMID: 36079880 PMCID: PMC9460608 DOI: 10.3390/nu14173623] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2022] [Revised: 08/24/2022] [Accepted: 08/30/2022] [Indexed: 11/16/2022] Open
Abstract
Optimum nutrition and weight before and during pregnancy are associated with a lower risk of conditions such as pre-eclampsia and gestational diabetes. There is a lack of user-friendly tools in most clinical settings to support healthcare practitioners (HCPs) in implementing them. This study aimed to evaluate the acceptability of (1) using a nutrition checklist designed by the International Federation of Gynecology and Obstetrics (FIGO) for nutritional screening of women in the preconception and early pregnancy period and (2) routine discussion of nutrition and weight in clinical care. An online cross-sectional survey was conducted with women (aged 18-45) and HCPs (e.g., general practitioners, obstetricians, and midwives). Quantitative statistical analysis and qualitative content analysis were performed. The concept and content of the checklist were acceptable to women (n = 251) and HCPs (n = 47) (over 80% in both groups). Several barriers exist to implementation such as lack of time, training for HCPs, and the need for sensitive and non-stigmatizing communication. Routine discussion of nutrition was considered important by both groups; however, results suggest that nutrition is not regularly discussed in perinatal visits in the UK. The FIGO nutrition checklist presents a valuable resource for use in clinical practice, offering long-term and intergenerational benefits for both mother and baby.
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Affiliation(s)
- Chandni Maria Jacob
- Institute of Developmental Sciences, School of Human Development and Health, Faculty of Medicine, University of Southampton, Southampton SO16 6YD, UK
- NIHR Southampton Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust, University of Southampton, Southampton SO16 6YD, UK
- Correspondence:
| | - Hazel M. Inskip
- Medical Research Council Lifecourse Epidemiology Centre, University of Southampton, Southampton SO16 6YD, UK
| | - Wendy Lawrence
- NIHR Southampton Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust, University of Southampton, Southampton SO16 6YD, UK
- Medical Research Council Lifecourse Epidemiology Centre, University of Southampton, Southampton SO16 6YD, UK
| | - Carmel McGrath
- NIHR Southampton Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust, University of Southampton, Southampton SO16 6YD, UK
- School of Human Development and Health, Faculty of Medicine, University of Southampton, Southampton SO17 1BJ, UK
| | - Fionnuala M. McAuliffe
- UCD Perinatal Research Centre, School of Medicine, University College Dublin, National Maternity Hospital, D02 YH21 Dublin, Ireland
| | - Sarah Louise Killeen
- UCD Perinatal Research Centre, School of Medicine, University College Dublin, National Maternity Hospital, D02 YH21 Dublin, Ireland
| | - Hema Divakar
- Divakar’s Specialty Hospital, Bengaluru 560078, India
| | - Mark Hanson
- Institute of Developmental Sciences, School of Human Development and Health, Faculty of Medicine, University of Southampton, Southampton SO16 6YD, UK
- NIHR Southampton Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust, University of Southampton, Southampton SO16 6YD, UK
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Abstract
The present paper outlines current issues in the nutritional care of women during pregnancy and potential resources to address them. Globally, overnutrition, undernutrition and nutritional imbalances are widespread among women of reproductive age; increasing the risk of pregnancy complications and non-communicable diseases in both mothers and their children. Most women do not meet dietary guidelines for pregnancy. The World Health Organisation (WHO) recommends nutrition and weight counselling during pregnancy for all women. However, clinical practices focusing on nutrition vary and there is no consensus on which outcomes are most important for pregnancy nutrition interventions, with little consideration for the 'patient voice'. The International Federation of Gynaecology and Obstetrics (FIGO) nutrition checklist is a clinical practice tool that is available for healthcare professionals that will address this issue. The pregnancy nutrition core outcome set will also support advancement of antenatal nutrition by identifying the most critical nutrition-related outcomes from the perspective of healthcare professionals, researchers and women with experience of pregnancy. While poor nutrition can result in adverse outcomes across women of all weight categories, those with obesity may require specialist care to reduce their risk. Obesity is a chronic, progressive, relapsing disease that has high individual variability in its prognosis. The use of obesity staging systems, which consider mental, physical and functional health, can stratify individuals into risk categories and aid in treatment prioritisation in pregnancy. As the prevalence of obesity continues to rise, an obesity staging approach may support clinicians, especially those in limited resource settings.
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Kaur D, Malhotra A, Ranjan P, Chopra S, Kumari A, Vikram NK. Weight management in postpartum women - An Indian perspective. Diabetes Metab Syndr 2021; 15:102291. [PMID: 34598009 DOI: 10.1016/j.dsx.2021.102291] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/08/2021] [Revised: 08/31/2021] [Accepted: 09/13/2021] [Indexed: 12/14/2022]
Abstract
BACKGROUND AND AIMS This narrative review is intended to present an evidence and opinion-based weight management module for Indian postpartum women to be used by clinicians. MATERIAL AND METHODS Electronic databases such as PubMed and Google Scholar were accessed to extract relevant studies to derive evidence-based information. The reference list of the extracted studies was also checked to obtain further relevant articles. The opinion-based information was achieved from the consensus among the gynaecologists, nutritionists and doctors from Medicine according to their practical experiences in real time. In this review, we have used the term "postpartum" to represent the time period of two years after delivery. RESULTS A postpartum weight management module consisting of information about diet, physical activity, sleep and breastfeeding was devised to be used in regular clinical practice, particularly in the Indian settings. CONCLUSION Postpartum women deal with various unique challenges as compared to other population groups. Individualised weight management strategies should be adopted to facilitate sustainable postpartum weight management.
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Affiliation(s)
- Divjyot Kaur
- Department of Home Science, University of Delhi, India
| | - Anita Malhotra
- Department of Home Science, Lakshmibai College, University of Delhi, India
| | - Piyush Ranjan
- Department of Medicine, All India Institute of Medical Sciences, New Delhi, India.
| | - Sakshi Chopra
- Department of Home Science, University of Delhi, India
| | - Archana Kumari
- Department of Obstetrics and Gynaecology, All India Institute of Medical Sciences, New Delhi, India
| | - Naval K Vikram
- Department of Medicine, All India Institute of Medical Sciences, New Delhi, India
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Gopalan HS, Haque I, Ahmad S, Gaur A, Misra A. Education and screening for obesity, hypertension, and diabetes (including gestational diabetes) "at the doorstep" of women from nine underprivileged urban areas in Delhi National Capital Region. Diabetes Metab Syndr 2021; 15:102209. [PMID: 34314922 DOI: 10.1016/j.dsx.2021.102209] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
BACKGROUND AND AIMS Women in underprivileged urban areas have poor access to health and education, making them vulnerable to non-communicable diseases (NCDs), specifically diabetes. The current project has sought to focus on this group, to educate and screen this population to prevent and manage obesity and diabetes. METHODS The project was conducted in 9 underprivileged areas of Delhi NCR using a mobile van unit. Women from these areas were invited for health education (this included talks, lectures and distribution of Information, Education & Communication material), screening {anthropometric, blood glucose and blood pressure (BP) measurements} diet counselling sessions and referral of subjects with uncontrolled blood glucose. RESULTS Baseline survey on knowledge of diabetes and nutrition showed low awareness. Health education sessions (n, 46) included face-to-face discussion and problem solving and distribution of simple pictorial leaflets (n, 3000). The health education sessions were well accepted. In total, 4% women (n,3175/91000- total population, 3056 non-pregnant, 119 pregnant) participated in the research trial. Among non-pregnant women, an average weight gain of 11.8 kg between the ages of 20-40 years was observed. The average BMI and waist circumference (WC) was 26.8 ± 5.3 kg/m2 and 91.1 ± 13.2 cm, respectively in non-pregnant women. Further, 75.3.0% (2207/2928) and 96.7% (2875/2971) of the non-pregnant women had overweight/obesity and abdominal obesity, respectively. In the non-pregnant women, 21.7% had known diabetes. Further, 7.4% non-pregnant women and 2.5% pregnant women were identified as having hyperglycaemic state. Hypertension was observed in 11.9% pregnant women and 49.9% of non-pregnant women. CONCLUSION Extremely high prevalence of obesity, along with diabetes and hypertension in underprivileged urban women requires intensive individualised and group health education, screening, and counselling "at the doorsteps", as has been shown in our model.
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Affiliation(s)
- Hema S Gopalan
- National-Diabetes, Obesity and Cholesterol Foundation (N-DOC), SDA, New Delhi, 110016, India
| | - Intazaamul Haque
- National-Diabetes, Obesity and Cholesterol Foundation (N-DOC), SDA, New Delhi, 110016, India
| | - Shamshad Ahmad
- National-Diabetes, Obesity and Cholesterol Foundation (N-DOC), SDA, New Delhi, 110016, India
| | - Ashok Gaur
- National-Diabetes, Obesity and Cholesterol Foundation (N-DOC), SDA, New Delhi, 110016, India
| | - Anoop Misra
- National-Diabetes, Obesity and Cholesterol Foundation (N-DOC), SDA, New Delhi, 110016, India; Diabetes Foundation (India), New Delhi, 110016, India; Fortis C-DOC Center of Excellence for Diabetes, Metabolic Diseases, and Endocrinology, B 16, Chirag Enclave, New Delhi, India.
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Babu GR, Das A, Lobo E, R D, John DA, Thankachan P, Khetrapal S, Benjamin-Neelon SE, Murthy G. Mid-upper arm circumference in pregnant women and birth weight in newborns as substitute for skinfold thickness: findings from the MAASTHI cohort study, India. BMC Pregnancy Childbirth 2021; 21:484. [PMID: 34229644 PMCID: PMC8258932 DOI: 10.1186/s12884-021-03915-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2021] [Accepted: 05/26/2021] [Indexed: 12/05/2022] Open
Abstract
BACKGROUND Estimating total body fat in public hospitals using gold-standard measurements such as air displacement plethysmography (ADP), deuterium oxide dilution, or dual-energy X-ray absorptiometry (DXA) is unaffordable, and it is challenging to use skinfold thickness. We aimed to identify the appropriate substitute marker for skinfold thickness to estimate total body fat in pregnant women and infants. METHODS The study is part of a prospective cohort study titled MAASTHI in Bengaluru, from 2016 to 19. Anthropometric measurements such as body weight, head circumference, mid-upper arm circumference (MUAC), and skinfold thickness were measured in pregnant women between 14 and 36 weeks of gestational age; while measurements such as birth weight, head, chest, waist, hip, mid-upper arm circumference, and skinfold thickness were recorded for newborns. We calculated Kappa statistics to assess agreement between these anthropometric markers with skinfold thickness. RESULTS We found the highest amount of agreement between total skinfold thickness and MUAC (Kappa statistic, 0.42; 95 % CI 0.38-0.46) in pregnant women. For newborns, the highest agreement with total skinfold thickness was with birth weight (0.57; 95 % CI 0.52-0.60). Our results indicate that MUAC higher than 29.2 cm can serve as a suitable alternative to total skinfolds-based assessments for obesity screening in pregnancy in public facilities. Similarly, a birth weight cut-off of 3.45 kg can be considered for classifying obesity among newborns. CONCLUSION Mid-upper arm circumference and birth weight can be used as markers of skinfold thickness, reflecting total body fat in pregnant women and the infant, respectively. These two anthropometric measurements could substitute for skinfold thickness in low- and middle-income urban India settings.
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Affiliation(s)
- Giridhara R Babu
- Indian Institute of Public Health-Bengaluru, Public Health Foundation of India (PHFI), Bengaluru, India.
- Wellcome Trust-DBT India Alliance Intermediate Research Fellow in Public Health, Hyderabad, India.
| | - Aritra Das
- Bihar Technical Support Program, CARE India, Patna, India
| | - Eunice Lobo
- Indian Institute of Public Health-Bengaluru, Public Health Foundation of India (PHFI), Bengaluru, India
| | - Deepa R
- Indian Institute of Public Health-Bengaluru, Public Health Foundation of India (PHFI), Bengaluru, India
| | - Daisy A John
- Indian Institute of Public Health-Bengaluru, Public Health Foundation of India (PHFI), Bengaluru, India
| | | | - Sonalini Khetrapal
- Asian Development Bank (ADB) NCR - National Capital Region, Manila, Philippines
| | - Sara E Benjamin-Neelon
- Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Gvs Murthy
- Indian Institute of Public Health-Hyderabad, Public Health Foundation of India (PHFI), Hyderabad, India
- Public Health Eye Care & Disability, London School of Hygiene & Tropical Medicine, London, United Kingdom
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