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Brito SM, Santana JDM, Pereira M, Santos DB, Oliveira AM. Post-partum weight retention in Northeastern Brazilian women: a prospective NISAMI cohort study. SAO PAULO MED J 2024; 142:e2023084. [PMID: 38597530 PMCID: PMC11000731 DOI: 10.1590/1516-3180.2023.0084.r1.010623] [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] [Received: 03/12/2023] [Revised: 04/21/2023] [Accepted: 06/01/2023] [Indexed: 04/11/2024] Open
Abstract
BACKGROUND Weight retention during the post-partum period is associated with excessive weight gain. OBJECTIVES To investigate factors associated with maternal weight retention at six months post-partum (PPWR). DESIGN AND SETTING A prospective cohort study was conducted with 127 women monitored using prenatal services. METHODS The outcome variable was represented by post-partum maternal weight retention and calculated as the difference between the mother's weight at sixth month post-partum and her pregestational weight. RESULTS The mean age of the pregnant women was 26.7 ± 5.25 years old, and the post-partum maternal weight retention was 46.5%. The proximal determinants showed a direct association with PPWR after adjusting for the distal and intermediate variables: excessive gestational weight gain (odds ratio [OR]:3.34; confidence interval [CI]:1.16-9.59), greater adhesion to dietary intake pattern 2 (composed of red meats and derivatives, eggs, industrialized foods, and coffee) (OR:2.70; CI:1.16-6.32), and the absence of exclusive maternal breastfeeding in the first month (OR:3.40; CI:1.27-9.12), as well as primiparity (OR:2.36; CI:1.00-5.55), an intermediate determinant. Insufficient weight gain in pregnancy was inversely associated with the outcome (OR:0.35; CI:0.31-0.93). CONCLUSIONS Among the hierarchical determinants, proximal factors were interrelated with maternal weight retention, indicating that excessive total weight gain, an inadequate dietary intake pattern, and the absence of exclusive maternal breastfeeding in the first month of life work as dampeners of the return to pre-gestational weight. Prepartum and post-partum care interventions can contribute to reducing excess weight in women.
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Affiliation(s)
- Sheila Monteiro Brito
- MSc, PhD. Adjunct Professor, Health Sciences Center, Universidade Federal do Recôncavo da Bahia (UFRB), Santo Antônio de Jesus (BA), Brazil
| | - Jerusa da Mota Santana
- MSc, PhD. Adjunct Professor, Health Sciences Center, Universidade Federal do Recôncavo da Bahia (UFRB), Santo Antônio de Jesus (BA), Brazil
| | - Marcos Pereira
- MSc, PhD. Adjunct Professor, Instituto de Saúde Coletiva (ISC), Universidade Federal da Bahia (UFBA), Salvador (BA), Brazil
| | - Djanilson Barbosa Santos
- MSc, PhD. Adjunct Professor, Health Sciences Center, Universidade Federal do Recôncavo da Bahia (UFRB), Santo Antônio de Jesus (BA), Brazil
| | - Ana Marlucia Oliveira
- MSc, PhD. Full Professor, School of Nutrition, Universidade Federal da Bahia (UFBA), Salvador (BA), Brazil
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R GM, Pricilla RA, Kurian S, Benjamin SJ, Rathore S, Yenuberi H, Minz SD, Kumar M, Ross BJ, Vijayaselvi R, Abraham A, Prasanthi A, Mani T, Abraham SG, Ebenezer ED, George A, Mittal R, Jeyaseelan L, Mathews JE. Study protocol: 'a large cohort study of postnatal events in a not-for-profit referral centre in Vellore, South India'. BMJ Open 2022; 12:e063497. [PMID: 36535722 PMCID: PMC9764659 DOI: 10.1136/bmjopen-2022-063497] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
INTRODUCTION In a large developing country, with diverse population characteristics and differential access to healthcare, it is important to identify factors that influence postnatal health. This knowledge will help frame recommendations to enhance universal postnatal care. METHODS AND ANALYSIS A prospective cohort study will be conducted by recruiting all participants who deliver in a referral centre in South India during a 1-year period after written consent is obtained from them. In addition to clinical information pertaining to their delivery and demographics, details of physical health, mental health socioeconomic status and emotional support will also be collected. Every participant will be followed up physically and/or by telephonic consultation at 3, 9 and 18 months of their postnatal period to reassess their status and that of their babies. As there are several independent and dependent variables requiring multivariate analysis, a sample size of 10 000 is considered adequate. Any unplanned visits to a health facility will be enquired into and documented for analysis.During data analysis, the effect of Caesarean section, high-risk characteristics and gestational age of the baby at delivery on various outcome measures and postnatal status will be evaluated. Interpretation of the large volume of collected data will help frame recommendations to improve postnatal care ETHICS AND DISSEMINATION: The study is approved by the Institutional Review Boards (Research and Ethics Committees) of Christian Medical College, Vellore, Tamil Nadu, India (IRB 12178 date 24 June 2020).Women are provided with a detailed information sheet and written consent is obtained. They are reassured that their care will not be compromised if they do not consent to the study. Data will be available on the clinical trial portal to assist in the dissemination of results after the project is published. TRIAL REGISTRATION NUMBER CTRI/2022/03/041343.
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Affiliation(s)
- Grace Mano R
- Obstetric and Genecology, Christian Medical College and Hospital Vellore, Vellore, Tamil Nadu, India
| | - Ruby Angeline Pricilla
- Low Cost Effective Care Unit, Christian Medical College and Hospital Vellore, Vellore, Tamil Nadu, India
| | - Suja Kurian
- Mental Health Centre, Christian Medical College and Hospital Vellore, Vellore, Tamil Nadu, India
| | - Santosh Joseph Benjamin
- Obstetric and Genecology, Christian Medical College and Hospital Vellore, Vellore, Tamil Nadu, India
| | - Swati Rathore
- Department of Obstetrics and Gynaecology, Christian Medical College and Hospital Vellore, Vellore, Tamil Nadu, India
| | - Hilda Yenuberi
- Obstetric and Genecology, Christian Medical College and Hospital Vellore, Vellore, Tamil Nadu, India
| | - Shanti Dani Minz
- Rural Unit for Health and Social Affairs, Christian Medical College and Hospital Vellore, Vellore, Tamil Nadu, India
| | - Manish Kumar
- Neonatology, CMC Vellore, Vellore, Tamilnadu, India
| | | | - Reeta Vijayaselvi
- Obstetric and Genecology, Christian Medical College and Hospital Vellore, Vellore, Tamil Nadu, India
| | - Anuja Abraham
- Obstetric and Genecology, Christian Medical College and Hospital Vellore, Vellore, Tamil Nadu, India
| | - Annie Prasanthi
- Obstetric and Genecology, Christian Medical College and Hospital Vellore, Vellore, Tamil Nadu, India
| | - Thenmozhi Mani
- Biostatistics, Christian Medical College Vellore, Vellore, Tamil Nadu, India
| | - Sunil George Abraham
- Low Cost Effective Care Unit, Christian Medical College and Hospital Vellore, Vellore, Tamil Nadu, India
| | - Emily Divya Ebenezer
- Obstetric and Genecology, Christian Medical College and Hospital Vellore, Vellore, Tamil Nadu, India
| | - Anne George
- Community Health and Development Unit, Christian Medical College and Hospital Vellore, Vellore, Tamil Nadu, India
| | - Rohin Mittal
- General Surgery, Christian Medical College and Hospital Vellore, Vellore, Tamil Nadu, India
| | - Lakshmanan Jeyaseelan
- College of Medicine, MBRU College of Medicine, Dubai Healthcare City, UAE
- Biostatistics, Christian Medical College and Hospital Vellore, Vellore, Tamil Nadu, India
| | - Jiji Elizabeth Mathews
- Obstetric and Genecology, Christian Medical College and Hospital Vellore, Vellore, Tamil Nadu, India
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Kossou J, Alaofè H, Hounkpatin WA, Lokonon J. Factors Associated With Postpartum Weight Retention in African Women: A Systematic Review. Food Nutr Bull 2022; 44:62-75. [PMID: 36415172 DOI: 10.1177/03795721221134566] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Background and Objective: The obesity epidemic among women in Africa is a health problem, and many studies attribute it to childbearing. However, most studies of postpartum weight retention (PPWR) occur in high-income countries. Therefore, this review sought to identify the potential factors affecting PPWR among African women. Methods: Four databases were searched from January 2000 to December 2020: Medline/PubMed, Google scholar, Ajol research, FreeFullPDF. The quality of included studies was assessed using the Newcastle Ottawa Scale. Results: Fifteen studies (5 from west, 4 from south, 3 from east, 2 from central, and 1 from north) were included: 8 cohort and 7 prospective cohort studies. Two studies examined the effect of obesity and weight gain during pregnancy on PPWR, 3 studies assessed the effect of childbirth, 4 examined the effect of breastfeeding, 4 assessed the impact of morbidities such as HIV, and 2 looked at food insecurity. Five studies demonstrated that postpartum weight is due to residual pregnancy weight gain and childbirth weight gain and is accentuated as parity increases (n = 2). Breastfeeding has a controversial effect, while morbidity (n = 4) and food insecurity (n = 4) contributed to weight loss. The variation in weight was also influenced by cultural practices (n = 1), prepregnancy weight (n = 1), and socioeconomic status (n = 1). On all domains, only 3 included studies were of good quality. Conclusions: Pregnancy weight gain, childbirth, breastfeeding, morbidity, and food insecurity were associated with PPWR. However, preexisting factors must be considered when developing PPWR modification strategies. In addition, due to the limited number of studies included, robust conclusions cannot be drawn.
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Affiliation(s)
- Jahdiel Kossou
- School of Nutrition, Food Sciences and Technologies, Faculty of Agronomics Sciences, University of Abomey-Calavi, Cotonou, Republic of Benin
| | - Halimatou Alaofè
- Department of Health Promotion Sciences, Mel and Enid Zuckerman College of Public Health, The University of Arizona, Tucson, AZ, USA
| | - Waliou Amoussa Hounkpatin
- School of Nutrition, Food Sciences and Technologies, Faculty of Agronomics Sciences, University of Abomey-Calavi, Cotonou, Republic of Benin
| | - Jaurès Lokonon
- School of Nutrition, Food Sciences and Technologies, Faculty of Agronomics Sciences, University of Abomey-Calavi, Cotonou, Republic of Benin
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Maternal Consumption of Ultra-Processed Foods-Rich Diet and Perinatal Outcomes: A Systematic Review and Meta-Analysis. Nutrients 2022; 14:nu14153242. [PMID: 35956418 PMCID: PMC9370797 DOI: 10.3390/nu14153242] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2022] [Revised: 07/30/2022] [Accepted: 08/01/2022] [Indexed: 11/23/2022] Open
Abstract
The consumption of ultra-processed food (UPF)-rich diets represents a potential threat to human health. Considering maternal diet adequacy during pregnancy is a major determinant for perinatal health outcomes, this study aimed to systematically review and meta-analyze studies investigating the association between maternal consumption of a UPF-rich diet and perinatal outcomes. Conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines, five electronic databases and gray literature using Google Scholar and ProQuest Dissertations and Theses Global were searched up to 31 May 2022. No restrictions were applied on language and publication date. Two reviewers independently conducted the study selection and data extraction process. Meta-analysis was conducted according to the random-effects model. In total, 61 studies were included in the systematic review and the overall population comprised 698,803 women from all gestational trimesters. Meta-analysis of cohort studies showed that maternal consumption of UPF-rich diets was associated with an increased risk of gestational diabetes mellitus (odds ratio (OR): 1.48; 95% confidence interval (CI): 1.17, 1.87) and preeclampsia (OR: 1.28; 95% CI: 1.15, 1.42). Neonatal outcomes showed no association. The overall GRADE quality of the evidence for the associations was very low. The findings highlight the need to monitor and reduce UPF consumption, specifically during the gestational period, as a strategy to prevent adverse perinatal outcomes.
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Krebs F, Lorenz L, Nawabi F, Alayli A, Stock S. Effectiveness of a Brief Lifestyle Intervention in the Prenatal Care Setting to Prevent Excessive Gestational Weight Gain and Improve Maternal and Infant Health Outcomes. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19105863. [PMID: 35627403 PMCID: PMC9141141 DOI: 10.3390/ijerph19105863] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/24/2022] [Revised: 05/09/2022] [Accepted: 05/10/2022] [Indexed: 02/04/2023]
Abstract
Research on perinatal programming shows that excessive gestational weight gain (GWG) increases the risk of overweight and obesity later in a child’s life and contributes to maternal weight retention and elevated risks of obstetrical complications. This study examined the effectiveness of a brief lifestyle intervention in the prenatal care setting, compared to routine prenatal care, in preventing excessive GWG as well as adverse maternal and infant health outcomes. The GeMuKi study was designed as a cluster RCT using a hybrid effectiveness implementation design and was conducted in the prenatal care setting in Germany. A total of 1466 pregnant women were recruited. Pregnant women in intervention regions received up to six brief counseling sessions on lifestyle topics (e.g., physical activity, nutrition, drug use). Data on GWG and maternal and infant outcomes were entered into a digital data platform by the respective healthcare providers. The intervention resulted in a significant reduction in the proportion of women with excessive GWG (OR = 0.76, 95% CI (0.60 to 0.96), p = 0.024). Gestational weight gain in the intervention group was reduced by 1 kg (95% CI (−1.56 to −0.38), p < 0.001). No evidence of intervention effects on pregnancy, birth, or neonatal outcomes was found.
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OUP accepted manuscript. Nutr Rev 2022; 80:2178-2197. [DOI: 10.1093/nutrit/nuac025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Misgina KH, Groen H, Bezabih AM, Boezen HM, van der Beek EM. Postpartum Weight Change in Relation to Pre-Pregnancy Weight and Gestational Weight Gain in Women in Low-Income Setting: Data from the KITE Cohort in the Northern Part of Ethiopia. Nutrients 2021; 14:131. [PMID: 35011006 PMCID: PMC8746538 DOI: 10.3390/nu14010131] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2021] [Revised: 12/22/2021] [Accepted: 12/24/2021] [Indexed: 11/16/2022] Open
Abstract
(1) Background: Postpartum weight may increase compared to pre-pregnancy due to weight retention or decrease due to weight loss. Both changes could pose deleterious effects on maternal health and subsequent pregnancy outcomes. Therefore, this study aimed to assess postpartum weight change and its associated factors. (2) Methods: A total of 585 women from the KIlte-Awlaelo Tigray Ethiopia (KITE) cohort were included in the analysis. (3) Results: The mean pre-pregnancy body mass index and weight gain during pregnancy were 19.7 kg/m2 and 10.8 kg, respectively. At 18 to 24 months postpartum, the weight change ranged from -3.2 to 5.5 kg (mean = 0.42 kg [SD = 1.5]). In addition, 17.8% of women shifted to normal weight and 5.1% to underweight compared to the pre-pregnancy period. A unit increase in weight during pregnancy was associated with higher weight change (β = 0.56 kg, 95% CI [0.52, 0.60]) and increased probability to achieve normal weight (AOR = 1.65, 95% CI [1.37, 2.00]). Food insecurity (AOR = 5.26, 95% CI [1.68, 16.50]), however, was associated with a shift to underweight postpartum. Interestingly, high symptoms of distress (AOR = 0.13, 95% CI [0.03, 0.48]) also negatively impacted a change in weight category. (4) Conclusions: In low-income settings such as northern Ethiopia, higher weight gain and better mental health during pregnancy may help women achieve a better nutritional status after pregnancy and before a possible subsequent pregnancy.
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Affiliation(s)
- Kebede Haile Misgina
- Department of Public Health, College of Health Sciences, University of Aksum, Axum P.O. Box 1010, Ethiopia
- Department of Epidemiology, University Medical Center Groningen, University of Groningen, 9700 RB Groningen, The Netherlands; (H.G.); (H.M.B.)
| | - Henk Groen
- Department of Epidemiology, University Medical Center Groningen, University of Groningen, 9700 RB Groningen, The Netherlands; (H.G.); (H.M.B.)
| | - Afework Mulugeta Bezabih
- School of Public Health, College of Health Sciences, University of Mekelle, Mekelle P.O. Box 231, Ethiopia;
| | - Hendrika Marike Boezen
- Department of Epidemiology, University Medical Center Groningen, University of Groningen, 9700 RB Groningen, The Netherlands; (H.G.); (H.M.B.)
| | - Eline M. van der Beek
- Department of Paediatrics, University Medical Center Groningen, University of Groningen, 9700 RB Groningen, The Netherlands;
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Molin J, Vanky E, Løvvik TS, Dehlin E, Bixo M. Gestational weight gain, appetite regulating hormones, and metformin treatment in polycystic ovary syndrome: A longitudinal, placebo-controlled study. BJOG 2021; 129:1112-1121. [PMID: 34865304 DOI: 10.1111/1471-0528.17042] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2021] [Revised: 11/23/2021] [Accepted: 12/01/2021] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To explore mechanisms that modulate gestational weight gain (GWG) in women with polycystic ovary syndrome (PCOS) and healthy controls. DESIGN Sub-sample of randomised controlled trials (PCOS) combined with a prospective cohort (controls). SETTING Eleven Norwegian, Swedish, and Icelandic hospitals. POPULATION Pregnant women with PCOS treated with metformin (PCOS-M, n = 36) or placebo (PCOS-P, n = 37), and healthy pregnant women (HC, n = 15). METHODS Serum levels of the appetite regulating hormones leptin, ghrelin, allopregnanolone, and soluble leptin receptor (sOB-R) were determined in the first and third trimesters. MAIN OUTCOME MEASURES Excessive GWG (eGWG) relative to body mass index according to Institute of Medicine (IOM) guideline. Serum leptin/sOB-R ratio, or free-leptin-index (FLI), as biomarker of leptin sensitivity. Serum ghrelin and allopregnanolone levels. RESULTS The overall prevalence of eGWG was 44% (38/86). Women with eGWG had higher first and third trimester FLI (P < 0.001), and lower third trimester allopregnanolone levels (P = 0.003) versus women with non-eGWG. The prevalence of eGWG was lower in PCOS-M versus PCOS-P (28% versus 62%, odds ratio = 0.4, 95% CI 0.2-0.8, P = 0.005). FLI decreased during pregnancy in PCOS-M (P = 0.01), but remained unaltered in PCOS-P and HC. Ghrelin and allopregnanolone levels were comparable in PCOS-M, PCOS-P and HC throughout pregnancy. CONCLUSION Excessive GWG is associated with enhanced leptin resistance, and attenuated physiological increase in serum allopregnanolone levels during pregnancy. Metformin reduces the risk for eGWG and improves leptin sensitivity in pregnant women with PCOS.
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Affiliation(s)
- Johanna Molin
- Department of Clinical Sciences, Obstetrics and Gynaecology, Umeå University, Umeå, Sweden
| | - Eszter Vanky
- Department of Clinical and Molecular Medicine, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway.,Department of Obstetrics and Gynaecology, St Olav's Hospital, Trondheim University Hospital, Trondheim, Norway
| | - Tone S Løvvik
- Department of Clinical and Molecular Medicine, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway.,Department of Obstetrics and Gynaecology, St Olav's Hospital, Trondheim University Hospital, Trondheim, Norway
| | - Eva Dehlin
- Department of Clinical Sciences, Obstetrics and Gynaecology, Umeå University, Umeå, Sweden
| | - Marie Bixo
- Department of Clinical Sciences, Obstetrics and Gynaecology, Umeå University, Umeå, Sweden
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Barriers and Facilitators to Healthy Eating and Physical Activity Postpartum: A Qualitative Systematic Review. J Acad Nutr Diet 2021; 122:602-613.e2. [PMID: 34839027 DOI: 10.1016/j.jand.2021.11.015] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2021] [Revised: 11/17/2021] [Accepted: 11/20/2021] [Indexed: 11/23/2022]
Abstract
BACKGROUND Postpartum weight retention increases the risk of long-term overweight and obesity and associated comorbidities. Healthy eating and physical activity are important lifestyle behaviors for achieving and maintaining a healthy weight. However, these habits may be hard for women to adopt or maintain during the postpartum period. OBJECTIVE To identify and describe barriers and facilitators to healthy eating and physical activity among postpartum women in the United States. METHODS A qualitative systematic review was conducted. Qualitative studies on women's experiences with weight loss, healthy eating, and physical activity in the postpartum period were identified using a comprehensive search strategy. The quality of included studies was assessed using the Critical Appraisal Skills Programme checklist. Data were qualitatively analyzed using thematic synthesis. Resulting themes were mapped onto components of the Social-Ecological Model for Food and Physical Activity Decisions. RESULTS Thirteen qualitative studies were included in the review. Barriers and facilitators to healthy eating and physical activity during the postpartum period included individual factors (emotional and mindless eating, physical limitations, and social support), settings and sectors (food environments, childcare needs, and structured information and support), and social and cultural norms (time constraints, and prioritization of maternal responsibilities). CONCLUSIONS Researchers and practitioners should consider how factors within various levels of the Social-Ecological Model may influence healthy eating and physical activity in the postpartum period.
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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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11
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Poncet L, Panjo H, Schmitz T, Luton D, Mandelbrot L, Estellat C, Andro A, Ringa V, Azria E. Gestational weight gain in a migration context: are migrant women more at risk of inadequate or excessive weight gain during pregnancy? J Epidemiol Community Health 2021; 76:230-238. [PMID: 34389663 DOI: 10.1136/jech-2021-216619] [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: 02/09/2021] [Accepted: 07/20/2021] [Indexed: 11/03/2022]
Abstract
BACKGROUND Inadequate or excessive gestational weight gain (GWG) is associated with adverse maternal and neonatal outcomes. Little is known on adequacy of GWG in migrant women. This study investigates whether migrant women in France are at higher risk of inadequate or excessive GWG, and what characteristics are associated with GWG in migrant and non-migrant groups. METHODS We used data from the PreCARE multicentric prospective cohort (N=10 419). The study includes 5403 women with singleton deliveries, with non-migrant (n=2656) and migrant (n=2747) status. We used multinomial logistic regression, adjusting for maternal age and parity, to investigate the association of migrant status, socioeconomic status-related variables and GWG. In stratified analyses, we identified factors associated with GWG in both groups. RESULTS Compared with non-migrant women, migrant women had increased risk of inadequate GWG (adjusted odds ratio (aOR) 1.18; 95% CI 1.03 to 1.34). Non-migrant women with foreign origins had increased risk of excessive GWG (aOR 1.58; 95% CI 1.30 to 1.92). Women born in Sub-Saharan Africa had increased risk of both inadequate and excessive GWG. Regardless of migration status, women with lower education and women who did not start pregnancy with a normal weight were less likely to gain adequately. Inadequate prenatal care was associated with inadequate GWG only among non-migrant women. CONCLUSION Migrant women are at higher risk of inadequate GWG.
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Affiliation(s)
- Lorraine Poncet
- CESP Primary Care and Prevention Team, Université Paris-Saclay, UVSQ, Université Paris-Sud, INSERM, Villejuif, France .,French Collaborative Institute on Migrations, France, Paris, France
| | - Henri Panjo
- CESP Primary Care and Prevention Team, Université Paris-Saclay, UVSQ, Université Paris-Sud, INSERM, Villejuif, France
| | - Thomas Schmitz
- Obstetrical, Perinatal and Pediatric Epidemiology (EPOPé research team), DHU Risks in Pregnancy, Paris Descartes University, 53 Avenue de l'Observatoire, INSERM U1153, Paris, France.,Department of Obstetrics and Gynecology, Hopital Universitaire Mere-enfant Robert-Debre, Paris, France
| | - Dominique Luton
- Department of Obstetrics and Gynecology, DHU Risks in Pregnancy, Hopital Bichat - Claude-Bernard, Paris, France
| | - Laurent Mandelbrot
- Department of Obstetrics and Gynecology, DHU Risks in Pregnancy, Hopital Louis-Mourier, Colombes, France
| | - Candice Estellat
- Department of Biostatistics, Public Health and Medical Information, Clinical research unit, Pharmacoepidemiology center, Hopital Universitaire Pitie Salpetriere, Paris, France
| | - Armelle Andro
- French Collaborative Institute on Migrations, France, Paris, France.,Institute of demography research center, Université Paris 1 Panthéon-Sorbonne, Paris, France
| | - Virginie Ringa
- CESP Primary Care and Prevention Team, Université Paris-Saclay, UVSQ, Université Paris-Sud, INSERM, Villejuif, France
| | - Elie Azria
- Obstetrical, Perinatal and Pediatric Epidemiology (EPOPé research team), DHU Risks in Pregnancy, Paris Descartes University, 53 Avenue de l'Observatoire, INSERM U1153, Paris, France.,Department of Obstetrics, Groupe hospitalier Paris Saint-Joseph, Paris, France
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Asefa F, Cummins A, Dessie Y, Foureur M, Hayen A. Patterns and predictors of gestational weight gain in Addis Ababa, Central Ethiopia: a prospective cohort study. Reprod Health 2021; 18:159. [PMID: 34321037 PMCID: PMC8317358 DOI: 10.1186/s12978-021-01202-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2020] [Accepted: 07/12/2021] [Indexed: 11/10/2022] Open
Abstract
INTRODUCTION Gaining excessive or inadequate gestational weight is associated with many adverse maternal and fetal outcomes. Inadequate gestational weight gain (GWG) increases the risk of fetal growth restriction, pre-term birth, and low birth weight. It is a public health concern in sub-Saharan Africa. The aim of this study was to assess the patterns and predictors of GWG in Addis Ababa, Ethiopia. METHODS We conducted a prospective cohort study among pregnant women who attended antenatal care in health centres in Addis Ababa, from January to September 2019. Data were collected by a structured questionnaire and checklists and analysed using Stata version-14. Weight at or before 16 weeks gestation was used as a proxy for pre-pregnancy weight. Women's height and baseline weight were measured by data collectors, and we obtained weight at the end of the 24th and 36th weeks of gestation from women's medical records. GWG was categorized as inadequate, adequate and excessive based on the United States Institute of Medicine criteria. Predictors of GWG were identified using multinomial logistic regression. RESULTS A total of 395 pregnant women were enrolled in the study. GWG was assessed for 369 (93%) women. The median GWG was 8.7 kg with inter quartile ranges (25th, 75th percentiles) of 7.0 kg and 11.6 kg. More than two-third of the participants, 248 (67.2% [95% CI: 62.2, 72.0%]), gained inadequate weight; 103 (27.9% [95% CI: 23.4, 32.8%]) gained adequate weight; and 18 (4.9% [95% CI: 2.9%, 7.6%]) gained excessive weight. Three quarters (75%) of underweight women gained inadequate gestational weight, whereas 43% of overweight or obese women gained inadequate gestational weight. Being underweight (AOR = 3.30 [95% CI: 1.32, 8.24]) or normal weight (AOR = 2.68 [95% CI: 1.37, 5.24]) before pregnancy increased the odds of gaining inadequate gestational weight compared to overweight or obese women. Not having paid employment was associated with higher odds of gaining inadequate gestational weight compared to women employed outside the home (AOR = 2.17 [95% CI: 1.16, 4.07]). CONCLUSIONS Most pregnant women in Addis Ababa gain inadequate gestational weight. In particular, three quarters of underweight women gained inadequate gestational weight. Being underweight, normal weight or having no paid employment were associated with higher odds of inadequate GWG. Promoting adequate GWG in Addis Ababa among underweight and normal weight women may be an important public health initiative.
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Affiliation(s)
- Fekede Asefa
- School of Public Health, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
- Centre for Midwifery, Child and Family Health, Faculty of Health, University of Technology Sydney,
Ultimo, Sydney, NSW Australia
- School of Public Health, Faculty of Health, University of Technology Sydney,
Ultimo, Sydney, NSW Australia
| | - Allison Cummins
- Centre for Midwifery, Child and Family Health, Faculty of Health, University of Technology Sydney,
Ultimo, Sydney, NSW Australia
| | - Yadeta Dessie
- School of Public Health, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Maralyn Foureur
- Centre for Midwifery, Child and Family Health, Faculty of Health, University of Technology Sydney,
Ultimo, Sydney, NSW Australia
- Hunter New England Health, Nursing and Midwifery Research Centre, University of Newcastle,
Newcastle
, NSW Australia
| | - Andrew Hayen
- School of Public Health, Faculty of Health, University of Technology Sydney,
Ultimo, Sydney, NSW Australia
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Amyx M, Zeitlin J, Hermann M, Castetbon K, Blondel B, Le Ray C. Maternal characteristics associated with gestational weight gain in France: a population-based, nationally representative study. BMJ Open 2021; 11:e049497. [PMID: 34215613 PMCID: PMC8256790 DOI: 10.1136/bmjopen-2021-049497] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
OBJECTIVES To provide nationally representative estimates of gestational weight gain (GWG) and identify maternal characteristics associated with inadequate GWG in France. DESIGN A population-based study using data from the French National Perinatal Survey: 2010 and 2016. SETTING All maternity units in metropolitan, mainland France (n=535 in 2010; n=493 in 2016). PARTICIPANTS Singleton live births with GWG data (N=24 850). PRIMARY OUTCOME MEASURES GWG was calculated as end of pregnancy minus pre-pregnancy weight (kg) and categorised as 'insufficient', 'adequate', or 'excessive' using 2009 Institute of Medicine thresholds. Classification accounted for pre-pregnancy body mass index (BMI) (kg/m2; underweight (<18.5), normal weight (18.5-24.9), overweight (25-29.9), obese (≥30)) and gestational age at birth. We estimated average GWG and the percentage of women in each GWG category. Polytomous logistic regression identified characteristics associated with GWG adequacy. RESULTS Average GWG was 13.0 kg (SD 5.6), with 26.8% of women gaining insufficiently, 37.0% adequately and 36.1% excessively. Among other factors, insufficient GWG was associated with underweight (vs normal weight; adjusted OR (aOR) 1.4, 95% CI 1.2 to 1.5) and obese (aOR 1.5, 95% CI 1.4 to 1.7) BMI. Excessive GWG was associated with overweight (aOR 2.8, 95% CI 2.6 to 3.1) and obese BMI (aOR 3.3, 95% CI 2.9 to 3.6). Examining obesity classes separately, odds of insufficient GWG increased from obesity class I to III, while odds of excessive GWG decreased from obesity class I to III. Primiparity (insufficient: aOR 0.9, 95% CI 0.9 to 1.0; excessive: aOR 1.2, 95% CI 1.2 to 1.3), maternal characteristics indicative of lower socioeconomic status, and continuing or quitting smoking during pregnancy were also associated with inadequate GWG. CONCLUSIONS In France, insufficient and excessive GWG are common. For optimal outcomes, clinician education, with special attention to the needs of higher risk/vulnerable groups, is needed to ensure all women receive appropriate advice for recommended GWG.
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Affiliation(s)
- Melissa Amyx
- Obstetrical, Perinatal and Pediatric Epidemiology Research Team (EPOPé), Center for Research on Epidemiology and Statistics Sorbonne Paris Cité (CRESS), University of Paris, INSERM UMR 1153, Paris, France
| | - Jennifer Zeitlin
- Obstetrical, Perinatal and Pediatric Epidemiology Research Team (EPOPé), Center for Research on Epidemiology and Statistics Sorbonne Paris Cité (CRESS), University of Paris, INSERM UMR 1153, Paris, France
| | - Monika Hermann
- Obstetrical, Perinatal and Pediatric Epidemiology Research Team (EPOPé), Center for Research on Epidemiology and Statistics Sorbonne Paris Cité (CRESS), University of Paris, INSERM UMR 1153, Paris, France
| | - Katia Castetbon
- Epidemiology, Biostatistics and Clinical Research Research Center, ULB School of Public Health, Brussels, Belgium
| | - Béatrice Blondel
- Obstetrical, Perinatal and Pediatric Epidemiology Research Team (EPOPé), Center for Research on Epidemiology and Statistics Sorbonne Paris Cité (CRESS), University of Paris, INSERM UMR 1153, Paris, France
| | - Camille Le Ray
- Obstetrical, Perinatal and Pediatric Epidemiology Research Team (EPOPé), Center for Research on Epidemiology and Statistics Sorbonne Paris Cité (CRESS), University of Paris, INSERM UMR 1153, Paris, France
- Cochin Hospital Port Royal, Port Royal Maternity, Department of Obstetrics, University of Paris, APHP, Paris, France
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Low selenium intake is associated with postpartum weight retention in Chinese women and impaired physical development of their offspring. Br J Nutr 2021; 126:1498-1509. [PMID: 33427139 DOI: 10.1017/s0007114521000015] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
The aim of this study was to investigate the association between daily Se intake and postpartum weight retention (PPWR) among Chinese lactating women, and the impact of their Se nutritional status on infants' physical development. Se contents in breast milk and plasma collected from 264 lactating Chinese women at the 42nd day postpartum were analysed with inductively coupled plasma MS. Daily Se intake was calculated based on plasma Se concentration. The dietary data of 24-h records on three consecutive days were collected. Infant growth status was evaluated with WHO standards by Z-scores. Linear regression analyses and multinomial logistic regression were conducted to examine the impact of Se disequilibrium (including other factors) on PPWR and growth of infants, respectively. The results indicated that: (1) the daily Se intake of the subjects was negatively associated with their PPWR (B = -0·002, 95 % CI - 0·003, 0·000, P = 0·039); (2) both insufficient Se daily intake (B = -0·001, OR 0·999, 95 % CI 0·998, 1·000, P = 0·014) and low level of Se in milk (B = -0·025, OR 0·975, 95 % CI 0·951, 0·999, P = 0·021) had potential associations with their infants' wasting, and low level of Se in milk (B = -0·159, OR 0·853, 95 % CI 0·743, 0·980, P = 0·024) had a significant association with their infants' overweight. In conclusion, the insufficient Se nutritional status of lactating Chinese women was first found as one possible influencing factor of their PPWR as well as low physical development of their offspring.
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Trimester-Specific and Total Gestational Weight Gain in Two Consecutive Pregnancies. JOURNAL OF OBSTETRICS AND GYNAECOLOGY CANADA 2020; 43:483-489.e3. [PMID: 33359554 DOI: 10.1016/j.jogc.2020.12.009] [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: 09/03/2020] [Revised: 12/03/2020] [Accepted: 12/05/2020] [Indexed: 11/22/2022]
Abstract
OBJECTIVE This retrospective study aimed to characterize trimester-specific and total gestational weight gain (GWG) over the course of two consecutive pregnancies, as well as maternal determinants associated with interpregnancy weight change (IPWC) and excessive GWG in the second pregnancy. METHODS We analyzed the electronic medical records of women who delivered their first two consecutive infants at term between 2001 and 2017. RESULTS Weight gain trajectories differed between the first and second pregnancy for the 1497 women included in this study, with lower second- and third-trimester weight gain in the second pregnancy. Respectively, 53% and 41% of women had excessive GWG in the first and second pregnancies, with a higher proportion of excessive GWG found in women with a higher body mass index (BMI). Most women (55%) experienced interpregnancy weight gain. Maternal determinants of IPWC were BMI before first pregnancy, first-trimester and total GWG in the first pregnancy, and interpregnancy interval (P < 0.0001). Maternal risk factors associated with excessive GWG in the second pregnancy were excessive total GWG in the first pregnancy (OR 6.23; 95% CI 4.67-8.32), interpregnancy weight gain (OR 1.58; 95% CI 1.19-2.09), and interpregnancy interval (OR 1.18; 95% CI 1.07-1.29) as well as BMI before the second pregnancy (OR 1.04, 95% CI 1.02-1.07). CONCLUSION Weight gain trajectories differ between consecutive pregnancies. GWG in the first pregnancy is a key determinant for IPWC and GWG in the second pregnancy.
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Asefa F, Cummins A, Dessie Y, Foureu M, Hayen A. Midwives' and obstetricians' perspectives about pregnancy related weight management in Ethiopia: A qualitative study. PLoS One 2020; 15:e0244221. [PMID: 33332406 PMCID: PMC7746277 DOI: 10.1371/journal.pone.0244221] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2020] [Accepted: 12/04/2020] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Midwives and obstetricians are key maternity care providers; they are the most trusted source of information regarding nutrition and gestational weight gain. However, their views, practices and perceived barriers to managing pregnancy related weight gain have not been studied in Ethiopia. The aim of this study was to explore midwives' and obstetricians' observations and perspectives about gestational weight gain and postpartum weight management in Ethiopia. METHODS We conducted face-to-face interviews with 11 midwives and 10 obstetricians, from January 2019 to March 2019. All interview data were transcribed verbatim. We analysed the data using thematic analysis with an inductive approach. RESULTS We identified three themes and associated subthemes. Midwives and obstetricians had limited knowledge of the optimal gestational weight gain. Almost all participants were unaware of the presence of the Institute of Medicine recommendations for optimal weight gain in pregnancy. According to the study participants, women in Ethiopia do not want to gain weight during pregnancy, but do want to gain weight after the birth. Counselling about gestational weight gain and postpartum weight management was not routinely provided for pregnant women. This is mostly because gestational weight gain counselling was not considered to be a priority by maternity care providers in Ethiopia. CONCLUSIONS The limited knowledge of and low attention to pregnancy related weight management by midwives and obstetricians in this setting needs appropriate intervention. Adapting a guideline for pregnancy weight management and integrating it into antenatal care is essential.
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Affiliation(s)
- Fekede Asefa
- School of Public Health, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
- Centre for Midwifery, Child and Family Health, Faculty of Health, University of Technology Sydney, Sydney, NSW, Australia
- School of Public Health, Faculty of Health, University of Technology Sydney, Sydney, NSW, Australia
| | - Allison Cummins
- Centre for Midwifery, Child and Family Health, Faculty of Health, University of Technology Sydney, Sydney, NSW, Australia
| | - Yadeta Dessie
- School of Public Health, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Maralyn Foureu
- Centre for Midwifery, Child and Family Health, Faculty of Health, University of Technology Sydney, Sydney, NSW, Australia
- Hunter New England Health, Nursing and Midwifery Research Centre, University of Newcastle, Newcastle, NSW, Australia
| | - Andrew Hayen
- School of Public Health, Faculty of Health, University of Technology Sydney, Sydney, NSW, Australia
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Maternal Characteristics that Impact Postpartum Weight Retention: Results from the 2016 Los Angeles Mommy and Baby (LAMB) Follow-Up Study. Matern Child Health J 2020; 25:151-161. [PMID: 33188470 DOI: 10.1007/s10995-020-03082-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/07/2020] [Indexed: 10/23/2022]
Abstract
OBJECTIVE To identify maternal characteristics associated with 24-month postpartum weight retention. METHODS Data were collected from the 2016 Los Angeles Mommy and Baby (LAMB) Follow-Up Survey, a population-based prospective cohort study that assesses maternal and infant health in Los Angeles County. In 2014, LAMB initially surveyed 6035 women 6 months following a live birth. The 2016 LAMB Follow-Up reevaluated this same cohort after the index child's second birthday. 2679 women completed 2016 LAMB Follow-Up (52% adjusted response rate). The final sample size was 1524 after excluding subjects with subsequent pregnancies after the index child and missing information for postpartum weight. Eight predictors were included in this analysis: gestational weight gain, pre-pregnancy BMI, exercise, depressed mood since having child, age, race, education, and job loss during pregnancy. Chi-square tests and logistic regression analyses were performed using SAS 9.3. RESULTS Two years after delivery, women with postpartum weight retention weighed on average of 15.3 lb. more than before the index pregnancy. Women were more likely to retain postpartum weight when they exceeded gestational weight gain guidelines (AOR = 2.03, 95% CI = 1.40-2.93), did not exercise (AOR = 3.32, CI = 1.85-5.98), were between ages 20-29 (AOR = 1.54, CI = 1.01-2.36), were Hispanic (AOR = 1.51, CI = 1.02-2.24), completed high school only (AOR = 1.77, CI = 1.15-2.73), or lost a job during pregnancy (AOR = 2.62, CI = 1.39-4.93). CONCLUSIONS Modifiable risk factors and sociodemographic characteristics can impact maternal weight retention 24 months after pregnancy. Understanding postpartum weight retention is essential for guiding future public health research, programming, and policy. Tailoring appropriate public health interventions may help women sustain healthy weight during their reproductive years and beyond.
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An application of psychosocial frameworks for eating disorder risk during the postpartum period: A review and future directions. Arch Womens Ment Health 2020; 23:625-633. [PMID: 32613296 DOI: 10.1007/s00737-020-01049-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2020] [Accepted: 06/23/2020] [Indexed: 02/06/2023]
Abstract
The postpartum period may be a particular window of vulnerability for eating disorder symptoms given changes to body shape and weight that women experience. However, no quantitative studies have identified risk factors for postpartum eating disorder symptoms, and current psychosocial frameworks of risk may be missing key elements unique to this period. This manuscript reviews existing quantitative and qualitative literature regarding the developmental trajectory of eating disorder symptoms during the perinatal period and proposes an application of three psychosocial models of eating disorder risk (objectification theory, the tripartite influence model of body image and eating disturbances, and social comparison theory) to the postpartum period. Drawing on quantitative and qualitative literature, this paper identifies novel postpartum-specific factors that should be included for consideration in psychosocial models (e.g., self-oriented body comparison and pressure to achieve a prepregnancy weight and shape). This review is the first to theorize potential postpartum-specific risk factors for postpartum eating disorder symptoms. Prior models of eating disorder risk omit key psychosocial factors that are unique to the postpartum period. Other limitations of prior research relate to measurement and methodology. This critical window of vulnerability has been largely ignored in the quantitative literature and necessitates further research.
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Quansah DY, Gross J, Gilbert L, Arhab A, Horsch A, Puder JJ. Predictors and consequences of weight retention in the early and late postpartum period in women with gestational diabetes. Diabetes Res Clin Pract 2020; 165:108238. [PMID: 32502690 DOI: 10.1016/j.diabres.2020.108238] [Citation(s) in RCA: 4] [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: 12/03/2019] [Revised: 04/20/2020] [Accepted: 05/21/2020] [Indexed: 12/30/2022]
Abstract
AIMS To assist preventive strategies, we investigated the predictors and consequences of postpartum weight retention (PPWR) in the early and late postpartum period in women with gestational diabetes (GDM). METHODS 862 women with GDM between 2011 and 2019 were prospectively included. We investigated PPWR at 6-8 weeks (n = 862) and at 1-year (n = 259) postpartum. Potential predictors included gestational weight gain (GWG), weight, BMI, and glucose control parameters during and after pregnancy. RESULTS Mean PPWR at 6-8 weeks and 1-year postpartum were 4.6 ± 5.7 kg and 4.0 ± 7.4 kg. The proportion of women with PPWR at 6-8 weeks and at 1-year postpartum were 81% and 66.4% respectively. At 6-8 weeks postpartum, women with PPWR had higher pre-pregnancy weight, 7.5 ± 0.2 kg higher GWG and higher postpartum weight (all p ≤ 0.02), without presenting metabolic differences. At 1-year postpartum, there were no differences in anthropometric parameters before and during pregnancy between women with or without PPWR, except for a 4 ± 0.4 kg higher GWG (p < 0.001). However, women with PPWR had increased postpartum weight and BMI, higher fasting glucose and more pronounced increase in Δfasting glucose and ΔHbA1c at 1-year postpartum (all p ≤ 0.03). GWG predicted higher PPWR at both 6-8 weeks and at 1-year postpartum (all p < 0.001). CONCLUSION Women with PPWR had increased anthropometric parameters and adverse metabolic consequences at 1-year postpartum. GWG was the most relevant predictor of PPWR.
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Affiliation(s)
- Dan Yedu Quansah
- Obstetric Service, Department Woman-Mother-Child, Lausanne University Hospital, Lausanne, Switzerland.
| | - Justine Gross
- Obstetric Service, Department Woman-Mother-Child, Lausanne University Hospital, Lausanne, Switzerland; Service of Endocrinology, Diabetes and Metabolism, Department of Medicine, Lausanne University Hospital, Lausanne, Switzerland.
| | - Leah Gilbert
- Obstetric Service, Department Woman-Mother-Child, Lausanne University Hospital, Lausanne, Switzerland.
| | - Amar Arhab
- Obstetric Service, Department Woman-Mother-Child, Lausanne University Hospital, Lausanne, Switzerland.
| | - Antje Horsch
- Institute of Higher Education and Research in Healthcare (IUFRS), University of Lausanne, Switzerland; Neonatology Service, Department Woman-Mother-Child, Lausanne University Hospital, Lausanne, Switzerland.
| | - Jardena J Puder
- Obstetric Service, Department Woman-Mother-Child, Lausanne University Hospital, Lausanne, Switzerland.
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Adam LM, Jarman M, Barker M, Manca DP, Lawrence W, Bell RC. Use of healthy conversation skills to promote healthy diets, physical activity and gestational weight gain: Results from a pilot randomised controlled trial. PATIENT EDUCATION AND COUNSELING 2020; 103:1134-1142. [PMID: 32035738 DOI: 10.1016/j.pec.2020.01.001] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/23/2019] [Revised: 12/06/2019] [Accepted: 01/01/2020] [Indexed: 06/10/2023]
Abstract
OBJECTIVES This study evaluated the use of Healthy Conversation Skills (a client-centered communication approach to behaviour change) in supporting women to achieve optimal gestational-weight-gain and health behaviours. METHODS Seventy pregnant women were randomised to the control or intervention group. Study visits and phone calls were delivered by Registered Dietitians (RDs) to women in the intervention and control groups. The intervention RD was trained in Healthy Conversation Skills while the control RD was not. Diet, physical activity and gestational-weight-gain were assessed at baseline and again at follow-up in the intervention and control groups. RESULTS Women in the intervention group improved their diet score between baseline and visit 2, while the control group did not. At 34 weeks, women in the control group reported being sedentary for longer than women in the intervention group. There were no differences in total gestational-weight-gain between the groups. CONCLUSIONS Pregnant women who interacted with an RD using Healthy Conversation Skills reported positive outcomes in health behaviours. PRACTICE IMPLICATIONS Healthy Conversation Skills shows promise as an approach to initiate, and maintain discussions promoting health behaviour change in pregnancy.
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Affiliation(s)
- Laura M Adam
- Department of Agricultural, Food and Nutritional Science, University of Alberta, Edmonton, AB, T6G 2H3, Canada
| | - Megan Jarman
- Department of Agricultural, Food and Nutritional Science, University of Alberta, Edmonton, AB, T6G 2H3, Canada
| | - Mary Barker
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, SO16 6YD, UK; NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - Donna P Manca
- Department of Family Medicine, Faculty of Medicine & Dentistry, University of Alberta, Edmonton, AB, T6G 2T4, Canada
| | - Wendy Lawrence
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, SO16 6YD, UK; NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - Rhonda C Bell
- Department of Agricultural, Food and Nutritional Science, University of Alberta, Edmonton, AB, T6G 2H3, Canada.
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Asefa F, Cummins A, Dessie Y, Hayen A, Foureur M. Gestational weight gain and its effect on birth outcomes in sub-Saharan Africa: Systematic review and meta-analysis. PLoS One 2020; 15:e0231889. [PMID: 32324783 PMCID: PMC7179909 DOI: 10.1371/journal.pone.0231889] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2019] [Accepted: 04/02/2020] [Indexed: 11/28/2022] Open
Abstract
INTRODUCTION An increased metabolic demand during pregnancy is fulfilled by gaining sufficient gestational weight. Women who gain inadequate-weight are at a high-risk of premature birth or having a baby with low-birth weight. However, women who gain excessive-weight are at a high-risk of having a baby with macrosomia. The aim of this review was to determine the distribution of gestational weight gain and its association with birth-outcomes in Sub-Saharan Africa. METHODS For this systematic review and meta-analysis, we performed a literature search using PubMed, Medline, Embase, Scopus, and the Cumulative Index to Nursing and Allied Health Literature (CINAHL) databases. We searched grey-literature from Google and Google Scholar, and region-specific journals from the African Journals Online (AJOL) database. We critically appraised the included studies using the Effective Public Health Practice Project Quality Assessment Tool for Quantitative Studies. Two independent reviewers evaluated the quality of the studies and extracted the data. We calculated pooled relative-risks (RR) with 95% confidence intervals. RESULTS Of 1450 retrieved studies, 26 met the inclusion criteria. Sixteen studies classified gestational weight gain according to the United States Institute of Medicine recommendations. The percentage adequate amount of gestational weight ranged from 3% to 62%. The percentage of inadequate weight was >50% among nine studies. Among underweight women, the percentage of women who gained inadequate gestational weight ranged from 67% to 98%. Only two studies were included in the meta-analyses to evaluate the association of gestational weight gain with pre-eclampsia and macrosomia. No difference was observed among women who gained inadequate and adequate gestational weight regarding experiencing pre-eclampsia (RR, 0.71; 95% CI: 0.22, 2.28, P = 0.57). Excessive gestational weight gain was not significantly associated with macrosomia compared to adequate weight gain (RR, 0.68; 95% CI: 0.38, 1.22, P = 0.20). CONCLUSION A substantial proportion of sub-Saharan African women gain inadequate gestational weight particularly high among underweight women. Future interventions would need to design effective pre-pregnancy weight management strategies.
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Affiliation(s)
- Fekede Asefa
- School of Public Health, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
- Centre for Midwifery, Child and Family Health, Faculty of Health, University of Technology Sydney, Ultimo, NSW, Australia
- Australian Centre for Public and Population Health Research, Faculty of Health, University of Technology Sydney, Ultimo, NSW, Australia
| | - Allison Cummins
- Centre for Midwifery, Child and Family Health, Faculty of Health, University of Technology Sydney, Ultimo, NSW, Australia
| | - Yadeta Dessie
- School of Public Health, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Andrew Hayen
- Australian Centre for Public and Population Health Research, Faculty of Health, University of Technology Sydney, Ultimo, NSW, Australia
| | - Maralyn Foureur
- Centre for Midwifery, Child and Family Health, Faculty of Health, University of Technology Sydney, Ultimo, NSW, Australia
- Hunter New England Health, Nursing and Midwifery Research Centre, University of Newcastle, Callaghan, NSW, Australia
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Abstract
PURPOSE OF REVIEW Gestational weight gain is a modifiable risk factor for adverse perinatal outcomes. After the Institute of Medicine (IOM) released updated recommendations for gestational weight gain in 2009, a multitude of studies were released examining the recommendations, particularly for women with obesity. As the obesity epidemic continues, many physicians are interested in minimizing gestational weight gain for all women. Our aim was to review the evidence for the association of gestational weight gain and perinatal outcomes, particularly for weight gain outside the IOM guidelines. RECENT FINDINGS Gestational weight gain is associated with several adverse perinatal outcomes including fetal growth, preterm delivery, cesarean delivery, gestational diabetes, hypertensive disorders of pregnancy, and infant mortality as well as with long-term offspring metabolic health outcomes. Multiple randomized controlled trials have been conducted evaluating the efficacy of lifestyle intervention on gestational weight gain, and while lifestyle interventions may alter gestational weight gain, they have not been associated with improvement in perinatal outcomes. Weight loss during pregnancy is associated with decreased risks of macrosomia and cesarean delivery; however, given an association with low birth weight, it is not currently recommended. Excessive gestational weight gain is known to be associated with multiple adverse fetal and maternal outcomes. Lifestyle interventions during pregnancy may be helpful in decreasing excessive weight gain, but have not shown to be beneficial for most adverse pregnancy outcomes. More research is needed before making recommendations for weight loss in women with obesity during pregnancy.
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Affiliation(s)
- Macie L Champion
- Division of Maternal Fetal Medicine. Department of Obstetrics and Gynecology, Center for Women's Reproductive Health at the University of Alabama at Birmingham, 1700 6th Ave S, Birmingham, AL, 35233, USA.
| | - Lorie M Harper
- Division of Maternal Fetal Medicine. Department of Obstetrics and Gynecology, Center for Women's Reproductive Health at the University of Alabama at Birmingham, 1700 6th Ave S, Birmingham, AL, 35233, USA
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Ha AVV, Zhao Y, Binns CW, Pham NM, Nguyen PTH, Nguyen CL, Chu TK, Lee AH. Postpartum Physical Activity and Weight Retention within One Year: A Prospective Cohort Study in Vietnam. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17031105. [PMID: 32050525 PMCID: PMC7038097 DOI: 10.3390/ijerph17031105] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/19/2019] [Revised: 02/05/2020] [Accepted: 02/06/2020] [Indexed: 12/13/2022]
Abstract
After delivery, mothers are encouraged to increase physical activity (PA) gradually to regulate body weight; however, data on PA in relation to postpartum weight retention remains scarce, particularly among Asian women. In a cohort of 1617 Vietnamese mothers, we investigated the prospective association between habitual PA exposures at 3-month postpartum and weight retention at 6-month and 12-month postpartum. Detailed information on PA intensity and domains was collected from participants using a validated instrument specifically for Vietnamese women. Linear regression analyses and a general linear model for the repeated weight retention measures were used to ascertain the apparent relationships. On average, the participants reported 3.6 (SD 3.9) and 2.6 (SD 3.8) kg weight loss at 6- and 12-month postpartum, respectively. Total and light-intensity PA were inversely associated with the postpartum weight retention (p for trend <0.05). Our findings highlight the importance of resuming PA in the early postpartum period as an appropriate weight management strategy.
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Affiliation(s)
- Anh Vo Van Ha
- School of Public Health, Curtin University, Perth, WA 6845, Australia; (A.V.V.H.)
- Faculty of Public Health, Pham Ngoc Thach University of Medicine, Ho Chi Minh City 700000, Vietnam
| | - Yun Zhao
- School of Public Health, Curtin University, Perth, WA 6845, Australia; (A.V.V.H.)
| | - Colin W. Binns
- School of Public Health, Curtin University, Perth, WA 6845, Australia; (A.V.V.H.)
| | - Ngoc Minh Pham
- School of Public Health, Curtin University, Perth, WA 6845, Australia; (A.V.V.H.)
- Faculty of Public Health, Thai Nguyen University of Medicine and Pharmacy, Thai Nguyen 250000, Vietnam
| | - Phung Thi Hoang Nguyen
- School of Public Health, Curtin University, Perth, WA 6845, Australia; (A.V.V.H.)
- Faculty of Public Health, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City 700000, Vietnam
| | - Cong Luat Nguyen
- National Institute of Hygiene and Epidemiology, Hanoi 100000, Vietnam
| | - Tan Khac Chu
- School of Public Health, Curtin University, Perth, WA 6845, Australia; (A.V.V.H.)
- Faculty of Public Health, Hai Phong University of Medicine and Pharmacy, Hai Phong 180000, Vietnam
| | - Andy H. Lee
- School of Public Health, Curtin University, Perth, WA 6845, Australia; (A.V.V.H.)
- Correspondence: ; Tel.: +61-8-9266-4180
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Koleilat M, Kim LP, Cortes B, Kodjebacheva GD. Perceived Motivators, Barriers and Intervention Strategies Related to Weight Loss After Childbirth Among WIC Participants in Southern California. Am J Health Promot 2019; 34:294-302. [PMID: 31876168 DOI: 10.1177/0890117119895948] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PURPOSE To explore perceived motivators and barriers to weight loss after childbirth and ideas for postpartum weight loss interventions among participants of the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC). APPROACH Four (2 with English-speaking and 2 with Spanish-speaking participants) focus groups were conducted. SETTING A WIC clinic in Southern California. PARTICIPANTS Of 22 participants, the majority were Hispanic/Latina. The mean age of the mothers' infants was 6.18 months. MEASURES A structured focus group guide was used. ANALYSIS Audio-recordings were transcribed verbatim. The Spanish transcriptions were reviewed for discrepancies by a bilingual coinvestigator and translated into English for analysis. Transcriptions of the focus group audio-recordings were organized in ATLAS.ti version 8.0. and analyzed using content analysis. RESULTS Participants had a mean age of 30.5 and a mean prepregnancy body mass index of 32.4. Motivators for weight loss after childbirth included modeling healthy behavior for children and a fear of developing chronic illness. Barriers to weight loss included lack of knowledge, self-efficacy, time, child care and support, postpartum depression, the 40-day rule, and having a c-section. Intervention ideas included providing accountability and peer support for weight loss, providing nutrition/exercise weight loss strategies, and integrating mobile phone technologies into weight loss programs. CONCLUSIONS Weight loss strategies for postpartum WIC participants should provide knowledge, support, accountability, and preferably integrate technology.
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Affiliation(s)
- Maria Koleilat
- Department of Public Health, College of Health and Human Development, California State University Fullerton, CA, USA
| | - Loan P Kim
- Flora L. Thornton Nutritional Science Program, Seaver College, Pepperdine University, Malibu, CA, USA
| | - Brittany Cortes
- Department of Public Health, College of Health and Human Development, California State University Fullerton, CA, USA
| | - Gergana Damianova Kodjebacheva
- Department of Public Health and Health Sciences, College of Health Sciences, University of Michigan-Flint, MI, USA.,International Institute, University of Michigan, Ann Arbor, MI, USA
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Hashim M, Radwan H, Hasan H, Obaid RS, Al Ghazal H, Al Hilali M, Rayess R, Chehayber N, Mohamed HJJ, Naja F. Gestational weight gain and gestational diabetes among Emirati and Arab women in the United Arab Emirates: results from the MISC cohort. BMC Pregnancy Childbirth 2019; 19:463. [PMID: 31795984 PMCID: PMC6892062 DOI: 10.1186/s12884-019-2621-z] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2018] [Accepted: 11/22/2019] [Indexed: 02/06/2023] Open
Abstract
Background Nutritional status of women during pregnancy has been considered an important prognostic indicator of pregnancy outcomes. Objectives To investigate the pattern of gestational weight gain (GWG) and gestational diabetes mellitus (GDM) and their risk factors among a cohort of Emirati and Arab women residing in the United Arab Emirates (UAE). A secondary objective was to investigate pre-pregnancy body mass index (BMI) and its socio-demographic correlates among study participants. Methods Data of 256 pregnant women participating in the cohort study, the Mother-Infant Study Cohort (MISC) were used in this study. Healthy pregnant mothers with no history of chronic diseases were interviewed during their third trimester in different hospitals in UAE. Data were collected using interviewer-administered multi-component questionnaires addressing maternal sociodemographic and lifestyle characteristics. Maternal weight, weight gain, and GDM were recorded from the hospital medical records. Results Among the study participants, 71.1% had inadequate GWG: 31.6% insufficient and 39.5% excessive GWG. 19.1% reported having GDM and more than half of the participants (59.4%) had a pre-pregnancy BMI ≥ 25 kg/m2. The findings of the multiple multinomial logistic regression showed that multiparous women had decreased odds of excessive gain as compared to primiparous [odds ratio (OR): 0.17; 95% CI: 0.05–0.54]. Furthermore, women with a pre-pregnancy BMI ≥ 25 kg/m2 had increased odds of excessive gain (OR: 2.23; 95%CI: 1.00–5.10) as compared to those with pre-pregnancy BMI < 25 kg/m2. Similarly, women who had a pre-pregnancy BMI ≥ 25 kg/m2 were at higher risk of having GDM (OR: 2.37; 95%CI: 1.10–5.12). As for the associations of women’s characteristics with pre-pregnancy BMI, age and regular breakfast consumption level were significant predictors of higher pre-pregnancy BMI. Conclusions This study revealed alarming prevalence rates of inadequate, mainly excessive, GWG and GDM among the MISC participants. Pre-pregnancy BMI was found a risk factor for both of these conditions (GWG and GDM). In addition, age and regular breakfast consumption were significant determinants of pre-pregnancy BMI. Healthcare providers are encouraged to counsel pregnant women to maintain normal body weight before and throughout pregnancy by advocating healthy eating and increased physical activity in order to reduce the risk of excessive weight gain and its associated complications.
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Affiliation(s)
- Mona Hashim
- Department of Clinical Nutrition and Dietetics, College of Health Sciences, Research Institute of Medical and Health Sciences (RIMHS), University of Sharjah, Sharjah, United Arab Emirates
| | - Hadia Radwan
- Department of Clinical Nutrition and Dietetics, College of Health Sciences, Research Institute of Medical and Health Sciences (RIMHS), University of Sharjah, Sharjah, United Arab Emirates
| | - Hayder Hasan
- Department of Clinical Nutrition and Dietetics, College of Health Sciences, Research Institute of Medical and Health Sciences (RIMHS), University of Sharjah, Sharjah, United Arab Emirates
| | - Reyad Shaker Obaid
- Department of Clinical Nutrition and Dietetics, College of Health Sciences, Research Institute of Medical and Health Sciences (RIMHS), University of Sharjah, Sharjah, United Arab Emirates
| | - Hessa Al Ghazal
- Family Health Promotion Center, Sharjah, United Arab Emirates
| | - Marwa Al Hilali
- Al Qassimi Hospital, Ministry of Health and Prevention, Sharjah, United Arab Emirates
| | - Rana Rayess
- Department of Clinical Nutrition and Dietetics, College of Health Sciences, Research Institute of Medical and Health Sciences (RIMHS), University of Sharjah, Sharjah, United Arab Emirates
| | - Noor Chehayber
- Department of Clinical Nutrition and Dietetics, College of Health Sciences, Research Institute of Medical and Health Sciences (RIMHS), University of Sharjah, Sharjah, United Arab Emirates
| | | | - Farah Naja
- Department of Nutrition and Food Sciences, American University of Beirut, Beirut, Lebanon.
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Gallagher K, Ralph J, Petros T, Qualls C, Leeman L, Rogers RG. Postpartum Weight Retention in Primiparous Women and Weight Outcomes in Their Offspring. J Midwifery Womens Health 2019; 64:427-434. [PMID: 31298482 DOI: 10.1111/jmwh.12986] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2018] [Revised: 03/19/2019] [Accepted: 03/28/2019] [Indexed: 11/27/2022]
Abstract
INTRODUCTION To explore the effect of prepregnancy body mass index (BMI) and gestational weight gain on postpartum weight retention in nulliparous women and weight-for-length percentiles of offspring to 2 years following birth. METHODS A retrospective secondary analysis of a large, prospective longitudinal study of women conducted during pregnancy and after their first birth was completed to examine outcomes associated with postpartum weight retention. A chart review of the offspring of these women was completed to explore the relationship between maternal prepregnancy BMI and gestational weight gain on offspring weight-for-length percentiles. RESULTS Data from 652 woman-infant dyads were available for analysis. Average postpartum weight retention was 4.0 kg at one year for all groups. At 6 weeks postpartum, women who were obese prior to pregnancy retained significantly less weight than did women who were normal weight prior to pregnancy (P < .05). Women who were normal weight or overweight at the onset of pregnancy and had gestational weight gain within Institute of Medicine recommendations retained significantly less weight at 6 weeks, 6 months, and 1 year postpartum (P < .01) when compared with women in those same weight groups who had a gestational weight gain in excess of the recommended guideline. Women who entered pregnancy obese and who had a gestational weight gain within the recommended weight range during pregnancy retained significantly less weight compared with women who were obese and who gained in excess of the guideline at 6 weeks postpartum only (P < .05). No statistically significant differences were seen in offspring weight-for-length percentiles at any time point based on maternal prepregnancy BMI or weight gain within guidelines. DISCUSSION Many women retained weight up to one year postpartum. In this study, we saw no statistically significant differences between the prepregnant BMI groups or between gestational weight gain within guidelines or in excess of guidelines on offspring weight-for-length percentiles.
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Affiliation(s)
- Kelly Gallagher
- Department of Obstetrics and Gynecology, University of New Mexico, Albuquerque, New Mexico
| | - Jody Ralph
- Faculty of Nursing, University of Windsor, Windsor, Ontario, Canada
| | - Thomas Petros
- Department of Psychology, University of North Dakota, Grand Forks, North Dakota
| | - Clifford Qualls
- Clinical and Translation Science Center, University of New Mexico, Albuquerque, New Mexico
| | - Lawrence Leeman
- Department of Obstetrics and Gynecology, University of New Mexico, Albuquerque, New Mexico.,Department of Family and Community Medicine, University of New Mexico, Albuquerque, New Mexico
| | - Rebecca G Rogers
- Department of Women's Health, The University of Texas at Austin Dell Medical School, Austin, Texas
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Ha AVV, Zhao Y, Pham NM, Nguyen CL, Nguyen PTH, Chu TK, Tang HK, Binns CW, Lee AH. Postpartum weight retention in relation to gestational weight gain and pre-pregnancy body mass index: A prospective cohort study in Vietnam. Obes Res Clin Pract 2019; 13:143-149. [PMID: 30857779 DOI: 10.1016/j.orcp.2019.02.001] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2018] [Revised: 02/01/2019] [Accepted: 02/01/2019] [Indexed: 02/07/2023]
Abstract
BACKGROUND The prevalence of maternal overweight and obesity is increasing in Asia. This study prospectively investigated the association between pre-pregnancy body mass index (BMI), gestational weight gain (GWG) and 12-month postpartum weight retention (PPWR) in a large cohort of Vietnamese mothers. METHODS Of the 2030 pregnant women recruited from three cities in Vietnam at 24-28 weeks of gestation, a total of 1666 mothers were followed up for 12 months after delivery and available for analysis. The outcome variable PPWR was determined by subtracting the pre-pregnancy weight from the 12-month postpartum measured weight, while GWG and pre-pregnancy BMI were classified according to the Institute of Medicine and WHO criteria for adults, respectively. Linear regression models were used to ascertain the association between pre-pregnancy BMI, GWG and PPWR accounting for the effects of plausible confounding factors. RESULTS Both pre-pregnancy BMI and GWG were significantly associated with PPWR (P<0.001). The adjusted mean weight retention in underweight women before pregnancy (3.71kg, 95% confidence interval (CI) 3.37-4.05) was significantly higher than that in those with normal pre-pregnancy weight (2.34kg, 95% CI 2.13-2.54). Women with excessive GWG retained significantly more weight (5.07kg, 95% CI 4.63-5.50) on average at 12 months, when compared to mothers with adequate GWG (2.92kg, 95% CI 2.67-3.17). CONCLUSIONS Being underweight before pregnancy and excessive GWG contribute to greater weight retention twelve months after giving birth. Interventions to prevent postpartum maternal obesity should target at risk women at the first antenatal visit and control their weight gain during the course of pregnancy.
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Affiliation(s)
- Anh Vo Van Ha
- Faculty of Public Health, Pham Ngoc Thach University of Medicine, Ho Chi Minh City 700000, Vietnam; School of Public Health, Curtin University, Perth, WA 6845, Australia.
| | - Yun Zhao
- School of Public Health, Curtin University, Perth, WA 6845, Australia.
| | - Ngoc Minh Pham
- Faculty of Public Health, Thai Nguyen University of Medicine and Pharmacy, Thai Nguyen 250000, Vietnam; Menzies Institute for Medical Research, University of Tasmania, Hobart, TAS 7000, Australia.
| | - Cong Luat Nguyen
- School of Public Health, Curtin University, Perth, WA 6845, Australia; National Institute of Hygiene and Epidemiology, Hanoi 100000, Vietnam.
| | - Phung Thi Hoang Nguyen
- School of Public Health, Curtin University, Perth, WA 6845, Australia; Faculty of Public Health, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City 700000, Vietnam.
| | - Tan Khac Chu
- School of Public Health, Curtin University, Perth, WA 6845, Australia; Faculty of Public Health, Hai Phong University of Medicine and Pharmacy, Hai Phong 180000, Vietnam.
| | - Hong Kim Tang
- Faculty of Public Health, Pham Ngoc Thach University of Medicine, Ho Chi Minh City 700000, Vietnam.
| | - Colin W Binns
- School of Public Health, Curtin University, Perth, WA 6845, Australia.
| | - Andy H Lee
- School of Public Health, Curtin University, Perth, WA 6845, Australia.
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Salehi-Pourmehr H, Niroomand S, Shakouri SK, Asgarlou Z, Farshbaf-Khalili A. Association Between Antenatal and Postpartum Depression and Anxiety with Weight Retention 1 Year After Childbirth: A Longitudinal Study. Community Ment Health J 2018; 54:1284-1294. [PMID: 30140991 DOI: 10.1007/s10597-018-0324-y] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2017] [Accepted: 08/07/2018] [Indexed: 01/11/2023]
Abstract
This was an observational, longitudinal study investigated the association between anxiety and depression in trimesters of pregnancy and early postpartum with weight retention 1 year after childbirth. Sixty-two pregnant women aged 18-35 years with a BMI of 35 or higher and 245 pregnant women with normal BMI (BMI 18.5-24.9 kg/m2) were recruited at their initial prenatal visit in the health centers. The Edinburgh Postnatal Depression Scale (EPDS) and Beck Anxiety Inventory (BAI-II) were completed in five time points, the first, second, third trimester of pregnancy, 6-8 weeks and 12 months after delivery. Pre-pregnancy weight and weight retention at 1 year postpartum was measured. A significant relationship was found between first trimester (adjusted mean difference: aMD 3.416; 95% CI 1.392-5.441) and postpartum (aMD 3.042; 95% CI 0.538-5.547) depression as well as first trimester's anxiety (aMD 3.050; 95% CI 0.631-5.470) with weight retention at 1 year after childbirth.
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Affiliation(s)
- Hanieh Salehi-Pourmehr
- Evidence Based Medicine Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Soudabeh Niroomand
- Midwifery Department, School of Nursing and Midwifery, Zanjan University of Medical Sciences, Zanjan, Iran
| | - Seyed Kazem Shakouri
- Aging Research Institute, Physical Medicine and Rehabilitation Research Centre, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Zoleikha Asgarlou
- Midwifery Department, School of Nursing and Midwifery, Zanjan University of Medical Sciences, Zanjan, Iran
| | - Azizeh Farshbaf-Khalili
- Aging Research Institute, Physical Medicine and Rehabilitation Research Centre, Tabriz University of Medical Sciences, Tabriz, Iran.
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Wanyama R, Obai G, Odongo P, Kagawa M, Baingana R. Effect of maternal Helicobacter Pylori infection on gestational weight gain in an urban community of Uganda. Pan Afr Med J 2017. [PMID: 29541293 PMCID: PMC5847056 DOI: 10.11604/pamj.2017.28.145.9989] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023] Open
Abstract
Introduction Maternal Helicobacter pylori (H. pylori) infection has been associated with undesirable effects during pregnancy such as; hyperemesis gravidarum, anemia, intrauterine fetal growth restriction and miscarriage. Our aim was to document the effect of H. pylori infection on gestational weight gain (GWG) in a low-income urban setting in Uganda. Methods This was a prospective cohort study conducted in Kampala between May 2012 and May 2013. The participants were HIV negative, H. pylori positive and H. pylori negative primigravidae and secundigravidae. Recruitment was at gestation age of eighteen or less weeks and follow up assessments were carried out at 26 and 36 weeks gestation age. H. pylori infection was determined using H. pylori stool antigen test. Maternal weight and height were measured, and body mass index (BMI) and rates of GWG were calculated. Results The participants’ mean±standard deviation (sd) age was 20.9±2.7 years. Primigravidae were 68.8% (n = 132) and 57.3% (n = 110) of the participants were positive for H. pylori infection. Low pre-women pregnancy BMI (< 18.5 kg/m2) was recorded in 14.6% (n = 28). The mean±sd rate of GWG during second and third trimesters was 300.5±79.7 grams/week. The mean±sd weight gained by 36 weeks of gestation was 9.6±2.2 kg while gestation age at delivery was 39.4±1.0 weeks. Factors independently associated with the rates of GWG during the second and third trimesters were parity (P=0.023), H. pylori infection (P = 0.006), pre-pregnancy BMI (P = 0.037), height (P = 0.022) and household income (P = 0.003). Conclusion H. pylori infection is associated with low rates of GWG among primigravidae and secundigravidae.
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Affiliation(s)
- Ronald Wanyama
- Department of Biochemistry, Faculty of Medicine, Gulu University, Gulu, Uganda
| | - Gerald Obai
- Department of Physiology, Faculty of Medicine, Gulu University, Gulu, Uganda
| | - Pancras Odongo
- Department of Internal Medicine, Faculty of Medicine, Gulu University, Gulu, Uganda
| | - Michael Kagawa
- Department of Obstetrics & Gynecology, College of Health Sciences, Makerere University, Kampala, Uganda
| | - Rhona Baingana
- Department of Biochemistry and Sports Science, School of Biolsciences, Makerere University, Kampala, Uganda
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Predictors of Postpartum Exercise According to Prepregnancy Body Mass Index and Gestational Weight Gain. J Phys Act Health 2017; 14:797-807. [DOI: 10.1123/jpah.2016-0585] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Background:The study purposes were to examine (1) differences in postpartum exercise (EX) and related personal/psychological correlates in women according to prepregnancy weight and pregnancy gestational weight gain (GWG) status and (2) predictors of EX at 2 weeks, 2 months, and 6 months postpartum.Methods:Participants (N = 891) were recruited at maternity hospitalization and completed interviews to assess EX (Leisure-Time Exercise Questionnaire) and personal correlates (demographics, anxiety/depressive symptoms) before/during pregnancy. Telephone interviews were conducted to assess postpartum EX/psychological correlates. Women were categorized according to prepregnancy weight (normal and overweight) and pregnancy GWG status (above or within weight gain guidelines): normal-above, normal-within, overweight-above, and overweight-within.Results:Low levels of EX minutes were observed in all women with significant differences for strenuous EX minutes (overweight-within women had the lowest strenuous EX; normal-weight women had more strenuous EX than overweight women regardless of GWG). Correlates explained 14%–37% of the variance in postpartum EX; prepregnancy EX and pregnancy EX were strong determinants of early postpartum EX, and early postpartum EX predicted 6-month postpartum EX. Unique predictors of EX also emerged (eg, depressive symptoms for women with GWG above guidelines).Conclusions:These study findings highlight the benefits of EX before/during pregnancy for promoting postpartum EX and suggest tailoring postpartum EX interventions based on personal/psychological correlates to maximize effectiveness.
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Predicting the Risk of Macrosomia at Mid-Pregnancy Among Non-Diabetics: A Retrospective Cohort Study. JOURNAL OF OBSTETRICS AND GYNAECOLOGY CANADA 2017; 39:1129-1136. [PMID: 28780218 DOI: 10.1016/j.jogc.2017.05.032] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2017] [Revised: 05/28/2017] [Accepted: 05/29/2017] [Indexed: 01/26/2023]
Abstract
OBJECTIVE To identify factors known in mid-pregnancy to be associated with risk of macrosomia (≥4000 g) among non-diabetic women and to develop a risk score to allow early identification of women at high risk. METHODS Data were obtained from a population-based perinatal database and a hospital laboratory database in Nova Scotia, Canada. The study included singleton live births born to non-diabetic women between 1998 and 2005. Logistic regression was used to identify risk factors significantly associated with macrosomia. Risk scoring systems were developed for nulliparous and parous women separately and validated using the C-statistic. RESULTS Of the 23 857 mother-infant pairs included in the study, 16.7% of the infants were macrosomic. In nulliparous women, seven risk factors were identified, of which pre-pregnancy weight ≥90 kg with an OR of 4.8 (95% CI: 3.9 to 6.0) contributed a greater number of points to the risk score. The resulting risk score corresponded to a range of estimated risk of 0.2% to 47.0% and had a C-statistic of 0.70. In parous women, the most points were assigned to women with a previous large birth (OR: 3.7; 95% CI: 3.2-4.0) and a pre-pregnancy weight ≥90 kg (OR: 3.8; 95% CI: 3.1-4.7). The resulting risk score corresponded to a range of estimated risk of 0.4% to 88.0% and had a C-statistic of 0.75. CONCLUSIONS Macrosomia risk can be estimated by a simple calculation based on a woman's risk factor profile at mid-pregnancy.
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Hill B, Bergmeier H, McPhie S, Fuller-Tyszkiewicz M, Teede H, Forster D, Spiliotis BE, Hills AP, Skouteris H. Is parity a risk factor for excessive weight gain during pregnancy and postpartum weight retention? A systematic review and meta-analysis. Obes Rev 2017; 18:755-764. [PMID: 28512991 DOI: 10.1111/obr.12538] [Citation(s) in RCA: 46] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2016] [Revised: 02/21/2017] [Accepted: 02/21/2017] [Indexed: 02/01/2023]
Abstract
The aim of this study was to systematically review and meta-analyse the associations between parity, pre-pregnancy body mass index (BMI), gestational weight gain (GWG) and, when included, postpartum weight retention (PPWR). Papers reporting associations between parity and BMI and/or GWG in adult women were eligible: 2,195 papers were identified, and 41 longitudinal studies were included in the narrative synthesis; 17 studies were included in a meta-analysis. Findings indicated that parity was associated positively with pre-pregnancy BMI. In contrast, the role of parity in GWG was less clear; both positive and negative relationships were reported across studies. Parity was not associated directly with PPWR. This pattern of results was supported by our meta-analysis with the only significant association between parity and pre-pregnancy BMI. Overall, parity was associated with higher pre-pregnancy BMI; however, the role of parity in GWG and PPWR remains unclear, and it is likely that its influence is indirect and complex. Further research to better understand the contribution of parity to maternal obesity is warranted.
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Affiliation(s)
- B Hill
- School of Psychology, Deakin University, Geelong, Victoria, Australia
| | - H Bergmeier
- School of Psychology, Deakin University, Geelong, Victoria, Australia
| | - S McPhie
- School of Psychology, Deakin University, Geelong, Victoria, Australia
| | | | - H Teede
- Monash Centre for Health Research and Implementation, School of Public Health and Preventative Medicine, Monash University in collaboration with Monash Health, Melbourne, Victoria, Australia
| | - D Forster
- School of Nursing and Midwifery, College of Science, Health and Engineering, Judith Lumley Centre, Melbourne, Victoria, Australia.,Midwifery Research Unit, Maternity Services, Royal Women's Hospital, Melbourne, Victoria, Australia
| | - B E Spiliotis
- Pediatric Endocrinology, Division of Pediatric Endocrinology and Diabetes, Department of Pediatrics, School of Medicine, University of Patras, Patras, Greece
| | - A P Hills
- Sport and Exercise Science, School of Health Sciences, University of Tasmania, Launceston, Tasmania, Australia
| | - H Skouteris
- School of Psychology, Deakin University, Geelong, Victoria, Australia
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Chagas DCD, Silva AAMD, Ribeiro CCC, Batista RFL, Alves MTSSDBE. [Effects of gestational weight gain and breastfeeding on postpartum weight retention among women in the BRISA cohort]. CAD SAUDE PUBLICA 2017; 33:e00007916. [PMID: 28614443 DOI: 10.1590/0102-311x00007916] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2016] [Accepted: 06/24/2016] [Indexed: 12/18/2022] Open
Abstract
This study analyzed the effects of gestational weight gain and breastfeeding on postpartum weight retention. The study followed 2,607 women from the BRISA cohort. The variables were age, socioeconomic status, parity, pre-gestational body mass index, gestational weight gain, duration of maternal breastfeeding, length of postpartum follow-up, and postpartum weight gain. Structural equation modeling was used to evaluate the total, direct, and indirect effects of the explanatory variables on postpartum weight retention. An increase of one standard deviation in gestational weight gain corresponded to a significant increase of 0.49 standard deviations in postpartum weight retention (p < 0.001). An increase of one standard deviation in duration of breastfeeding corresponded to mean decrease of 0.10 standard deviations in postpartum weight retention (p < 0.001). Independently of pre-gestational BMI, gestational weight gain is a risk factor and duration of breastfeeding is a protective factor against postpartum weight retention.
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Bogaerts A, De Baetselier E, Ameye L, Dilles T, Van Rompaey B, Devlieger R. Postpartum weight trajectories in overweight and lean women. Midwifery 2017; 49:134-141. [DOI: 10.1016/j.midw.2016.08.010] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2016] [Revised: 08/11/2016] [Accepted: 08/31/2016] [Indexed: 01/13/2023]
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Maternal and neonatal outcomes in obese women who lose weight during pregnancy. J Perinatol 2016; 36:278-83. [PMID: 26741574 DOI: 10.1038/jp.2015.202] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/19/2015] [Revised: 11/09/2015] [Accepted: 11/19/2015] [Indexed: 11/09/2022]
Abstract
OBJECTIVE To evaluate neonatal and maternal outcomes in obese pregnant women whose weight gain differed from the Institute of Medicine (IOM) recommendations. STUDY DESIGN Maternal and neonatal outcomes associated with weight change in pregnancy were retrospectively investigated in women with obesity (body mass index (BMI) ⩾30 kg m(-2); N=10734) who gave birth at 12 hospitals. Using a 1:1:1:1 design (n=778 matched groups), we matched women with obesity who lost, maintained, gained appropriate (IOM recommended) and gained excessive weight during pregnancy by gestational age at delivery, maternal age, race/ethnicity, prepregnancy BMI, chronic hypertension, pregestational diabetes and smoking status. Regression techniques were used to adjust for confounders and compare outcomes across weight change categories. RESULT Compared with IOM recommendations, weight loss was associated with twofold greater odds of low birth weight infants and a mean decrease in estimated blood loss of 30 ml; excessive weight gain was associated with doubled odds of gestational hypertension or preeclampsia, fourfold greater odds of macrosomia and a mean decrease in 5-min APGAR of 0.09. From lost to excessively gained weight, the odds of cesarean delivery increased 1.4 times and mean infant birth weight increased by 197 g. In contrast, the odds of small-for-gestational age were 1.8 times greater for women who lost than gained excessive weight. CONCLUSION Weight loss in obese pregnant women is associated with increased risk for low birth weight neonates but significantly decreased or maintained risk for other maternal and neonatal morbidities, as compared with appropriate or excessive weight gain. This study supports re-evaluation of the current IOM guidelines for women with obesity.
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Australian Pregnant Women's Awareness of Gestational Weight Gain and Dietary Guidelines: Opportunity for Action. J Pregnancy 2016; 2016:8162645. [PMID: 26881080 PMCID: PMC4736585 DOI: 10.1155/2016/8162645] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2015] [Accepted: 12/15/2015] [Indexed: 11/17/2022] Open
Abstract
Background. Excessive gestational weight gain (GWG) can negatively impact on maternal and foetal health. Guidelines based on Institute of Medicine (IOM) encourage managing GWG by following healthy eating recommendations and increasing physical activity. This study investigated pregnant women's knowledge of their optimal GWG and recommended dietary approaches for GWG management. Method. English-speaking pregnant women were recruited from five hospitals in New South Wales (Australia) and an online link. Prepregnancy Body Mass Index (BMI) was calculated from self-reported height and prepregnancy weight. Participants identified their recommended GWG. A survey assessed practical dietary knowledge and asked about broad dietary recommendations to prevent excessive GWG. Chi square and logistic regression analyses were used. Results. N = 326 pregnant women completed the surveys; 49% entered pregnancy overweight (25.2%) or obese (23.6%); and knowledge of recommended GWG was lacking. Prepregnancy BMI was a significant predictor of GWG recommendation knowledge (P < 0.000). Pregnant women were highly knowledgeable about broad dietary recommendations but had poor knowledge of detailed recommendations. Conclusions. Limited knowledge of IOM's GWG guidelines and of specific dietary recommendations for pregnancy should be addressed by health care providers and education initiatives to assist the high number of women who enter pregnancy overweight or obese.
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Hill B, McPhie S, Skouteris H. The Role of Parity in Gestational Weight Gain and Postpartum Weight Retention. Womens Health Issues 2016; 26:123-9. [DOI: 10.1016/j.whi.2015.09.012] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2015] [Revised: 09/22/2015] [Accepted: 09/23/2015] [Indexed: 11/30/2022]
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Widen EM, Whyatt RM, Hoepner LA, Ramirez-Carvey J, Oberfield SE, Hassoun A, Perera FP, Gallagher D, Rundle AG. Excessive gestational weight gain is associated with long-term body fat and weight retention at 7 y postpartum in African American and Dominican mothers with underweight, normal, and overweight prepregnancy BMI. Am J Clin Nutr 2015; 102:1460-7. [PMID: 26490495 PMCID: PMC4658466 DOI: 10.3945/ajcn.115.116939] [Citation(s) in RCA: 51] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2015] [Accepted: 09/16/2015] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND Excessive gestational weight gain (GWG) is associated with postpartum weight retention (PPWR) and abdominal adiposity, but long-term effects are understudied in low-income and minority populations at high risk of obesity and associated sequelae. OBJECTIVE We examined associations between GWG and long-term PPWR and adiposity in a prospective cohort of African American and Dominican mothers in the Bronx and Northern Manhattan. DESIGN Women (n = 302) were enrolled during pregnancy and were followed for 7 y postpartum. Linear regression was used to relate excessive GWG [greater than 2009 Institute of Medicine (IOM) guidelines] to outcomes [percentage body fat and long-term PPWR (change in weight from prepregnancy to 7 y postpartum)], adjusting for covariates and included an interaction term between prepregnancy body mass index (BMI; in kg/m(2)) and GWG. RESULTS Mean ± SD prepregnancy BMI and total GWG were 25.6 ± 5.8 (42% of women had BMI ≥25) and 16.6 ± 7.8 kg (64% of women had total GWG greater than IOM guidelines), respectively. Associations between GWG and long-term PPWR and the percentage body fat varied by prepregnancy BMI (P-interaction ≤ 0.06); excessive GWG was associated with a higher percentage body fat and greater long-term PPWR in mothers with lower prepregnancy BMI. To illustrate the interaction, a predicted covariate-adjusted model, which was used to derive estimates for the percentage body fat and PPWR associated with excessive GWG, was estimated for 2 prepregnancy BMI examples. For a woman with prepregnancy BMI of 22, excessive GWG was associated with 3.0% higher body fat (P < 0.001) and a 5.6-kg higher PPWR (P < 0.001); however, for a woman with a prepregnancy BMI of 30, excessive GWG was associated with 0.58% higher body fat (P = 0.55) and 2.06 kg PPWR (P = 0.24). CONCLUSIONS Long-term adiposity and PPWR in low-income African American and Dominican mothers were predicted by interacting effects of prepregnancy BMI and excessive GWG. The provision of support for mothers to begin pregnancy at a healthy weight and to gain weight appropriately during pregnancy may have important lasting implications for weight-related health in this population. This study was registered at clinicaltrials.gov as NCT00043498.
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Affiliation(s)
- Elizabeth M Widen
- Institute of Human Nutrition, New York Obesity Research Center, Department of Medicine, and Departments of Epidemiology and
| | - Robin M Whyatt
- Environmental Health Sciences, Mailman School of Public Health, Columbia University Medical Center, New York, NY; and Columbia Center for Children's Environmental Health, Columbia University, New York, NY
| | - Lori A Hoepner
- Environmental Health Sciences, Mailman School of Public Health, Columbia University Medical Center, New York, NY; and Columbia Center for Children's Environmental Health, Columbia University, New York, NY
| | - Judyth Ramirez-Carvey
- Environmental Health Sciences, Mailman School of Public Health, Columbia University Medical Center, New York, NY; and Columbia Center for Children's Environmental Health, Columbia University, New York, NY
| | - Sharon E Oberfield
- Division of Pediatric Endocrinology, Department of Pediatrics, Columbia University College of Physicians and Surgeons, New York, NY; Columbia Center for Children's Environmental Health, Columbia University, New York, NY
| | - Abeer Hassoun
- Division of Pediatric Endocrinology, Department of Pediatrics, Columbia University College of Physicians and Surgeons, New York, NY
| | - Frederica P Perera
- Environmental Health Sciences, Mailman School of Public Health, Columbia University Medical Center, New York, NY; and Columbia Center for Children's Environmental Health, Columbia University, New York, NY
| | - Dympna Gallagher
- Institute of Human Nutrition, New York Obesity Research Center, Department of Medicine, and
| | - Andrew G Rundle
- Departments of Epidemiology and Columbia Center for Children's Environmental Health, Columbia University, New York, NY
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Bliddal M, Pottegård A, Kirkegaard H, Olsen J, Jørgensen JS, Sørensen TIA, Wu C, Nohr EA. Mental disorders in motherhood according to prepregnancy BMI and pregnancy-related weight changes--A Danish cohort study. J Affect Disord 2015; 183:322-9. [PMID: 26047960 DOI: 10.1016/j.jad.2015.04.053] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/20/2015] [Revised: 04/29/2015] [Accepted: 04/29/2015] [Indexed: 10/23/2022]
Abstract
BACKGROUND Previous studies have shown an association between prepregnancy BMI and postpartum depression, but little is known about this association beyond one year postpartum and the influence of postpartum weight retention (PPWR). METHODS We used data from 70355 mothers from the Danish National Birth Cohort to estimate the associations between maternal prepregnancy BMI and PPWR, respectively, and incident depression/anxiety disorders until six years postpartum. Outcome was depression or anxiety diagnosed clinically or filling a prescription for an antidepressant. Cox regression was used to estimate hazard ratios (HR) with 95% confidence intervals (CI). Follow-up started at the day of delivery. For the analysis regarding PPWR, follow-up started six months postpartum. RESULTS Underweight, overweight and obesity were associated with depression and/or anxiety disorders when compared to normal-weight, though the associations were attenuated after adjustments (HR 1.24 [95% CI 1.06-1.45], 1.05 [95% CI 0.96-1.15] and 1.07 [95% CI 0.95-1.21] for underweight, overweight and obese, respectively). Compared to mothers who had returned to their prepregnancy BMI, risk of depression/anxiety disorders was increased for mothers, who from prepregnancy to 6 months postpartum experienced either weight loss >1 BMI unit (HR 1.19 [95% CI 1.06-1.25]), weight gain of 2-3 BMI units (HR 1.23 [95% CI 1.08-1.40]), or weight gain of ≥3 BMI units (HR 1.21 [95% CI 1.05-1.40]). LIMITATION Causal direction and mechanisms behind the associations are largely unknown. CONCLUSIONS Low prepregnancy body weight and postpartum weight gain or loss are associated with occurrence of depression and anxiety disorders.
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Affiliation(s)
- Mette Bliddal
- Department of Gynaecology and Obstetrics, Odense University Hospital, and Institute of Clinical Research, Research Unit of Gynaecology and Obstetrics, University of Southern Denmark, Odense, Denmark.
| | - Anton Pottegård
- Clinical Pharmacology, Department of Public Health, University of Southern Denmark, Odense, Denmark
| | - Helene Kirkegaard
- Department of Public Health, Section for Epidemiology, Aarhus University, Aarhus, Denmark
| | - Jørn Olsen
- Department of Public Health, Section for Epidemiology, Aarhus University, Aarhus, Denmark
| | - Jan Stener Jørgensen
- Department of Gynaecology and Obstetrics, Odense University Hospital, and Institute of Clinical Research, Research Unit of Gynaecology and Obstetrics, University of Southern Denmark, Odense, Denmark
| | - Thorkild I A Sørensen
- Novo Nordisk Foundation Center for Basic Metabolic Research, University of Copenhagen, Denmark and Institute of Preventive Medicine, Bispebjerg and Frederiksberg Hospitals-Part of Copenhagen University Hospital, Copenhagen, Denmark
| | - Chunsen Wu
- Department of Public Health, Section for Epidemiology, Aarhus University, Aarhus, Denmark
| | - Ellen A Nohr
- Department of Gynaecology and Obstetrics, Odense University Hospital, and Institute of Clinical Research, Research Unit of Gynaecology and Obstetrics, University of Southern Denmark, Odense, Denmark
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Skouteris H, McPhie S, Hill B, McCabe M, Milgrom J, Kent B, Bruce L, Herring S, Gale J, Mihalopoulos C, Shih S, Teale G, Lachal J. Health coaching to prevent excessive gestational weight gain: A randomized-controlled trial. Br J Health Psychol 2015; 21:31-51. [DOI: 10.1111/bjhp.12154] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2015] [Revised: 07/09/2015] [Indexed: 11/28/2022]
Affiliation(s)
- Helen Skouteris
- School of Psychology; Deakin University; Burwood Victoria Australia
| | - Skye McPhie
- School of Psychology; Deakin University; Burwood Victoria Australia
| | - Briony Hill
- School of Psychology; Deakin University; Burwood Victoria Australia
| | - Marita McCabe
- School of Psychology; Deakin University; Burwood Victoria Australia
| | - Jeannette Milgrom
- School of Psychological Sciences; University of Melbourne; Parkville Victoria Australia
| | - Bridie Kent
- School of Nursing and Midwifery; Drake Circus; Plymouth University; Devon UK
| | - Lauren Bruce
- School of Psychology; Deakin University; Burwood Victoria Australia
| | - Sharon Herring
- Section of General Internal Medicine; Department of Medicine; Temple University; Philadelphia Pennsylvania USA
| | - Janette Gale
- Healthchange Australia; Bomaderry New South Wales Australia
| | | | - Sophy Shih
- Deakin Health Economics; Deakin University; Burwood Victoria Australia
| | - Glyn Teale
- Women's and Children's Services; Western Health; Sunshine Hospital; St Albans Victoria Australia
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Holowko N, Chaparro MP, Nilsson K, Ivarsson A, Mishra G, Koupil I, Goodman A. Social inequality in pre-pregnancy BMI and gestational weight gain in the first and second pregnancy among women in Sweden. J Epidemiol Community Health 2015. [DOI: 10.1136/jech-2015-205598] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Paulino DSDM, Surita FG, Peres GB, Nascimento SLD, Morais SS. Association between parity, pre-pregnancy body mass index and gestational weight gain. J Matern Fetal Neonatal Med 2015; 29:880-4. [DOI: 10.3109/14767058.2015.1021674] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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