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Takeda J, Morisaki N, Itakura A, Aoki S, Sago H, Nagamatsu T, Masuyama H, Matsubara S, Umazume T, Mitsuda N, Itoh H, Ikeda T. Investigation of optimal weight gain during pregnancy: A retrospective analysis of the Japanese perinatal registry database. J Obstet Gynaecol Res 2024; 50:403-423. [PMID: 38163757 DOI: 10.1111/jog.15863] [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] [Received: 04/01/2023] [Accepted: 12/07/2023] [Indexed: 01/03/2024]
Abstract
AIM This study aimed to determine the weight gain during pregnancy that minimizes the predicted probability of various perinatal adverse events according to the pre-pregnancy body mass index (BMI) and make recommendations for optimal weight gain in Japan. METHODS The Japan Society of Obstetrics and Gynecology perinatal database for 2015-2017 was used. From the 719 723 deliveries included in this database, parturients with underlying diseases or missing data were excluded, and 419 114 deliveries were analyzed. A questionnaire survey was also conducted to weigh each perinatal adverse event. For each of the nine outcomes, a restricted cubic spline model was made to estimate the association between the "expected gestational weight gain at 40 weeks" and the outcome risk. RESULTS Since the classes of medical facilities were generally the same, weights were assigned according to the mean of the questionnaires rather than by the class of the facility. For each pre-pregnancy BMI, the weight gains during pregnancy that minimized the predicted probability of various adverse perinatal events were 12-15, 10-13, 7-10, and upper limit of 5 kg for the underweight, normal-weight, obese 1, and obese ≥2 groups, respectively. CONCLUSIONS The weight gain during pregnancy that minimizes the predicted probability of various perinatal adverse events according to the pre-pregnancy BMI was established.
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Affiliation(s)
- Jun Takeda
- Faculty of Medicine, Department of Obstetrics and Gynecology, Juntendo University, Tokyo, Japan
| | - Naho Morisaki
- Department of Social Medicine, National Center for Child Health and Development, Tokyo, Japan
| | - Atsuo Itakura
- Faculty of Medicine, Department of Obstetrics and Gynecology, Juntendo University, Tokyo, Japan
| | - Shigeru Aoki
- Perinatal Center for Maternity and Neonate, Yokohama City University Medical Center, Yokohama, Japan
| | - Haruhiko Sago
- Center for Maternal-Fetal, Neonatal and Reproductive Medicine, National Center for Child Health and Development, Tokyo, Japan
| | - Takeshi Nagamatsu
- Faculty of Medicine, Department of Obstetrics and Gynecology, International University of Health and Welfare, Chiba, Japan
| | - Hisashi Masuyama
- Department of Obstetrics and Gynecology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Shigeki Matsubara
- Department of Obstetrics and Gynecology, Jichi Medical University, Shimotsuke, Tochigi, Japan
| | - Takeshi Umazume
- Department of Obstetrics, Hokkaido University Hospital, Sapporo, Japan
| | - Nobuaki Mitsuda
- Department of Maternal Fetal Medicine, Osaka Women's and Children's Hospital, Osaka, Japan
| | - Hiroaki Itoh
- Department of Obstetrics and Gynecology, Hamamatsu University School of Medicine, Hamamatsu, Japan
| | - Tomoaki Ikeda
- Faculty Medicine, Department of Obstetrics and Gynecology, Mie University, Tsu, Mie, Japan
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Wei X, Shen S, Huang P, Xiao X, Lin S, Zhang L, Wang C, Lu MS, Lu J, Tam WH, Wang CC, He JR, Qiu X. Gestational weight gain rates in the first and second trimesters are associated with small for gestational age among underweight women: a prospective birth cohort study. BMC Pregnancy Childbirth 2022; 22:106. [PMID: 35123424 PMCID: PMC8818159 DOI: 10.1186/s12884-022-04433-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2021] [Accepted: 01/17/2022] [Indexed: 12/16/2022] Open
Abstract
Background Despite the well-studied effects of gestational weight gain (GWG) on offspring health, little is known about the association of trimester-specific GWG with offspring birth weight among underweight pregnant women. This study aimed to explore the association of trimester-specific GWG rate with small for gestational age (SGA) in underweight women. Methods The GWG rate of underweight pregnant women (pre-pregnancy body mass index [BMI] lower than 18.5 kg/m2) of the Born in Guangzhou Cohort Study was calculated as the weight gain during a specific trimester divided by the corresponding duration of week. Total GWG was calculated as the weight difference between pre-pregnancy and delivery, and was categorized into inadequate, adequate, and excessive weight gain based on the 2009 Institute of Medicine (IOM) weight gain recommendation. The INTERGROWTH-21st standards were used to define SGA. Logistic regression models were used to examine the associations of total GWG and trimester-specific GWG rates with SGA. Associations between trimester-specific GWG rates and SGA were also analyzed separately based on different total GWG categories (i.e. inadequate and adequate/excessive GWG). Results Of the 3839 participants, SGA births occurred in 397 (10.3%), and mean GWG was 14.9 kg (SD 3.9). A lower risk of SGA was observed among women with higher GWG rate (per 0.5 kg/week increase) during the first (adjusted OR [aOR] 0.74, 95%CI 0.57, 0.96) and second (adjusted OR [aOR] 0.40, 95%CI 0.30, 0.55) but not third trimester. Similar association between higher GWG rate during the second trimester and a decreased risk of SGA were observed among women with inadequate (< 12.5 kg) and adequate/excessive (≥12.5 kg) total GWG, respectively. Compared to women with adequate GWG rate, women with inadequate GWG rate during the second trimester had a significantly increased risk of SGA (aOR 1.58, 95% CI 1.14, 2.20). Conclusions Second-trimester GWG might be the key driver for the association between inadequate GWG and increased risk of SGA births in underweight women. Supplementary Information The online version contains supplementary material available at 10.1186/s12884-022-04433-4.
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Insufficient maternal gestational weight gain and infant neurodevelopment at 12 months of age: the Japan Environment and Children's Study. Eur J Pediatr 2022; 181:921-931. [PMID: 34642790 PMCID: PMC8897327 DOI: 10.1007/s00431-021-04232-7] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2021] [Revised: 07/29/2021] [Accepted: 07/30/2021] [Indexed: 11/16/2022]
Abstract
Abnormal maternal gestational weight gain (GWG) increases the risk of obstetric-related complications. This investigation examined the impact of GWG on infant neurodevelopmental abnormalities at 12 months of age using the data of a nationwide Japanese cohort study. Questionnaire data were obtained from the ongoing Japan Environment and Children's Study cohort study. Maternal GWG was subdivided as below, within, or above the reference values of the Institution of Medicine pregnancy weight guidelines. The Ages and Stages Questionnaire, third edition (ASQ-3) is a parent-reported developmental screening instrument for children across five domains: communication, gross motor, fine motor, problem-solving, and personal-social. Multiple logistic regression analysis was employed to identify correlations between GWG and developmental delay defined as ASQ-3 scores of less than two standard deviations below the mean. A total of 30,694 mothers with singleton live births and partners who completed the questionnaire were analyzed. The prevalence of mothers below, within, and above the GWG guidelines was 60.4% (18,527), 32.1% (9850), and 7.5% (2317), respectively. We recorded 10,943 infants (35.7%) who were outliers in at least one ASQ-3 domain. After controlling for covariates, GWG below established guidelines was associated with a significantly higher risk of developmental delay for the communication (odds ratio [OR] 1.21, 95% confidence interval [CI] 1.09-1.34), gross motor (OR 1.14, 95% CI 1.05-1.24), fine motor (OR 1.13, 95% CI 1.04-1.24), problem-solving (OR 1.09, 95% CI 1.01-1.18), and personal-social (OR 1.15, 95% CI 1.07-1.24) domains.Conclusion: This large survey revealed a possible deleterious effect of insufficient maternal GWG on infant neurodevelopment.Trial registration: The Japan Environment and Children's Study (JECS) was registered in the UMIN Clinical Trials Registry on January 15, 2018 (number UMIN000030786). What is Known: • Inappropriate maternal gestational weight gain may cause obstetric complications and adverse birth outcomes. • Excess maternal weight gain may result in gestational diabetes, hypertension, eclampsia, caesarean delivery, and macrosomia, while insufficient maternal weight gain has been associated with pre-term birth and small for gestational age. What is New: • This study provides important information on a possible adverse effect of insufficient maternal gestational weight gain on offspring neurodevelopment at 12 months of age. • Our findings indicate a need to reconsider the optimal body mass index and gestational weight gain for women desiring pregnancy.
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Tsunematsu Y, Hosomi K, Kunisawa J, Sato M, Shibuya N, Saito E, Murakami H, Yoshikawa Y, Iwashita Y, Miyoshi N, Mutoh M, Ishikawa H, Sugimura H, Miyachi M, Wakabayashi K, Watanabe K. Mother-to-infant transmission of the carcinogenic colibactin-producing bacteria. BMC Microbiol 2021; 21:235. [PMID: 34429063 PMCID: PMC8386082 DOI: 10.1186/s12866-021-02292-1] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2020] [Accepted: 08/09/2021] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND The Escherichia coli strain that is known to produce the genotoxic secondary metabolite colibactin is linked to colorectal oncogenesis. Therefore, understanding the properties of such colibactin-positive E. coli and the molecular mechanism of oncogenesis by colibactin may provide us with opportunities for early diagnosis or prevention of colorectal oncogenesis. While there have been major advances in the characterization of colibactin-positive E. coli and the toxin it produces, the infection route of the clb + strain remains poorly characterized. RESULTS We examined infants and their treatments during and post-birth periods to examine potential transmission of colibactin-positive E. coli to infants. Here, analysis of fecal samples of infants over the first month of birth for the presence of a colibactin biosynthetic gene revealed that the bacterium may be transmitted from mother to infant through intimate contacts, such as natural childbirth and breastfeeding, but not through food intake. CONCLUSIONS Our finding suggests that transmission of colibactin-positive E. coli appears to be occurring at the very early stage of life of the newborn and hints at the possibility of developing early preventive measures against colorectal cancer.
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Affiliation(s)
- Yuta Tsunematsu
- Department of Pharmaceutical Sciences, University of Shizuoka, 422-8526, Shizuoka, Japan
| | - Koji Hosomi
- Laboratory of Vaccine Materials, Center for Vaccine and Adjuvant Research, Laboratory of Gut Environmental System, Health and Nutrition (NIBIOHN), National Institutes of Biomedical Innovation, 567-0085, Ibaraki-city, Japan
| | - Jun Kunisawa
- Laboratory of Vaccine Materials, Center for Vaccine and Adjuvant Research, Laboratory of Gut Environmental System, Health and Nutrition (NIBIOHN), National Institutes of Biomedical Innovation, 567-0085, Ibaraki-city, Japan
| | - Michio Sato
- Department of Pharmaceutical Sciences, University of Shizuoka, 422-8526, Shizuoka, Japan
| | - Noriko Shibuya
- Department of Pediatrics, Maternal and Child Health Center, Aiiku Clinic, 106-8580, Tokyo, Japan
| | - Emiko Saito
- Department of Human Nutrition, Tokyo Kasei Gakuin University, 194-0292, Tokyo, Japan
| | - Haruka Murakami
- Department of Physical Activity Research, Health and Nutrition (NIBIOHN), National Institutes of Biomedical Innovation, 162-8636, Tokyo, Japan
| | - Yuko Yoshikawa
- School of Veterinary Medicine, Faculty of Veterinary Science, Nippon Veterinary and Life Science University, 180-8602, Tokyo, Japan
| | - Yuji Iwashita
- Department of Tumor Pathology, Hamamatsu University School of Medicine, 431- 3192, Shizuoka, Japan
| | - Noriyuki Miyoshi
- Graduate School of Nutritional and Environmental Sciences, University of Shizuoka, 422-8526, Shizuoka, Japan
| | - Michihiro Mutoh
- Department of Molecular-Targeting Cancer Prevention, Kyoto Prefectural University of Medicine, 602-8566, Kyoto, Japan
| | - Hideki Ishikawa
- Department of Molecular-Targeting Cancer Prevention, Kyoto Prefectural University of Medicine, 602-8566, Kyoto, Japan
| | - Haruhiko Sugimura
- Department of Tumor Pathology, Hamamatsu University School of Medicine, 431- 3192, Shizuoka, Japan
| | - Motohiko Miyachi
- Department of Physical Activity Research, Health and Nutrition (NIBIOHN), National Institutes of Biomedical Innovation, 162-8636, Tokyo, Japan
| | - Keiji Wakabayashi
- Graduate School of Nutritional and Environmental Sciences, University of Shizuoka, 422-8526, Shizuoka, Japan
| | - Kenji Watanabe
- Department of Pharmaceutical Sciences, University of Shizuoka, 422-8526, Shizuoka, Japan.
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Robillard PY. Epidemiological evidence that severe obese women (pre-pregnancy BMI ≥40 kg/m 2) should lose weight during their pregnancy. J Matern Fetal Neonatal Med 2021; 35:6618-6623. [PMID: 34030588 DOI: 10.1080/14767058.2021.1918666] [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: 10/21/2022]
Abstract
OBJECTIVES Defining the optimal gestational weight gain (optGWG) allowing to have "normal shaped" babies (10% of Small for gestational age, SGA, and10% of large LGA babies) in severe obese women (pre-pregnancy BMI ≥40 kg/m2). STUDY DESIGN South-Reunion University's maternity (Reunion Island, Indian Ocean). 20 year-observational cohort study (2001-2019). Epidemiological perinatal data base with information on obstetrical and neonatal risk factors. All consecutive term (37-42 weeks gestation) singleton pregnancies (>21 weeks) live birth pregnancies delivered in the maternity. MAIN OUTCOME MEASURES OptGWG to obtain newborns as close as possible of the 10% SGA/LGA goal for each BMI categories, 15-19.9, 20-24.9 …, as well as severe obese ≥40 kg/m2. RESULTS Of the 71,318 singleton term live births (37 weeks onward), we could define the maternal pre-pregnancy body mass index and the GWG in of 61,764 patients (86.6%). Severe obese 40 kg/m2 losing 5-9.9 kg have 12.9% of LGA and 11.9% of SGA babies. Those losing 10 kg and more 12.7% of LGA and 7.3% of SGA. Our formerly proposed linear equation (validated from 15 to 40 kg/m2) may be prolonged at 45 kg/m2. opGWG(kg)=-1.2pp BMI(Kg/m2)+42±2kg. CONCLUSION In our population, a 32 kg/m2 obese should gain 3.6 kg (instead of 5-9 kg, IOM 2009). A very obese 40 kg/m2 should lose 6 kg, and a severe obese 45 kg/m2 lose 12 kg.
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Affiliation(s)
- Pierre-Yves Robillard
- Service de Néonatologie. Centre Hospitalier Universitaire Sud Réunion, Saint-Pierre Cedex, France.,Centre d'Etudes Périnatales Océan Indien (CEPOI). Centre Hospitalier Universitaire Sud Réunion, Saint-Pierre Cedex, France
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Wada Y, Ehara T, Tabata F, Komatsu Y, Izumi H, Kawakami S, Noshiro K, Umazume T, Takeda Y. Maternal Serum Albumin Redox State Is Associated with Infant Birth Weight in Japanese Pregnant Women. Nutrients 2021; 13:nu13061764. [PMID: 34067270 PMCID: PMC8224550 DOI: 10.3390/nu13061764] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2021] [Revised: 05/17/2021] [Accepted: 05/19/2021] [Indexed: 01/10/2023] Open
Abstract
Background: Plasma albumin (ALB) reflects protein nutritional status in rats, but it is not clear whether it is associated with dietary protein insufficiency in pregnant women and/or their risk of low birth weight delivery. This study aimed to investigate whether maternal serum ALB redox state reflects maternal protein nutritional status and/or is associated with infant birth weights. Methods: The relationship between the serum reduced ALB ratio and infant birth weight was examined in an observational study of 229 Japanese pregnant women. A rat model simulating fetal growth restriction, induced by protein-energy restriction, was used to elucidate the relationship between maternal nutritional status, maternal serum ALB redox state, and birth weight of the offspring. Results: In the human study, serum reduced ALB ratio in the third trimester was significantly and positively correlated with infant birth weight. In the rat study, serum reduced ALB ratio and birth weight in the litter decreased as the degree of protein-energy restriction intensified, and a significant and positive correlation was observed between them in late pregnancy. Conclusions: Maternal serum reduced ALB ratio in the third trimester is positively associated with infant birth weight in Japanese pregnant women, which would be mediated by maternal protein nutritional status.
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Affiliation(s)
- Yasuaki Wada
- Wellness & Nutrition Science Institute, Morinaga Milk Industry Co., Ltd., 5-1-83 Higashihara, Zama, Kanagawa 252-8583, Japan; (T.E.); (F.T.); (Y.K.); (H.I.); (S.K.); (Y.T.)
- Center for Food and Medical Innovation Promotion, Institute for the Promotion of Business-Regional Collaboration of Hokkaido University, Kita-21, Nishi-11, Kita-ku, Sapporo, Hokkaido 001-0021, Japan
- Correspondence: ; Tel.: +81-46-252-3046 (ext. 3055)
| | - Tatsuya Ehara
- Wellness & Nutrition Science Institute, Morinaga Milk Industry Co., Ltd., 5-1-83 Higashihara, Zama, Kanagawa 252-8583, Japan; (T.E.); (F.T.); (Y.K.); (H.I.); (S.K.); (Y.T.)
- Center for Food and Medical Innovation Promotion, Institute for the Promotion of Business-Regional Collaboration of Hokkaido University, Kita-21, Nishi-11, Kita-ku, Sapporo, Hokkaido 001-0021, Japan
| | - Fuka Tabata
- Wellness & Nutrition Science Institute, Morinaga Milk Industry Co., Ltd., 5-1-83 Higashihara, Zama, Kanagawa 252-8583, Japan; (T.E.); (F.T.); (Y.K.); (H.I.); (S.K.); (Y.T.)
- Center for Food and Medical Innovation Promotion, Institute for the Promotion of Business-Regional Collaboration of Hokkaido University, Kita-21, Nishi-11, Kita-ku, Sapporo, Hokkaido 001-0021, Japan
| | - Yosuke Komatsu
- Wellness & Nutrition Science Institute, Morinaga Milk Industry Co., Ltd., 5-1-83 Higashihara, Zama, Kanagawa 252-8583, Japan; (T.E.); (F.T.); (Y.K.); (H.I.); (S.K.); (Y.T.)
- Center for Food and Medical Innovation Promotion, Institute for the Promotion of Business-Regional Collaboration of Hokkaido University, Kita-21, Nishi-11, Kita-ku, Sapporo, Hokkaido 001-0021, Japan
| | - Hirohisa Izumi
- Wellness & Nutrition Science Institute, Morinaga Milk Industry Co., Ltd., 5-1-83 Higashihara, Zama, Kanagawa 252-8583, Japan; (T.E.); (F.T.); (Y.K.); (H.I.); (S.K.); (Y.T.)
- Center for Food and Medical Innovation Promotion, Institute for the Promotion of Business-Regional Collaboration of Hokkaido University, Kita-21, Nishi-11, Kita-ku, Sapporo, Hokkaido 001-0021, Japan
| | - Satomi Kawakami
- Wellness & Nutrition Science Institute, Morinaga Milk Industry Co., Ltd., 5-1-83 Higashihara, Zama, Kanagawa 252-8583, Japan; (T.E.); (F.T.); (Y.K.); (H.I.); (S.K.); (Y.T.)
- Center for Food and Medical Innovation Promotion, Institute for the Promotion of Business-Regional Collaboration of Hokkaido University, Kita-21, Nishi-11, Kita-ku, Sapporo, Hokkaido 001-0021, Japan
| | - Kiwamu Noshiro
- Department of Obstetrics and Gynecology, Hokkaido University Graduate School of Medicine, Kita-15, Nishi-7, Kita-ku, Sapporo, Hokkaido 060-8648, Japan; (K.N.); (T.U.)
| | - Takeshi Umazume
- Department of Obstetrics and Gynecology, Hokkaido University Graduate School of Medicine, Kita-15, Nishi-7, Kita-ku, Sapporo, Hokkaido 060-8648, Japan; (K.N.); (T.U.)
| | - Yasuhiro Takeda
- Wellness & Nutrition Science Institute, Morinaga Milk Industry Co., Ltd., 5-1-83 Higashihara, Zama, Kanagawa 252-8583, Japan; (T.E.); (F.T.); (Y.K.); (H.I.); (S.K.); (Y.T.)
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