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Pereira AP, Montero MF, Souza FD, Jordão MC, Oliveira MCM, Mattar R, Dib SA, Dualib PM, de Almeida-Pititto B. High-Density Lipoproteins-Cholesterol (HDL-C) in Women With Gestational Diabetes (GDM): A Predictor for Large Gestational Age (LGA) Babies. Cureus 2024; 16:e65546. [PMID: 39188439 PMCID: PMC11347017 DOI: 10.7759/cureus.65546] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/27/2024] [Indexed: 08/28/2024] Open
Abstract
Introduction The present study aimed to evaluate the associations between the clinical and biochemical characteristics of women with gestational diabetes (GDM) and the incidence of large for gestational age (LGA) babies. Methods This cohort study included data collected during prenatal follow-up of GDM women from January 2008 to August 2022. Clinical and biochemical variables were compared among small (SGA), adequate (AGA), or large for gestational age (LGA) babies. Associations of the main variables with the incidence of LGA were determined by multiple regression analysis. Results Out of 659 women, 56 had LGA, 547 had AGA, and 56 had SGA babies. We observed differences in the means of age, pregestational body mass index (BMI), high-density lipoproteins-cholesterol (HDL-C) levels, gestational weight gain (GWG), and gestational age at birth according to LGA, AGA, and SGA (p < 0.05). All other variables were not different between the groups. The frequencies (%) and relative risk (RR) of LGA babies were evaluated according to HDL-C in the first tertile and/or obesity, with 12.2% and risk ratio (RR)=2.77 (95% confidence interval (CI) 1.35-5.69, p=0.005) if the women had obesity and HDL in the first tertile, 11.3% and RR=2.27 (95% CI 1.03-5.03, p=0.042) if only HDL in the first tertile was present, 10.9% and RR=2.68 (95% CI 1.31-5.48, p=0.007) if the women had only obesity, using as a reference group those women without obesity or HDL-C in the first tertile (4.6% and RR=1) adjusted for age, age at birth and GWG. Conclusion In women with GDM, lower levels of HDL-cholesterol during pregnancy, as well as pregestational obesity, seem to be good predictors of the occurrence of LGA babies.
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Affiliation(s)
| | - Micaela F Montero
- Department of Endocrinology, Universidade Federal de São Paulo, São Paulo, BRA
| | - Filipe D Souza
- Department of Endocrinology, Universidade Federal de São Paulo, São Paulo, BRA
| | - Martha C Jordão
- Department of Endocrinology, Universidade Federal de São Paulo, São Paulo, BRA
| | | | - Rosiane Mattar
- Department of Obstetrics and Gynecology, Universidade Federal de São Paulo, São Paulo, BRA
| | - Sergio A Dib
- Department of Endocrinology, Universidade Federal de São Paulo, São Paulo, BRA
| | - Patricia M Dualib
- Department of Endocrinology, Universidade Federal de São Paulo, São Paulo, BRA
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Lyu Y, Cui M, Zhang L, Zheng G, Zuo H, Xiu Q, Shah PS. Pre-pregnancy body mass index, gestational diabetes mellitus, and gestational weight gain: individual and combined effects on fetal growth. Front Public Health 2024; 12:1354355. [PMID: 38528861 PMCID: PMC10961333 DOI: 10.3389/fpubh.2024.1354355] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2024] [Accepted: 02/29/2024] [Indexed: 03/27/2024] Open
Abstract
Background Pre-pregnancy body mass index (BMI), gestational diabetes mellitus (GDM), and gestational weight gain (GWG) are interlinked and may play a complex role in fetal growth. We aimed to examine the relationship between pre-pregnancy BMI, GDM, GWG, and fetal growth outcomes and explore the contribution of GDM and GWG to the relationship between Pre-pregnancy obesity/overweight and large-for-gestational-age (LGA) in a prospective cohort. Methods We prospectively recruited women in the first trimester and having one-step GDM screened with a 75-g oral glucose tolerance test between 24 and 28 weeks of gestation (n = 802). Outcomes included LGA, small-for-gestational-age (SGA), and preterm birth. To assess the individual and cumulative associations between pre-pregnancy BMI, GDM, GWG, and these outcomes, we used multivariate logistic regression analysis. Furthermore, we employed structural equation modeling (SEM) to investigate the mediating role of GDM and excessive GWG in the correlation between pre-pregnancy overweight/obesity and LGA. Results Pre-pregnancy obesity, GDM, and excessive GWG were all independently associated with increased odds of LGA. Inadequate GWG was associated with higher odds of preterm birth. Compared with women unexposed to pre-pregnancy overweight/obesity, GDM, or excessive GWG, women exposed any two conditions had higher odds for LGA (AOR 3.18, 95% CI 1.25-8.11) and women with coexistence of all had the highest odds for LGA (AOR 8.09, 95% CI 2.18-29.97). The mediation analysis showed that GDM explained 18.60% (p < 0.05) of the total effect of pre-pregnancy overweight/obesity on LGA, and GWG explained 17.44% (p < 0.05) of the total effect. Conclusion Pre-pregnancy obesity/overweight, GDM, and excessive GWG are associated with higher odds of fetal growth disturbances as individual factors and when they co-exist. The effect of pre-pregnancy overweight/obesity on LGA is partially achieved through GDM and excessive GWG.
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Affiliation(s)
- Yanyu Lyu
- Experiment Center, Capital Institute of Pediatrics, Beijing, China
| | - Mingming Cui
- Beijing Municipal Key Laboratory of Child Development and Nutriomics, Capital Institute of Pediatrics, Beijing, China
| | - Lingling Zhang
- Robert and Donna Manning College of Nursing and Health Sciences, University of Massachusetts Boston, Boston, MA, United States
| | - Guang Zheng
- School of Information Science and Engineering, Lanzhou University, Lanzhou, China
| | - Hanxiao Zuo
- School of Public Health, University of Alberta, Edmonton, AB, Canada
| | - Qingyong Xiu
- Department of Pediatrics, Beijing Daxing Maternal and Child Care Hospital, Beijing, China
| | - Prakesh S. Shah
- Department of Pediatrics, Mount Sinai Hospital, Toronto, ON, Canada
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Wang Y, Gong Y, Xu Y, Wang X, Shan S, Cheng G, Zhang B. Maternal age-specific risks for adverse birth weights according to gestational weight gain: a prospective cohort in Chinese women older than 30. BMC Pregnancy Childbirth 2024; 24:36. [PMID: 38182970 PMCID: PMC10768087 DOI: 10.1186/s12884-023-06231-y] [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: 10/20/2023] [Accepted: 12/27/2023] [Indexed: 01/07/2024] Open
Abstract
BACKGROUND It is unclear whether the effects of abnormal gestational weight gain (GWG) on birth outcomes are differently in women with different maternal ages. This study aimed to investigate maternal age-specific association between GWG and adverse birth weights in Chinese women older than 30. METHODS 19,854 mother-child dyads were selected from a prospective cohort study in Southwest China between 2019 and 2022. Logistic regression model was used to assess the association between GWG, which defined by the 2009 Institute of Medicine guidelines, and adverse birth weights including large- and small-for-gestational-age (LGA and SGA), stratified by maternal age (31-34 years and ≥ 35 years). RESULTS In both maternal age groups, excessive and insufficient GWG were associated with increased odds of LGA and SGA, respectively. After women were categorized by pre-pregnancy body mass index, the associations remained significant in women aged 31-34 years, whereas for women aged ≥ 35 years, the association between excessive GWG and the risk of LGA was only significant in normal weight and overweight/obese women, and the significant effect of insufficient GWG on the risk of SGA was only observed in underweight and overweight/obese women. Moreover, among overweight/obese women, the magnitude of the association between insufficient GWG and the risk of SGA was greater in those aged ≥ 35 years (31-34 years: OR 2.08, 95% CI 1.19-3.55; ≥35 years: OR 2.65, 95% CI 1.47-4.74), while the impact of excessive GWG on the risk of LGA was more pronounced in those aged 31-34 years (31-34 years: OR 2.18, 95% CI 1.68-2.88; ≥35 years: OR 1.71, 95% CI 1.30-2.25). CONCLUSIONS The stronger associations between abnormal GWG and adverse birth weights were mainly observed in women aged 31-34 years, and more attention should be paid to this age group.
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Affiliation(s)
- Yidi Wang
- Department of Epidemiology and Biostatistics, Institute of Systems Epidemiology, and West China-PUMC C. C. Chen Institute of Health, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Yunhui Gong
- Department of Gynaecology, West China Women's and Children's Hospital, Sichuan University, Chengdu, China
| | - Yujie Xu
- Laboratory of Molecular Translational Medicine, Center for Translational Medicine, Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Department of Pediatrics, West China Women's and Children's Hospital, Sichuan University, Chengdu, China
| | - Xiaoyu Wang
- Laboratory of Molecular Translational Medicine, Center for Translational Medicine, Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Department of Pediatrics, West China Women's and Children's Hospital, Sichuan University, Chengdu, China
| | - Shufang Shan
- Laboratory of Molecular Translational Medicine, Center for Translational Medicine, Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Department of Pediatrics, West China Women's and Children's Hospital, Sichuan University, Chengdu, China
| | - Guo Cheng
- Laboratory of Molecular Translational Medicine, Center for Translational Medicine, Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Department of Pediatrics, West China Women's and Children's Hospital, Sichuan University, Chengdu, China.
| | - Ben Zhang
- Department of Epidemiology and Biostatistics, Institute of Systems Epidemiology, and West China-PUMC C. C. Chen Institute of Health, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China.
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Zhang Y, Zhao Y, Duan Y, Liu C, Yang Z, Duan J, Cui Z. Effects of prepregnancy dietary patterns on infant birth weight: a prospective cohort study. J Matern Fetal Neonatal Med 2023; 36:2273216. [PMID: 37904502 DOI: 10.1080/14767058.2023.2273216] [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: 06/12/2023] [Accepted: 10/16/2023] [Indexed: 11/01/2023]
Abstract
BACKGROUND Maternal nutrition can have a profound effect on fetal growth, development, and subsequent infant birth weight. However, little is known regarding the influence of prepregnancy dietary patterns. OBJECTIVES This study aimed to explore the effects between prepregnancy dietary patterns on birth weight. METHODS This study included 911 singleton live-born infants from the Taicang and Wuqiang Mother-Child Cohort Study (TAWS). Baseline information and prepregnancy diet data were collected during early pregnancy. Newborn birth information was obtained from the Wuqiang County Hospital. Macrosomia, defined as a birth weight of ≥4000 g, and large for gestational age (LGA), defined as a birth weight higher than the 90th percentile for the same sex and gestational age, were the outcomes of interest. The dietary patterns were extracted using principal component analysis. Logistic regression models were used to investigate the association between prepregnancy dietary patterns (in tertiles) and macrosomia and LGA, and subgroup analysis was further explored by pre-pregnancy body mass index (BMI). RESULTS Four dietary patterns were identified based on 15 food groups. These patterns were named as "cereals-vegetables-fruits," "vegetables-poultry-aquatic products," "milk-meat-eggs," and "nuts-aquatic products-snacks." After adjusting for sociodemographic characteristics, pregnancy complications, and other dietary patterns, greater adherence to the "cereals-vegetables-fruits" pattern before pregnancy was associated with a higher risk of macrosomia (adjusted OR = 2.220, 95% CI: 1.018, 4.843), while greater adherence to the "nuts-aquatic products-snacks" pattern was associated with a lower risk of macrosomia (adjusted OR = 0.357, 95% CI: 0.175, 0.725) compared to the lowest tertile. No significant association was observed between prepregnancy dietary patterns and LGA. However, after subgroup analysis of pre-pregnancy BMI, "cereals-vegetables-fruits" pattern was associated with an increased risk of LGA in overweight and obese mothers (adjusted OR = 2.353, 95% CI: 1.010, 5.480). CONCLUSIONS An unbalanced pre-pregnancy diet increases the risk of macrosomia and LGA, especially in overweight or obese women before pre-pregnancy.
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Affiliation(s)
- Yiman Zhang
- School of Public Health, North China University of Science and Technology, Tangshan, China
| | - Yongli Zhao
- Institute for Nutrition and Food Safety, Hebei Provincial Center for Disease Control and Prevention, Shijiazhuang, China
| | - Yifan Duan
- National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Changqing Liu
- Institute for Nutrition and Food Safety, Hebei Provincial Center for Disease Control and Prevention, Shijiazhuang, China
| | - Zhenyu Yang
- Institute for Nutrition and Food Safety, Hebei Provincial Center for Disease Control and Prevention, Shijiazhuang, China
| | - Jingtao Duan
- Department of Epidemiology, Wuqiang Center for Disease Control and Prevention, Hengshui, China
| | - Ze Cui
- Institute for Nutrition and Food Safety, Hebei Provincial Center for Disease Control and Prevention, Shijiazhuang, China
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Dreisbach C, Prescott S, Siega-Riz AM, McCulloch J, Habermeyer L, Dudley D, Trinchieri G, Kelsey C, Alhusen J. Composition of the maternal gastrointestinal microbiome as a predictor of neonatal birth weight. Pediatr Res 2023; 94:1158-1165. [PMID: 37029236 DOI: 10.1038/s41390-023-02584-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2022] [Revised: 12/19/2022] [Accepted: 12/27/2022] [Indexed: 04/09/2023]
Abstract
BACKGROUND The biological mechanism by which the maternal gastrointestinal microbiota contributes to fetal growth and neonatal birth weight is currently unknown. The purpose of this study was to explore how the composition of the maternal microbiome in varying pre-gravid body mass index (BMI) groups are associated with neonatal birth weight adjusted for gestational age. METHODS Retrospective, cross-sectional metagenomic analysis of bio-banked fecal swab biospecimens (n = 102) self-collected by participants in the late second trimester of pregnancy. RESULTS Through high-dimensional regression analysis using principal components (PC) of the microbiome, we found that the best performing multivariate model explained 22.9% of the variation in neonatal weight adjusted for gestational age. Pre-gravid BMI (p = 0.05), PC3 (p = 0.03), and the interaction of the maternal microbiome with maternal blood glucose on the glucose challenge test (p = 0.01) were significant predictors of neonatal birth weight after adjusting for potential confounders including maternal antibiotic use during gestation and total gestational weight gain. CONCLUSIONS Our results indicate a significant association between the maternal gastrointestinal microbiome in the late second trimester and neonatal birth weight adjusted for gestational age. Moderated by blood glucose at the time of the universal glucose screening, the gastrointestinal microbiome may have a role in the regulation of fetal growth. IMPACT Maternal blood glucose in the late second trimester significantly moderates the relationship between the maternal gastrointestinal microbiome and neonatal size adjusted for gestational age. Our findings provide preliminary evidence for fetal programming of neonatal birth weight through the maternal gastrointestinal microbiome during pregnancy.
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Affiliation(s)
- Caitlin Dreisbach
- School of Nursing, University of Virginia, Charlottesville, VA, USA.
- Data Science Institute, Columbia University, New York, NY, USA.
- School of Nursing, University of Rochester, Rochester, NY, USA.
| | - Stephanie Prescott
- College of Nursing, University of South Florida, Tampa, FL, USA
- Center for Cancer Research, National Cancer Institute, Bethesda, MD, USA
| | - Anna Maria Siega-Riz
- School of Public Health and Health Sciences, University of Massachusetts, Amherst, MA, USA
| | - John McCulloch
- Center for Cancer Research, National Cancer Institute, Bethesda, MD, USA
| | - Laura Habermeyer
- School of Nursing, University of Virginia, Charlottesville, VA, USA
| | - Donald Dudley
- Division of Maternal-Fetal Medicine, University of Virginia Health System, Charlottesville, VA, USA
| | - Giorgio Trinchieri
- Center for Cancer Research, National Cancer Institute, Bethesda, MD, USA
| | - Caroline Kelsey
- Department of Pediatrics, Division of Developmental Medicine, Boston Children's Hospital, Boston, MA, USA
- Department of Pediatrics, Harvard Medical School, Boston, MA, USA
| | - Jeanne Alhusen
- School of Nursing, University of Virginia, Charlottesville, VA, USA
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Yang J, Qian J, Qu Y, Zhan Y, Yue H, Ma H, Li X, Man D, Wu H, Huang P, Ma L, Jiang Y. Pre-pregnancy body mass index and risk of maternal or infant complications with gestational diabetes mellitus as a mediator: A multicenter, longitudinal cohort study in China. Diabetes Res Clin Pract 2023; 198:110619. [PMID: 36906233 DOI: 10.1016/j.diabres.2023.110619] [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: 06/01/2022] [Revised: 02/03/2023] [Accepted: 03/06/2023] [Indexed: 03/11/2023]
Abstract
AIMS We explored the complex relationships between pre-pregnancy body mass index (pBMI) and maternal or infant complications and the mediating role of gestational diabetes mellitus (GDM) in these relationships. METHODS Pregnant women from 24 hospitals in 15 different provinces of China were enrolled in 2017 and followed through 2018. Propensity score-based inverse probability of treatment weighting, logistic regression, restricted cubic spline models, and causal mediation analysis were utilized. In addition, the E-value method was used to evaluate unmeasured confounding factors. RESULTS A total of 6174 pregnant women were finally included. Compared to women with a normal pBMI, obese women had a higher risk for gestational hypertension (odds ratio [OR] = 5.38, 95% confidence interval [CI]: 3.48-8.34), macrosomia (OR = 2.65, 95% CI: 1.83-3.84), and large for gestational age (OR = 2.05, 95% CI: 1.45-2.88); 4.73% (95% CI: 0.57%-8.88%), 4.61% (95% CI: 0.51%-9.74%), and 5.02% (95% CI: 0.13%-10.18%) of the associations, respectively, were mediated by GDM. Underweight women had a high risk for low birth weight (OR = 1.42, 95% CI: 1.15-2.08) and small for gestational age (OR = 1.62, 95% CI: 1.23-2.11). Dose-response analyses indicated that 21.0 kg/m2 may be the appropriate tipping point pBMI for risk for maternal or infant complications in Chinese women. CONCLUSION A high or low pBMI is associated with the risk for maternal or infant complications and partly mediated by GDM. A lower pBMI cutoff of 21 kg/m2 may be appropriate for risk for maternal or infant complications in pregnant Chinese women.
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Affiliation(s)
- Jichun Yang
- Department of Epidemiology and Biostatistics, School of Population Medicine and Public Health, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, China.
| | - Jie Qian
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, China.
| | - Yimin Qu
- Department of Epidemiology and Biostatistics, School of Population Medicine and Public Health, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, China.
| | - Yongle Zhan
- School of Public Health, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong 999077, China.
| | - Hexin Yue
- Department of Epidemiology and Biostatistics, School of Population Medicine and Public Health, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, China.
| | - Haihui Ma
- Department of Obstetrics, Tongzhou Maternal and Child Health Hospital of Beijing, Beijing 101149, China.
| | - Xiaoxiu Li
- Department of Pediatric Gastroenterology, Dongguan Maternal and Child Health Care Hospital, Dongguan 523125, China.
| | - Dongmei Man
- Department of Obstetrics, Affiliated Hospital of Jining Medical University, Jining 272007, China.
| | - Hongguo Wu
- Department of Perinatal Health, Jiaxian Maternal and Child Health Care Hospital, Jiaxian 467199, China.
| | - Ping Huang
- Department of Nutrition, First Affiliated Hospital of Nanchang University, Nanchang 330006, China.
| | - Liangkun Ma
- Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Beijing 100730, China.
| | - Yu Jiang
- Department of Epidemiology and Biostatistics, School of Population Medicine and Public Health, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, China.
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van der Pligt PF, Ellery SJ, de Guingand DL, Abbott G, Della Gatta PA, Daly RM. Maternal plasma vitamin D levels across pregnancy are not associated with neonatal birthweight: findings from an Australian cohort study of low-risk pregnant women. BMC Pregnancy Childbirth 2023; 23:67. [PMID: 36703113 PMCID: PMC9878969 DOI: 10.1186/s12884-022-05336-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Accepted: 12/26/2022] [Indexed: 01/27/2023] Open
Abstract
BACKGROUND In utero environments can be highly influential in contributing to the development of offspring obesity. Specifically, vitamin D deficiency during pregnancy is associated with adverse maternal and child health outcomes, however its relationship with offspring obesity remains unclear. We assessed maternal vitamin D status across pregnancy, change in plasma vitamin D concentrations and associations with neonatal birthweight, macrosomia and large for gestational age. METHODS Women (n = 221) aged 18-40 years with singleton (low-risk) pregnancies, attending antenatal clinics at a tertiary-level maternity hospital were recruited at 10-20 weeks gestation. Medical history, maternal weight and blood samples at three antenatal clinic visits were assessed; early (15 ± 3 weeks), mid (27 ± 2 weeks) and late (36 ± 1 weeks) gestation. Maternal 25(OH)D was analysed from stored plasma samples via liquid chromatography-tandem mass spectrometry (LC/MS/MS). Neonatal growth parameters were collected at birth. Unadjusted and adjusted linear and logistic regression assessed associations of maternal vitamin D with birthweight, macrosomia and large for gestational age. RESULTS Mean plasma 25(OH)D increased from early (83.8 ± 22.6 nmol/L) to mid (96.5 ± 28.9 nmol/L) and late (100.8 ± 30.8 nmol/L) gestation. Overall 98% of women were taking vitamin D-containing supplements throughout their pregnancy. Prevalence of vitamin D deficiency (25(OH)D < 50 nmol/L) was 6.5%, 6.3% and 6.8% at early, mid and late pregnancy respectively. No statistically significant association was found between 25(OH)D or vitamin D deficiency at any timepoint with neonatal birthweight, macrosomia or large for gestational age. CONCLUSIONS Prevalence of vitamin D deficiency was low in this cohort of pregnant women and likely related to the high proportion of women taking vitamin D supplements during pregnancy. Maternal 25(OH)D did not impact offspring birth weight or birth size. Future studies in high-risk pregnant populations are needed to further assess maternal vitamin D status and factors in utero which promote early life obesity.
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Affiliation(s)
- Paige F. van der Pligt
- grid.1021.20000 0001 0526 7079Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, Australia ,Department of Nutrition, Western Health, Footscray, VIC Australia
| | - Stacey J. Ellery
- grid.452824.dThe Ritchie Centre, Hudson Institute of Medical Research, Clayton, VIC Australia ,grid.1002.30000 0004 1936 7857Department of Obstetrics and Gynaecology, Monash University, Clayton, VIC Australia
| | - Deborah L. de Guingand
- grid.452824.dThe Ritchie Centre, Hudson Institute of Medical Research, Clayton, VIC Australia ,grid.1002.30000 0004 1936 7857Department of Obstetrics and Gynaecology, Monash University, Clayton, VIC Australia
| | - Gavin Abbott
- grid.1021.20000 0001 0526 7079Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, Australia
| | - Paul A. Della Gatta
- grid.1021.20000 0001 0526 7079Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, Australia
| | - Robin M. Daly
- grid.1021.20000 0001 0526 7079Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, Australia
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Voigt M, Nikischin W, Hentschel R, Strauss A, Kunze M, Ensenauer R, Wittwer-Backofen U, Hagenah HP, Olbertz D, Rochow N. [Individualized Somatic Classification of Newborns Using Birth Weight Percentiles Based On Maternal Body Height and Weight (Results of a Validation Study)]. Z Geburtshilfe Neonatol 2022; 226:377-383. [PMID: 36265498 DOI: 10.1055/a-1830-5519] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
INTRODUCTION Birth weight is influenced by maternal anthropometry. The SGA-rate of newborns of short and light mothers (<158 cm,<53 kg) and the LGA-rate of tall and heavy mothers (>177 cm,>79 kg) are overestimated. The LGA-rate of newborns of shorter mothers and the SGA-rate of taller mothers are underestimated. Individualized birth weight percentiles (IBWP) based on 18 maternal groups (6 groups of height combined with 3 groups of weight), sex and weeks of gestation have been published. The aim of this study is to validate IBWP by evaluating SGA-, AGA-, and LGA-rates using perinatal data. METHODS The validation study compares IBWP (1995 to 2000, n=2.2 million singletons) with percentile values from two German cohorts (i: 1995 to 2000; n=2.3 million and ii: 2007 to 2011, n=3.2 million singletons) using newborns from the Lower Saxony Perinatal Survey (n=0.56 million singleton newborns, 2001 to 2009). SGA-, AGA-, and LGA-rates were calculated using R statistical analysis. RESULTS Common percentile charts based on the total population 1995-2000 and 2007-2011 yielded SGA-rates among shorter mothers of 21.1 to 21.6% and LGA-rates of 2.0 to 3.1%. In taller mothers, SGA-rates were 3.3 to 3.5% and LGA-rates were 26.6 to 27.1%. IBWP achieved SGA-rates of 9.0% and LGA-rates of 11.4 to 11.6% in shorter mothers and SGA- and LGA-rates of 10% in taller mothers. DISCUSSION IBWP consider the maternal size for estimation of the fetal growth potential and achieve expected SGA- and LGA-rates of 10%. Consideration of individual growth potential avoids underestimation and overestimation of SGA- and LGA-rates. It aided analyses of birth weight with IBWP simplify the assessment of the nutritional status.
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Affiliation(s)
- Manfred Voigt
- Universitätsklinikum Freiburg, Klinik für Frauenheilkunde, Freiburg, Germany.,Institut für Kinderernährung, Max-Rubner-Institut, Karlsruhe, Germany.,Universitätsklinikum Freiburg, Biologische Anthropologie, Freiburg, Germany
| | - Werner Nikischin
- Christian-Albrechts- Universität, Medizinische Fakultät, Kiel, Germany
| | - Roland Hentschel
- Universitätsklinikum Freiburg, Zentrum für Kinder- und Jugendmedizin, Funktionsbereich Neonatologie/Intensivmedizin, Freiburg, Germany
| | | | - Mirjam Kunze
- Universitätsklinikum Freiburg, Klinik für Frauenheilkunde, Freiburg, Germany
| | - Regina Ensenauer
- Institut für Kinderernährung, Max-Rubner-Institut, Karlsruhe, Germany
| | | | | | - Dirk Olbertz
- Klinikum Südstadt, Klinik für Neonatologie, Rostock, Germany
| | - Niels Rochow
- Universitätsklinik für Neugeborene, Kinder-und Jugendliche, Paracelsus Medizinische Privatuniversität Nürnberg, Nürnberg, Germany.,Universitätsmedizin Rostock, Kinder und Jugendklinik, Rostock, Germany
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Łoniewska B, Michalczyk K, Podsiadło K, Adamek K, Michalczyk B, Tousty P, Kaczmarczyk M, Łoniewski I. Analysis of the Influence of Pre-Pregnancy BMI and Weight Gain during Pregnancy on the Weight of Healthy Children during the First 2 Years of Life: A Prospective Study. CHILDREN 2022; 9:children9101431. [PMID: 36291367 PMCID: PMC9600872 DOI: 10.3390/children9101431] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/10/2022] [Revised: 09/18/2022] [Accepted: 09/20/2022] [Indexed: 11/16/2022]
Abstract
Background: Increased pre-pregnancy maternal BMI (pBMI) and gestational weight gain (GWG) have been found to increase infants’ birthweight and result in the programming of child weight and impact its later weight gain. Aim: To assess the impact of pBMI and GWG on the weight of children from birth to 2 years of age and over the duration of breastfeeding. Methods: Single Centre observational prospective longitudinal cohort study. Data were collected from medical records, and medical history. The analysis of multiple linear and mixed models was involved. Findings: 20% of females were overweight, while 13% were obese before the pregnancy. An overall model, including gender and smoking, indicated a significant impact of pBMI category on a child’s birth mass (p = 0.01). The GWG category affected a child’s birth weight (p = 0.018, Effect size 0.41). pBMI did not affect the breastfeeding duration. Conclusion: pBMI and GWG correlate with birth weight and weight in neonatal period, however they become insignificant in later childhood. Weight assessment methods among children aged up to two years of age require standardization. Maternal weight before the pregnancy nor the weight gain during the pregnancy do not influence the length of breastfeeding. The biggest limitation was the small sample size and the failure to account for weight gain per trimester of pregnancy. Further research on a larger population should be continued.
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Affiliation(s)
- Beata Łoniewska
- Department of Neonatology and Intensive Neonatal Care, Pomeranian Medical University in Szczecin, al. Powstańców Wielkopolskich 72, 70-111 Szczecin, Poland
| | - Kaja Michalczyk
- Department of Gynecological Surgery and Gynecological Oncology of Adults and Adolescents, Pomeranian Medical University in Szczecin, al. Powstańców Wielkopolskich 72, 70-111 Szczecin, Poland
- Correspondence:
| | - Konrad Podsiadło
- Department of Clinical and Molecular Biochemistry, Pomeranian Medical University in Szczecin, al. Powstańców Wielkopolskich 72, 70-111 Szczecin, Poland
| | - Karolina Adamek
- Department of Neonatology and Intensive Neonatal Care, Pomeranian Medical University in Szczecin, al. Powstańców Wielkopolskich 72, 70-111 Szczecin, Poland
| | - Barbara Michalczyk
- Department of Neonatology and Intensive Neonatal Care, Pomeranian Medical University in Szczecin, al. Powstańców Wielkopolskich 72, 70-111 Szczecin, Poland
| | - Piotr Tousty
- Department of Obstetrics and Gynecology, Pomeranian Medical University in Szczecin, al. Powstańców Wielkopolskich 72, 70-111 Szczecin, Poland
| | - Mariusz Kaczmarczyk
- Department of Clinical and Molecular Biochemistry, Pomeranian Medical University in Szczecin, al. Powstańców Wielkopolskich 72, 70-111 Szczecin, Poland
| | - Igor Łoniewski
- Department of Human Nutrition and Metabolomics, Pomeranian Medical University in Szczecin, 71-460 Szczecin, Poland
- Department of Biochemical Sciences, Pomeranian Medical University in Szczecin, Broniewskiego 24, 71-460 Szczecin, Poland
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10
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Xue Y, Xin W, Li C, Zeng X, Song Z, Cao C, Zhao T. Maternal alloimmune antibodies against HPA and HLA class I antigens are associated with reduced birthweight among healthy neonates delivered by Chinese women. Acta Obstet Gynecol Scand 2022; 101:1215-1219. [PMID: 35871773 PMCID: PMC9812071 DOI: 10.1111/aogs.14421] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Revised: 05/25/2022] [Accepted: 06/17/2022] [Indexed: 01/07/2023]
Abstract
INTRODUCTION It is well known that HPA-1a antibodies lead to fetal and neonatal alloimmune thrombocytopenia (FNAIT), and an association with reduced birthweight in boys has been reported. Although it remains unclear whether HLA antibodies cause FNAIT, an association between HLA class I antibodies and reduced birthweight in FNAIT neonates has been observed. The aim of this study was to investigate the incidence of platelet antibodies among Chinese women and the impact of maternal alloimmune antibodies on birthweight among healthy neonates. MATERIAL AND METHODS In this retrospective observational cohort study, platelet antibody screening was performed among women hospitalized for delivery from March 2019 to November 2020. A portion of each serum sample was used to distinguish HLA class I antibodies from HPA antibodies. Based on neonatal sex, gestational age and maternal age, platelet antibody-negative women who were hospitalized for delivery during the same period were randomly selected as reference groups at a 1:1 ratio for comparisons of the birthweights of healthy neonates delivered by women who were positive or negative for platelet antibodies. RESULTS Among 15 156 women, 1008 (6.7%) were positive for platelet antibodies; the incidences of positive platelet antibody were 1.2%, 1.9%, 1.6% and 2.0% among women with 1, 2, 3 and >3 pregnancies, respectively. Among 787 platelet antibody-positive serum samples available for further analysis, 548 (69.6%) were positive for HLA class I antibodies bound to platelets, and 239 (30.4%) were positive for HPA antibodies. The average birthweight of healthy neonates delivered by women who were positive for platelet antibodies, HLA class I antibodies or HPA antibodies was 161-483 g lower than that of neonates delivered by women who were negative for these antibodies (P < 0.001). Regarding birthweight reduction, there was no significant difference among women who were positive for these antibodies or between boys and girls (P > 0.05). CONCLUSIONS This study is the first to report that maternal HPA and HLA class I antibodies are associated with reduced birthweight among healthy neonates delivered by Chinese women. This finding provides information for the study of the effect of maternal alloimmune antibodies on fetal development.
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Affiliation(s)
- Yang Xue
- Department of TransfusionGuiyang Maternal and Child Health Care HospitalGuiyangGuizhouChina
| | - Wenlong Xin
- Department of TransfusionGuiyang Maternal and Child Health Care HospitalGuiyangGuizhouChina
| | - Chao Li
- Department of TransfusionGuiyang Maternal and Child Health Care HospitalGuiyangGuizhouChina
| | - Xing Zeng
- Department of TransfusionGuiyang Maternal and Child Health Care HospitalGuiyangGuizhouChina
| | - Zhanyun Song
- Department of TransfusionGuiyang Maternal and Child Health Care HospitalGuiyangGuizhouChina
| | - Chen Cao
- The United Reference Laboratory (jiangyin) for Blood Group Gene Detection of National Health CommissionJiangyinJiangsuChina
| | - Tongmao Zhao
- The United Reference Laboratory (jiangyin) for Blood Group Gene Detection of National Health CommissionJiangyinJiangsuChina
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11
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Ge J, Zhao S, Peng X, Walker AN, Yang N, Zhou H, Wang L, Zhang C, Zhou M, You H. Analysis of the Weight Management Behavior of Chinese Pregnant Women: An Integration of the Protection Motivation Theory and the Information-Motivation-Behavioral Skills Model. Front Public Health 2022; 10:759946. [PMID: 35186832 PMCID: PMC8855928 DOI: 10.3389/fpubh.2022.759946] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2021] [Accepted: 01/13/2022] [Indexed: 11/13/2022] Open
Abstract
Inappropriate gestational weight gain has become a public health concern that threatens maternal and child health. Pregnant women's ability to manage their weight during pregnancy directly impacts their weight gain. In this study, we integrated the protection motivation theory and the information-motivation-behavioral skills model to develop an integrative theoretical model suitable for pregnancy weight management and reveal significant explainable factors of weight management behaviors during pregnancy. Based on a cross-sectional survey of 550 pregnant women from Jiangsu province, we came up with our findings. The results showed that several factors influenced pregnancy weight management behavior. According to the research, information, self-efficacy, response costs, and behavioral skills were significantly associated with weight management behaviors during pregnancy, while behavioral skills were also significant mediators of information, self-efficacy, and behavior. Furthermore, the information related to pregnancy weight management had the biggest impact on weight management behavior during pregnancy. The results of the model fit were acceptable and the integrative model could explain 30.6% of the variance of weight management behavior during pregnancy, which implies that the integrative theoretical model can effectively explain and predict weight management behaviors during pregnancy. Our study provides practical implications for the integrative model in improving pregnancy weight management behavior and offers a theoretical base for the weight management of pregnant women.
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Affiliation(s)
- Jinjin Ge
- Department of Social Medicine and Health Education, School of Public Health, Nanjing Medical University, Nanjing, China
| | - Shiqi Zhao
- Department of Social Medicine and Health Education, School of Public Health, Nanjing Medical University, Nanjing, China
| | - Xueqing Peng
- Department of Social Medicine and Health Education, School of Public Health, Nanjing Medical University, Nanjing, China
| | - Anita Nyarkoa Walker
- Department of Social Medicine and Health Education, School of Public Health, Nanjing Medical University, Nanjing, China
| | - Ni Yang
- Department of Gynecology and Obstetrics, Changzhou Maternal and Child Health Care Hospital Affiliated to Nanjing Medical University, Changzhou, China
| | - Hua Zhou
- Department of Gynecology and Obstetrics, Changzhou Maternal and Child Health Care Hospital Affiliated to Nanjing Medical University, Changzhou, China
| | - Li Wang
- Department of Gynecology and Obstetrics, Changzhou Maternal and Child Health Care Hospital Affiliated to Nanjing Medical University, Changzhou, China
| | - Chi Zhang
- School of Nursing, Nanjing Medical University, Nanjing, China
| | - Meng Zhou
- School of Nursing, Nanjing Medical University, Nanjing, China
| | - Hua You
- Department of Social Medicine and Health Education, School of Public Health, Nanjing Medical University, Nanjing, China
- Institute of Healthy Jiangsu Development, Nanjing Medical University, Nanjing, China
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12
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Clinical Observation of Effects of Prepregnancy Body Mass Index and Weight Gain during Pregnancy on Neonatal Weight and Delivery Outcome. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2021; 2021:8323189. [PMID: 34616482 PMCID: PMC8487824 DOI: 10.1155/2021/8323189] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/11/2021] [Accepted: 09/02/2021] [Indexed: 11/17/2022]
Abstract
Objective. The increase of BMI before pregnancy and during pregnancy will lead to hypertensive disorder in pregnancy (HDP) and abnormal glycolipid metabolism, as well as increase the risk of neonatal weight abnormalities and adverse pregnancy outcome. This study retrospectively analyzed the clinical data of 358 women who were admitted to the obstetrics department of our hospital from January 2018 to July 2019. And the relationship between prepregnancy BMI, BMI increase during pregnancy and delivery methods, postpartum hemorrhage, neonatal weight, premature delivery, neonatal asphyxia, gestational diabetes mellitus (GDM), and hypertension during pregnancy (HDP) was observed and compared. The results show that both high BMI before pregnancy and excessive weight gain during pregnancy can lead to the incidence of abnormal birth weight and adverse birth outcome increase. Therefore, in order to reduce the incidence of neonatal weight abnormalities and adverse birth outcomes and to prevent the adverse effects during pregnancy and postpartum, clinically, obese women should be guided to eat according to reasonable diet and exercise to control their weight.
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13
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Wang Z, Zhao J, Ma X, Sun Y, Hao G, Yang A, Ren W, Jin L, Lu Q, Wu G, Ling X, Hao C, Zhang B, Liu X, Yang D, Zhu Y, Li J, Bao H, Wang A, Liu J, Chen ZJ, Tan J, Shi Y. Effect of Orlistat on Live Birth Rate in Overweight or Obese Women Undergoing IVF-ET: A Randomized Clinical Trial. J Clin Endocrinol Metab 2021; 106:e3533-e3545. [PMID: 33991186 DOI: 10.1210/clinem/dgab340] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2021] [Indexed: 11/19/2022]
Abstract
CONTEXT Obesity management prior to infertility treatment remains a challenge. To date, results from randomized clinical trials involving weight loss by lifestyle interventions have shown no evidence of improved live birth rate. OBJECTIVE This work aimed to determine whether pharmacologic weight-loss intervention before in vitro fertilization and embryo transfer (IVF-ET) can improve live birth rate among overweight or obese women. METHODS We conducted a randomized, double-blinded, placebo-controlled trial across 19 reproductive medical centers in China, from July 2017 to January 2019. A total of 877 infertile women scheduled for IVF who had a body mass index of 25 or greater were randomly assigned to receive orlistat (n = 439) or placebo (n = 438) treatment for 4 to 12 weeks. The main outcome measurement was the live birth rate after fresh ET. RESULTS The live birth rate was not significantly different between the 2 groups (112 of 439 [25.5%] with orlistat and 112 of 438 [25.6%] with placebo; P = .984). No significant differences existed between the groups as to the rates of conception, clinical pregnancy, or pregnancy loss. A statistically significant increase in singleton birth weight was observed after orlistat treatment (3487.50 g vs 3285.17 g in the placebo group; P = .039). The mean change in body weight during the intervention was -2.49 kg in the orlistat group, as compared to -1.22 kg in the placebo group, with a significant difference (P = .005). CONCLUSION Orlistat treatment, prior to IVF-ET, did not improve the live birth rate among overweight or obese women, although it was beneficial for weight reduction.
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Affiliation(s)
- Ze Wang
- Center for Reproductive Medicine, Cheeloo College of Medicine, Shandong University; The Key Laboratory of Reproductive Endocrinology of Ministry of Education; National Research Center for Assisted Reproductive Technology and Reproductive Genetics, Jinan, Shandong Province, 250001,China
| | - Junli Zhao
- Department of Reproductive Medicine, General Hospital of Ningxia Medical University, Ningxia, China
| | - Xiang Ma
- Department of Reproductive Medicine, First Affiliated Hospital of Nanjing Medical University/Jiangsu Province Hospital; State Key Laboratory of Reproductive Medicine, Nanjing, Jiangsu Province, 210029, China
| | - Yun Sun
- Center for Reproductive Medicine, Ren Ji Hospital; School of Medicine, Shanghai Jiao Tong University; Shanghai Key Laboratory of Assisted Reproduction and Reproductive Genetics, Shanghai, 200135, China
| | - Guimin Hao
- Department of Reproductive Medicine, the Second Hospital of Hebei Medical University, Shijiazhuang, Hebei Province, 050000, China
| | - Aijun Yang
- Department of Reproductive Medicine, Affiliated Hospital of Jining Medical University, Jining, Shandong Province, 272001, China
| | - Wenchao Ren
- Reproductive Hospital of Weifang Medical University, Weifang, Shandong Province, 261031, China
| | - Lei Jin
- Department of Reproductive Medicine, Tongji Hospital of Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei Province, 430030, China
| | - Qun Lu
- Center of Reproductive Medicine, Peking University People's Hospital, Beijing, 100044, China
| | - Gengxiang Wu
- Center for Reproductive Medicine, Renmin Hospital of Wuhan University, Wuhan, Hubei Province, 430060, China
| | - Xiufeng Ling
- Department of Reproductive Medicine, Maternity and Child Health Care Hospital, Women's Hospital of Nanjing Medical University, Nanjing, Jiangsu Province, 210004, China
| | - Cuifang Hao
- Center for Reproductive Medicine, Yantai Yuhuangding Hospital, Yantai, Shandong Province, 264000, China
| | - Bo Zhang
- Center for Reproductive Medicine, Maternal and Child Health Hospital/Obstetrics and Gynecology Hospital of Guangxi Zhuang Autonomous Region, Guangxi, 530000, China
| | - Xinyu Liu
- Department of Reproductive Medicine, Shenyang 204 Hospital, Shenyang, Liaoning Province, 110122, China
| | - Dongzi Yang
- Division of Reproductive Medicine, Department of Obstetrics and Gynecology, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, Guangdong Province, 510120, China
| | - Yimin Zhu
- Department of Reproductive Endocrinology, Women's Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang Province, 310006, China
| | - Jing Li
- Center for Reproductive Medicine, Cheeloo College of Medicine, Shandong University; The Key Laboratory of Reproductive Endocrinology of Ministry of Education; National Research Center for Assisted Reproductive Technology and Reproductive Genetics, Jinan, Shandong Province, 250001,China
| | - Hongchu Bao
- Center for Reproductive Medicine, Yantai Yuhuangding Hospital, Yantai, Shandong Province, 264000, China
| | - Ancong Wang
- Department of Reproductive Medicine, Linyi People' Hospital, Linyi, Shandong Province, 276000, China
| | - Jianqiao Liu
- Department of Obstetrics and Gynecology, Center for Reproductive Medicine/Department of Fetal Medicine and Prenatal Diagnosis/BioResource Research Center, Key Laboratory for Major Obstetric Diseases of Guangdong Province, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong Province, 510150, China
| | - Zi-Jiang Chen
- Center for Reproductive Medicine, Cheeloo College of Medicine, Shandong University; The Key Laboratory of Reproductive Endocrinology of Ministry of Education; National Research Center for Assisted Reproductive Technology and Reproductive Genetics, Jinan, Shandong Province, 250001,China
| | - Jichun Tan
- Center for Reproductive Medicine, Department of Obstetrics and Gynecology, Shengjing Hospital of China Medical University, Shenyang, Liaoning Province, 110022, China
| | - Yuhua Shi
- Center for Reproductive Medicine, Cheeloo College of Medicine, Shandong University; The Key Laboratory of Reproductive Endocrinology of Ministry of Education; National Research Center for Assisted Reproductive Technology and Reproductive Genetics, Jinan, Shandong Province, 250001,China
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14
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Skow RJ, Steinback CD, Davenport MH. Prenatal Exercise and Cardiovascular Health (PEACH) Study: Impact on the Vascular System. Med Sci Sports Exerc 2021; 53:2605-2617. [PMID: 34225321 DOI: 10.1249/mss.0000000000002736] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
PURPOSE Healthy pregnancy is typically associated with favorable vascular adaptations to both structure and function of the peripheral arteries. Exercise is independently associated with improvements in peripheral vascular health; however, the impact of exercise on prenatal adaptations is unclear. Therefore, we hypothesized that a structured aerobic exercise intervention between the second and third trimester (TM2 and TM3, respectively) of pregnancy would augment the already-positive changes in vascular outcomes. METHODS We recruited 59 inactive pregnant women (<20 weeks gestation) and randomized them into control (standard care; n = 28) or exercise (moderate intensity aerobic exercise, 3-4 days/week, 25-40 minutes, 14 ± 1 weeks; n = 31) conditions. Before and after the intervention all women completed comprehensive peripheral vascular assessment, which included blood markers of vascular health, carotid distensibility metrics, measures of arterial stiffness (pulse wave velocity; PWV), and [superficial] femoral artery reactivity during cold pressor test (CPT). RESULTS Carotid artery diameter increased from 6.5 mm to 6.9 mm (p < 0.001) strain (%)decreased from 9.9% to 8.4% (p < 0.001). Carotid artery blood flow, compliance and distensibility coefficients, stiffness (β), distensibility (1/β), and Elastic modulus were not different across gestation. PWV was not different across gestation. Superficial femoral artery diameter was increased from 5.4 mm to 5.6 mm (p = 0.004) while blood flow, conductance, and resistance at rest and during CPT were not different across gestation. None of our measures of vascular health were impacted by exercise. CONCLUSION We did not observe an impact of aerobic exercise on altering the changes across pregnancy in blood vessel health. However, the present study was conducted in women who were overall at low risk for developing gestational hypertension and should be interpreted with caution. Future work in high-risk women is needed.
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Affiliation(s)
- Rachel J Skow
- Program for Pregnancy and Postpartum Health, Faculty of Kinesiology, Sport, and Recreation, University of Alberta, Edmonton, Alberta, Canada
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