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Slana N, Hočevar-Boltežar I, Kornhauser-Cerar L. Risk Factors for Feeding and Swallowing Disorders in Very Low Birth Weight Infants in Their Second Year of Life. MEDICINA (KAUNAS, LITHUANIA) 2022; 58:1536. [PMID: 36363492 PMCID: PMC9697318 DOI: 10.3390/medicina58111536] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/02/2022] [Revised: 10/09/2022] [Accepted: 10/24/2022] [Indexed: 10/07/2023]
Abstract
Background and Objectives: This study aimed to identify the prevalence of feeding and swallowing disorders (FSD) in very low birth weight (VLBW, 1500 g or less) infants in the first two years after discharge from the maternity hospital, their possible risk factors, and the consequences of them. Materials and Methods: A total of 117 preterm children with VLBW born between 2013 and 2015 were included. The data concerning possible FSD after discharge from the hospital were obtained through accessible medical documentation for the child and a short parental questionnaire. Results: FSD was reported in 32 (27.4%) infants following discharge from the hospital but in only five children (4.3%) at a mean age of four years. Four variables (birth gestational age less than 28 weeks, birth weight equal to or less than 1000 g, birth length below 33 cm, and start of oral feeding after the 34th gestational week) were identified as risk factors for FSD after discharge. However, only birth length remained a significant predictor after being included in a binary logistic regression model (p = 0.000). Abnormal oral sensitivity and a decrease in weight to under the 10th percentile were significantly more common in the FSD group at follow-up visits at the age of about 2 years. Conclusions: FSD was still present in more than one-quarter of VLBW infants after discharge from the maternity hospital but mostly disappeared within four years. A birth gestational age under 28 weeks, weight up to 1000 g, the late beginning of per oral feeding, and a birth length below 33 cm were determined to be significant predictive factors for FSD. Having a birth length below 33 cm was associated with an almost 6.5-fold increase in the odds of having persistent FSD after discharge from the hospital. FSD in the first years of life may have an impact on the child's further growth and development.
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Affiliation(s)
- Nuša Slana
- Department for (Re)Habilitation of Children, University Rehabilitation Institute Republic of Slovenia Soča, SI-1000 Ljubljana, Slovenia
- Department of Special Education and Rehabilitation, Faculty of Education, University of Ljubljana, SI-1000 Ljubljana, Slovenia
| | - Irena Hočevar-Boltežar
- Department of Otorhinolaryngology and Cervicofacial Surgery, University Medical Center Ljubljana, SI-1525 Ljubljana, Slovenia
- Department of Otorhinolaryngology and Cervicofacial Surgery, Faculty of Medicine, University of Ljubljana, SI-1000 Ljubljana, Slovenia
| | - Lilijana Kornhauser-Cerar
- Neonatal Intensive Care Unit, Department for Obstetrics and Gynaecology, Division for Perinatology, University Medical Center Ljubljana, SI-1525 Ljubljana, Slovenia
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Hartel TC, Turawa EB, Oelofse A, De Smidt JJA. Effect of maternal cigarette smoking and alcohol consumption during pregnancy on birth weight and cardiometabolic risk factors in infants, children and adolescents: a systematic review protocol. BMJ Open 2022; 12:e061811. [PMID: 35840294 PMCID: PMC9295650 DOI: 10.1136/bmjopen-2022-061811] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2022] [Accepted: 06/27/2022] [Indexed: 11/14/2022] Open
Abstract
INTRODUCTION Tobacco smoking and alcohol consumption during pregnancy are particularly prevalent in low socioeconomic status populations, with an adverse association with birth outcomes and cardiometabolic risk factors. However, the direct and indirect effects of prenatal cigarette smoking and alcohol consumption during pregnancy on cardiometabolic risk in offspring have been rather inconsistent. This may be attributed to multiple factors, such as the amount and timing of exposure to tobacco smoking and alcohol during pregnancy; the influence of maternal, environmental and socioeconomic factors; or how risk factors were defined by individual researchers and studies. Therefore, this review aims to provide a summary of the most recent evidence on birth outcomes and cardiometabolic risk in children associated with alcohol and/or tobacco exposure in utero. METHODS AND ANALYSIS PubMed, Scopus and Web of Science will be searched to identify published articles from 1 January 2001. Clinical studies that investigate the association between maternal cigarette smoking or alcohol consumption and birth weight and cardiometabolic risk factors in infants, children and adolescents will be included. Prospective cohort, case-control studies and birth cohort studies will be eligible for inclusion. Grey literature will be searched including conference proceedings, Google Scholar and the ProQuest Dissertation and Theses database. Only studies published in English will be included, with no restrictions regarding country, race or gender. Two independent reviewers will conduct the literature search and article screening. Eligibility criteria will be based on the population (infants, children, adolescents), exposure (maternal cigarette smoking, alcohol consumption or both), comparator (control group with no exposure during pregnancy) and outcomes (birth weight and cardiometabolic risk factors). Quality assessment and risk of bias will be assessed using a risk of bias tool for observational studies, and data will be extracted for analysis using a researcher-generated data extraction form. A meta-analysis will be performed to estimate pooled effect sizes if there are sufficient good-quality studies available. Sources of heterogeneity will be explored using subgroup analysis. ETHICS AND DISSEMINATION Ethical clearance will not be required as this review will extract publicly available secondary data. Findings from this review will be disseminated via publication in a peer-review journal. PROSPERO REGISTRATION NUMBER CRD42021286630.
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Affiliation(s)
- Tammy Charlene Hartel
- Medical Bioscience, University of the Western Cape, Bellville, Western Cape, South Africa
| | | | - André Oelofse
- Medical Bioscience, University of the Western Cape, Bellville, Western Cape, South Africa
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Syakur R, Syam A, Hadju V, Palutturi S, Hadi AJ, Hafid R, Musaidah M. The Effect of Pumpkin Seed Biscuits on Nutritional and Zinc Status: A Randomized Controlled Trial in Pregnant Women. Open Access Maced J Med Sci 2022. [DOI: 10.3889/oamjms.2022.9937] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
BACKGROUND: In several studies in Indonesia, low birth weight (LBW) is shown as the most dominant risk factor for stunting. Some of the causes of LBW are chronic energy deficiency during pregnancy, anemia during pregnancy, lack of nutrient supply during pregnancy, pregnancy complications, maternal parity, and birth spacing. In this case, women commonly suffer from micronutrient deficiencies including iodine, iron, Vitamin A, zinc, and folate. Related to this, about 80% of pregnant women in the world fulfill normative pregnancy needs due to inadequate zinc intake. One source of micronutrients rich in zinc is pumpkin seeds. The nutritional potential of pumpkin seeds is realized in the form of food products for pregnant women, including amino acids. One example of pumpkin seed fortification has been assessed in biscuit products by trained panelists and consumers, obtaining results that 20% additional pumpkin seed flour to biscuits becomes the best treatment. Meanwhile, in the case of this study, we expect that the pumpkin seed biscuits provided can increase the energy intake in pregnant women because when pumpkin seeds are added, the nutrition contained in the biscuits is also increased, in this case, the nutrition includes the zinc and Fe.
AIM: The purpose this research is to figure out how pumpkin seed biscuits affect pregnant women concerning their nutrition status and serum zinc levels.
METHODS: The method employed was a double-blind and randomized experimental research involving pre- and post-test control groups. The inclusion criteria of the participants involved were pregnant women aged 20–35 years old who were at their first and second trimesters of pregnancy and parity one to three and singleton pregnancy. Meanwhile, the exclusion criteria of the participants were pregnant women suffering from severe complications. There were 89 pregnant women further gathered in this study, but only 66 of them met the criteria and idled into two groups. In this case, one group received the pumpkin seed biscuit intervention, while the other received placebo biscuits. The intervention was conducted for 90 days where the pregnant women were provided with four biscuits for daily consumption.
RESULTS: The nutritional status parameter of pregnant women involved in the current research was assessed, including body weight, mid-upper arm circumference (MUAC), and serum zinc levels. In this case, the average serum zinc level obtained was 48.75 g/dL from 60 pregnant women. Furthermore, a significant increase occurred in nutritional status for each group, marked by body weight gain, and increased MUAC. However, no significant difference emerged between the pumpkin seed biscuit group and the placebo biscuit group with p = 0.914 and p = 0.916, respectively. A significant increase in zinc levels was observed in both groups. In this case, changes in zinc levels between the two groups were significantly different (13.72 ± 1.84 vs. 9.81 ± 11.81, p = 0.007).
CONCLUSION: Giving pumpkin seed biscuits contribute to weight gain and increase the MUAC the pregnant women which, in turn, improves their nutritional status and serum zinc.
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Chen Q, Chen H, Wang M, Qiu L, Xi F, Jiang Y, Lv M, Huang HF, Luo Q. The association between alteration of maternal lipid levels and birthweight at term: A within-family comparison. Front Endocrinol (Lausanne) 2022; 13:989663. [PMID: 36246889 PMCID: PMC9562839 DOI: 10.3389/fendo.2022.989663] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/08/2022] [Accepted: 09/16/2022] [Indexed: 11/29/2022] Open
Abstract
CONTEXT Maternal lipid levels affect birthweight and the long-term health of the offsprings. However, this association could be influenced by genetic and other common factors. OBJECTIVE This work aimed to explore the relationship between maternal lipid levels and birthweight of two pregnancies in the same mother. METHODS In this population-based cohort study, 705 women and their 1 410 offsprings were included. From an initial sample of women with more than one singleton birth in the database, we made the following exclusions: missing data for pre-pregnancy BMI, pregnancy weight gain, birthweight and lipid values; maternal age less than 19 or older than 44 years old; gestational age < 37 weeks or > 41weeks, gestational diabetes mellitus/diabetic. In the second and third trimesters, serum samples were collected for the determination of fasting total cholesterol (TC), triglycerides (TG), high-density lipoprotein cholesterol (HDL-C), and low-density lipoprotein cholesterol (LDL-C) levels. Then we assessed the association between maternal lipids and birthweight. RESULTS Infants of women whose 2nd-trimester TC increased by 10th-20th percentile (-0.92~-0.56 mmol/L) from 1st to 2nd pregnancy were 239.69 (62.32~417.06) g lighter at birth than were infants of women those of 40th-50th percentile (-0.20~-0.03 mmol/L). Parity, gestational age, neonatal gender, maternal pre-pregnancy body mass index, maternal weight gain, and 3rd-trimester TC and HDL-C were all associated with higher birth weight. Every unit increase in TC in the third trimester increases birthweight by 53.13 (14.32 ~91.94) g. CONCLUSION Maternal TC level is associated with birthweight independent of shared genes. TC may be used to guide diet and predict birthweight combined with ultrasound and other indicators.
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Affiliation(s)
- Qinqing Chen
- Department of Obstetrics, Women’s Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Huiqi Chen
- School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Minmin Wang
- Department of Obstetrics, Women’s Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Liping Qiu
- Department of Obstetrics, Women’s Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Fangfang Xi
- Department of Obstetrics, Women’s Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Ying Jiang
- Department of Obstetrics, Women’s Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Min Lv
- Department of Obstetrics, Women’s Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - He-Feng Huang
- Department of Obstetrics, Women’s Hospital, School of Medicine, Zhejiang University, Hangzhou, China
- *Correspondence: Qiong Luo, ; He-Feng Huang,
| | - Qiong Luo
- Department of Obstetrics, Women’s Hospital, School of Medicine, Zhejiang University, Hangzhou, China
- *Correspondence: Qiong Luo, ; He-Feng Huang,
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Birth weight, life course factors and excess weight among schoolchildren in Niterói, Rio de Janeiro, Brazil in 2010. J Pediatr (Rio J) 2021; 97:531-539. [PMID: 33290734 PMCID: PMC9432005 DOI: 10.1016/j.jped.2020.10.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/04/2020] [Revised: 09/11/2020] [Accepted: 10/08/2020] [Indexed: 11/28/2022] Open
Abstract
OBJECTIVE To investigate the association between birth weight and excess weight among students aged 6-14 years, adjusted for life course confounding factors. METHODS Cross-sectional study with 6-14-year-old schoolchildren in 2010; 795 school children from two public schools. In addition, a sub-sample was selected using a case-cohort study approach. Sociodemographic, breastfeeding, food introduction, previous weight gain, family history, current clinical and behavioral variables as well as maternal variables related to pregnancy, were collected. Multivariable weighted logistic regression was used to evaluate the association between birth weight and overweight. All prevalent cases of overweight (n = 160) were selected to compose the case group and a random sub-sample of all students participating in the study (n = 276 students, of whom 88 were cases) were the control group. RESULTS An unadjusted 6% increase in the excess weight prevalence ratio (p-value = 0.004) was found for each 100 g increase in birth weight. With adjustment for age, sex and behavioral variables (models 1 and 2), the association of birth weight with excess weight was positive and statistically significant, but it was no longer significant in the final model (model 3) when clinical variables were considered. CONCLUSIONS Although some of the secondary associations were statistically significant, we could not identify a significant association between birthweight and excess weight in adolescents.
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Evolution of perinatal outcomes and sociodemographic variables in Chile (1996-2017). J Dev Orig Health Dis 2020; 12:788-797. [PMID: 33272350 DOI: 10.1017/s2040174420001117] [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] [Indexed: 01/12/2023]
Abstract
The evolution of birth weight (BW), birth length (BL), and gestational age at delivery (GAD) and their correlation with various maternal sociodemographic variables were studied in Chilean newborns from years 1996 to 2017. A slight decrease in the mean values of these perinatal outcomes was observed; however, their risk sub-categories increased significantly, especially for GAD, indicating an important deterioration. GAD was strongly correlated with BW and BL. In the contingency tables, all sociodemographic variables, with the exemption of sex, had a higher proportion of early term 37-38-week and late pre-term 34-36-week newborns in women with a higher socioeconomic level; the strongest positive association was observed between mother's years of education and the GAD risk category 37-38 weeks. Different maternal factors, such as a higher frequency of cesarean sections, including either obesity presence or smoking habit, could be influencing presented results.
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Herath HP, Herath RP, Wickremasinghe R. Hyperglycaemia in Pregnancy and Anthropometric Parameters in the Offspring at 10 Years: A Community-Based Retrospective Cohort Study in Sri Lanka. J Obes 2020; 2020:2735148. [PMID: 32670637 PMCID: PMC7350072 DOI: 10.1155/2020/2735148] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/31/2019] [Revised: 05/02/2020] [Accepted: 06/01/2020] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Studies of developmental origins of health and disease have highlighted the possible role of intrauterine hyperglycaemia, increasing the future risk of obesity, diabetes, and cardiovascular diseases in the offspring. There is limited evidence from South Asian populations for risk estimates for childhood obesity that are attributable to maternal diabetes in utero. OBJECTIVE The aim of this study was to determine the association between hyperglycaemia in pregnancy (HIP) and anthropometric parameters in the offspring at 10-11 years of age. METHODS A community-based retrospective cohort study was conducted in Colombo district, Sri Lanka. In the first stage, children born in 2005 were identified, and the availability of antenatal records was assessed. In the second stage, the exposure status of participants was ascertained based on antenatal records and predefined criteria. In the third stage, height, weight, waist circumference, and triceps skinfold thickness (TSFT) of eligible participants were measured to ascertain the outcome status. Background characteristics were collected by interviewing mothers. A 24-hour dietary recall and a 3-day diet diary were recorded. RESULTS 159 children of mothers with HIP (exposed) and 253 children of mothers with no HIP (nonexposed) participated. Mean ages (SD) of exposed and unexposed groups were 10.9 (0.3) and 10.8 (0.3) years, respectively. The median BMI (17.6 vs 16.1, p < 0.001), waist circumference (63 cm vs 59.3 cm, p < 0.001), and triceps skinfold thickness (13.7 mm vs 11.2 mm, p < 0.001) were significantly higher in the exposed group. Offspring of women with HIP were more likely to be overweight (aOR = 2.6, 95% CI 1.4-4.9) and have abdominal obesity (aOR = 2.7, 95% CI 1.1-6.5) and high TSFT (aOR = 2.2, 95% CI 1.06-4.7) at 10-11 years than children who were not exposed after adjusting for maternal BMI, maternal age at delivery, and birth order. CONCLUSIONS Intrauterine exposure to HIP is a significant determinant of overweight, high TSFT, and abdominal obesity in the offspring.
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Affiliation(s)
- Himali P. Herath
- Department of Nutrition, Medical Research Institute, Colombo 00800, Sri Lanka
| | - Rasika P. Herath
- Department of Obstetrics and Gynaecology, Faculty of Medicine, University of Kelaniya, Ragama, Sri Lanka
| | - Rajitha Wickremasinghe
- Department of Public Health, Faculty of Medicine, University of Kelaniya, Ragama, Sri Lanka
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Are All Breast-fed Infants Equal? Clustering Metabolomics Data to Identify Predictive Risk Clusters for Childhood Obesity. J Pediatr Gastroenterol Nutr 2019; 68:408-415. [PMID: 30358737 DOI: 10.1097/mpg.0000000000002184] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/10/2022]
Abstract
OBJECTIVES Fetal and early life represent a period of developmental plasticity during which metabolic pathways are modified by environmental and nutritional cues. Little is known on the pathways underlying this multifactorial complex. We explored whether 6 months old breast-fed infants could be clustered into metabolically similar groups and that those metabotypes could be used to predict later obesity risk. METHODS Plasma samples were obtained from 183 breast-fed infants aged 6 months participating in the European multicenter Childhood Obesity Project study. We measured amino acids along with polar lipid concentrations (acylcarnitines, lysophosphatidylcholines, phosphatidylcholines, sphingomyelins). We determined the metabotypes using a Bayesian agglomerative clustering method and investigated the properties of these clusters with respect to clinical, programming, and metabolic factors up to 6 years of age. RESULTS We identified 20 metabolite clusters comprising 1 to 39 children. Phosphatidylcholines predominantly influenced the clustering process. In the largest clusters (n ≥ 14), large differences existed for birth length (unadjusted P < 0.0001) and length and weight at 6 months (unadjusted P < 0.0001 and P = 0.012, respectively). Infants tended to cluster together by country (unadjusted P < 0.001). The body mass index (BMI) z score at 6 years of age tended to differ (unadjusted P = 0.07). CONCLUSIONS Our exploratory study provided evidence that breast-fed infants are not metabolically homogeneous and that variation in metabolic profiles among infants may provide insight into later development and health. This work highlights the potential of metabotypes for identifying inter-individual differences that may form the basis for developing personalized early preventive strategies.
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Sunsaneevithayakul P, Titapant V, Ruangvutilert P, Sutantawibul A, Phatihattakorn C, Wataganara T, Talungchit P. Relation between gestational weight gain and pregnancy outcomes. J Obstet Gynaecol Res 2014; 40:995-1001. [DOI: 10.1111/jog.12293] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2013] [Accepted: 09/09/2013] [Indexed: 11/29/2022]
Affiliation(s)
- Prasert Sunsaneevithayakul
- Division of Maternal Fetal Medicine; Department of Obstetrics and Gynecology; Faculty of Medicine Siriraj Hospital; Bangkok Thailand
| | - Vitaya Titapant
- Division of Maternal Fetal Medicine; Department of Obstetrics and Gynecology; Faculty of Medicine Siriraj Hospital; Bangkok Thailand
| | - Pornpimol Ruangvutilert
- Division of Maternal Fetal Medicine; Department of Obstetrics and Gynecology; Faculty of Medicine Siriraj Hospital; Bangkok Thailand
| | - Anuwat Sutantawibul
- Division of Maternal Fetal Medicine; Department of Obstetrics and Gynecology; Faculty of Medicine Siriraj Hospital; Bangkok Thailand
| | - Chayawat Phatihattakorn
- Division of Maternal Fetal Medicine; Department of Obstetrics and Gynecology; Faculty of Medicine Siriraj Hospital; Bangkok Thailand
| | - Tuangsit Wataganara
- Division of Maternal Fetal Medicine; Department of Obstetrics and Gynecology; Faculty of Medicine Siriraj Hospital; Bangkok Thailand
| | - Pattarawalai Talungchit
- Division of Maternal Fetal Medicine; Department of Obstetrics and Gynecology; Faculty of Medicine Siriraj Hospital; Bangkok Thailand
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Ruiz JR, Perales M, Pelaez M, Lopez C, Lucia A, Barakat R. Supervised exercise-based intervention to prevent excessive gestational weight gain: a randomized controlled trial. Mayo Clin Proc 2013; 88:1388-97. [PMID: 24290112 DOI: 10.1016/j.mayocp.2013.07.020] [Citation(s) in RCA: 116] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/09/2013] [Revised: 07/10/2013] [Accepted: 07/29/2013] [Indexed: 12/25/2022]
Abstract
OBJECTIVE To study the effect on maternal weight gain of a supervised light- to moderate-intensity exercise-based intervention performed from the ninth week of pregnancy. PARTICIPANTS AND METHODS A total of 962 healthy pregnant women were randomly assigned to a standard care or exercise intervention group conducted between September 1, 2007, and January 31, 2011. The intervention included light- to moderate-intensity aerobic and resistance exercises performed 3 days a week (50-55 minutes per session). Excessive gestational weight gain was calculated on the basis of the 2009 Institute of Medicine (IOM) recommendations. Gestational body weight gain was calculated on the basis of the weight measured at the first prenatal visit (fifth to sixth weeks of gestation) and weight measured at the last visit to the clinic before delivery. Women were categorized into normal weight or overweight or obese. RESULTS Women in the intervention group gained less weight (adjusted mean difference, 1.039 kg; 95% CI, 0.534-1.545 kg; P<.001) and were less likely to gain weight above the IOM recommendations (odds ratio, 0.625; 95% CI, 0.461-0.847) compared with those in the standard care group. The main treatment effects according to body mass index category were that normal weight women in the intervention group gained less weight (adjusted mean difference, 1.393 kg; 95% CI, 0.813-1.972 kg; P<.001) and were less likely to gain weight above the IOM recommendations (odds ratio, 0.508; 95% CI, 0.334-0.774) than normal weight women who received standard care. No significant treatment effect was observed in overweight or obese women. CONCLUSION Supervised exercise of light to moderate intensity can be used to prevent excessive gestational weight gain, especially in normal weight women. TRIAL REGISTRATION clinicaltrials.gov Identifier: NCT01790347.
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Affiliation(s)
- Jonatan R Ruiz
- Promoting Fitness and Health Through Physical Activity Research Group, Department of Physical Education and Sports, School of Sport Sciences, University of Granada, Granada, Spain.
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Sousa MACAD, Guimarães ICB, Daltro C, Guimarães AC. Association between birth weight and cardiovascular risk factors in adolescents. Arq Bras Cardiol 2013; 101:9-17. [PMID: 23740400 PMCID: PMC3998182 DOI: 10.5935/abc.20130114] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2012] [Revised: 09/21/2012] [Accepted: 03/25/2013] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND Birth weight (BW) is a medium- and long-term risk determinant of cardiovascular risk factors. OBJECTIVE To assess the association between BW and cardiovascular risk factors in adolescents of the city of Salvador, Bahia state. METHODS Cross-sectional study with comparison of BW groups. Sample comprising 250 adolescents classified according to the BMI as follows: high-normal (> 50th percentile and < 85th percentile); overweight (> 85th percentile and < 95th percentile); and obesity (> 95th percentile). The risk variables compared were as follows: waist circumference (WC); arterial blood pressure; lipid profile; glycemia; serum insulin; HOMA-IR; and metabolic syndrome. The BW was informed by parents and classified as follows: low (BW < 2,500g); normal (BW > 2,500g and < 4,000g); and high (BW > 4,000g). RESULTS One hundred and fifty-three (61.2%) girls, age 13.74 ± 2.03 years, normal BW 80.8%, low BW 8.0%, and high BW 11.2%. The high BW group as compared with the normal BW group showed a higher frequency of obesity (42.9%, p=0.005), elevated SBP and DBP (42.9%, p=0.000 and 35.7%, p=0.007, respectively), and metabolic syndrome (46.4%, p=0.002). High BW adolescents as compared with normal BW adolescents had a prevalence ratio for high SBP 3.3 (95% CI: 1.7-6.4) and obesity 2.6 (95% CI: 1.3-5.2). The WC of high BW adolescents was 83.3 ± 10.1 (p=0.038). The lipid profile showed no statistically significant differences. CONCLUSION Our findings suggest that obesity, elevated SBP and DBP, and metabolic syndrome during adolescence might be associated with high BW.
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Kato T, Yorifuji T, Inoue S, Doi H, Kawachi I. Association of birth length and risk of hospitalisation among full-term babies in Japan. Paediatr Perinat Epidemiol 2013; 27:361-70. [PMID: 23772938 DOI: 10.1111/ppe.12062] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Barker's fetal programming hypothesis suggests that disproportionate size at birth may have a lifelong impact on one's health. However, the literature on birth length is considerably more sparse compared with birthweight. We, therefore, examined the relationship between birth length and hospitalisation early in life among Japanese children. METHODS We used the nationwide Longitudinal Survey of Babies in 21st Century and restricted the study subjects to full-term singleton babies (n = 44,057). We estimated the effects of birth length and birthweight on the risk of hospitalisation using log linear regression models. We controlled for a set of neonatal and maternal factors. RESULTS Birth length was associated with the chance of hospitalisation due to all causes between 6 and 18 months of age. In addition, the association was stronger than that with birthweight. Adjusted risk ratios showed that the relationship between birth length and hospitalisation was U-shaped: 1.16 [95% confidence intervals, 1.08, 1.25] at 30-48 cm, 1 [Reference] at 49 cm, 1.13 [1.04, 1.22] at 50 cm, and 1.11 [1.02, 1.20] at 51-60 cm. Short babies with low or high weight, as well as long babies with low weight, seem to be at increased risk of hospitalisation. CONCLUSIONS We found a U-shaped relationship between birth length and risk of hospitalisation due to all causes during the period from 6 to 18 months.
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Affiliation(s)
- Tsuguhiko Kato
- Department of Human Ecology, Okayama University Graduate School of Environmental and Life Science, Japan
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Dratva J, Breton CV, Hodis HN, Mack WJ, Salam MT, Zemp E, Gilliland F, Kuenzli N, Avol E. Birth weight and carotid artery intima-media thickness. J Pediatr 2013; 162:906-11.e1-2. [PMID: 23260106 PMCID: PMC4030536 DOI: 10.1016/j.jpeds.2012.10.060] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/12/2012] [Revised: 09/25/2012] [Accepted: 10/31/2012] [Indexed: 01/17/2023]
Abstract
OBJECTIVES To determine the association between birth weight and carotid artery intima-media thickness (CIMT), a measure of atherogenesis, in a population of 11-year-old children. STUDY DESIGN CIMT measured by high-resolution ultrasound, and birth registry data were available for 670 children of the Southern California Children's Health Study. Multivariate regression analyses were performed to investigate the association between birth weight and CIMT, with adjustment for child's health status and lifestyle, pregnancy information, and parental health. RESULTS Mean CIMT was 0.57 mm (SD 0.04). We found a nonlinear association between birth weight and CIMT, with an increase in CIMT of 0.014 mm in the fifth (P value .01) compared with the third birth weight quintile. These associations were robust in subsample analyses in children considered normal-weight by gestational age or in term-born children. No significant association with CIMT was found for the lowest quintile. CONCLUSIONS Greater birth weight was significantly associated with increased CIMT at age 11 years. No evidence for an impact of lower birth weight was found. The predictive value of childhood CIMT on future cardiovascular outcomes is largely unknown, but strong associations between childhood cardiovascular disease risk factors and adult vascular disease suggest that increased CIMT in childhood may be clinically important.
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Affiliation(s)
- Julia Dratva
- Swiss Tropical and Public Health Institute, Basel, Switzerland.
| | - Carrie V. Breton
- Division of Environmental Health, Department of Preventive Medicine, University of Southern California, Los Angeles, CA
| | - Howard N. Hodis
- Division of Environmental Health, Department of Preventive Medicine, University of Southern California, Los Angeles, CA,Atherosclerosis Research Unit, Health Sciences Campus, University of Southern California, Los Angeles, CA
| | - Wendy J. Mack
- Division of Environmental Health, Department of Preventive Medicine, University of Southern California, Los Angeles, CA,Atherosclerosis Research Unit, Health Sciences Campus, University of Southern California, Los Angeles, CA
| | - Muhammad T. Salam
- Division of Environmental Health, Department of Preventive Medicine, University of Southern California, Los Angeles, CA
| | - Elisabeth Zemp
- Swiss Tropical and Public Health Institute, Basel, Switzerland,University of Basel, Basel, Switzerland
| | - Frank Gilliland
- Division of Environmental Health, Department of Preventive Medicine, University of Southern California, Los Angeles, CA
| | - Nino Kuenzli
- Swiss Tropical and Public Health Institute, Basel, Switzerland,University of Basel, Basel, Switzerland
| | - Ed Avol
- Division of Environmental Health, Department of Preventive Medicine, University of Southern California, Los Angeles, CA
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Schellong K, Schulz S, Harder T, Plagemann A. Birth weight and long-term overweight risk: systematic review and a meta-analysis including 643,902 persons from 66 studies and 26 countries globally. PLoS One 2012; 7:e47776. [PMID: 23082214 PMCID: PMC3474767 DOI: 10.1371/journal.pone.0047776] [Citation(s) in RCA: 252] [Impact Index Per Article: 21.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2012] [Accepted: 09/17/2012] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Overweight is among the major challenging health risk factors. It has been claimed that birth weight, being a critical indicator of prenatal developmental conditions, is related to long-term overweight risk. In order to check this important assumption of developmental and preventive medicine, we performed a systematic review and comprehensive meta-analysis. METHODS AND FINDINGS Relevant studies published up to January 2011 that investigated the relation between birth weight and later risk of overweight were identified through literature searches using MEDLINE and EMBASE. For meta-analysis, 66 studies from 26 countries and five continents were identified to be eligible, including 643,902 persons aged 1 to 75 years. We constructed random-effects and fixed-effects models, performed subgroup-analyses, influence-analyses, assessed heterogeneity and publication bias, performed meta-regression analysis as well as analysis of confounder adjusted data. Meta-regression revealed a linear positive relationship between birth weight and later overweight risk (p<0.001). Low birth weight (<2,500 g) was found to be followed by a decreased risk of overweight (odds ratio (OR) =0.67; 95% confidence interval (CI) 0.59-0.76). High birth weight (>4,000 g) was associated with increased risk of overweight (OR=1.66; 95% CI 1.55-1.77). Results did not change significantly by using normal birth weight (2,500-4,000 g) as reference category (OR=0.73, 95% CI 0.63-0.84, and OR=1.60, 95% CI 1.45-1.77, respectively). Subgroup- and influence-analyses revealed no indication for bias/confounding. Adjusted estimates indicate a doubling of long-term overweight risk in high as compared to normal birth weight subjects (OR=1.96, 95% CI 1.43-2.67). CONCLUSIONS Findings demonstrate that low birth weight is followed by a decreased long-term risk of overweight, while high birth weight predisposes for later overweight. Preventing in-utero overnutrition, e.g., by avoiding maternal overnutrition, overweight and/or diabetes during pregnancy, might therefore be a promising strategy of genuine overweight prevention, globally.
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Affiliation(s)
- Karen Schellong
- Clinic of Obstetrics, Division of ‘Experimental Obstetrics’, Charité – University Medicine Berlin, Campus Virchow-Klinikum, Berlin, Germany
| | - Sandra Schulz
- Clinic of Obstetrics, Division of ‘Experimental Obstetrics’, Charité – University Medicine Berlin, Campus Virchow-Klinikum, Berlin, Germany
| | - Thomas Harder
- Clinic of Obstetrics, Division of ‘Experimental Obstetrics’, Charité – University Medicine Berlin, Campus Virchow-Klinikum, Berlin, Germany
| | - Andreas Plagemann
- Clinic of Obstetrics, Division of ‘Experimental Obstetrics’, Charité – University Medicine Berlin, Campus Virchow-Klinikum, Berlin, Germany
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15
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Stokes TA, Holston A, Olsen C, Choi Y, Curtis J, Higginson J, Enright L, Adimora C, Hunt CE. Preterm infants of lower gestational age at birth have greater waist circumference-length ratio and ponderal index at term age than preterm infants of higher gestational ages. J Pediatr 2012; 161:735-41.e1. [PMID: 22534153 DOI: 10.1016/j.jpeds.2012.03.023] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2011] [Revised: 02/16/2012] [Accepted: 03/13/2012] [Indexed: 01/02/2023]
Abstract
OBJECTIVE To assess anthropometric changes from birth to hospital discharge in infants born preterm and compare with a reference birth cohort of infants born full-term. STUDY DESIGN Retrospective chart review was conducted of 501 preterm and 1423 full-term infants. We evaluated birth and hospital discharge weight, length, and waist circumference (WC). WC/length ratio (WLR), ponderal index, and body mass index (BMI) were calculated. Preterm infants were categorized into quartiles (Q1-4) based on birth weight (BW). RESULTS At birth mean length, WC, WLR, BMI, and ponderal index were all significantly less for preterm infants in the lowest BW quartile (Q1) than preterm infants in higher BW quartiles or full-term infants. Although their weight, length, and BMI remained significantly less at discharge, preterm infants in Q1 had a disproportionate increase in WLR and ponderal index such that at discharge their WLR and ponderal index were greater than infants in Q2-3 and comparable with infants in Q4 and full-term infants. Discharge WLR and ponderal index in Q1 were significantly higher with decreasing postmenstrual age at birth. CONCLUSIONS Preterm infants of a lower birth postmenstrual age have disproportionate increases in WLR and ponderal index that are suggestive of increased visceral and total adiposity.
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Affiliation(s)
- Theophil A Stokes
- Department of Pediatrics, Walter Reed National Military Medical Center, Bethesda, MD 20814-4799, USA.
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16
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Yu ZB, Han SP, Zhu GZ, Zhu C, Wang XJ, Cao XG, Guo XR. Birth weight and subsequent risk of obesity: a systematic review and meta-analysis. Obes Rev 2011; 12:525-42. [PMID: 21438992 DOI: 10.1111/j.1467-789x.2011.00867.x] [Citation(s) in RCA: 356] [Impact Index Per Article: 27.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
This report describes the association between birth weight (BW) and obesity. Screening of 478 citations from five electronic databases resulted in the inclusion of 33 studies, most of medium quality. The meta-analysis included 20 of these published studies. The 13 remaining articles did not provide sufficient dichotomous data and were systematically reviewed, revealing results consistent with the meta-analysis. Our results revealed that high BW (>4000 g) was associated with increased risk of obesity (odds ratio [OR], 2.07; 95% confidence interval [CI], 1.91-2.24) compared with subjects with BW ≤ 4000 g. Low BW (<2500 g) was associated with decreased risk of obesity (OR, 0.61; 95% CI, 0.46-0.80) compared with subjects with BW ≥ 2500 g. However, when two studies exhibited selection bias were removed, the results indicated no significant association between low BW and obesity (OR, 0.77; 95% CI, 0.58-1.04). Sensitivity analyses showed that differences in the study design, sample size and quality grade of the study had an effect on the low BW/obesity association, which low BW was not associated with the risk of obesity in cohort studies, studies with large sample sizes and studies with high quality grades. Pooled results were similar when normal birth weight (2500-4000 g) was used as the reference category. Subgroup analyses based on different growth and developmental stages (pre-school children, school children and adolescents) also revealed that high BW was associated with increased risk of obesity from childhood to early adulthood. No significant evidence of publication bias was present. These results suggest that high BW is associated with increased risk of obesity and may serve as a mediator between prenatal influences and later disease risk.
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Affiliation(s)
- Z B Yu
- Department of Pediatrics, Nanjing Maternal and Child Health Hospital, Nanjing Medical University, Nanjing, China
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17
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Abstract
BACKGROUND Excessive weight gain during pregnancy seems to increase birthweight and the offspring's risk of obesity later in life. However, this association might be confounded by genetic and other shared effects. We aimed to examine the association between maternal weight gain and birthweight using state-based birth registry data that allowed us to compare several pregnancies in the same mother. METHODS In this population-based cohort study, we used vital statistics natality records to examine all known births in Michigan and New Jersey, USA, between Jan 1, 1989, and Dec 31, 2003. From an initial sample of women with more than one singleton birth in the database, we made the following exclusions: gestation less than 37 weeks or 41 weeks or more; maternal diabetes; birthweight less than 500 g or more than 7000 g; and missing data for pregnancy weight gain. We examined how differences in weight gain that occurred during two or more pregnancies for each woman predicted the birthweight of her offspring, using a within-subject design to reduce confounding to a minimum. FINDINGS Our analysis included 513 501 women and their 1 164 750 offspring. We noted a consistent association between pregnancy weight gain and birthweight (β 7·35, 95% CI 7·10-7·59, p<0·0001). Infants of women who gained more than 24 kg during pregnancy were 148·9 g (141·7-156·0) heavier at birth than were infants of women who gained 8-10 kg. The odds ratio of giving birth to an infant weighing more than 4000 g was 2·26 (2·09-2·44) for women who gained more than 24 kg during pregnancy compared with women who gained 8-10 kg. INTERPRETATION Maternal weight gain during pregnancy increases birthweight independently of genetic factors. In view of the apparent association between birthweight and adult weight, obesity prevention efforts targeted at women during pregnancy might be beneficial for offspring. FUNDING US National Institutes of Health.
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Affiliation(s)
- David S Ludwig
- Department of Medicine, Children's Hospital, Boston, MA 02115, USA.
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18
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López LB, Calvo EB, Poy MS, del Valle Balmaceda Y, Cámera K. Changes in skinfolds and mid-upper arm circumference during pregnancy in Argentine women. MATERNAL AND CHILD NUTRITION 2010; 7:253-62. [PMID: 21689268 DOI: 10.1111/j.1740-8709.2009.00237.x] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
This investigation describes the pattern of changes in mid-upper arm circumference (MUAC), triceps, biceps and subscapular skinfold thicknesses during the course of pregnancy, and its relationship with maternal and newborn outcomes. A prospective cohort of 1066 pregnant women were selected in seven different urban regions in Argentina. Measurements of MUAC were carried out at 16, 28 and 36 gestational weeks. In a subsample of 488 women, triceps, biceps and subscapular skinfold thicknesses were measured. Mean total increase in subscapular, tricipital and bicipital skinfolds from 16 to 36 weeks of gestation were 4.5, 3.6 and 2.6 mm, respectively. MUAC showed a mean increase of 1.7 cm in the same period. Overweight or obese women at the start of pregnancy had lower increases in all measurements compared with women with normal or low body mass index. Maternal anthropometry was related to birthweight; women who gave birth to infants of less than 3000 g had lower average values in all measurements than those who had normal birthweight infants. LMS curves for MUAC and skinfolds by gestational age are presented, which can be used as a reference to assess maternal nutrition status during pregnancy. MUAC, tricipital and subscapular skinfold for gestational age curves are proposed for monitoring maternal nutritional status during pregnancy. MUAC cut-off points of 24.5, 25.5 and 26.5 cm for 16, 28 and 36 weeks of gestation, respectively, are also proposed as a proxy to detect low birthweight.
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Affiliation(s)
- Laura Beatriz López
- School of Nutrition, Faculty of Medicine, University of Buenos Aires, Marcelo T de Alvear 2202, Ciudad de Buenos Aires, Argentina.
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Barakat R, Lucia A, Ruiz JR. Resistance exercise training during pregnancy and newborn's birth size: a randomised controlled trial. Int J Obes (Lond) 2009; 33:1048-57. [PMID: 19636320 DOI: 10.1038/ijo.2009.150] [Citation(s) in RCA: 95] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
OBJECTIVE We examined the effect of light intensity resistance exercise training performed during the second and third trimester of pregnancy on the newborn's birth size. We also studied the association between maternal body weight prior to pregnancy and newborn's birth size. DESIGN Randomised controlled trial. SUBJECTS We randomly assigned 160 sedentary gravidae to either a training (n=80) or a control (n=80) group. The training programme focused on light resistance and toning exercises (three times per week, 35-40 min per session). We recorded the Apgar score, birth weight, birth length, and head circumference of the newborn, as well as gestational age at time of delivery from hospital perinatal records. We also measured maternal weight and height before parity and gestational weight gain. RESULTS Maternal characteristics neither differed between groups (all P>0.1) nor newborn characteristics (all P>0.1). Maternal body weight was positively and significantly associated with newborn's birth weight and length only in the control group (beta=19.20 and 0.065, respectively, P<0.01). CONCLUSION Light intensity resistance training performed over the second and third trimester of pregnancy does not have a negative impact on the newborn's body size or overall health. Exercise interventions might attenuate the adverse consequences of maternal body weight before pregnancy on the newborn's birth size.
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Affiliation(s)
- R Barakat
- Facultad de Ciencias de la Actividad Física y del Deporte-INEF, Universidad Politécnica de Madrid, Madrid, Spain
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