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Sullivan EL, Molloy KR, Dunn GA, Balanzar AL, Young AS, Loftis JM, Ablow JC, Nigg JT, Gustafsson HC. Adipokines measured during pregnancy and at birth are associated with infant negative affect. Brain Behav Immun 2024; 120:34-43. [PMID: 38772428 DOI: 10.1016/j.bbi.2024.05.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/22/2023] [Revised: 03/18/2024] [Accepted: 05/18/2024] [Indexed: 05/23/2024] Open
Abstract
BACKGROUND Increased adiposity during pregnancy may be related to offspring risk for mental health disorders, although the biological mechanisms are poorly understood. One promising hypothesis is that factors secreted from adipocytes such as leptin and adiponectin may explain this association. The current study examined whether pregnancy or umbilical cord blood concentrations of leptin and/or adiponectin a) predict elevated infant negative affect at 6 months (an early life marker of risk for psychopathology); and b) help explain the association between pregnancy adiposity and increased infant negative affect. METHODS Data came from a prospective cohort (N = 305) of pregnant individuals and their offspring. Second trimester adiposity was assessed using air displacement plethysmography. Concentrations of leptin and adiponectin were measured in second trimester plasma and umbilical cord plasma. Infant negative affect was assessed by standardized observation at 6 months. Second trimester inflammation was assessed using a comprehensive panel of cytokines. RESULTS Lower second trimester adiponectin was associated with elevated infant negative affect, and mediated the effect of pregnancy adiposity on infant negative affect. This association was independent of the effect of second trimester inflammation. Umbilical cord leptin also predicted higher infant negative affect and mediated the association between pregnancy adiposity and infant negative affect. CONCLUSIONS This is the first study to link pregnancy adiponectin or cord blood leptin to infant markers of risk for psychopathology, and the first to demonstrate that these adipokines mediate the association between pregnancy adiposity and offspring behavioral outcomes, suggesting novel markers of risk and potential mechanisms of effect.
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Affiliation(s)
- Elinor L Sullivan
- Department of Psychiatry, Oregon Health & Science University, United States; Center for Mental Health Innovation, Oregon Health & Science University, United States; Division of Neuroscience, Oregon National Primary Research Center, United States.
| | - Kelly R Molloy
- Department of Psychiatry, Oregon Health & Science University, United States; Center for Mental Health Innovation, Oregon Health & Science University, United States
| | - Geoffrey A Dunn
- Department of Psychiatry, Oregon Health & Science University, United States; Center for Mental Health Innovation, Oregon Health & Science University, United States
| | - Adriana L Balanzar
- Department of Psychiatry, Oregon Health & Science University, United States; Center for Mental Health Innovation, Oregon Health & Science University, United States
| | - Anna S Young
- Department of Psychiatry, Oregon Health & Science University, United States; Center for Mental Health Innovation, Oregon Health & Science University, United States
| | - Jennifer M Loftis
- Department of Psychiatry, Oregon Health & Science University, United States; VA Portland Health Care System, United States
| | | | - Joel T Nigg
- Department of Psychiatry, Oregon Health & Science University, United States; Center for Mental Health Innovation, Oregon Health & Science University, United States
| | - Hanna C Gustafsson
- Department of Psychiatry, Oregon Health & Science University, United States; Center for Mental Health Innovation, Oregon Health & Science University, United States
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Roland CB, Seyedhosseini P, Knudsen SDP, Jessen AD, Jensen IKB, Bendix JM, van Hall G, Molsted S, Alomairah SA, Løkkegaard E, Stallknecht B, Clausen TD. Effects of prenatal exercise interventions on maternal body composition: A secondary analysis of the FitMum randomized controlled trial. PLoS One 2024; 19:e0308214. [PMID: 39088510 PMCID: PMC11293652 DOI: 10.1371/journal.pone.0308214] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2024] [Accepted: 07/18/2024] [Indexed: 08/03/2024] Open
Abstract
The main objective of the study was to investigate the effects of prenatal exercise interventions on maternal body composition at 28 weeks gestation and 7-14 days after delivery. We also explored associations between physical activity (PA) per se and body composition. This study presents secondary outcomes of the FitMum randomized controlled trial, which included healthy inactive pregnant women at gestational age ≤ 15+0 weeks. They were randomized to structured supervised exercise training, motivational counselling on PA, or standard care. Maternal body composition was measured by doubly labeled water at 28 weeks gestation (n = 134) and by dual-energy X-ray absorptiometry scan 7-14 days after delivery (n = 117). PA, including moderate-to-vigorous-intensity PA (MVPA), active kilocalories, and steps, were measured continuously from inclusion to delivery by a wrist-worn activity tracker. One hundred fifty pregnant women were included with a median pre-pregnancy body mass index (BMI) of 24.1 (21.6-27.9) kg/m2. We found no differences between groups in fat mass, fat percentage or fat-free mass at 28 weeks gestation or 7-14 days after delivery. Visceral adipose tissue mass and bone mineral density measured 7-14 days after delivery did not differ between groups either. Linear regression analyses adjusted for pre-pregnancy BMI showed that a higher number of daily steps was associated with lower fat mass, fat percentage, and visceral adipose tissue mass at 28 weeks gestation and 7-14 days after delivery. Active kilocalories during pregnancy was positively associated with fat-free mass 7-14 days after delivery. Neither structured supervised exercise training nor motivational counselling on PA during pregnancy affected maternal body composition at 28 weeks gestation or 7-14 days after delivery compared to standard care. Interestingly, when adjusted for pre-pregnancy BMI, higher number of daily steps was associated with lower fat content during pregnancy and after delivery, whereas MVPA and active kilocalories were not. Trial registration: ClinicalTrials.gov; NCT03679130; 20/09/2018.
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Affiliation(s)
- Caroline Borup Roland
- Department of Biomedical Sciences, University of Copenhagen, Copenhagen, Denmark
- Department of Gynaecology and Obstetrics, Copenhagen University Hospital–North Zealand, Hilleroed, Denmark
| | - Parisa Seyedhosseini
- Department of Nuclear Medicine and Clinical Physiology, Copenhagen University Hospital–North Zealand, Hilleroed, Denmark
| | - Signe de Place Knudsen
- Department of Biomedical Sciences, University of Copenhagen, Copenhagen, Denmark
- Department of Gynaecology and Obstetrics, Copenhagen University Hospital–North Zealand, Hilleroed, Denmark
| | - Anne Dsane Jessen
- Department of Biomedical Sciences, University of Copenhagen, Copenhagen, Denmark
- Department of Gynaecology and Obstetrics, Copenhagen University Hospital–North Zealand, Hilleroed, Denmark
| | - Ida Karoline Bach Jensen
- Department of Gynaecology and Obstetrics, Copenhagen University Hospital–North Zealand, Hilleroed, Denmark
| | - Jane M. Bendix
- Department of Gynaecology and Obstetrics, Copenhagen University Hospital–North Zealand, Hilleroed, Denmark
- Department of Clinical Research, Copenhagen University Hospital–North Zealand, Hilleroed, Denmark
| | - Gerrit van Hall
- Department of Biomedical Sciences, University of Copenhagen, Copenhagen, Denmark
- Clinical Biochemistry, Clinical Metabolomics Core Facility, Rigshospitalet, Copenhagen, Denmark
| | - Stig Molsted
- Department of Clinical Research, Copenhagen University Hospital–North Zealand, Hilleroed, Denmark
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Saud Abdulaziz Alomairah
- Department of Biomedical Sciences, University of Copenhagen, Copenhagen, Denmark
- Department of Mental Health, John Hopkins Bloomberg School of Public Health, Baltimore, MD, United States of America
| | - Ellen Løkkegaard
- Department of Gynaecology and Obstetrics, Copenhagen University Hospital–North Zealand, Hilleroed, Denmark
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Bente Stallknecht
- Department of Biomedical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Tine D. Clausen
- Department of Gynaecology and Obstetrics, Copenhagen University Hospital–North Zealand, Hilleroed, Denmark
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
- Department of Gynecology, Fertility and Obstetrics, Copenhagen University Hospital–Rigshospitalet, Copenhagen, Denmark
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3
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Wood EK, Stamos G, Mitchell AJ, Gonoud R, Horgan AM, Nomura O, Young A, Nigg JT, Gustafsson HC, Sullivan EL. The association between food desert severity, socioeconomic status, and metabolic state during pregnancy in a prospective longitudinal cohort. Sci Rep 2023; 13:7197. [PMID: 37137940 PMCID: PMC10156695 DOI: 10.1038/s41598-023-32783-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2022] [Accepted: 04/02/2023] [Indexed: 05/05/2023] Open
Abstract
Poor metabolic health during pregnancy is associated with health concerns for pregnant individuals and their offspring. Lower socioeconomic status (SES) is one risk factor for poor metabolic health, and may be related to limited access to healthful and affordable foods (e.g., living in a food desert). This study evaluates the respective contributions of SES and food desert severity on metabolic health during pregnancy. The food desert severity of 302 pregnant individuals was determined using the United States Department of Agriculture Food Access Research Atlas. SES was measured using total household income adjusted for household size, years of education, and amount of reserve savings. Information about participants' glucose concentrations one hour following an oral glucose tolerance test during the second trimester was extracted from medical records and percent adiposity during the second trimester was assessed using air displacement plethysmography. Information about participants' nutritional intake during the second trimester was obtained by trained nutritionists via three unannounced 24-h dietary recalls. Structural equation models showed that lower SES predicted higher food desert severity (β = - 0.20, p = 0.008) and higher adiposity (β = - 0.27, p = 0.016) and consumption of a more pro-inflammatory diet (β = - 0.25, p = 0.003) during the second trimester of pregnancy. Higher food desert severity also predicted higher percent adiposity during the second trimester (β = 0.17, p = 0.013). Food desert severity significantly mediated the relationship between lower SES and higher percent adiposity during the second trimester (βindirect = - 0.03, 95% CI [- 0.079, - 0.004]). These findings indicate that access to healthful and affordable foods is a mechanism by which SES contributes to adiposity during pregnancy and may inform interventions intended to improve metabolic health during pregnancy.
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Affiliation(s)
- Elizabeth K Wood
- Department of Psychiatry, Oregon Health & Science University, Portland, USA
| | - Gayle Stamos
- Department of Psychiatry, Oregon Health & Science University, Portland, USA
| | - A J Mitchell
- Department of Behavioral Neuroscience, Oregon Health & Science University, Portland, USA
| | - Rose Gonoud
- Department of Psychiatry, Oregon Health & Science University, Portland, USA
| | - Angela M Horgan
- Clinical & Translational Research Center, Oregon Health & Science University, Portland, USA
| | - Olivia Nomura
- Department of Psychiatry, Oregon Health & Science University, Portland, USA
| | - Anna Young
- Department of Psychiatry, Oregon Health & Science University, Portland, USA
| | - Joel T Nigg
- Department of Psychiatry, Oregon Health & Science University, Portland, USA
| | - Hanna C Gustafsson
- Department of Psychiatry, Oregon Health & Science University, Portland, USA
| | - Elinor L Sullivan
- Department of Psychiatry, Oregon Health & Science University, Portland, USA.
- Department of Behavioral Neuroscience, Oregon Health & Science University, Portland, USA.
- Division of Neuroscience, Oregon National Primate Research Center, Portland, USA.
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SANDBORG JOHANNA, MIGUELES JAIROH, SÖDERSTRÖM EMMIE, BLOMBERG MARIE, HENRIKSSON PONTUS, LÖF MARIE. Physical Activity, Body Composition, and Cardiometabolic Health during Pregnancy: A Compositional Data Approach. Med Sci Sports Exerc 2022; 54:2054-2063. [PMID: 36069838 PMCID: PMC9671591 DOI: 10.1249/mss.0000000000002996] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
PURPOSE The aim of this study was to examine the cross-sectional and longitudinal associations of 24-h movement behaviors (sleep, sedentary behavior (SB), light physical activity (LPA), and moderate-to-vigorous physical activity (MVPA)) with body composition and cardiometabolic health in i) early and ii) late pregnancy (gestational weeks 14 and 37). METHODS This observational study utilized cross-sectional ( n = 273) and longitudinal data ( n = 242) from the HealthyMoms trial. Time spent in movement behaviors over seven consecutive 24-h periods (ActiGraph wGT3x-BT accelerometer), body composition (Bod Pod), and cardiometabolic health indicators (glucose levels, homeostatic model for insulin resistance (HOMA-IR), systolic and diastolic blood pressure, metabolic syndrome (MetS) score) were measured in early and late pregnancy. RESULTS In early pregnancy, reallocating time to MVPA from LPA, SB, and sleep was associated with lower MetS score (adjusted γ = -0.343, P = 0.002). Correspondingly, reallocating time to LPA from SB and sleep in early pregnancy was associated with lower body weight (adjusted γ = -5.959, P = 0.047) and HOMA-IR (adjusted γ = -0.557, P = 0.031) at the same time point. Furthermore, reallocating time to LPA from SB and sleep in early pregnancy was associated with lower fat mass index (adjusted γ = -0.668, P = 0.028), glucose levels (adjusted γ = -0.315, P = 0.006), HOMA-IR (adjusted γ = -0.779, P = 0.004), and MetS score (adjusted γ = -0.470, P = 0.027) in late pregnancy. The changes in behaviors throughout pregnancy were not associated with body weight, body composition, and MetS score in late pregnancy. CONCLUSIONS Our results demonstrated that increasing LPA or MVPA while reducing SB and sleep was associated with lower weight and more favorable cardiometabolic health in early pregnancy. In contrast, LPA in early pregnancy seems to be a stimulus of enough intensity to improve body composition and cardiometabolic health indicators in late pregnancy.
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Affiliation(s)
- JOHANNA SANDBORG
- Department of Biosciences and Nutrition, Karolinska Institutet, Huddinge, Stockholm, SWEDEN
- Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, SWEDEN
| | - JAIRO H. MIGUELES
- Department of Biosciences and Nutrition, Karolinska Institutet, Huddinge, Stockholm, SWEDEN
- PROFITH (PROmoting FITness and Health through physical activity) Research Group, Department of Physical Education and Sports, Faculty of Sport Sciences, Research Institute of Sport and Health, University of Granada, Granada, SPAIN
| | - EMMIE SÖDERSTRÖM
- Department of Biosciences and Nutrition, Karolinska Institutet, Huddinge, Stockholm, SWEDEN
- Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, SWEDEN
| | - MARIE BLOMBERG
- Department of Obstetrics and Gynecology and Department of Biomedical and Clinical Sciences, Linköping University, Linköping, SWEDEN
| | - PONTUS HENRIKSSON
- Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, SWEDEN
| | - MARIE LÖF
- Department of Biosciences and Nutrition, Karolinska Institutet, Huddinge, Stockholm, SWEDEN
- Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, SWEDEN
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Garr Barry V, Martin SL, Chandler-Laney P, Carter EB, Worthington CS. A Comparison of Bioimpedance Analysis vs. Dual X-ray Absorptiometry for Body Composition Assessment in Postpartum Women and Non-Postpartum Controls. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:13636. [PMID: 36294216 PMCID: PMC9602548 DOI: 10.3390/ijerph192013636] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Revised: 09/28/2022] [Accepted: 09/30/2022] [Indexed: 06/16/2023]
Abstract
Postpartum fat mass (FM) and fat-free mass (FFM) may be informative predictors of future disease risk among women; hence, there is growing use of bioelectrical impedance analysis (BIA) to quantify FFM and FM among postpartum women due to the quick, non-invasive, and inexpensive nature of BIA. Despite this, very few studies have examined BIA's performance, and it remains unclear as to whether specific BIA equations are needed for postpartum women. To explore these questions, we measured total body FFM and FM with a multi-frequency, segmental BIA, and dual-X-ray absorptiometry (DXA) in (1) women at one and four months postpartum (n = 21); and (2) height- and weight-matched non-postpartum women (controls, n = 21). BIA was compared to DXA using Deming regression models, paired t-tests, and Bland-Altman plots. Between-group comparisons were performed using an analysis of variance models. The mean difference between DXA and BIA was 1.2 ± 1.7 kg FFM (p < 0.01) and -1.0 ± 1.7 kg FM (p < 0.05) in postpartum women at both time points. The measurements of longitudinal changes in FFM and FM were not significantly different between BIA and DXA. Furthermore, there was no significant difference in BIA's performance in postpartum vs. non-postpartum women (p = 0.29), which suggests that population-specific equations are not needed for postpartum women. The results of this study suggest that BIA is a suitable method to assess postpartum body composition among women at one and four months postpartum, using existing age-, race-, and sex-adjusted equations.
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Affiliation(s)
- Valene Garr Barry
- Department of Obstetrics and Gynecology, Washington University School of Medicine in St. Louis, St. Louis, MO 63110, USA
| | - Samantha L. Martin
- Department of Obstetrics and Gynecology, The University of Alabama at Birmingham, Birmingham, AL 35233, USA
| | - Paula Chandler-Laney
- Department of Nutrition Sciences, The University of Alabama at Birmingham, Birmingham, AL 35294, USA
| | - Ebony B. Carter
- Department of Obstetrics and Gynecology, Washington University School of Medicine in St. Louis, St. Louis, MO 63110, USA
| | - Camille S. Worthington
- Department of Nutrition Sciences, The University of Alabama at Birmingham, Birmingham, AL 35294, USA
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6
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Maran A, Atkinson SA, Bertram V, Vanniyasingam T, Thabane L, Mottola MF, Phillips SM. Exploring comparative assessment of adiposity measures during pregnancy and postpartum. Clin Nutr ESPEN 2022; 49:365-371. [PMID: 35623838 DOI: 10.1016/j.clnesp.2022.03.021] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2021] [Revised: 02/28/2022] [Accepted: 03/14/2022] [Indexed: 10/18/2022]
Abstract
BACKGROUND & AIMS Excessive adiposity in pregnancy is associated with an altered cardiometabolic profile and adverse maternal and offspring outcomes. Pre-pregnancy body mass index (pBMI) is a proxy measure for adiposity that is most often used in clinical settings; however, it may not identify at-risk pregnancies caused by adiposity-related cardiometabolic dysfunction. The challenge is that validated direct adiposity measures are limited due to the dynamic nature of pregnancy. This exploratory analysis aimed to, 1) evaluate longitudinal changes in % body fat (BF) and the agreement between skinfold thickness (SFT) and bioelectrical impedance analysis (BIA) across pregnancy and in postpartum; 2) compare the discrimination power of SFT, BIA, and pBMI regarding adiposity status; and 3) assess agreement between SFT and BIA with dual-energy X-ray absorptiometry (DXA) in the postpartum. METHODS Participants enrolled in the Be Healthy in Pregnancy (BHIP) RCT (NCT01693510) had demographic data and pBMI collected at enrollment and adiposity measured at 12-17, 26-28, and 36-38 weeks gestation by BIA (%BF) and SFT (sum and %BF), and also by DXA at 6 months postpartum. Agreement between methods was assessed by Bland Altman plots and McNemar's test and C-statistic for discriminative power. RESULTS In 181 women with mean pBMI of 25.1 kg/m2 (min: 17.4 kg/m2, max: 39.6 kg/m2) and age 31.6 (SD: 4.0 yr), maternal adiposity increased significantly (p < 0.001) across pregnancy when measured by the sum of SFT or %BF by BIA, but not %BF by SFT. In early pregnancy, BF by BIA and SFT showed good agreement, with BIA values 1.8% greater than SFT, but low agreement in late pregnancy, with BIA values 7.1% greater than SFT. However, in the postpartum, agreement was similar to early pregnancy, and both BIA and SFT demonstrated good agreement with DXA. By pBMI, 45.5% of participants were categorized as overweight/obese, compared to 66.5% by BIA (p < 0.0001) and 54.5% by SFT (p < 0.0001). CONCLUSIONS In comparison to SFT and BIA, the results suggest that pBMI is less sensitive in identifying participants with excessive adiposity, limiting its use as a screening tool for adiposity-related adverse outcomes in pregnancy. It would be preferable to use a direct measure of adiposity to screen for at-risk pregnancies. Both %BF by BIA and sum of SFT can quantify the change in adiposity across pregnancy and in the postpartum and thus could be adopted as clinical practice tools. Future research efforts should further refine and validate adiposity techniques for use, particularly in mid and late pregnancy. CLINICAL TRIAL The BHIP clinical trial (NCT01693510). REGISTRATION SITE: https://clinicaltrials.gov/ct2/show/NCT01693510.
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Affiliation(s)
- Atherai Maran
- Department of Pediatrics, McMaster University, Hamilton, Ontario, L8S 4L8, Canada
| | - Stephanie A Atkinson
- Department of Pediatrics, McMaster University, Hamilton, Ontario, L8S 4L8, Canada.
| | - Valerie Bertram
- Department of Pediatrics, McMaster University, Hamilton, Ontario, L8S 4L8, Canada
| | - Thuva Vanniyasingam
- Biostatistics Unit, St. Joseph's Healthcare Hamilton, Hamilton, Ontario, L8N 4A6, Canada
| | - Lehana Thabane
- Biostatistics Unit, St. Joseph's Healthcare Hamilton, Hamilton, Ontario, L8N 4A6, Canada
| | - Michelle F Mottola
- School of Kinesiology, Western University, London, Ontario, N6A 3K7, Canada
| | - Stuart M Phillips
- Department of Kinesiology, McMaster University, Hamilton, Ontario, L8S 4K1, Canada
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7
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Vesco KK, Marshall NE, Baetscher E, Leo MC, Rooney W, Francisco M, Baker E, King JC, Catalano P, Frias AE, Purnell JQ. Changes in Visceral and Ectopic Adipose Tissue Stores Across Pregnancy and Their Relationship to Gestational Weight Gain. J Nutr 2022; 152:1130-1137. [PMID: 35022776 PMCID: PMC8970982 DOI: 10.1093/jn/nxac010] [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: 07/07/2021] [Revised: 10/25/2021] [Accepted: 01/06/2022] [Indexed: 01/13/2023] Open
Abstract
BACKGROUND Excessive gestational weight gain has been associated with increased total body fat (TBF), metabolic syndrome, and abdominal obesity. However, little is known about the relationship of gestational weight gain with changes in metabolically active visceral or ectopic (hepatic and skeletal muscle) lipid stores. OBJECTIVES In a prospective study of 50 healthy, pregnant women, we assessed whether changes in weight were associated with changes in total, visceral, and ectopic lipid stores. METHODS Participants (ages 19-39) were primarily White (84%). The mean preconception BMI was 25.8 kg/m2 (SD, 4.5 kg/m2; min-max, 17.1-35.9 kg/m2). Measurements were completed at visits 1 and 2 at means of 16 and 34 weeks gestation, respectively, and included TBF using BOD POD; abdominal subcutaneous adipose tissue (SAT) and visceral adipose tissue (VAT) using MRI; and intrahepatic lipids (IHL), intramyocellular lipids (IMCL), and extramyocellular lipids (EMCL) using magnetic resonance spectroscopy. We used paired t-tests to examine changes in adipose tissue and Pearson's correlation to examine associations of adipose tissue changes and weight changes. We also examined whether changes in adipose tissue stores differed by preconception BMI (normal, overweight, and obese), using 1-way ANOVA. RESULTS The TBF (mean change, +3.5 kg; 95% CI: 2.4-4.6 kg), SAT (mean change, +701 cm3; 95% CI: 421-981 cm3), VAT (mean change, +275 cm3; 95% CI: 170-379 cm3), and IHL (percentage water peak; median, +0.15; IQR = -0.01 to 0.32) values increased significantly; the IMCL and EMCL values did not change. Changes varied by BMI strata, with the least increase (or, for SAT, net loss) among women with obesity. Weight change was positively correlated with changes in TBF (r = 0.83; P < 0.001), SAT (r = 0.74; P < 0.001), and VAT (r = 0.63; P < 0.001) but not significantly correlated with changes in ectopic lipids (IHL, IMCL, and EMCL; -0.14 < r < 0.26). CONCLUSIONS Preferential deposition of adipose tissue to the viscera in pregnancy, as seen in our sample, could serve an important metabolic function; however, excessive deposition in this region could negatively affect maternal health.
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Affiliation(s)
- Kimberly K Vesco
- Center for Health Research, Kaiser Permanente Northwest, Portland, OR, USA
| | - Nicole E Marshall
- Department of Obstetrics and Gynecology, Division of Maternal Fetal Medicine, Oregon Health & Science University, Portland, OR, USA
| | - Eric Baetscher
- Advanced Imaging Research Center, Oregon Health & Science University, Portland, OR, USA
| | - Michael C Leo
- Center for Health Research, Kaiser Permanente Northwest, Portland, OR, USA
| | - William Rooney
- Advanced Imaging Research Center, Oregon Health & Science University, Portland, OR, USA
| | - Melanie Francisco
- Center for Health Research, Kaiser Permanente Northwest, Portland, OR, USA
| | - Eric Baker
- Advanced Imaging Research Center, Oregon Health & Science University, Portland, OR, USA
| | - Janet C King
- Department of Nutritional Sciences and Toxicology, University of California, Berkeley, CA, USA
| | - Patrick Catalano
- Mother Infant Research Institute, Department of Obstetrics and Gynecology, Tufts University School of Medicine, Boston, MA, USA
| | - Antonio E Frias
- Department of Obstetrics and Gynecology, Division of Maternal Fetal Medicine, Oregon Health & Science University, Portland, OR, USA
| | - Jonathan Q Purnell
- Department of Medicine, Knight Cardiovascular Institute, Oregon Health & Science University, Portland, OR, USA
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8
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Pregnancy and weaning regulate human maternal liver size and function. Proc Natl Acad Sci U S A 2021; 118:2107269118. [PMID: 34815335 PMCID: PMC8640831 DOI: 10.1073/pnas.2107269118] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/07/2021] [Indexed: 12/19/2022] Open
Abstract
During pregnancy, the rodent liver undergoes hepatocyte proliferation and increases in size, followed by weaning-induced involution via hepatocyte cell death and stromal remodeling, creating a prometastatic niche. These data suggest a mechanism for increased liver metastasis in breast cancer patients with recent childbirth. It is unknown whether the human liver changes in size and function during pregnancy and weaning. In this study, abdominal imaging was obtained in healthy women at early and late pregnancy and postwean. During pregnancy time points, glucose production and utilization and circulating bile acids were measured. Independently of weight gain, most women's livers increased in size with pregnancy, then returned to baseline postwean. Putative roles for bile acids in liver growth and regression were observed. Together, the data support the hypothesis that the human liver is regulated by reproductive state with growth during pregnancy and volume loss postwean. These findings have implications for sex-specific liver diseases and for breast cancer outcomes.
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9
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Self-reported (IFIS) versus measured physical fitness, and their associations to cardiometabolic risk factors in early pregnancy. Sci Rep 2021; 11:22719. [PMID: 34811456 PMCID: PMC8608964 DOI: 10.1038/s41598-021-02149-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Accepted: 11/09/2021] [Indexed: 11/18/2022] Open
Abstract
Physical fitness is a strong marker of health, but objective fitness measurements are not always feasible. The International FItness Scale (IFIS) for self-reported fitness is a simple-to-use tool with demonstrated validity and reliability; however, validation in pregnancy needs to be confirmed. Also, its association with cardiometabolic health in pregnant women is unknown. Hence, we examined (1) the validity of the IFIS with objectively measured fitness, and (2) the associations of self-reported versus objectively measured cardiorespiratory fitness (CRF) and muscular strength with cardiometabolic risk factors in early pregnancy. Women (n = 303) from the HealthyMoms trial were measured at gestational week 14 for: CRF (6-min walk test); upper-body muscular strength (handgrip strength test); self-reported fitness (IFIS), body composition (air-displacement plethysmography); blood pressure and metabolic parameters (lipids, glucose, insulin). Higher self-reported fitness was associated with better measured fitness (ANOVA overall p < 0.01 for all fitness types), indicating the usefulness of the IFIS in pregnancy. Furthermore, higher self-reported overall fitness and CRF were associated with lower cardiometabolic risk scores (ANOVA p < 0.001), with similar results shown for measured CRF (ANOVA p < 0.001). The findings suggest that IFIS could be useful to stratify pregnant women in appropriate fitness levels on a population-based level where objective measurement is not possible.
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10
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Weight gain and body composition during pregnancy: a randomised pilot trial with probiotics and/or fish oil. Br J Nutr 2021; 126:541-551. [PMID: 33143755 DOI: 10.1017/s0007114520004407] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
We evaluated the effects of fish oil and/or probiotic supplementation in a randomised placebo-controlled intervention pilot trial on gestational weight gain (GWG) and body composition. Additionally, the influence of gestational diabetes (GDM) on GWG and body composition was assessed. We randomised 439 overweight women into intervention groups: fish oil + placebo, probiotics + placebo, fish oil + probiotics and placebo + placebo (fish oil: 1·9 g DHA and 0·22 g EPA and probiotics: Lactobacillus rhamnosus HN001 and Bifidobacterium animalis ssp. lactis 420, 1010 colony-forming units each). GDM was diagnosed with oral glucose tolerance test. Body composition was measured with air displacement plethysmography at randomisation (mean 13·9) and in late pregnancy (mean 35·2 gestational weeks). Intervention did not influence mean GWG or change in body fat mass/percentage (P > 0·17). Body composition in early pregnancy did not differ between the women who did or did not develop GDM (adjusted P > 0·23). Compared with the normoglycaemic women (n 278), women diagnosed with GDM (n 119) gained less weight (7·7 (sd 0·4) v. 9·3 (sd 0·4) kg, adjusted mean difference -1·66 (95 % CI -2·52, -0·80) and fat mass (0·4 (sd 0·4) v. 1·8 (sd 0·3) kg, adjusted mean difference -1·43 (95 % CI -2·19, -0·67) during the follow-up. In conclusion, adiposity of pregnant overweight women was not affected by supplementation with fish oil and/or probiotics, nor did it predict the development of GDM. However, adiposity was reduced in women with GDM compared with normoglycaemic women irrespective of the dietary intervention.
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11
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Phase Angle and Bio-Impedance Values during the First Year after Delivery in Women with Previous Excessive Gestational Weight Gain: Innovative Data from the Belgian INTER-ACT Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18147482. [PMID: 34299927 PMCID: PMC8306720 DOI: 10.3390/ijerph18147482] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/16/2021] [Revised: 07/06/2021] [Accepted: 07/09/2021] [Indexed: 01/26/2023]
Abstract
Phase angle (PhA) is a body composition parameter that measures changes in the amount and quality of soft tissue. Few studies have explored PhA in pregnancy or postpartum. The aim of this study was to explore the PhA during the first year postpartum in a Belgian cohort using data from the control group of the INTER-ACT study, an intervention trial targeting those with excess gestational weight gain. A secondary aim was to examine associations between PhA and potential explanatory variables. Women aged ≥18 with excessive weight gain in a singleton pregnancy and without a chronic disease were eligible. Data collection included anthropometry as well as demographic and lifestyle questionnaires at 6 weeks, 6 months and 12 months postpartum. Body composition, including PhA, was measured with the Tanita MC780SMA device. Data was analysed using correlation and mixed model analyses. A total of 509 participants (median age 31.2) were included. The median PhA at 6 weeks postpartum was 5.8°. Higher PhA values were seen in multiparous women (p = 0.02) but there was no association with any other lifestyle or demographic factors. PhA values were positively associated with muscle mass and BMI (r = 0.13, p = 0.004 and r = 0.18, p < 0.001) at 6 weeks postpartum. PhA increased slightly in the 12 months postpartum, which was related to a decrease in fat percentage (p = 0.004). Further research in the pregnant/postpartum population is needed to elucidate any links with perinatal or future health outcomes.
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12
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Tinius RA, Yoho K, Blankenship MM, Maples JM. Postpartum Metabolism: How Does It Change from Pregnancy and What are the Potential Implications? Int J Womens Health 2021; 13:591-599. [PMID: 34168507 PMCID: PMC8216742 DOI: 10.2147/ijwh.s314469] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2021] [Accepted: 05/25/2021] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Metabolic dysfunction after pregnancy may have serious consequences for a new mother. The purpose of the study was to characterize basic changes that occur in metabolic profiles from late pregnancy through 4-6 months postpartum. A secondary purpose was to determine metabolic factors that may be contributing to postpartum weight retention. METHODS Participants (n=25) came in for 2 visits: late pregnancy (~34 weeks gestation) and postpartum (4-6 months). Resting metabolic rate (RMR), respiratory quotient (RQ), and substrate oxidation values were assessed for 15 minutes during fasted conditions. Blood was drawn and skinfold anthropometry was performed to assess additional outcomes (inflammation, insulin resistance, lipid profiles, body composition). The participants completed a number of surveys that examined other lifestyle and demographic data of interest. At the postpartum visit, additional assessments regarding sleep and breastfeeding habits were administered. RESULTS RMR was lower during postpartum (1517.2±225.1 kcal/day) compared to pregnancy (1867.9±302.6 kcal/day) (p<0.001), and remained lower when expressing RMR per kg body weight (postpartum: 22.3±2.7 vs pregnant: 23.7±3.4 kcal/kg, (p=0.034). Relative RMR (RMR per kg body weight) was negatively correlated to insulin resistance (HOMA-IR) during postpartum (r=-.463, p=0.034). Maternal HOMA-IR, inflammation (CRP), triglycerides (TAG), and carbohydrate oxidation were all positively correlated to postpartum weight retention (HOMA-IR: r=0.617, p=0.004; CRP: r=0.477, p=0.039, TAG: r=0.463, p=0.040; Carbohydrate Oxidation: (r=0.469, p=0.018). CONCLUSION Metabolic rate is lower during postpartum compared to pregnancy, and may be connected to insulin resistance. Maternal insulin resistance, inflammation, blood lipids, and substrate metabolism are all related to postpartum weight retention.
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Affiliation(s)
- Rachel A Tinius
- School of Kinesiology, Recreation, and Sport, Western Kentucky University, Bowling Green, KY, 42101, USA
| | - Kristin Yoho
- School of Kinesiology, Recreation, and Sport, Western Kentucky University, Bowling Green, KY, 42101, USA
| | - Maire M Blankenship
- School of Nursing and Allied Health, Western Kentucky University, Bowling Green, KY, 42101, USA
| | - Jill M Maples
- Department of Obstetrics and Gynecology, University of Tennessee Graduate School of Medicine, Knoxville, TN, 37920, USA
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13
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Henriksson P, Sandborg J, Söderström E, Leppänen MH, Snekkenes V, Blomberg M, Ortega FB, Löf M. Associations of body composition and physical fitness with gestational diabetes and cardiovascular health in pregnancy: Results from the HealthyMoms trial. Nutr Diabetes 2021; 11:16. [PMID: 34099629 PMCID: PMC8184768 DOI: 10.1038/s41387-021-00158-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2020] [Revised: 05/10/2021] [Accepted: 05/17/2021] [Indexed: 11/16/2022] Open
Abstract
The aim of this study was to examine associations of body composition (fat mass index, % fat mass, fat-free mass index, body mass index) and physical fitness (cardiorespiratory fitness and handgrip strength) with gestational diabetes and cardiovascular health in early pregnancy. This cross-sectional study utilized baseline data (n = 303) collected in early pregnancy from the HealthyMoms trial. Body composition was measured using air-displacement plethysmography, cardiorespiratory fitness was assessed by means of the 6-min walk test and handgrip strength using a dynamometer. Logistic regression was used to estimate odds ratios (ORs) for gestational diabetes as well as high (defined as 1 SD above the mean) blood pressure, homeostatic model assessment for insulin resistance (HOMA-IR), and metabolic syndrome score (MetS score) per 1 SD increase in body composition and fitness variables. Fat mass index, % fat mass and body mass index were all strongly associated with gestational diabetes (ORs: 1.72–2.14, P ≤ 0.003), HOMA-IR (ORs: 3.01–3.80, P < 0.001), blood pressure (ORs: 1.81–2.05, P < 0.001) and MetS score (ORs: 3.29–3.71, P < 0.001). Associations with fat-free mass index were considerably weaker (ORs: 1.26–1.82, P = 0.001–0.15) and were strongly attenuated after adjustments for fat mass index (ORs: 0.88–1.54, P = 0.039–0.68). Finally, greater cardiorespiratory fitness was associated with lower risk of high HOMA-IR and MetS score (ORs: 0.57–0.63, P ≤ 0.004) although these associations were attenuated when accounting for fat mass index (ORs: 1.08-1.11, P ≥ 0.61). In conclusion, accurately measured fat mass index or % fat mass were strongly associated with gestational diabetes risk and markers of cardiovascular health although associations were not stronger than the corresponding ones for body mass index. Fat-free mass index had only weak associations with gestational diabetes and cardiovascular health which support that the focus during clinical care would be on excess fat mass and not fat-free mass.
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Affiliation(s)
- Pontus Henriksson
- Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden.
| | - Johanna Sandborg
- Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden.,Department of Biosciences and Nutrition, Karolinska Institutet, Huddinge, Stockholm, Sweden
| | - Emmie Söderström
- Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
| | - Marja H Leppänen
- Department of Biosciences and Nutrition, Karolinska Institutet, Huddinge, Stockholm, Sweden.,Folkhälsan Research Center, Helsinki, Finland.,Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Victoria Snekkenes
- Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
| | - Marie Blomberg
- Department of Obstetrics and Gynecology and Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden
| | - Francisco B Ortega
- Department of Biosciences and Nutrition, Karolinska Institutet, Huddinge, Stockholm, Sweden.,PROFITH (PROmoting FITness and Health through physical activity) Research Group, Department of Physical Education and Sports, Faculty of Sport Sciences, Research Institute of Sport and Health, University of Granada, Granada, Spain
| | - Marie Löf
- Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden.,Department of Biosciences and Nutrition, Karolinska Institutet, Huddinge, Stockholm, Sweden
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14
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Ana Y, Lewis MG, van Schayck OCP, Babu GR. Is physical activity in pregnancy associated with prenatal and postnatal depressive symptoms?: Results from MAASTHI cohort study in South India. J Psychosom Res 2021; 144:110390. [PMID: 33740554 PMCID: PMC7611353 DOI: 10.1016/j.jpsychores.2021.110390] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2020] [Revised: 02/04/2021] [Accepted: 02/05/2021] [Indexed: 12/14/2022]
Abstract
OBJECTIVE Physical inactivity leads to depression and other adverse health consequences. Pregnant women are an important subgroup to study the health consequences due to physical inactivity since it can lead to adverse outcomes in pregnancy and even after delivery. Therefore, we aimed at understanding the level of physical activity among pregnant women, prevalence of prenatal and postnatal depressive symptoms and whether level of physical activity is associated with prenatal and postnatal depressive symptoms. METHODS In an ongoing cohort study, we measured the physical activity using a validated Physical Activity Level (PAL) questionnaire. We administered the Edinburgh Postnatal Depression Scale (EPDS) during pregnancy and within seven days of delivery to assess depressive symptoms in 1406 women. Associations were adjusted for potential confounders such as maternal age, education, socioeconomic status, gravida, EPDS score during pregnancy, social support, skinfold thickness, blood pressure, blood sugar level. RESULTS We found that 7.2% of pregnant women had low levels of physical activity. The prevalence of prenatal and postnatal depressive symptoms was 9.0% and 31.9% respectively. Pregnant women with a low level of physical activity had significantly higher odds of developing postpartum depressive symptoms (OR = 3.15, CI: 1.98-5.02, p < 0.001) when adjusted for potential confounders. CONCLUSIONS Moderate level of physical activity among pregnant mothers is essential and has its association with postnatal depressive symptoms. Health care professionals need to counsel pregnant women to assess depressive symptoms at both the prenatal and postpartum period and inform them about the importance of the optimal level of physical activity.
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Affiliation(s)
- Yamuna Ana
- Indian Institute of Public Health-Bangalore, Public Health Foundation of India (PHFI), Bangalore, India.
| | - Melissa Glenda Lewis
- Indian Institute of Public Health-Hyderabad, Public Health Foundation of India (PHFI), Hyderabad, India.
| | - Onno C P van Schayck
- Care, and Public Health Research Institute, Maastricht University, Maastricht, Limburg, the Netherlands.
| | - Giridhara R Babu
- Lifecourse Epidemiology, Indian Institute of Public Health-Bangalore, Public Health Foundation of India (PHFI), Bangalore, India; Public health and clinical medicine, Wellcome Trust/DBT India Alliance, New Delhi, India.
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15
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Kdekian A, Sietzema M, Scherjon SA, Lutgers H, van der Beek EM. Pregnancy Outcomes and Maternal Insulin Sensitivity: Design and Rationale of a Multi-Center Longitudinal Study in Mother and Offspring (PROMIS). J Clin Med 2021; 10:jcm10050976. [PMID: 33801180 PMCID: PMC7957868 DOI: 10.3390/jcm10050976] [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: 01/30/2021] [Revised: 02/18/2021] [Accepted: 02/19/2021] [Indexed: 01/01/2023] Open
Abstract
The worldwide prevalence of overweight and obesity in women of reproductive age is rapidly increasing and a risk factor for the development of gestational diabetes (GDM). Excess adipose tissue reduces insulin sensitivity and may underlie adverse outcomes in both mother and child. The present paper describes the rationale and design of the PRegnancy Outcomes and Maternal Insulin Sensitivity (PROMIS) study, an exploratory cohort study to obtain detailed insights in insulin sensitivity and glucose metabolism during pregnancy and its relation to pregnancy outcomes including early infancy growth. We aim to recruit healthy pregnant women with a body mass index (BMI) ≥ 25 kg/m2 before 12 weeks of gestation in Northern Netherlands. A total of 130 woman will be checked on fasted (≤7.0 mmol/L) or random (≤11.0 mmol/L) blood glucose to exclude pregestational diabetes at inclusion. Subjects will be followed up to six months after giving birth, with a total of nine contact moments for data collection. Maternal data include postprandial measures following an oral meal tolerance test (MTT), conducted before 16 weeks and repeated around 24 weeks of gestation, followed by a standard oral glucose tolerance test before 28 weeks of gestation. The MTT is again performed around three months postpartum. Blood analysis is done for baseline and postprandial glucose and insulin, baseline lipid profile and several biomarkers of placental function. In addition, specific body circumferences, skinfold measures, and questionnaires about food intake, eating behavior, physical activity, meal test preference, mental health, and pregnancy complications will be obtained. Fetal data include assessment of growth, examined by sonography at week 28 and 32 of gestation. Neonatal and infant data consist of specific body circumferences, skinfolds, and body composition measurements, as well as questionnaires about eating behavior and complications up to 6 months after birth. The design of the PROMIS study will allow for detailed insights in the metabolic changes in the mother and their possible association with fetal and postnatal infant growth and body composition. We anticipate that the data from this cohort women with an elevated risk for the development of GDM may provide new insights to detect metabolic deviations already in early pregnancy. These data could inspire the development of new interventions that may improve the management of maternal, as well as offsrping complications from already early on in pregnancy with the aim to prevent adverse outcomes for mother and child.
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Affiliation(s)
- Anoush Kdekian
- Laboratory of Pediatrics, University Medical Centre Groningen, University of Groningen, Hanzeplein 1, 9713 GZ Groningen, The Netherlands;
| | - Maaike Sietzema
- Clinical Endocrinology, Medical Centre Leeuwarden, Henri Dunantweg 2, 8934 AD Leeuwarden, The Netherlands; (M.S.); (H.L.)
| | - Sicco A. Scherjon
- Department of Gynaecology and Obstectrics, University Medical Centre Groningen, Hanzeplein 1, 9713 GZ Groningen, The Netherlands;
| | - Helen Lutgers
- Clinical Endocrinology, Medical Centre Leeuwarden, Henri Dunantweg 2, 8934 AD Leeuwarden, The Netherlands; (M.S.); (H.L.)
| | - Eline M. van der Beek
- Laboratory of Pediatrics, University Medical Centre Groningen, University of Groningen, Hanzeplein 1, 9713 GZ Groningen, The Netherlands;
- Correspondence:
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16
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Prado-Nóvoa O, Rodríguez J, Martín García A, Mateos A. Body composition helps: Differences in energy expenditure between pregnant and nonpregnant females. Am J Hum Biol 2020; 33:e23518. [PMID: 33155733 DOI: 10.1002/ajhb.23518] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2020] [Revised: 09/28/2020] [Accepted: 09/29/2020] [Indexed: 01/22/2023] Open
Abstract
OBJECTIVES Human pregnancy is associated with important physiological changes that usually increase energetic requirements. However, great variability exists in the costs and mechanisms required to bear pregnancy. Since body mass (BM) and composition are modified during gestation, it is of great interest to compare the influence of BM on energy expenditure (EE) in pregnant and nonpregnant females. METHODS BM, body composition, and EE of 77 volunteers (35 pregnant and 42 nonpregnant females) were measured. The pregnant volunteers completed two measurement rounds at 28 and 32 gestation weeks. Differences on the measured parameters were sought, and comparison of regression lines was computed to test how BM affected the EE of the volunteers. RESULTS BM and body composition parameters are significantly higher in pregnant females, but EE is not statistically different. Pregnant females have a larger percentage of fat mass, but lower percentage of fat-free mass (FFM). The EE per kg of FFM is similar in both groups. Comparison of regression lines shows that pregnancy does not change the relationship between BM and EE, but for similar BM pregnant females expend less energy than nonpregnant females. CONCLUSIONS We propose that their larger percentage of passive body tissues is the reason why pregnant females expend less energy than nonpregnant females of similar BM, without changing the scaling of EE on BM. Thus, pregnancy could not be as energetically constraining as usually assumed, with important consequences for human reproductive ecology.
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Affiliation(s)
- Olalla Prado-Nóvoa
- Postgraduate School of Human Evolution, University of Burgos, Burgos, Spain
| | - Jesús Rodríguez
- Paleobiology Program, National Research Center on Human Evolution (CENIEH), Burgos, Spain
| | - Adrián Martín García
- Gynecology and Obstetrics Department, Complejo Asistencial Universitario de Burgos, Burgos, Spain
| | - Ana Mateos
- Paleobiology Program, National Research Center on Human Evolution (CENIEH), Burgos, Spain
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17
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Zhang RY, Wang L, Zhou W, Zhong QM, Tong C, Zhang T, Han TL, Wang LR, Fan X, Zhao Y, Ran RT, Xia YY, Qi HB, Zhang H, Norris T, Baker PN, Saffery R. Measuring maternal body composition by biomedical impedance can predict risk for gestational diabetes mellitus: a retrospective study among 22,223 women. J Matern Fetal Neonatal Med 2020; 35:2695-2702. [PMID: 32722949 DOI: 10.1080/14767058.2020.1797666] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
OBJECTIVES This study aimed to identify which element of body composition measurements taken before 17th week gestation was the strongest risk factor for gestational diabetes mellitus (GDM) in Chinese pregnant women. DESIGN AND SETTING A retrospective study was performed using data retrieved from the Electronic Medical Record database of Chongqing Health Center for Women and Children (China) from January 2014 to December 2015. PARTICIPANTS A total of 22,223 women were included with singleton pregnancies and no preexisting diabetes who underwent bioelectrical impedance analysis (BIA) before 17 gestational weeks and 75-g OGTT at 24-28 gestational weeks. RESULTS The prevalence of GDM from 2014 to 2015 was 27.13% (IADPSG). All indicators of BIA (total body water, fat mass, fat-free mass, percent body fat, muscle mass, visceral fat levels, proteins, bone minerals, basal metabolic rate, lean trunk mass), age, weight and body mass index (BMI) were risk factors that significantly increased the occurrence of GDM (p < .001 for all). Women older than 30 years or with a BMI more than 23, had a significantly higher GDM prevalence (34.89% and 34.77%). After adjusted covariates, visceral fat levels at the third quartile, the ORs of GDM were 1.142 (95% CI 1.032-1.263) in model I and 1.419 (95% CI 1.274-1.581) in model II used the first quartile as reference (p < .05 for both); bone minerals at the third quartile, the ORs of GDM were 1.124 (95% CI 1.020-1.238) in model I and 1.311 (95% CI 1.192-1.442) in model II (p < .05 for both). After adjusted for age, visceral fat levels and bone minerals, OR of GDM for percent body fat more than 28.77% at the third quartile was 1.334 (95% CI 1.201-1.482) in model II (p < .05 for both). CONCLUSIONS Visceral fat levels, bone minerals and percent body fat were significantly associated with an increased risk of GDM, providing the reference ranges of visceral fat levels, bone minerals and percent body fat as predictive factors for Chinese women to estimate the risk of GDM by BIA during pregnancy.
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Affiliation(s)
- Rui-Yuan Zhang
- Department of Occupational and Environmental Hygiene, School of Public Health and Management, Research Center for Medicine and Social Development, Innovation Center for Social Risk Governance in Health, Chongqing Medical University, Chongqing, People's Republic of China
| | - Lan Wang
- Chongqing Health Centre for Women and Children, Chongqing, People's Republic of China
| | - Wei Zhou
- Chongqing Health Centre for Women and Children, Chongqing, People's Republic of China
| | - Qi-Mei Zhong
- Chongqing Health Centre for Women and Children, Chongqing, People's Republic of China
| | - Chao Tong
- Department of Obstetrics and Gynecology, the First Affiliated Hospital of Chongqing Medical University, Chongqing, People's Republic of China
| | - Ting Zhang
- State Key Laboratory of Maternal and Fetal Medicine of Chongqing Municipality, Chongqing Medical University, Chongqing, People's Republic of China
| | - Ting-Li Han
- Department of Obstetrics and Gynecology, the First Affiliated Hospital of Chongqing Medical University, Chongqing, People's Republic of China.,State Key Laboratory of Maternal and Fetal Medicine of Chongqing Municipality, Chongqing Medical University, Chongqing, People's Republic of China
| | - Lian-Rong Wang
- Chongqing Health Centre for Women and Children, Chongqing, People's Republic of China
| | - Xin Fan
- Chongqing Health Centre for Women and Children, Chongqing, People's Republic of China
| | - Yan Zhao
- Chongqing Health Centre for Women and Children, Chongqing, People's Republic of China
| | - Rui-Tu Ran
- Departments of Urinary Surgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing, People's Republic of China
| | - Yin-Yin Xia
- Department of Occupational and Environmental Hygiene, School of Public Health and Management, Research Center for Medicine and Social Development, Innovation Center for Social Risk Governance in Health, Chongqing Medical University, Chongqing, People's Republic of China
| | - Hong-Bo Qi
- Department of Obstetrics and Gynecology, the First Affiliated Hospital of Chongqing Medical University, Chongqing, People's Republic of China.,State Key Laboratory of Maternal and Fetal Medicine of Chongqing Municipality, Chongqing Medical University, Chongqing, People's Republic of China
| | - Hua Zhang
- Department of Obstetrics and Gynecology, the First Affiliated Hospital of Chongqing Medical University, Chongqing, People's Republic of China.,State Key Laboratory of Maternal and Fetal Medicine of Chongqing Municipality, Chongqing Medical University, Chongqing, People's Republic of China
| | - Tom Norris
- School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK
| | - Philip N Baker
- College of Life Sciences, University of Leicester, Leicester, UK
| | - Richard Saffery
- Murdoch Children's Research Institute, Royal Children's Hospital, Melbourne, Australia.,Department of Pediatrics, University of Melbourne, Parkville, Australia
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18
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Jones KS, Meadows SR, Schoenmakers I, Prentice A, Moore SE. Vitamin D Status Increases During Pregnancy and in Response to Vitamin D Supplementation in Rural Gambian Women. J Nutr 2020; 150:492-504. [PMID: 31834380 PMCID: PMC7056615 DOI: 10.1093/jn/nxz290] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2019] [Revised: 10/11/2019] [Accepted: 11/05/2019] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Vitamin D is important to maternal, fetal, and infant health, but quality data on vitamin D status in low- and middle-income countries and response to cholecalciferol supplementation in pregnancy are sparse. OBJECTIVE We characterized vitamin D status and vitamin D metabolite change across pregnancy and in response to cholecalciferol supplementation in rural Gambia. METHODS This study was a secondary analysis of samples collected in a 4-arm trial of maternal nutritional supplementation [iron folic acid (FeFol); multiple micronutrients (MMN); protein energy (PE) as lipid-based supplement; PE + MMN]; MMN included 10 μg/d cholecalciferol. Plasma 25-hydroxycholecalciferol [25(OH)D3], 24,25-dihydroxycholecalciferol [24,25(OH)2D3], and C3-epimer-25-hydroxycholecalciferol [3-epi-25(OH)D3] were measured by LC-MS/MS in 863 women [aged 30 ± 7 y (mean ± SD)] in early pregnancy (presupplementation) and late pregnancy, (gestational age 14 ± 3 and 30 ± 1 wk). Changes in 25(OH)D3 and vitamin D metabolite concentrations and associations with pregnancy stage and maternal age and anthropometry were tested. RESULTS Early pregnancy 25(OH)D3 concentration was 70 ± 15 nmol/L and increased according to pregnancy stage (82 ± 18 and 87 ± 17 nmol/L in the FeFol and PE-arms) and to cholecalciferol supplementation (95 ± 19 and 90 ± 20 nmol/L in the MMN and PE + MMN-arms) (P < 0.0001). There was no difference between supplemented groups. Early pregnancy 25(OH)D3 was positively associated with maternal age and gestational age. Change in 25(OH)D3 was negatively associated with late pregnancy, but not early pregnancy, triceps skinfold thickness. The pattern of change of 24,25(OH)2D3 mirrored that of 25(OH)D3 and appeared to flatten as pregnancy progressed, whereas 3-epi-25(OH)D3 concentration increased across pregnancy. CONCLUSION This study provides important data on the vitamin D status of a large cohort of healthy pregnant women in rural Africa. Without supplementation, vitamin D status increased during pregnancy, demonstrating that pregnancy stage should be considered when assessing vitamin D status. Nutritionally relevant cholecalciferol supplementation further increased vitamin D status. These data are relevant to the development of fortification and supplementation policies in pregnant women in West Africa.
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Affiliation(s)
- Kerry S Jones
- MRC Nutrition and Bone Health Research Group, MRC Elsie Widdowson Laboratory, Cambridge, UK,NIHR Nutritional Biomarker Laboratory, MRC Epidemiology Unit, University of Cambridge, Cambridge, UK,Address correspondence to KSJ (e-mail: )
| | - Sarah R Meadows
- MRC Nutrition and Bone Health Research Group, MRC Elsie Widdowson Laboratory, Cambridge, UK,NIHR Nutritional Biomarker Laboratory, MRC Epidemiology Unit, University of Cambridge, Cambridge, UK
| | - Inez Schoenmakers
- MRC Nutrition and Bone Health Research Group, MRC Elsie Widdowson Laboratory, Cambridge, UK,Norwich Medical School, University of East Anglia, Norwich, UK
| | - Ann Prentice
- MRC Nutrition and Bone Health Research Group, MRC Elsie Widdowson Laboratory, Cambridge, UK,MRC Unit The Gambia at the London School of Hygiene and Tropical Medicine, Fajara, The Gambia
| | - Sophie E Moore
- MRC Unit The Gambia at the London School of Hygiene and Tropical Medicine, Fajara, The Gambia,Department of Women and Children's Health, King's College London, UK
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19
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Most J, Altazan AD, Hsia DS, Beyl RA, Redman LM. Body Composition During Pregnancy Differs by Obesity Class. Obesity (Silver Spring) 2020; 28:268-276. [PMID: 31891231 PMCID: PMC6981013 DOI: 10.1002/oby.22699] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/04/2019] [Accepted: 10/08/2019] [Indexed: 01/02/2023]
Abstract
OBJECTIVE The aim of this study is to characterize changes in body composition during pregnancy in women with obesity. METHODS Fifty-four healthy women with obesity (class 1, 30-34.9 kg/m2 : n = 25; class 2, 35-39.9 kg/m2 : n = 21; class 3, ≥ 40.0 kg/m2 : n = 8) expecting a singleton pregnancy were studied. Body composition was measured in early pregnancy (13-16 weeks), midpregnancy (24-27 weeks), and late pregnancy (35-37 weeks) using air displacement plethysmography, stable isotopes, and skinfold thickness measurements. Fasting glucose, insulin, and leptin were measured. RESULTS The gain in fat-free mass was lower in the second trimester compared with the third (2.7 ± 0.2 to 5.3 ± 0.2 kg; P < 0.001), whereas fat mass accumulation declined over time (0.6 ± 0.3 to -0.7 ± 0.4 kg; P = 0.005). Women with class 1 and 2 obesity gained 1.1 ± 0.7 kg of fat mass during pregnancy, while women with class 3 obesity lost 4.1 ± 0.6 kg (both P < 0.001). The difference in fat accumulation between obesity classes was observed only in the second trimester (P = 0.02). Gestational weight gain was associated positively with changes in plasma concentrations of insulin, leptin, and insulin resistance (all P < 0.01). CONCLUSIONS Gestational weight gain in pregnancy differs by obesity class and trimester. Women with class 3 obesity gain less body weight and fat mass. Fat mass gain is most likely preventable in the second trimester.
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Affiliation(s)
- Jasper Most
- Pennington Biomedical Research Center, Baton Rouge, Louisiana, USA
| | - Abby D Altazan
- Pennington Biomedical Research Center, Baton Rouge, Louisiana, USA
| | - Daniel S Hsia
- Pennington Biomedical Research Center, Baton Rouge, Louisiana, USA
| | - Robbie A Beyl
- Pennington Biomedical Research Center, Baton Rouge, Louisiana, USA
| | - Leanne M Redman
- Pennington Biomedical Research Center, Baton Rouge, Louisiana, USA
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Bosaeus M, Andersson-Hall U, Andersson L, Karlsson T, Ellegård L, Holmäng A. Body Composition During Pregnancy: Longitudinal Changes and Method Comparisons. Reprod Sci 2020; 27:1477-1489. [PMID: 31993997 PMCID: PMC7272490 DOI: 10.1007/s43032-020-00141-6] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2019] [Accepted: 12/16/2019] [Indexed: 12/21/2022]
Abstract
The Pregnancy Obesity Nutrition and Child Health study is a longitudinal study of reproductive health. Here we analyzed body composition of normal-weight and obese Swedish women by three methods during each trimester of pregnancy. Cross-sectional and longitudinal fat mass estimates using quantitative magnetic resonance (QMR) and bioelectrical impedance analysis (BIA) (Tanita MC-180MA-III) were compared with fat mass determined by air displacement plethysmography (ADP) in pregnancy weeks 8-12, 24-26, and 35-37 in normal-weight women (n = 122, BMI = 22.1 ± 1.6 kg/m2) and obese women (n = 29, BMI = 34.6 ± 3.6 kg/m2). ADP results were calculated from pregnancy-adjusted fat-free mass densities. Mean fat mass by QMR and ADP were similar in obese women, although with wide limits of agreement. In normal-weight women, QMR overestimated mean fat mass in all trimesters, with systematic overestimation at low fat mass values in trimesters 1 and 3. In obese women, fat mass by BIA was grossly underestimated and imprecise in all trimesters, especially at higher values in trimester 2. In normal-weight women, fat mass by BIA was moderately lower than by ADP in trimester 1, similar in trimester 2, and moderately higher in trimester 3. QMR and ADP assessed fat mass changes similarly in obese women, whereas BIA overestimated fat mass changes in normal-weight women. Mean fat mass and fat mass changes by QMR and pregnancy-adjusted ADP were similar in pregnant obese women. Mean fat mass by QMR and fat mass changes by BIA were higher than corresponding values determined by pregnancy-adjusted ADP in normal-weight women.
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Affiliation(s)
- Marja Bosaeus
- Department of Physiology, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Box 432, SE-405 30 Gothenburg, Sweden
| | - Ulrika Andersson-Hall
- Department of Physiology, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Box 432, SE-405 30 Gothenburg, Sweden
| | - Louise Andersson
- Department of Physiology, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Box 432, SE-405 30 Gothenburg, Sweden
| | - Therese Karlsson
- Department of Physiology, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Box 432, SE-405 30 Gothenburg, Sweden
| | - Lars Ellegård
- Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Department of Endocrinology, Diabetes and Metabolism, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Agneta Holmäng
- Department of Physiology, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Box 432, SE-405 30 Gothenburg, Sweden
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21
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Zhu F, Kaysen GA, Sarkar S, Finkelstein FO, Carter M, Levin NW, Hoenich NA. Evaluation of one year of frequent dialysis on fluid load and body composition using calf bioimpedance technique. Physiol Meas 2019; 40:055004. [PMID: 31035269 DOI: 10.1088/1361-6579/ab1d8f] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
OBJECTIVE The primary aim of this study was to evaluate the effect of increased frequency of dialysis (FHD) on change in fluid status and body composition using segmental bioimpedance. APPROACH Twelve stable HD patients were switched from 3 times/week to 6 times/week HD (FHD). Systolic blood pressure (SBP), body mass and body mass index (BMI) were measured pre- and post-HD. Calf resistance (R 5) at 5 kHz was measured using a multifrequency bioimpedance device (Hydra 4200). Calf resistivity (ρ = R 5 * area/length), normalized resistivity (CNR = ρ/BMI) and calf extracellular volume (cECV) were calculated. Fat mass was measured by Futrex body composition analyzers (Futrex 6100, Futrex Tech, Inc.). All measurements were performed at baseline (BL) and monthly for up to one year. MAIN RESULTS Nine patients completed one year of FHD. Compared to BL, body weight and cECV decreased, and CNR increased significantly by the first month but did not change thereafter. SBP pre-HD decreased significantly by the end of the first month with further reduction until month 12. Additionally, antihypertensive medication decreased significantly from baseline by month 4 and remained stable from month 6 throughout the rest of the study. The post-HD CNR in five of nine patients reached the range of normal (>18.5 10-2 * Ohm * m3 kg-1 for males and >19.1 10-2 * Ohm * m3 kg-1 for females) after 1 year FHD. In patients who returned to 3 times/week dialysis, CNR decreased significantly in the first week, and this was associated with increases in body weight and SBP. SIGNIFICANCE Reduction of fluid overload with no alteration of body composition was observed in this study. Accordingly, improving fluid status was confirmed by reducing BP and use of antihypertensive drugs together with increase in CNR. Measurement of fluid status by CNR in hemodialysis patients is a new method to quantitatively assess hydration potentially creating a target for volume of fluid removal.
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Affiliation(s)
- Fansan Zhu
- Renal Research Institute, 315 East 62nd Street, New York, NY 10065, United States of America. Author to whom any correspondence should be addressed
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22
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Henriksson P, Sandborg J, Blomberg M, Alexandrou C, Maddison R, Silfvernagel K, Henriksson H, Leppänen MH, Migueles JH, Widman L, Thomas K, Trolle Lagerros Y, Löf M. A Smartphone App to Promote Healthy Weight Gain, Diet, and Physical Activity During Pregnancy (HealthyMoms): Protocol for a Randomized Controlled Trial. JMIR Res Protoc 2019; 8:e13011. [PMID: 30821695 PMCID: PMC6418485 DOI: 10.2196/13011] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2018] [Revised: 01/16/2019] [Accepted: 01/18/2019] [Indexed: 01/20/2023] Open
Abstract
Background Excessive gestational weight gain is common and associated with adverse outcomes both in the short and long term. Although traditional lifestyle-based interventions have shown to mitigate excess gestational weight gain, little is known about whether mobile Health (mHealth) apps can promote healthy weight gain, diet, and physical activity during pregnancy. Objective The primary aim of the HealthyMoms trial is to determine the effectiveness of a smartphone app (HealthyMoms) for mitigating excess gestational weight gain during pregnancy. Secondary aims are to determine the effectiveness of the app on dietary habits, physical activity, body fatness, and glycemia during pregnancy. Methods HealthyMoms is a two-arm randomized controlled trial. Women are being recruited at routine visits at the maternity clinics in Linköping, Norrköping and Motala, Sweden. Women are randomized to the control or intervention group (n=150 per group). All women will receive standard care, and women in the intervention group will also receive the HealthyMoms smartphone app. Results Recruitment of participants to the trial was initiated in October 2017, and 190 women have so far completed the baseline measurement. The baseline measures are estimated to be finalized in December 2019, and the follow-up measures are estimated to be completed in June 2020. Conclusions This project will evaluate a novel smartphone app intervention integrated with existing maternity health care. If successful, it has great potential to be implemented nationally in order to promote healthy weight gain and health behaviors during pregnancy. International Registered Report Identifier (IRRID) DERR1-10.2196/13011
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Affiliation(s)
- Pontus Henriksson
- Department of Biosciences and Nutrition, Karolinska Institutet, Huddinge, Sweden.,Department of Medical and Health Sciences, Linköping University, Linköping, Sweden
| | - Johanna Sandborg
- Department of Biosciences and Nutrition, Karolinska Institutet, Huddinge, Sweden.,Department of Medical and Health Sciences, Linköping University, Linköping, Sweden
| | - Marie Blomberg
- Department of Obstetrics and Gynecology, Linköping University, Linköping, Sweden.,Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden
| | - Christina Alexandrou
- Department of Biosciences and Nutrition, Karolinska Institutet, Huddinge, Sweden
| | - Ralph Maddison
- Institute for Physical Activity and Nutrition, Deakin University, Burwood, Australia
| | - Kristin Silfvernagel
- Division of Psychology, Department of Behavioural Sciences and Learning, Linköping University, Linköping, Sweden
| | - Hanna Henriksson
- Department of Medical and Health Sciences, Linköping University, Linköping, Sweden
| | - Marja H Leppänen
- Department of Biosciences and Nutrition, Karolinska Institutet, Huddinge, Sweden.,Faculty of Sport and Health Sciences, University of Jyvaskyla, Jyvaskyla, Finland
| | - Jairo H Migueles
- Department of Physical and Sports Education, Faculty of Sport Sciences, University of Granada, Granada, Spain
| | - Linnea Widman
- Department of Biostatistics, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Kristin Thomas
- Department of Medical and Health Sciences, Linköping University, Linköping, Sweden
| | - Ylva Trolle Lagerros
- Clinical Epidemiology Unit, Department of Medicine, Karolinska Institutet, Solna, Sweden.,Obesity Center, Academic Specialist Center, Stockholm Health Services, Stockholm, Sweden
| | - Marie Löf
- Department of Biosciences and Nutrition, Karolinska Institutet, Huddinge, Sweden.,Department of Medical and Health Sciences, Linköping University, Linköping, Sweden
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23
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Oliveira E, Marano D, Amaral YNDVD, Abranches A, Soares FVM, Moreira MEL. Overweight modifies the nutritional composition of human milk? A systematic review. CIENCIA & SAUDE COLETIVA 2019; 25:3969-3980. [PMID: 32997028 DOI: 10.1590/1413-812320202510.29902018] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2018] [Accepted: 02/11/2019] [Indexed: 11/22/2022] Open
Abstract
This paper aims to identify the association between overweight and the nutritional composition of human milk. A systematic review was performed by searching on PubMed, Virtual Health Library (BVS), EMBASE, Web of Science, and SCOPUS databases, from May to June 2018, using keywords "Human Milk" AND "Overweight" OR "Obesity" OR "Body Mass Index". The bibliographic search returned 435 papers after the duplicates were removed. Of this total, 12 papers were selected for abstract reading, and nine works were incorporated into this systematic review. Eight papers showed that overweight increased the total concentration of lipids or glucose or macronutrient fractions, and only one study found no association between overweight and the nutritional composition of human milk. Most works selected evidenced that obesity changed the total concentration of lipids and their fractions. Thus, we recommend that women's weight and height be evaluated in the pregestational visit to identify and monitor nutritional deviations, contributing to weight adequacy before pregnancy and assisting in the production of milk with adequate nutritional composition.
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Affiliation(s)
- Elissa Oliveira
- Fundação Oswaldo Cruz. Av. Brasil 4365, Manguinhos. 21040-900 Rio de Janeiro RJ Brasil.
| | - Daniele Marano
- Instituto Nacional da Saúde da Mulher. da Criança e do Adolescente Fernandes Figueira. Rio de Janeiro RJ Brasil
| | | | - Andrea Abranches
- Instituto Nacional da Saúde da Mulher. da Criança e do Adolescente Fernandes Figueira. Rio de Janeiro RJ Brasil
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24
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Marshall NE, Lau B, Purnell JQ, Thornburg KL. Impact of maternal obesity and breastfeeding intention on lactation intensity and duration. MATERNAL AND CHILD NUTRITION 2018; 15:e12732. [PMID: 30345729 DOI: 10.1111/mcn.12732] [Citation(s) in RCA: 39] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/30/2018] [Revised: 08/01/2018] [Accepted: 09/19/2018] [Indexed: 12/30/2022]
Abstract
Exclusive breastfeeding (EBF) has numerous maternal health benefits. However, EBF rates are lower in mothers with obesity. We sought to better understand whether maternal body composition measurements in early pregnancy are also predictive of lower rates of EBF. Healthy pregnant women with prepregnancy body mass index (BMI) of 17.5-51 kg/m2 underwent determination of percent body fat (% body fat) in early (12-16 weeks) and late (37 weeks) gestation. Intent and duration of EBF were determined by surveys completed at 6 weeks and 6 months postpartum (PP). Unadjusted and adjusted analyses were performed to compare EBF rates and weaning by maternal BMI and % body fat. Increasing BMI and % body fat in early pregnancy were significantly associated with lower rates of EBF among women intending EBF. Women with BMI ≥ 25 were less likely to be EBF at 6 weeks and 6 months PP compared with women of normal BMI (67 and 37% vs. 91 and 79%, P value 0.005 and 0.001, respectively). Among primiparous women intending EBF, 100% of women in the lowest two body fat quartiles in early pregnancy were EBF at 6 weeks PP compared with 66.7 and 63.6% of women in the higher quartiles (P = 0.03). Lactation cessation by 6 months PP was higher with increasing maternal BMI (P = 0.001). Maternal obesity in early gestation is associated with lower EBF rates among women intending EBF and earlier weaning. Excess adiposity in early pregnancy may impede EBF.
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Affiliation(s)
- Nicole E Marshall
- Department of Obstetrics and Gynecology, Oregon Health & Science University, Portland, Oregon, USA
| | - Bernard Lau
- Department of Obstetrics and Gynecology, Oregon Health & Science University, Portland, Oregon, USA
| | - Jonathan Q Purnell
- Knight Cardiovascular Institute, Oregon Health & Science University, Portland, Oregon, USA
| | - Kent L Thornburg
- Knight Cardiovascular Institute, Oregon Health & Science University, Portland, Oregon, USA
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25
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Sutton EF, Morrison CD, Stephens JM, Redman LM. Fibroblast growth factor 21, adiposity, and macronutrient balance in a healthy, pregnant population with overweight and obesity. Endocr Res 2018; 43:275-283. [PMID: 29768065 PMCID: PMC6215499 DOI: 10.1080/07435800.2018.1473421] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2017] [Revised: 04/27/2018] [Accepted: 05/02/2018] [Indexed: 12/18/2022]
Abstract
AIM OF THE STUDY The regulation and actions of fibroblast growth factor 21 (FGF21) are responsive to energy status and macronutrient balance, and investigations of FGF21 in normal pregnancy, which could be informative for FGF21 biology, are seldom. The goal of our study was to examine FGF21 levels in a contemporary healthy, pregnant population. METHODS We phenotyped 43 women with overweight and obesity during pregnancy for weight, body composition, and fasting blood. Serum FGF21 was measured during the first and third trimesters. Placentas were collected at delivery. RESULTS Maternal FGF21 concentrations were positively correlated with body mass index and adiposity, but not lean mass or glucose homeostasis. FGF21 concentrations significantly increased from the first to third trimester of pregnancy (0.105 vs. 0.256 ng/mL, p < 0.0001). Changes in FGF21 concentrations across pregnancy were not associated with changes in body weight or composition but inversely with the change in fasting glucose. FGF21 mRNA levels in placenta were very low and do not likely contribute to FGF21 in the maternal circulation. CONCLUSIONS FGF21 increases throughout pregnancy in our healthy cohort with overweight and obesity, independent of the placenta, and does not appear to be sensing the changes in energy balance (reflected in the change in maternal energy stores), but changes in macronutrient status. Thus, we propose FGF21 may be a potential signal of maternal nutrient status in pregnancy.
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Affiliation(s)
- Elizabeth F Sutton
- a Reproductive Endocrinology and Women's Health Laboratory , Pennington Biomedical Research Center-Louisiana State University , Baton Rouge , LA , USA
| | - Christopher D Morrison
- b Neurosignaling Laboratory , Pennington Biomedical Research Center-Louisiana State University , Baton Rouge , LA , USA
| | - Jacqueline M Stephens
- c Adipocyte Biology Laboratory , Pennington Biomedical Research Center-Louisiana State University , Baton Rouge , LA , USA
| | - Leanne M Redman
- a Reproductive Endocrinology and Women's Health Laboratory , Pennington Biomedical Research Center-Louisiana State University , Baton Rouge , LA , USA
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26
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Pellonperä O, Koivuniemi E, Vahlberg T, Mokkala K, Tertti K, Rönnemaa T, Laitinen K. Body composition measurement by air displacement plethysmography in pregnancy: Comparison of predicted versus measured thoracic gas volume. Nutrition 2018; 60:227-229. [PMID: 30677546 DOI: 10.1016/j.nut.2018.09.035] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2018] [Revised: 08/09/2018] [Accepted: 09/01/2018] [Indexed: 11/30/2022]
Abstract
OBJECTIVES Body composition measurements with air displacement plethysmography (ADP) define body volume, which must be corrected for thoracic gas volume (TGV). We hypothesized that physiologic changes owing to pregnancy could affect the accuracy of predicted TGV and introduce errors into body composition measurements. METHODS We investigated the effect of measuring versus predicting TGV on the accuracy of body composition calculations measured with ADP in overweight and obese pregnant women. The fat and fat-free masses of 110 women were determined with ADP with predicted and measured TGV. RESULTS Measured TGV decreased from early to late pregnancy (P = 0.0002). Compared with measured TGV, predicted TGV was 6.3% higher during early gestation and 12.6% higher during late gestation (both P ≤ 0.001). The use of predicted instead of measured TGV in body composition calculations resulted in an overestimation of fat mass by 0.8% during the early stage, and 2.6% during the late stage of pregnancy (both P ≤ 0.001). CONCLUSIONS Measuring TGV increases the accuracy of body composition measurement by ADP in overweight and obese women, particularly during the late stage of pregnancy.
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Affiliation(s)
- Outi Pellonperä
- University of Turku and Turku University Hospital, Department of Obstetrics and Gynecology, Turku, Finland.
| | - Ella Koivuniemi
- University of Turku, Institute of Biomedicine, Turku, Finland
| | - Tero Vahlberg
- University of Turku and Turku University Hospital, Department of Biostatistics, Turku, Finland
| | - Kati Mokkala
- University of Turku, Institute of Biomedicine, Turku, Finland
| | - Kristiina Tertti
- University of Turku and Turku University Hospital, Department of Obstetrics and Gynecology, Turku, Finland
| | - Tapani Rönnemaa
- University of Turku and Turku University Hospital, Department of Medicine, Turku, Finland
| | - Kirsi Laitinen
- University of Turku, Institute of Biomedicine, Turku, Finland
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27
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Pellonperä O, Koivuniemi E, Vahlberg T, Mokkala K, Tertti K, Rönnemaa T, Laitinen K. Dietary quality influences body composition in overweight and obese pregnant women. Clin Nutr 2018; 38:1613-1619. [PMID: 30224302 DOI: 10.1016/j.clnu.2018.08.029] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2017] [Revised: 06/26/2018] [Accepted: 08/25/2018] [Indexed: 12/21/2022]
Abstract
BACKGROUND & AIMS Excessive adiposity and gestational weight gain (GWG) have been linked with maternal and offspring morbidity. We investigated the relation of maternal diet, physical activity and GWG on body composition in overweight and obese pregnant women. METHODS Fat mass (FM) and fat free mass (FFM) of 110 overweight and obese pregnant women were measured by air displacement plethysmography in early and late pregnancy (mean 13.5 and 35.3 gestational weeks). At the same time points, the quality of overall diet was assessed by validated index of diet quality (IDQ) questionnaire (score < 10/15 denotes poor dietary quality and score ≥ 10/15 denotes good dietary quality), nutrient intakes by 3-day food diaries, and physical activity by questionnaire. Weight gain between early and late pregnancy was compared to the gestational weight gain guidelines issued by Institute of Medicine. RESULTS Of the women, 77% gained more weight than recommended; this was related to greater dietary fat consumption (80 ± 21 g/day vs. 67 ± 11 g/day, p = 0.010) and greater increase in FM (2.7 ± 3.0 kg vs. -1.0 ± 2.4 kg, p < 0.001) compared to women with ideal GWG. Dietary protein intake (g) correlated positively with FFM at both time points (early pregnancy: r = 0.31, p < 0.002, late pregnancy: r = 0.39, p < 0.001). Women with higher dietary quality index score had more FFM, compared to women with lower dietary quality (early pregnancy FFM: 48.8 ± 5.8 kg vs. 45.8 ± 4.7 kg, p = 0.004, late pregnancy FFM: 56.1 ± 6.4 kg vs. 53.4 ± 5.6 kg, p = 0.025). No correlations were detected between total energy intake or physical activity and FM or FFM at early or late pregnancy. CONCLUSIONS Body composition changes from early to late pregnancy were related to the amount of weight gained and overall dietary quality during pregnancy. Higher dietary quality and protein intake were associated with greater FFM, while dietary fat intake was related to excess weight gain. Identification of these dietary determinants of body composition and weight offers new targets for dietary counseling of pregnant women and thus potential for ensuing health benefits through reduced adiposity.
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Affiliation(s)
- Outi Pellonperä
- University of Turku and Turku University Hospital, Department of Obstetrics and Gynecology, Finland.
| | | | - Tero Vahlberg
- University of Turku and Turku University Hospital, Department of Clinical Medicine, Biostatistics, Finland
| | - Kati Mokkala
- University of Turku, Institute of Biomedicine, Finland
| | - Kristiina Tertti
- University of Turku and Turku University Hospital, Department of Obstetrics and Gynecology, Finland
| | - Tapani Rönnemaa
- University of Turku and Turku University Hospital, Department of Medicine, Finland
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28
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Russak EM, Bednarczyk EM. Impact of Deuterium Substitution on the Pharmacokinetics of Pharmaceuticals. Ann Pharmacother 2018; 53:211-216. [DOI: 10.1177/1060028018797110] [Citation(s) in RCA: 58] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023] Open
Abstract
Objective: Stable heavy isotopes of hydrogen, carbon, and other elements have been incorporated into drug molecules, largely as tracers for quantitation during the drug development process. Studies involving the human use of drugs labeled with deuterium suggest that these compounds may offer some advantages when compared with their nondeuterated counterparts. Deuteration has gained attention because of its potential to affect the pharmacokinetic and metabolic profiles of drugs. Deutetrabenazine (Austedo, Teva Pharmaceutical Industries, Ltd) is the first deuterated drug to receive Food and Drug Administration approval. This deuterated form of the drug tetrabenazine is indicated for the treatment of chorea associated with Huntington’s disease as well as tardive dyskinesia. Ongoing clinical trials suggest that a number of other deuterated compounds are being evaluated for the treatment of human diseases and not merely as research tools. Data Sources: A search of the MEDLINE (1946 to present) database was undertaken using the Ovid interface. The search was conducted using the heading deuterium and then limited to Administration & Dosage, Adverse Effects, Pharmacokinetics, Pharmacology, Poisoning, Therapeutic Use, and Toxicity. Study Selection and Data Extraction: All articles were reviewed and those with human information were included. Review articles were likewise interrogated for additional published human data. Conclusions: Deuterated compounds may, in some cases, offer advantages over nondeuterated forms, often through alterations in clearance. Deuteration may also redirect metabolic pathways in directions that reduce toxicities. The approval of additional deuterated compounds may soon follow. Clinicians will need to be familiar with the dosing, efficacy, potential side effects, and unique metabolic profiles of these new entities.
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29
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Sureshchandra S, Marshall NE, Wilson RM, Barr T, Rais M, Purnell JQ, Thornburg KL, Messaoudi I. Inflammatory Determinants of Pregravid Obesity in Placenta and Peripheral Blood. Front Physiol 2018; 9:1089. [PMID: 30131724 PMCID: PMC6090296 DOI: 10.3389/fphys.2018.01089] [Citation(s) in RCA: 52] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2018] [Accepted: 07/23/2018] [Indexed: 01/02/2023] Open
Abstract
Pre-pregnancy (pregravid) obesity has been linked to several adverse health outcomes for both mother and offspring. Complications during pregnancy include increased risk for gestational diabetes, hypertension, preeclampsia, placental abruption, and difficulties during delivery. Several studies suggest that these negative outcomes are mediated by heightened systemic inflammation as well as changes in placental development and function. However, the molecular mechanisms by which pregravid obesity affects these processes are poorly understood. In this study, we aimed to address this question by carrying out a comprehensive analysis of the systemic maternal immune system coupled with placental gene expression and microbial profiling at term delivery (11 lean and 14 obese). Specifically, we examined the impact of pregravid obesity on circulating cytokines, chemokine, adipokines, and growth factors using multiplex Luminex assay. Innate and adaptive immune cell frequencies and their cytokine production in response to stimuli were measured using flow cytometry. Finally, changes in placental transcriptome and microbiome were profiled using RNA- and 16S-sequencing, respectively. Pregravid obesity is characterized by insulin and leptin resistance, high levels of circulating inflammatory markers IL-6 and CRP, in addition to chemokine IL-8 (p < 0.01). Moreover, pregravid obesity was associated with lower frequency of naïve CD4+ T-cells (p < 0.05), increased frequency of memory CD4+ T-cells (p < 0.01), and a shift towards Th2 cytokine production (p = 0.05). Myeloid cells from the obese cohort produced higher levels of pro-inflammatory cytokines but lower levels of chemokines following TLR stimulation (p < 0.05). Lastly, pregravid obesity is associated with increased abundance of Bacteroides and changes in the expression of genes important for nutrient transport and immunity (FDR < 0.05). Collectively, these data indicate that pregravid obesity is associated with heightened systemic inflammation and of dysregulated nutrient transport in the placenta and provide insight into the basis of fetal reprogramming.
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Affiliation(s)
- Suhas Sureshchandra
- Department of Molecular Biology and Biochemistry, University of California, Irvine, Irvine, CA, United States
| | - Nicole E. Marshall
- Maternal-Fetal Medicine, Oregon Health & Science University, Portland, OR, United States
| | - Randall M. Wilson
- Division of Biomedical Sciences, School of Medicine, University of California, Riverside, Riverside, CA, United States
| | - Tasha Barr
- Division of Biomedical Sciences, School of Medicine, University of California, Riverside, Riverside, CA, United States
| | - Maham Rais
- Division of Biomedical Sciences, School of Medicine, University of California, Riverside, Riverside, CA, United States
| | - Jonathan Q. Purnell
- Department of Medicine, The Knight Cardiovascular Institute, Oregon Health & Science University, Portland, OR, United States
| | - Kent L. Thornburg
- Department of Medicine, The Knight Cardiovascular Institute, Oregon Health & Science University, Portland, OR, United States
| | - Ilhem Messaoudi
- Department of Molecular Biology and Biochemistry, University of California, Irvine, Irvine, CA, United States
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Grandy M, Snowden JM, Boone-Heinonen J, Purnell JQ, Thornburg KL, Marshall NE. Poorer maternal diet quality and increased birth weight . J Matern Fetal Neonatal Med 2018; 31:1613-1619. [PMID: 28514885 PMCID: PMC5694379 DOI: 10.1080/14767058.2017.1322949] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2017] [Revised: 04/14/2017] [Accepted: 04/21/2017] [Indexed: 10/19/2022]
Abstract
OBJECTIVE Maternal diet and gestational weight gain (GWG) influence birth weight and infant adiposity, which are important predictors of lifetime health. To better understand these relationships, we studied associations between maternal diet and GWG, adiposity, and birth weight in a well characterized cohort of pregnant women. STUDY DESIGN Data were obtained from 41 term (>37 weeks), uncomplicated, singleton pregnancies according to pre-pregnancy BMI categories of normal (n = 11), overweight (n = 15), or obese (n = 15). Daily consumption of protein, fat, and carbohydrates and a Healthy Eating Index (HEI-2010) score were determined from 24 h food recall collections. Associations were modeled using multinomial logistic and linear regression. RESULTS Neither the third trimester maternal diet quality nor the macronutrient consumption was associated with GWG after adjusting for pre-pregnancy BMI, maternal age, and parity. A ten-point lower HEI-2010 score was associated with 200 g higher infant birth weight and a 1.0 cm longer length. However, maternal HEI-2010 and macronutrient composition were unrelated to infant percent body fat, ponderal index, or abdominal circumference. CONCLUSIONS Poorer third trimester maternal diet quality was associated with higher birth weight and longer length, but was unrelated to markers of infant adiposity. GWG was independent of third trimester maternal diet composition and quality.
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Affiliation(s)
- Madeline Grandy
- School of Medicine, Oregon Health & Science University, Portland, OR
| | - Jonathan M. Snowden
- Department of Obstetrics and Gynecology, Oregon Health & Science University, Portland, OR
| | - Janne Boone-Heinonen
- School of Public Health, Oregon Health & Science University/Portland State University, Portland, OR
| | - Jonathan Q. Purnell
- Department of Medicine, Oregon Health & Science University, Portland, OR
- Knight Cardiovascular Institute, Center for Developmental Health, Oregon Health & Science University, Portland, OR
| | - Kent L. Thornburg
- Knight Cardiovascular Institute, Center for Developmental Health, Oregon Health & Science University, Portland, OR
| | - Nicole E. Marshall
- Department of Obstetrics and Gynecology, Oregon Health & Science University, Portland, OR
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Most J, Marlatt KL, Altazan AD, Redman LM. Advances in assessing body composition during pregnancy. Eur J Clin Nutr 2018; 72:645-656. [PMID: 29748651 DOI: 10.1038/s41430-018-0152-8] [Citation(s) in RCA: 59] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2018] [Accepted: 02/08/2018] [Indexed: 01/06/2023]
Abstract
The prevalence of excess gestational weight gain is increasing worldwide and is associated with pregnancy complications, including gestational diabetes mellitus, pre-eclampsia, preterm birth, macrosomia, and development of obesity in offspring. Whereas gestational weight gain positively correlates with the gain in fat mass (FM), fat-free mass (FFM) gain is relatively consistent across pregnancies. Commonly used methods to assess body composition include anthropometry, densitometry (air displacement plethysmography, underwater weighing), and hydrometry (isotope dilution, bioimpedance analysis). While these techniques can be applied to pregnancy, they require specific adjustments to assumptions inherent within each method, most importantly to accommodate for the hydration of FFM which is transient throughout gestation. Here we discuss the application of the abovementioned methods to pregnant women and the relevant adjustments needed to more accurately calculate FM based on body weight, body volume, or total body water. We also present a novel application of classical data to provide FFM density estimates for pregnant women at any stage of pregnancy. Use of these adjustments will help standardize assumptions on FFM hydration and minimize error in FM estimation. Techniques still fail, however, to fully distinguish tissue gains between mother and fetus. To fill this important gap, imaging techniques such as ultrasound and magnetic resonance imaging are being used more frequently and will provide more insight into fetal development, fetal adiposity, and depot specificity of maternal FM acquisition. Efforts to synchronize protocols are necessary to allow seamless comparison of data to advance the understanding of maternal body composition changes that contribute to pregnancy-related complications.
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Affiliation(s)
- Jasper Most
- Reproductive Endocrinology and Women's Health, Pennington Biomedical Research Center, 6400 Perkins Road, Baton Rouge, LA, 70808, USA
| | - Kara Lynn Marlatt
- Reproductive Endocrinology and Women's Health, Pennington Biomedical Research Center, 6400 Perkins Road, Baton Rouge, LA, 70808, USA
| | - Abby Duhé Altazan
- Reproductive Endocrinology and Women's Health, Pennington Biomedical Research Center, 6400 Perkins Road, Baton Rouge, LA, 70808, USA
| | - Leanne Maree Redman
- Reproductive Endocrinology and Women's Health, Pennington Biomedical Research Center, 6400 Perkins Road, Baton Rouge, LA, 70808, USA.
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Piuri G, Ferrazzi E, Bulfoni C, Mastricci L, Di Martino D, Speciani AF. Longitudinal changes and correlations of bioimpedance and anthropometric measurements in pregnancy: Simple possible bed-side tools to assess pregnancy evolution. J Matern Fetal Neonatal Med 2016; 30:2824-2830. [PMID: 27892802 DOI: 10.1080/14767058.2016.1265929] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
PURPOSE The aim of this study was to assess longitudinal changes of bioimpedance analysis compared with anthropometric measurements in low-risk pregnant woman recruited in the first trimester and to observe possible differences in these indices in women who developed high-risk pregnancies. MATERIALS AND METHODS Bioimpedance indices for the three trimesters of pregnancies were calculated separately for uneventful pregnancies delivered of newborns > the 10th centile. These findings were compared with anthropometric measurements. Data of women who developed hypertensive disorders of pregnancy (HDP) or delivered SGA newborns were calculated and compared. RESULTS Significantly longitudinal increases were observed in these pregnancies for total body water (TBW), free fat mass, fat mass, and extra-cellular water. These increases were paralleled body mass index (BMI), skinfolds, and waist measurements. The correlations between these two sets of findings were poor. Women who developed HDP with AGA fetuses showed significantly different bioimpedance from normal cases. TBW indices were highly significantly different since the first trimester. In pregnancies delivered of SGA newborns, these indices were opposite of the values observed in patients with HDP-AGA, TBW in these patients was significantly reduced compared with normal pregnancies. CONCLUSIONS The bioelectrical impedance is a fast, simple, noninvasive way to assess the TBW content in pregnancy. Our findings are in agreement with the hypothesis that bioimpedance might help to identify early in gestation patients at risk of developing different clinical phenotypes of hypertensive disease of pregnancy and SGA fetuses.
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Affiliation(s)
- Gabriele Piuri
- a Inflammation Society , Church Hill , Orpington , BR6OHH , Kent, UK
| | - Enrico Ferrazzi
- b Department of Woman, Mother, and Neonate, Unit of Obstetrics, Buzzi Children's Hospital , University of Milan School of Medicine , Milan , Italy EU
| | - Camilla Bulfoni
- b Department of Woman, Mother, and Neonate, Unit of Obstetrics, Buzzi Children's Hospital , University of Milan School of Medicine , Milan , Italy EU
| | - Luciana Mastricci
- b Department of Woman, Mother, and Neonate, Unit of Obstetrics, Buzzi Children's Hospital , University of Milan School of Medicine , Milan , Italy EU
| | - Daniela Di Martino
- b Department of Woman, Mother, and Neonate, Unit of Obstetrics, Buzzi Children's Hospital , University of Milan School of Medicine , Milan , Italy EU
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