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Soria-Contreras DC, Liu J, Lawn RB, Wang S, Purdue-Smithe A, Grodstein F, Oken E, Chavarro JE. Lifetime History of Low Birth Weight Delivery and Cognitive Function in Middle-Aged Parous Women. Neurology 2024; 103:e209504. [PMID: 38865681 DOI: 10.1212/wnl.0000000000209504] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/14/2024] Open
Abstract
BACKGROUND AND OBJECTIVES Pregnancy outcomes such as low birth weight (LBW) delivery may reflect vascular or metabolic dysfunction in mothers and presage future cognitive impairment and dementia. However, the evidence is currently limited. Our objective was to examine the extent to which a lifetime history of LBW delivery was associated with cognitive function in parous middle-aged women. METHODS We studied participants from the Nurses' Health Study II, an ongoing longitudinal cohort of female nurses enrolled in 1989. In 2009, participants completed a reproductive history questionnaire. Participants who completed at least one of 2 post-traumatic stress disorder questionnaires were invited to participate in a cognition substudy with 2 waves of baseline data collection (2014 or 2018). We restricted the analysis to participants with one valid cognitive assessment who reported ≥1 birth at 18 years and older. We defined LBW delivery history as having delivered offspring with a birth weight <2,500 g (<5.5 lbs) in any pregnancy. The outcome was a single assessment of cognitive function evaluated with the self-administered Cogstate Brief Battery. The battery comprises 4 tasks, which we used to create 2 composite z-scores measuring psychomotor speed/attention and learning/working memory (higher z-scores = better cognitive function). We used multivariable linear regression models. RESULTS The analysis included 15,323 participants with a mean age of 62 (standard deviation: 4.9 years) at cognitive assessment. Among them, 1,224 (8%) had a history of LBW delivery. After adjusting for age at cognitive assessment, race, and ethnicity, participants' education, wave of baseline cognitive assessment, socioeconomic status, and prepregnancy characteristics, women with a history of LBW delivery had lower z-scores in the psychomotor speed/attention (β, -0.06; 95% CI -0.12 to -0.01) and learning/working memory (β, -0.05; 95% CI -0.09 to -0.01) composites than parous women without a history of LBW delivery. We observed a gradient of lower z-scores with an increasing number of LBW deliveries. DISCUSSION History of LBW delivery may be marker of future poorer cognition. If confirmed, our findings support future investigations into the value of early preventive efforts targeting women with a history of LBW delivery to reduce the burden of cognitive impairment in women.
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Affiliation(s)
- Diana C Soria-Contreras
- From the Departments of Nutrition (D.C.S.-C., S.W., E.O., J.E.C.) and Epidemiology (J.L., R.B.L., J.E.C.), Harvard T.H. Chan School of Public Health, Boston; Division of Women's Health (A.P.-S.) and Channing Division of Network Medicine, Department of Medicine (J.E.C.), Brigham and Women's Hospital and Harvard Medical School, Boston, MA; Rush Alzheimer's Disease Center (F.G.), Rush University Medical Center, Chicago, IL; Division of Chronic Disease Research Across the Lifecourse, Department of Population Medicine (E.O.), Harvard Medical School, Boston; and Harvard Pilgrim Health Care Institute (E.O.), Boston, MA
| | - Jiaxuan Liu
- From the Departments of Nutrition (D.C.S.-C., S.W., E.O., J.E.C.) and Epidemiology (J.L., R.B.L., J.E.C.), Harvard T.H. Chan School of Public Health, Boston; Division of Women's Health (A.P.-S.) and Channing Division of Network Medicine, Department of Medicine (J.E.C.), Brigham and Women's Hospital and Harvard Medical School, Boston, MA; Rush Alzheimer's Disease Center (F.G.), Rush University Medical Center, Chicago, IL; Division of Chronic Disease Research Across the Lifecourse, Department of Population Medicine (E.O.), Harvard Medical School, Boston; and Harvard Pilgrim Health Care Institute (E.O.), Boston, MA
| | - Rebecca B Lawn
- From the Departments of Nutrition (D.C.S.-C., S.W., E.O., J.E.C.) and Epidemiology (J.L., R.B.L., J.E.C.), Harvard T.H. Chan School of Public Health, Boston; Division of Women's Health (A.P.-S.) and Channing Division of Network Medicine, Department of Medicine (J.E.C.), Brigham and Women's Hospital and Harvard Medical School, Boston, MA; Rush Alzheimer's Disease Center (F.G.), Rush University Medical Center, Chicago, IL; Division of Chronic Disease Research Across the Lifecourse, Department of Population Medicine (E.O.), Harvard Medical School, Boston; and Harvard Pilgrim Health Care Institute (E.O.), Boston, MA
| | - Siwen Wang
- From the Departments of Nutrition (D.C.S.-C., S.W., E.O., J.E.C.) and Epidemiology (J.L., R.B.L., J.E.C.), Harvard T.H. Chan School of Public Health, Boston; Division of Women's Health (A.P.-S.) and Channing Division of Network Medicine, Department of Medicine (J.E.C.), Brigham and Women's Hospital and Harvard Medical School, Boston, MA; Rush Alzheimer's Disease Center (F.G.), Rush University Medical Center, Chicago, IL; Division of Chronic Disease Research Across the Lifecourse, Department of Population Medicine (E.O.), Harvard Medical School, Boston; and Harvard Pilgrim Health Care Institute (E.O.), Boston, MA
| | - Alexandra Purdue-Smithe
- From the Departments of Nutrition (D.C.S.-C., S.W., E.O., J.E.C.) and Epidemiology (J.L., R.B.L., J.E.C.), Harvard T.H. Chan School of Public Health, Boston; Division of Women's Health (A.P.-S.) and Channing Division of Network Medicine, Department of Medicine (J.E.C.), Brigham and Women's Hospital and Harvard Medical School, Boston, MA; Rush Alzheimer's Disease Center (F.G.), Rush University Medical Center, Chicago, IL; Division of Chronic Disease Research Across the Lifecourse, Department of Population Medicine (E.O.), Harvard Medical School, Boston; and Harvard Pilgrim Health Care Institute (E.O.), Boston, MA
| | - Francine Grodstein
- From the Departments of Nutrition (D.C.S.-C., S.W., E.O., J.E.C.) and Epidemiology (J.L., R.B.L., J.E.C.), Harvard T.H. Chan School of Public Health, Boston; Division of Women's Health (A.P.-S.) and Channing Division of Network Medicine, Department of Medicine (J.E.C.), Brigham and Women's Hospital and Harvard Medical School, Boston, MA; Rush Alzheimer's Disease Center (F.G.), Rush University Medical Center, Chicago, IL; Division of Chronic Disease Research Across the Lifecourse, Department of Population Medicine (E.O.), Harvard Medical School, Boston; and Harvard Pilgrim Health Care Institute (E.O.), Boston, MA
| | - Emily Oken
- From the Departments of Nutrition (D.C.S.-C., S.W., E.O., J.E.C.) and Epidemiology (J.L., R.B.L., J.E.C.), Harvard T.H. Chan School of Public Health, Boston; Division of Women's Health (A.P.-S.) and Channing Division of Network Medicine, Department of Medicine (J.E.C.), Brigham and Women's Hospital and Harvard Medical School, Boston, MA; Rush Alzheimer's Disease Center (F.G.), Rush University Medical Center, Chicago, IL; Division of Chronic Disease Research Across the Lifecourse, Department of Population Medicine (E.O.), Harvard Medical School, Boston; and Harvard Pilgrim Health Care Institute (E.O.), Boston, MA
| | - Jorge E Chavarro
- From the Departments of Nutrition (D.C.S.-C., S.W., E.O., J.E.C.) and Epidemiology (J.L., R.B.L., J.E.C.), Harvard T.H. Chan School of Public Health, Boston; Division of Women's Health (A.P.-S.) and Channing Division of Network Medicine, Department of Medicine (J.E.C.), Brigham and Women's Hospital and Harvard Medical School, Boston, MA; Rush Alzheimer's Disease Center (F.G.), Rush University Medical Center, Chicago, IL; Division of Chronic Disease Research Across the Lifecourse, Department of Population Medicine (E.O.), Harvard Medical School, Boston; and Harvard Pilgrim Health Care Institute (E.O.), Boston, MA
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Farkas K, Bodnar LM, Tavernier RLE, Friedman JK, Johnson ST, MacLehose RF, Mason SM. Validation of Long-term Recall of Pregnancy-related Weight in the Life-course Experiences And Pregnancy Study. Epidemiology 2024; 35:489-498. [PMID: 38567930 PMCID: PMC11196197 DOI: 10.1097/ede.0000000000001734] [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] [Indexed: 06/25/2024]
Abstract
BACKGROUND Prepregnancy body mass index (BMI) and gestational weight gain (GWG) are determinants of maternal and child health. However, many studies of these factors rely on error-prone self-reported measures. METHODS Using data from Life-course Experiences And Pregnancy (LEAP), a US-based cohort, we assessed the validity of prepregnancy BMI and GWG recalled on average 8 years postpartum against medical record data treated as alloyed gold standard ("true") values. We calculated probabilities of being classified into a self-reported prepregnancy BMI or GWG category conditional on one's true category (analogous to sensitivities and specificities) and probabilities of truly being in each prepregnancy BMI or GWG category conditional on one's self-reported category (analogous to positive and negative predictive values). RESULTS There was a tendency toward under-reporting prepregnancy BMI. Self-report misclassified 32% (95% confidence interval [CI] = 19%, 48%) of those in LEAP with truly overweight and 13% (5%, 27%) with obesity into a lower BMI category. Self-report correctly predicted the truth for 72% (55%, 84%) with self-reported overweight to 100% (90%, 100%) with self-reported obesity. For GWG, both under- and over-reporting were common; self-report misclassified 32% (15%, 55%) with truly low GWG as having moderate GWG and 50% (28%, 72%) with truly high GWG as moderate or low GWG. Self-report correctly predicted the truth for 45% (25%, 67%) with self-reported high GWG to 85% (76%, 91%) with self-reported moderate GWG. Misclassification of BMI and GWG varied across maternal characteristics. CONCLUSION Findings can be used in quantitative bias analyses to estimate bias-adjusted associations with prepregnancy BMI and GWG.
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Affiliation(s)
- Kriszta Farkas
- Division of Epidemiology & Community Health, University of Minnesota School of Public Health, Minneapolis, MN, USA
| | - Lisa M. Bodnar
- Department of Epidemiology, University of Pittsburgh School of Public Health, Pittsburgh, PA, USA
| | - Rebecca L. Emery Tavernier
- Weitzman Institute, Moses Weitzman Health System, Middletown, CT, USA
- Department of Family Medicine and Biobehavioral Health, University of Minnesota Medical School, Duluth campus, Duluth, MN, USA
| | - Jessica K. Friedman
- Center for Care Delivery and Outcomes Research, Minneapolis Veterans Administration Health Care System, Minneapolis, MN, USA
- VA HSR&D Center for the Study of Healthcare Innovation, Implementation and Policy, VA Greater Los Angeles Health Care System, Los Angeles, CA, USA
| | - Sydney T. Johnson
- Division of Epidemiology & Community Health, University of Minnesota School of Public Health, Minneapolis, MN, USA
| | - Richard F. MacLehose
- Division of Epidemiology & Community Health, University of Minnesota School of Public Health, Minneapolis, MN, USA
| | - Susan M. Mason
- Division of Epidemiology & Community Health, University of Minnesota School of Public Health, Minneapolis, MN, USA
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Adgent MA, Buth E, Noroña-Zhou A, Szpiro AA, Loftus CT, Moore PE, Wright RJ, Barrett ES, LeWinn KZ, Zhao Q, Nguyen R, Karr CJ, Bush NR, Carroll KN. Maternal stressful life events during pregnancy and childhood asthma and wheeze. Ann Allergy Asthma Immunol 2024; 132:594-601.e3. [PMID: 38122928 PMCID: PMC11069451 DOI: 10.1016/j.anai.2023.12.015] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2023] [Revised: 11/28/2023] [Accepted: 12/03/2023] [Indexed: 12/23/2023]
Abstract
BACKGROUND Studies have linked prenatal maternal psychosocial stress to childhood wheeze/asthma but have rarely investigated factors that may mitigate risks. OBJECTIVE To investigate associations between prenatal stress and childhood wheeze/asthma, evaluating factors that may modify stress effects. METHODS Participants included 2056 mother-child dyads from Environmental influences on Child Health Outcomes (ECHO)-PATHWAYS, a consortium of 3 prospective pregnancy cohorts (the Conditions Affecting Neurocognitive Development and Learning in Early Childhood study, The Infant Development and Environment Study, and a subset of the Global Alliance to Prevent Prematurity and Stillbirth study) from 6 cities. Maternal stressful life events experienced during pregnancy (PSLEs) were reported using the Pregnancy Risk Assessment Monitoring System Stressful Life Events questionnaire. Parents reported child wheeze/asthma outcomes at age 4 to 6 years using standardized questionnaires. We defined outcomes as ever asthma, current wheeze, current asthma, and strict asthma. We used modified Poisson regression with robust standard errors (SEs) to estimate risk ratios (RRs) and 95% CI per 1-unit increase in PSLE, adjusting for confounders. We evaluated effect modification by child sex, maternal history of asthma, maternal childhood traumatic life events, neighborhood-level resources, and breastfeeding. RESULTS Overall, we observed significantly elevated risk for current wheeze with increasing PSLE (RR, 1.09 [95% CI, 1.03-1.14]), but not for other outcomes. We observed significant effect modification by child sex for strict asthma (P interaction = .03), in which risks were elevated in boys (RR, 1.10 [95% CI, 1.02-1.19]) but not in girls. For all other outcomes, risks were significantly elevated in boys and not in girls, although there was no statistically significant evidence of effect modification. We observed no evidence of effect modification by other factors (P interactions > .05). CONCLUSION Risk of adverse childhood respiratory outcomes is higher with increasing maternal PSLEs, particularly in boys.
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Affiliation(s)
| | - Erin Buth
- University of Washington, Seattle WA
| | | | | | | | | | | | - Emily S. Barrett
- Rutgers School of Public Health, Environmental and Occupational Health Sciences Institute; Piscataway NJ
| | - Kaja Z. LeWinn
- University of California San Francisco, San Francisco CA
| | - Qi Zhao
- University of Tennessee Health Sciences Center, Memphis TN
| | | | | | - Nicole R. Bush
- University of California San Francisco, San Francisco CA
| | - Kecia N. Carroll
- Vanderbilt University Medical Center, Nashville TN
- Icahn School of Medicine at Mount Sinai, New York NY
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McNamara KA, Murnion B, Fotheringham P, Terplan M, Lintzeris N, Oei JL, Bond DM, Nassar N, Black KI. Interconnections between unintended pregnancy, alcohol and other drug use, and pregnancy, birth, infant, childhood and socioeconomic outcomes: a scoping review. BMJ SEXUAL & REPRODUCTIVE HEALTH 2024:bmjsrh-2023-202140. [PMID: 38471787 DOI: 10.1136/bmjsrh-2023-202140] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/03/2023] [Accepted: 02/29/2024] [Indexed: 03/14/2024]
Abstract
BACKGROUND Unintended pregnancy (UIP) and substance use disorder share underlying root causes with similar impacts for women and their offspring in pregnancy, birth and beyond. Furthermore, intoxication with alcohol and other drugs (AOD) increases the risk of UIP. OBJECTIVES To assess the available evidence on associations between UIP and health, social and economic outcomes, in women who use AOD. SEARCH STRATEGY The review utilised the Joanna Briggs Institute Methodology for Scoping Reviews and PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) reporting guidelines. The search was conducted across multiple databases, including Scopus and Medline, and limited to studies published between January 2000 to June 2023. SELECTION CRITERIA Studies reporting on interactions between AOD use and UIP, and pregnancy, birth, infant, childhood, social or economic outcomes. All patterns and types of AOD use, except isolated use of tobacco, were included. Studies were available in English and conducted in high-income countries. DATA COLLECTION AND ANALYSIS Selected articles were reviewed, and data collected by two independent reviewers using a standardised data extraction sheet. Findings were summarised and reported descriptively. MAIN RESULTS A total of 2536 titles and abstracts were screened, 97 full texts were reviewed, and three studies were selected for inclusion in the scoping review. There was heterogeneity in types and patterns of AOD use, differences in study design and tools to assess pregnancy intention, and each focused on disparate outcomes. No study assessed or reported on birth outcomes. CONCLUSION There is a paucity of data examining the intersection between AOD use and UIP and further research is needed.
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Affiliation(s)
- Kelly A McNamara
- Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
- School of Medicine and Public Health, The University of Newcastle, Callaghan, New South Wales, Australia
| | - Bridin Murnion
- Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
- Faculty of Medicine & Health, University of New South Wales, Sydney, New South Wales, Australia
| | - Penelope Fotheringham
- School of Medicine and Public Health, The University of Newcastle, Callaghan, New South Wales, Australia
- MotherSafe Counselling Service, The Royal Hospital for Women, Randwick, New South Wales, Australia
| | - Mishka Terplan
- Friends Research Institute Inc, Baltimore, Maryland, USA
| | - Nicholas Lintzeris
- Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
- Drug and Alcohol Services, South Eastern Sydney Local Health District, Kogarah, New South Wales, Australia
| | - Ju Lee Oei
- Faculty of Medicine & Health, University of New South Wales, Sydney, New South Wales, Australia
- Department of Newborn Care, The Royal Hospital for Women, Randwick, New South Wales, Australia
| | - Diana M Bond
- Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Natasha Nassar
- Child Population and Translational Health Research, Children's Hospital at Westmead Clinical School, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Kirsten I Black
- Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
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Mitro SD, Sundaram R, Qiao Y, Gleason JL, Yeung E, Hinkle SN, Mendola P, Mills JL, Grandi SM, Mumford SL, Schisterman EF, Zhang C, Grantz KL. History of multifetal gestation and long-term maternal mortality. Paediatr Perinat Epidemiol 2024; 38:219-226. [PMID: 37969031 PMCID: PMC10978292 DOI: 10.1111/ppe.13020] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/14/2023] [Revised: 10/31/2023] [Accepted: 11/01/2023] [Indexed: 11/17/2023]
Abstract
BACKGROUND Multifetal gestation could be associated with higher long-term maternal mortality because it increases the risk of pregnancy complications such as preeclampsia and preterm birth, which are in turn linked to postpartum cardiovascular risk. OBJECTIVES We examined whether spontaneously conceived multifetal versus singleton gestation was associated with long-term maternal mortality in a racially diverse U.S. COHORT METHODS We ascertained vital status as of 2016 via linkage to the National Death Index and Social Security Death Master File of 44,174 mothers from the Collaborative Perinatal Project (CPP; 1959-1966). Cox proportional hazards models with maternal age as the time scale assessed associations between history of spontaneous multifetal gestation (in the last CPP observed pregnancy or prior pregnancy) and all-cause and cardiovascular mortality, adjusted for demographics, smoking status, and preexisting medical conditions. We calculated hazard ratios (HR) for all-cause and cause-specific mortality over the study period and until age 50, 60, and 70 years (premature mortality). RESULTS Of eligible participants, 1672 (3.8%) had a history of multifetal gestation. Participants with versus without a history of multifetal gestation were older, more likely to have a preexisting condition, and more likely to smoke. By 2016, 51% of participants with and 38% of participants without a history of multifetal gestation had died (unadjusted all-cause HR 1.14, 95% confidence interval [CI] 1.07, 1.23). After adjustment for smoking and preexisting conditions, a history of multifetal gestation was not associated with all-cause (adjusted HR 1.00, 95% CI 0.93, 1.08) or cardiovascular mortality (adjusted HR 0.99, 95% CI 0.87, 1.11) over the study period. However, history of multifetal gestation was associated with an 11% lower risk of premature all-cause mortality (adjusted HR 0.89, 95% CI 0.82, 0.96). CONCLUSIONS In a cohort with over 50 years of follow-up, history of multifetal gestation was not associated with all-cause mortality, but may be associated with a lower risk of premature mortality.
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Affiliation(s)
- Susanna D Mitro
- Division of Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, Maryland, USA
- Division of Research, Kaiser Permanente Northern California, Oakland, California, USA
| | - Rajeshwari Sundaram
- Division of Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, Maryland, USA
| | - Yan Qiao
- Division of Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, Maryland, USA
| | - Jessica L Gleason
- Division of Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, Maryland, USA
| | - Edwina Yeung
- Division of Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, Maryland, USA
| | - Stefanie N Hinkle
- Department of Biostatistics, Epidemiology and Informatics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Pauline Mendola
- Department of Epidemiology and Environmental Health, School of Public Health and Health Professions, University at Buffalo, Buffalo, New York, USA
| | - James L Mills
- Division of Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, Maryland, USA
| | - Sonia M Grandi
- Division of Epidemiology, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Sunni L Mumford
- Department of Biostatistics, Epidemiology and Informatics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Enrique F Schisterman
- Department of Biostatistics, Epidemiology and Informatics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Cuilin Zhang
- Bia-Echo Asia Centre for Reproductive Longevity & Equality, Department of Obstetrics and Gynecology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Katherine L Grantz
- Division of Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, Maryland, USA
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Shapiro I, Youssim I, Paltiel O, Calderon-Margalit R, Manor O, Friedlander Y, Hochner H. Perinatal exposures and adolescence overweight: The role of shared maternal-offspring pathways. Atherosclerosis 2024; 389:117438. [PMID: 38241794 PMCID: PMC10872218 DOI: 10.1016/j.atherosclerosis.2023.117438] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2023] [Revised: 12/11/2023] [Accepted: 12/21/2023] [Indexed: 01/21/2024]
Abstract
BACKGROUND AND AIMS Early life exposures affect offspring health across the life-course. We aimed to examine whether prevalent perinatal exposures and obstetric complications are independently associated with offspring overweight in adolescence. We then assessed whether shared maternal-offspring pathways drive the association of perinatal exposures with offspring overweight. METHODS Using data from the Jerusalem Perinatal Study birth cohort, two perinatal scores were constructed: obstetric complications (OC) and prevalent perinatal exposures (PPE) scores. PPE score, generated by principal component analysis, included three primary components. Logistic regressions were used to assess associations of scores with offspring overweight, with and without adjustment for maternal life-course survival. RESULTS OC and PPE scores were independently associated with offspring overweight (OROC = 1.15, 95%CI:1.07,1.25; ORPPE1- SEP and lifestyle = 0.85, 95%CI:0.79,0.91; ORPPE2- Maternal body size = 1.20, 95%CI: 1.13,1.28; ORPPE3-Fetal growth = 1.18, 95%CI:1.11,1.26). Maternal survival was associated with offspring overweight (OR = 1.38, 95%CI:1.08,1.76), yet introducing PPE score to the same model attenuated this association (OR = 1.16, 95%CI:0.90, 1.49). When OC score and maternal survival were included in the same model, their associations with offspring overweight remained unchanged. CONCLUSIONS Mother-offspring shared factors, captured by maternal life-course survival, underlie the effect of prevalent perinatal exposures on offspring overweight. However, the effect of obstetric complications was independent, highlighting the contribution of additional pathways.
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Affiliation(s)
- Ilona Shapiro
- Braun School of Public Health, Hebrew University of Jerusalem, Jerusalem, 99112102, Israel.
| | - Iaroslav Youssim
- Braun School of Public Health, Hebrew University of Jerusalem, Jerusalem, 99112102, Israel
| | - Ora Paltiel
- Braun School of Public Health, Hebrew University of Jerusalem, Jerusalem, 99112102, Israel
| | | | - Orly Manor
- Braun School of Public Health, Hebrew University of Jerusalem, Jerusalem, 99112102, Israel
| | - Yechiel Friedlander
- Braun School of Public Health, Hebrew University of Jerusalem, Jerusalem, 99112102, Israel
| | - Hagit Hochner
- Braun School of Public Health, Hebrew University of Jerusalem, Jerusalem, 99112102, Israel
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Post A, Veri S, Moore D, Poole M, Kreider H, Brunner Huber L. The Association between Early Menarche and Small for Gestational Age Birth. J Biosoc Sci 2023; 55:1039-1043. [PMID: 36852575 DOI: 10.1017/s0021932023000020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/01/2023]
Abstract
In the U.S., approximately 11% of infants are born small for gestational age (SGA). While there are many known behavioral risk factors for SGA births, there are still many factors yet to be explored. The purpose of this study was to investigate the maternal early menarche (< 12 years old)- SGA birth association. Data were retrieved from the 2011-2017 National Survey of Family Growth, and multivariate logistic regression was used to evaluate the association. Approximately 4% of mothers reported having an SGA infant and 24% of mothers reported early age at menarche. After controlling for maternal age, race/ethnicity, and annual household income, early menarche was associated with 3% increased odds of SGA, although this finding was not statistically significant (adjusted odds ratio: 1.03, 95% CI: 0.70, 1.53). Additional research is needed on the long-term birth outcomes and health consequences of early menarche.
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Affiliation(s)
- Abigail Post
- Department of Public Health Sciences, University of North Carolina at Charlotte, 9201 University City Blvd, Charlotte, NC28223USA
| | - Shelby Veri
- Department of Public Health Sciences, University of North Carolina at Charlotte, 9201 University City Blvd, Charlotte, NC28223USA
| | - Danielle Moore
- Department of Public Health Sciences, University of North Carolina at Charlotte, 9201 University City Blvd, Charlotte, NC28223USA
| | - Morgan Poole
- Department of Public Health Sciences, University of North Carolina at Charlotte, 9201 University City Blvd, Charlotte, NC28223USA
| | - Hannah Kreider
- Department of Public Health Sciences, University of North Carolina at Charlotte, 9201 University City Blvd, Charlotte, NC28223USA
| | - Larissa Brunner Huber
- Department of Public Health Sciences, University of North Carolina at Charlotte, 9201 University City Blvd, Charlotte, NC28223USA
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Soria-Contreras DC, Aris IM, Rifas-Shiman SL, Perng W, Hivert MF, Chavarro JE, Oken E. Associations of age at first birth and lifetime parity with weight and adiposity across midlife in women from Project Viva. Obesity (Silver Spring) 2023; 31:2407-2416. [PMID: 37485799 PMCID: PMC10524615 DOI: 10.1002/oby.23831] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/12/2022] [Revised: 05/05/2023] [Accepted: 05/08/2023] [Indexed: 07/25/2023]
Abstract
OBJECTIVE This study aimed to evaluate the associations of age at first birth and parity with weight, waist circumference (WC), and body fat across midlife. METHODS A secondary data analysis was conducted with 735 participants from Project Viva who reported their age at first birth and lifetime parity at a midlife study visit. Weight, WC, and body fat were measured up to four times after the participants' final birth, and associations were examined using linear mixed-effects regression models. RESULTS Participants' mean (SD) age was 32.6 (4.9) years at enrollment and 30.4 (5.5) years at their first birth, and they had 2.4 (0.9) lifetime births. In adjusted models, women who had their first birth at age <23 or ≥40 years, versus age 30 to 34 years, had a higher trajectory of weight, WC, and body fat after their final birth (i.e., mean differences in weight 8.38 kg [95% CI: 4.13-12.63] for age <23 years and 6.54 kg [95% CI: 0.64-12.45] for age ≥40 years). Women with four or more births, versus two, had a higher trajectory of adiposity after accounting for covariates. CONCLUSIONS Women who have a first birth before age 23 years or after age 40 years and those with multiple births may benefit from more intensive monitoring for excess adiposity gain.
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Affiliation(s)
- Diana C. Soria-Contreras
- Department of Nutrition, Harvard T.H. Chan School of Public Health, 665 Huntington Ave, Boston, MA 02115, USA
| | - Izzuddin M. Aris
- Division of Chronic Disease Research Across the Lifecourse, Department of Population Medicine, Harvard Medical School, and Harvard Pilgrim Health Care Institute, Landmark Center, 401 Park Drive, Suite 401 East, Boston, MA 02215, USA
| | - Sheryl L. Rifas-Shiman
- Division of Chronic Disease Research Across the Lifecourse, Department of Population Medicine, Harvard Medical School, and Harvard Pilgrim Health Care Institute, Landmark Center, 401 Park Drive, Suite 401 East, Boston, MA 02215, USA
| | - Wei Perng
- Department of Epidemiology, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, 13001 E. 17th Place, Aurora, CO 80045, USA
- Lifecourse Epidemiology of Adiposity and Diabetes (LEAD) Center, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, 12474 East 19 Ave, Aurora, CO 80045, USA
| | - Marie-France Hivert
- Division of Chronic Disease Research Across the Lifecourse, Department of Population Medicine, Harvard Medical School, and Harvard Pilgrim Health Care Institute, Landmark Center, 401 Park Drive, Suite 401 East, Boston, MA 02215, USA
- Diabetes Unit, Massachusetts General Hospital, 50 Staniford Street, Boston, MA 02114
| | - Jorge E. Chavarro
- Department of Nutrition, Harvard T.H. Chan School of Public Health, 665 Huntington Ave, Boston, MA 02115, USA
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, 75 Francis St, Boston, MA 02115, USA
| | - Emily Oken
- Department of Nutrition, Harvard T.H. Chan School of Public Health, 665 Huntington Ave, Boston, MA 02115, USA
- Division of Chronic Disease Research Across the Lifecourse, Department of Population Medicine, Harvard Medical School, and Harvard Pilgrim Health Care Institute, Landmark Center, 401 Park Drive, Suite 401 East, Boston, MA 02215, USA
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9
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Bizuayehu HM, Harris ML, Chojenta C, Cavenagh D, Forder PM, Loxton D. Patterns of Labour Interventions and Associated Maternal Biopsychosocial Factors in Australia: a Path Analysis. Reprod Sci 2023; 30:2767-2779. [PMID: 36973581 PMCID: PMC10480095 DOI: 10.1007/s43032-023-01219-7] [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: 12/15/2022] [Accepted: 03/09/2023] [Indexed: 03/29/2023]
Abstract
In Australia, nearly half of births involve labour interventions. Prior research in this area has relied on cross-sectional and administrative health data and has not considered biopsychosocial factors. The current study examined direct and indirect associations between biopsychosocial factors and labour interventions using 19 years of population-based prospective data. The study included singleton babies among primiparous women of the 1973-1978 cohort of the Australian Longitudinal Study on Women's Health. Data from 5459 women who started labour were analysed using path analysis. 42.2% of babies were born without intervention (episiotomy, instrumental, or caesarean delivery): Thirty-seven percent reported vaginal birth with episiotomy and instrumental birth interventions, 18% reported an unplanned caesarean section without episiotomy and/or instrumental interventions, and 3% reported unplanned caesarean section after episiotomy and/or instrumental interventions. Vaginal births with episiotomy and/or instrumental interventions were more likely among women with chronic hypertension (RRR(95%-CI):1.50(1.12-2.01)), a perceived length of labour of more than 36 h (RRR(95%-CI):1.86(1.45-2.39)), private health insurance (RRR(95%-CI):1.61(1.41-1.85)) and induced labour (RRR(95%-CI):1.69(1.46-1.94)). Risk factors of unplanned caesarean section without episiotomy and/or instrumental birth intervention included being overweight (RRR(95%-CI):1.30(1.07-1.58)) or obese prepregnancy (RRR(95%-CI):1.63(1.28-2.08)), aged ≥ 35 years (RRR(95%-CI):1.87(1.46-2.41)), having short stature (< 154 cm) (RRR(95%-CI):1.68(1.16-2.42)), a perceived length of labour of more than 36 h (RRR(95%-CI):3.26(2.50-4.24)), private health insurance (RRR(95%-CI):1.38(1.17-1.64)), and induced labour (RRR(95%-CI):2.56(2.16-3.05)). Prevention and management of hypertension, diabetes, and obesity during preconception and/or antenatal care are keys for reducing labour interventions and strengthening the evidence-base around delivery of best practice obstetric care.
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Affiliation(s)
- Habtamu Mellie Bizuayehu
- School of Medicine and Public Health, College of Health, Medicine and Wellbeing, Centre for Women's Health Research, The University of Newcastle, Newcastle, Australia.
- Descriptive Epidemiology, Cancer Council Queensland, Brisbane, Australia.
- Department of Public Health, Debre Markos University, Debre Markos, Ethiopia.
- The First Nations Cancer & Wellbeing Research (FNCWR) Program, School of Public Health, The University of Queensland, Brisbane, Australia.
| | - Melissa L Harris
- School of Medicine and Public Health, College of Health, Medicine and Wellbeing, Centre for Women's Health Research, The University of Newcastle, Newcastle, Australia
| | - Catherine Chojenta
- School of Medicine and Public Health, College of Health, Medicine and Wellbeing, Centre for Women's Health Research, The University of Newcastle, Newcastle, Australia
| | - Dominic Cavenagh
- School of Medicine and Public Health, College of Health, Medicine and Wellbeing, Centre for Women's Health Research, The University of Newcastle, Newcastle, Australia
| | - Peta M Forder
- School of Medicine and Public Health, College of Health, Medicine and Wellbeing, Centre for Women's Health Research, The University of Newcastle, Newcastle, Australia
| | - Deborah Loxton
- School of Medicine and Public Health, College of Health, Medicine and Wellbeing, Centre for Women's Health Research, The University of Newcastle, Newcastle, Australia
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10
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Branda JIF, de Almeida-Pititto B, Bensenor I, Lotufo PA, Ferreira SRG. Associations of prematurity and low birth weight with blood pressure and kidney function in middle-aged participants of the Brazilian Longitudinal Study of Adult Health: ELSA-Brasil. J Nephrol 2023; 36:1373-1382. [PMID: 36646972 DOI: 10.1007/s40620-022-01549-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2022] [Accepted: 12/03/2022] [Indexed: 01/18/2023]
Abstract
BACKGROUND An adverse intrauterine environment reflected by low birth weight (LBW) and prematurity may induce fetal programming that favors kidney dysfunction in adulthood. We examined the association of LBW and prematurity with blood pressure (BP) and kidney function markers in non-diabetic, middle-aged adults without kidney disease from the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil). METHODS A cross-sectional analysis of 768 subjects aged 35-54 years was conducted. Comparisons were performed according to self-reported birth weight: LBW (< 2.5 kg) or normal birth weight (2.5-4.0 kg). Associations of LBW and prematurity with BP levels and kidney function markers "(estimated glomerular filtration rate [eGFR], albumin-creatinine ratio [ACR] and serum cystatin-C) were tested by multiple linear regression using adjustments based on Directed Acyclic Graphs. Propensity score matching was applied to control imbalances. RESULTS Mean age of participants was 45.5 ± 4.6 years and 56.8% were female; 64 (8.3%) participants reported LBW and 39 (5.0%) prematurity. The LBW group had higher systolic (p = 0.015) and diastolic BP (p = 0.014) and ACR values (p = 0.031) and lower eGFR (p = 0.015) than the normal birth weight group, but no group difference for cystatin-C was found. The preterm group had higher mean levels of systolic and diastolic BP, but no difference in kidney function markers was evident. In a regression model adjusted for sex, skin color and family history of hypertension, both systolic and diastolic BP levels were associated with LBW, but this association disappeared after adding for prematurity, which remained associated with BP (p = 0.017). Having applied a propensity score matching, LBW was associated with ACR values (p = 0.003), but not with eGFR or BP levels. CONCLUSION The study findings of independent associations of prematurity with higher BP levels, and of LBW with markers of kidney function in adulthood, support that early life events may predict risk for hypertension and kidney dysfunction in adulthood. The study design precluded the inferring of causality, and prospective studies are needed to further investigate this hypothesis.
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Affiliation(s)
- Julia Ines F Branda
- Department of Epidemiology, School of Public Health, University of São Paulo, Av. Dr. Arnaldo, 715, São Paulo, SP, 01246-904, Brazil
- Center of Clinical and Epidemiological Research at University of São Paulo, São Paulo, Brazil
| | - Bianca de Almeida-Pititto
- Department of Preventive Medicine, Federal University of São Paulo, São Paulo, Brazil
- Center of Clinical and Epidemiological Research at University of São Paulo, São Paulo, Brazil
| | - Isabela Bensenor
- Department of Internal Medicine, Medical School, University of São Paulo, São Paulo, Brazil
- Center of Clinical and Epidemiological Research at University of São Paulo, São Paulo, Brazil
| | - Paulo A Lotufo
- Department of Internal Medicine, Medical School, University of São Paulo, São Paulo, Brazil
- Center of Clinical and Epidemiological Research at University of São Paulo, São Paulo, Brazil
| | - Sandra Roberta G Ferreira
- Department of Epidemiology, School of Public Health, University of São Paulo, Av. Dr. Arnaldo, 715, São Paulo, SP, 01246-904, Brazil.
- Center of Clinical and Epidemiological Research at University of São Paulo, São Paulo, Brazil.
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11
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Kim C, Catov J, Schreiner PJ, Appiah D, Wellons MF, Siscovick D, Calderon‐Margalit R, Huddleston H, Ebong IA, Lewis CE. Women's Reproductive Milestones and Cardiovascular Disease Risk: A Review of Reports and Opportunities From the CARDIA Study. J Am Heart Assoc 2023; 12:e028132. [PMID: 36847077 PMCID: PMC10111436 DOI: 10.1161/jaha.122.028132] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/01/2023]
Abstract
In 1985 to 1986, the CARDIA (Coronary Artery Risk Development in Young Adults) study enrolled 5115 Black or White participants, including 2788 women, aged 18 to 30 years. Over the following 35 years, the CARDIA study amassed extensive longitudinal data on women's reproductive milestones, spanning menarche to menopause. Although not initially conceived as a study of women's health, >75 CARDIA study publications address relationships between reproductive factors and events with cardiovascular and metabolic risk factors, subclinical and clinical cardiovascular disease, and social determinants of health. The CARDIA study was one of the earliest population-based reports to note Black-White differences in age at menarche and associations with cardiovascular risk factors. Adverse pregnancy outcomes, particularly gestational diabetes and preterm birth, have been assessed along with postpartum behaviors, such as lactation. Existing studies have examined risk factors for adverse pregnancy outcomes and lactation, as well as their relationship to future cardiovascular and metabolic risk factors, diagnoses, and subclinical atherosclerosis. Ancillary studies examining components of polycystic ovary syndrome and ovarian biomarkers, such as anti-Müllerian hormone, have facilitated examination of reproductive health in a population-based cohort of young adult women. As the cohort transitioned through menopause, examination of the importance of premenopausal cardiovascular risk factors along with menopause has improved our understanding of shared mechanisms. The cohort is now aged in the 50s to mid-60s, and women will begin to experience a greater number of cardiovascular events as well as other conditions, such as cognitive impairment. Thus, in the next decade, the CARDIA study will provide a unique resource for understanding how the women's reproductive life course epidemiology informs cardiovascular risk, as well as reproductive and chronological aging.
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Affiliation(s)
- Catherine Kim
- Departments of Medicine, Obstetrics and Gynecology, and EpidemiologyUniversity of MichiganAnn ArborMI
| | - Janet Catov
- Department of Obstetrics, Gynecology and Reproductive SciencesUniversity of PittsburghPittsburghPA
| | - Pamela J. Schreiner
- Division of Epidemiology and Community HealthUniversity of MinnesotaMinneapolisMN
| | - Duke Appiah
- Department of Public Health, Graduate School of Biomedical SciencesTexas Tech UniversityLubbockTX
| | | | | | | | - Heather Huddleston
- Department of Obstetrics, Gynecology and Reproductive SciencesUniversity of California San FranciscoSan FranciscoCA
| | | | - Cora E. Lewis
- Department of EpidemiologyUniversity of Alabama at BirminghamBirminghamAL
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12
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de Oliveira Nascimento Freitas RGB, Vasques ACJ, Ribeiro FB, Solar I, Hanada AS, Barbosa MG, Valente AMM, de Almeida Pititto B, Eshriqui I, da Cunha Lopes TL, Geloneze B, Ferreira SRG. Parental body mass index and maternal gestational weight gain associations with offspring body composition in young women from the Nutritionists' Health Study. ARCHIVES OF ENDOCRINOLOGY AND METABOLISM 2023; 67:101-110. [PMID: 36155122 PMCID: PMC9983792 DOI: 10.20945/2359-3997000000516] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
Objective Intrauterine environment can induce fetal metabolic programming that predisposes to adiposity-related chronic diseases in its lifespan. We examined the associations of parental nutritional status and gestational weight gain with offspring body composition in early adulthood. Methods This is cross-sectional analysis of female participants of the NutriHS who were submitted to questionnaires, clinical examinations and body composition assessed by DXA. Association of preconception parental BMI and maternal gestational weight gain (exposures) with body composition measurements (outcomes) were analyzed using multiple linear models adjusted for Directed Acyclic Graphs-based covariables (maternal and paternal educational level, maternal age, and tobacco, alcohol and/or drugs use). The sample included 124 women (median 28 (24-31) years) with a mean BMI of 25.4 ± 4.7 kg/m2. Results No association between previous paternal BMI and offspring's body composition was detected. In the fully adjusted linear regression model, maternal BMI was associated with offspring's total lean mass (β = 0.66, p = 0.001), appendicular skeletal muscle mass index (ASMI) (β = 0.11, p = 0.003) and fat mass index (FMI) (β = 0.03, p = 0.039). Gestational weight gain was associated with increased offspring's BMI (OR 1.12 [95% CI 1.02-1.20], p = 0.01). The linear regression model adjusted for maternal age and maternal and paternal education levels showed associations of gestational weight gain with offspring's ASMI (β = 0.42, p = 0.046), FMI (β = 0.22, p = 0.005) and android-to-gynoid fat ratio (β = 0.09, p = 0.035). Conclusion Our findings suggest that preconception maternal BMI could influence lean mass and general adiposity of young adult female offspring and that gestational weight gain could be useful for predicting centrally distributed adiposity.
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Affiliation(s)
- Renata Germano Borges de Oliveira Nascimento Freitas
- Departamento de Epidemiologia, Escola de Saúde Pública, Universidade de São Paulo, São Paulo, SP, Brasil.,Laboratório de Investigação em Metabolismo e Diabetes, Gastrocentro, Faculdade de Ciências Médicas, Universidade Estadual de Campinas, Campinas, SP, Brasil
| | - Ana Carolina Junqueira Vasques
- Laboratório de Investigação em Metabolismo e Diabetes, Gastrocentro, Faculdade de Ciências Médicas, Universidade Estadual de Campinas, Campinas, SP, Brasil.,Escola de Ciências Aplicadas, Universidade Estadual de Campinas, Campinas, SP, Brasil
| | - Francieli Barreiro Ribeiro
- Laboratório de Investigação em Metabolismo e Diabetes, Gastrocentro, Faculdade de Ciências Médicas, Universidade Estadual de Campinas, Campinas, SP, Brasil.,Escola de Ciências Aplicadas, Universidade Estadual de Campinas, Campinas, SP, Brasil
| | - Isabela Solar
- Laboratório de Investigação em Metabolismo e Diabetes, Gastrocentro, Faculdade de Ciências Médicas, Universidade Estadual de Campinas, Campinas, SP, Brasil.,Escola de Ciências Aplicadas, Universidade Estadual de Campinas, Campinas, SP, Brasil
| | - Alfredo Shigueo Hanada
- Laboratório de Investigação em Metabolismo e Diabetes, Gastrocentro, Faculdade de Ciências Médicas, Universidade Estadual de Campinas, Campinas, SP, Brasil.,Escola de Ciências Aplicadas, Universidade Estadual de Campinas, Campinas, SP, Brasil
| | - Marina Gomes Barbosa
- Escola de Ciências Aplicadas, Universidade Estadual de Campinas, Campinas, SP, Brasil
| | | | | | - Ilana Eshriqui
- Departamento de Epidemiologia, Escola de Saúde Pública, Universidade de São Paulo, São Paulo, SP, Brasil.,Hospital Israelita Albert Einstein, São Paulo, SP, Brasil
| | | | - Bruno Geloneze
- Laboratório de Investigação em Metabolismo e Diabetes, Gastrocentro, Faculdade de Ciências Médicas, Universidade Estadual de Campinas, Campinas, SP, Brasil.,Centro de Pesquisa de Obesidade e Comorbidades, Universidade Estadual de Campinas, Campinas, SP, Brasil
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13
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Langton CR, Harmon QE, Upson K, Baird DD. Soy-Based Infant Formula Feeding and Uterine Fibroid Development in a Prospective Ultrasound Study of Black/African-American Women. ENVIRONMENTAL HEALTH PERSPECTIVES 2023; 131:17006. [PMID: 36696103 PMCID: PMC9875846 DOI: 10.1289/ehp11089] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/10/2022] [Revised: 11/14/2022] [Accepted: 12/19/2022] [Indexed: 06/17/2023]
Abstract
BACKGROUND Uterine fibroids are highly prevalent, benign tumors. They are the leading indication for hysterectomy, and Black women are disproportionally burdened. Soy-based infant formula contains phytoestrogens, and exposure during sensitive developmental windows may adversely affect the developing uterus; early phytoestrogen treatment in rodent studies led to detrimental uterine effects, including increased fibroid risk in Eker rats. Limited epidemiological studies also have suggested increased fibroid development with soy formula infant feeding. OBJECTIVE The goal of this study was to examine the association between soy formula feeding in infancy and fibroid development in adulthood. METHODS We evaluated this association among 1,610 Black/African-American women age 23-35 y in the Study of Environment, Lifestyle & Fibroids (SELF). Soy formula feeding data was gathered directly from the participants' mothers (89%). A standardized ultrasound examination was conducted during 4 clinic visits over 5 y to detect fibroids ≥0.5cm in diameter. We used Cox proportional hazards regression to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) for the association between soy formula feeding and incident fibroids adjusted for early-life and adult factors. Fibroid growth was calculated as change in log-volume for fibroids matched at successive visits. RESULTS Of 1,121 fibroid-free participants at baseline, 150 (13%) were ever fed soy formula as infants, and 269 (24%) developed incident fibroids. We did not observe an association between ever being fed soy formula and incident fibroid risk (HR=1.08; 95% CI: 0.75, 1.54). However, participants fed soy formula within 2 months of birth and for >6 months (n=53) had an elevated risk of fibroid incidence in comparison with those never fed soy formula (HR=1.56; 95% CI: 0.92, 2.65). Fibroid growth rates did not differ. DISCUSSION Adding support to limited human data, this prospective fibroid study found that soy-based formula feeding during infancy was associated with a suggestive increase in risk of ultrasound-identified incident fibroids in adulthood. https://doi.org/10.1289/EHP11089.
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Affiliation(s)
- Christine R. Langton
- Women’s Health Group, Epidemiology Branch, National Institute of Environmental Health Sciences, Durham, North Carolina, USA
| | - Quaker E. Harmon
- Women’s Health Group, Epidemiology Branch, National Institute of Environmental Health Sciences, Durham, North Carolina, USA
| | - Kristen Upson
- Department of Epidemiology and Biostatistics, College of Human Medicine, Michigan State University, East Lansing, Michigan, USA
| | - Donna D. Baird
- Women’s Health Group, Epidemiology Branch, National Institute of Environmental Health Sciences, Durham, North Carolina, USA
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14
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Physical Activity Beliefs and Behaviors during Pregnancy and their Association with Provider Counseling among Women in the Southern United States. PHYSICAL ACTIVITY AND HEALTH 2022. [DOI: 10.5334/paah.210] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
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15
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Freitas RGBON, Vasques ACJ, Fernandes GR, Ribeiro FB, Solar I, Barbosa MG, Almeida-Pititto B, Geloneze B, Ferreira SRG. Gestational weight gain and visceral adiposity in adult offspring: Is there a link with the fecal abundance of Acidaminococcus genus? Eur J Clin Nutr 2022; 76:1705-1712. [PMID: 35906333 DOI: 10.1038/s41430-022-01182-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2022] [Revised: 07/05/2022] [Accepted: 07/11/2022] [Indexed: 11/08/2022]
Abstract
Intrauterine environment can influence the offspring's body adiposity whose distribution affect the cardiometabolic risk. Underlying mechanisms may involve the gut microbiome. We investigated associations of gestational weight gain with the adult offspring's gut microbiota, body adiposity and related parameters in participants of the Nutritionists' Health Study. METHODS This cross-sectional analysis included 114 women who had early life and clinical data, body composition, and biological samples collected. The structure of fecal microbiota was analyzed targeting the V4 region of the 16 S rRNA gene. Beta diversity was calculated by PCoA and PERMANOVA used to test the impact of categorical variables into the diversity. Bacterial clusters were identified based on the Jensen-Shannon divergence matrix and Calinski-Harabasz index. Correlations were tested by Spearman coefficient. RESULTS Median age was 28 (IQR 24-31) years and BMI 24.5 (IQR 21.4-28.0) kg/m2. Fifty-eight participants were assigned to a profile driven by Prevotella and 56 to another driven by Blautia. Visceral adipose tissue was correlated to abundance of Acidaminococcus genus considering the entire sample (r = 0.37; p < 0.001) and the profiles (Blautia: r = 0.35, p = 0.009, and Prevotella: r = 0.38, p = 0.006). In Blautia-driven profile, the same genus was also correlated to maternal gestational weight gain (r = 0.38, p = 0.006). CONCLUSIONS Association of Acidaminococcus with gestational weight gain could reinforce the relevance with mothers' nutritional status for gut colonization at the beginning of life. Whether Acidaminococcus abundance could be a marker for central distribution of adiposity in young women requires further investigation.
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Affiliation(s)
- R G B O N Freitas
- Department of Epidemiology, School of Public Health, University of São Paulo, São Paulo, Brazil
- Laboratory of Investigation in Metabolism and Diabetes, Gastrocentro, School of Medical Sciences - University of Campinas, São Paulo, Brazil
| | - A C J Vasques
- Laboratory of Investigation in Metabolism and Diabetes, Gastrocentro, School of Medical Sciences - University of Campinas, São Paulo, Brazil
- School of Applied Sciences - University of Campinas, São Paulo, Brazil
| | - G R Fernandes
- Oswaldo Cruz Foundation, Belo Horizonte, São Paulo, Brazil
| | - F B Ribeiro
- Laboratory of Investigation in Metabolism and Diabetes, Gastrocentro, School of Medical Sciences - University of Campinas, São Paulo, Brazil
| | - I Solar
- Laboratory of Investigation in Metabolism and Diabetes, Gastrocentro, School of Medical Sciences - University of Campinas, São Paulo, Brazil
- School of Applied Sciences - University of Campinas, São Paulo, Brazil
| | - M G Barbosa
- School of Applied Sciences - University of Campinas, São Paulo, Brazil
| | - B Almeida-Pititto
- Department of Preventive Medicine, Federal University of São Paulo, São Paulo, Brazil
| | - B Geloneze
- Laboratory of Investigation in Metabolism and Diabetes, Gastrocentro, School of Medical Sciences - University of Campinas, São Paulo, Brazil
- Obesity and Comorbidities Research Center, University of Campinas, São Paulo, Brazil
| | - S R G Ferreira
- Department of Epidemiology, School of Public Health, University of São Paulo, São Paulo, Brazil.
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16
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Freitas RGBDON, Vasques ACJ, Fernandes GDR, Ribeiro FB, Solar I, Barbosa MG, Pititto BDA, Geloneze B, Ferreira SRG. Associations of Blautia Genus With Early-Life Events and Later Phenotype in the NutriHS. Front Cell Infect Microbiol 2022; 12:838750. [PMID: 35646726 PMCID: PMC9134825 DOI: 10.3389/fcimb.2022.838750] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2021] [Accepted: 04/11/2022] [Indexed: 12/15/2022] Open
Abstract
Introduction Early-life events are associated with the risk of obesity and comorbidities later in life. The gut microbiota—whose composition is influenced by genetics and environmental factors—could be involved. Since the microbiota affects metabolism and fat storage, early-life insults could contribute to the occurrence of obesity driven, in part, by microbiota composition. We examined associations of gut bacteria with early-life events, nutritional status, and body composition in the Nutritionist’s Health Study (NutriHS). Methods A cross-sectional study of 114 female participants examining early-life data, body composition, and biological samples was conducted. Fecal microbiota structure was determined targeting the V4 region of the 16S rRNA gene. Principal coordinates analysis (PCoA) and permutational multivariate analysis of variance (PERMANOVA) were used to test the impact of variables on microbial diversity. Profiles were identified using the Jensen-Shannon divergence matrix and Calinski–Harabasz index. Differential abundance between the categories of exclusive breastfeeding duration and nutritional status was tested using DESeq2. Results In the sample [median age 28 years and body mass index (BMI) 24.5 kg/m2], 2 microbiota profiles driven by the Blautia or Prevotella genus were identified. An estimated 9.1% of the variation was explained by the profiles (p < 0.001), 2.1% by nutritional status (p = 0.004), and 1.8% by exclusive breastfeeding (p = 0.012). The proportion of participants with BMI <25 kg/m2 and who were breastfed for at least 6 months was higher in the Blautia profile (p < 0.05). Conclusion Findings in a Blautia-driven profile of healthy women reinforce that early-life events play a role in defining gut microbiota composition, confirming the importance of exclusive breastfeeding for infant gut colonization in establishing a protective profile against adiposity-related outcomes in adulthood.
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Affiliation(s)
- Renata G. Borges de Oliveira Nascimento Freitas
- Department of Epidemiology, School of Public Health, University of São Paulo, São Paulo, Brazil
- Laboratory of Investigation in Metabolism and Diabetes, Gastrocentro, School of Medical Sciences, University of Campinas, Campinas, Brazil
| | - Ana Carolina J. Vasques
- Laboratory of Investigation in Metabolism and Diabetes, Gastrocentro, School of Medical Sciences, University of Campinas, Campinas, Brazil
- School of Applied Sciences, University of Campinas, Campinas, Brazil
| | | | - Francieli B. Ribeiro
- Laboratory of Investigation in Metabolism and Diabetes, Gastrocentro, School of Medical Sciences, University of Campinas, Campinas, Brazil
- School of Applied Sciences, University of Campinas, Campinas, Brazil
| | - Isabela Solar
- Laboratory of Investigation in Metabolism and Diabetes, Gastrocentro, School of Medical Sciences, University of Campinas, Campinas, Brazil
- School of Applied Sciences, University of Campinas, Campinas, Brazil
| | - Marina G. Barbosa
- School of Applied Sciences, University of Campinas, Campinas, Brazil
| | | | - Bruno Geloneze
- Laboratory of Investigation in Metabolism and Diabetes, Gastrocentro, School of Medical Sciences, University of Campinas, Campinas, Brazil
- Obesity and Comorbidities Research Center, University of Campinas, Campinas, Brazil
| | - Sandra Roberta G. Ferreira
- Department of Epidemiology, School of Public Health, University of São Paulo, São Paulo, Brazil
- *Correspondence: Sandra Roberta G. Ferreira,
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Bizuayehu HM, Harris ML, Chojenta C, Forder PM, Loxton D. Biopsychosocial factors influencing the occurrence and recurrence of preterm singleton births among Australian women: a prospective cohort study. Midwifery 2022; 110:103334. [DOI: 10.1016/j.midw.2022.103334] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2021] [Revised: 03/23/2022] [Accepted: 04/02/2022] [Indexed: 10/18/2022]
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Branda JIF, de Almeida-Pititto B, Bensenor I, Lotufo PA, Ferreira SRG. Low Birth Weight, β-Cell Function and Insulin Resistance in Adults: The Brazilian Longitudinal Study of Adult Health. Front Endocrinol (Lausanne) 2022; 13:842233. [PMID: 35360053 PMCID: PMC8964259 DOI: 10.3389/fendo.2022.842233] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/23/2021] [Accepted: 02/14/2022] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Adverse intrauterine environment-reflected by low birth weight (LBW)-has been linked to insulin resistance and type 2 diabetes later in life. Whether β-cell function reduction and insulin resistance could be detected even in middle-aged adults without overt diabetes is less investigated. We examined the association of LBW with β-cell function and insulin sensitivity in non-diabetic middle-aged adults from the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil). METHODS This is a cross-sectional analysis of 2,634 ELSA-Brasil participants aged between 34 and 59 years, without diabetes. Participants were stratified according to LBW defined as <2.5 kg and their clinical data were compared. HOMA-IR, HOMA-β, HOMA-adiponectin, TyG index, QUICKI and TG/HDL were calculated and their association with LBW were tested using multiple linear regression including adjustments suggested by Directed Acyclic Graphs and propensity score matching was applied. RESULTS The sample (47.4 ± 6.3 years) was composed of 57.5% of women and 9% had LBW. Subjects with LBW and normal-weight reported similar BMI values at the age of 20 years and current BMI was slightly lower in the LBW group. In average, cardiometabolic risk profile and also indexes of β-cell function and insulin sensitivity were within normal ranges. In regression analysis, log-transformed HOMA-β-but not with the other indexes-was associated with LBW (p = 0.014) independent of sex, skin color, prematurity, and family history of diabetes. After applying propensity-score matching in a well-balanced sample, HOMA-AD and TG/HDL indexes were associated with LBW. CONCLUSION The association between LBW and insulin sensitivity markers may occur in healthy middle-aged adults before overt glucose metabolism disturbances. Our data are coherent with the detection of early life events consequent with insulin resistance markers that could contribute to the risk of glucose metabolism disturbances.
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Affiliation(s)
- Julia Ines F. Branda
- Department of Epidemiology, School of Public Health, University of São Paulo, São Paulo, Brazil
- Center of Clinical and Epidemiological Research at University of São Paulo, São Paulo, Brazil
| | - Bianca de Almeida-Pititto
- Center of Clinical and Epidemiological Research at University of São Paulo, São Paulo, Brazil
- Department of Preventive Medicine, Federal University of São Paulo, São Paulo, Brazil
| | - Isabela Bensenor
- Center of Clinical and Epidemiological Research at University of São Paulo, São Paulo, Brazil
- Department of Internal Medicine, Medical School, University of São Paulo, São Paulo, Brazil
| | - Paulo A. Lotufo
- Center of Clinical and Epidemiological Research at University of São Paulo, São Paulo, Brazil
- Department of Internal Medicine, Medical School, University of São Paulo, São Paulo, Brazil
| | - Sandra Roberta G. Ferreira
- Department of Epidemiology, School of Public Health, University of São Paulo, São Paulo, Brazil
- Center of Clinical and Epidemiological Research at University of São Paulo, São Paulo, Brazil
- *Correspondence: Sandra Roberta G. Ferreira,
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Cabiddu G, Longhitano E, Cataldo E, Lepori N, Chatrenet A, Torreggiani M, Attini R, Masturzo B, Rossini M, Versino E, Moroni G, Pani A, Gesualdo L, Santoro D, Piccoli GB. History of Preeclampsia in Patients Undergoing a Kidney Biopsy: A Biphasic, Multiple-Hit Pathogenic Hypothesis. Kidney Int Rep 2021; 7:547-557. [PMID: 35257067 PMCID: PMC8897305 DOI: 10.1016/j.ekir.2021.12.014] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2021] [Revised: 12/01/2021] [Accepted: 12/06/2021] [Indexed: 12/20/2022] Open
Affiliation(s)
- Gianfranca Cabiddu
- Nephrology, Department of Medical Science and Public Health, San Michele Hospital, ARNAS G. Brotzu, University of Cagliari, Cagliari, Italy
| | - Elisa Longhitano
- Unit of Nephrology and Dialysis, Department of Clinical and Experimental Medicine, A.O.U. “G. Martino,” University of Messina, Messina, Italy
| | | | - Nicola Lepori
- Nephrology, Department of Medical Science and Public Health, San Michele Hospital, ARNAS G. Brotzu, University of Cagliari, Cagliari, Italy
| | | | | | - Rossella Attini
- Department of Surgery, Obstetrics, University of Torino, Torino, Italy
| | - Bianca Masturzo
- Department of Surgery, Obstetrics, University of Torino, Torino, Italy
| | | | - Elisabetta Versino
- Department of Clinical and Biological Sciences, University of Torino, Torino, Italy
| | - Gabriella Moroni
- Division of Nephrology and Dialysis, Humanitas Research Hospital, Milan, Italy
| | - Antonello Pani
- Nephrology, Department of Medical Science and Public Health, San Michele Hospital, ARNAS G. Brotzu, University of Cagliari, Cagliari, Italy
| | | | - Domenico Santoro
- Unit of Nephrology and Dialysis, Department of Clinical and Experimental Medicine, A.O.U. “G. Martino,” University of Messina, Messina, Italy
| | - Giorgina Barbara Piccoli
- Néphrologie et Dialyse, Centre Hospitalier, Le Mans, France
- Correspondence: Giorgina Barbara Piccoli, Nephrology and Dialysis Centre Hospitalier Le Mans, 194 Avenue Rubillard, 72037 Le Mans, France.
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20
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Nurses' experiences of working while pregnant: A qualitative descriptive study. Int J Nurs Stud 2021; 124:104092. [PMID: 34689012 DOI: 10.1016/j.ijnurstu.2021.104092] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2020] [Revised: 09/15/2021] [Accepted: 09/20/2021] [Indexed: 11/23/2022]
Abstract
BACKGROUND Healthcare work environments are fraught with occupational hazards that can impact nurse health as well as patient care. However, little is known about how these hazards impact nurse health during pregnancy, and the experiences of nurses in the work environment during pregnancy and upon their return postpartum. OBJECTIVE To describe registered nurses' (RNs') experiences of working while pregnant and returning to work postpartum. Specifically, their experiences related to the work environment and work-related hazards. DESIGN A qualitative descriptive design was utilized to describe nurse experiences at work, occupational hazards during pregnancy, and experiences of returning to work after pregnancy. PARTICIPANTS AND SETTING A convenience sample of twenty nurses working in direct patient care roles across the United States were recruited for virtual semi-structured interviews. METHOD Participants were interviewed using a semi-structured question guide to explore nurse experiences, specifically occupational hazards at work during pregnancy and upon returning to work. Interview transcripts were analyzed using deductive and inductive content analysis. RESULTS Deductive findings for occupational hazards and risks during pregnancy and postpartum included exposure to infectious diseases, imaging, physical tasks (e.g., lifting and performing CPR), cleaning products, patient violence, and medication administration. Inductive thematic findings included: support needed avoid occupational hazards and make necessary modifications; desire to be 'supernurses' and put the patient first even when it meant taking risks for our health and that of their child; and fear of the consequences of occupational hazards and exposures. CONCLUSIONS Occupational hazards experienced by nurses during pregnancy that may impact their health and that of their baby were broader than previously studied. Pregnant nurses should receive education from their healthcare providers early in their pregnancies about the occupational hazards themselves and the potential modifications they should seek. Managers, occupational health and other health system leaders, and policymakers should be aware of occupational hazards for nurses, including pregnant nurses, and support workplace modifications. Future research should focus on assessing the prevalence of these hazards, the longitudinal impact of exposures that can lead to negative consequences for nurse and fetal health, and reducing the risk of exposure to these hazards for pregnant nurses. TWEETABLE ABSTRACT RNs described a variety of occupational hazards of working while pregnant and postpartum. Inconsistent ability to modify work to protect self and baby leads to completing work demands known to be hazardous.
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Abstract
Confounding, selection bias, and measurement error are well-known sources of bias in epidemiologic research. Methods for assessing these biases have their own limitations. Many quantitative sensitivity analysis approaches consider each type of bias individually, although more complex approaches are harder to implement or require numerous assumptions. By failing to consider multiple biases at once, researchers can underestimate-or overestimate-their joint impact. We show that it is possible to bound the total composite bias owing to these three sources and to use that bound to assess the sensitivity of a risk ratio to any combination of these biases. We derive bounds for the total composite bias under a variety of scenarios, providing researchers with tools to assess their total potential impact. We apply this technique to a study where unmeasured confounding and selection bias are both concerns and to another study in which possible differential exposure misclassification and confounding are concerns. The approach we describe, though conservative, is easier to implement and makes simpler assumptions than quantitative bias analysis. We provide R functions to aid implementation.
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Affiliation(s)
- Louisa H. Smith
- Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, MA
| | - Maya B. Mathur
- Quantitative Sciences Unit, Stanford University, Palo Alto, CA
| | - Tyler J. VanderWeele
- Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, MA
- Department of Biostatistics, Harvard T. H. Chan School of Public Health, Boston, MA
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Bidwell P, Sevdalis N, Silverton L, Harris J, Gurol-Urganci I, Hellyer A, Freeman R, van der Meulen J, Thakar R. Women's experiences of the OASI Care Bundle; a package of care to reduce severe perineal trauma. Int Urogynecol J 2021; 32:1807-1816. [PMID: 33475817 PMCID: PMC8295065 DOI: 10.1007/s00192-020-04653-2] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2020] [Accepted: 12/10/2020] [Indexed: 02/03/2023]
Abstract
INTRODUCTION AND HYPOTHESIS Obstetric anal sphincter injury (OASI) is a severe form of perineal trauma that can occur during vaginal birth. Long-term morbidities include anal incontinence and psychosocial disorders. To reduce these injuries within England, Scotland and Wales, the OASI Care Bundle was introduced to 16 maternity units (January 2017-March 2018). The OASI Care Bundle comprises four elements: (1) antenatal information, (2) manual perineal protection, (3) medio-lateral episiotomy (when indicated) and 4) recognition and diagnosis of tears. As part of the project evaluation, a qualitative study was conducted to explore women's experiences of the OASI Care Bundle. METHODS Semi-structured interviews were conducted with women (n = 19) who received the OASI Care Bundle as part of their maternity care. This was to explore their experience of each element. A thematic analysis of the interview data was performed. RESULTS Three themes were identified: (1) memories of touch, whereby women reported that a 'hands-on' approach to perineal protection was a positive experience; (2) midwife as a supportive guide, where women reported that good communication facilitated a calm birth and post-birth diagnosis; (3) education: women need more information about perineal trauma. CONCLUSION This study contributes to the literature through its exploration of women's experiences of perineal protection techniques and diagnosis of perineal trauma. Interviewed women indicated that they did not experience any of the care bundle elements as an intrusion of their physical integrity. Additionally, an urgent need was identified for more information about perineal trauma in terms of risk, prevention and recovery.
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Affiliation(s)
- Posy Bidwell
- Centre for Quality Improvement and Clinical Audit, Royal College of Obstetricians and Gynaecologists, 10-18 Union Street, London, SE1 1SZ, UK.
| | - Nick Sevdalis
- Health Service and Population Research Department, King's College London, De Crespingy Park, London, SE5 8AF, UK
| | - Louise Silverton
- Royal College of Midwives, 10-18 Union Street, London, SE1 1SZ, UK
| | - James Harris
- Chelsea and Westminster Hospital, 369 Fulham Road, London, SW10 9NH, UK
| | - Ipek Gurol-Urganci
- Centre for Quality Improvement and Clinical Audit, Royal College of Obstetricians and Gynaecologists, 10-18 Union Street, London, SE1 1SZ, UK
- Department of Health Services Research and Policy, London School of Hygiene and Tropical Medicine, 15-17 Tavistock Place, London, WC1H 9SH, UK
| | - Alexandra Hellyer
- Centre for Quality Improvement and Clinical Audit, Royal College of Obstetricians and Gynaecologists, 10-18 Union Street, London, SE1 1SZ, UK
| | - Robert Freeman
- University Hospitals Plymouth NHS Trust, Derriford Road, Devon, PL6 8DH, UK
| | - Jan van der Meulen
- Department of Health Services Research and Policy, London School of Hygiene and Tropical Medicine, 15-17 Tavistock Place, London, WC1H 9SH, UK
| | - Ranee Thakar
- Croydon Health Services NHS Trust, 530 London Road, Croydon, CR7 7YE, UK
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23
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Schneider BC, Menezes AMB, Wehrmeister FC, Gonçalves H. Gestational weight gain and childhood body mass index across three generations: Results from the 1993 Pelotas (Brazil) Birth Cohort. Pediatr Obes 2021; 16:e12760. [PMID: 33496054 DOI: 10.1111/ijpo.12760] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/09/2020] [Revised: 11/13/2020] [Accepted: 11/16/2020] [Indexed: 12/16/2022]
Abstract
BACKGROUND Gestational weight gain (GWG) has been associated with the accumulation of body fat in offspring, but little is known about the intergenerational relationship. OBJECTIVE To assess the effect of GWG in grandmothers and mothers on the child's body mass index (BMI). METHODS This is a sub-study nested in the 1993 Pelotas (Brazil) Birth Cohort at 22 years follow-up visit. We calculated the BMI-for-age z-score (BAZ) and evaluated overweight (>2 SD in ≤5 years of age and >1 SD for >5 years of age for BAZ). Grandmothers' and mothers' GWG were calculated as the difference between weight in the beginning of pregnancy and the last recorded weight before delivery. We standardized the GWG by adjusting for pre-gestational BMI. We also categorized GWG as adequate, excessive, or insufficient, in accordance with the Institute of Medicine (2009). Linear and logistic regressions stratified by child's age (≤2 years; 2.01-5 years; >5 years) were used. Structural equations were modelled to calculate the total, indirect, and direct effects of grandmothers' and mothers' GWG on children's BAZ. RESULTS Nine hundred and forty-six out of 1113 children evaluated were 5 years of age or under. There was an indirect effect (through maternal birthweight, maternal pre-gestational BMI, maternal GWG, and child birthweight) of grandmother GWG on grandchild BAZ, from 2.01 to 5 years of age [β = 0.12 95% CI: 0.04-0.20 (P < 0.01)]. Maternal GWG directly increased the child's BAZ at >5 years of age [β = 0.34 95% CI: 0.15-0.53 (P < 0.001)]. CONCLUSIONS GWG's effect on BMI does seem to be transmitted across three generations. Managing this will require health education during the gestational period for women and their families.
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Affiliation(s)
- Bruna C Schneider
- Postgraduate Program in Epidemiology, Universidade Federal de Pelotas, Pelotas, Brazil
| | - Ana M B Menezes
- Postgraduate Program in Epidemiology, Universidade Federal de Pelotas, Pelotas, Brazil
| | | | - Helen Gonçalves
- Postgraduate Program in Epidemiology, Universidade Federal de Pelotas, Pelotas, Brazil
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Jurczuk M, Bidwell P, Gurol-Urganci I, van der Meulen J, Sevdalis N, Silverton L, Thakar R. The OASI care bundle quality improvement project: lessons learned and future direction. Int Urogynecol J 2021; 32:1989-1995. [PMID: 33988784 PMCID: PMC8295109 DOI: 10.1007/s00192-021-04786-y] [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: 01/20/2021] [Accepted: 03/24/2021] [Indexed: 12/11/2022]
Abstract
Rising rates of obstetric anal sphincter injury (OASI) led to a collaborative effort by the Royal College of Obstetricians and Gynaecologists (RCOG) and the Royal College of Midwives (RCM) to develop and evaluate the OASI Care Bundle (OASI-CB). The OASI-CB comprises four practices (antenatal discussion about OASI, manual perineal protection, mediolateral episiotomy at 60° from the midline, and systematic examination of the perineum, vagina and ano-rectum after vaginal birth) and was initially implemented as part of a quality improvement (QI) project—“OASI1”—in 16 maternity units across Great Britain. Evaluation of the OASI1 project found that the care bundle reduced OASI rates and identified several barriers and enablers to implementation. This paper summarises the key findings, including strengths, limitations and lessons learned from the OASI1 QI project, and provides rationale for further evaluation of the OASI-CB.
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Affiliation(s)
- Magdalena Jurczuk
- Centre for Quality Improvement and Clinical Audit, Royal College of Obstetricians and Gynaecologists, 10-18 Union Street, London, SE1 1SZ, UK.
| | - Posy Bidwell
- Centre for Quality Improvement and Clinical Audit, Royal College of Obstetricians and Gynaecologists, 10-18 Union Street, London, SE1 1SZ, UK
| | - Ipek Gurol-Urganci
- Centre for Quality Improvement and Clinical Audit, Royal College of Obstetricians and Gynaecologists, 10-18 Union Street, London, SE1 1SZ, UK.,Department of Health Services Research and Policy, London School of Hygiene and Tropical Medicine, 15-17 Tavistock Place, London, WC1H 9SH, UK
| | - Jan van der Meulen
- Department of Health Services Research and Policy, London School of Hygiene and Tropical Medicine, 15-17 Tavistock Place, London, WC1H 9SH, UK
| | - Nick Sevdalis
- Centre for Implementation Science, Health Service and Population Research Department, King's College London, De Crespigny Park, London, SE5 8AF, UK.
| | - Louise Silverton
- Royal College of Midwives, 10-18 Union Street, London, SE1 1SZ, UK
| | - Ranee Thakar
- Croydon University Hospitals NHS Trust, 530 London Road, Croydon, CR7 7YE, UK
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Nasreen S, Wilk P, Mullowney T, Karp I. The effect of gestational diabetes mellitus on the risk of asthma in offspring. Ann Epidemiol 2021; 57:7-13. [PMID: 33596445 DOI: 10.1016/j.annepidem.2021.02.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2020] [Revised: 12/14/2020] [Accepted: 02/09/2021] [Indexed: 11/20/2022]
Abstract
PURPOSE To examine the effect of maternal gestational diabetes mellitus on the risk of asthma in the offspring. METHODS This cohort study used data from 19,933 children in the National Longitudinal Survey of Children and Youth (NLSCY), 1994/1995-2008/2009, Canada. Children were followed until the first-time report of having health professional-diagnosed asthma (hereafter incident asthma), loss to follow-up, or end of the NLSCY follow-up, whichever occurred first. As a surrogate for Cox proportional hazards regression, pooled logistic regression models, crude and adjusted for potential confounders, were fitted to estimate the effect of gestational diabetes mellitus on the risk of asthma in the offspring. RESULTS Among the 19,933 children, 1,178 (5.9%) had mothers with gestational diabetes mellitus. The median duration of follow-up was 4 (interquartile range: 4) years. A total of 1639 children in the cohort had reported incident asthma during the follow-up, and 119 of them had mothers with gestational diabetes mellitus. The adjusted hazard ratio for the association between gestational diabetes mellitus and incident asthma in offspring was 1.25 (95% confidence interval [CI] 1.03, 1.51). CONCLUSIONS Our findings suggest that gestational diabetes mellitus increases the risk of asthma in the offspring.
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Affiliation(s)
- Sharifa Nasreen
- Department of Epidemiology and Biostatistics, Schulich School of Medicine and Dentistry, Western University, London, ON, Canada.
| | - Piotr Wilk
- Department of Epidemiology and Biostatistics, Schulich School of Medicine and Dentistry, Western University, London, ON, Canada
| | - Tara Mullowney
- Department of Pediatrics, Schulich School of Medicine and Dentistry, Western University, London, ON, Canada
| | - Igor Karp
- Department of Epidemiology and Biostatistics, Schulich School of Medicine and Dentistry, Western University, London, ON, Canada; Department of Social and Preventive Medicine, School of Public Health, University of Montreal, Montreal, QC, Canada
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Lukacz ES, Constantine ML, Kane Low L, Lowder JL, Markland AD, Mueller ER, Newman DK, Rickey LM, Rockwood T, Rudser K. Rationale and design of the validation of bladder health instrument for evaluation in women (VIEW) protocol. BMC WOMENS HEALTH 2021; 21:18. [PMID: 33413284 PMCID: PMC7789348 DOI: 10.1186/s12905-020-01136-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/10/2020] [Accepted: 11/24/2020] [Indexed: 12/04/2022]
Abstract
Background Bladder health is an understudied state and difficult to measure due to lack of valid and reliable instruments. While condition specific questionnaires assess presence, severity and degree of bother from lower urinary tract symptoms, the absence of symptoms is insufficient to assume bladder health. This study describes the methodology used to validate a novel bladder health instrument to measure the spectrum of bladder health from very healthy to very unhealthy in population based and clinical research.
Methods Three samples of women are being recruited: a sample from a nationally representative general population and two locally recruited clinical center samples—women with a targeted range of symptom severity and type, and a postpartum group. The general population sample includes 694 women, 18 years or older, randomly selected from a US Postal delivery sequence file. Participants are randomly assigned to electronic or paper versions of the bladder health instrument along with a battery of criterion questionnaires and a demographic survey; followed by a retest or a two-day voiding symptom diary. A total of 354 women around 7 clinical centers are being recruited across a spectrum of self-reported symptoms and randomized to mode of completion. They complete the two-day voiding symptom diary as well as a one-day frequency volume diary prior to an in-person evaluation with a standardized cough stress test, non-invasive urine flowmetry, chemical urine analysis and post void residual measurement. Independent judge ratings of bladder health are obtained by interview with a qualified health care provider. A total of 154 postpartum women recruited around 6 of the centers are completing similar assessments within 6–12 weeks postpartum. Dimensional validity will be evaluated using factor analysis and principal components analysis with varimax rotation, and internal consistency with Cronbach’s alpha. Criterion validity will be assessed using multitrait-multimethod matrix including correlations across multiple data sources and multiple types of measures. Discussion We aim to validate a bladder health instrument to measure the degree of bladder health within the general population and among women (including postpartum) recruited from local clinical centers.
Trial registration NCT04016298 Posted July 11, 2019 (https://www.clinicaltrials.gov/ct2/show/NCT04016298?cond=bladder+health&draw=2&rank=1).
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Affiliation(s)
- Emily S Lukacz
- Division of Female Pelvic Medicine and Reconstructive Surgery, University of California San Diego, San Diego, CA, USA. .,Department of Obstetrics, Gynecology and Reproductive Sciences, UC San Diego Health, 9500 Gilman Dr. #0971, La Jolla, CA, 92093, USA.
| | | | - Lisa Kane Low
- Practice and Professional Graduate Programs, School of Nursing, University of Michigan, Ann Arbor, MI, USA
| | - Jerry L Lowder
- Division of Female Pelvic Medicine and Reconstructive Surgery, Washington University in St. Louis, St. Louis, MO, USA
| | - Alayne D Markland
- Division of Gerontology, Geriatrics, and Palliative Care, Department of Medicine, University of Alabama At Birmingham, Birmingham, AL, USA.,Department of Veterans Affairs, Birmingham/Atlanta Geriatric Research, Education, and Clinical Center (GRECC), Birmingham, AL, USA
| | - Elizabeth R Mueller
- Division of Female Pelvic Medicine and Reconstructive Surgery, Loyola University Medical Center, Loyola University Chicago, Maywood, IL, USA
| | - Diane K Newman
- Division of Urology, Department of Surgery, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | - Leslie M Rickey
- Departments of Urology and Obstetrics, Gynecology and Reproductive Sciences, Yale University, New Haven, CT, USA
| | - Todd Rockwood
- Division of Health Policy and Management, University of Minnesota, Minneapolis, MN, USA
| | - Kyle Rudser
- Division of Biostatistics, University of Minnesota, Minneapolis, MN, USA
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Pre-pregnancy BMI is associated with offspring body composition in adulthood before adiposity-related disorders: a retrospective cohort. Public Health Nutr 2020; 24:1296-1303. [PMID: 33357251 DOI: 10.1017/s1368980020005285] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
OBJECTIVE To investigate the association between maternal pre-pregnancy BMI and offspring body composition in adulthood. DESIGN Retrospective cohort. Undergraduates of nutrition or nutritionists were recruited at the baseline of the Nutritionists' Health Study between 2014 and 2017. Maternal pre-pregnancy BMI and current life aspects were self-reported through online questionnaires. Three body compartments were dual-energy x-ray absorptiometry-determined. The following variables were obtained: body fat (%), fat mass index (FMI) (kg/m2), android-to-gynoid fat ratio, visceral adipose tissue (VAT) (cm3), appendicular skeletal muscle mass index (ASMI) (kg/m2), total bone and femur mineral content (g) and density (g/cm2). Linear regression adjusted according to directed acyclic graphs recommendation was performed. SETTING São Paulo, Brazil. PARTICIPANTS Healthy non-pregnant women (aged 20-45 years) (n 150). RESULTS Median age and BMI were 22 years (IQR = 20, 29) and 22·3 kg/m2 (IQR = 20·4, 25·3), respectively. Pre-pregnancy BMI ≥ 25 kg/m2 was reported by 14·7 % of mothers. In fully adjusted models, maternal pre-pregnancy BMI was associated with their daughters' body fat % (β = 0·31; 95 % CI 0·0004, 0·63), FMI (β = 0·17; 95 % CI 0·03, 0·30), android-to-gynoid ratio (β = 0·01; 95 % CI 0·004, 0·02) and VAT (β = 0·09; 95 % CI 0·02, 0·16), but not with total bone density (β = 0·001; 95 % CI -0·003, 0·006) and content (β = 7·13; 95 % CI -4·19, 18·46). Direct association with ASMI was also detected, but lost statistical significance when participants whose mothers were underweight were excluded. CONCLUSIONS Maternal pre-pregnancy BMI was directly associated with offspring general and visceral adiposity but seems not to be associated with bone mass. Results reinforce importance of avoiding excess of maternal adiposity, as an attempt to break the vicious cycle of obesity transmission.
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Freitas RGBDON, Vasques ACJ, Ribeiro FB, Solar I, Hanada AS, Barbosa MG, Valente AMM, Pititto BDA, Lopes TLDC, Geloneze B, Ferreira SRG. Maternal and paternal obesity are associated with offspring obestatin levels in the Nutritionists' Health Study. Nutrition 2020; 83:111067. [PMID: 33348107 DOI: 10.1016/j.nut.2020.111067] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2020] [Revised: 10/27/2020] [Accepted: 11/05/2020] [Indexed: 12/15/2022]
Abstract
OBJECTIVES The aim of this study was to examine whether paternal and maternal body mass indexes (BMIs) were independently associated with obestatin and visfatin levels in adult offspring. METHODS This cross-sectional analysis included 124 women who participated in the Nutritionists' Health Study (NutriHS) at baseline. Early life events, anthropometry, dual-energy x-ray absorptiometry-determined body composition and blood sample were obtained. Associations of parental BMI with outcomes (obestatin and visfatin) were tested by multiple linear regression, using minimal sufficient adjustments recommended by Directed Acyclic Graph. Participants' mean BMI was 25 ± 5 kg/m2 and 74% were metabolically healthy. Median obestatin and visfatin levels were 56.4 pg/mL (42-72) and 17.7 ng/mL (14-21.8), respectively. Eleven percent of mothers and 39% of fathers were overweight/obese. RESULTS Daughters born from overweight/obese mothers had higher BMI than those born from normal weight women (P = 0.003). In adjusted regression model, offspring obestatin levels were associated with maternal BMI (β = -0.03; P = 0.045) and paternal BMI (β = -0.02; P = 0.048) independently of maternal and paternal education, maternal age, and maternal use of tobacco, alcohol, and/or drugs. No association was detected with visfatin levels. CONCLUSION Inverse associations of maternal and paternal BMIs with offspring obestatin concentrations in women could suggest a utility of this biomarker of energy regulation determined in early adulthood. Whether obestatin could be an indicator of protection against obesity-related disorders in the life course requires investigation in studies designed to test such hypothesis.
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Affiliation(s)
- Renata Germano Borges de Oliveira Nascimento Freitas
- Department of Epidemiology, School of Public Health, University of São Paulo, Brazil; Laboratory of Investigation in Metabolism and Diabetes, Gastrocentro, School of Medical Sciences, University of Campinas, Brazil
| | - Ana Carolina Junqueira Vasques
- Laboratory of Investigation in Metabolism and Diabetes, Gastrocentro, School of Medical Sciences, University of Campinas, Brazil; School of Applied Sciences, University of Campinas, Brazil
| | - Francieli Barreiro Ribeiro
- Laboratory of Investigation in Metabolism and Diabetes, Gastrocentro, School of Medical Sciences, University of Campinas, Brazil; School of Applied Sciences, University of Campinas, Brazil
| | - Isabela Solar
- Laboratory of Investigation in Metabolism and Diabetes, Gastrocentro, School of Medical Sciences, University of Campinas, Brazil; School of Applied Sciences, University of Campinas, Brazil
| | - Alfredo Shigueo Hanada
- Laboratory of Investigation in Metabolism and Diabetes, Gastrocentro, School of Medical Sciences, University of Campinas, Brazil; School of Applied Sciences, University of Campinas, Brazil
| | | | | | | | | | - Bruno Geloneze
- Laboratory of Investigation in Metabolism and Diabetes, Gastrocentro, School of Medical Sciences, University of Campinas, Brazil; Obesity and Comorbidities Research Center, University of Campinas, Brazil
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Birth weight associated with dual energy X-ray absorptiometry-determined muscle-bone unit in young healthy women from the Nutritionists' Health Study. J Dev Orig Health Dis 2020; 12:42-49. [PMID: 31902386 DOI: 10.1017/s2040174419000874] [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: 01/17/2023]
Abstract
Muscle and bone have been considered a functional unit that grows together early in life, deteriorates with aging, and can cause osteosarcopenia. Due to its importance in public health, detecting risk factors in early life is desirable. This study examined whether birth weight (BW) was associated with muscle-bone unit using dual energy X-ray absorptiometry (DXA) parameters in young women from the Nutritionists' Health Study (NutriHS), a cohort study of undergraduates and Nutrition graduates. This cross-sectional analysis included 170 young healthy women who answered early life events-questionnaire, and had anthropometric, muscle tests and DXA-determined body composition and bone densitometry (iDXA-Lunar®). A blood sample was obtained for a subsample of 148 participants. Appendicular skeletal muscle mass index (ASMI) was calculated. BW was categorized in quartiles (BWq) and variables of interest compared by ANOVA. Associations of BWq with calf circumference (CC), handgrip, muscle performance tests, ASMI, bone mineral density and content (BMD and BMC), and plasma glucose, lipids, insulin, and 25-hydroxyvitamin D were performed using multiple linear regression and directed acyclic graph-recommended adjustments. Mean values of age, body mass index, and BW were 23.0 years (20.0-28.0), 22.9 ± 2.9 kg/m2, and 3199 ± 424 g, respectively. Comparing variables across BWq, significant differences in CC, handgrip, ASMI, and total body BMC were detected. Regression models adjusted for confounders showed associations of BWq with CC (β = 0.72, p = 0.005), handgrip (β = 1.53, p = 0.001), ASMI (β = 0.16, p = 0.022), total body BMC (β = 64.8, p = 0.005), total femur BMC (β = 0.70, p = 0.041), total body BMD (β = 0.02, p = 0.043), and lumbar spine BMD (β = 0.03, p = 0.028). We conclude that BW is associated with muscle-bone unit using DXA-parameters in Brazilian young healthy women from the NutriHS, suggesting a role for intrauterine environment for musculoskeletal health.
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Mazul AL, Weinberg CR, Engel SM, Siega-Riz AM, Zou F, Carrier KS, Basta PV, Vaksman Z, Maris JM, Diskin SJ, Maxen C, Naranjo A, Olshan AF. Neuroblastoma in relation to joint effects of vitamin A and maternal and offspring variants in vitamin A-related genes: A report of the Children's Oncology Group. Cancer Epidemiol 2019; 61:165-171. [PMID: 31279991 PMCID: PMC6730673 DOI: 10.1016/j.canep.2019.06.009] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2019] [Revised: 06/14/2019] [Accepted: 06/19/2019] [Indexed: 11/16/2022]
Abstract
BACKGROUND There is evidence vitamin A plays a role in neuroblastoma. Not only is 13-cis-retinoic acid used as maintenance therapy for high-risk cases, but prenatal vitamin intake use may decrease neuroblastoma risk. We hypothesized that single nucleotide polymorphisms (SNPs) in vitamin A-related genes are may be associated with neuroblastoma risk and potentially be modified by vitamin A intake. METHODS The Neuroblastoma Epidemiology in North America (NENA) study recruited 563 case-parent sets through the Children's Oncology Group's Childhood Cancer Research Network. We ascertained dietary nutrient intake through questionnaires and genotyped 463 SNPs in vitamin A-related genes from saliva DNA. Offspring and maternal log-additive risk ratios (RR) and stratum-specific RR for gene-environment interaction were estimated with a log-linear model. We avoided false positives due to multiple testing by using the false discovery rate (FDR). RESULTS When all neuroblastoma cases were considered together, no offspring variants met the significance criteria (FDR Q-value < 0.2). One maternal SNP (rs12442054) was associated with decreased risk of neuroblastoma (RR: 0.61; 95% Confidence Interval (CI): 0.47-0.79, Q = 0.076). When the cases were categorized according to prognostic risk category and age at onset, nine offspring SNPs were significantly associated with intermediate-risk neuroblastoma. Maternal rs6776706 was associated with (RR: 0.49; 95% CI: 0.33-0.72, Q = 0.161) high-risk neuroblastoma and maternal rs11103603 (RR: 0.60; 95% CI: 0.45-0.79, Q = 0.127) was associated with neuroblastoma aged <1 year. For gene-environment interaction, maternal rs729147 was associated with decreased risk of neuroblastoma among mothers with vitamin A consumption above the recommendation. CONCLUSIONS Although there is biologic plausibility for the role of vitamin A in neuroblastoma, we found weak evidence of a relationship between vitamin A related genes and neuroblastoma.
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Affiliation(s)
- Angela L Mazul
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, United States; Department of Otolaryngology, Washington University School of Medicine, St Louis, MO, 63110.
| | - Clarice R Weinberg
- Biostatistics and Computational Biology Branch, National Institute of Environmental Health Sciences Durham, NC, United States
| | - Stephanie M Engel
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, United States
| | - Anna Maria Siega-Riz
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, United States; Department of Nutrition, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, United States
| | - Fei Zou
- Department of Biostatistics, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, United States
| | - Kathryn S Carrier
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, United States
| | - Patricia V Basta
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, United States; Biospecimen Processing Center, University of North Carolina, Chapel Hill, NC, United States
| | - Zalman Vaksman
- Division of Oncology and Center for Childhood Cancer Research, Children's Hospital of Philadelphia, Philadelphia, PA, United States; Department of Biomedical and Health Informatics, Children's Hospital of Philadelphia, Philadelphia, PA, United States
| | - John M Maris
- Division of Oncology and Center for Childhood Cancer Research, Children's Hospital of Philadelphia, Philadelphia, PA, United States; Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States
| | - Sharon J Diskin
- Division of Oncology and Center for Childhood Cancer Research, Children's Hospital of Philadelphia, Philadelphia, PA, United States; Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States
| | - Charlene Maxen
- Showers Center for Childhood Cancer and Blood Disorder, Akron Children's Hospital, Akron, OH, United States
| | - Arlene Naranjo
- Department of Biostatistics, Colleges of Medicine and Public Health & Health Professions, University of Florida, Children's Oncology Group Statistics & Data Center, Gainesville, FL, United States
| | - Andrew F Olshan
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, United States
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Breastfeeding duration is associated with offspring’s adherence to prudent dietary pattern in adulthood: results from the Nutritionist’s Health Study. J Dev Orig Health Dis 2019; 11:136-145. [DOI: 10.1017/s204017441900031x] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
AbstractLittle is known about the long-term effect of breastfeeding on dietary habits. We examined the association between breastfeeding duration and adherence to current dietary patterns of young women. This was a cross-sectional analysis of 587 healthy women aged ≤45 years, undergraduates or nutrition graduates. Maternal characteristics and breastfeeding duration [<6; 6–<12; ≥12 months (reference)] were recalled. Diet was assessed using a food frequency questionnaire and patterns were identified using factor analysis by principal component. Adherence to patterns was categorized in tertiles; the first (T1 = reference) was compared to T2 + T3 (moderate-to-high adherence). Logistic regression was performed considering the minimal sufficient adjustment recommended by the directed acyclic graph. Median age was 22 (interquartile range (IQR) 20; 27) years and body mass index (BMI) 22.2 (IQR 20.4; 25.0) kg/m2. The four dietary patterns identified (Processed, Prudent, Brazilian and Lacto-vegetarian) explained 27% of diet variance. Women breastfed for <6 months showed lower chance of moderate-to-high adherence to the Prudent pattern (odds ratio (OR) = 0.53, p = 0.04). Breastfeeding was not associated with the other patterns. Maternal pre-pregnancy BMI was directly associated with moderate-to-high adherence to the Processed pattern (OR = 2.01, p = 0.03) and inversely to the Prudent pattern (OR = 0.52, p = 0.02). Higher adherence to the Brazilian pattern was associated with proxies of low socioeconomic status and the Lacto-vegetarian pattern with the opposite. Confirmation in prospective studies of the association found in this study between breastfeeding with the Prudent pattern in adult offspring could suggest that early feeding practices influence long-term dietary habits, which could then affect the risk of nutrition-related diseases.
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Oliverio AL, Zee J, Mariani LH, Reynolds ML, O'Shaughnessy M, Hendren EM, Alachkar N, Herreshoff E, Rizk DV, Nester CM, Steinke J, Twombley KE, Hladunewich MA. Renal Complications in Pregnancy Preceding Glomerulonephropathy Diagnosis. Kidney Int Rep 2018; 4:159-162. [PMID: 30596179 PMCID: PMC6308828 DOI: 10.1016/j.ekir.2018.10.012] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2018] [Revised: 09/20/2018] [Accepted: 10/15/2018] [Indexed: 11/24/2022] Open
Affiliation(s)
- Andrea L Oliverio
- Division of Nephrology, Department of Internal Medicine, University of Michigan, Ann Arbor, Michigan, USA
| | - Jarcy Zee
- Arbor Research Collaborative for Health, Ann Arbor, Michigan, USA
| | - Laura H Mariani
- Division of Nephrology, Department of Internal Medicine, University of Michigan, Ann Arbor, Michigan, USA.,Arbor Research Collaborative for Health, Ann Arbor, Michigan, USA
| | - Monica L Reynolds
- Division of Nephrology, Department of Internal Medicine, University of North Carolina, Chapel Hill, North Carolina, USA
| | - Michelle O'Shaughnessy
- Division of Nephrology, Department of Medicine, Stanford University, Palo Alto, California, USA
| | - Elizabeth M Hendren
- Division of Nephrology, Department of Medicine, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada
| | - Nada Alachkar
- Division of Nephrology, Department of Medicine, The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Emily Herreshoff
- Department of Pediatrics and Communicable Diseases, University of Michigan, Ann Arbor, Michigan, USA
| | - Dana V Rizk
- Division of Nephrology, Department of Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Carla M Nester
- Division of Nephrology, Departments of Internal Medicine and Pediatrics, University of Iowa, Iowa City, Iowa, USA
| | - Julia Steinke
- Helen DeVos Children's Hospital, Grand Rapids, Michigan, USA
| | - Katherine E Twombley
- Division of Nephrology, Department of Pediatrics, Medical University of South Carolina, Charleston, South Carolina, USA
| | - Michelle A Hladunewich
- Division of Nephrology, Department of Medicine, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada
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