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Bazzazian S, Ozgoli G, Riazi H, Mahmoodi Z, Vafa M, Nasiri M. The relationship between social determinants of health and postpartum weight retention based on the World Health Organization model: path analysis. BMC Public Health 2023; 23:323. [PMID: 36788506 PMCID: PMC9926434 DOI: 10.1186/s12889-023-15207-8] [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: 07/05/2022] [Accepted: 02/03/2023] [Indexed: 02/16/2023] Open
Abstract
BACKGROUND Postpartum weight retention (PPWR) causes obesity, chronic diseases, and occurring adverse maternal-fetal and neonatal outcomes. Given the social factors' effect on health and disease and considering the lack of information on social determinants of health (SDH) effects on PPWR, this study was conducted to survey the relationship between SDH and PPWR based on the World Health Organization (WHO) model. METHODS A cross-sectional study was performed on 400 women six months after delivery in 2020. Twelve health centers were randomly selected from the three universities of Medical Sciences in the city of Tehran, Iran. Participants were selected by convenience method and based on eligibility. Questionnaires used included: Lifestyle Profile Health Promoting II, Short Form Postpartum Quality of Life Questionnaire, Multidimensional Scale of Perceived Social Support, Postpartum Social Support, Depression Anxiety Stress Scales, and questionnaires designed by reviewing the literature about breastfeeding, sleep, contraceptive, child health, unhealthy behaviors, postpartum nutritional awareness/beliefs, body satisfaction, access to postpartum care, socioeconomic status, demographic, and obstetric questionnaire. Data analysis was performed in SPSS-23, and the relationship model was examined using the path analysis method in LISREL-8.8. RESULTS Path analysis indicated the direct effect of six intermediate factors on PPWR including: gestational weight gain (β = 0.42), access to postpartum care (β = 0.11), postpartum nutritional awareness/beliefs (β=-0.17), anxiety (β = 0.09), sleep duration (β=-0.09), pre-pregnancy body mass index (β = 0.09). Among the structural factors, woman's education and socioeconomic status had an indirect negative effect on PPWR. The model fit indices showed good fit (RMSE = 0/05, GFI = 0.92, CFI = 0.92, χ2/df = 2.17). CONCLUSION The results indicate the effect of structural and intermediate determinants of health on PPWR. It is recommended to use the proposed model as an appropriate framework in the research, design, and implementation of programs to prevent and control PPWR.
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Affiliation(s)
- Shahin Bazzazian
- grid.411600.2Department of Midwifery and Reproductive Health, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Giti Ozgoli
- Midwifery and Reproductive Health Research Center, Department of Midwifery and Reproductive Health, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Vali Asr Ave., Niayesh Cross Road, Niayesh Complex, 1985717443, Tehran, Iran.
| | - Hedyeh Riazi
- grid.411600.2Department of Midwifery and Reproductive Health, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Zohreh Mahmoodi
- grid.411705.60000 0001 0166 0922Social Determinants of Health Research Center, Alborz University of Medical Sciences, Karaj, Iran
| | - Mohammadreza Vafa
- grid.411746.10000 0004 4911 7066Nutrition Department, School of Public Health, Iran University of Medical Sciences, Tehran, Iran
| | - Malihe Nasiri
- grid.411600.2 Department of Basic Sciences, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Effect of Ultra-Processed Foods Consumption and Some Lifestyle Factors during Pregnancy on Baby's Anthropometric Measurements at Birth. Nutrients 2022; 15:nu15010044. [PMID: 36615702 PMCID: PMC9824718 DOI: 10.3390/nu15010044] [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: 11/09/2022] [Revised: 12/07/2022] [Accepted: 12/12/2022] [Indexed: 12/24/2022] Open
Abstract
OBJECTIVE This study aimed to assess the association between ultra-processed foods (UPF) consumption and some lifestyle factors during pregnancy and the baby's anthropometric measurements at birth. METHODS Cross-sectional study conducted with immediate postpartum women and their babies. Food consumption during pregnancy was assessed retrospectively by a semi-quantitative food frequency questionnaire, and the baby's anthropometric measurements were obtained from the medical records. The percentual of energy from UPF was estimated, categorized in tertiles, and associated with the baby's anthropometric measurements using multinomial logistic regression, adjusting by maternal characteristics (per capita income, maternal age, gestational weight gain, parity, physical activity, and number of prenatal consultations). RESULTS A total of 626 immediate postpartum women and their babies were evaluated. The mean percentual of energy from UPF consumption during pregnancy was 30.56%. Before adjustment, there was a greater chance of insufficient birth weight among babies of immediate postpartum women in the highest tertile of UPF consumption (OR 1.72; 95% CI 1.09-2.70; p = 0.020); however, such an association was not significant in the adjusted analyses. CONCLUSIONS No association between UPF consumption during pregnancy and baby's anthropometric measurements at birth was observed, probably due to the multifactorial nature of anthropometry and the interference of sociodemographic, gestational, and environmental factors in the baby's health outcomes.
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Weight Gain and Change in Body Mass Index after Age 20 in the Brazilian Population and Associated Sociodemographic Factors: Data from the National Health Survey. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19052851. [PMID: 35270542 PMCID: PMC8910275 DOI: 10.3390/ijerph19052851] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/26/2022] [Revised: 02/17/2022] [Accepted: 02/23/2022] [Indexed: 12/21/2022]
Abstract
Obesity is considered one of the main contemporary public health problems. We aim to assess changes in body weight and nutritional status in adulthood and the associated sociodemographic variables. We use data from the 2013 National Health Survey (n = 21,743). Changes in weight and body mass index (BMI) were calculated based on mean difference between measurements at age 20 and data collected at the interview, stratified by sex. The association was analyzed using linear regression. Mean weight gain was greater among women than men. The largest gain was verified among the younger adults for both sexes. Age was found to be associated with weight and BMI change in men and women where, for every additional year of age, there was an increase in weight and BMI of 0.10 kg and 0.04 kg/m2 in men and of 0.22 kg and 0.09 kg/m2 in women, respectively. For education, a direct association was found for men and an inverse for women. Association with area of residence was significant among males only, where rural men gained less than their urban counterparts. Weight gain was progressive, being more marked in the younger group, and was associated with education differently according to sex.
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Flores TR, Nunes BP, Miranda VIA, Silveira MFD, Domingues MR, Bertoldi AD. [Gestational weight gain and postpartum weight retention: data from the 2015 birth cohort in Pelotas, Rio Grande do Sul State, Brazil]. CAD SAUDE PUBLICA 2020; 36:e00203619. [PMID: 33237206 DOI: 10.1590/0102-311x00203619] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2019] [Accepted: 04/14/2020] [Indexed: 11/22/2022] Open
Abstract
The study's objectives were to describe the prevalence of gestational weight gain and weight retention at 3 and 12 months postpartum and to identify possible socioeconomic inequalities in adequate gestational weight gain. A longitudinal study was performed with data from the 2015 Pelotas, Rio Grande do Sul State, Brazil, birth cohort. Gestational weight gain was classified according to the US Institute of Medicine guidelines. Weight retention at 3 and 12 months was calculated according to the mother's weight at each period, subtracting pregestational weight. To identify possible inequalities, the study used Slope Index (SII) and Concentration Index (CIX). The sample included mothers with information on the study's outcome (n = 4,102). Prevalence of adequate gestational weight gain was 33.5% (95% confidence interval - 95%CI: 32.1; 35.0). Slight inequalities were observed in the prevalence of adequate weight gain in mothers with less schooling [CIX = 1.88 (95%CI: -0.76; 4.52); SII = 4.27 (95%CI: -0.87; 9.41)] and in mothers belonging to the poorest income quintile- 1st quintile- [CIX = 1.04 (95%CI: -1.60; 3.67); SII = 2.93 (95%CI: -2.06; 7.92)], but these differences were not statistically significant. Mean postpartum weight gain was 2.3kg (standard deviation - SD = 6.4) and 1.4kg (SD = 8.8) at 3 and 12 months, respectively. One-third of the women showed adequate weight gain. The observed inequalities in prevalence of adequate gestational weight gain in women with less schooling and in the poorest income quintile were not statistically significant.
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Carrilho TRB, Farias DR, Batalha MA, Costa NCF, Rasmussen KM, Reichenheim ME, Ohuma EO, Hutcheon JA, Kac G. Brazilian Maternal and Child Nutrition Consortium: establishment, data harmonization and basic characteristics. Sci Rep 2020; 10:14869. [PMID: 32913200 PMCID: PMC7483530 DOI: 10.1038/s41598-020-71612-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2020] [Accepted: 08/18/2020] [Indexed: 12/03/2022] Open
Abstract
Pooled data analysis in the field of maternal and child nutrition rarely incorporates data from low- and middle-income countries and existing studies lack a description of the methods used to harmonize the data and to assess heterogeneity. We describe the creation of the Brazilian Maternal and Child Nutrition Consortium dataset, from multiple pooled longitudinal studies, having gestational weight gain (GWG) as an example. Investigators of the eligible studies published from 1990 to 2018 were invited to participate. We conducted consistency analysis, identified outliers, and assessed heterogeneity for GWG. Outliers identification considered the longitudinal nature of the data. Heterogeneity was performed adjusting multilevel models. We identified 68 studies and invited 59 for this initiative. Data from 29 studies were received, 21 were retained for analysis, resulting in a final sample of 17,344 women with 72,616 weight measurements. Fewer than 1% of all weight measurements were flagged as outliers. Women with pre-pregnancy obesity had lower values for GWG throughout pregnancy. GWG, birth length and weight were similar across the studies and remarkably similar to a Brazilian nationwide study. Pooled data analyses can increase the potential of addressing important questions regarding maternal and child health, especially in countries where research investment is limited.
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Affiliation(s)
- Thaís Rangel Bousquet Carrilho
- Nutritional Epidemiology Observatory, Josué de Castro Nutrition Institute, Federal University of Rio de Janeiro, Avenida Carlos Chagas Filho 373/CCS, bloco J, 2 andar, sala 29, Cidade Universitária, Ilha do Fundão, Rio de Janeiro, RJ, 21941-902, Brazil
| | - Dayana Rodrigues Farias
- Nutritional Epidemiology Observatory, Josué de Castro Nutrition Institute, Federal University of Rio de Janeiro, Avenida Carlos Chagas Filho 373/CCS, bloco J, 2 andar, sala 29, Cidade Universitária, Ilha do Fundão, Rio de Janeiro, RJ, 21941-902, Brazil
| | - Mônica Araújo Batalha
- Nutritional Epidemiology Observatory, Josué de Castro Nutrition Institute, Federal University of Rio de Janeiro, Avenida Carlos Chagas Filho 373/CCS, bloco J, 2 andar, sala 29, Cidade Universitária, Ilha do Fundão, Rio de Janeiro, RJ, 21941-902, Brazil
| | - Nathalia Cristina Freitas Costa
- Nutritional Epidemiology Observatory, Josué de Castro Nutrition Institute, Federal University of Rio de Janeiro, Avenida Carlos Chagas Filho 373/CCS, bloco J, 2 andar, sala 29, Cidade Universitária, Ilha do Fundão, Rio de Janeiro, RJ, 21941-902, Brazil
| | - Kathleen M Rasmussen
- Division of Nutritional Sciences, Cornell University, 227 Savage Hall, Ithaca, NY, 14850, USA
| | - Michael E Reichenheim
- Department of Epidemiology, Institute of Social Medicine, Rio de Janeiro State University, Rua São Francisco Xavier, 524, 7 andar, Bloco D, Sala 7018, Maracanã, Rio de Janeiro, RJ, 20550-013, Brazil
| | - Eric O Ohuma
- Maternal, Adolescent, Reproductive and Child Health (MARCH) Centre, London School of Hygiene and Tropical Medicine, Keppel Street, London, WC1E 7HT, UK.,Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Peter Medawar Building for Pathogen Research (PMB), South Parks Road, Oxford, OX1 3SY, UK
| | - Jennifer A Hutcheon
- Department of Obstetrics and Gynaecology, Faculty of Medicine, University of British Columbia, Suite 930, 1125 Howe Street, Vancouver, BC, V6Z 2K8, Canada
| | - Gilberto Kac
- Nutritional Epidemiology Observatory, Josué de Castro Nutrition Institute, Federal University of Rio de Janeiro, Avenida Carlos Chagas Filho 373/CCS, bloco J, 2 andar, sala 29, Cidade Universitária, Ilha do Fundão, Rio de Janeiro, RJ, 21941-902, Brazil.
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