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Mehta-Lee SS, Echevarria GC, Brubaker SG, Yaghoubian Y, Long SE, Dolin CD. The Association between Psychosocial Stressors and Gestational Weight Gain: Analysis of the National Pregnancy Risk Assessment Monitoring System (PRAMS) Results from 2012 to 2015. Matern Child Health J 2024; 28:1250-1257. [PMID: 38427279 DOI: 10.1007/s10995-024-03923-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/15/2024] [Indexed: 03/02/2024]
Abstract
OBJECTIVE Both psychosocial stress and gestational weight gain are independently associated with adverse maternal and fetal outcomes. Studies of the association between psychosocial stress and gestational weight gain (GWG) have yielded mixed results. The objective of this study was to evaluate the association between psychosocial stress and GWG in a large population-based cohort. METHODS Data from the nationally representative Pregnancy Risk Assessment Monitoring System (PRAMS) Phase 7 questionnaire 2012-2015 was utilized. Maternal psychosocial stress was assessed through response to questions designed to examine four domains of psychosocial stress (i.e., traumatic, financial, emotional, partner-related) three months prior to or during pregnancy. GWG was categorized using pre-pregnancy BMI and total GWG into inadequate, adequate, or excessive according to the Institute of Medicine's GWG guidelines. Multinomial logistic regression was used to evaluate the association between psychosocial stressors and adequacy of GWG. Analyses took into account complex survey design. RESULTS All respondents who delivered ≥ 37 weeks gestation with GWG information available were included in the analysis (n = 119,183). After adjusting for confounders, patients who reported financial stress were more likely to experience excessive versus adequate GWG (RRR 1.09 [95%CI: 1.02-1.17]). Exposure to any of the stressor groups did not significantly increase the risk of inadequate GWG. CONCLUSIONS This large, population-based study revealed that among pregnant people in the US, exposure to financial stress is associated with higher risk of excessive GWG. Understanding the role stress plays in GWG will help to inform initiatives targeting this important aspect of prenatal care.
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Affiliation(s)
- Shilpi S Mehta-Lee
- Department of Obstetrics and Gynecology, New York University Langone Health/NYU Grossman School of Medicine, New York, NY, USA.
| | - Ghislaine C Echevarria
- Department of Anesthesiology, Perioperative and Pain Medicine, Icahn School of Medicine at Mount Sinai West, New York, NY, USA
| | - Sara G Brubaker
- Department of Obstetrics and Gynecology, New York University Langone Health/NYU Grossman School of Medicine, New York, NY, USA
| | - Yasaman Yaghoubian
- Department of Obstetrics and Gynecology, Zucker School of Medicine at Hofstra, NorthwellHempstead, USA
| | - Sara E Long
- Department of Pediatrics, Division of Environmental Pediatrics, NYU Langone Medical Center, New York, NY, USA
| | - Cara D Dolin
- Division of Maternal-Fetal Medicine, Department of Reproductive Biology, Cleveland Clinic Lerner College of Medicine, Case Western Reserve University, Cleveland, OH, USA
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2
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Olukade T, Salama H, Al-Obaidly S, AlQubaisi M, Al-Rifai H. Maternal Body Mass Index and Recommended Gestational Weight Gain in a Middle Eastern Setting. Matern Child Health J 2024; 28:524-531. [PMID: 37955839 PMCID: PMC10914897 DOI: 10.1007/s10995-023-03816-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/23/2023] [Indexed: 11/14/2023]
Abstract
OBJECTIVE Maternal body mass index (BMI) and gestational weight gain (GWG) are modifiable risk factors that influence pregnancy outcomes. We examined the association between the two factors in pregnant women in Qatar with regard to the GWG recommendations by the Institute of Medicine (IOM) in 2009. METHODS We performed a population-based retrospective cohort analysis of 3547 singleton births, using routinely collected data from a Middle Eastern hospital database. RESULTS The mean maternal age was 29.7 ± 5.5 years, prepregnancy BMI was 27.5 ± 5.8 kg/m2, GWG was 9.58 kg ± 6.87 kg and gestational age at birth was 38.5 ± 1.9 weeks. In line with IOM recommendations, we found that higher BMI was correlated with decreased GWG and BMI was significantly associated with GWG even after adjusting for maternal age, parity, and infants' gestational age at birth. Nonetheless, GWG in more than one-third of women who were overweight or obese exceeded the IOM recommendation.
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Affiliation(s)
- Tawa Olukade
- Department of Pediatrics, Hamad Medical Corporation, Doha, Qatar.
| | - Husam Salama
- Neonatal Intensive Care Unit, Hamad Medical Corporation, Doha, Qatar
| | - Sawsan Al-Obaidly
- Department of Obstetrics and Gynecology, Hamad Medical Corporation, Doha, Qatar
| | - Mai AlQubaisi
- Neonatal Intensive Care Unit, Hamad Medical Corporation, Doha, Qatar
| | - Hilal Al-Rifai
- Neonatal Intensive Care Unit, Hamad Medical Corporation, Doha, Qatar
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3
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Bastain T, Naya C, Yang T, Vigil M, Chen C, Chavez T, Toledo-Corral C, Farzan S, Habre R, Lerner D, Lurvey N, Grubbs B, Dunton G, Breton C, Eckel S. Poor Sleep Quality Increases Gestational Weight Gain Rate in Pregnant People: Findings from the MADRES Study. RESEARCH SQUARE 2023:rs.3.rs-2944456. [PMID: 37841879 PMCID: PMC10571604 DOI: 10.21203/rs.3.rs-2944456/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/17/2023]
Abstract
Background Poor sleep quality is associated with weight gain in non-pregnant populations, but evidence in pregnant people is lacking. Our study examined the association between early-to-mid pregnancy sleep quality and weekly gestational weight gain (GWG) rate during mid-to-late pregnancy by pre-pregnancy body mass index (BMI). Method Participants were 316 pregnant participants from the Maternal and Developmental Risks from Environmental and Social Stressors (MADRES) study. During early-to-mid pregnancy, participants reported their sleep quality which was used to construct four categories: very poor, poor, good, and very good. Linear growth curve models examined the association between early-to-mid pregnancy sleep quality and weekly rate of GWG (kg/week) during mid-to-late pregnancy (> 20 weeks gestation), with a three-way cross-level interaction between gestational age, sleep quality, and pre-pregnancy BMI category. Models adjusted for ethnicity by birthplace, hypertensive disorders, perceived stress score, and physical activity level. Results Overall, poorer early-to-mid pregnancy sleep quality was associated with increased weekly weight gain during mid-to-late pregnancy. For example, amongst normal weight participants, mid-to-late pregnancy weight gain was, on average, 0.39 kg (95% CI: 0.29, 0.48) per week for those with very good sleep quality, 0.53 kg (95% CI: 0.44, 0.61) per week for those with poor sleep quality, and 0.54 kg (95% CI: 0.46, 0.62) per week for those with very poor sleep quality during early-to-mid pregnancy. This difference in GWG rate was statistically significantly comparing very good to poor sleep (0.14 kg/week, 95% CI: 0.01, 0.26) and very good to very poor sleep (0.15kg/week, 85% CI: 0.02, 0.27). This association between sleep quality and GWG rate did not statistically differ by pre-pregnancy BMI. Conclusion Our study found very poor early-to-mid pregnancy sleep quality was associated with higher mid-to-late pregnancy GWG rate. Incorporating pregnancy-specific sleep recommendations into routine obstetric care may be a critical next step in promoting healthy GWG.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | | | | | - Carrie Breton
- Keck School of Medicine, University of Southern California
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4
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Levine MD, Tavernier RLE, Conlon RPK, Grace JL, Sweeny GM, Wang B, Cheng Y. Loss of control eating during pregnancy is associated with excessive gestational weight gain among individuals with overweight and obesity. BMC Pregnancy Childbirth 2023; 23:340. [PMID: 37173628 PMCID: PMC10176920 DOI: 10.1186/s12884-023-05618-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2021] [Accepted: 04/14/2023] [Indexed: 05/15/2023] Open
Abstract
BACKGROUND Excessive gestational weight gain (GWG) predicts negative health outcomes among individuals with overweight or obesity. Loss of control eating (LOC), the ingestion of food associated with being unable to control eating, is the core psychopathology of binge eating disorders. We evaluated the contribution of LOC to GWG among pregnant individuals with prepregnancy overweight/obesity. METHODS In a prospective longitudinal study, individuals with prepregnancy BMI ≥ 25 (N = 257) were interviewed monthly to assess LOC and reported demographic, parity, and smoking information. GWG was abstracted from medical records. RESULTS Among individuals with prepregnancy overweight/obesity, 39% endorsed LOC prior to or during pregnancy. After adjusting for factors that have previously been linked to GWG, LOC during pregnancy, uniquely predicted higher GWG and greater likelihood of exceeding GWG recommendations. Participants with prenatal LOC gained 3.14 kg (p = 0.03) more than did those without LOC during pregnancy and 78.7% (n = 48/61) exceeded IOM guidelines for GWG. The frequency of LOC episodes was also associated with greater weight gain. CONCLUSIONS Prenatal LOC is common among pregnant individuals with overweight/obesity and predicts greater GWG and increased likelihood of exceeding IOM GWG guidelines. LOC may represent a modifiable behavioral mechanism to prevent excessive GWG among individuals at risk for adverse pregnancy outcomes.
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Affiliation(s)
- Michele D Levine
- Department of Psychiatry, University of Pittsburgh School of Medicine, 3811 O'Hara Street, Pittsburgh, PA, 15213, USA.
| | - Rebecca L Emery Tavernier
- Department of Psychiatry, University of Pittsburgh School of Medicine, 3811 O'Hara Street, Pittsburgh, PA, 15213, USA
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN, USA
| | - Rachel P K Conlon
- Department of Psychiatry, University of Pittsburgh School of Medicine, 3811 O'Hara Street, Pittsburgh, PA, 15213, USA
| | - Jennifer L Grace
- Western Psychiatric Hospital, University of Pittsburgh Medical Center, Pittsburgh, PA, USA
| | - Gina M Sweeny
- Western Psychiatric Hospital, University of Pittsburgh Medical Center, Pittsburgh, PA, USA
| | - Bang Wang
- Department of Statistics, University of Pittsburgh, Pittsburgh, PA, USA
| | - Yu Cheng
- Department of Statistics, University of Pittsburgh, Pittsburgh, PA, USA
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5
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Conlon RPK, Hu H, Saptono A, Hawkins MS, Parmanto B, Levine MD, Buysse DJ. Formative Development of ClockWork for the Postpartum Period: A Theory-Based Intervention to Harness the Circadian Timing System to Address Cardiometabolic Health-Related Behaviors. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:3669. [PMID: 36834364 PMCID: PMC9961849 DOI: 10.3390/ijerph20043669] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/15/2023] [Revised: 02/08/2023] [Accepted: 02/09/2023] [Indexed: 06/18/2023]
Abstract
Individuals with body mass index (BMI) ≥ 25 kg/m2 before pregnancy have greater difficulty losing the weight gained during pregnancy, and this postpartum weight retention predicts higher risk for cardiometabolic disease. The postpartum period involves substantial disruptions in circadian rhythms, including rhythms related to eating, physical activity, sleep, and light/dark exposure, each of which are linked to obesity and cardiometabolic disease in non-pregnant adult humans and animals. We posit that a multi-component, circadian timing system-based behavioral intervention that uses digital tools-ClockWork-will be feasible and acceptable to postpartum individuals and help promote weight- and cardiometabolic health-related behaviors. We provide data from stakeholder interviews with postpartum individuals (pre-pregnancy BMI ≥ 25; n = 7), which were conducted to obtain feedback on and improve the relevance and utility of digital self-monitoring tools for health behaviors and weight during the postpartum period. Participants perceived the ClockWork intervention and digital monitoring app to be helpful for management of postpartum weight-related health behaviors. They provided specific recommendations for increasing the feasibility intervention goals and improving app features for monitoring behaviors. Personalized, easily accessible interventions are needed to promote gestational weight loss after delivery; addressing circadian behaviors is an essential component of such interventions. Future studies will evaluate the efficacy of the ClockWork intervention and associated digital tools for improving cardiometabolic health-related behaviors linked to the circadian timing system during the postpartum period.
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Affiliation(s)
- Rachel P. Kolko Conlon
- Department of Psychiatry, School of Medicine, University of Pittsburgh, Pittsburgh, PA 15213, USA
| | - Haomin Hu
- Department of Health Information Management, School of Health and Rehabilitation Sciences, University of Pittsburgh, Pittsburgh, PA 15213, USA
| | - Andi Saptono
- Department of Health Information Management, School of Health and Rehabilitation Sciences, University of Pittsburgh, Pittsburgh, PA 15213, USA
| | - Marquis S. Hawkins
- Department of Epidemiology, School of Public Health, University of Pittsburgh, Pittsburgh, PA 15213, USA
| | - Bambang Parmanto
- Department of Health Information Management, School of Health and Rehabilitation Sciences, University of Pittsburgh, Pittsburgh, PA 15213, USA
| | - Michele D. Levine
- Department of Psychiatry, School of Medicine, University of Pittsburgh, Pittsburgh, PA 15213, USA
| | - Daniel J. Buysse
- Department of Psychiatry, School of Medicine, University of Pittsburgh, Pittsburgh, PA 15213, USA
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6
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Mitchell AM, Kowalsky JM, Christian LM, Belury MA, Cole RM. Perceived social support predicts self-reported and objective health and health behaviors among pregnant women. J Behav Med 2022; 45:589-602. [PMID: 35449357 DOI: 10.1007/s10865-022-00306-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2020] [Accepted: 03/07/2022] [Indexed: 02/06/2023]
Abstract
Perinatal health and health behaviors play a crucial role in maternal and neonatal health. Data examining psychosocial factors which predict self-reported health and health behaviors as well as objective indicators downstream of health behaviors among pregnant women are lacking. In this longitudinal study design with 131 pregnant women, perceived social support was examined as a predictor of self-rated health and average levels of sleep quality, health-promoting and health-impairing behaviors, and red blood cell (RBC) polyunsaturated fatty acids across early, mid, and late pregnancy. Participants provided a blood sample and fatty acid methyl esters were analyzed by gas chromatography. Measures included the Multidimensional Scale of Perceived Social Support, Pittsburgh Sleep Quality Index, and Prenatal Health Behavior Scale. Regression models demonstrated that, after adjustment for income, race/ethnicity, age, relationship status, pre-pregnancy body mass index, greater social support was associated with better self-rated health (p = 0.001), greater sleep quality (p = 0.001), fewer health-impairing behaviors (p = 0.02), and higher RBC omega-3 fatty acids (p = 0.003). Associations among social support with health-promoting behaviors, RBC omega-6 fatty acids, or gestational weight gain were not significant. Findings underscore the benefits of perceived social support in the context of pregnancy. Examination of pathways that link social support with these outcomes will be meaningful in determining the ways in which perinatal psychosocial interventions may promote health.
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Affiliation(s)
- Amanda M Mitchell
- Department of Counseling and Human Development, College of Education and Human Development, University of Louisville, Woodford and Harriett Porter Building, 1905 South 1st Street, Louisville, KY, 40292, USA.
| | | | - Lisa M Christian
- Department of Psychiatry &, Behavioral Health, The Ohio State University Wexner Medical Center, Columbus, OH, USA
- The Institute for Behavioral Medicine Research, The Ohio State University Wexner Medical Center, Columbus, OH, USA
| | - Martha A Belury
- Department of Human Nutrition, The Ohio State University, Columbus, OH, USA
| | - Rachel M Cole
- Department of Human Nutrition, The Ohio State University, Columbus, OH, USA
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7
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Naya CH, Toledo-Corral CM, Chavez T, Lerner D, Lurvey N, Eckel SP, Peterson AK, Grubbs BH, Dunton GF, Breton CV, Bastain TM. Third trimester cortisol is positively associated with gestational weight gain in pregnant women with class one obesity. Int J Obes (Lond) 2022; 46:366-373. [PMID: 34718334 PMCID: PMC9012147 DOI: 10.1038/s41366-021-01009-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/19/2020] [Revised: 09/27/2021] [Accepted: 10/19/2021] [Indexed: 02/03/2023]
Abstract
BACKGROUND/OBJECTIVE Prevalence of pre-pregnancy obesity and excessive gestational weight gain (GWG) are higher among women of color with low SES. Dysregulation of the Hypothalamic-Pituitary-Adrenal (HPA) axis and its end-product, cortisol, during pregnancy is hypothesized to be associated with excessive GWG. However, past studies have produced inconsistent findings and often did not include health disparities populations. This study examined the association between pre-pregnancy body mass index (BMI), third trimester diurnal cortisol, and GWG in low-income, predominantly Hispanic women. SUBJECTS/METHODS The MADRES study is an ongoing prospective cohort study of primarily Hispanic, low-income pregnant women and their children in Los Angeles, California. Data from 176 participants were included in this study. Total cortisol secretion (area under the curve, AUC) was quantified using four salivary cortisol samples (awakening, 30 min after awakening, afternoon, and bedtime) that were collected at home on one day during the third trimester of pregnancy. Moderation of the association between total cortisol and GWG by pre-pregnancy BMI was tested using multiple linear regression with a multiplicative interaction term. RESULTS There was no association between total cortisol secretion and GWG overall (p = 0.82), but the association between total cortisol and GWG was stronger for women with class 1 pre-pregnancy obesity compared to women with normal pre-pregnancy BMI (interaction term p = 0.04). CONCLUSIONS Results suggest that obesity status before pregnancy may be exacerbating the physiological impact of cortisol on GWG.
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Affiliation(s)
- Christine H Naya
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Claudia M Toledo-Corral
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
- Department of Health Sciences, California State University Northridge, Northridge, CA, USA
| | - Thomas Chavez
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | | | | | - Sandrah P Eckel
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Alicia K Peterson
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Brendan H Grubbs
- Department of Obstetrics and Gynecology, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Genevieve F Dunton
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
- Department of Psychology, University of Southern California, Los Angeles, CA, USA
| | - Carrie V Breton
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Theresa M Bastain
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA.
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8
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Kominiarek MA, Cordero C, Stuebe AM, Simon M, Evenson KR, Perreira KM, Gallo LC, Castañeda SF, Potter JE, Wu D, Isasi CR, Daviglus ML. Pre-pregnancy Health Behaviors and Gestational Weight Gain Among Hispanic/Latino Women: Hispanic Community Health Study/Study of Latinos. Matern Child Health J 2021; 25:2002-2013. [PMID: 34647266 PMCID: PMC9830652 DOI: 10.1007/s10995-021-03252-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/30/2021] [Indexed: 01/13/2023]
Abstract
OBJECTIVE To examine the association between preconception diet quality, sedentary behavior, and physical activity with gestational weight gain (GWG) among Hispanic/Latina women. METHODS This was a retrospective cohort study of participants from visits 1 and 2 of the Hispanic Community Health Study/Study of Latinos and singleton pregnancies between the 2 visits. Diet quality (alternative healthy eating index/AHEI-2010), sedentary behaviors, and physical activity (global physical activity questionnaire) were measured at visit 1 and accounted for preconception health behaviors. GWG was evaluated as a continuous and categorical variable according to the 2009 Institute of Medicine guidelines (inadequate, adequate, excessive). Linear and generalized logit survey regressions were used to study the association between health behaviors and GWG, using adequate GWG as the reference. RESULTS Of the 457 women included, deliveries occurred at 3.2 years (mean) from visit 1; 48.7% of women had excessive GWG. Mean AHEI-2010 scores were < 45% for women of all Hispanic/Latina backgrounds. There was no association between each 10-unit increase in AHEI-2010 or a 500 kcal/day increase in energy intake for mean and categorical GWG. There was no association between 30 min/day higher sedentary behavior, 30 min/day higher physical activity, or meeting the 2008 US physical activity guidelines for mean and categorical GWG. CONCLUSIONS We did not find any association between diet quality, sedentary behavior, and physical activity at visit 1 with GWG in pregnancies occurring between visits 1 and 2. We noted widespread poor diet quality as measured by the AHEI-2010 and low levels of physical activity among Hispanic/Latina women.
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Affiliation(s)
- Michelle A Kominiarek
- Department of Obstetrics and Gynecology, Northwestern Memorial, Prentice Hospital, Northwestern University, 250 East Superior Street, Suite 05-2154, Chicago, IL, 60611, USA.
| | - Christina Cordero
- Department of Psychology, University of Miami, Coral Gables, FL, USA
| | - Alison M Stuebe
- Department of Obstetrics and Gynecology, University of North Carolina School of Medicine, Chapel Hill, NC, USA
| | - Melissa Simon
- Department of Obstetrics and Gynecology, Northwestern Memorial, Prentice Hospital, Northwestern University, 250 East Superior Street, Suite 05-2154, Chicago, IL, 60611, USA
| | - Kelly R Evenson
- Department of Epidemiology, Gillings School of Global Public Health, UNC, Chapel Hill, NC, USA
| | - Krista M Perreira
- Department of Social Medicine, UNC School of Medicine, Chapel Hill, NC, 27599, USA
| | - Linda C Gallo
- Department of Psychology, San Diego State University, San Diego, USA
| | | | - JoNell E Potter
- Department of Obstetrics, Gynecology and Reproductive Sciences, University of Miami Miller School of Medicine, Miami, FL, 33101, USA
| | - Donghong Wu
- Institute for Minority Health Research, University of Illinois at Chicago, Chicago, USA
| | - Carmen R Isasi
- Department of Epidemiology & Population Health, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Martha L Daviglus
- Institute for Minority Health Research, University of Illinois at Chicago, Chicago, USA
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9
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Mulyani EY, Hardinsyah, Briawan D, Santoso BI, Jus'at I. Effect of dehydration during pregnancy on birth weight and length in West Jakarta. J Nutr Sci 2021; 10:e70. [PMID: 34527228 PMCID: PMC8411261 DOI: 10.1017/jns.2021.59] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2021] [Revised: 07/20/2021] [Accepted: 07/22/2021] [Indexed: 11/25/2022] Open
Abstract
Nutrition and maternal behavior are critical factors in fetal development. Maternal water intake is necessary to regulate metabolism and may influence fetal growth. This study aims to determine the effect of dehydration during pregnancy on birth weight and length. This cohort-prospective study took place in the area of Kebon Jeruk District Health Centre. A total of 38 subjects of pregnant women in their second trimester were examined. Subject characteristics were collected through direct measurements and interviews. Urine and blood samples were collected at the sixth trimester (32-34 and 35-37 weeks) to determine hydration status. Nutritional status was collected through food recall, while birth weight and length were obtained from the anthropometric measurements 30 min after birth. From a total of 38 subjects, 20 were dehydrated, and 18 were well hydrated. There was a significant relationship between hydration status and water intake, birth weight and length, head circumference, and chest circumference. After being corrected to the level of water intake, the difference in birth weight and length between the two groups were 500⋅6 g and 0⋅4 cm, and 0⋅8 cm and 1⋅4 cm for the head circumference and chest circumference (P < 0⋅05). It is recommended for mothers to monitor their weight and ensure fluid intake of 3⋅0 l per day. Further research requires more subjects to observe the effects of chronic maternal dehydration on pregnancy output and a cohort study that monitors infant development in the first six months of life.
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Affiliation(s)
- Erry Y. Mulyani
- Department of Nutrition, Faculty of Health Sciences, Esa Unggul University, Jalan Arjuna Utara No.9, Kebon Jeruk11510, West Jakarta, Indonesia
| | - Hardinsyah
- Department of Community Nutrition, Faculty of Human Ecology, Bogor Agricultural University, Bogor, Indonesia
| | - Dodik Briawan
- Department of Community Nutrition, Faculty of Human Ecology, Bogor Agricultural University, Bogor, Indonesia
| | - Budi I. Santoso
- Department of Obstetrics and Gynaecology, Faculty of Medicine, University of Indonesia - Dr. Cipto Mangunkusumo General Hospital, Depok, Indonesia
| | - Idrus Jus'at
- Department of Nutrition, Faculty of Health Sciences, Esa Unggul University, Jalan Arjuna Utara No.9, Kebon Jeruk11510, West Jakarta, Indonesia
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10
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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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11
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Wild LE, Alderete TL, Naik NC, Patterson WB, Berger PK, Jones RB, Plows JF, Goran MI. Specific amino acids but not total protein attenuate postpartum weight gain among Hispanic women from Southern California. Food Sci Nutr 2021; 9:1842-1850. [PMID: 33841803 PMCID: PMC8020954 DOI: 10.1002/fsn3.2085] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2020] [Revised: 12/09/2020] [Accepted: 12/11/2020] [Indexed: 12/17/2022] Open
Abstract
There is a high prevalence of obesity and type 2 diabetes in the United States, particularly among Hispanic women, which may be partly explained by failure to lose gestational weight during the postpartum period. Previous work indicates that protein and amino acids may protect against weight gain; therefore, this study examined the impact of dietary protein and amino acid intake on changes in postpartum weight and the percent of women meeting the Estimated Average Requirement (EAR) for these dietary variables among Hispanic women from the Southern California Mother's Milk Study (n = 99). Multivariable linear regression analysis was used to examine the associations between protein and amino acid intake with change in weight after adjusting for maternal age, height, and energy intake. Women's weight increased from prepregnancy to 1-month and 6-months postpartum (71.1 ± 14.6 vs. 73.1 ± 13.1 vs. 74.5 ± 14.6 kg, p < .0001). Although dietary protein was not associated with weight change (β = -1.09; p = .13), phenylalanine (β = -1.46; p = .04), tryptophan (β = -1.71; p = .009), valine (β = -1.34; p = .04), isoleucine (β = -1.26; p = .045), and cysteine (β = -1.52; p = .02) intake were inversely associated with weight change. Additionally, fewer women met the EAR values for cysteine (11.1%), phenylalanine (60.6%), and methionine (69.7%), whereas most women met the EAR values for tryptophan (92.9%), valine (96.0%), and isoleucine (94.9%). Study results indicate that several essential and conditionally essential amino acids were associated with postpartum weight loss, with a significant portion of women not meeting recommended intake levels for some of these amino acids. These results highlight the importance of postpartum maternal diet as a potential modifiable risk factor.
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Affiliation(s)
- Laura E. Wild
- Department of Integrative PhysiologyUniversity of Colorado BoulderBoulderCOUSA
| | - Tanya L. Alderete
- Department of Integrative PhysiologyUniversity of Colorado BoulderBoulderCOUSA
| | - Noopur C. Naik
- Department of Integrative PhysiologyUniversity of Colorado BoulderBoulderCOUSA
| | | | - Paige K. Berger
- Department of PediatricsThe Saban Research InstituteChildren's Hospital Los AngelesUniversity of Southern CaliforniaLos AngelesCAUSA
| | - Roshonda B. Jones
- Department of PediatricsThe Saban Research InstituteChildren's Hospital Los AngelesUniversity of Southern CaliforniaLos AngelesCAUSA
| | - Jasmine F. Plows
- Department of PediatricsThe Saban Research InstituteChildren's Hospital Los AngelesUniversity of Southern CaliforniaLos AngelesCAUSA
| | - Michael I. Goran
- Department of PediatricsThe Saban Research InstituteChildren's Hospital Los AngelesUniversity of Southern CaliforniaLos AngelesCAUSA
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12
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Bodnar LM, Abrams B, Simhan HN, Scifres CM, Silver RM, Parry S, Crosland BA, Chung J, Himes KP. The impact of setting a pregnancy weight gain goal on total weight gain. Paediatr Perinat Epidemiol 2021; 35:164-173. [PMID: 33155708 PMCID: PMC7878338 DOI: 10.1111/ppe.12724] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/29/2020] [Revised: 08/04/2020] [Accepted: 08/07/2020] [Indexed: 01/15/2023]
Abstract
BACKGROUND Expert groups recommend that women set a pregnancy weight gain goal with their care provider to optimise weight gain. OBJECTIVE Our aim was to describe the concordance between first-trimester personal and provider pregnancy weight gain goals with the Institute of Medicine (IOM) recommendations and to determine the association between these goals and total weight gain. METHODS We used data from 9353 women in the Nulliparous Pregnancy Outcomes Study: monitoring mothers-to-be. In the first trimester, women reported their personal pregnancy weight gain goal and their provider weight gain goal, and we categorised personal and provider weight gain goals and total weight gain according to IOM recommendations. We used log-binomial or linear regression models to relate goals to total weight gain, adjusting for confounders including race/ethnicity, maternal age, education, smoking, marital status and planned pregnancy. RESULTS Approximately 37% of women reported no weight gain goals, while 24% had personal and provider goals, 31% had only a personal goal, and 8% had only a provider goal. Personal and provider goals were outside the recommended ranges in 12%-23% of normal-weight women, 31%-41% of overweight women and 47%-63% of women with obesity. Women with both personal and provider pregnancy weight gain goals were 6%-14% more likely than their counterparts to have a goal within IOM-recommended ranges. Having any goal or a goal within the IOM-recommended ranges was unrelated to pregnancy weight gain. Excessive weight gain occurred in approximately half of normal-weight or obese women and three-quarters of overweight women, regardless of goal setting group. CONCLUSIONS These findings do not support the effectiveness of early-pregnancy personal or provider gestational weight gain goal setting alone in optimising weight gain. Multifaceted interventions that address a number of mediators of goal setting success may assist women in achieving weight gain consistent with their goals.
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Affiliation(s)
- Lisa M. Bodnar
- Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA, USA,Department of Obstetrics, Gynecology, and Reproductive Sciences, School of Medicine, University of Pittsburgh, Pittsburgh, PA, USA,Magee-Womens Research Institute, Pittsburgh, PA, USA
| | - Barbara Abrams
- School of Public Health, University of California at Berkeley, Berkeley, CA, USA
| | - Hyagriv N. Simhan
- Department of Obstetrics, Gynecology, and Reproductive Sciences, School of Medicine, University of Pittsburgh, Pittsburgh, PA, USA,Magee-Womens Research Institute, Pittsburgh, PA, USA
| | - Christina M. Scifres
- Department of Obstetrics and Gynecology, Indiana University School of Medicine, IN, USA
| | - Robert M. Silver
- Department of Obstetrics and Gynecology, University of Utah, Salt Lake City, UT, USA
| | - Samuel Parry
- Department of Obstetrics and Gynecology, University of Pennsylvania School of Medicine, Philadelphia, PA, USA
| | - Brian A. Crosland
- Department of Obstetrics and Gynecology, University of California Irvine College of Medicine, Irvine, CA, USA
| | - Judith Chung
- Department of Obstetrics and Gynecology, University of California Irvine College of Medicine, Irvine, CA, USA
| | - Katherine P. Himes
- Department of Obstetrics, Gynecology, and Reproductive Sciences, School of Medicine, University of Pittsburgh, Pittsburgh, PA, USA,Magee-Womens Research Institute, Pittsburgh, PA, USA
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13
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Garay SM, Sumption LA, Pearson RM, John RM. Risk factors for excessive gestational weight gain in a UK population: a biopsychosocial model approach. BMC Pregnancy Childbirth 2021; 21:43. [PMID: 33423656 PMCID: PMC7798251 DOI: 10.1186/s12884-020-03519-1] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2020] [Accepted: 12/22/2020] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND Gestational weight gain (GWG) can have implications for the health of both mother and child. However, the contributing factors remain unclear. Despite the advantages of using a biopsychosocial approach, this approach has not been applied to study GWG in the UK. This study aimed to investigate the risk factors of excessive GWG in a UK population, employing a biopsychosocial model. METHODS This study utilised data from the longitudinal Grown in Wales (GiW) cohort, which recruited women in late pregnancy in South Wales. Specifically, data was collected from midwife recorded notes and an extensive questionnaire completed prior to an elective caesarean section (ELCS) delivery. GWG was categorised according to Institute of Medicine (IOM) guidelines. The analysis was undertaken for 275 participants. RESULTS In this population 56.0% of women had excessive GWG. Increased prenatal depression symptoms (Exp(B)=1.10, p=.019) and an overweight (Exp(B)=4.16, p<.001) or obese (Exp(B)=4.20, p=.010) pre-pregnancy BMI, consuming alcohol in pregnancy (Exp(B)=.37, p=.005) and an income of less than £18,000 (Exp(B)=.24, p=.043) and £25-43,000 (Exp(B)=.25, p=.002) were associated with excessive GWG. CONCLUSION GWG is complex and influenced by a range of biopsychosocial factors, with the high prevalence of excessive weight gain in this population a cause for concern. Women in the UK may benefit from a revised approach toward GWG within the National Health Service (NHS), such as tracking weight gain throughout pregnancy. Additionally, this research provides evidence for potential targets for future interventions, and potentially at-risk populations to target, to improve GWG outcomes.
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Affiliation(s)
- S. M. Garay
- grid.5600.30000 0001 0807 5670Biomedicine Division, School of Biosciences, Cardiff University, Cardiff, CF10 3AX UK
| | - L. A. Sumption
- grid.5600.30000 0001 0807 5670Biomedicine Division, School of Biosciences, Cardiff University, Cardiff, CF10 3AX UK
| | - R. M. Pearson
- grid.5337.20000 0004 1936 7603Centre for Academic Mental Health, Population Health Sciences, Bristol Medical School, University of Bristol, Oakfield House, Bristol, BS8 2BN UK
| | - R. M. John
- grid.5600.30000 0001 0807 5670Biomedicine Division, School of Biosciences, Cardiff University, Cardiff, CF10 3AX UK
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14
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Seely EW, Weitzman PF, Cortes D, Romero Vicente S, Levkoff SE. Development and Feasibility of an App to Decrease Risk Factors for Type 2 Diabetes in Hispanic Women With Recent Gestational Diabetes (Hola Bebé, Adiós Diabetes): Pilot Pre-Post Study. JMIR Form Res 2020; 4:e19677. [PMID: 33382039 PMCID: PMC7808888 DOI: 10.2196/19677] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2020] [Revised: 10/30/2020] [Accepted: 11/03/2020] [Indexed: 11/13/2022] Open
Abstract
Background Hispanic women have increased risk of gestational diabetes mellitus (GDM), which carries an increased risk for future type 2 diabetes, compared to non-Hispanic women. In addition, Hispanic women are less likely to engage in healthy eating and physical activity, which are both risk factors for type 2 diabetes. Supporting patients to engage in healthy lifestyle behaviors through mobile health (mHealth) interventions is increasingly recognized as a viable, underused tool for disease prevention, as they reduce barriers to access frequently experienced in face-to-face interventions. Despite the high percentage of smartphone ownership among Hispanics, mHealth programs to reduce risk factors for type 2 diabetes in Hispanic women with prior GDM are lacking. Objective This study aimed to (1) develop a mobile app (¡Hola Bebé, Adiós Diabetes!) to pilot test a culturally tailored, bilingual (Spanish/English) lifestyle program to reduce risk factors for type 2 diabetes in Hispanic women with GDM in the prior 5 years; (2) examine the acceptability and usability of the app; and (3) assess the short-term effectiveness of the app in increasing self-efficacy for both healthy eating and physical activity, and in decreasing weight. Methods Social cognitive theory provided the framework for the study. A prototype app was developed based on prior research and cultural tailoring of content. Features included educational audiovisual modules on healthy eating and physical activity; personal action plans; motivational text messages; weight tracking; user-friendly, easy-to-follow recipes; directions on building a balanced plate; and tiered badges to reward achievements. Perceptions of the app’s acceptability and usability were explored through four focus groups. Short-term effectiveness of the app was tested in an 8-week single group pilot study. Results In total, 11 Hispanic women, receiving care at a federally qualified community health center, aged 18-45 years, and with GDM in the last 5 years, participated in four focus groups to evaluate the app’s acceptability and usability. Participants found the following sections most useful: audiovisual modules, badges for completion of activities, weight-tracking graphics, and recipes. Suggested modifications included adjustments in phrasing, graphics, and a tiering system of badges. After app modifications, we conducted usability testing with 4 Hispanic women, with the key result being the suggestion for a “how-to tutorial.” To assess short-term effectiveness, 21 Hispanic women with prior GDM participated in the pilot. There was a statistically significant improvement in both self-efficacy for physical activity (P=.003) and self-efficacy for healthy eating (P=.007). Weight decreased but not significantly. Backend process data revealed a high level of user engagement. Conclusions These data support the app’s acceptability, usability, and short-term effectiveness, suggesting that this mHealth program has the potential to fill the gap in care experienced by Hispanic women with prior GDM following pregnancy. Future studies are needed to determine the effectiveness of an enhanced app in a randomized controlled trial. Trial Registration ClinicalTrials.gov NCT04149054; https://clinicaltrials.gov/ct2/show/NCT04149054
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Affiliation(s)
- Ellen W Seely
- Endocrinology, Diabetes and Hypertension Division, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, United States
| | | | - Dharma Cortes
- Environment and Health Group, Cambridge, MA, United States
| | | | - Sue E Levkoff
- Environment and Health Group, Cambridge, MA, United States.,University of South Carolina, Columbia, SC, United States
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15
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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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16
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Su L, Chen C, Lu L, Xiang AH, Dodds L, He K. Association Between Gestational Weight Gain and Autism Spectrum Disorder in Offspring: A Meta-Analysis. Obesity (Silver Spring) 2020; 28:2224-2231. [PMID: 33001584 PMCID: PMC7644585 DOI: 10.1002/oby.22966] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/01/2020] [Revised: 06/26/2020] [Accepted: 07/08/2020] [Indexed: 12/19/2022]
Abstract
OBJECTIVE This study aimed to quantitatively examine the association between gestational weight gain (GWG) and risk of autism spectrum disorder (ASD) in offspring. METHODS Electronic databases were searched for studies of excessive or inadequate GWG, as compared with recommended GWG, in relation to the risk of ASD in offspring. Measures of the association from primary studies were pooled using a meta-analytic approach and expressed as weighted odds ratios (ORs) with 95% CIs. RESULTS Nine studies were identified, including 323,253 participants with 4,135 cases of ASD from five cohort studies and 1,462 cases and 3,265 controls from four case-control studies. Evidence from cohort studies indicates that both excessive and inadequate GWG was significantly associated with a higher risk for ASD in offspring. The pooled OR of ASD was 1.10 (95% CI: 1.02-1.18) for excessive GWG and 1.13 (95% CI: 1.04-1.24) for inadequate GWG using recommended GWG as the reference. Evidence from case-control studies suggests that excessive GWG (1.38 [95% CI: 1.19-1.62]) but not inadequate GWG (0.87 [95% CI: 0.72-1.04]) was significantly associated with a higher risk for ASD. CONCLUSIONS The accumulated evidence has supported that gaining weight outside the recommended GWG is associated with a higher risk for ASD in offspring.
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Affiliation(s)
- Le Su
- Department of Epidemiology and Biostatistics, School of Public Health, Indiana University – Bloomington, Bloomington, IN, USA
| | - Cheng Chen
- Department of Obstetrics and Gynecology and Department of Epidemiology, Columbia University Irving Medical Center, New York, NY, USA
| | - Liping Lu
- Department of Obstetrics and Gynecology and Department of Epidemiology, Columbia University Irving Medical Center, New York, NY, USA
| | - Anny H. Xiang
- Department of Research and Evaluation, Southern California Permanente Medical Group, Pasadena, USA
| | - Linda Dodds
- Perinatal Epidemiology Research Unit, Departments of Obstetrics and Gynaecology and Pediatrics, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Ka He
- Department of Obstetrics and Gynecology and Department of Epidemiology, Columbia University Irving Medical Center, New York, NY, USA
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17
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Dolatian M, Sharifi N, Mahmoodi Z, Fathnezhad‐kazemi A, Bahrami‐vazir E, Rashidian T. Weight gain during pregnancy and its associated factors: A Path analysis. Nurs Open 2020; 7:1568-1577. [PMID: 32802378 PMCID: PMC7424458 DOI: 10.1002/nop2.539] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2020] [Revised: 05/01/2020] [Accepted: 05/04/2020] [Indexed: 11/22/2022] Open
Abstract
Aim Weight gain during pregnancy is an important indicator in the prediction of morbidity and mortality in infants and mothers. This study aimed to determine the association factors for weight gain during pregnancy. Design A longitudinal study. Methods A total of 734 women were selected using multistage cluster sampling. Data were collected using demographic and midwifery questionnaires, economic and social status, psychological factors, domestic violence, perceived social support and food insecurity. Results Of participants 28.7%, 49.6% and 21.7%, respectively, received insufficient, adequate and excessive weight gain in pregnancy respectively. Among health determinants entered in the model, mother's age, prepartum body mass index and direct and indirect prenatal care, size of households, food insecurity, stress, anxiety, stress and pregnancy-specific stress as well as violence had a positive and increasing effect on weight gain during pregnancy. Conclusion Considering the effect of inappropriate weight gain during pregnancy on undesirable pregnancy outcomes, related factors such as nutritional status, stress and depression in prenatal care should be assessed. Healthcare providers should consult, educate pregnant women.
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Affiliation(s)
- Mahrokh Dolatian
- Department of Midwifery and Reproductive HealthSchool of Nursing and MidwiferyShahid Beheshti University of Medical SciencesTehranIran
| | - Nasibeh Sharifi
- Department of MidwiferySchool of Nursing & MidwiferyIlam University of Medical SciencesIlamIran
| | - Zohreh Mahmoodi
- Social Determinants of Health Research CenterAlborz University of Medical SciencesKarajIran
| | - Azita Fathnezhad‐kazemi
- Department of MidwiferyFaculty of Nursing and MidwiferyIslamic Azad University, Tabriz branchTabrizIran
| | - Elahe Bahrami‐vazir
- Department of MidwiferySchool of Nursing & MidwiferyIlam University of Medical SciencesIlamIran
| | - Tayebeh Rashidian
- Department of Obstetrics and GynecologyMedical SchoolIlam University of Medical SciencesIlamIran
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18
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Evaluation of antenatal risk factors for postpartum depression: a secondary cohort analysis of the cluster-randomised GeliS trial. BMC Med 2020; 18:227. [PMID: 32703266 PMCID: PMC7379365 DOI: 10.1186/s12916-020-01679-7] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2020] [Accepted: 06/23/2020] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Maternal weight variables are important predictors of postpartum depression (PPD). While preliminary evidence points to an association between pre-pregnancy obesity and PPD, the role of excessive gestational weight gain (GWG) on PPD is less studied. In this secondary cohort analysis of the German 'healthy living in pregnancy' (GeliS) trial, we aimed to investigate associations between weight-related variables and PPD and to assess the influence of GWG on the risk for PPD. METHODS We included women with normal weight, overweight, and obesity (BMI 18.5-40.0 kg/m2). Symptoms of PPD were assessed 6-8 weeks postpartum using the Edinburgh Postnatal Depression Scale. Pre-pregnancy BMI was self-reported. During the course of pregnancy, weight was measured at gynaecological practices within regular check-ups. GWG was defined as the difference between the last measured weight before delivery and the first measured weight at the time of recruitment (≤ 12th week of gestation). Excessive GWG was classified according to the Institute of Medicine. Multiple logistic regression analyses were used to estimate the odds of PPD in relation to pre-pregnancy BMI, GWG, and excessive GWG adjusting for important confounders. RESULTS Of the total 1583 participants, 45.6% (n = 722) showed excessive GWG and 7.9% (n = 138) experienced PPD. Pre-pregnancy BMI (per 5-unit increase; OR = 1.23, 95% CI 1.08-1.41, p = 0.002) and pre-pregnancy overweight or obesity were significantly positively associated with the odds of developing PPD, particularly among women with an antenatal history of anxiety or depressive symptoms (overweight: OR = 1.93, 95% CI = 1.15-3.22, p = 0.01; obesity: OR = 2.11, 95% CI = 1.13-3.96, p = 0.02). Sociodemographic or lifestyle factors did not additively influence the odds of having PPD. In fully adjusted models, there was no significant evidence that GWG or the occurrence of excessive GWG increased the odds of experiencing PPD (excessive vs. non-excessive: OR = 3.48, 95% CI 0.35-34.94; GWG per 1 kg increase: OR = 1.16, 95% CI 0.94-1.44). CONCLUSION Pre-pregnancy overweight or obesity is associated with PPD independent of concurrent risk factors. History of anxiety or depressive symptoms suggests a stress-induced link between pre-pregnancy weight and PPD. TRIAL REGISTRATION NCT01958307 , ClinicalTrials.gov, retrospectively registered on 9 October 2013.
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19
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Walker LO, Sterling BS. Weight Loss, Gain, or Stability from 6 Weeks to 6 Months Postpartum: Associations with Depressive Symptoms and Behavioral Habits. J Womens Health (Larchmt) 2020; 29:541-549. [DOI: 10.1089/jwh.2019.7949] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Affiliation(s)
- Lorraine O. Walker
- Family, Public Health, and Nursing Administration Division, School of Nursing, The University of Texas at Austin, Austin, Texas
| | - Bobbie S. Sterling
- Family, Public Health, and Nursing Administration Division, School of Nursing, The University of Texas at Austin, Austin, Texas
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20
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Braig S, Logan CA, Reister F, Rothenbacher D, Genuneit J. Psychosocial stress and longitudinally measured gestational weight gain throughout pregnancy: The Ulm SPATZ Health Study. Sci Rep 2020; 10:1996. [PMID: 32029794 PMCID: PMC7005281 DOI: 10.1038/s41598-020-58808-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2019] [Accepted: 01/17/2020] [Indexed: 12/14/2022] Open
Abstract
Psychosocial stress is thought to influence gestational weight gain (GWG), but results are inconsistent. We investigated the relationship of questionnaire-based maternal stress and related constructs assessed at childbirth with maternal weight measured throughout pregnancy. Data were derived from the Ulm SPATZ Health Study, a birth cohort recruited from the general population (04/2012-05/2013, Ulm, Germany). Adjusted generalized estimating equations were performed. Regression coefficients (b) and 95% confidence intervals, each highest versus lowest tertile of stress or related constructs, are presented. In 748 women, we observed positive associations for maternal chronic stress (b = 4.36 kg (1.77; 6.95)), depressive symptoms (b = 2.50 kg (0.14; 4.86)), anxiety symptoms (b = 3.26 kg (0.62, 5.89)), and hair cortisol (b = 3.35 kg (0.86; 5.83)) with maternal weight at the first gestational month. GWG was considerably lower in mothers with higher chronic stress. Pregnancy-related anxiety was positively related to weight at first month (b = 4.16 kg (1.74; 6.58)) and overall GWG. In contrast, no association was observed between anxiety symptoms and GWG. Odds ratios for association with inadequate weight gain according to Institute of Medicine recommended cutoffs differed from the results presented obove. There is evidence of an association between stress and weight gain lying beyond the recommended cut-offs, which however needs further corroboration.
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Affiliation(s)
- S Braig
- Institute of Epidemiology and Medical Biometry, Ulm University, Ulm, Germany
| | - C A Logan
- Institute of Epidemiology and Medical Biometry, Ulm University, Ulm, Germany
| | - F Reister
- Department of Gynecology and Obstetrics, University Medical Center Ulm, Ulm, Germany
| | - D Rothenbacher
- Institute of Epidemiology and Medical Biometry, Ulm University, Ulm, Germany.
| | - J Genuneit
- Institute of Epidemiology and Medical Biometry, Ulm University, Ulm, Germany
- Pediatric Epidemiology, Department of Pediatrics, Leipzig University Medicine, Leipzig, Germany
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21
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Koech WA, Lilly CL. Association of county perinatal resources and gestational weight gain in West Virginia, United States. BMC Pregnancy Childbirth 2019; 19:497. [PMID: 31842827 PMCID: PMC6915988 DOI: 10.1186/s12884-019-2650-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2018] [Accepted: 11/29/2019] [Indexed: 11/15/2022] Open
Abstract
Background Inappropriate (inadequate or excessive) gestational weight gain (GWG) is of great concern to maternal, fetal and infant health. Different maternal and fetal risk factors are associated with GWG, but little is known about a more distal risk factor: inadequate county-level perinatal resources. Therefore, the study aim was to investigate GWG in women living in counties with below average perinatal resources in comparison with their counterparts living in counties with above average perinatal resources. Methods Retrospective study of 406,792,010–2011 West Virginia births in 55 counties. The outcome was GWG and the main predictor was county perinatal resources. Hierarchical linear mixed model was used to investigate the association of county perinatal resources and GWG. Results County perinatal resources was associated with GWG (p = 0.009), controlling for important covariates. Below average county perinatal resources was not significantly associated with a decrease in mean GWG (M: − 5.29 lbs., 95% CI: − 13.94, 3.35, p = 0.2086), in comparison with counties with above average county perinatal resources. There was significant difference between average, and above average county perinatal resources (M: − 17.20 lbs., 95% CI: − 22.94, − 11.47, p < 0.0001), controlling for smoking during pregnancy and other covariates. Conclusions Average county perinatal resources was associated with reduced mean GWG relative to above average county perinatal resources, but not below average county perinatal resources. However, this could be due to the small number of counties with above average resources as the effect was in the hypothesized direction. This highlights one of the challenges in county perinatal resource studies.
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Affiliation(s)
- Wilson A Koech
- Department of Epidemiology, School of Public Health, WV University Health Sciences Center, Morgantown, WV, USA.
| | - Christa L Lilly
- Department of Biostatistics, School of Public Health, WV University Health Sciences Center, Morgantown, WV, USA
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Murray-Davis B, Grenier L, Atkinson SA, Mottola MF, Wahoush O, Thabane L, Xie F, Vickers-Manzin J, Moore C, Hutton EK. Experiences regarding nutrition and exercise among women during early postpartum: a qualitative grounded theory study. BMC Pregnancy Childbirth 2019; 19:368. [PMID: 31638920 PMCID: PMC6805669 DOI: 10.1186/s12884-019-2508-z] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2019] [Accepted: 09/13/2019] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND Excess gestational weight gain has long- and short-term implications for women and children, and postpartum weight retention is associated with an increased risk of long-term obesity. Despite the existence of dietary and exercise guidelines, many women struggle to return to pre-pregnancy weight. Experiences of women in tackling postpartum weight loss are poorly understood. We undertook this study to explore experiences related to nutrition, exercise and weight in the postpartum in women in Ontario, Canada. METHODS This was a nested qualitative study within The Be Healthy in Pregnancy Study, a randomized controlled trial. Women randomized to the control group were invited to participate. Semi-structured focus groups were conducted at 4-6 months postpartum. Focus groups were audio recorded, transcribed verbatim, coded and analyzed thematically using a constructivist grounded theory approach. RESULTS Women experienced a complex relationship with their body image, due to unrealistic expectations related to their postpartum body. Participants identified barriers and enablers to healthy habits during pregnancy and postpartum. Gestational weight gain guidelines were regarded as unhelpful and unrealistic. A lack of guidance and information about weight management, healthy eating, and exercise in the postpartum period was highlighted. CONCLUSION Strategies for weight management that target the unique characteristics of the postpartum period have been neglected in research and in patient counselling. Postpartum women may begin preparing for their next pregnancy and support during this period could improve their health for subsequent pregnancies. TRIAL REGISTRATION NCT01689961 registered September 21, 2012.
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Affiliation(s)
- Beth Murray-Davis
- McMaster Midwifery Research Center, Department of Obstetrics and Gynecology, McMaster University, Hamilton, ON Canada
| | - Lindsay Grenier
- McMaster Midwifery Research Center, Department of Obstetrics and Gynecology, McMaster University, Hamilton, ON Canada
| | | | - Michelle F. Mottola
- R. Samuel McLaughlin Foundation- Exercise and Pregnancy Lab, School of Kinesiology, The University of Western Ontario, London, ON Canada
| | - Olive Wahoush
- Global Health, McMaster University, Hamilton, ON Canada
- School of Nursing, McMaster University, Hamilton, ON Canada
| | - Lehana Thabane
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, ON Canada
- Biostatistics Unit, Father Sean O’Sullivan Research Centre, St Joseph’s Healthcare Hamilton, Hamilton, ON Canada
| | - Feng Xie
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, ON Canada
| | - Jennifer Vickers-Manzin
- Public Health Services-Healthy Families, Healthy & Safe Communities, City of Hamilton, Hamilton, ON Canada
| | - Caroline Moore
- Department of Pediatrics, McMaster University, Hamilton, ON Canada
| | - Eileen K. Hutton
- McMaster Midwifery Research Center, Department of Obstetrics and Gynecology, McMaster University, Hamilton, ON Canada
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He S, Allen JC, Razali NS, Win NM, Zhang JJ, Ng MJ, Yeo GSH, Chern BSM, Tan KH. Are women in Singapore gaining weight appropriately during pregnancy: a prospective cohort study. BMC Pregnancy Childbirth 2019; 19:290. [PMID: 31409285 PMCID: PMC6693141 DOI: 10.1186/s12884-019-2443-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2018] [Accepted: 07/31/2019] [Indexed: 01/21/2023] Open
Abstract
BACKGROUND We aimed to study gestational weight gain (GWG) in a Singaporean population and compare it with Institute of Medicine (IOM) 2009 GWG guidelines. METHODS Nine hundred twenty-six women with low-risk singleton pregnancy were enrolled in a prospective cohort study from 2010 to 2014 in a Singapore tertiary maternity hospital. Seven hundred twenty-four patients had maternal weight information till term pregnancy and were included in analysis. Participants were categorized according to their first antenatal visit body mass index (BMI) as underweight, normal weight, overweight and obese. Total GWG for each BMI group was calculated. Multivariate logistic regression was performed to determine the predictors of total GWG above and below IOM guidelines. RESULTS Obese women had a mean total GWG (9.1 kg) that exceeded the upper limit IOM guidelines (9 kg). In multivariate analysis of predictors of total GWG above IOM guidelines, being overweight (adjusted OR: 3.91 [95% CI, 2.60-5.88]; p < .0001) and obese (adjusted OR: 4.78 [95% CI, 2.80, 8.15]; p < .0001) significantly increased the risks of gaining weight above IOM guidelines during pregnancy, compared to being normal weight. CONCLUSIONS Overweight and obesity are independent significant risk factors for gaining excessive gestational weight. Appropriate weight management for overweight and obese Singaporean women prior to and during pregnancy is important.
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Affiliation(s)
- Song He
- Division of Obstetrics and Gynaecology, KK Women's and Children's Hospital, Singapore, Singapore
| | - John Carson Allen
- Office of Clinical Sciences, Duke-NUS Medical School, Singapore, Singapore
| | - Nurul Syaza Razali
- Division of Obstetrics and Gynaecology, KK Women's and Children's Hospital, Singapore, Singapore
| | - Nyo Mie Win
- Division of Obstetrics and Gynaecology, KK Women's and Children's Hospital, Singapore, Singapore
| | - Jun Jim Zhang
- Division of Obstetrics and Gynaecology, OBGYN Academic Clinical Program (ACP), KK Women's and Children's Hospital, Singapore, Singapore
| | - Mor Jack Ng
- Division of Obstetrics and Gynaecology, KK Women's and Children's Hospital, Singapore, Singapore
| | - George Seow Heong Yeo
- Department of Maternal Fetal Medicine, KK Women's and Children's Hospital, 100 Bukit Timah Road, Singapore, 229899,, Singapore
| | - Bernard Su Min Chern
- Division of Obstetrics and Gynaecology, KK Women's and Children's Hospital, Singapore, Singapore
| | - Kok Hian Tan
- Department of Maternal Fetal Medicine, KK Women's and Children's Hospital, 100 Bukit Timah Road, Singapore, 229899,, Singapore.
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Bastain TM, Chavez T, Habre R, Girguis MS, Grubbs B, Toledo-Corral C, Amadeus M, Farzan SF, Al-Marayati L, Lerner D, Noya D, Quimby A, Twogood S, Wilson M, Chatzi L, Cousineau M, Berhane K, Eckel SP, Lurmann F, Johnston J, Dunton GF, Gilliland F, Breton C. Study Design, Protocol and Profile of the Maternal And Developmental Risks from Environmental and Social Stressors (MADRES) Pregnancy Cohort: a Prospective Cohort Study in Predominantly Low-Income Hispanic Women in Urban Los Angeles. BMC Pregnancy Childbirth 2019; 19:189. [PMID: 31146718 PMCID: PMC6543670 DOI: 10.1186/s12884-019-2330-7] [Citation(s) in RCA: 54] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2018] [Accepted: 05/03/2019] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND The burden of childhood and adult obesity disproportionally affects Hispanic and African-American populations in the US, and these groups as well as populations with lower income and education levels are disproportionately affected by environmental pollution. Pregnancy is a critical developmental period where maternal exposures may have significant impacts on infant and childhood growth as well as the future health of the mother. We initiated the "Maternal And Developmental Risks from Environmental and Social Stressors (MADRES)" cohort study to address critical gaps in understanding the increased risk for childhood obesity and maternal obesity outcomes among minority and low-income women in urban Los Angeles. METHODS The MADRES cohort is specifically examining whether pre- and postpartum environmental exposures, in addition to exposures to psychosocial and built environment stressors, lead to excessive gestational weight gain and postpartum weight retention in women and to perturbed infant growth trajectories and increased childhood obesity risk through altered psychological, behavioral and/or metabolic responses. The ongoing MADRES study is a prospective pregnancy cohort of 1000 predominantly lower-income, Hispanic women in Los Angeles, CA. Enrollment in the MADRES cohort is initiated prior to 30 weeks gestation from partner community health clinics in Los Angeles. Cohort participants are followed through their pregnancies, at birth, and during the infant's first year of life through a series of in-person visits with interviewer-administered questionnaires, anthropometric measurements and biospecimen collection as well as telephone interviews conducted with the mother. DISCUSSION In this paper, we outline the study rationale and data collection protocol for the MADRES cohort, and we present a profile of demographic, health and exposure characteristics for 291 participants who have delivered their infants, out of 523 participants enrolled in the study from November 2015 to October 2018 from four community health clinics in Los Angeles. Results from the MADRES cohort could provide a powerful rationale for regulation of targeted chemical environmental components, better transportation and urban design policies, and clinical recommendations for stress-coping strategies and behavior to reduce lifelong obesity risk.
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Affiliation(s)
- Theresa M. Bastain
- Department of Preventive Medicine, USC Keck School of Medicine, University of Southern California, 2001 N. Soto Street, M/C 9237, Los Angeles, CA 90032 USA
| | - Thomas Chavez
- Department of Preventive Medicine, USC Keck School of Medicine, University of Southern California, 2001 N. Soto Street, M/C 9237, Los Angeles, CA 90032 USA
| | - Rima Habre
- Department of Preventive Medicine, USC Keck School of Medicine, University of Southern California, 2001 N. Soto Street, M/C 9237, Los Angeles, CA 90032 USA
| | - Mariam S. Girguis
- Department of Preventive Medicine, USC Keck School of Medicine, University of Southern California, 2001 N. Soto Street, M/C 9237, Los Angeles, CA 90032 USA
| | - Brendan Grubbs
- Department of Obstetrics and Gynecology, University of Southern California, Los Angeles, CA USA
| | - Claudia Toledo-Corral
- Department of Preventive Medicine, USC Keck School of Medicine, University of Southern California, 2001 N. Soto Street, M/C 9237, Los Angeles, CA 90032 USA
- Department of Public Health, California State University Northridge, Los Angeles, CA USA
| | - Milena Amadeus
- Department of Preventive Medicine, USC Keck School of Medicine, University of Southern California, 2001 N. Soto Street, M/C 9237, Los Angeles, CA 90032 USA
| | - Shohreh F. Farzan
- Department of Preventive Medicine, USC Keck School of Medicine, University of Southern California, 2001 N. Soto Street, M/C 9237, Los Angeles, CA 90032 USA
| | - Laila Al-Marayati
- Department of Obstetrics and Gynecology, University of Southern California, Los Angeles, CA USA
- Eisner Health, Los Angeles, CA USA
| | | | - David Noya
- South Central Family Health Center, Los Angeles, CA USA
| | - Alyssa Quimby
- Department of Obstetrics and Gynecology, University of Southern California, Los Angeles, CA USA
| | - Sara Twogood
- Department of Obstetrics and Gynecology, University of Southern California, Los Angeles, CA USA
| | - Melissa Wilson
- Department of Preventive Medicine, USC Keck School of Medicine, University of Southern California, 2001 N. Soto Street, M/C 9237, Los Angeles, CA 90032 USA
| | - Leda Chatzi
- Department of Preventive Medicine, USC Keck School of Medicine, University of Southern California, 2001 N. Soto Street, M/C 9237, Los Angeles, CA 90032 USA
| | - Michael Cousineau
- Department of Preventive Medicine, USC Keck School of Medicine, University of Southern California, 2001 N. Soto Street, M/C 9237, Los Angeles, CA 90032 USA
| | - Kiros Berhane
- Department of Preventive Medicine, USC Keck School of Medicine, University of Southern California, 2001 N. Soto Street, M/C 9237, Los Angeles, CA 90032 USA
| | - Sandrah P. Eckel
- Department of Preventive Medicine, USC Keck School of Medicine, University of Southern California, 2001 N. Soto Street, M/C 9237, Los Angeles, CA 90032 USA
| | | | - Jill Johnston
- Department of Preventive Medicine, USC Keck School of Medicine, University of Southern California, 2001 N. Soto Street, M/C 9237, Los Angeles, CA 90032 USA
| | - Genevieve F. Dunton
- Department of Preventive Medicine, USC Keck School of Medicine, University of Southern California, 2001 N. Soto Street, M/C 9237, Los Angeles, CA 90032 USA
- Department of Psychology, University of Southern California, Los Angeles, CA USA
| | - Frank Gilliland
- Department of Preventive Medicine, USC Keck School of Medicine, University of Southern California, 2001 N. Soto Street, M/C 9237, Los Angeles, CA 90032 USA
| | - Carrie Breton
- Department of Preventive Medicine, USC Keck School of Medicine, University of Southern California, 2001 N. Soto Street, M/C 9237, Los Angeles, CA 90032 USA
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Gupta V, Saxena R, Walia GK, Agarwal T, Vats H, Dunn W, Relton C, Sovio U, Papageorghiou A, Davey Smith G, Khadgawat R, Sachdeva MP. Gestational route to healthy birth (GaRBH): protocol for an Indian prospective cohort study. BMJ Open 2019; 9:e025395. [PMID: 31048433 PMCID: PMC6501957 DOI: 10.1136/bmjopen-2018-025395] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/12/2018] [Revised: 10/17/2018] [Accepted: 03/12/2019] [Indexed: 11/13/2022] Open
Abstract
INTRODUCTION Pregnancy is characterised by a high rate of metabolic shifts from early to late phases of gestation in order to meet the raised physiological and metabolic needs. This change in levels of metabolites is influenced by gestational weight gain (GWG), which is an important characteristic of healthy pregnancy. Inadequate/excessive GWG has short-term and long-term implications on maternal and child health. Exploration of gestational metabolism is required for understanding the quantitative changes in metabolite levels during the course of pregnancy. Therefore, our aim is to study trimester-specific variation in levels of metabolites in relation to GWG and its influence on fetal growth and newborn anthropometric traits at birth. METHODS AND ANALYSIS A prospective longitudinal study is planned (start date: February 2018; end date: March 2023) on pregnant women that are being recruited in the first trimester and followed in subsequent trimesters and at the time of delivery (total 3 follow-ups). The study is being conducted in a hospital located in Bikaner district (66% rural population), Rajasthan, India. The estimated sample size is of 1000 mother-offspring pairs. Information on gynaecological and obstetric history, socioeconomic position, diet, physical activity, tobacco and alcohol consumption, depression, anthropometric measurements and blood samples is being collected for metabolic assays in each trimester using standardised methods. Mixed effects regression models will be used to assess the role of gestational weight in influencing metabolite levels in each trimester. The association of maternal levels of metabolites with fetal growth, offspring's weight and body composition at birth will be investigated using regression modelling. ETHICS AND DISSEMINATION The study has been approved by the ethics committees of the Department of Anthropology, University of Delhi and Sardar Patel Medical College, Rajasthan. We are taking written informed consent after discussing the various aspects of the study with the participants in the local language.
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Affiliation(s)
- Vipin Gupta
- Department of Anthropology, University of Delhi, Delhi, India
| | - Ruchi Saxena
- Department of Obstetrics and Gynaecology, Sardar Patel Medical College, Bikaner, Rajasthan, India
| | | | | | - Harsh Vats
- Department of Anthropology, University of Delhi, Delhi, India
| | - Warwick Dunn
- School of Biosciences, Phenome Centre Birmingham and Institute of Metabolism and Systems Research, University of Birmingham, Birmingham, UK
| | - Caroline Relton
- MRC Integrative Epidemiology Unit and Bristol Medical School, University of Bristol, Bristol, UK
| | - Ulla Sovio
- Obstetrics and Gyneacology, University of Cambridge, Cambridge, UK
| | - Aris Papageorghiou
- Nuffield Department of Women’s & Reproductive Health, University of Oxford, Oxford, United Kingdom
| | - George Davey Smith
- MRC Integrative Epidemiology Unit and Bristol Medical School, University of Bristol, Bristol, UK
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Germeroth LJ, Benno MT, Kolko Conlon RP, Emery RL, Cheng Y, Grace J, Salk RH, Levine MD. Trial design and methodology for a non-restricted sequential multiple assignment randomized trial to evaluate combinations of perinatal interventions to optimize women's health. Contemp Clin Trials 2019; 79:111-121. [PMID: 30851434 PMCID: PMC6436999 DOI: 10.1016/j.cct.2019.03.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2018] [Revised: 02/26/2019] [Accepted: 03/05/2019] [Indexed: 02/01/2023]
Abstract
Pre-pregnancy overweight/obesity and excessive gestational weight gain (GWG) independently predict negative maternal and child health outcomes. To date, however, interventions that target GWG have not produced lasting improvements in maternal weight or health at 12-months postpartum. Given that interventions solely aimed at addressing GWG may not equip women with the skills needed for postpartum weight management, interventions that address health behaviors over the perinatal period might maximize maternal health in the first postpartum year. Thus, the current study leveraged a sequential multiple assignment randomized trial (SMART) design to evaluate sequences of prenatal (i.e., during pregnancy) and postpartum lifestyle interventions that optimize maternal weight, cardiometabolic health, and psychosocial outcomes at 12-months postpartum. Pregnant women (N = 300; ≤16 weeks pregnant) with overweight/obesity (BMI ≥ 25 kg/m2) are being recruited. Women are randomized to intervention or treatment as usual on two occasions: (1) early in pregnancy, and (2) prior to delivery, resulting in four intervention sequences. Intervention during pregnancy is designed to moderate GWG and introduce skills for management of weight as a chronic condition, while intervention in the postpartum period addresses weight loss. The primary outcome is weight at 12-months postpartum and secondary outcomes include variables of cardiometabolic health and psychosocial well-being. Analyses will evaluate the combination of prenatal and postpartum lifestyle interventions that optimizes maternal weight and secondary outcomes at 12-months postpartum. Optimizing the sequence of behavioral interventions to address specific needs during pregnancy and the first postpartum year can maximize intervention potency and mitigate longer-term cardiometabolic health risks for women.
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Affiliation(s)
- Lisa J Germeroth
- Department of Psychiatry, University of Pittsburgh, 3811 O'Hara Street, Pittsburgh, PA 15213, USA
| | - Maria T Benno
- Department of Psychiatry, University of Pittsburgh, 3811 O'Hara Street, Pittsburgh, PA 15213, USA
| | - Rachel P Kolko Conlon
- Department of Psychiatry, University of Pittsburgh, 3811 O'Hara Street, Pittsburgh, PA 15213, USA
| | - Rebecca L Emery
- Department of Psychiatry, University of Pittsburgh, 3811 O'Hara Street, Pittsburgh, PA 15213, USA
| | - Yu Cheng
- Department of Statistics, University of Pittsburgh, 1800 Wesley W. Posvar Hall, 230 South Bouquet Street, Pittsburgh, PA 15260, USA
| | - Jennifer Grace
- Department of Psychiatry, University of Pittsburgh, 3811 O'Hara Street, Pittsburgh, PA 15213, USA
| | - Rachel H Salk
- Department of Psychiatry, University of Pittsburgh, 3811 O'Hara Street, Pittsburgh, PA 15213, USA
| | - Michele D Levine
- Department of Psychiatry, University of Pittsburgh, 3811 O'Hara Street, Pittsburgh, PA 15213, USA.
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27
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O’Connor SG, Habre R, Bastain TM, Toledo-Corral CM, Gilliland FD, Eckel SP, Cabison J, Naya CH, Farzan SF, Chu D, Chavez TA, Breton CV, Dunton GF. Within-subject effects of environmental and social stressors on pre- and post-partum obesity-related biobehavioral responses in low-income Hispanic women: protocol of an intensive longitudinal study. BMC Public Health 2019; 19:253. [PMID: 30819155 PMCID: PMC6396454 DOI: 10.1186/s12889-019-6583-x] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2018] [Accepted: 02/22/2019] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Disproportionately high rates of maternal overweight and obesity among the Hispanic population before, during, and after pregnancy pose serious health concerns for both mothers (e.g., preeclampsia, gestational diabetes, weight retention) and children (e.g., elevated lifelong obesity risk). A growing body of evidence implicates environmental exposures (e.g., air pollution, metals) and social stressors (e.g., poverty, violence) in contributing to obesity-related biobehavioral processes, such as physical activity, dietary intake, perceived stress, and cortisol regulation. However, current understanding of the role of environmental exposures and social stressors on obesity-related biobehavioral processes is limited by infrequent, inter-individual measurement, and lack of personal exposure monitoring. METHODS The "Maternal and Developmental Risks from Environmental and Social Stressors" (MADRES) real-time and personal sampling study examines the within-subject day-level effects of environmental and social stressors on maternal pre- and post-partum obesity-related biobehavioral responses. Among a cohort of 65 low-income, Hispanic women in urban Los Angeles, this study uses innovative personal, real-time data capture strategies (e.g., ecological momentary assessment [EMA], personal exposure monitoring, geolocation monitoring, accelerometry) to repeatedly assess obesity-related processes during the 1st and 3rd trimester, and at 4-6 months postpartum. Day-level effects of environmental exposures and social stressors on women's physical activity, diet, perceived stress and salivary cortisol measured across repeated days will be tested using multilevel modeling. DISCUSSION Hispanic women of childbearing age bear a disproportionately high burden of obesity, and this population is also unduly exposed to numerous obesogenic settings. By using innovative real-time data capture strategies, the current study will uncover the daily impacts of environmental and social stressor exposures on women's obesity-related biobehavioral responses, which over time can lead to excessive gestational weight gain, postpartum weight retention and can pose serious consequences for both mother and child. Findings from the real-time and personal sampling study will identify key mechanistic targets for policy, clinical, and programmatic interventions, with the potential for broad-reaching public health impacts.
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Affiliation(s)
- Sydney G. O’Connor
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, 2001 N. Soto Street, Los Angeles, CA 90032 USA
| | - Rima Habre
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, 2001 N. Soto Street, Los Angeles, CA 90032 USA
| | - Theresa M. Bastain
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, 2001 N. Soto Street, Los Angeles, CA 90032 USA
| | - Claudia M. Toledo-Corral
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, 2001 N. Soto Street, Los Angeles, CA 90032 USA
- Department of Health Sciences, California State University, Northridge, 18111 Nordhoff Street, Northridge, CA 91330 USA
| | - Frank D. Gilliland
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, 2001 N. Soto Street, Los Angeles, CA 90032 USA
| | - Sandrah P. Eckel
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, 2001 N. Soto Street, Los Angeles, CA 90032 USA
| | - Jane Cabison
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, 2001 N. Soto Street, Los Angeles, CA 90032 USA
| | - Christine H. Naya
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, 2001 N. Soto Street, Los Angeles, CA 90032 USA
| | - Shohreh F. Farzan
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, 2001 N. Soto Street, Los Angeles, CA 90032 USA
| | - Daniel Chu
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, 2001 N. Soto Street, Los Angeles, CA 90032 USA
| | - Thomas A. Chavez
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, 2001 N. Soto Street, Los Angeles, CA 90032 USA
| | - Carrie V. Breton
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, 2001 N. Soto Street, Los Angeles, CA 90032 USA
| | - Genevieve F. Dunton
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, 2001 N. Soto Street, Los Angeles, CA 90032 USA
- Department of Psychology, University of Southern California, 3620 South McClintock Ave, Los Angeles, CA 90089 USA
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Masturzo B, Franzè V, Germano C, Attini R, Gennarelli G, Lezo A, Rolfo A, Plazzotta C, Brunelli E, Youssef A, Todros T, Farina A. Risk of adverse pregnancy outcomes by pre-pregnancy Body Mass Index among Italian population: a retrospective population-based cohort study on 27,807 deliveries. Arch Gynecol Obstet 2019; 299:983-991. [PMID: 30770990 DOI: 10.1007/s00404-019-05093-0] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2018] [Accepted: 02/02/2019] [Indexed: 11/25/2022]
Abstract
PURPOSE To estimate the impact of increasing pre-pregnancy Body Mass Index (BMI) on the risk of adverse maternal and perinatal outcomes, in patients who delivered in an Italian tertiary care Obstetric department. METHODS Data, related to women who delivered at Sant'Anna Hospital, Turin, between 2011 and 2015, were collected retrospectively from the hospital database. According to BMI, women were considered as normal weight, overweight, and class 1, 2 and 3 obese (WHO criteria). Logistic regression analysis studied the impact of BMI on maternal and neonatal outcomes, adjusting results for maternal age and parity. Adjusted absolute risks of each outcome were reported according to incremental values in pre-pregnancy BMI. RESULTS A total of 27,807 women were included. 75.8% of pregnancies occurred among normal-weight women, whereas 16.7% were overweight, and 7.5% obese women (5.4% class 1, 1.7% class 2 and 0.4% class 3). A 10% decrease in pre-pregnancy BMI was associated with a reduction of at least 15% of Gestational diabetes mellitus (GDM), preeclampsia, maternal admission to intensive care unit (ICU), macrosomia, APGAR 5' < 6 and neonatal admission to ICU. GDM and preeclampsia resulted in the highest reduction being almost 30%. Larger differences in BMI (20-25%) corresponded to at least a 10% in reduction of risk of preterm and very preterm delivery and emergency cesarean section. Differences in maternal pre-pregnancy BMI had no impact on the frequency of shoulder dystocia and stillbirth. CONCLUSIONS This study offers a quantitative estimation of negative impact of pre-pregnancy obesity on the most common pregnancy and perinatal complications.
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Affiliation(s)
- Bianca Masturzo
- Department of Surgical Sciences, OIRM S. Anna Hospital University of Turin, Turin, Italy
| | - Vera Franzè
- Department of Surgical Sciences, OIRM S. Anna Hospital University of Turin, Turin, Italy
| | - Chiara Germano
- Department of Surgical Sciences, OIRM S. Anna Hospital University of Turin, Turin, Italy
| | - Rossella Attini
- Department of Surgical Sciences, OIRM S. Anna Hospital University of Turin, Turin, Italy
| | - Gianluca Gennarelli
- Department of Surgical Sciences, OIRM S. Anna Hospital University of Turin, Turin, Italy
| | - Antonella Lezo
- Department of Surgical Sciences, OIRM S. Anna Hospital University of Turin, Turin, Italy
| | - Alessandro Rolfo
- Department of Surgical Sciences, OIRM S. Anna Hospital University of Turin, Turin, Italy
| | - Claudio Plazzotta
- Department of Surgical Sciences, OIRM S. Anna Hospital University of Turin, Turin, Italy
| | - Elena Brunelli
- Division of Obstetrics and Prenatal Medicine, Department of Medicine and Surgery (DIMEC) Sant'Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy
| | - Aly Youssef
- Division of Obstetrics and Prenatal Medicine, Department of Medicine and Surgery (DIMEC) Sant'Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy
| | - Tullia Todros
- Department of Surgical Sciences, OIRM S. Anna Hospital University of Turin, Turin, Italy
| | - Antonio Farina
- Division of Obstetrics and Prenatal Medicine, Department of Medicine and Surgery (DIMEC) Sant'Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy.
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Relationship Between Psychosocial Factors, Dietary Intake and Gestational Weight Gain: A Narrative Review. JOURNAL OF OBSTETRICS AND GYNAECOLOGY CANADA 2018; 41:495-504. [PMID: 30393057 DOI: 10.1016/j.jogc.2018.02.023] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2017] [Revised: 02/21/2018] [Accepted: 02/23/2018] [Indexed: 12/25/2022]
Abstract
Inadequate gestational weight gain (GWG), which has reached almost two-thirds of Canadian pregnant women, is associated with several adverse effects both in the mother and her child. The aim of this review was to establish how psychosocial factors, diet and GWG are interrelated during pregnancy. More specifically, it aimed to evaluate how psychosocial factors can impact on diet and, thus, influence GWG. Studies published through May 2017 that examined factors related to GWG were included. Of 3268 non-duplicate titles and abstract, 77 articles underwent full-text review. Regarding dietary intakes, the majority of the included studies demonstrated that a higher caloric intake was associated with an elevated GWG. Also, a negative body image and attitude toward weight gain as well as a poor knowledge of GWG recommendations and inadequate prenatal care is associated with an increased GWG. Only few studies examined altogether the factors included and conclusions about how psychosocial factors can impact on diet and, thus, influence GWG cannot be drawn at this point. In the few studies that evaluated the interrelationships between psychosocial factors, diet and GWG, energy intake was not identified as a mediator of the association between psychosocial factors and GWG. This review highlights the scarcity of findings regarding psychosocial and dietary factors in relation to GWG and the need for high quality prospective cohort studies that will include all these factors to provide a better understanding of how they are interrelated to influence short- and long-term health.
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Jarman M, Mathe N, Ramazani F, Pakseresht M, Robson PJ, Johnson ST, Bell RC. Dietary Patterns Prior to Pregnancy and Associations with Pregnancy Complications. Nutrients 2018; 10:nu10070914. [PMID: 30018227 PMCID: PMC6073508 DOI: 10.3390/nu10070914] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2018] [Revised: 07/10/2018] [Accepted: 07/12/2018] [Indexed: 01/02/2023] Open
Abstract
Few studies have explored pre-pregnancy diet and its relationship with pregnancy outcomes. The objectives of this study were to: (1) derive pre-pregnancy dietary patterns for women enrolled in a prospective cohort in the province of Alberta, Canada; (2) describe associations between dietary patterns and socio-demographic characteristics; and (3) describe associations between dietary patterns and pregnancy complications. Upon enrolment into the Alberta Pregnancy Outcomes and Nutrition (APrON) study (median age of gestation, 17 weeks), women (n = 1545) completed a validated 142-item food frequency questionnaire recording food and beverages consumed “in the 12 months prior to pregnancy”. Other assessments included pre-pregnancy body mass index (BMI), gestational weight gain, gestational hypertension, gestational diabetes, and socio-demographic characteristics. Dietary patterns were derived using principal components analysis. Scores were calculated to represent adherence with each dietary pattern retained. Four dietary patterns were retained, accounting for 22.9% of the variation in the overall diet. Dietary patterns were named the “healthy”, “meat and refined carbohydrate”, “beans, cheese and salad” or “tea and coffee” patterns. Higher “healthy” pattern scores prior to pregnancy were associated with lower odds of developing gestational hypertension during pregnancy (adjusted Odds Ratio (OR): 0.6, 95% Confidence Intervals (CI): 0.4, 0.9). Diet prior to pregnancy is an important target for interventions and may reduce the likelihood of developing complications such as gestational hypertension during pregnancy.
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Affiliation(s)
- Megan Jarman
- Li Ka Shing Centre for Health Research Innovation, Department of Agricultural, Food and Nutritional Sciences, Division of Human Nutrition, University of Alberta, Edmonton, AB T6G 2E1, Canada; (M.J.); (M.P.)
| | - Nonsikelelo Mathe
- Alliance for Health Outcomes Research in Diabetes (ACHORD), University of Alberta, Edmonton, AB T6G 2E1, Canada; (N.M.); (F.R.); (S.T.J.)
| | - Fatemeh Ramazani
- Alliance for Health Outcomes Research in Diabetes (ACHORD), University of Alberta, Edmonton, AB T6G 2E1, Canada; (N.M.); (F.R.); (S.T.J.)
| | - Mohammadreza Pakseresht
- Li Ka Shing Centre for Health Research Innovation, Department of Agricultural, Food and Nutritional Sciences, Division of Human Nutrition, University of Alberta, Edmonton, AB T6G 2E1, Canada; (M.J.); (M.P.)
- Cancer Research, CancerControl Alberta, Alberta Health Services, Edmonton, AB T5J 3H1, Canada;
| | - Paula J. Robson
- Cancer Research, CancerControl Alberta, Alberta Health Services, Edmonton, AB T5J 3H1, Canada;
| | - Steven T. Johnson
- Alliance for Health Outcomes Research in Diabetes (ACHORD), University of Alberta, Edmonton, AB T6G 2E1, Canada; (N.M.); (F.R.); (S.T.J.)
- Faculty of Health Disciplines, Athabasca University, Athabasca, AB T9S 3A3, Canada
| | - Rhonda C. Bell
- Li Ka Shing Centre for Health Research Innovation, Department of Agricultural, Food and Nutritional Sciences, Division of Human Nutrition, University of Alberta, Edmonton, AB T6G 2E1, Canada; (M.J.); (M.P.)
- Correspondence:
| | - the APrON and ENRICH study teams
- Li Ka Shing Centre for Health Research Innovation, Department of Agricultural, Food and Nutritional Sciences, Division of Human Nutrition, University of Alberta, Edmonton, AB T6G 2E1, Canada; (M.J.); (M.P.)
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Bichteler A, Gershoff ET. Identification of Children's BMI Trajectories and Prediction from Weight Gain in Infancy. Obesity (Silver Spring) 2018; 26:1050-1056. [PMID: 29722476 PMCID: PMC8287871 DOI: 10.1002/oby.22177] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2017] [Revised: 02/13/2018] [Accepted: 02/15/2018] [Indexed: 01/04/2023]
Abstract
OBJECTIVE The goal of this study was to identify patterns of BMI changes across childhood (ages 24 months to 13 years) and to assess whether demographic characteristics, birth weight, and percent infant weight gain from birth to 15 months predicted BMI patterns. METHODS Eleven waves of data from the Study of Early Child Care and Youth Development were used. Trained technicians assessed children's weight at birth and 10 times from 15 months to eighth grade (N = 1364). Latent growth modeling was used to estimate BMI change trajectories, and logistic regression was used to predict membership in trajectory classes. RESULTS Children in the high-rising and low-to-high BMI patterns had the highest BMI of all trajectory groups during middle childhood. Birth weight and infant weight gain were stronger predictors of trajectory membership than gender or race/ethnicity. Infant weight gain predicted high-rising membership over and above the effect of birth weight. African American children had lower birth weight, faster infant weight increase, and higher odds of being in one of the rising trajectories. Risk algorithms are provided. CONCLUSIONS Clinicians should monitor weight gain during infancy independent of birth weight. Researchers should continue investigating the lasting physiological effects of early rapid weight gain in infancy.
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Affiliation(s)
- Anne Bichteler
- Department of Human Development and Family Sciences, University of Texas at Austin, Austin, Texas, USA
| | - Elizabeth T Gershoff
- Department of Human Development and Family Sciences, University of Texas at Austin, Austin, Texas, USA
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Kominiarek MA, Gray EL, Vyhmeister H, Grobman W, Simon M. Association of Gestational Weight Gain with Prenatal Care Model. J Midwifery Womens Health 2018; 63:283-288. [PMID: 29758122 DOI: 10.1111/jmwh.12759] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2017] [Revised: 03/07/2018] [Accepted: 03/08/2018] [Indexed: 11/29/2022]
Abstract
INTRODUCTION The objective of this study was to compare gestational weight gain (GWG) among women in group and traditional prenatal care. METHODS This is a retrospective cohort study of women who received prenatal care between 2011 and 2015 in a setting in which low-risk women had the option of group prenatal care. Women with height and initial and final weight were eligible. Women who chose group prenatal care were compared with women who chose traditional prenatal care and gave birth during the same study period. A propensity score analysis was used to create a matched control group from women who received traditional prenatal care. Bivariable comparisons of demographics, maternal characteristics, and GWG as a categorical variable (inadequate, adequate, or excessive per the 2009 Institute of Medicine guidelines) were performed with chi-square or Wilcoxon rank-sum tests. A logistic regression analysis was performed to estimate the association of group prenatal care with excessive GWG. RESULTS The final sample included 818 women who received either group or traditional prenatal care and were matched according to age, body mass index (BMI), nulliparity, and marital status. In the unadjusted analysis, women in group prenatal care had lower odds of excessive GWG (odds ratio [OR], 0.75; 95% CI, 0.57-0.99), but the statistical significance of this finding did not persist in the adjusted analysis (OR, 0.77; 95% CI, 0.45-1.30). When the analyses were limited to women who had at least 5 group or traditional prenatal care visits, there were no differences in excessive GWG in unadjusted (OR, 0.83; 95% CI, 0.59-1.16) or adjusted (OR, 0.97; 95% CI, 0.24-3.96) analyses. DISCUSSION In this propensity score matched cohort study of predominantly Hispanic women, there were no differences in excessive GWG between women in group compared with traditional prenatal care. Further study is indicated to determine the relationship between prenatal care model and GWG outcomes.
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Kominiarek MA, Grobman W, Adam E, Buss C, Culhane J, Entringer S, Simhan H, Wadhwa PD, Kim KY, Keenan-Devlin L, Borders A. Stress during pregnancy and gestational weight gain. J Perinatol 2018; 38:462-467. [PMID: 29379158 PMCID: PMC5999529 DOI: 10.1038/s41372-018-0051-9] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2017] [Revised: 12/11/2017] [Accepted: 01/02/2018] [Indexed: 11/11/2022]
Abstract
OBJECTIVE To evaluate the association between prenatal stress and gestational weight gain (GWG). STUDY DESIGN This was an analysis of women recruited between 2013-2015 from four sites in the US. We tested associations between responses at 32-35 weeks to the Life Experiences Survey (LES), a 37-item measure of events and perceived stress, and GWG categories. Bivariable comparisons and logistic regression were used to estimate the association between the total LES score and the odds of achieving adequate GWG. RESULT Among the 725 women, those with adequate GWG had lower median LES scores (5) compared to women with inadequate (7) and excessive (7) GWG, p = 0.02. After adjusting for age, initial BMI, income, education, marital status and gestational diabetes, lower LES scores (multiples of the median) were associated with adequate GWG (aOR 0.81, 95% CI 0.67-0.98). CONCLUSION Lower reported stress, as measured by the LES, was associated with a greater chance of women achieving adequate GWG. This relationship highlights the potential for interventions directed toward psychosocial support to have salutary effects upon GWG.
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Affiliation(s)
| | - William Grobman
- Department of Obstetrics and Gynecology, Northwestern University, Chicago, IL, USA
| | - Emma Adam
- Department of Education and Social Policy, Northwestern University, Chicago, IL, USA
| | - Claudia Buss
- Development, Health and Disease Research Program, University of California, Irvine, Irvine, CA, USA
- Charite, Universitatsmedizin, Berlin, Germany
| | - Jennifer Culhane
- Division of Adolescent Medicine, Children's Hospital of Pennsylvania, Philadelphia, PA, USA
| | - Sonja Entringer
- Development, Health and Disease Research Program, University of California, Irvine, Irvine, CA, USA
- Charite, Universitatsmedizin, Berlin, Germany
| | - Hyagriv Simhan
- Department of Obstetrics and Gynecology, University of Pittsburgh, Pittsburgh, PA, USA
| | - Pathik D Wadhwa
- Development, Health and Disease Research Program, University of California, Irvine, Irvine, CA, USA
| | | | - Lauren Keenan-Devlin
- Department of Obstetrics and Gynecology, NorthShore University Health System and University of Chicago Priztker School of Medicine, Chicago, IL, USA
| | - Ann Borders
- Department of Obstetrics and Gynecology, NorthShore University Health System and University of Chicago Priztker School of Medicine, Chicago, IL, USA
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Abstract
Since the inception of prenatal care in the early 1900s, the focus of care has been on risk reduction rather than on health promotion. Prenatal care began as individualized care, but more recently group prenatal care has been shown to be very successful in improving birth outcomes. For all women, an emphasis on improving health behaviors is important at this critical time while women are engaging regularly with the healthcare system. An emphasis on mental health promotion may decrease some of the disparities in birth outcomes that are well documented between minority and majority women, as minority women are known to experience increased levels of stress, anxiety, and depression. Providing support for pregnant women and incorporating knowledge and skills through prenatal care may promote both physical and mental health in minority women.
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Novel Interventions to Reduce Stress and Overeating in Overweight Pregnant Women: A Feasibility Study. Matern Child Health J 2018; 22:670-678. [DOI: 10.1007/s10995-018-2435-z] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Tebbani F, Oulamara H, Agli A. Effects of gestational weight gain on pregnancy complications. NUTR CLIN METAB 2018. [DOI: 10.1016/j.nupar.2017.09.011] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
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Nunnery D, Ammerman A, Dharod J. Predictors and outcomes of excess gestational weight gain among low-income pregnant women. Health Care Women Int 2017; 39:19-33. [PMID: 29068777 DOI: 10.1080/07399332.2017.1391263] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Low-income women were interviewed and their post-natal records were retrieved (n = 160) to assess prevalence of excess gestational weight gain and its socio-demographic predictors. More than half of the women (64%) gained excess weight during pregnancy, with an average of 10 lbs in excess of Institute of Medicine guidelines. Logistic regression indicated that women that started pregnancy at an obese body mass index; who were African American or having an unplanned pregnancy were at significant risk of gaining excess weight in pregnancy. Intervention to prevent excess weight gain during pregnancy is critical in addressing obesity epidemic in the United States and worldwide.
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Affiliation(s)
- Danielle Nunnery
- a Department of Human Nutrition , Winthrop University , Rock Hill , SC , USA
| | - Alice Ammerman
- b Department of Nutrition , Gillings School of Global Public Health and School of Medicine, University of North Carolina at Chapel Hill , Chapel Hill , NC , USA
| | - Jigna Dharod
- c Department of Nutrition , University of North Carolina at Greensboro , Greensboro , NC , USA
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Psychosocial predictors of gestational weight gain and the role of mindfulness. Midwifery 2017; 56:86-93. [PMID: 29096284 DOI: 10.1016/j.midw.2017.10.008] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2016] [Revised: 09/17/2017] [Accepted: 10/14/2017] [Indexed: 01/17/2023]
Abstract
OBJECTIVE To identify the psychosocial factors (i.e., stress, anxiety, depression, social support) that are associated with gestational weight gain (GWG) and the relationship of mindfulness with GWG during each trimester of pregnancy. DESIGN In this cross-sectional study, an online survey that assessed physical and mental health and wellness practices was administered to pregnant women. PARTICIPANTS Pregnant women ≥8 weeks gestation, ≥18 years old, and could read and write in English. MEASUREMENT AND FINDINGS Women who responded to the survey (N=1,073) were on average 28.7±4.6 years old. Findings from a regression analysis suggest that increased levels of depression may be predictive of increased GWG in the second trimester and decreased levels of mindfulness may be predictive of increased GWG in the first trimester. Anxiety, stress, and overall social support were not associated with GWG in any trimester. KEY CONCLUSIONS Mindfulness-based strategies (e.g., yoga) may have the potential to manage both depression and excessive GWG and may beneficial for and preferred by pregnant women. More research is warranted to determine clear relationships between psychosocial health, mindfulness, and GWG. IMPLICATIONS FOR PRACTICE Health care providers are encouraged to screen for depression in early pregnancy (i.e., first or second trimester) and provide resources to manage symptoms of depression and GWG to promote optimal birth outcomes. Health care providers may want to counsel patients on how to manage depression and/or GWG by suggesting mindfulness-based approaches.
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Washington Cole KO, Gudzune KA, Bleich SN, Bennett WL, Cheskin LJ, Henderson JL, Caulfield LE, Guan Y, Roter DL. Influence of the 5A's Counseling Strategy on Weight Gain During Pregnancy: An Observational Study. J Womens Health (Larchmt) 2017; 26:1123-1130. [PMID: 28525296 PMCID: PMC5651961 DOI: 10.1089/jwh.2016.6115] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Healthy weight gain during pregnancy may improve health outcomes for women and infants. The objective of this study was to examine providers' use of the 5A's (Assess, Advise, Agree, Assist, and Arrange) in discussions of weight, nutrition, and physical activity during prenatal visits and evaluate the effect of this approach on gestational weight gain. MATERIALS AND METHODS We studied audio recordings of prenatal visits between 22 obstetrics providers and 120 of their patients, coding visits for providers' use of the 5A's. The relationship between the 5A's and gestational weight gain (total weight gain and excess gestational weight gain) was evaluated using multilevel models to account for patient clustering within provider, and adjusted for prepregnancy body mass index, parent study intervention assignment, gestational age at the study visit, and study visit length. RESULTS Overall, 55% of prenatal visits included any weight-related behavioral counseling. Of these, 59.1% included one of the 5A's and 40.9% included two or more of the 5A's. Counseling conversations most commonly included Assess or Advise (49% and 85% of counseling conversations, respectively). No recorded visits used all 5A's. In adjusted analyses, patients who received counseling with two or more of the 5A's gained an average of 11.8 fewer pounds than patients who received no counseling (p = 0.001). The odds of excess gestational weight gain were lower among women receiving counseling with at least one of the 5A's (p < 0.05). CONCLUSIONS The 5A's were associated with lower gestational weight gain and may be a promising counseling strategy to promote healthy weight gain during pregnancy.
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Affiliation(s)
- Katie O. Washington Cole
- Department of Health, Behavior and Society, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland
| | - Kimberly A. Gudzune
- Division of General Internal Medicine, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Sara N. Bleich
- Department of Health Policy and Management, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland
| | - Wendy L. Bennett
- Division of General Internal Medicine, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Lawrence J. Cheskin
- Department of Health, Behavior and Society, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland
| | - Janice L. Henderson
- Department of Gynecology and Obstetrics, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Laura E. Caulfield
- Department of International, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland
| | - Yue Guan
- Department of Health, Behavior and Society, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland
| | - Debra L. Roter
- Department of Health, Behavior and Society, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland
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Ledoux T, Daundasekara S, Van Den Berg P, Leung P, Walker L, Berens PD. Association Between Health Beliefs and Gestational Weight Gain. J Womens Health (Larchmt) 2017; 27:341-347. [PMID: 28933637 DOI: 10.1089/jwh.2016.6185] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023] Open
Abstract
BACKGROUND The Institute of Medicine (IOM) provides recommendations for optimal weight gain during pregnancy to minimize complications associated with obesity and excessive weight gain. The Health Belief Model and prior research suggest knowledge of health recommendations and associated risks motivate health behaviors. This study determined whether knowledge of maternal and infant obesity risks during pregnancy (ORDP) and knowledge of IOM gestational weight gain (GWG) recommendations were associated with total GWG and likelihood of adhering to IOM recommendations. MATERIALS AND METHODS In this prospective survey study, healthy women with a singleton pregnancy were recruited from prenatal clinic waiting rooms of a university medical center to complete a one-time survey of prepregnancy weight and height, demographic variables, knowledge of infant-related ORDP (e.g., large for gestational age), knowledge of maternal-related ORDP (e.g., Cesarean delivery), and knowledge of IOM GWG recommendations. Total GWG was obtained from clinic medical records. Logistic and multiple regression analyses were performed. RESULTS The sample consisted of 159 women with average age of 25 and prepregnancy body mass index of 28. Women in the sample were predominantly African American (57%) and from low socioeconomic conditions. Results showed (1) knowledge of GWG recommendations was inversely related to total GWG among normal and underweight women and (2) knowledge of infant-related ORDP was positively related to total GWG among overweight and obese women and the likelihood of exceeding recommendations among normal and underweight women. Knowledge of maternal-related ORDP was not related to GWG. CONCLUSION As the Health Belief Model suggests, knowledge appears to be a modifiable factor in preventing excess GWG. However, there may be misinformation regarding how to adhere to clinical recommendations.
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Affiliation(s)
- Tracey Ledoux
- 1 Department of Health and Human Performance, University of Houston , Houston, Texas
| | - Saumali Daundasekara
- 1 Department of Health and Human Performance, University of Houston , Houston, Texas
| | - Patricia Van Den Berg
- 2 Department of Obstetrics & Gynecology, University of Texas Medical Branch , Galveston, Texas
| | - Patrick Leung
- 1 Department of Health and Human Performance, University of Houston , Houston, Texas
| | - Lorraine Walker
- 3 School of Nursing, University of Texas at Austin , Austin, Texas
| | - Pamela D Berens
- 4 University of Texas Health Science Center , McGovern Medical School, Houston, Texas
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Cheney K, Berkemeier S, Sim KA, Gordon A, Black K. Prevalence and predictors of early gestational weight gain associated with obesity risk in a diverse Australian antenatal population: a cross-sectional study. BMC Pregnancy Childbirth 2017; 17:296. [PMID: 28882122 PMCID: PMC5590236 DOI: 10.1186/s12884-017-1482-6] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2017] [Accepted: 09/04/2017] [Indexed: 01/06/2023] Open
Abstract
Background Excess gestational weight gain (GWG) leads to adverse short- and long-term consequences for women and their offspring. Evidence suggests that excess GWG in early pregnancy may be particularly detrimental, contributing to the intergenerational cycle of obesity. The primary outcome was to investigate the prevalence and predictors of excess GWG in early pregnancy, and if women understand the risks to themselves and their offspring stratified by maternal body mass index (BMI). Methods This was a secondary analysis (n = 2131) of a cross-sectional study (n = 2338) conducted over 6 months in 2015 of pregnant women attending antenatal clinics at four maternity hospitals across Sydney, Australia before 22 completed weeks gestation An self-completed questionnaire was used to investigate knowledge of expected weight gain in pregnancy, understanding of risks associated with excess GWG, self-reported anthropometric measures and socio-demographic data. Results One third (34.2%) of women gained weight in excess of the recommendations by 22 completed weeks gestation. Women who were overweight (OR: 1.69, 95% CI: 1.33–2.14) or obese (OR: 1.64, 95% CI: 1.20–2.24) pre-pregnancy were more likely to gain excess weight in early pregnancy compared to normal weight women; as were women from lower socio-economic areas (OR: 1.89, 95% CI: 1.49–2.41). Half (51%) the women were unsure about the effect of excess GWG on their baby; 11% did not believe that excess GWG would affect the weight of the baby and 14% did not believe that excess GWG would affect longer term outcomes for their baby. Women who gained weight above the recommendations were significantly more likely to believe that excessive GWG in pregnancy would not have any adverse future effect on health outcomes or weight of their baby. Conclusions The women at particular risk of excess early GWG are those who are overweight and obese and/or residing in lower socio-economic areas. These women need to be targeted for appropriate counselling preconception or in early pregnancy. Given the significant adverse outcomes associated with excess GWG in early pregnancy, preconception or early pregnancy counselling with respect to GWG and intervention research regarding best approach remains a public health priority. Electronic supplementary material The online version of this article (10.1186/s12884-017-1482-6) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- K Cheney
- Women's and Babies, Royal Prince Alfred Hospital, Missenden Road, Camperdown, Sydney, NSW, 2050, Australia. .,Discipline of Obstetrics, Gynaecology and Neonatology, The University of Sydney, Sydney, NSW, 2006, Australia.
| | - S Berkemeier
- Division of Obstetrics and Gynaecology, Campbelltown Hospital, Sydney, NSW, 2560, Australia
| | - K A Sim
- The Boden Institute, Charles Perkins Centre, The University of Sydney, Sydney, NSW, 2006, Australia
| | - A Gordon
- Discipline of Obstetrics, Gynaecology and Neonatology, The University of Sydney, Sydney, NSW, 2006, Australia.,Charles Perkins Centre, The University of Sydney, Sydney, NSW, 2006, Australia
| | - K Black
- Women's and Babies, Royal Prince Alfred Hospital, Missenden Road, Camperdown, Sydney, NSW, 2050, Australia.,Discipline of Obstetrics, Gynaecology and Neonatology, The University of Sydney, Sydney, NSW, 2006, Australia
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Willcox JC, Ball K, Campbell KJ, Crawford DA, Wilkinson SA. Correlates of pregnant women's gestational weight gain knowledge. Midwifery 2017; 49:32-39. [DOI: 10.1016/j.midw.2016.08.011] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2016] [Revised: 08/17/2016] [Accepted: 08/31/2016] [Indexed: 10/21/2022]
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Garmendia ML, Zamudio C, Araya M, Kain J. Association between prepregnancy obesity and metabolic risk in Chilean premenopausal women 10 y postpartum. Nutrition 2017; 38:20-27. [DOI: 10.1016/j.nut.2017.01.003] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2016] [Revised: 12/30/2016] [Accepted: 01/05/2017] [Indexed: 11/26/2022]
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Mercado A, Marquez B, Abrams B, Phipps MG, Wing RR, Phelan S. Where Do Women Get Advice About Weight, Eating, and Physical Activity During Pregnancy? J Womens Health (Larchmt) 2017; 26:951-956. [PMID: 28525293 DOI: 10.1089/jwh.2016.6078] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Most women report not receiving information about gestational weight gain (GWG) from prenatal providers, but less is known about other sources of information and their potential impacts on GWG. The purpose of this study was to investigate sources of information about diet, physical activity, and weight control during pregnancy, and the impact of information sources on maternal GWG. MATERIALS AND METHODS Participants were 183 women with normal weight and 172 women with overweight/obesity who had enrolled in a prenatal lifestyle intervention trial. At 6 weeks postpartum, women were asked whether they had received information about "diet, physical activity, or weight control" from 12 sources uninvolved in the trial (e.g., physician, Internet, and friend) and, if received, the extent to which they followed the advice. Information sources were examined in relation to odds of exceeding Institute of Medicine (IOM) GWG guidelines based on measured weights. RESULTS Most women reported receiving information from a book (60.6%) or the Internet (58.3%). Advice from physicians, dietitians, or nurses was reported in 55.6%, 48.2%, and 33.9% of women, respectively. Reported receipt of information from physicians was associated with reduced Odds Ratio ([95% Confidence Interval] = 0.55 [0.35-0.88]; p = 0.01) of exceeding IOM GWG guidelines. Reported receipt of information from other sources was not related to GWG. CONCLUSIONS Books and the Internet were the most prevalent information sources reported for prenatal diet, physical activity, and weight control. However, of all sources, only physician provision of information was associated with reduced odds of excessive GWG.
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Affiliation(s)
- Adrian Mercado
- 1 Kinesiology Department, California Polytechnic State University , San Luis Obispo, California
| | - Becky Marquez
- 2 Department of Family Medicine and Public Health, University of California , San Diego, San Diego, California
| | - Barbara Abrams
- 3 Epidemiology Division, School of Public Health, University of California , Berkeley, Berkeley, California
| | - Maureen G Phipps
- 5 Division of Research, Department of Obstetrics and Gynecology, Women and Infants Hospital of Rhode Island, Warren Alpert Medical School of Brown University , Providence, Rhode Island
| | - Rena R Wing
- 4 Department of Psychiatry, The Miriam Hospital, Weight Control and Diabetes Research Center, Warren Alpert Medical School of Brown University , Providence, Rhode Island
| | - Suzanne Phelan
- 1 Kinesiology Department, California Polytechnic State University , San Luis Obispo, California
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Maternal excess gestational weight gain and infant waist circumference: a 2-y observational study. Pediatr Res 2017; 81:63-67. [PMID: 27632776 PMCID: PMC6257997 DOI: 10.1038/pr.2016.174] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2016] [Accepted: 07/07/2016] [Indexed: 11/08/2022]
Abstract
BACKGROUND The purpose of this study was to examine the effects of gestational weight gain (GWG) and infant feeding practices on infant growth parameters in infants from 6 to 24 mo of age. METHODS Forty mother-infant pairs were recruited after delivery and followed up to 24 mo postpartum. GWG was calculated as prepregnancy weight subtracted from weight at delivery. Infant weight velocity was calculated as the change in weight between consecutive visits divided by the intervening time. Infant feeding practices were measured by interview and infant growth and waist circumference by standard anthropometry. RESULTS Infants born to mothers with excess GWG were heavier at birth (3,521 ± 91 vs. 3,196 ± 97 g, P = 0.02) and had an average 2.16 ± 1.1 cm (P = 0.03) larger waist circumference throughout the 24 mo compared with infants born to mothers with appropriate GWG. Waist circumference increased by 0.12 and 2.0 cm for every 1 unit increase in GWG and infant birth weight. CONCLUSION Infants born to women who exceeded the Institute of Medicine (IOM)-recommended guidelines for GWG were heavier at birth and had a significantly higher waist circumference up to 2 y of age. Strategies to control maternal excess GWG and thus the outcome on infant birth weight and waist circumference should be pursued.
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Galin J, Abrams B, Leonard SA, Matthay EC, Goin DE, Ahern J. Living in Violent Neighbourhoods is Associated with Gestational Weight Gain Outside the Recommended Range. Paediatr Perinat Epidemiol 2017; 31:37-46. [PMID: 27921300 PMCID: PMC5195875 DOI: 10.1111/ppe.12331] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
BACKGROUND During pregnancy, most women do not meet gestational weight gain (GWG) guidelines, potentially resulting in adverse maternal and infant health consequences. Social environment determinants of GWG have been identified, but evidence on the relationship between neighbourhood violence and GWG is scant. Our study aims to examine the relationship between neighbourhood violence and GWG outside the recommended range. METHODS We used statewide vital statistics and health care utilization data from California for 2006-12 (n = 2 364 793) to examine the relationship of neighbourhood violence (quarters of zip-code rates of homicide and assault) in the first 37 weeks of pregnancy with GWG (categorized using the Institute of Medicine's pregnancy weight gain guidelines). We estimated risk ratios (RR) and marginal risk differences, and analyses were stratified by maternal race/ethnicity and prepregnancy body mass index. RESULTS Residence in neighbourhoods with the highest quartile of violence was associated with more excessive GWG (adjusted RR 1.04, 95% confidence interval CI 1.03, 1.05), compared to the lowest quartile of violence; violence was not associated with inadequate GWG. On the difference scale, this association translates to 2.3% more women gaining weight excessively rather than adequately if all women were exposed to high violence compared to if all women were exposed to low violence. Additionally, associations between neighbourhood violence and excessive GWG were larger in non-white women than in white women. CONCLUSIONS These findings support the hypothesis that violence can affect weight gain during pregnancy, emphasizing the importance of neighbourhood violence as a public health issue.
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Affiliation(s)
- Jessica Galin
- Division of Epidemiology, School of Public Health, University of California, Berkeley, Berkeley, CA, USA
| | - Barbara Abrams
- Division of Epidemiology, School of Public Health, University of California, Berkeley, Berkeley, CA, USA
| | - Stephanie A. Leonard
- Division of Epidemiology, School of Public Health, University of California, Berkeley, Berkeley, CA, USA
| | - Ellicott C. Matthay
- Division of Epidemiology, School of Public Health, University of California, Berkeley, Berkeley, CA, USA
| | - Dana E. Goin
- Division of Epidemiology, School of Public Health, University of California, Berkeley, Berkeley, CA, USA
| | - Jennifer Ahern
- Division of Epidemiology, School of Public Health, University of California, Berkeley, Berkeley, CA, USA
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Ulrich F, Petermann F. Consequences and Possible Predictors of Health-damaging Behaviors and Mental Health Problems in Pregnancy - A Review. Geburtshilfe Frauenheilkd 2016; 76:1136-1156. [PMID: 27904164 PMCID: PMC5123885 DOI: 10.1055/s-0042-118180] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2016] [Revised: 09/13/2016] [Accepted: 09/25/2016] [Indexed: 12/29/2022] Open
Abstract
In recent decades, the understanding of the short and longer term effects of health-damaging behaviors and mental health problems in pregnant women and the underlying mechanisms of these behaviors and illnesses has significantly increased. In contrast, little is known about the factors affecting individual pregnant women which contribute to health-damaging behaviors and mental illness. The aim of this paper was therefore to summarize the current state of research into the consequences of nicotine and alcohol consumption, malnutrition, excessive weight gain or obesity, and impaired mental health (depression and anxiety) during pregnancy. In addition, the characteristics of pregnant women which increase their risk of developing such behaviors or mental disorders are described. A better knowledge of these risks should make it easier for clinicians to identify cases at risk early on and put measures of support in place. A review of the literature has shown that certain characteristics of pregnant women (e.g. her relationship with her partner, a previous history of mental illness prior to pregnancy) are associated with various health-damaging behaviors as well as with impaired mental health. Affected women often show an accumulated psychosocial stress which was already present prior to the pregnancy and which may persist even after the birth of the child.
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Affiliation(s)
- F. Ulrich
- Zentrum für Klinische Psychologie und Rehabilitation der Universität Bremen, Bremen, Germany
| | - F. Petermann
- Zentrum für Klinische Psychologie und Rehabilitation der Universität Bremen, Bremen, Germany
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Thanos PK, Zhuo J, Robison L, Kim R, Ananth M, Choai I, Grunseich A, Grissom NM, George R, Delis F, Reyes TM. Suboptimal maternal diets alter mu opioid receptor and dopamine type 1 receptor binding but exert no effect on dopamine transporters in the offspring brain. Int J Dev Neurosci 2016; 64:21-28. [PMID: 27666382 DOI: 10.1016/j.ijdevneu.2016.09.008] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2016] [Revised: 09/07/2016] [Accepted: 09/15/2016] [Indexed: 11/18/2022] Open
Abstract
Birthweight is a marker for suboptimal fetal growth and development in utero. Offspring can be born large for gestational age (LGA), which is linked to maternal obesity or excessive gestational weight gain, as well as small for gestational age (SGA), arising from nutrient or calorie deficiency, placental dysfunction, or other maternal conditions (hypertension, infection). In humans, LGA and SGA babies are at an increased risk for certain neurodevelopmental disorders, including Attention Deficit/Hyperactivity Disorder, schizophrenia, and social and mood disorders. Using mouse models of LGA (maternal high fat (HF) diet) and SGA (maternal low protein (LP) diet) offspring, our lab has previously shown that these offspring display alterations in the expression of mesocorticolimbic genes that regulate dopamine and opioid function, thus indicating that these brain regions and neurotransmitter systems are vulnerable to gestational insults. Interestingly, these two maternal diets affected dopamine and opioid systems in somewhat opposing directions (e.g., LP offspring are generally hyperdopaminergic with reduced opioid expression, and the reverse is found for the HF offspring). These data largely involved evaluation at the transcriptional level, so the present experiment was designed to extend these analyses through an assessment of receptor binding. In this study, control, SGA and LGA offspring were generated from dams fed control, low protein or high fat diet, respectively, throughout pregnancy and lactation. At weaning, mice were placed on the control diet and sacrificed at 12 weeks of age. In vitro autoradiography was used to measure mu-opioid receptor (MOR), dopamine type 1 receptor (D1R), and dopamine transporter (DAT) binding level in mesolimbic brain regions. Results showed that the LP offspring (males and females) had significantly higher MOR and D1R binding than the control animals in the regions associated with reward. In HF offspring there were no differences in MOR binding, and limited increases in D1R binding, seen only in females in the nucleus accumbens core and the dorsomedial caudate/putamen. DAT binding revealed no differences in either models. In conclusion, LP but not HF offspring show significantly elevated MOR and D1R binding in the brain thus affecting DA and opioid signaling. These findings advance the current understanding of how suboptimal gestational diets can adversely impact neurodevelopment and increase the risk for disorders such as ADHD, obesity and addiction.
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Affiliation(s)
- Panayotis K Thanos
- Behavioral Neuropharmacology and Neuroimaging Laboratory, Research Institute on Addictions, University at Buffalo, 14203, USA.
| | - Jianmin Zhuo
- Behavioral Neuropharmacology and Neuroimaging Laboratory, Research Institute on Addictions, University at Buffalo, 14203, USA
| | - Lisa Robison
- Behavioral Neuropharmacology and Neuroimaging Laboratory, Research Institute on Addictions, University at Buffalo, 14203, USA
| | - Ronald Kim
- Behavioral Neuropharmacology and Neuroimaging Laboratory, Research Institute on Addictions, University at Buffalo, 14203, USA
| | - Mala Ananth
- Behavioral Neuropharmacology and Neuroimaging Laboratory, Research Institute on Addictions, University at Buffalo, 14203, USA
| | - Ilon Choai
- Behavioral Neuropharmacology and Neuroimaging Laboratory, Research Institute on Addictions, University at Buffalo, 14203, USA
| | - Adam Grunseich
- Behavioral Neuropharmacology and Neuroimaging Laboratory, Research Institute on Addictions, University at Buffalo, 14203, USA
| | - Nicola M Grissom
- Department of Psychiatry and Behavioral Neurosciences, University of Cincinnati, Cincinnati, OH 45237, USA
| | - Robert George
- Department of Pharmacology, University of Pennsylvania School of Medicine, Philadelphia, PA 19104, USA
| | - Foteini Delis
- Behavioral Neuropharmacology and Neuroimaging Laboratory, Research Institute on Addictions, University at Buffalo, 14203, USA
| | - Teresa M Reyes
- Department of Psychiatry and Behavioral Neurosciences, University of Cincinnati, Cincinnati, OH 45237, USA
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Rosal MC, Wang ML, Moore Simas TA, Bodenlos JS, Crawford SL, Leung K, Sankey HZ. Predictors of Gestational Weight Gain among White and Latina Women and Associations with Birth Weight. J Pregnancy 2016; 2016:8984928. [PMID: 27688913 PMCID: PMC5027040 DOI: 10.1155/2016/8984928] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2016] [Accepted: 06/20/2016] [Indexed: 11/17/2022] Open
Abstract
This study examined racial/ethnic differences in gestational weight gain (GWG) predictors and association of first-trimester GWG to overall GWG among 271 White women and 300 Latina women. Rates of within-guideline GWG were higher among Latinas than among Whites (28.7% versus 24.4%, p < 0.016). Adjusted odds of above-guideline GWG were higher among prepregnancy overweight (OR = 3.4, CI = 1.8-6.5) and obese (OR = 4.5, CI = 2.3-9.0) women than among healthy weight women and among women with above-guideline first-trimester GWG than among those with within-guideline first-trimester GWG (OR = 4.9, CI = 2.8-8.8). GWG was positively associated with neonate birth size (p < 0.001). Interventions targeting prepregnancy overweight or obese women and those with excessive first-trimester GWG are needed.
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Affiliation(s)
- Milagros C. Rosal
- Department of Medicine, Division of Preventive and Behavioral Medicine, University of Massachusetts Medical School, 55 Lake Avenue North, Worcester, MA 01655, USA
| | - Monica L. Wang
- Boston University School of Public Health, 801 Massachusetts Avenue, Boston, MA 02215, USA
- Harvard School of Public Health, 677 Huntington Avenue, Boston, MA 02215, USA
| | - Tiffany A. Moore Simas
- Department of Medicine, Division of Preventive and Behavioral Medicine, University of Massachusetts Medical School, 55 Lake Avenue North, Worcester, MA 01655, USA
| | - Jamie S. Bodenlos
- Department of Psychology, Hobart and William Smith Colleges, 217 Gulick Hall, Geneva, NY 14456, USA
| | - Sybil L. Crawford
- Department of Medicine, Division of Preventive and Behavioral Medicine, University of Massachusetts Medical School, 55 Lake Avenue North, Worcester, MA 01655, USA
| | - Katherine Leung
- Department of Medicine, Division of Preventive and Behavioral Medicine, University of Massachusetts Medical School, 55 Lake Avenue North, Worcester, MA 01655, USA
| | - Heather Z. Sankey
- Department of Obstetrics and Gynecology, Baystate Medical Center, 759 Chestnut Street, Springfield, MA 01199, USA
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