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Navaee M, Kashanian M, Kabir A, Zamaninour N, Chamari M, Pazouki A. Maternal and fetal/neonatal outcomes in pregnancy, delivery and postpartum following bariatric surgery and comparison with pregnant women with obesity: a study protocol for a prospective cohort. Reprod Health 2024; 21:8. [PMID: 38233940 PMCID: PMC10795358 DOI: 10.1186/s12978-023-01736-3] [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: 12/14/2023] [Accepted: 12/29/2023] [Indexed: 01/19/2024] Open
Abstract
BACKGROUND Being obese can lead to various complications during pregnancy, such as Gestational Diabetes Mellitus (GDM), pregnancy induced hypertension (PIH), Pre-Eclampsia (PE), and Large Gestational Age (LGA). Although bariatric surgery is an effective way to treat obesity, it can also result in complications and may be linked to having small for gestational age (SGA) babies. This cohort study protocol aims to compare the maternal and fetal/neonatal outcomes of two groups of Iranian pregnant women: those who have undergone bariatric surgery and those who are obese but have not had bariatric surgery. METHODS In this study Pregnant women (< 14 weeks' gestation) (n = 38 per group) are recruited either from one of the obesity clinic (exposure group = with a history of bariatric surgery) or primary healthcare clinics in Tehran city (comparison group = pregnant women with obesity and and no history of bariatric surgery). Dietary intake and nutrient status are assessed at < 14, 28, and 36 weeks. Maternal and fetal/neonatal outcomes are compared between the two groups, including gestational diabetes, preeclampsia, preterm labor, intrauterine growth restriction, severe nausea and vomiting, abortion, placenta previa and abruption, venous thrombosis, vaginal bleeding, cesarean delivery, meconium aspiration, and respiratory distress. Maternal serum levels of ferritin, albumin, zinc, calcium, magnesium, selenium, copper, vitamins A, B9, B12, and 25-hydroxy Vit D are checked during 24th to 28th weeks. Maternal and neonatal outcomes, including height, weight, head circumference, fetal abnormality, infection, small or large fetus, low birth weight, macrosomia, NICU admission, and total weight gain during pregnancy, are measured at birth. Maternal and offspring outcomes, including weight, height, head circumference, total weight gain during pregnancy, newborn diseases, postpartum bleeding, breastfeeding, and related problems, are assessed 6 weeks after delivery. Child's weight, height, and head circumference are followed at 2, 4, 6, 8, 10, and 12 months after birth. Maternal stress, anxiety, and depression are assessed with the DASS-21 questionnaire, and physical activity is evaluated using the PPAQ questionnaire in the first and third trimesters. DISCUSSION By assessing the levels of micronutrients in the blood of pregnant women along with the evaluation of pregnancy outcomes, it is feasible to gain a more accurate understanding of how bariatric surgery affects the health and potential complications for both the mother and the fetus/newborn. This information can help specialists and patients make more informed decisions about the surgery. Additionally, by examining issues such as stress, anxiety, and depression in women undergoing surgery, this study can contribute to recognizing these problems, which can also affect pregnancy outcomes.
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Affiliation(s)
- Maryam Navaee
- Minimally Invasive Surgery Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Maryam Kashanian
- Minimally Invasive Surgery Research Center, Iran University of Medical Sciences, Tehran, Iran
- Department of Obstetrics and Gynecology, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Ali Kabir
- Minimally Invasive Surgery Research Center, Iran University of Medical Sciences, Tehran, Iran.
| | - Negar Zamaninour
- Minimally Invasive Surgery Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Maryam Chamari
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | - Abdolreza Pazouki
- Minimally Invasive Surgery Research Center, Iran University of Medical Sciences, Tehran, Iran
- Center of Excellence of European Branch of International Federation for Surgery of Obesity, Tehran, Iran
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Gerges S, Obeid S, Hallit S. Traversing mental health disorders during pregnancy: Lebanese women's experiences of antepartum depression and anxiety. Ir J Med Sci 2023; 192:2949-2959. [PMID: 37081286 PMCID: PMC10117264 DOI: 10.1007/s11845-023-03371-0] [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: 07/23/2022] [Accepted: 04/11/2023] [Indexed: 04/22/2023]
Abstract
INTRODUCTION Over the past few years, Lebanon-a developing country-has faced a plethora of economic and political challenges, with more than half of the general population presenting depressive and anxiety symptoms. However, when it comes to maternal mental health during pregnancy, the last examination in Lebanon dates far back to 2005. Our study's aim was to help delineate the factors associated with Lebanese women's mental health disorders during pregnancy, namely antepartum depression and anxiety. METHODS We launched a cross-sectional study among Lebanese pregnant women (age ≥ 18 years) between June and July 2021, during the COVID-19 lockdown (N = 433). RESULTS In total, 87.8% of the participants experienced depression (mild to severe), where severe depression was observed in 7.9%. In addition, 70.3% had a significant level of anxiety. Increased pregnancy-specific hassles (beta = 0.93), being Muslim compared to Christians (beta = 3.19), being afraid of an existing aggressor (beta = 8.75), urinary tract infections (beta = 2.02), and higher gestational age (beta = 0.07) were significantly associated with higher depression, whereas higher physical activity index (beta = - 0.09) and increased disordered eating attitudes during pregnancy (beta = - 0.27) were significantly associated with less depression, all accounting for 60.4% of the model's variance. Additionally, increased pregnancy-specific hassles (beta = 0.54), being Muslim compared to Christians (beta = 2.42), urinary tract infections (beta = 1.72), and having been emotionally or physically abused (beta = 1.19) were significantly associated with higher levels of anxiety and could predict 49% of the total variance. CONCLUSION Our study has suggested the existence of factors that have additive effects in potentiating the risk for depression and anxiety among Lebanese pregnant women, namely cultural beliefs, pregnancy-related distress, medical complications during pregnancy, and a history of abuse. Therefore, it would be judicious to implement screening programs targeting pregnant women at risk for antepartum depression and anxiety. In addition, high rates of prenatal depression and anxiety were detected among our sample, supporting that recognizing and treating maternal mental health disorders should be prioritized during antenatal care in Lebanon.
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Affiliation(s)
- Sarah Gerges
- School of Medicine and Medical Sciences, Holy Spirit University of Kaslik, P.O. Box 446, Jounieh, Lebanon
| | - Sahar Obeid
- Social and Education Sciences Department, School of Arts and Sciences, Lebanese American University, Jbeil, Lebanon
| | - Souheil Hallit
- School of Medicine and Medical Sciences, Holy Spirit University of Kaslik, P.O. Box 446, Jounieh, Lebanon
- Research Department, Psychiatric Hospital of the Cross, Jal-Eddib, Lebanon
- Applied Science Research Center, Applied Science Private University, Amman, Jordan
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Van Assche IA, Lemiere J, Amant F, Van Calsteren K. Direct and indirect effects on child neurocognitive development when maternal cancer is diagnosed during pregnancy: What do we know so far? Crit Rev Oncol Hematol 2022; 179:103824. [PMID: 36174901 DOI: 10.1016/j.critrevonc.2022.103824] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Revised: 09/23/2022] [Accepted: 09/23/2022] [Indexed: 11/25/2022] Open
Abstract
Cancer during pregnancy threatens the lives of mother and foetus and its incidence is rising, making it an emerging medical challenge. Evidence on the direct impact of cancer therapies on neonatal outcomes resulted in general guidelines for maternal treatment that safeguards foetal development. Less focus has been placed on indirect factors, in pre- and postnatal periods, that may exert long-term impacts specifically on child neurocognition. Foetal development, in the context of maternal cancer during pregnancy, may be influenced directly by exposure to cancer diagnostics and (co-)treatment, or indirectly through maternal inflammation, malnutrition, hormonal fluctuations, prematurity, and psycho-biological stress. Maternal stress and insecure mother-infant bonding related to postpartum cancer treatment may further impact child cognitive-behavioural development. Understanding the independent and synergistic effects of the factors impacting neurocognitive development creates the opportunity to intervene during the oncological treatment to improve the child's long-term outcome, both by medical and psychosocial care and support.
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Affiliation(s)
- Indra A Van Assche
- Department of Development and Regeneration: Woman and Child, KU Leuven, Belgium.
| | - Jurgen Lemiere
- Department of Oncology: Pediatric Oncology, KU Leuven, Belgium; Department of Pediatrics: Pediatric Hemato-Oncology, University Hospitals Leuven, Belgium.
| | - Frédéric Amant
- Department of Oncology: Gynaecological Oncology, KU Leuven, Belgium; Department of Obstetrics and Gynaecology: Gynaecological Oncology, University Hospitals Leuven, Belgium; Center for Gynaecologic Oncology, Netherlands Cancer Institute, Amsterdam, the Netherlands.
| | - Kristel Van Calsteren
- Department of Development and Regeneration: Woman and Child, KU Leuven, Belgium; Department of Obstetrics and Gynaecology: Foetomaternal Medicine, University Hospitals Leuven, Belgium.
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Loo RSX, Yap F, Ku CW, Cheung YB, Tan KH, Chan JKY, Loy SL. Maternal meal irregularities during pregnancy and lifestyle correlates. Appetite 2021; 168:105747. [PMID: 34637771 DOI: 10.1016/j.appet.2021.105747] [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] [Received: 04/13/2021] [Revised: 10/05/2021] [Accepted: 10/08/2021] [Indexed: 11/02/2022]
Abstract
Meal regularity can influence metabolic health. However, habits of skipping and delaying meals are rarely studied among pregnant women. This study examined the incidence of maternal meal skipping and meal delaying, and their associated lifestyle patterns during pregnancy. Pregnant women in the second trimester (18-24 weeks' gestation; n = 90) were recruited from the antenatal clinics in KK Women's and Children's Hospital, Singapore, 2019-2020. Data on sociodemographic, lifestyle and dietary habits were collected. Firstly, principal component analysis was used to identify lifestyle patterns. Subsequently, multiple logistic regression model was used to examine the association of lifestyle patterns with meal skipping and delaying. In total, 32 (35.6%) women had irregular meals, in which 25 (27.8%) and 26 (28.9%) women reported meal skipping and meal delaying for at least 3 times a week, respectively. Women with 'poor sleep and emotion' pattern as characterized by higher scores for poor sleep, depression, anxiety, and stress symptoms were associated with higher odds of meal skipping (OR 1.99; 95% CI 1.13, 3.53) and meal delaying (2.50; 1.31, 4.79). 'Sedentary' pattern, as characterized by greater daily time spent on television and screen electronic devices, and 'weight and inactivity' pattern, as characterized by higher BMI and physical inactivity level, were not associated with meal regularity. In this study, almost one-third of women reporting meal irregularities during pregnancy. 'Poor sleep and emotion' pattern is associated with a higher incidence of meal skipping and delaying. These findings suggest the need to address sleep and emotional health in interventions promoting healthy nutrition specifically regular eating in pregnancy.
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Affiliation(s)
| | - Fabian Yap
- Department of Paediatrics, KK Women's and Children's Hospital, Singapore; Duke-NUS Medical School, Singapore; Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore
| | - Chee Wai Ku
- Duke-NUS Medical School, Singapore; Department of Obstetrics & Gynaecology, KK Women's and Children's Hospital, Singapore
| | - Yin Bun Cheung
- Program in Health Services & Systems Research and Center for Quantitative Medicine, Duke-NUS Medical School, Singapore; Tampere Center for Child, Adolescent and Maternal Health Research, Tampere University, Tampere, Finland
| | - Kok Hian Tan
- Duke-NUS Medical School, Singapore; Department of Maternal Fetal Medicine, KK Women's and Children's Hospital, Singapore
| | - Jerry Kok Yen Chan
- Duke-NUS Medical School, Singapore; Department of Reproductive Medicine, KK Women's and Children's Hospital, Singapore
| | - See Ling Loy
- Duke-NUS Medical School, Singapore; Department of Reproductive Medicine, KK Women's and Children's Hospital, Singapore; Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research (A*STAR), Singapore.
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Disordered Eating Behaviors Are Associated with Gestational Weight Gain in Adolescents. Nutrients 2021; 13:nu13093186. [PMID: 34579063 PMCID: PMC8470326 DOI: 10.3390/nu13093186] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2021] [Revised: 09/01/2021] [Accepted: 09/07/2021] [Indexed: 11/26/2022] Open
Abstract
Disordered eating behaviors (DEBs) and adolescent pregnancy are public health problems. Among adolescents, there is little evidence concerning the relationship of DEB with gestational weight gain (GWG) and the birth weight and length of their offspring. We aimed to determine the association between DEB with GWG and the weight and length of adolescents’ offspring. We conducted a study with 379 participants. To evaluate DEB, we applied a validated scale. We identified three factors from DEB by factorial analysis: restrictive, compensatory, and binge–purge behaviors. The main events were GWG and offspring’s birth weight and length. We performed linear regression models. We found that 50% of adolescents have at least one DEB. Excessive and insufficient GWG were 37 and 34%, respectively. The median GWG was 13 kg; adolescents with restrictive behaviors had higher GWG (13 vs. 12 kg, p = 0.023). After adjusting for pregestational body mass index and other covariables, the restrictive (β = 0.67, p = 0.039), compensatory (β = 0.65, p = 0.044), and binge–purge behaviors (β = 0.54, p = 0.013) were associated with higher GWG. We did not find an association between the birth weight and length of newborns with DEB, and suggest that DEB is associated with GWG but not with the birth weight or length of the offspring.
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Savard C, Yan E, Plante AS, Bégin C, Robitaille J, Michaud A, Lemieux S, Provencher V, Morisset AS. Positive attitudes toward weight gain in late pregnancy are associated with healthy eating behaviours. Eat Weight Disord 2021; 26:2051-2058. [PMID: 33128720 DOI: 10.1007/s40519-020-01057-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/11/2020] [Accepted: 10/15/2020] [Indexed: 11/25/2022] Open
Abstract
PURPOSE This cross-sectional study examined the associations between 3rd trimester attitudes toward weight gain and (1) pre-pregnancy BMI, (2) gestational weight gain (GWG) and (3) eating behaviours assessed in the 3rd trimester. METHODS Seventy-nine (79) pregnant women completed the French version of the Pregnancy Weight Gain Attitude Scale (PWGAS), the Three-Factor Eating Questionnaire (TFEQ) and the Intuitive Eating Scale-2 (IES-2) in their 3rd trimester. Total GWG was calculated as the difference between the weight recorded before delivery and self-reported pre-pregnancy weight. RESULTS Most (55.6%) women gained weight above the Institute of Medicine's (IOM) recommendations, but there was no association between PWGAS scores and total or 3rd trimester GWG. Women with obesity had lower PWGAS total scores compared to women with overweight (3.48 ± 0.6 vs. 3.99 ± 0.3, p = 0.005), indicating more negative attitudes in women with obesity vs. overweight. Higher total PWGAS scores were positively correlated with intuitive eating scores (r = 0.28, p < 0.05), and inversely associated with unfavourable eating behaviours such as dietary restraint (r = - 0.42, p < 0.01). CONCLUSION Women with positive attitudes toward weight gain reported healthier eating behaviours in late pregnancy, which remains to be confirmed in prospective studies. Interventions addressing body image issues during pregnancy may positively influence pregnant women's health, including eating behaviours. LEVEL OF EVIDENCE Level III, case-control analytic study.
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Affiliation(s)
- Claudia Savard
- School of Nutrition, Laval University, Québec City, Canada
- Institute of Nutrition and Functional Foods, NUTRISS Research Center, Laval University, Québec City, Canada
- Endocrinology and Nephrology Unit, CHU of Québec-Université Laval Research Center, Québec City, Canada
| | - Emmanuelle Yan
- Biology's Formation and Research Unit, Clermont-Auvergne University, Clermont-Ferrand, France
| | - Anne-Sophie Plante
- Endocrinology and Nephrology Unit, CHU of Québec-Université Laval Research Center, Québec City, Canada
| | - Catherine Bégin
- School of Nutrition, Laval University, Québec City, Canada
- School of Psychology, Laval University, Québec City, Canada
| | - Julie Robitaille
- School of Nutrition, Laval University, Québec City, Canada
- Institute of Nutrition and Functional Foods, NUTRISS Research Center, Laval University, Québec City, Canada
- Endocrinology and Nephrology Unit, CHU of Québec-Université Laval Research Center, Québec City, Canada
| | - Andréanne Michaud
- School of Nutrition, Laval University, Québec City, Canada
- Institute of Nutrition and Functional Foods, NUTRISS Research Center, Laval University, Québec City, Canada
- Québec Heart and Lung Institute Research Center, Laval University, Québec City, Canada
| | - Simone Lemieux
- School of Nutrition, Laval University, Québec City, Canada
- Institute of Nutrition and Functional Foods, NUTRISS Research Center, Laval University, Québec City, Canada
| | - Véronique Provencher
- School of Nutrition, Laval University, Québec City, Canada
- Institute of Nutrition and Functional Foods, NUTRISS Research Center, Laval University, Québec City, Canada
| | - Anne-Sophie Morisset
- School of Nutrition, Laval University, Québec City, Canada.
- Institute of Nutrition and Functional Foods, NUTRISS Research Center, Laval University, Québec City, Canada.
- Endocrinology and Nephrology Unit, CHU of Québec-Université Laval Research Center, Québec City, Canada.
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Bannatyne AJ, McNeil E, Stapleton P, MacKenzie-Shalders K, Watt B. Disordered eating measures validated in pregnancy samples: a systematic review. Eat Disord 2021; 29:421-446. [PMID: 31675283 DOI: 10.1080/10640266.2019.1663478] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Although disordered eating in pregnancy has been linked to numerous negative consequences, there is currently no published instrument specifically devised to identify or measure such symptoms in pregnancy. As such, this study systematically reviewed the literature to evaluate the performance of general measures of disordered eating in pregnancy samples. A systematic search of the following electronic databases was undertaken from inception to April 2019: Scopus, Medline, PsycINFO, Embase, ProQuest Dissertations and Theses, and the Cumulative Index to Nursing and Allied Health Literature. From 1724 citations, eight publications met the inclusion criteria and were included in the review. Most of the included studies (6/8) were of reasonable quality. Overall, three self-report inventories (EDE-Q, EDI-2, and DEBS) and one semi-structured clinical interview (EDE) had some form of psychometric information available. Most studies reported reliability, with only two reporting validity. No studies assessed screening accuracy. Other than the EDE-Q, which had preliminary evidence to suggest possible utility in pregnancy, the findings of this review revealed little to no evidence to support the use of general measures of disordered eating in pregnancy. A strong need for research exploring the validity of existing measures in pregnancy samples, including the EDE-Q, was also evident.
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Affiliation(s)
- Amy Jean Bannatyne
- Faculty of Health Sciences and Medicine, Bond University, Gold Coast, Australia.,School of Psychology, Bond University, Gold Coast, Australia
| | - Elyse McNeil
- Faculty of Health Sciences and Medicine, Bond University, Gold Coast, Australia.,School of Psychology & Counselling, Queensland University of Technology, Brisbane, Australia
| | - Peta Stapleton
- School of Psychology, Bond University, Gold Coast, Australia
| | | | - Bruce Watt
- School of Psychology, Bond University, Gold Coast, Australia
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Wei Q, Shi H, Ma X, Shi Y, Zhang Y, Wang L. The impact of maternal stress on offspring birth weight and the mediating effect of dietary patterns: the Shanghai Maternal-Child Pairs Cohort study. J Affect Disord 2021; 278:643-649. [PMID: 33038709 DOI: 10.1016/j.jad.2020.09.077] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/23/2020] [Revised: 07/24/2020] [Accepted: 09/18/2020] [Indexed: 02/08/2023]
Abstract
BACKGROUND Maternal stress and nutrition during pregnancy are two of the most commonly studied factors in the context of fetal development. However, few investigators have considered the combined effects of stress and diet in pregnant women and their offspring. AIMS To determine the impact of maternal stress on offspring birth weight, and the potential mediating role of maternal dietary patterns. METHODS A total of 3542 pregnant women and their singleton live births were recruited from Shanghai Maternal-Child Pairs Cohort (Shanghai MCPC). Maternal stress was assessed using the Life Event Scale for Pregnant Women (LESPW) in early and late pregnancy. Food frequency questionnaire (FFQ) was performed to evaluate maternal diet in late pregnancy. Multiple linear regression was conducted to estimate the associations between maternal stress and child birth weight. Logistic regression was performed to calculate the association between maternal stress and small for gestational age (SGA)/large for gestational age (LGA). The bootstrap method was used to investigate the mediating effects of maternal dietary patterns. RESULTS Maternal subjective events stress (β = 0.367) and total stress (β = 0.079) in early pregnancy, and positive objective life events stress (β = 0.275) in late pregnancy, were positively associated with birth weight. Maternal dietary pattern of "high-fat and sugar" mediated the associations between subjective events stress and total stress during early pregnancy and birth weight. An increased risk for LGA was observed among women exposed to relatively higher stress during early pregnancy (OR, 1.416; 95% CI, 1.035-1.937). No statistically significant associations were found between maternal stress during late pregnancy and child birth weight or SGA/LGA. CONCLUSIONS Maternal life events stress during early pregnancy significantly increases neonatal birth weight and risk for LGA, which may mediate by a "high-fat and sugar" dietary pattern. LIMITATIONS The lack of biological markers limits the explanation of the mechanism. The assessment of diet used food intake frequency to evaluate dietary characteristics, which may miss information of energy intake.
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Affiliation(s)
- Qian Wei
- Department of Maternal, Child and Adolescent Health, School of Public Health, Fudan University, Shanghai, China
| | - Huijing Shi
- Department of Maternal, Child and Adolescent Health, School of Public Health, Fudan University, Shanghai, China.
| | - Xuemei Ma
- Department of Maternal, Child and Adolescent Health, School of Public Health, Fudan University, Shanghai, China
| | - Yuyang Shi
- Department of Maternal, Child and Adolescent Health, School of Public Health, Fudan University, Shanghai, China
| | - Yunhui Zhang
- Department of Environmental Health, School of Public Health, Fudan University, Shanghai, China
| | - Ling Wang
- Shanghai Medical College of Fudan University, Shanghai, CN.
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Baskin R, Galligan R, Meyer D. Disordered eating from pregnancy to the postpartum period: The role of psychosocial and mental health factors. Appetite 2020; 156:104862. [PMID: 32905822 DOI: 10.1016/j.appet.2020.104862] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2020] [Revised: 09/01/2020] [Accepted: 09/04/2020] [Indexed: 10/23/2022]
Abstract
The postpartum period has been identified as high-risk period for the increase of disordered eating. This study examined the psychosocial factors-attitudes to motherhood, self-compassion and relationship satisfaction- and mental health factors-depressive and anxiety symptoms-associated with this increase. One hundred and fourteen women completed online questionnaires about their eating behaviours between: 18-24 weeks gestation (T1), 30-32 weeks gestation (T2) and 8-10 weeks postpartum (T3). A cluster analysis examined the change of disordered eating from T2 to T3. Multinomial logistic regressions examined which demographic, psychosocial and mental health factors were associated with disordered eating cluster groups, as individual factors and as a combined model of predictors at T1, T2 and T3. Four cluster groups were identified: 'lower disordered eating', 'increasing risk', 'sub-clinical' and 'clinical'. All psychosocial and mental health predictors were individually associated with a risk group, when compared to the lower disordered eating group. However, when combined, only multiparity and higher depressive symptoms were associated with the sub-clinical group. Multiparity, higher pre-pregnancy body mass index and lower self-compassion were associated with the increasing risk group. This study introduces self-compassion as a psychosocial factor worthy of further investigation and application in the field of perinatal disordered eating, with promising avenues for antenatal intervention.
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Affiliation(s)
- Rachel Baskin
- Department of Psychological Sciences, Swinburne University of Technology, Hawthorn, VIC, 3122, Australia.
| | - Roslyn Galligan
- Department of Psychological Sciences, Swinburne University of Technology, Hawthorn, VIC, 3122, Australia.
| | - Denny Meyer
- Centre for Mental Health, Swinburne University of Technology, Hawthorn, VIC, 3122, Australia.
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Braig S, Logan CA, Reister F, Rothenbacher D, Genuneit J. Psychosocial stress and longitudinally measured gestational weight gain throughout pregnancy: The Ulm SPATZ Health Study. Sci Rep 2020; 10:1996. [PMID: 32029794 PMCID: PMC7005281 DOI: 10.1038/s41598-020-58808-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2019] [Accepted: 01/17/2020] [Indexed: 12/14/2022] Open
Abstract
Psychosocial stress is thought to influence gestational weight gain (GWG), but results are inconsistent. We investigated the relationship of questionnaire-based maternal stress and related constructs assessed at childbirth with maternal weight measured throughout pregnancy. Data were derived from the Ulm SPATZ Health Study, a birth cohort recruited from the general population (04/2012-05/2013, Ulm, Germany). Adjusted generalized estimating equations were performed. Regression coefficients (b) and 95% confidence intervals, each highest versus lowest tertile of stress or related constructs, are presented. In 748 women, we observed positive associations for maternal chronic stress (b = 4.36 kg (1.77; 6.95)), depressive symptoms (b = 2.50 kg (0.14; 4.86)), anxiety symptoms (b = 3.26 kg (0.62, 5.89)), and hair cortisol (b = 3.35 kg (0.86; 5.83)) with maternal weight at the first gestational month. GWG was considerably lower in mothers with higher chronic stress. Pregnancy-related anxiety was positively related to weight at first month (b = 4.16 kg (1.74; 6.58)) and overall GWG. In contrast, no association was observed between anxiety symptoms and GWG. Odds ratios for association with inadequate weight gain according to Institute of Medicine recommended cutoffs differed from the results presented obove. There is evidence of an association between stress and weight gain lying beyond the recommended cut-offs, which however needs further corroboration.
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Affiliation(s)
- S Braig
- Institute of Epidemiology and Medical Biometry, Ulm University, Ulm, Germany
| | - C A Logan
- Institute of Epidemiology and Medical Biometry, Ulm University, Ulm, Germany
| | - F Reister
- Department of Gynecology and Obstetrics, University Medical Center Ulm, Ulm, Germany
| | - D Rothenbacher
- Institute of Epidemiology and Medical Biometry, Ulm University, Ulm, Germany.
| | - J Genuneit
- Institute of Epidemiology and Medical Biometry, Ulm University, Ulm, Germany
- Pediatric Epidemiology, Department of Pediatrics, Leipzig University Medicine, Leipzig, Germany
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Baskin R, Galligan R. Disordered eating and the perinatal period: A systematic review and best evidence synthesis of mental health and psychosocial correlates. EUROPEAN EATING DISORDERS REVIEW 2019; 27:462-480. [DOI: 10.1002/erv.2675] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2018] [Revised: 03/07/2019] [Accepted: 03/10/2019] [Indexed: 02/01/2023]
Affiliation(s)
- Rachel Baskin
- Department of Psychological SciencesSwinburne University Hawthorn, Melbourne Australia
| | - Roslyn Galligan
- Department of Psychological SciencesSwinburne University Hawthorn, Melbourne Australia
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Relationship Between Psychosocial Factors, Dietary Intake and Gestational Weight Gain: A Narrative Review. JOURNAL OF OBSTETRICS AND GYNAECOLOGY CANADA 2018; 41:495-504. [PMID: 30393057 DOI: 10.1016/j.jogc.2018.02.023] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2017] [Revised: 02/21/2018] [Accepted: 02/23/2018] [Indexed: 12/25/2022]
Abstract
Inadequate gestational weight gain (GWG), which has reached almost two-thirds of Canadian pregnant women, is associated with several adverse effects both in the mother and her child. The aim of this review was to establish how psychosocial factors, diet and GWG are interrelated during pregnancy. More specifically, it aimed to evaluate how psychosocial factors can impact on diet and, thus, influence GWG. Studies published through May 2017 that examined factors related to GWG were included. Of 3268 non-duplicate titles and abstract, 77 articles underwent full-text review. Regarding dietary intakes, the majority of the included studies demonstrated that a higher caloric intake was associated with an elevated GWG. Also, a negative body image and attitude toward weight gain as well as a poor knowledge of GWG recommendations and inadequate prenatal care is associated with an increased GWG. Only few studies examined altogether the factors included and conclusions about how psychosocial factors can impact on diet and, thus, influence GWG cannot be drawn at this point. In the few studies that evaluated the interrelationships between psychosocial factors, diet and GWG, energy intake was not identified as a mediator of the association between psychosocial factors and GWG. This review highlights the scarcity of findings regarding psychosocial and dietary factors in relation to GWG and the need for high quality prospective cohort studies that will include all these factors to provide a better understanding of how they are interrelated to influence short- and long-term health.
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Lindsay KL, Buss C, Wadhwa PD, Entringer S. Maternal Stress Potentiates the Effect of an Inflammatory Diet in Pregnancy on Maternal Concentrations of Tumor Necrosis Factor Alpha. Nutrients 2018; 10:nu10091252. [PMID: 30200631 PMCID: PMC6163870 DOI: 10.3390/nu10091252] [Citation(s) in RCA: 18] [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: 07/31/2018] [Revised: 09/04/2018] [Accepted: 09/04/2018] [Indexed: 12/12/2022] Open
Abstract
Maternal inflammation during pregnancy is known to adversely impact fetal development, birth outcomes, and offspring physical and mental health. Diet and stress have been identified as important determinants of inflammation, yet their combined effects have not been examined in the context of pregnancy. The aim of this study was to examine the relationship between maternal diet with inflammatory potential and psychological stress, and to determine their interaction effect on concentrations of tumor necrosis factor (TNF)-α across pregnancy. We conducted a prospective longitudinal study of n = 202 women with three assessments during pregnancy, which included: ecological momentary assessment (EMA) of maternal stress using the perceived stress scale (PSS) short version; 24-h dietary recalls from which the dietary inflammatory index (DII) was computed; and serum measurements of TNF-α. Across pregnancy, higher perceived stress was associated with consumption of a more pro-inflammatory diet (r = 0.137; p < 0.05). In a linear regression model adjusted for covariates, DII was positively associated with TNF-α (B = 0.093, p = 0.010). The effect of the pro-inflammatory diet on concentrations of TNF-α was more pronounced in women reporting higher levels of stress (B = 0.134, p = 0.018 for DII*PSS interaction). These results highlight the need to consider nutrition and stress concurrently in the context of inflammation during pregnancy.
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Affiliation(s)
- Karen L Lindsay
- Departments of Pediatrics, University of California, Irvine, CA 92697, USA.
- UC Irvine Development, Health and Disease Research Program, University of California, Irvine, CA 92697, USA.
| | - Claudia Buss
- UC Irvine Development, Health and Disease Research Program, University of California, Irvine, CA 92697, USA.
- Charité⁻Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health (BIH), Institute of Medical Psychology, Charitéplatz 1, 10117 Berlin, Germany.
| | - Pathik D Wadhwa
- UC Irvine Development, Health and Disease Research Program, University of California, Irvine, CA 92697, USA.
- Departments of Psychiatry & Human Behavior, and Obstetrics & Gynecology, University of California, Irvine, CA 92697, USA.
| | - Sonja Entringer
- UC Irvine Development, Health and Disease Research Program, University of California, Irvine, CA 92697, USA.
- Charité⁻Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health (BIH), Institute of Medical Psychology, Charitéplatz 1, 10117 Berlin, Germany.
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Terres NM. Resources for Psychiatric Clinicians Working With Breastfeeding Mothers. J Psychosoc Nurs Ment Health Serv 2018; 56:37-46. [PMID: 29667697 DOI: 10.3928/02793695-20180329-03] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2017] [Accepted: 02/07/2018] [Indexed: 11/20/2022]
Abstract
In today's health care-focused climate, in which encouraging breastfeeding is part of national and international health care initiatives, clinicians in any field should have resources available for breastfeeding mothers. The current article provides information for psychiatric clinicians on how breastfeeding may affect women with psychiatric conditions, the type of lactation counselor likely to be best prepared to collaborate with psychiatric clinicians, and resources available regarding maternal psychiatric medications safe for breastfeeding infants. These resources can assist informed choices that support the mother's breastfeeding goals while providing the psychological care the nursing mother requires. [Journal of Psychosocial Nursing and Mental Health Services, 56(8),37-46.].
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Lindsay KL, Buss C, Wadhwa PD, Entringer S. The Interplay between Maternal Nutrition and Stress during Pregnancy: Issues and Considerations. ANNALS OF NUTRITION AND METABOLISM 2017; 70:191-200. [PMID: 28301838 DOI: 10.1159/000457136] [Citation(s) in RCA: 51] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/28/2016] [Accepted: 01/20/2017] [Indexed: 12/17/2022]
Abstract
BACKGROUND Several studies about humans and animals have separately examined the effects of prenatal nutrition and stress on fetal development, pregnancy, and birth outcomes, and subsequent child health and disease risk. Although substantial evidence from non-pregnant literature supports the presence of bidirectional interactions between nutrition and stress at various psychological, behavioral, and physiological levels, such interaction effects have not yet been systematically examined in the context of pregnancy. SUMMARY This paper discusses the multifaceted and multilevel relationship between nutrition and stress. It then reviews the currently available observational and experimental evidence in animals and humans regarding the interplay between maternal psychosocial stress, dietary intake, and nutritional state during pregnancy, and implications for maternal and child health-related outcomes. Key Messages: During pregnancy, maternal psychosocial stress, dietary behavior, and nutritional state likely regulate and counter-regulate one another. Emerging evidence suggests that omega-3 fatty acids may attenuate maternal psychosocial stress, and that high maternal pre-pregnancy body mass index exacerbates unhealthy dietary behaviors under high-stress conditions. Longitudinal studies are warranted in order to understand the interplay between prenatal psychosocial stress, diet, and stress- and nutrition-related biomarkers to obtain further insight and inform the development and design of future, more effective intervention trials for improved maternal and child health outcomes.
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Affiliation(s)
- Karen L Lindsay
- UC Irvine Development, Health and Disease Research Program, University of California, Irvine, CA, USA
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