1
|
Suzuki T, Yanagisawa K, Kakogawa J, Babazono T. Clinical factors associated with birth weight of infants born to pregnant women with diabetes. Diabetol Int 2024; 15:177-186. [PMID: 38524925 PMCID: PMC10959873 DOI: 10.1007/s13340-023-00667-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/10/2023] [Accepted: 09/22/2023] [Indexed: 03/26/2024]
Abstract
We aimed to examine the clinical factors associated with the birth weight of infants born to Japanese pregnant women with diabetes. This retrospective observational study enrolled 204 Japanese women with singleton pregnancies with type 1 diabetes (n = 135) or type 2 diabetes (n = 69). We used multiple regression analyses to examine factors associated with birth weight standard deviation (SD) scores. In addition, we compared the clinical findings among the groups of mothers who gave birth to appropriate for gestational age infants (AGA group), large for gestational age infants (LGA group), and small for gestational age infants (SGA group). Multiple regression analyses showed that the birth weight SD score was positively associated with type 2 diabetes. In women with type 1 diabetes, the birth weight SD score was positively associated with glycated albumin levels and gestational weight gain and negatively associated with pre-pregnancy underweight. Only gestational weight gain was positively associated with birth weight SD scores in women with type 2 diabetes. Glycated hemoglobin levels, gestational weight gain, and triglyceride levels were significantly higher in the LGA group than in the AGA group. The SGA group showed significantly lower gestational weight gain and triglyceride levels than the AGA group. These results suggest that it is important to manage not only blood glucose levels but also pre-pregnancy body weight and gestational weight gain for appropriate fetal growth. The effects of clinical factors on infant birth weight may differ between patients with type 1 and those with type 2 diabetes.
Collapse
Affiliation(s)
- Tomoko Suzuki
- Division of Diabetology and Metabolism, Department of Internal Medicine, Tokyo Women’s Medical University School of Medicine, 8-1 Kawada-cho, Shinjuku-ku, Tokyo, 162-8666 Japan
| | - Keiko Yanagisawa
- Division of Diabetology and Metabolism, Department of Internal Medicine, Tokyo Women’s Medical University School of Medicine, 8-1 Kawada-cho, Shinjuku-ku, Tokyo, 162-8666 Japan
| | - Jun Kakogawa
- Maternal and Perinatal Center, Tokyo Women’s Medical University School of Medicine, Tokyo, Japan
| | - Tetsuya Babazono
- Division of Diabetology and Metabolism, Department of Internal Medicine, Tokyo Women’s Medical University School of Medicine, 8-1 Kawada-cho, Shinjuku-ku, Tokyo, 162-8666 Japan
| |
Collapse
|
2
|
Ikenoue S, Akiba Y, Ishii R, Otani T, Kasuga Y, Tanaka M. Association of maternal obesity with growth of fetal fractional limb volume. Early Hum Dev 2024; 191:105990. [PMID: 38518425 DOI: 10.1016/j.earlhumdev.2024.105990] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2024] [Revised: 02/29/2024] [Accepted: 03/15/2024] [Indexed: 03/24/2024]
Abstract
BACKGROUND Maternal obesity influences birth weight and newborn adiposity. Fetal fractional limb volume has recently been introduced as a useful parameter for the proxy of fetal adiposity. However, the association between maternal adiposity and the growth of fetal fractional limb volume has not been examined. AIMS To investigate the association of maternal pre-pregnancy BMI with the growth of fetal fractional limb volume. STUDY DESIGN Prospective cohort study. SUBJECTS Women with singleton uncomplicated pregnancies enrolled between July 2017 and June 2020. OUTCOME MEASURES Fetal fractional limb volume was assessed between 20 and 40 weeks' gestation, measured as cylindrical limb volume based on 50 % of the total diaphysis length. The measured fractional limb volume at each gestational week were converted to z-scores based on a previous report. The association between pre-pregnancy BMI and fetal fractional limb volume was examined. Maternal age, parity, gestational weight gain and fetal sex were considered as potential confounding variables. RESULTS Ultrasound scans of 455 fractional arm volume and thigh volume were obtained. Fractional limb volume increased linearly until the second trimester of gestation, then increased exponentially in the third trimester. Maternal pre-pregnancy BMI was significantly correlated with z-scores of fractional arm volume and thigh volume across gestation. The post-hoc analysis showed the association between pre-pregnancy BMI and fractional arm volume was significant especially between 34 and 40 weeks. CONCLUSIONS Maternal obesity influences the growth pattern of fetal fractional limb volume. Fractional arm volume may potentially provide a useful surrogate marker of fetal nutritional status in late gestation.
Collapse
Affiliation(s)
- Satoru Ikenoue
- Department of Obstetrics and Gynecology, Keio University School of Medicine, Tokyo, Japan; Department of Obstetrics and Gynecology, Saitama Municipal Hospital, Saitama, Japan.
| | - Yohei Akiba
- Department of Obstetrics and Gynecology, Saitama Municipal Hospital, Saitama, Japan
| | - Ryota Ishii
- Department of Biostatistics, Institute of Medicine, University of Tsukuba, Japan
| | - Toshimitsu Otani
- Department of Obstetrics and Gynecology, Keio University School of Medicine, Tokyo, Japan
| | - Yoshifumi Kasuga
- Department of Obstetrics and Gynecology, Keio University School of Medicine, Tokyo, Japan
| | - Mamoru Tanaka
- Department of Obstetrics and Gynecology, Keio University School of Medicine, Tokyo, Japan
| |
Collapse
|
3
|
Zhang J, Wang X, Zhu P, Huang X, Cao X, Li J. Exploring the relationships between pre-pregnancy BMI, gestational weight gain, and nutritional intake: a real-world investigation in Shandong, China. PeerJ 2024; 12:e17099. [PMID: 38529313 PMCID: PMC10962341 DOI: 10.7717/peerj.17099] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2023] [Accepted: 02/21/2024] [Indexed: 03/27/2024] Open
Abstract
This study investigated the associations between gestational weight gain (GWG), pre-pregnancy body mass index (BMI), and prenatal diet quality in pregnant women from Shandong, China. We analyzed a sample of 532 early-stage pregnant women registered at an outpatient clinic. Diet quality was evaluated using the Chinese Healthy Dietary Index for Pregnancy (CHDI-P), encompassing three dimensions: diversity, adequacy, and limitation, with an overall score out of 100. Dietary intake was documented via 24-h dietary recalls spanning three consecutive days and subsequently translated to a CHDI-P score. At the time of enrollment, BMI was measured on-site and classified as underweight (<18.5), normal weight (18.5-24.9), overweight (25.0-29.9), and obese (≥30.0). Pregnant women were also categorized into inadequate, adequate, and excessive weight gain groups based on their GWG. We employed a Tukey-adjusted generalized linear model to compare the CHDI-P scores between the pre-pregnancy BMI groups and GWG groups. The results revealed that the underweight group had significantly higher total scores and limitation total scores on the CHDI-P (p < 0.001). Conversely, the overweight and obese groups were more susceptible to suboptimal dietary quality. Notably, the inadequate weight gain group displayed significantly elevated food adequacy scores compared to the other two groups (p < 0.05). This indicates that greater GWGs do not necessarily align with principles of adequate nutrition.
Collapse
Affiliation(s)
- Juan Zhang
- Jinan Maternity and Child Care Hospital, Jinan, China
| | - Xue Wang
- Jinan Maternity and Child Care Hospital, Jinan, China
| | - Ping Zhu
- Jinan Maternity and Child Care Hospital, Jinan, China
| | - Xiaoge Huang
- Jinan Maternity and Child Care Hospital, Jinan, China
| | - Xingru Cao
- Jinan Maternity and Child Care Hospital, Jinan, China
| | - Junmin Li
- Jinan Maternity and Child Care Hospital, Jinan, China
| |
Collapse
|
4
|
Lian S, Huang Y, Li J, Nie J, Li M, Zhou J, He J, Liu C. Combined effects of pre-pregnancy BMI and gestational weight gain on preterm birth: comparison between spontaneous and ART conception. J Assist Reprod Genet 2024; 41:673-681. [PMID: 38277112 PMCID: PMC10957804 DOI: 10.1007/s10815-024-03024-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2023] [Accepted: 01/04/2024] [Indexed: 01/27/2024] Open
Abstract
BACKGROUND Inappropriate pre-pregnancy body mass index (BMI) and gestational weight gain (GWG) are both linked to preterm birth (PTB); however, which one plays a dominant role in PTB risk is not yet sure. We aimed to evaluate the combined effect of pre-pregnancy BMI and GWG on the risk of PTB in singleton pregnancies conceived both spontaneously and through assisted reproductive technology (ART). METHODS The data included all mothers (n = 17,540,977) who had a live singleton birth from the US National Vital Statistics System (NVSS) 2015-2019. Logistic regression models, quantile-g-computation, and generalized additive model were used to analyze the combined association of pre-pregnancy BMI and GWG with PTB. RESULTS The singleton PTB rate was significantly higher in ART pregnancies (11.5%) than in non-ART pregnancies (7.9%). When compared to those women with pre-pregnancy normal weight and GWG within Institute of Medicine (IOM) guidelines, the highest PTB risk was observed in non-ART women with pre-pregnancy underweight and GWG below IOM guidelines (aOR 2.56; 95% CI 2.53-2.60) and in ART women with pre-pregnancy obese and GWG below IOM guidelines (aOR 2.56; 95%CI 2.36-2.78). GWG dominated the combined effect with its joint effect coefficient of - 0.281 (P < 0.05) in non-ART women and - 0.108 (P < 0.05) in ART women. CONCLUSIONS Inappropriate GWG played a dominant role in increasing the risk of PTB in both non-ART and ART populations. Counseling regarding pre-pregnancy BMI and especially GWG appears to be even more crucial for pregnancies conceived via ART, given their impact on PTB.
Collapse
Affiliation(s)
- Shaoyan Lian
- Department of Nutrition, School of Medicine, Jinan University, Guangzhou, 510632, Guangdong, China
| | - Ying Huang
- Department of Nutrition, School of Medicine, Jinan University, Guangzhou, 510632, Guangdong, China
| | - Jieying Li
- Department of Nutrition, School of Medicine, Jinan University, Guangzhou, 510632, Guangdong, China
| | - Jiaying Nie
- Department of Nutrition, School of Medicine, Jinan University, Guangzhou, 510632, Guangdong, China
| | - Meilin Li
- Department of Nutrition, School of Medicine, Jinan University, Guangzhou, 510632, Guangdong, China
| | - Jiaxin Zhou
- Department of Nutrition, School of Medicine, Jinan University, Guangzhou, 510632, Guangdong, China
| | - Jiang He
- Department of Mathematics and Physics, School of Biomedical Engineering, Southern Medical University, Guangzhou, 510515, Guangdong, China.
| | - Chaoqun Liu
- Department of Nutrition, School of Medicine, Jinan University, Guangzhou, 510632, Guangdong, China.
| |
Collapse
|
5
|
Rouhana S, Hallit S, Nicolas G. The association of maternal pre-pregnancy Body Mass Index and gestational weight gain with pregnancy and neonatal outcomes. Ir J Med Sci 2024; 193:303-312. [PMID: 37498477 DOI: 10.1007/s11845-023-03472-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Accepted: 07/23/2023] [Indexed: 07/28/2023]
Abstract
BACKGROUND Overweight and obesity epidemic is still expanding, and it is affecting women of childbearing age. Multiple studies have shown unmatched results concerning the effect of body mass index (BMI) besides gestational weight gain (GWG) on pregnancy and neonatal outcomes. This study aims to determine the effect of each of the two anthropometric indicators: pre-gestational BMI and gestational weight gain on the course of pregnancy, and neonatal outcomes. METHODS A retrospective study was conducted at Notre Dame de Secours University Hospital (CHU-NDS) Jbeil-Lebanon. The data was collected from the hospital archive. Out of 804 deliveries during 2020, 583 women were included after randomly choosing their files and eliminating those with exclusion criteria or incomplete data. RESULTS Underweight/healthy BMI mothers had a higher chance of having low GWG (45.5%), vaginal delivery (51.3%), and a baby of appropriate size (78.6%) or small size for gestational age (10.4%). Obese women had a higher risk of excessive GWG (49.3%), delivery via C-section. (69.3%), and large for gestational age babies (26.7%). Mothers who had low GWG were at a higher risk of having babies of appropriate size (80.1%) or small size for gestational age (13.1%). Mothers who had high GWG had a higher risk of having baby boys (58.9%), large for their gestational age (26.1%), with hypoglycemia at birth (20.6%). CONCLUSION Both extremes of BMI and GWG are linked to adverse neonatal outcomes. This highlights the importance of weight monitoring even during pregnancy to prevent its negative impact on neonates.
Collapse
Affiliation(s)
- Saly Rouhana
- School of Medicine and Medical Sciences, Holy Spirit University of Kaslik, P.O. Box 446, Jounieh, Lebanon
| | - Souheil Hallit
- School of Medicine and Medical Sciences, Holy Spirit University of Kaslik, P.O. Box 446, Jounieh, Lebanon.
- Applied Science Research Center, Applied Science Private University, Amman, 11931, Jordan.
- Research Department, Psychiatric Hospital of the Cross, Jal-Eddib, Lebanon.
| | - Georges Nicolas
- School of Medicine and Medical Sciences, Holy Spirit University of Kaslik, P.O. Box 446, Jounieh, Lebanon
- Department of Pediatrics, Notre Dame des Secours University Hospital Center, Street 93, Byblos, Postal Code 3, Lebanon
| |
Collapse
|
6
|
Girchenko P, Lahti-Pulkkinen M, Hämäläinen E, Laivuori H, Villa PM, Kajantie E, Räikkönen K. Associations of polymetabolic risk of high maternal pre-pregnancy body mass index with pregnancy complications, birth outcomes, and early childhood neurodevelopment: findings from two pregnancy cohorts. BMC Pregnancy Childbirth 2024; 24:78. [PMID: 38267899 PMCID: PMC10807109 DOI: 10.1186/s12884-024-06274-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2023] [Accepted: 01/15/2024] [Indexed: 01/26/2024] Open
Abstract
BACKGROUND A substantial proportion of maternal pregnancy complications, adverse birth outcomes and neurodevelopmental delay in children may be attributable to high maternal pre-pregnancy Body Mass Index (BMI). However, BMI alone is insufficient for the identification of all at-risk mothers and children as many women with non-obesity(< 30 kg/m2) or normal weight(18.5-24.99 kg/m2) and their children may suffer from adversities. Evidence suggests that BMI-related metabolic changes during pregnancy may predict adverse mother-child outcomes better than maternal anthropometric BMI. METHODS In a cohort of 425 mother-child dyads, we identified maternal BMI-defined metabolome based on associations of 95 metabolic measures measured three times during pregnancy with maternal pre-pregnancy BMI. We then examined whether maternal BMI-defined metabolome performed better than anthropometric BMI in predicting gestational diabetes, hypertensive disorders, gestational weight gain (GWG), Caesarian section delivery, child gestational age and weight at birth, preterm birth, admission to neonatal intensive care unit (NICU), and childhood neurodevelopment. Based on metabolic measures with the highest contributions to BMI-defined metabolome, including inflammatory and glycolysis-related measures, fatty acids, fluid balance, ketone bodies, lipids and amino acids, we created a set of maternal high BMI-related polymetabolic risk scores (PMRSs), and in an independent replication cohort of 489 mother-child dyads tested their performance in predicting the same set of mother-child outcomes in comparison to anthropometric BMI. RESULTS BMI-defined metabolome predicted all of the studied mother-child outcomes and improved their prediction over anthropometric BMI, except for gestational hypertension and GWG. BMI-related PMRSs predicted gestational diabetes, preeclampsia, Caesarian section delivery, admission to NICU, lower gestational age at birth, lower cognitive development score of the child, and improved their prediction over anthropometric BMI. BMI-related PMRSs predicted gestational diabetes, preeclampsia, Caesarean section delivery, NICU admission and child's lower gestational age at birth even at the levels of maternal non-obesity and normal weight. CONCLUSIONS Maternal BMI-defined metabolome improves the prediction of pregnancy complications, birth outcomes, and neurodevelopment in children over anthropometric BMI. The novel, BMI-related PMRSs generated based on the BMI-defined metabolome have the potential to become biomarkers identifying at-risk mothers and their children for timely targeted interventions even at the level of maternal non-obesity and normal weight.
Collapse
Affiliation(s)
- Polina Girchenko
- Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, (Haartmaninkatu 3), P.O BOX 21, 00014, Helsinki, Finland.
- Clinical Medicine Research Unit, MRC Oulu, University of Oulu and Oulu University Hospital, Oulu, Finland.
| | - Marius Lahti-Pulkkinen
- Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, (Haartmaninkatu 3), P.O BOX 21, 00014, Helsinki, Finland
- National Institute for Health and Welfare, Helsinki, Finland
- Queen's Medical Research Institute, University of Edinburgh, Edinburgh, UK
| | - Esa Hämäläinen
- Department of Clinical Chemistry, University of Eastern Finland, Kuopio, Finland
| | - Hannele Laivuori
- Department of Obstetrics and Gynecology, Tampere University Hospital, Tampere, Finland
- Center for Child, Adolescent and Maternal Health Research, Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland
- Medical and Clinical Genetics, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
- Institute for Molecular Medicine Finland, Helsinki Institute of Life Science, University of Helsinki, Helsinki, Finland
| | - Pia M Villa
- Obstetrics and Gynaecology, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - Eero Kajantie
- Finnish Institute for Health and Welfare, Public Health Unit, Helsinki, Finland
- Clinical Medicine Research Unit, MRC Oulu, University of Oulu and Oulu University Hospital, Oulu, Finland
- Department of Clinical and Molecular Medicine, Norwegian University of Science and Technology, Trondheim, Norway
| | - Katri Räikkönen
- Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, (Haartmaninkatu 3), P.O BOX 21, 00014, Helsinki, Finland
- Obstetrics and Gynaecology, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| |
Collapse
|
7
|
Chen S, Zhou Y, Mu Q, Wang Y. The interaction effect of pre-pregnancy body mass index and maternal age on the risk of pregnancy complications in twin pregnancies after assisted reproductive technology. J Matern Fetal Neonatal Med 2023; 36:2271623. [PMID: 37884444 DOI: 10.1080/14767058.2023.2271623] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2023] [Accepted: 10/11/2023] [Indexed: 10/28/2023]
Abstract
OBJECTIVE The widespread use of assisted reproductive technology (ART) has led to an increased twin pregnancy rate and increased risk of pregnancy complications. Pre-pregnancy body mass index (BMI) and maternal age are both risk factors for pregnancy complications. This study aimed to explore whether there is an interaction effect between pre-pregnancy BMI and maternal age on pregnancy complications in women with twin pregnancies after ART. METHODS Data of 445,750 women with twin pregnancies after ART were extracted from the National Vital Statistics System (NVSS) database in 2016-2021 in this retrospective cohort study. Univariate and multivariate logistic regression analyses were used to explore (1) the associations between pre-pregnancy BMI, maternal age, and total pregnancy complications; (2) interaction effect between pre-pregnancy BMI and maternal age on total pregnancy complications; and (3) this interaction effect in parity, race, gestational weight gain (GWG), and preterm birth subgroups. The evaluation indexes were odds ratios (ORs), relative excess risk of interaction (RERI), attributable proportions of interaction (AP), and synergy index (S) with 95% confidence intervals (CIs). RESULTS A total of 6,827 women had pregnancy complications. After adjusting for the covariates, compared with women had non-AMA and pre-pregnancy BMI <25 kg/m2, higher maternal age combined with higher pre-pregnancy BMI was associated with higher odds of total pregnancy complications [OR = 2.16, 95%CI: (1.98-2.36)]. The RERI (95% CI) was 0.22 (0.04-0.41), AP (95% CI) was 0.10 (0.02-0.19), and S (95% CI) was 1.24 (1.03-1.49). Subgroup analysis results indicated that the potential additive effect between pre-pregnancy BMI and maternal age on total pregnancy complications was also found in women with different race, multipara/unipara, GWG levels, or preterm births/non-preterm births (all p < 0.05). CONCLUSION Pre-pregnancy BMI and maternal age may have an additive effect on the odds of pregnancy-related complications in women with twin pregnancy after ART.
Collapse
Affiliation(s)
- Shenglan Chen
- College of Nursing, Jiangsu Vocational College of Medicine, Yancheng, Jiangsu, P.R. China
| | - Yu Zhou
- College of Nursing, Jiangsu Vocational College of Medicine, Yancheng, Jiangsu, P.R. China
| | - Qin Mu
- Department of Paediatrics, Yancheng Third People's Hospital, Yancheng, Jiangsu, P.R. China
| | - Yina Wang
- Department of Obstetrics and Gynecology, Yancheng Third People's Hospital, Yancheng, Jiangsu, P.R. China
| |
Collapse
|
8
|
Pi Z, Chen Y, Nie Z, Peng J, Jiang Z. Association between pre-pregnancy body mass index and the risk of preterm birth: a mediating effect of hypertensive disorders of pregnancy. J Matern Fetal Neonatal Med 2023; 36:2224489. [PMID: 37365012 DOI: 10.1080/14767058.2023.2224489] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2023] [Revised: 05/29/2023] [Accepted: 06/07/2023] [Indexed: 06/28/2023]
Abstract
OBJECTIVE We aim to explore the mediating effect of hypertensive disorders of pregnancy (HDP) on the relationship between pre-pregnancy body mass index (BMI) and the risk of preterm birth (PTB) in women with singleton live births. METHODS Demographic and clinical data of 3,249,159 women with singleton live births were extracted from the National Vital Statistics System (NVSS) database in this retrospective cohort study. The associations between pre-pregnancy BMI and HDP, HDP, and PTB, and pre-pregnancy BMI and PTB were evaluated using univariate and multivariate logistic regression analyses, with odds ratios (ORs) and 95% confidence intervals (CIs). Structural equation modeling (SEM) was used to explore the mediating effect of HDP on the relationship between pre-pregnancy BMI and PTB. RESULTS In total, 324,627 women (9.99%) had PTB. After adjustment for covariables, there were significant associations between pre-pregnancy BMI and HDP [OR = 2.07, 95% CI: 2.05-2.09)], HDP and PTB [OR = 2.54, 95% CI: (2.52-2.57)], and pre-pregnancy BMI and PTB [OR = 1.03, 95% CI: 1.02-1.03)]. The effect of pre-pregnancy BMI on PTB was significantly mediated by HDP with a mediation proportion of 63.62%, especially in women of different ages and having gestational diabetes mellitus (GDM) or not. CONCLUSION HDP may play a mediating role in the effect of pre-pregnancy BMI on PTB risk. Women preparing for pregnancy should pay close attention to BMI, and pregnant women should monitor and develop interventions for HDP to reduce the risk of PTB.
Collapse
Affiliation(s)
- Zixin Pi
- Department of Obstetrics and Gynecology, The First People's Hospital of Jiangxia District, Wuhan City. Union Jiangnan Hospital Huazhong University of Science and Technology, Wuhan, Hubei, P.R. China
| | - Yinghui Chen
- Department of Obstetrics and Gynecology, Central People's Hospital of Zhanjiang, Zhanjiang, Guangdong, P.R. China
| | - Zhimin Nie
- Department of Science and Education, The First People's Hospital of Jiangxia District, Wuhan City. Union Jiangnan Hospital Huazhong University of Science and Technology, Wuhan, Hubei, P.R. China
| | - Jing Peng
- Department of Obstetrics and Gynecology, The First People's Hospital of Jiangxia District, Wuhan City. Union Jiangnan Hospital Huazhong University of Science and Technology, Wuhan, Hubei, P.R. China
| | - Zhaoyang Jiang
- Department of Obstetrics and Gynecology, Shenzhen Maternity &Child Healthcare Hospital, Shenzhen, Guangdong, P.R. China
| |
Collapse
|
9
|
Chen C, Okawa S, Okubo R, Nakagawa S, Tabuchi T. Risk factors for mother-to-infant bonding difficulties and maternal anger/rejection towards the infant in a Japanese longitudinal study. Asian J Psychiatr 2023; 89:103778. [PMID: 37769544 DOI: 10.1016/j.ajp.2023.103778] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/21/2023] [Revised: 09/18/2023] [Accepted: 09/21/2023] [Indexed: 10/03/2023]
Affiliation(s)
- Chong Chen
- Division of Neuropsychiatry, Department of Neuroscience, Yamaguchi University Graduate School of Medicine, Ube, Japan.
| | - Sumiyo Okawa
- Institute for Global Health Policy Research, Bureau of International Health Cooperation, National Center for Global Health and Medicine, Tokyo, Japan
| | - Ryo Okubo
- Department of Psychiatry, National Hospital Organization Obihiro Hospital, Obihiro, Japan
| | - Shin Nakagawa
- Division of Neuropsychiatry, Department of Neuroscience, Yamaguchi University Graduate School of Medicine, Ube, Japan
| | - Takahiro Tabuchi
- Cancer Control Center, Osaka International Cancer Institute, Osaka, Japan
| |
Collapse
|
10
|
Dickert JJ, Mbang Springer DL, von Kaisenberg C, Hillemanns P, de Zwaan M, Brodowski L. Comprehensive Questionnaire in Postpartum Women to Assess Women's Knowledge of the Current Weight Gain Guidelines during Pregnancy in Lower Saxony. Obes Facts 2023; 16:576-587. [PMID: 37647859 PMCID: PMC10697741 DOI: 10.1159/000533276] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Accepted: 07/21/2023] [Indexed: 09/01/2023] Open
Abstract
INTRODUCTION Maternal body mass index and gestational weight gain (GWG) are important factors for maternal and neonatal health. The objective of this study was to assess women's knowledge and examine adherence to the Institute of Medicine (IOM) criteria for weight gain during pregnancy by evaluating the information received from obstetricians and women's knowledge about GWG. METHODS This is an analytical semi-longitudinal observational study. Weight data from a nonconsecutive convenience sample of 389 women who gave birth at the Hannover Medical School in the period from August 2020 to July 2021 were taken from their maternal records. Immediately after giving birth, the whole collective (n = 389) was asked to participate in a questionnaire study including questions that were taken from the EMat Health Survey inquiring about their knowledge and received information about GWG and about their eating behavior. Here, a subset of 202 women participated. RESULTS Sixty-five percent of the participants who answered the questionnaire reported that they had not been informed by their obstetrician about GWG recommendations. Additionally, a minority of women knew the correct IOM GWG category based on their pre-pregnancy weight. Meeting the IOM GWG guidelines did not depend on whether or not women received GWG recommendations or knew about the correct GWG category. The majority of women were not concerned about gaining too much weight during pregnancy. 20.7% of all women participating in the study were affected by obesity pre-pregnancy. According to the IOM criteria for GWG, 50.4% gained too much weight. The proportion of women exceeding IOM recommendations was highest in women with pre-pregnancy overweight and obesity (67%). DISCUSSION Weight gain outside of the IOM recommendations is widespread in our survey. Information received and knowledge about GWG recommendations were inadequate in our sample. Considering the fact that GWG outside recommended ranges can contribute to short- and long-term health complications, especially when a woman enters pregnancy already with overweight or obesity, identifying ways of achieving a healthier GWG is warranted.
Collapse
Affiliation(s)
- Jennifer Jessica Dickert
- Department of Gynecology and Obstetrics, Hannover Medical School, Hannover, Germany
- Department of Psychosomatic Medicine and Psychotherapy, Hannover Medical School, Hannover, Germany
| | - Daliah Laura Mbang Springer
- Department of Gynecology and Obstetrics, Hannover Medical School, Hannover, Germany
- Department of Psychosomatic Medicine and Psychotherapy, Hannover Medical School, Hannover, Germany
| | | | - Peter Hillemanns
- Department of Gynecology and Obstetrics, Hannover Medical School, Hannover, Germany
| | - Martina de Zwaan
- Department of Psychosomatic Medicine and Psychotherapy, Hannover Medical School, Hannover, Germany
| | - Lars Brodowski
- Department of Gynecology and Obstetrics, Hannover Medical School, Hannover, Germany
| |
Collapse
|
11
|
Lee CS, Zhu S, Wu Q, Hu Y, Chen Y, Chen D, Liang Z. Independent and Joint Associations of Age, Pre-pregnancy BMI, and Gestational Weight Gain with Adverse Pregnancy Outcomes in Gestational Diabetes Mellitus. Diabetes Ther 2023; 14:363-375. [PMID: 36562982 PMCID: PMC9944684 DOI: 10.1007/s13300-022-01352-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/14/2022] [Accepted: 11/29/2022] [Indexed: 12/24/2022] Open
Abstract
INTRODUCTION To explore the independent and combined effects of maternal age, pre-pregnancy body mass index (BMI), and gestational weight gain (GWG) on pregnancy outcomes in gestational diabetes mellitus (GDM). METHODS A total of 2171 pregnant women with GDM attending the Women's Hospital of Zhejiang University were retrospectively included. We compared pregnancy outcomes in different age, BMI, and GWG groups after adjusting for confounding variables. RESULTS Results showed that (1) advanced maternal age increased the risk of primary Cesarean section and hypertensive disorders of pregnancy (HDP) in normal weight; (2) independent of age and GWG, high BMI significantly increased the risk of HDP, primary Cesarean section, and macrosomia; (3) Women with excessive GWG had a higher risk of primary Cesarean section and HDP, even they were ≤ 29 years old or normal weight, respectively; (4) Pregnant women with inadequate GWG had a higher risk of preterm birth and a lower risk of macrosomia in both the 30-34 age group and the normal weight group; (5) BMI was a better predictor of HDP than GWG among women younger than 30. CONCLUSIONS Among the GDM population, women over the age of 35, overweight and obese, or with an excessive GWG were more prone to adverse pregnancy outcomes, especially primary Cesarean delivery and HDP.
Collapse
Affiliation(s)
- Chee S Lee
- Obstetrical Department, Women's Hospital, School of Medicine, Zhejiang University, Hangzhou, 310006, China
| | - Shuqi Zhu
- Obstetrical Department, Women's Hospital, School of Medicine, Zhejiang University, Hangzhou, 310006, China
| | - Qi Wu
- Obstetrical Department, Women's Hospital, School of Medicine, Zhejiang University, Hangzhou, 310006, China
| | - Ying Hu
- Obstetrical Department, Women's Hospital, School of Medicine, Zhejiang University, Hangzhou, 310006, China
| | - Yunyan Chen
- Obstetrical Department, Women's Hospital, School of Medicine, Zhejiang University, Hangzhou, 310006, China
- Huzhou Women and Children's Hospital, Zhejiang, China
| | - Danqing Chen
- Obstetrical Department, Women's Hospital, School of Medicine, Zhejiang University, Hangzhou, 310006, China.
| | - Zhaoxia Liang
- Obstetrical Department, Women's Hospital, School of Medicine, Zhejiang University, Hangzhou, 310006, China.
- Department of Epidemiology, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA, USA.
| |
Collapse
|
12
|
Azcorra H, Dickinson F, Batún JL. The relationship between pre-pregnancy BMI and energy and macronutrients intakes during pregnancy in women from Yucatan, Mexico. J OBSTET GYNAECOL 2022:1-7. [PMID: 36394296 DOI: 10.1080/01443615.2022.2143259] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2022] [Accepted: 10/25/2022] [Indexed: 11/19/2022]
Abstract
In this observational study, our aim was to analyse the association between pre-pregnancy BMI and adequacy rates of energy and macronutrient intakes in a sample of pregnant women from Yucatan, Mexico. From September to December 2019, we collected data on socioeconomic, pregnancy, and dietary characteristics, and took anthropometric measurements of women during household visits. Pre-pregnancy BMI was calculated from measured height and self-reported body weight. Energy and macronutrient intakes (obtained from three 24-h dietary recalls) were compared with the estimated trimester-specific requirements to calculate adequacies (%). Multiple linear regression models showed that after accounting for maternal socioeconomic characteristics and perinatal variables, each unit increase in pre-pregnancy BMI was associated with decreases of 2%, 2%, and 2.6% in energy, carbohydrate, and total fat intakes, respectively. These results were significant when under- and over-reporters were excluded from the analyses. Women who enter pregnancy with higher BMI values may voluntarily or involuntarily reduce their food intake.IMPACT STATEMENTWhat is already know about this subject? Some studies have analysed the relationship between pre-pregnancy BMI categories (normal weight, overweight, and obesity) and diet quality during pregnancy, but few studies have focussed on quantitative energy and macronutrient intakes or their adequacies in relation to pre-pregnancy BMI.What do the results of this study contribute? In this sample of Mexican women belonging to a middle socioeconomic status, we found that after excluding under- and over-reporters from the analyses and accounting for maternal socioeconomic characteristics and perinatal variables, BMI was negatively associated with adequacy intake rates of energy, carbohydrates, and total fats during pregnancy.What are the implications of these findings for clinical practice and/or further research? Women who enter pregnancy with higher BMI values may voluntarily or involuntarily reduce their food intake. These results can be used to accordingly plan diet counselling during pregnancy.
Collapse
Affiliation(s)
- Hugo Azcorra
- Centro de Investigaciones Silvio Zavala, Universidad Modelo, Mérida, México
| | | | - José Luis Batún
- Facultad de Matemáticas, Universidad Autónoma de Yucatán, Mérida, México
| |
Collapse
|
13
|
Wang Z, Niu J, Ji H, Miao M, Yang L, Chen X, Li X, Song X, Chen A, Liang H, Yuan W. Association of pre-pregnancy body mass index and gestational weight gain with neonatal anogenital distance in a Chinese birth cohort. Reprod Health 2022; 19:152. [PMID: 35768839 PMCID: PMC9245211 DOI: 10.1186/s12978-022-01458-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2021] [Accepted: 06/15/2022] [Indexed: 11/18/2022] Open
Abstract
Background This study aimed to investigate the associations of pre-pregnancy body mass index (BMI) and gestational weight gain (GWG) with anogenital distance (AGD) among newborns. Methods The study included 556 mother-newborn pairs from the Jiashan birth cohort. AGD was measured as AGDAP (from the center of the anus to the anterior base of the penis, where the penile tissue meets the pubic bone) and AGDAS (from the center of the anus to the posterior base of the scrotum, where the skin changes from rugate to smooth) in males and AGDAC (from the center of the anus to the clitoris) and AGDAF (from the center of the anus to the posterior convergence of the fourchette) in females. Multiple linear regression models were used to estimate the associations of pre-pregnancy BMI and GWG, with AGD. Results After adjusting for pre-pregnancy BMI and other potential confounders, male newborns whose mothers had excessive GWG had shorter AGDAP than those whose mothers had normal GWG. Male newborns whose mothers had normal pre-pregnancy BMI and inadequate/excessive GWG had shorter AGDAP than the reference group where mothers had normal pre-pregnancy BMI and GWG in stratified analyses. Conclusion Gestational weight gain during pregnancy was associated with AGD in newborns in this birth cohort. Supplementary Information The online version contains supplementary material available at 10.1186/s12978-022-01458-y. In China, the prevalence of underweight and overweight/obesity remained high among women. Appropriate pre-pregnancy body mass index (BMI) and gestation weight gain (GWG) were critical to reduce the risk of adverse birth outcomes. The anogenital distance (AGD) was measured as an indicator of neonatal reproductive function and was associated with adverse reproductive outcomes in adults. Thus, we investigated the associations of both sub-optimal pre-pregnancy BMI, as well as GWG, with AGD among newborns to draw a picture about their effect on offspring reproductive health. A total of 556 mother-newborns were included in the study from the Jiashan birth cohort in China. We extracted information about maternal lifestyles, social demographic characteristics, diet, and medical history from questionnaires conducted during 8–16 gestational weeks and medical records. AGD among newborns was measured within 3 days of delivery. We found that maternal excessive GWG was associated with shorter AGD in male newborns after adjusting for maternal pre-pregnancy BMI in multiple linear regression models. The study also suggested that maternal inadequate GWG was associated with a shorter AGD in male newborns, which needed to be corroborated in further studies with a larger sample size. In conclusion, health professionals shall implement sufficient intervention to prevent suboptimal GWG during prenatal checkups.
Collapse
Affiliation(s)
- Zhiyang Wang
- NHC Key Lab. of Reproduction Regulation, Shanghai Institute for Biomedical and Pharmaceutical Technologies, #779 Lao Hu Min Road, Shanghai, 200032, China.,Department of Biological Sciences, University of Cincinnati, Cincinnati, OH, 45221, USA
| | - Jinbo Niu
- The First People's Hospital of Jiashan, Jiaxing, Zhejiang, China
| | - Honglei Ji
- NHC Key Lab. of Reproduction Regulation, Shanghai Institute for Biomedical and Pharmaceutical Technologies, #779 Lao Hu Min Road, Shanghai, 200032, China
| | - Maohua Miao
- NHC Key Lab. of Reproduction Regulation, Shanghai Institute for Biomedical and Pharmaceutical Technologies, #779 Lao Hu Min Road, Shanghai, 200032, China
| | - Limei Yang
- Obstetrics and Gynecology Department, Maternity and Child Health Care Hospital, Jiashan County, Jiaxing, Zhejiang, China
| | - Xia Chen
- Maternal Health Care Department, Maternity and Child Health Care Hospital, Jiashan County, Jiaxing, Zhejiang, China
| | - Xiufeng Li
- Maternal Health Care Department, Maternity and Child Health Care Hospital, Jiashan County, Jiaxing, Zhejiang, China
| | - Xiuxia Song
- NHC Key Lab. of Reproduction Regulation, Shanghai Institute for Biomedical and Pharmaceutical Technologies, #779 Lao Hu Min Road, Shanghai, 200032, China
| | - Aimin Chen
- Department of Biostatistics, Epidemiology and Informatics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, 19104, USA
| | - Hong Liang
- NHC Key Lab. of Reproduction Regulation, Shanghai Institute for Biomedical and Pharmaceutical Technologies, #779 Lao Hu Min Road, Shanghai, 200032, China.
| | - Wei Yuan
- NHC Key Lab. of Reproduction Regulation, Shanghai Institute for Biomedical and Pharmaceutical Technologies, #779 Lao Hu Min Road, Shanghai, 200032, China
| |
Collapse
|
14
|
Aji AS, Lipoeto NI, Yusrawati Y, Malik SG, Kusmayanti NA, Susanto I, Majidah NM, Nurunniyah S, Alfiana RD, Wahyuningsih W, Vimaleswaran KS. Association between pre-pregnancy body mass index and gestational weight gain on pregnancy outcomes: a cohort study in Indonesian pregnant women. BMC Pregnancy Childbirth 2022; 22:492. [PMID: 35705902 PMCID: PMC9202216 DOI: 10.1186/s12884-022-04815-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Accepted: 06/08/2022] [Indexed: 11/27/2022] Open
Abstract
Background Pre-pregnancy BMI (PP BMI) and gestational weight gain (GWG) are prominent anthropometric indicators for maternal nutritional status and are related to an increased risk of adverse pregnancy outcomes. This study aimed to determine the factors affecting total GWG, PP BMI and pregnancy outcomes among pregnant women in West Sumatra, Indonesia. Methods This observational analysis was conducted among healthy women in the Vitamin D Pregnant Mother (VDPM) cohort study. A total of 195 pregnant women and their newborn babies were enrolled, and information regarding their socio-demographic characteristics, obstetric history, dietary intake and anthropometric data were assessed through direct interviews. Furthermore, the Institute of Medicine (IOM) 2009 guidelines were used to obtain the total GWG. Results PP BMI was used to categorise the 195 pregnant women as overweight/obese (43.1%), normal (46.7%) and underweight (10.2%). There were 53.3%, 34.4% and 12.3% of women who had inadequate, adequate and excessive GWG, respectively. The multinomial logistic regression model indicated that overweight or obese women at the pre-pregnancy stage were 4.09 times more likely to have an excessive rate of GWG (AOR = 4.09, 95% CI: 1.38–12.12, p = 0.011) than those whose weight was normal. Furthermore, women with excessive GWG were 27.11 times more likely to have a baby with macrosomia (AOR = 27.11, 95% CI: 2.99–245.14) (p = 0.001) and those with inadequate GWG were 9.6 times more likely to give birth to a baby with low birth weight (LBW) (AOR = 9.60, 95% CI; 0.88–105.2) (p = 0.002). Conclusions This study demonstrates that the malnutrition status prior to pregnancy and inadequate or excessive GWG status during pregnancy as significant risk factors for developing adverse pregnancy outcomes. These findings highlight the importance of providing information, preconception counselling and health education on weight management for healthy pregnancies. Supplementary information The online version contains supplementary material available at 10.1186/s12884-022-04815-8.
Collapse
Affiliation(s)
- Arif Sabta Aji
- Graduate School of Public Health Department, Faculty of Health Sciences, Alma Ata University, Yogyakarta, 55183, Indonesia. .,Department of Nutrition, Faculty of Health Sciences, Alma Ata University, Yogyakarta, 55183, Indonesia. .,Alma Ata Graduate School of Public Health, Alma Ata University, Jl Brawijaya 99, Kasihan, Bantul, Yogyakarta, 552813, Indonesia.
| | - Nur Indrawaty Lipoeto
- Department of Nutrition, Faculty of Medicine, Andalas University, Padang, 25127, Indonesia
| | - Yusrawati Yusrawati
- Department of Obstetrics and Gynaecology Department, Faculty of Medicine, Andalas University, Padang, 25127, Indonesia
| | - Safarina G Malik
- Eijkman Institute for Molecular Biology, Jakarta, 10430, Indonesia
| | | | - Isman Susanto
- Graduate School of Public Health Department, Faculty of Health Sciences, Alma Ata University, Yogyakarta, 55183, Indonesia
| | - Nur Mukhlishoh Majidah
- Graduate School of Public Health Department, Faculty of Health Sciences, Alma Ata University, Yogyakarta, 55183, Indonesia
| | - Siti Nurunniyah
- Graduate School of Public Health Department, Faculty of Health Sciences, Alma Ata University, Yogyakarta, 55183, Indonesia.,Department of Midwifery, Faculty of Health Sciences, Alma Ata University, Bantul, 55183, Indonesia
| | - Ratih Devi Alfiana
- Department of Midwifery, Faculty of Health Sciences, Alma Ata University, Bantul, 55183, Indonesia
| | - Wahyuningsih Wahyuningsih
- Graduate School of Public Health Department, Faculty of Health Sciences, Alma Ata University, Yogyakarta, 55183, Indonesia.,Department of Nursing, Faculty of Health Sciences, Alma Ata University, Bantul, 55183, Indonesia
| | - Karani S Vimaleswaran
- Department of Food and Nutritional Sciences, Hugh Sinclair Unit of Human Nutrition, University of Reading, Reading, UK.,The Institute for Food, Nutrition, and Health (IFNH), University of Reading, Reading, UK
| |
Collapse
|
15
|
Tekin Guler T, Koc N, Kara Uzun A, Fisunoglu M. The association of pre-pregnancy BMI on leptin, ghrelin, adiponectin and insulin-like growth factor-1 in breast milk: a case-control study. Br J Nutr 2022; 127:1675-81. [PMID: 34348809 DOI: 10.1017/S0007114521002932] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
The nutrient composition of breast milk alters during lactation, and maternal BMI adds more intricacy into its complexity. We aimed to compare leptin, ghrelin, adiponectin and insulin-like growth factor-1 (IGF-1) levels of pre-feed and post-feed breast milk in mothers with obesity and normal weight, and tried to determine their effects on infants' growth over weight for length z-score. Twenty obese and twenty normal weight mothers with 2-month-old infants were enrolled in this case-control study. Five millilitre pre-feed breast milk and 5 ml post-feed breast milk were collected. Breast milk leptin, ghrelin, adiponectin and IGF-1 were measured by commercial kits. The pre-feed breast milk of mothers with obesity had significantly higher levels of ghrelin than mothers with normal weight (P = 0·025), whereas the post-feed breast milk of mothers with normal weight had higher levels of adiponectin than the mothers with obesity (P = 0·010). No significant differences were observed in leptin and IGF-1 levels between the two groups. Post-feed breast milk IGF-1 levels of mothers with obesity were correlated with infant's weight for length z-score at 2 months (r -0·476; P = 0·034). In linear regression models, parity affected the ghrelin in pre-feed breast milk (P = 0·025). Our results revealed that maternal pre-pregnancy BMI was associated with breast milk components.
Collapse
|
16
|
Parker SE, Carlson JM, Kebede N, Werler MM, Janulewicz PA. Pre-pregnancy body mass index and parent and teacher-reported behavioral outcomes among offspring in childhood. Neurotoxicol Teratol 2022; 89:107049. [PMID: 34780987 PMCID: PMC8819681 DOI: 10.1016/j.ntt.2021.107049] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2021] [Revised: 10/15/2021] [Accepted: 11/09/2021] [Indexed: 01/03/2023]
Abstract
OBJECTIVE Pre-pregnancy obesity has been linked to childhood neurodevelopmental outcomes, including autism and attention-deficit hyperactivity disorder. The aim of our study was to examine the association between pre-pregnancy body mass index (BMI) and scores on behavioral scales according to both mother and teacher report. METHODS We conducted a longitudinal study of 469 mother-child pairs. Information on pre-pregnancy body mass index (BMI) was collected from standardized maternal interviews conducted after delivery and assessment of childhood behavioral problems was measured at 5-12 years of age according to maternal-report using the Child Behavior Checklist (CBCL) and teacher-report using the Teacher Report Form (TRF). Using normal pre-pregnancy BMI (18.5-24.9 kg/m2) as the reference (n = 305), we calculated adjusted mean differences (MD) for t-scores on broadband and syndrome scales of behavior for children of mothers with pre-pregnancy overweight (n = 101) or obese (n = 63) BMI. We also examined associations with scores in the clinical range using risk ratios (RR) and compared results across informants. To account for loss to follow-up between the initial interview and the childhood behavioral assessment, we weighted models using stabilized inverse probability weights. RESULTS Pre-pregnancy obesity was associated with a mean increase in child's total behavior problem t-scores according to both mother and teacher report, after adjustment for confounders and weighted for loss to follow-up (MD: 0.7, 95% CI: -2.2, 3.6 on CBCL; MD: 3.1, 95% CI: 0.5, 5.7 on TRF), indicating poorer behavioral outcomes. Comparing the magnitude of associations between mother and teacher-report, mean differences for pre-pregnancy obesity and most behavioral problem scales were larger for teacher-reported outcomes than mother-reported outcomes. Pre-pregnancy obesity was associated with increased risks of externalizing behaviors in the clinical range regardless of informant (CBCL RR: 1.6, 95% CI: 0.8, 3.2 and TRF RR: 1.7, 95% CI: 0.8, 3.5). Pre-pregnancy obesity was also associated with increased risks of internalizing behaviors according to teacher-report (TRF RR: 2.6, 95% CI:1.5, 4.6). CONCLUSIONS Pre-pregnancy obesity, compared to pre-pregnancy normal weight, is associated with generally higher scores on both mother and teacher reported childhood behavioral assessments, indicating an increased likelihood of behavioral problems.
Collapse
Affiliation(s)
- Samantha E. Parker
- Department of Epidemiology, Boston University School of
Public Health, Boston, MA 02118
| | - Jeffrey M. Carlson
- Department of Environmental Health, Boston University
School of Public Health, Boston, MA 02118
| | - Nehemiah Kebede
- Department of Epidemiology, Boston University School of
Public Health, Boston, MA 02118
| | - Martha M. Werler
- Department of Epidemiology, Boston University School of
Public Health, Boston, MA 02118
| | - Patricia A. Janulewicz
- Department of Environmental Health, Boston University
School of Public Health, Boston, MA 02118
| |
Collapse
|
17
|
Vats H, Saxena R, Sachdeva MP, Walia GK, Gupta V. Impact of maternal pre-pregnancy body mass index on maternal, fetal and neonatal adverse outcomes in the worldwide populations: A systematic review and meta-analysis. Obes Res Clin Pract 2021; 15:536-45. [PMID: 34782256 DOI: 10.1016/j.orcp.2021.10.005] [Citation(s) in RCA: 50] [Impact Index Per Article: 16.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2021] [Revised: 10/25/2021] [Accepted: 10/29/2021] [Indexed: 12/25/2022]
Abstract
OBJECTIVE Systematic review and meta-analysis conducted to investigate the effect of stratified pre-pregnancy maternal body mass index on twenty maternal and fetal/neonatal adverse outcomes. METHODS PubMed, Google Scholar, Medline, Embase, Web of Science databases were searched from inception till July 11, 2020. Cohort studies were included. The pooled odds ratio with 95% confidence interval was reported considering the random effect and the quality effect model. The sub-group analysis and meta-regression were conducted for BMI cut-offs, geographical region, source of BMI, and sample size. RESULTS Overall, 86 studies representing 20,328,777 pregnant women were included in this meta-analysis. Our study reveals that overweight and obese mothers are at increased odds of cesarean delivery, elective cesarean delivery, emergency cesarean delivery, gestational diabetes, gestational hypertension, induction of labor, postpartum hemorrhage, pre-eclampsia, pre-term premature rupture of membrane, and the fetuses/neonates of overweight and obese mothers are at increased risk of admission in the newborn intensive care unit, APGAR scores less than 7 at 5 min, large for gestational age, macrosomia, extreme pre-term birth in pregnant mothers compared with standard BMI mothers. However, the underweight mothers showed increased odds for small for gestational age infant and pre-term birth, whereas obese mothers were at higher risk for post-term birth and stillbirths. The subgroup and meta-regression analyses have shown the impact of BMI cut-offs, geographical region, source of BMI, and sample size on several maternal, fetal/neonatal adverse outcomes. CONCLUSION The meta-analysis confirmed the association of elevated pre-pregnancy maternal BMI with higher odds of adverse maternal and fetal/neonatal outcomes.
Collapse
|
18
|
Sun Y, Shen Z, Zhan Y, Wang Y, Ma S, Zhang S, Liu J, Wu S, Feng Y, Chen Y, Cai S, Shi Y, Ma L, Jiang Y. Investigation of optimal gestational weight gain based on the occurrence of adverse pregnancy outcomes for Chinese women: a prospective cohort study. Reprod Biol Endocrinol 2021; 19:130. [PMID: 34461936 PMCID: PMC8404327 DOI: 10.1186/s12958-021-00797-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2021] [Accepted: 07/08/2021] [Indexed: 12/12/2022] Open
Abstract
OBJECTIVE To investigate recommendations for appropriate gestational weight gain (GWG) of Chinese females. METHODS In total of 3,172 eligible women in the first trimester were recruited into the Chinese Pregnant Women Cohort Study (CPWCS) project. Pregnancy complications and outcomes were collated using the hospital medical records system. The method of occurrence of participants with adverse pregnancy outcomes (Occurrence Method) was conducted to calculate the recommended total GWG for each participant's pre-pregnancy BMI. Occurrence Method data were judged against the Institute of Medicine (IOM) and Japanese recommended criteria in terms of the total occurrence of adverse pregnancy outcomes of pregnant women with appropriate weight gain. RESULTS The most frequent GWG was ≥ 14 kg and < 16 kg (19.4%), followed by ≥ 10 kg and < 12 kg (15.5%) and ≥ 12 kg and < 14 kg (15.2%). The most frequently occurring adverse pregnancy outcomes were cesarean sections for underweight (30.0%), normal weight (40.4%), overweight (53.6%) and obese (53.7%) women. A large for gestational age (LGA) accounted for 18.0% of the overweight and 20.9% of the obesity group. Gestational diabetes mellitus (GDM) occurred in 16.9% of overweight and 23.1% of obese women. The recommended total GWG in a Chinese women population is ≥ 8 and < 12 kg if underweight, ≥ 12 and < 14 kg for normal weight, ≥ 8.0 and < 10.0 kg if overweight, and < 8 kg for women with obesity. CONCLUSIONS Current Chinese recommendations provide the optimal ranges of GWG to minimize the occurrence of undesirable pregnancy outcomes for each group of pre-pregnancy BMIs in a Chinese population. TRIAL REGISTRATION Registered with ClinicalTrials ( NCT03403543 ).
Collapse
Affiliation(s)
- Yin Sun
- Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, National Clinical Research Center for Obstetric & Gynecologic Diseases, No. 1 Shuaifuyuan Wangfujing, Dongcheng District, Beijng, 100730, China
| | - Zhongzhou Shen
- School of Public Health, Chinese Academy of Medical Sciences and Peking Union Medical College, No. 9 Dongdan Santiao, Dongcheng District, Beijing, 100730, China
| | - Yongle Zhan
- School of Public Health, Chinese Academy of Medical Sciences and Peking Union Medical College, No. 9 Dongdan Santiao, Dongcheng District, Beijing, 100730, China
| | - Yawen Wang
- School of Public Health, Chinese Academy of Medical Sciences and Peking Union Medical College, No. 9 Dongdan Santiao, Dongcheng District, Beijing, 100730, China
| | - Shuai Ma
- School of Public Health, Chinese Academy of Medical Sciences and Peking Union Medical College, No. 9 Dongdan Santiao, Dongcheng District, Beijing, 100730, China
| | - Suhan Zhang
- Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, National Clinical Research Center for Obstetric & Gynecologic Diseases, No. 1 Shuaifuyuan Wangfujing, Dongcheng District, Beijng, 100730, China
| | - Juntao Liu
- Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, National Clinical Research Center for Obstetric & Gynecologic Diseases, No. 1 Shuaifuyuan Wangfujing, Dongcheng District, Beijng, 100730, China
| | - Sansan Wu
- School of Public Health, Chinese Academy of Medical Sciences and Peking Union Medical College, No. 9 Dongdan Santiao, Dongcheng District, Beijing, 100730, China
| | - Yahui Feng
- School of Public Health, Chinese Academy of Medical Sciences and Peking Union Medical College, No. 9 Dongdan Santiao, Dongcheng District, Beijing, 100730, China
| | - Yunli Chen
- School of Public Health, Chinese Academy of Medical Sciences and Peking Union Medical College, No. 9 Dongdan Santiao, Dongcheng District, Beijing, 100730, China
| | - Shuya Cai
- School of Public Health, Chinese Academy of Medical Sciences and Peking Union Medical College, No. 9 Dongdan Santiao, Dongcheng District, Beijing, 100730, China
| | - Yingjie Shi
- School of Public Health, Chinese Academy of Medical Sciences and Peking Union Medical College, No. 9 Dongdan Santiao, Dongcheng District, Beijing, 100730, China
| | - Liangkun Ma
- Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, National Clinical Research Center for Obstetric & Gynecologic Diseases, No. 1 Shuaifuyuan Wangfujing, Dongcheng District, Beijng, 100730, China.
| | - Yu Jiang
- School of Public Health, Chinese Academy of Medical Sciences and Peking Union Medical College, No. 9 Dongdan Santiao, Dongcheng District, Beijing, 100730, China.
| |
Collapse
|
19
|
Li G, Xing Y, Wang G, Zhang J, Wu Q, Ni W, Jiao N, Chen W, Liu Q, Gao L, Zhang Z, Wang Y, Xing Q. Differential effect of pre-pregnancy low BMI on fetal macrosomia: a population-based cohort study. BMC Med 2021; 19:175. [PMID: 34344359 PMCID: PMC8335988 DOI: 10.1186/s12916-021-02046-w] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Accepted: 06/23/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The differential effect of pre-pregnancy low BMI on macrosomia has not been fully addressed. Herein, we conducted a city-wide population-based cohort study to illuminate the association between pre-pregnancy low BMI and macrosomia, stratifying by maternal age, parity, and GDM status. METHODS All pregnant women who paid their first prenatal visit to the hospital in Qingdao during August 1, 2018, to June 30, 2020, were recruited to this study. The interactive effect of maternal age and pre-pregnancy low BMI on macrosomia was evaluated using logistic regression models, followed by strata-specific analyses. RESULTS A total of 105,768 mother-child pairs were included, and the proportion of fetal macrosomia was 11.66%. The interactive effect of maternal pre-pregnancy BMI and age was statistically significant on macrosomia irrespective of parity (nullipara: Padjusted=0.0265; multipara: Padjusted=0.0356). The protective effect of low BMI on macrosomia was most prominent among nullipara aged 35 years and above (aOR=0.16, 95% CI 0.05-0.49) and multipara aged 25 years and below (aOR=0.17, 95% CI 0.05-0.55). In nullipara without GDM, the risk estimates gradually declined with increasing conception age (20-to-24 years: aOR=0.64, 95% CI 0.51-0.80; 25-to-29 years: aOR=0.43 95% CI 0.36-0.52; 30-to-34 years: aOR=0.40 95% CI 0.29-0.53; and ≥35 years: aOR=0.19, 95% CI 0.06-0.60). A similar pattern could also be observed in nullipara with GDM, where the aOR for low BMI on macrosomia decreased from 0.54 (95% CI 0.32-0.93) in pregnant women aged 25-29 years to 0.30 (95% CI 0.12-0.75) among those aged 30-34 years. However, younger multiparous mothers, especially those aged 25 years and below without GDM (aOR=0.21, 95% CI 0.06-0.68), were more benefited from a lower BMI against the development of macrosomia. CONCLUSIONS Maternal low BMI is inversely associated with macrosomia irrespective of maternal age and parity. The impact of pre-pregnancy low BMI on macrosomia varied by maternal age and parity. The protective effect of a lower maternal BMI against fetal macrosomia was more prominent in nulliparous mothers aged 35 years and above, whereas multiparous mothers younger than 25 years of age were more benefited.
Collapse
Affiliation(s)
- Guoju Li
- Qingdao Women and Children's Hospital, Qingdao University, No.6 Tongfu Road, Qingdao, 266000, Shandong Province, China
| | - Yuhan Xing
- Department of Paediatrics, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China
| | - Guolan Wang
- Qingdao Women and Children's Hospital, Qingdao University, No.6 Tongfu Road, Qingdao, 266000, Shandong Province, China
| | - Jun Zhang
- Qingdao Women and Children's Health Care and Family Planning Service Center, Qingdao, Shandong Province, China
| | - Qin Wu
- Qingdao Women and Children's Hospital, Qingdao University, No.6 Tongfu Road, Qingdao, 266000, Shandong Province, China
| | - Wei Ni
- Qingdao Women and Children's Hospital, Qingdao University, No.6 Tongfu Road, Qingdao, 266000, Shandong Province, China
| | - Na Jiao
- Qingdao Women and Children's Hospital, Qingdao University, No.6 Tongfu Road, Qingdao, 266000, Shandong Province, China
| | - Wenjing Chen
- Qingdao Women and Children's Health Care and Family Planning Service Center, Qingdao, Shandong Province, China
| | - Qing Liu
- Qingdao Women and Children's Health Care and Family Planning Service Center, Qingdao, Shandong Province, China
| | - Li Gao
- Qingdao Women and Children's Hospital, Qingdao University, No.6 Tongfu Road, Qingdao, 266000, Shandong Province, China
| | - Zhenhong Zhang
- Public Health School, Medical College of Qingdao University, Qingdao, China
| | - Yao Wang
- Public Health School, Medical College of Qingdao University, Qingdao, China
| | - Quansheng Xing
- Qingdao Women and Children's Hospital, Qingdao University, No.6 Tongfu Road, Qingdao, 266000, Shandong Province, China.
| |
Collapse
|
20
|
Mayasari NR, Hu TY, Chao JC, Bai CH, Chen YC, Huang YL, Chang CC, Wang FF, Hadi H, Nurwanti E, Chang JS. Associations of the pre-pregnancy weight status with anaemia and the erythropoiesis-related micronutrient status. Public Health Nutr 2021;:1-11. [PMID: 34120669 DOI: 10.1017/S1368980021002627] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVE The coexistence of underweight (UW) and overweight (OW)/obese (OB) at the population level is known to affect iron deficiency (ID) anaemia (IDA), but how the weight status affects erythropoiesis during pregnancy is less clear at a population scale. This study investigated associations between the pre-pregnancy BMI (pBMI) and erythropoiesis-related nutritional deficiencies. DESIGN Anthropometry, blood biochemistry and 24-h dietary recall data were collected during prenatal care visits. The weight status was defined based on the pBMI. Mild nutrition deficiency-related erythropoiesis was defined if individuals had an ID, folate depletion or a vitamin B12 deficiency. SETTING The Nationwide Nutrition and Health Survey in Taiwan (Pregnant NAHSIT 2017-2019). PARTICIPANTS We included 1456 women aged 20 to 45 years with singleton pregnancies. RESULTS Among these pregnant women, 9·6 % were UW, and 29·2 % were either OW (15·8 %) or OB (13·4 %). A U-shaped association between the pBMI and IDA was observed, with decreased odds (OR; 95 % CI) for OW subjects (0·6; 95 % CI (0·4, 0·9)) but increased odds for UW (1·2; 95 % CI (0·8, 2·0)) and OB subjects (1·2; 95 % CI (0·8, 1·8)). The pBMI was positively correlated with the prevalence of a mild nutritional deficiency. Compared to normal weight, OB pregnant women had 3·4-fold (3·4; 95 % CI (1·4, 8·1)) higher odds for multiple mild nutritional deficiencies, while UW individuals had lowest odds (0·3; 95 % CI (0·1, 1·2)). A dietary analysis showed negative relationships of pBMI with energy, carbohydrates, protein, Fe and folate intakes, but positive relationship with fat intakes. CONCLUSION The pre-pregnancy weight status can possibly serve as a good nutritional screening tool for preventing IDA during pregnancy.
Collapse
|
21
|
Tore EC, Antoniou EE, de Groot RHM, Gielen M, Godschalk RWL, Roumeliotaki T, Smits L, Southwood TR, Spaanderman MEA, Stratakis N, Vafeiadi M, Chatzi VL, Zeegers MP. Gestational Weight Gain by Maternal Pre-pregnancy BMI and Childhood Problem Behaviours in School-Age Years: A Pooled Analysis of Two European Birth Cohorts. Matern Child Health J 2020; 24:1288-1298. [PMID: 32557131 PMCID: PMC7476966 DOI: 10.1007/s10995-020-02962-y] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Objectives Maternal pre-pregnancy weight is known to affect foetal development. However, it has not yet been clarified if gestational weight gain is associated with childhood behavioural development. Methods We performed a pooled analysis of two prospective birth cohorts to investigate the association between gestational weight gain and childhood problem behaviours, and the effect modification of maternal pre-pregnancy BMI. In total, 378 mother–child pairs from the Maastricht Essential Fatty Acids Birth cohort (MEFAB) and 414 pairs from the Rhea Mother–Child cohort were followed up from early pregnancy to 6–7 years post-partum. At follow up, parents assessed their children’s behaviour, measured as total problems, internalizing and externalizing behaviours, with the Child Behaviour Checklist. We computed cohort- and subject-specific gestational weight gain trajectories using mixed-effect linear regression models. Fractional polynomial regressions, stratified by maternal pre-pregnancy BMI status, were then used to examine the association between gestational weight gain and childhood problem behaviours. Results In the pre-pregnancy overweight/obese group, greater gestational weight gain was associated with higher problem behaviours. On average, children of women with overweight/obesity who gained 0.5 kg/week scored 25 points higher (on a 0–100 scale) in total problems and internalizing behaviours, and about 18 points higher in externalizing behaviours than children whose mothers gained 0.2 kg/week. Inconsistent results were found in the pre-pregnancy normal weight group. Conclusions for Practice Excessive gestational weight gain in women with pre-pregnancy overweight/obesity might increase problem behaviours in school-age children. Particular attention should be granted to avoid excessive weight gain in women with a pre-pregnancy overweight or obesity. Electronic supplementary material The online version of this article (10.1007/s10995-020-02962-y) contains supplementary material, which is available to authorized users.
Collapse
Affiliation(s)
- Elena C Tore
- Department of Complex Genetics, Care and Public Health Research Institute, Maastricht University, 6200 MD, Maastricht, The Netherlands. .,Institute of Applied Health Research, College of Medical and Dental Sciences, University of Birmingham, Birmingham, B15 2TT, UK.
| | - Evangelia E Antoniou
- Department of Complex Genetics, Care and Public Health Research Institute, Maastricht University, 6200 MD, Maastricht, The Netherlands
| | - Renate H M de Groot
- Welten Institute, Research Centre for Learning, Teaching, and Technology, Open University of the Netherlands, 6419 AT, Heerlen, The Netherlands.,Department of Complex Genetics, School for Nutrition and Translational Research in Metabolism, Maastricht University, 6200 MD, Maastricht, The Netherlands
| | - Marij Gielen
- Department of Complex Genetics, School for Nutrition and Translational Research in Metabolism, Maastricht University, 6200 MD, Maastricht, The Netherlands
| | - Roger W L Godschalk
- Department of Pharmacology and Toxicology, School for Nutrition and Translational Research in Metabolism, Maastricht University, 6200 MD, Maastricht, The Netherlands
| | - Theano Roumeliotaki
- Department of Social Medicine, Faculty of Medicine, University of Crete, 71003, Heraklion, Greece
| | - Luc Smits
- Department of Epidemiology, Care and Public Health Research Institute, Maastricht University, 6200 MD, Maastricht, The Netherlands
| | - Taunton R Southwood
- Institute of Child Health, University of Birmingham, Birmingham, B15 2TT, UK
| | - Marc E A Spaanderman
- Department of Obstetrics and Gynaecology, School for Oncology and Developmental Biology, Maastricht University, 6200 MD, Maastricht, The Netherlands
| | - Nikos Stratakis
- Department of Complex Genetics, Care and Public Health Research Institute, Maastricht University, 6200 MD, Maastricht, The Netherlands.,Department of Social Medicine, Faculty of Medicine, University of Crete, 71003, Heraklion, Greece.,Keck School of Medicine, University of Southern California, Los Angeles, CA, 90032, USA
| | - Marina Vafeiadi
- Department of Social Medicine, Faculty of Medicine, University of Crete, 71003, Heraklion, Greece
| | - Vaia L Chatzi
- Department of Complex Genetics, Care and Public Health Research Institute, Maastricht University, 6200 MD, Maastricht, The Netherlands.,Department of Social Medicine, Faculty of Medicine, University of Crete, 71003, Heraklion, Greece.,Keck School of Medicine, University of Southern California, Los Angeles, CA, 90032, USA
| | - Maurice P Zeegers
- Department of Complex Genetics, Care and Public Health Research Institute, Maastricht University, 6200 MD, Maastricht, The Netherlands.,Department of Complex Genetics, School for Nutrition and Translational Research in Metabolism, Maastricht University, 6200 MD, Maastricht, The Netherlands
| |
Collapse
|
22
|
Wang Y, Wang K, Han T, Zhang P, Chen X, Wu W, Feng Y, Yang H, Li M, Xie B, Guo P, Warren JL, Shi X, Wang S, Zhang Y. Exposure to multiple metals and prevalence for preeclampsia in Taiyuan, China. Environ Int 2020; 145:106098. [PMID: 32916414 DOI: 10.1016/j.envint.2020.106098] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/24/2020] [Revised: 08/19/2020] [Accepted: 08/25/2020] [Indexed: 06/11/2023]
Abstract
BACKGROUND Several studies with small sample size have reported inconsistent associations between single metal and preeclampsia (PE). Very few studies have investigated metal mixtures and PE. METHODS Blood concentrations of chromium (Cr), cadmium, mercury (Hg), arsenic (As), lead (Pb), nickel, cobalt, and antimony were measured using inductively coupled plasma-mass spectrometry among 427 PE women and 427 matched controls from Taiyuan, China. Multivariate logistic regression models, weighted quantile sum (WQS) regression, and principal component analysis were employed to examine exposure to single metals and metal mixtures in relation to PE. RESULTS An increased prevalence of PE was associated with Cr (OR = 1.76, 95% CI: 1.18, 2.62 and 1.90, 1.22, 2.93 for the middle and high vs. low), Hg (OR = 1.60, 95% CI: 1.08, 2.38 for the high vs. low) and As (OR = 1.64, 95% CI: 1.07, 2.52 for the middle vs. low). The WQS index, predominated by Cr, Hg, Pb, and As, was positively associated with PE. A principal component characterized by Cr and As also exhibited excessive association with PE. The highest PE prevalence was found among women who were overweight/obese before pregnancy and had high Cr levels compared to women who had pre-pregnancy normal body mass index (BMI) and low Cr levels. CONCLUSIONS Our study provided evidence that exposure to multiple metals was associated with increased prevalence of PE, and the observed association with multiple metals was dominated by Cr, As. Our study also suggested that pre-pregnancy BMI might modify the association between Cr and PE.
Collapse
Affiliation(s)
- Ying Wang
- Department of Epidemiology, Shanxi Medical University School of Public Health, Taiyuan, China; Department of Environmental Health Sciences, Yale School of Public Health, New Haven, CT, USA
| | - Keke Wang
- Department of Epidemiology, Shanxi Medical University School of Public Health, Taiyuan, China
| | - Tianbi Han
- Department of Epidemiology, Shanxi Medical University School of Public Health, Taiyuan, China
| | - Ping Zhang
- Department of Epidemiology, Shanxi Medical University School of Public Health, Taiyuan, China
| | - Xi Chen
- National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Weiwei Wu
- Department of Epidemiology, Shanxi Medical University School of Public Health, Taiyuan, China
| | - Yongliang Feng
- Department of Epidemiology, Shanxi Medical University School of Public Health, Taiyuan, China
| | - Hailan Yang
- Department of Obstetrics, The First Affiliated Hospital, Shanxi Medical University, Taiyuan, China
| | - Mei Li
- Department of Epidemiology, Shanxi Medical University School of Public Health, Taiyuan, China
| | - Bingjie Xie
- Department of Epidemiology, Shanxi Medical University School of Public Health, Taiyuan, China
| | - Pengge Guo
- Department of Epidemiology, Shanxi Medical University School of Public Health, Taiyuan, China
| | - Joshua L Warren
- Department of Biostatistics, Yale School of Public Health, New Haven, CT, USA
| | - Xiaoming Shi
- National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Suping Wang
- Department of Epidemiology, Shanxi Medical University School of Public Health, Taiyuan, China.
| | - Yawei Zhang
- Department of Environmental Health Sciences, Yale School of Public Health, New Haven, CT, USA; Department of Surgery, Yale School of Medicine, New Haven, CT, USA.
| |
Collapse
|
23
|
Martin H, Thevenet-Morrison K, Dozier A. Maternal pre-pregnancy body mass index, gestational weight gain and breastfeeding outcomes: a cross-sectional analysis. BMC Pregnancy Childbirth 2020; 20:471. [PMID: 32807132 PMCID: PMC7433137 DOI: 10.1186/s12884-020-03156-8] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2019] [Accepted: 08/04/2020] [Indexed: 12/20/2022] Open
Abstract
Background It is well established that mothers with above-normal pre-pregnancy BMI are at increased risk of breastfeeding cessation; however, the impact of pregnancy weight-gain (PWG) is less well-defined. Excess PWG may alter the hormonal preparation of breast tissue for lactation, increase the risk of complications that negatively impact breastfeeding (e.g. Cesarean-section, gestational diabetes), and may make effective latch more difficult to achieve. Methods Our objective was to determine the impact of PWG and pre-pregnancy BMI on the risk of breastfeeding cessation utilizing the Institute of Medicine’s 2009 recommendations. Cox proportional hazards models were utilized to estimate the risk of cessation of exclusive breastfeeding, and cessation of any breastfeeding among women who initiated exclusive and any breastfeeding, respectively, in a cross sectional sample of survey respondents from a New York county (N = 1207). PWG category was interacted with pre-pregnancy BMI (3 levels of pre-pregnancy BMI, 3 levels of PWG). Confounders of the relationship of interest were evaluated using directed acyclic graphs and bivariate analyses; variables not on the proposed causal pathway and associated with the exposure and outcome were included in multivariate models. Results: After adjustment, women of normal and obese pre-pregnancy BMI with greater-than-recommended PWG had 1.39 (1.03–1.86) and 1.48 (1.06–2.07) times the risk of any breastfeeding cessation within the first 3 months postpartum compared to women with normal pre-pregnancy BMI who gained within PWG recommendations. Overweight women with greater-than-recommended PWG were at increased risk of cessation, although not significantly (aHR [95% CI]: 1.29 [0.95–1.75]). No significant relationship was observed for exclusive breastfeeding cessation. Conclusions Pre-pregnancy BMI and PWG may be modifiable risk factors for early breastfeeding cessation. Understanding the mechanism behind this risk should be ascertained by additional studies aimed at understanding the physiological, social, logistical (positioning) and other issues that may lead to early breastfeeding cessation.
Collapse
Affiliation(s)
- Hayley Martin
- Public Health Sciences, University of Rochester School of Medicine and Dentistry, 265 Crittenden Blvd. CU 420644, Rochester, NY, 14642, USA
| | - Kelly Thevenet-Morrison
- Public Health Sciences, University of Rochester School of Medicine and Dentistry, 265 Crittenden Blvd. CU 420644, Rochester, NY, 14642, USA
| | - Ann Dozier
- Public Health Sciences, University of Rochester School of Medicine and Dentistry, 265 Crittenden Blvd. CU 420644, Rochester, NY, 14642, USA.
| |
Collapse
|
24
|
Sun Y, Shen Z, Zhan Y, Wang Y, Ma S, Zhang S, Liu J, Wu S, Feng Y, Chen Y, Cai S, Shi Y, Ma L, Jiang Y. Effects of pre-pregnancy body mass index and gestational weight gain on maternal and infant complications. BMC Pregnancy Childbirth 2020; 20:390. [PMID: 32631269 PMCID: PMC7336408 DOI: 10.1186/s12884-020-03071-y] [Citation(s) in RCA: 121] [Impact Index Per Article: 30.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2020] [Accepted: 06/19/2020] [Indexed: 02/06/2023] Open
Abstract
Background The potential effects of pre-pregnancy body mass (BMI) and gestational weight gain (GWG) on pregnancy outcomes remain unclear. Thus, we investigated socio-demographic characteristics that affect pre-pregnancy BMIs and GWG and the effects of pre-pregnancy BMI and GWG on Chinese maternal and infant complications. Methods 3172 women were enrolled in the Chinese Pregnant Women Cohort Study-Peking Union Medical College from July 25, 2017 to July 24, 2018, whose babies were delivered before December 31, 2018. Regression analysis was employed to evaluate the socio-demographic characteristics affecting pre-pregnancy BMI and GWG values and their effects on adverse maternal and infant complications. Results Multivariate logistic regression analysis revealed that age groups < 20 years (OR: 1.97), 25–30 years (OR: 1.66), 30–35 years (OR: 2.24), 35–40 years (OR: 3.90) and ≥ 40 years (OR: 3.33) as well as elementary school or education below (OR: 3.53), middle school (OR: 1.53), high school (OR: 1.40), and living in the north (OR: 1.37) were risk factors in maintaining a normal pre-pregnancy BMI. An age range of 30–35 years (OR: 0.76), living in the north (OR: 1.32) and race of ethnic minorities (OR: 1.51) were factors affecting GWG. Overweight (OR: 2.01) and inadequate GWG (OR: 1.60) were risk factors for gestational diabetes mellitus (GDM). Overweight (OR: 2.80) and obesity (OR: 5.42) were risk factors for gestational hypertension (GHp). Overweight (OR: 1.92), obesity (OR: 2.48) and excessive GWG (OR: 1.95) were risk factors for macrosomia. Overweight and excessive GWG were risk factors for a large gestational age (LGA) and inadequate GWG was a risk factor for low birth weights. Conclusions Overweight and obesity before pregnancy and an excessive GWG are associated with a greater risk of developing GDM, GHp, macrosomia and LGA. The control of body weight before and during the course of pregnancy is recommended to decrease adverse pregnancy outcomes, especially in pregnant women aged < 20 or > 25 years old educated below university and college levels, for ethnic minorities and those women who live in the north of China. Trial registration Registered at Clinical Trials (NCT03403543), September 29, 2017.
Collapse
Affiliation(s)
- Yin Sun
- Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, No. 1 Shuaifuyuan Wangfujing, Dongcheng District, Beijing, 100730, China
| | - Zhongzhou Shen
- Department of Epidemiology and Health Statistics, School of Public Health, Chinese Academy of Medical Sciences and Peking Union Medical College, No. 9 Dongdan Santiao, Dongcheng District, Beijing, 100730, China
| | - Yongle Zhan
- Department of Epidemiology and Health Statistics, School of Public Health, Chinese Academy of Medical Sciences and Peking Union Medical College, No. 9 Dongdan Santiao, Dongcheng District, Beijing, 100730, China
| | - Yawen Wang
- Department of Epidemiology and Health Statistics, School of Public Health, Chinese Academy of Medical Sciences and Peking Union Medical College, No. 9 Dongdan Santiao, Dongcheng District, Beijing, 100730, China
| | - Shuai Ma
- Department of Epidemiology and Health Statistics, School of Public Health, Chinese Academy of Medical Sciences and Peking Union Medical College, No. 9 Dongdan Santiao, Dongcheng District, Beijing, 100730, China
| | - Suhan Zhang
- Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, No. 1 Shuaifuyuan Wangfujing, Dongcheng District, Beijing, 100730, China
| | - Juntao Liu
- Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, No. 1 Shuaifuyuan Wangfujing, Dongcheng District, Beijing, 100730, China
| | - Sansan Wu
- Department of Epidemiology and Health Statistics, School of Public Health, Chinese Academy of Medical Sciences and Peking Union Medical College, No. 9 Dongdan Santiao, Dongcheng District, Beijing, 100730, China
| | - Yahui Feng
- Department of Epidemiology and Health Statistics, School of Public Health, Chinese Academy of Medical Sciences and Peking Union Medical College, No. 9 Dongdan Santiao, Dongcheng District, Beijing, 100730, China
| | - Yunli Chen
- Department of Epidemiology and Health Statistics, School of Public Health, Chinese Academy of Medical Sciences and Peking Union Medical College, No. 9 Dongdan Santiao, Dongcheng District, Beijing, 100730, China
| | - Shuya Cai
- Department of Epidemiology and Health Statistics, School of Public Health, Chinese Academy of Medical Sciences and Peking Union Medical College, No. 9 Dongdan Santiao, Dongcheng District, Beijing, 100730, China
| | - Yingjie Shi
- Department of Epidemiology and Health Statistics, School of Public Health, Chinese Academy of Medical Sciences and Peking Union Medical College, No. 9 Dongdan Santiao, Dongcheng District, Beijing, 100730, China
| | - Liangkun Ma
- Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, No. 1 Shuaifuyuan Wangfujing, Dongcheng District, Beijing, 100730, China.
| | - Yu Jiang
- Department of Epidemiology and Health Statistics, School of Public Health, Chinese Academy of Medical Sciences and Peking Union Medical College, No. 9 Dongdan Santiao, Dongcheng District, Beijing, 100730, China.
| |
Collapse
|
25
|
Al-Otaibi H, Hussein N, Mustafa H, Al-Mudaires N. Obesity, gestational weight gain, and polyunsaturated fatty acids profile in pregnant Saudi women. Bioinformation 2020; 16:493-500. [PMID: 32884215 PMCID: PMC7452740 DOI: 10.6026/97320630016493] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2020] [Revised: 05/25/2020] [Accepted: 05/26/2020] [Indexed: 12/11/2022] Open
Abstract
Obesity and excessive gestational weight gain (GWG) are associated with a deficiency of essential fatty acids, affecting maternal health during and after pregnancy. Therefore, it
is of interest to identify the associations of pre-pregnancy body mass index (BMI) and GWG with lipid profiles in Saudi women after giving birth. Hence, a cross-sectional study of 238
pregnant women aged 20-40 years was conducted at the King Abdul Aziz Hospital, in Al-Ahsa Governorate-Saudi Arabia. Thus, socio-demographic and anthropometric data were collected
using a structured questionnaire. Poly-unsaturated fatty acids (PUFAs), saturated fatty acids (SFAs), and monounsaturated fatty acids (MUFAs) levels were assessed from blood samples
collected after the women gave birth. The participants generally consumed diets low in omega-3 and omega-6 PUFAs and high in SFAs and MUFAs. Among them, 51% had university degrees,
only 20.4% were employed, and 50% had pre-pregnancy overweight/obesity. Women with overweight/obesity had a higher omega-6 to omega-3 PUFA ratio than women with normal weight.
Overweight, obesity, and excessive GWG were not associated with higher levels of total n-3 PUFAs, docosahexaenoic acid, and α-linolenic acid but were associated with higher levels of
total n-6 PUFAs and linoleic acid. Women with obesity had significantly higher SFA and MUFA levels than women with normal weight, whereas women with excessive GWG were twice as likely
to have higher SFA levels than women with adequate GWG. We show that a higher pre-pregnancy BMI and excessive GWG were significantly associated with abnormal lipid profiles in Saudi
women after giving birth. We believe that future studies will help explore these associations in detail.
Collapse
Affiliation(s)
- Hala Al-Otaibi
- Department of Food Sciences and Nutrition, College of Agriculture and Food Sciences, King Faisal University, Al-Ahsa, Saudi Arabia
| | - Nahed Hussein
- Faculty of Specific Education, Ain Shams University, Cairo, Egypt
| | - Hani Mustafa
- King Abdul Aziz Hospital, National Guard Health Affairs, Al-Ahsa, Saudi Arabia
| | - Norah Al-Mudaires
- Department of Physical Education, College of Education, King Faisal University, Al-Ahsa, Saudi Arabia
| |
Collapse
|
26
|
Hashim M, Radwan H, Hasan H, Obaid RS, Al Ghazal H, Al Hilali M, Rayess R, Chehayber N, Mohamed HJJ, Naja F. Gestational weight gain and gestational diabetes among Emirati and Arab women in the United Arab Emirates: results from the MISC cohort. BMC Pregnancy Childbirth 2019; 19:463. [PMID: 31795984 PMCID: PMC6892062 DOI: 10.1186/s12884-019-2621-z] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2018] [Accepted: 11/22/2019] [Indexed: 02/06/2023] Open
Abstract
Background Nutritional status of women during pregnancy has been considered an important prognostic indicator of pregnancy outcomes. Objectives To investigate the pattern of gestational weight gain (GWG) and gestational diabetes mellitus (GDM) and their risk factors among a cohort of Emirati and Arab women residing in the United Arab Emirates (UAE). A secondary objective was to investigate pre-pregnancy body mass index (BMI) and its socio-demographic correlates among study participants. Methods Data of 256 pregnant women participating in the cohort study, the Mother-Infant Study Cohort (MISC) were used in this study. Healthy pregnant mothers with no history of chronic diseases were interviewed during their third trimester in different hospitals in UAE. Data were collected using interviewer-administered multi-component questionnaires addressing maternal sociodemographic and lifestyle characteristics. Maternal weight, weight gain, and GDM were recorded from the hospital medical records. Results Among the study participants, 71.1% had inadequate GWG: 31.6% insufficient and 39.5% excessive GWG. 19.1% reported having GDM and more than half of the participants (59.4%) had a pre-pregnancy BMI ≥ 25 kg/m2. The findings of the multiple multinomial logistic regression showed that multiparous women had decreased odds of excessive gain as compared to primiparous [odds ratio (OR): 0.17; 95% CI: 0.05–0.54]. Furthermore, women with a pre-pregnancy BMI ≥ 25 kg/m2 had increased odds of excessive gain (OR: 2.23; 95%CI: 1.00–5.10) as compared to those with pre-pregnancy BMI < 25 kg/m2. Similarly, women who had a pre-pregnancy BMI ≥ 25 kg/m2 were at higher risk of having GDM (OR: 2.37; 95%CI: 1.10–5.12). As for the associations of women’s characteristics with pre-pregnancy BMI, age and regular breakfast consumption level were significant predictors of higher pre-pregnancy BMI. Conclusions This study revealed alarming prevalence rates of inadequate, mainly excessive, GWG and GDM among the MISC participants. Pre-pregnancy BMI was found a risk factor for both of these conditions (GWG and GDM). In addition, age and regular breakfast consumption were significant determinants of pre-pregnancy BMI. Healthcare providers are encouraged to counsel pregnant women to maintain normal body weight before and throughout pregnancy by advocating healthy eating and increased physical activity in order to reduce the risk of excessive weight gain and its associated complications.
Collapse
Affiliation(s)
- Mona Hashim
- Department of Clinical Nutrition and Dietetics, College of Health Sciences, Research Institute of Medical and Health Sciences (RIMHS), University of Sharjah, Sharjah, United Arab Emirates
| | - Hadia Radwan
- Department of Clinical Nutrition and Dietetics, College of Health Sciences, Research Institute of Medical and Health Sciences (RIMHS), University of Sharjah, Sharjah, United Arab Emirates
| | - Hayder Hasan
- Department of Clinical Nutrition and Dietetics, College of Health Sciences, Research Institute of Medical and Health Sciences (RIMHS), University of Sharjah, Sharjah, United Arab Emirates
| | - Reyad Shaker Obaid
- Department of Clinical Nutrition and Dietetics, College of Health Sciences, Research Institute of Medical and Health Sciences (RIMHS), University of Sharjah, Sharjah, United Arab Emirates
| | - Hessa Al Ghazal
- Family Health Promotion Center, Sharjah, United Arab Emirates
| | - Marwa Al Hilali
- Al Qassimi Hospital, Ministry of Health and Prevention, Sharjah, United Arab Emirates
| | - Rana Rayess
- Department of Clinical Nutrition and Dietetics, College of Health Sciences, Research Institute of Medical and Health Sciences (RIMHS), University of Sharjah, Sharjah, United Arab Emirates
| | - Noor Chehayber
- Department of Clinical Nutrition and Dietetics, College of Health Sciences, Research Institute of Medical and Health Sciences (RIMHS), University of Sharjah, Sharjah, United Arab Emirates
| | | | - Farah Naja
- Department of Nutrition and Food Sciences, American University of Beirut, Beirut, Lebanon.
| |
Collapse
|
27
|
Nucci D, Chiavarini M, Duca E, Pieroni L, Salmasi L, Minelli L. Pre-pregnancy body mass index, gestational weight gain and adverse birth outcomes: some evidence from Italy. Ann Ig 2019; 30:140-152. [PMID: 29465151 DOI: 10.7416/ai.2018.2205] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
BACKGROUND Overweight and obese women present an increased risk of poor maternal and child health outcomes. The aim of this paper is to analyze the joint effects of pre-pregnancy body mass index and inadequate gestational weight gain on birth weight and gestational age in an Italian sample of pregnant women. METHODS Data were obtained from a sample of about 2,000 pregnant women at the University Teaching Hospital of Perugia University (Italy) in 2013. We used the revised classification proposed by Institute of Medicine to identify gestational weight gains considered as appropriate. Logistic regression models were used to estimate the adjusted odds-ratios of women belonging to any BMI class different from normal (used as the reference category) and of women who increased their weight by an amount smaller or greater than normal, controlling for a large set of observable confounders. RESULTS Higher probability of low birth weight was associated with both obesity (OR = 1.9124, s.e. = 0.526) and less than normal weight gains (OR = 2.3614, s.e. = 0.388). The probability of fetal macrosomia was found to be positively associated with more than normal weight increases (OR = 2.6232, s.e. = 0.465). Pre-term deliveries were associated with less than normal gestational weight gains (OR 1.7338, s.e. = 0.320). CONCLUSION Overweight and obesity represent a big issue for public health. In particular, weight management during pregnancy and pre-pregnancy could determine negative health outcomes in newborns. In our study we found that inadequate weight variations during pregnancy, according to the Classification of the Institute of Medicine, negatively influence health conditions at birth. Stronger initiatives, especially in terms of midwifery, nurse training and informative policies should be adopted by policy makers.
Collapse
Affiliation(s)
- D Nucci
- Unit of Public Health, Department of Experimental Medicine, University of Perugia, Perugia, Italy - Digestive Endoscopy Unit, Veneto Institute of Oncology IOV-IRCCS, Padua, Italy
| | - M Chiavarini
- Unit of Public Health, Department of Experimental Medicine, University of Perugia, Perugia, Italy
| | - E Duca
- General Direction, Azienda Ospedaliera of Perugia "Santa Maria della Misericordia", Italy
| | - L Pieroni
- Department of Political Sciences, University of Perugia, Perugia, Italy
| | - L Salmasi
- Department of Political Sciences, University of Perugia, Perugia, Italy
| | - L Minelli
- Unit of Public Health, Department of Experimental Medicine, University of Perugia, Perugia, Italy - Digestive Endoscopy Unit, Veneto Institute of Oncology IOV-IRCCS, Padua, Italy
| |
Collapse
|
28
|
Cao LJ, Lin HY, Liang X, Chen YJ, Liu YY, Zheng YZ, Wang XY, Li W, Yan J, Huang GW. Association between Pre-pregnancy Body Mass Index and Offspring Neuropsychological Development from 1 to 24 Months of Age: A Birth Cohort Study in China. Biomed Environ Sci 2019; 32:730-738. [PMID: 31843043 DOI: 10.3967/bes2019.093] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 04/25/2019] [Accepted: 09/16/2019] [Indexed: 06/10/2023]
Abstract
OBJECTIVE To explore the interactions between pre-pregnancy body mass index (BMI) and age on offspring neuropsychological development from 1 to 24 months in China. METHODS In this birth cohort study, a total of 2,253 mother-child pairs were enrolled in Tianjin, China, between July 2015 and May 2018. The China Developmental Scale for Children was used to assess developmental quotient (DQ) of children aged from 1 to 24 months. RESULTS Mixed-models analysis revealed significant age × pre-pregnancy BMI interactions for total DQ and five neurobehavioral domains (gross motor, fine motor, adaptive, language, and social; P < 0.001). Age × pre-pregnancy BMI ⪖ 25 kg/m2 was associated with a negative effect on total DQ and five neurobehavioral domains, as compared to pre-pregnancy BMI < 25 kg/m2 (P < 0.01). Multiple comparisons showed pre-pregnancy BMI ⪖ 25 kg/m2 of mothers had a positive effect on child total DQ at the age of 1 month but a negative effect at 24 months (P < 0.05). CONCLUSION This study supported the age × pre-pregnancy BMI interaction on offspring neuropsychological development. It also revealed a short-term positive impact of high pre-pregnancy BMI on neuropsychological development at 1 month of age, but a long-term negative effect (from 1 to 24 months).
Collapse
Affiliation(s)
- Lu Jia Cao
- Department of Nutrition and Food Science, School of Public Health, Tianjin Medical University, Tianjin 300070, China; Tianjin Key Laboratory of Environment, Nutrition and Public Health, Tianjin 300070, China
| | - Hong Yan Lin
- Department of Nutrition and Food Science, School of Public Health, Tianjin Medical University, Tianjin 300070, China; Tianjin Key Laboratory of Environment, Nutrition and Public Health, Tianjin 300070, China
| | - Xuan Liang
- Tianjin Key Laboratory of Environment, Nutrition and Public Health, Tianjin 300070, China; Department of Epidemiology and Statistics, School of Public Health, Tianjin Medical University, Tianjin 300070, China
| | - Yong Jie Chen
- Tianjin Key Laboratory of Environment, Nutrition and Public Health, Tianjin 300070, China; Department of Epidemiology and Statistics, School of Public Health, Tianjin Medical University, Tianjin 300070, China
| | - Yu Yan Liu
- Department of Nutrition and Food Science, School of Public Health, Tianjin Medical University, Tianjin 300070, China; Tianjin Key Laboratory of Environment, Nutrition and Public Health, Tianjin 300070, China
| | - Yu Zhi Zheng
- Department of Nutrition and Food Science, School of Public Health, Tianjin Medical University, Tianjin 300070, China; Tianjin Key Laboratory of Environment, Nutrition and Public Health, Tianjin 300070, China
| | - Xin Yan Wang
- Department of Nutrition and Food Science, School of Public Health, Tianjin Medical University, Tianjin 300070, China; Tianjin Key Laboratory of Environment, Nutrition and Public Health, Tianjin 300070, China
| | - Wen Li
- Department of Nutrition and Food Science, School of Public Health, Tianjin Medical University, Tianjin 300070, China; Tianjin Key Laboratory of Environment, Nutrition and Public Health, Tianjin 300070, China
| | - Jing Yan
- Department of Nutrition and Food Science, School of Public Health, Tianjin Medical University, Tianjin 300070, China; Tianjin Key Laboratory of Environment, Nutrition and Public Health, Tianjin 300070, China; Department of Social Medicine and Health Administration, School of Public Health, Tianjin Medical University, Tianjin 300070, China
| | - Guo Wei Huang
- Department of Nutrition and Food Science, School of Public Health, Tianjin Medical University, Tianjin 300070, China; Tianjin Key Laboratory of Environment, Nutrition and Public Health, Tianjin 300070, China
| |
Collapse
|
29
|
Masturzo B, Franzè V, Germano C, Attini R, Gennarelli G, Lezo A, Rolfo A, Plazzotta C, Brunelli E, Youssef A, Todros T, Farina A. Risk of adverse pregnancy outcomes by pre-pregnancy Body Mass Index among Italian population: a retrospective population-based cohort study on 27,807 deliveries. Arch Gynecol Obstet 2019; 299:983-991. [PMID: 30770990 DOI: 10.1007/s00404-019-05093-0] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2018] [Accepted: 02/02/2019] [Indexed: 11/25/2022]
Abstract
PURPOSE To estimate the impact of increasing pre-pregnancy Body Mass Index (BMI) on the risk of adverse maternal and perinatal outcomes, in patients who delivered in an Italian tertiary care Obstetric department. METHODS Data, related to women who delivered at Sant'Anna Hospital, Turin, between 2011 and 2015, were collected retrospectively from the hospital database. According to BMI, women were considered as normal weight, overweight, and class 1, 2 and 3 obese (WHO criteria). Logistic regression analysis studied the impact of BMI on maternal and neonatal outcomes, adjusting results for maternal age and parity. Adjusted absolute risks of each outcome were reported according to incremental values in pre-pregnancy BMI. RESULTS A total of 27,807 women were included. 75.8% of pregnancies occurred among normal-weight women, whereas 16.7% were overweight, and 7.5% obese women (5.4% class 1, 1.7% class 2 and 0.4% class 3). A 10% decrease in pre-pregnancy BMI was associated with a reduction of at least 15% of Gestational diabetes mellitus (GDM), preeclampsia, maternal admission to intensive care unit (ICU), macrosomia, APGAR 5' < 6 and neonatal admission to ICU. GDM and preeclampsia resulted in the highest reduction being almost 30%. Larger differences in BMI (20-25%) corresponded to at least a 10% in reduction of risk of preterm and very preterm delivery and emergency cesarean section. Differences in maternal pre-pregnancy BMI had no impact on the frequency of shoulder dystocia and stillbirth. CONCLUSIONS This study offers a quantitative estimation of negative impact of pre-pregnancy obesity on the most common pregnancy and perinatal complications.
Collapse
Affiliation(s)
- Bianca Masturzo
- Department of Surgical Sciences, OIRM S. Anna Hospital University of Turin, Turin, Italy
| | - Vera Franzè
- Department of Surgical Sciences, OIRM S. Anna Hospital University of Turin, Turin, Italy
| | - Chiara Germano
- Department of Surgical Sciences, OIRM S. Anna Hospital University of Turin, Turin, Italy
| | - Rossella Attini
- Department of Surgical Sciences, OIRM S. Anna Hospital University of Turin, Turin, Italy
| | - Gianluca Gennarelli
- Department of Surgical Sciences, OIRM S. Anna Hospital University of Turin, Turin, Italy
| | - Antonella Lezo
- Department of Surgical Sciences, OIRM S. Anna Hospital University of Turin, Turin, Italy
| | - Alessandro Rolfo
- Department of Surgical Sciences, OIRM S. Anna Hospital University of Turin, Turin, Italy
| | - Claudio Plazzotta
- Department of Surgical Sciences, OIRM S. Anna Hospital University of Turin, Turin, Italy
| | - Elena Brunelli
- Division of Obstetrics and Prenatal Medicine, Department of Medicine and Surgery (DIMEC) Sant'Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy
| | - Aly Youssef
- Division of Obstetrics and Prenatal Medicine, Department of Medicine and Surgery (DIMEC) Sant'Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy
| | - Tullia Todros
- Department of Surgical Sciences, OIRM S. Anna Hospital University of Turin, Turin, Italy
| | - Antonio Farina
- Division of Obstetrics and Prenatal Medicine, Department of Medicine and Surgery (DIMEC) Sant'Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy.
| |
Collapse
|
30
|
Bashir M, Naem E, Taha F, Konje JC, Abou-Samra AB. Outcomes of type 1 diabetes mellitus in pregnancy; effect of excessive gestational weight gain and hyperglycaemia on fetal growth. Diabetes Metab Syndr 2019; 13:84-88. [PMID: 30641818 DOI: 10.1016/j.dsx.2018.08.030] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2018] [Accepted: 08/27/2018] [Indexed: 01/01/2023]
Abstract
AIMS To study pregnancy outcomes in patients with type 1 diabetes mellitus (T1DM) and the factors associated with poor outcomes. METHODS A retrospective study of 110 patients with T2DM who attended our diabetes in pregnancy clinic at the Women's Wellness and Research centre, Doha, between March 2015 and December 2016 and 1419 normoglycaemic controls. RESULTS There was no difference in age, weight, and BMI between the two groups. The incidence of macrosomia, shoulder dystocia and stillbirth were similar in the two groups while that of pre-term labour, pre-eclampsia, Caesarean section (CS), large for gestational age (LGA), neonatal ICU (NICU) admission and neonatal hypoglycaemia were significantly higher in the T1DM than in the control group. From a multivariate regression analysis, excessive gestational weight gain was associated with increased risk of LGA (OR 4.53; 95% CI [1.42-14.25]). Last trimester HBA1c was associated with increased risk for macrosomia [OR 2.46, 95% CI [1.03-5.86)]; LGA [ OR 3.25, 95% CI [1.65-6.40)]; increased risk for C-section (OR 1.96, 95% CI [1.12-3.45]), and increased risk of NICU admission (OR 2.46, 95% CI [1.04-5.86]). The changes in HBA1C between the first and last trimester HBA1c was associated with a reduction in the risk of LGA [OR 0.46, 95% CI [(0.28-0.75)] CONCLUSION: T1DM in pregnancy is associated with adverse pregnancy outcomes compared to the general population. Reducing gestational weight gain and improving glycaemic control might improve pregnancy outcomes.
Collapse
Affiliation(s)
- Mohammed Bashir
- Qatar Metabolic Institute, Hamad Medical Corporation, Doha, Qatar.
| | - Emad Naem
- Qatar Metabolic Institute, Hamad Medical Corporation, Doha, Qatar
| | - Faten Taha
- Department of Obstetrics and Gynaecology, Women's Wellness and Research Centre, Hamad Medical Corporation, Doha, Qatar
| | - Justin C Konje
- Women's Clinical Services Management Group (WCMG), Sidra Medicine, Doha, Qatar
| | | |
Collapse
|
31
|
Bashir M, Dabbous Z, Baagar K, Elkhatib F, Ibrahim A, Brich SA, Abdel-Rahman ME, Konje JC, Abou-Samra AB. Type 2 diabetes mellitus in pregnancy: The impact of maternal weight and early glycaemic control on outcomes. Eur J Obstet Gynecol Reprod Biol 2018; 233:53-57. [PMID: 30572188 DOI: 10.1016/j.ejogrb.2018.12.008] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2018] [Revised: 12/03/2018] [Accepted: 12/07/2018] [Indexed: 11/18/2022]
Abstract
OBJECTIVES To study the pregnancy outcomes in women with type 2 diabetes mellitus (T2DM) and to relate these to maternal risk factors. METHODS We conducted a retrospective study of 419 women with T2DM (index group)- who attended our diabetes in pregnancy clinic at the Hamad Women's Hospital, Doha, between March 2015 and December 2016 -and 1419 normoglycaemic women (control group). RESULTS Compared with the controls, T2DM women were older (mean age 34.7 ± 6.9 vs 29.6 ± 5.5 years; p < 0.001) and had a higher BMI (34.5 ± 6.7 vs 28.8 ± 6.1 kg/m2; p < 0.001). The incidence of macrosomia, shoulder dystocia and stillbirth were similar in the two groups, while that of pre-term labour, pre-eclampsia, caesarean section (CS), large for gestational age (LGA), neonatal ICU (NICU) admission, and neonatal hypoglycaemia were significantly higher in the T2DM compared to the control group (p < 0.05). Multivariate regression analysis showed that first trimester HbA1C was associated with an increased risk of LGA (OR 1.17; 95% CI [1.01-1.36]), pre-eclampsia (OR 1.26; 95% CI [1.02-1.54]), neonatal hypoglycaemia (OR 1.32; 95% CI 1.10-1.60) and NICU admission (OR 1.32; 95% CI 1.10-1.60). Pre-pregnancy BMI was associated with increased risk of LGA (OR 1.04; 95%CI [1.00-1.08]), macrosomia (OR 1.06; 95%CI [1.00-1.12]) and CS (OR 1.05; 95% CI [1.01-1.09]). Last trimester HbA1c was associated with an increased risk of LGA [OR 1.53, 95% CI [1.13-2.10)] and CS (OR 1.37, 95% CI [1.01-1.87]). CONCLUSION T2DM is associated with adverse pregnancy outcomes compared to the normal control in Qatar. Maternal obesity and glycaemic control before and during pregnancy are the main determinants of pregnancy outcomes in women with T2DM.
Collapse
MESH Headings
- Adult
- Case-Control Studies
- Cesarean Section/statistics & numerical data
- Diabetes Mellitus, Type 2/complications
- Diabetes Mellitus, Type 2/drug therapy
- Diabetes Mellitus, Type 2/physiopathology
- Female
- Fetal Macrosomia/epidemiology
- Fetal Macrosomia/etiology
- Gestational Weight Gain
- Glycated Hemoglobin/administration & dosage
- Glycated Hemoglobin/analysis
- Humans
- Hypoglycemia/epidemiology
- Hypoglycemia/etiology
- Hypoglycemic Agents/therapeutic use
- Infant, Newborn
- Infant, Newborn, Diseases/epidemiology
- Infant, Newborn, Diseases/etiology
- Insulin/therapeutic use
- Intensive Care Units, Neonatal/statistics & numerical data
- Metformin/therapeutic use
- Obesity/complications
- Obstetric Labor, Premature/epidemiology
- Obstetric Labor, Premature/etiology
- Pre-Eclampsia/epidemiology
- Pre-Eclampsia/etiology
- Pregnancy
- Pregnancy in Diabetics/drug therapy
- Pregnancy in Diabetics/physiopathology
- Qatar
- Retrospective Studies
- Risk Factors
- Young Adult
Collapse
Affiliation(s)
- Mohammed Bashir
- Qatar Metabolic Institute, Hamad Medical Corporation, Doha, Qatar.
| | - Zeinab Dabbous
- Qatar Metabolic Institute, Hamad Medical Corporation, Doha, Qatar
| | - Khaled Baagar
- Qatar Metabolic Institute, Hamad Medical Corporation, Doha, Qatar
| | - Fadi Elkhatib
- Department of Obstetrics and Gynaecology, Women's Hospital, Hamad Medical Corporation, Doha, Qatar
| | - Amin Ibrahim
- Department of Obstetrics and Gynaecology, Women's Hospital, Hamad Medical Corporation, Doha, Qatar
| | - Sanam-Alhouda Brich
- Department of Obstetrics and Gynaecology, Women's Hospital, Hamad Medical Corporation, Doha, Qatar
| | - Manar E Abdel-Rahman
- Department of Biostatistics, College of Health Science, Qatar University, Doha, Qatar
| | - Justin C Konje
- Women's Clinical Services Management Group (WCMG), Sidra Medicine, Doha, Qatar
| | | |
Collapse
|
32
|
Bianchi C, de Gennaro G, Romano M, Aragona M, Battini L, Del Prato S, Bertolotto A. Pre-pregnancy obesity, gestational diabetes or gestational weight gain: Which is the strongest predictor of pregnancy outcomes? Diabetes Res Clin Pract 2018; 144:286-293. [PMID: 30189224 DOI: 10.1016/j.diabres.2018.08.019] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/19/2018] [Revised: 08/16/2018] [Accepted: 08/30/2018] [Indexed: 11/19/2022]
Abstract
AIMS Both obesity and gestational diabetes (GDM) are risk factors for adverse pregnancy outcomes. The aim of our study is to ascertain the independent role of prepregnancy BMI (pp-BMI), gestational weight gain (GWG), and GDM on pregnancy outcomes. METHODS We analyzed data of 1198 pregnant women, who underwent selective screening for GDM. Data on pregnancy outcomes was collected from hospital discharge records. RESULTS Cesarean section (CS) was comparable in GDM and NGT women. Prevalence of fetal macrosomia was 5.9%, with no difference between GDM and normal glucose tolerance (NGT), neonatal hyperbilirubinemia were more frequent in newborns of GDM women (63.3% vs. 52.2%; p < 0.01). Offspring of women with excessive GWG weighed more than those of women with regular GWG (3405 ± 510 g vs. 3287 ± 524 g; p < 0.01). On a logistic regression analysis, GWG was an independent risk factor for macrosomia (OR 1.08, 95% CI 1.02-1.13; p < 0.01) and delivery at a gestational age <37 weeks (OR 0.29, 95% CI 0.16-0.53; p < 0.0001). GDM and pp-BMI were not independent risk factors for adverse outcomes in this cohort. CONCLUSIONS GWG rather than GDM is associated with adverse pregnancy outcomes. These findings call for an early education and implementation of a healthy lifestyle in women planning a pregnancy.
Collapse
Affiliation(s)
| | | | - Matilde Romano
- Maternal-Infant Department, University Hospital of Pisa, Italy
| | | | - Lorella Battini
- Maternal-Infant Department, University Hospital of Pisa, Italy
| | - Stefano Del Prato
- Department of Clinical and Experimental Medicine, University of Pisa, Italy
| | | |
Collapse
|
33
|
Solmi F, Morris S. Overweight and obese pre-pregnancy BMI is associated with higher hospital costs of childbirth in England. BMC Pregnancy Childbirth 2018; 18:253. [PMID: 29925340 PMCID: PMC6011257 DOI: 10.1186/s12884-018-1893-z] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2016] [Accepted: 06/11/2018] [Indexed: 11/10/2022] Open
Abstract
Background Women who have an overweight or obese BMI are more likely to experience pregnancy complications. However, little is known on the cost of childbirth in this group and no studies have been undertaken in England to date. The aim of this paper is therefore to investigate whether women with overweight and obese pre-pregnancy body mass index (BMI) incur higher average hospital costs of childbirth. Methods We employed data from 7564 women in the first wave of data collection of the Millennium Cohort Study. Using interval regression, we investigated the association between hospital costs of childbirth and pre-pregnancy BMI, fitting four models, progressively adjusting for additional potential confounders and mediators. Model 1 was a univariate model; model 2 adjusted for maternal age, education, marital status, ethnicity, income, and region; model 3 additionally included number of previous children, number of babies delivered, whether birth was at term, and type of delivery; model 4 also included length of hospital stay. Results Childbirth costs incurred by women who were overweight, obese class I and obese class II and III were £22, £82 and £126 higher than those incurred by women whose BMI was in the normal range (p ≤ 0.05). Delivery method, pre-term delivery, and length of hospital stay accounted for the observed difference. Conclusions Women with elevated pre-pregnancy BMI make greater use of services resulting in higher hospital costs. Interventions promoting healthy BMI in pre-pregnancy among women of child-bearing age have the potential to reduce pregnancy complications and be cost-effective. Electronic supplementary material The online version of this article (10.1186/s12884-018-1893-z) contains supplementary material, which is available to authorized users.
Collapse
Affiliation(s)
- Francesca Solmi
- Department of Applied Health Research, University College London, London, UK. .,Division of Psychiatry, University College London, 6th Floor, Wing B, Maple House, 149 Tottenham Court Road, London, W1T 7NF, UK.
| | - Stephen Morris
- Department of Applied Health Research, University College London, London, UK
| |
Collapse
|
34
|
Lin YJ, Cai QY, Xu YY, Liu HY, Han WH, Wang Y, Tan Y, Xiong HY, Hu AQ, Zheng YJ. [Association and interaction of pre-pregnant body mass index and gestational weight gain of women on neonatal birthweight]. Zhonghua Liu Xing Bing Xue Za Zhi 2018; 39:770-775. [PMID: 29936745 DOI: 10.3760/cma.j.issn.0254-6450.2018.06.015] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Objective: To investigate the association between maternal pre-pregnant body mass index and gestational weight gain, as well as their interaction on neonatal birthweight. Methods: We built a cohort in Anqing Municipal Hospital from January 2014 to March 2015, enrolling pregnant women who decided to give birth in this hospital. All women were asked to fill a questionnaire for basic information collection. Medical information of both pregnant women and their newborns were obtained through electronic medical record. Chi-square analysis, multinomial logistic regression, multiplicative and additive interaction methods were used to analyze the association between pre-pregnant body mass index and gestational weight gain as well as their interactions on birth weight of the neonates. Results: A total of 2 881 pregnant women were included in this study. Of the 2 881 newborns, 359 (12.46%) were small for gestational age (SGA) and 273 (9.48%) were large for gestational age (LGA). After adjusting the possible confounding factors, results from the multinomial logistic regression showed that pre-pregnancy underweight women were more possible to deliver SGA (aRR=1.33, 95%CI: 1.02-1.73). If the gestational weight gain was below the recommended criteria, the risk of SGA (aRR=1.64, 95%CI: 1.23-2.19) might increase. Pre-pregnancy overweight/obese could increase the risk of being LGA (aRR=1.86, 95%CI: 1.33-2.60). Maternal gestational weight gain above the recommendation level was associated with higher rates of LGA (aRR=2.03, 95%CI: 1.49-2.78). Results from the interaction analysis showed that there appeared no significant interaction between pre-pregnancy BMI and gestational weight on birthweight. Conclusion: Pre-pregnancy body mass index and gestational weight gain were independently associated with neonatal birthweight while pre-pregnancy BMI and gestational weight gain did not present interaction on birthweight.
Collapse
Affiliation(s)
- Y J Lin
- Department of Public Health Microbiology, School of Public Health, Fudan University, Shanghai 200032, China;Department of Epidemiology, School of Public Health, Fudan University, Shanghai 200032, China
| | - Q Y Cai
- Department of Public Health Microbiology, School of Public Health, Fudan University, Shanghai 200032, China
| | - Y Y Xu
- Department of Laboratory, Anqing Municipal Hospital, Anqing 246003, China
| | - H Y Liu
- Department of Laboratory, Anqing Municipal Hospital, Anqing 246003, China
| | - W H Han
- Department of Obstetrics and Gynecology, Anqing Municipal Hospital, Anqing 246003, China
| | - Y Wang
- Department of Obstetrics and Gynecology, Anqing Municipal Hospital, Anqing 246003, China
| | - Y Tan
- Department of Laboratory, Anqing Municipal Hospital, Anqing 246003, China
| | - H Y Xiong
- Department of Public Health Microbiology, School of Public Health, Fudan University, Shanghai 200032, China
| | - A Q Hu
- Department of Laboratory, Anqing Municipal Hospital, Anqing 246003, China
| | - Y J Zheng
- Department of Public Health Microbiology, School of Public Health, Fudan University, Shanghai 200032, China;Key Laboratory for Public Health Safety, Ministry of Education, School of Public Health, Fudan University, Shanghai 200032, China;Key Laboratory for Health Technology Assessment, National Commission of Health and Family Planning, School of Public Health, Fudan University, Shanghai 200032, China
| |
Collapse
|
35
|
Jiang C, Hou Q, Huang Y, Ye J, Qin X, Zhang Y, Meng W, Wang Q, Jiang Y, Zhang H, Li M, Mo Z, Yang X. The effect of pre-pregnancy hair dye exposure on infant birth weight: a nested case-control study. BMC Pregnancy Childbirth 2018; 18:144. [PMID: 29743046 PMCID: PMC5944114 DOI: 10.1186/s12884-018-1782-5] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2018] [Accepted: 04/26/2018] [Indexed: 11/29/2022] Open
Abstract
Background Limited evidences were reported about the risk of pre-pregnancy hair dye use or irregular menstruation with abnormal birth weight during pregnancy, and their joint effects were also unknown. The aim of our study was to explore whether the pre-pregnancy exposure of hair dye and irregular menstruation were associated with the risk of abnormal birth weight. Methods We conducted a nested case-control study from a prospective cohort of 6203 pregnant women. Low birth weight study included 315 mother-infant pairs (105 LBW cases and 210 matched controls), and macrosomia study included 381 mother-infant pairs (127 macrosomia cases and 254 matched controls). Meanwhile, lifestyle information including hair dying custom and menstrual history were collected by face-to-face questionnaires and birth outcomes were extracted from the medical records. The logistic regressions models were used to analyze the join effect of irregular menstruation and hair dye use. Results Pre-pregnancy hair dye use was associated with increased risk of LBW (adjusted OR = 1.71, 95% CI: 1.01–2.92, P = 0.048). Irregular menstruation had high risk of LBW (adjusted OR = 2.79, 95% CI: 1.53–5.09, P = 0.001) and macrosomia (adjusted OR = 1.93, 95% CI: 1.09–3.44, P = 0.023). Additionally, in the LBW study, women who used hair dye with pre-pregnancy BMI < 18.5 kg/m2 had higher OR than those with only one risk factor (3.07 vs 2.53, Ptrend = 0.015), and women with both hair dye use and irregular menstruation also had higher risk than those with only one factor (4.53 vs 2.07, Ptrend = 0.05). Moreover, in macrosomia study, women with irregular menstruation and pre-pregnancy BMI ≥ 24 kg/m2 had higher risk than those with one factor (13.31 vs 2.09, Ptrend = 0.001). Conclusion Our study showed that either pre-pregnancy hair dye use or irregular menstruation was associated with abnormal birth weight, especially, their joint effects could furthermore increase the risk of low birth weight infants when these two factors existed simultaneously.
Collapse
Affiliation(s)
- Chao Jiang
- Center for Genomic and Personalized Medicine, Guangxi Medical University, Nanning, Guangxi Zhuang Autonomous Region, China.,Guangxi key Laboratory for Genomic and Personalized Medicine, Nanning, Guangxi Zhuang Autonomous Region, China.,Guangxi Collaborative Innovation Center for Genomic and Personalized Medicine, Nanning, Guangxi Zhuang Autonomous Region, China.,Guangxi Key Laboratory of Colleges and Universities, Nanning, Guangxi Zhuang Autonomous Region, China.,Department of Occupational and Environmental Medicine School of Public Health, Guangxi Medical University, 22 Shuangyong Rd, Nanning, 530021, Guangxi, China
| | - Qingzhi Hou
- Center for Genomic and Personalized Medicine, Guangxi Medical University, Nanning, Guangxi Zhuang Autonomous Region, China.,Guangxi key Laboratory for Genomic and Personalized Medicine, Nanning, Guangxi Zhuang Autonomous Region, China.,Guangxi Collaborative Innovation Center for Genomic and Personalized Medicine, Nanning, Guangxi Zhuang Autonomous Region, China.,Guangxi Key Laboratory of Colleges and Universities, Nanning, Guangxi Zhuang Autonomous Region, China.,Department of Occupational and Environmental Medicine School of Public Health, Guangxi Medical University, 22 Shuangyong Rd, Nanning, 530021, Guangxi, China
| | - Yaling Huang
- Center for Genomic and Personalized Medicine, Guangxi Medical University, Nanning, Guangxi Zhuang Autonomous Region, China.,Guangxi key Laboratory for Genomic and Personalized Medicine, Nanning, Guangxi Zhuang Autonomous Region, China.,Guangxi Collaborative Innovation Center for Genomic and Personalized Medicine, Nanning, Guangxi Zhuang Autonomous Region, China.,Guangxi Key Laboratory of Colleges and Universities, Nanning, Guangxi Zhuang Autonomous Region, China
| | - Juan Ye
- Center for Genomic and Personalized Medicine, Guangxi Medical University, Nanning, Guangxi Zhuang Autonomous Region, China.,Guangxi key Laboratory for Genomic and Personalized Medicine, Nanning, Guangxi Zhuang Autonomous Region, China.,Guangxi Collaborative Innovation Center for Genomic and Personalized Medicine, Nanning, Guangxi Zhuang Autonomous Region, China.,Guangxi Key Laboratory of Colleges and Universities, Nanning, Guangxi Zhuang Autonomous Region, China
| | - Xiaolian Qin
- Department of Antenatal care, the Maternal & Child Health Hospital of Yulin, Yulin, Guangxi, China
| | - Yu Zhang
- Department of Gynecology and Obstetrics, the Maternal & Child Health Hospital of Liuzhou, Liuzhou, Guangxi, China
| | - Wen Meng
- Department of Medical Services Section, the Maternal & Child Health Hospital of Guigang, Guigang, Guangxi, China
| | - Qiuyan Wang
- Center for Genomic and Personalized Medicine, Guangxi Medical University, Nanning, Guangxi Zhuang Autonomous Region, China.,Guangxi key Laboratory for Genomic and Personalized Medicine, Nanning, Guangxi Zhuang Autonomous Region, China.,Guangxi Collaborative Innovation Center for Genomic and Personalized Medicine, Nanning, Guangxi Zhuang Autonomous Region, China.,Guangxi Key Laboratory of Colleges and Universities, Nanning, Guangxi Zhuang Autonomous Region, China
| | - Yonghua Jiang
- Center for Genomic and Personalized Medicine, Guangxi Medical University, Nanning, Guangxi Zhuang Autonomous Region, China.,Guangxi key Laboratory for Genomic and Personalized Medicine, Nanning, Guangxi Zhuang Autonomous Region, China.,Guangxi Collaborative Innovation Center for Genomic and Personalized Medicine, Nanning, Guangxi Zhuang Autonomous Region, China.,Guangxi Key Laboratory of Colleges and Universities, Nanning, Guangxi Zhuang Autonomous Region, China
| | - Haiying Zhang
- Center for Genomic and Personalized Medicine, Guangxi Medical University, Nanning, Guangxi Zhuang Autonomous Region, China.,Guangxi key Laboratory for Genomic and Personalized Medicine, Nanning, Guangxi Zhuang Autonomous Region, China.,Guangxi Collaborative Innovation Center for Genomic and Personalized Medicine, Nanning, Guangxi Zhuang Autonomous Region, China.,Guangxi Key Laboratory of Colleges and Universities, Nanning, Guangxi Zhuang Autonomous Region, China.,Department of Occupational and Environmental Medicine School of Public Health, Guangxi Medical University, 22 Shuangyong Rd, Nanning, 530021, Guangxi, China
| | - Mujun Li
- Department of Reproductive Center, First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, China
| | - Zengnan Mo
- Center for Genomic and Personalized Medicine, Guangxi Medical University, Nanning, Guangxi Zhuang Autonomous Region, China.,Guangxi key Laboratory for Genomic and Personalized Medicine, Nanning, Guangxi Zhuang Autonomous Region, China.,Guangxi Collaborative Innovation Center for Genomic and Personalized Medicine, Nanning, Guangxi Zhuang Autonomous Region, China.,Guangxi Key Laboratory of Colleges and Universities, Nanning, Guangxi Zhuang Autonomous Region, China
| | - Xiaobo Yang
- Center for Genomic and Personalized Medicine, Guangxi Medical University, Nanning, Guangxi Zhuang Autonomous Region, China. .,Guangxi key Laboratory for Genomic and Personalized Medicine, Nanning, Guangxi Zhuang Autonomous Region, China. .,Guangxi Collaborative Innovation Center for Genomic and Personalized Medicine, Nanning, Guangxi Zhuang Autonomous Region, China. .,Guangxi Key Laboratory of Colleges and Universities, Nanning, Guangxi Zhuang Autonomous Region, China. .,Department of Occupational and Environmental Medicine School of Public Health, Guangxi Medical University, 22 Shuangyong Rd, Nanning, 530021, Guangxi, China.
| |
Collapse
|
36
|
Bannon AL, Waring ME, Leung K, Masiero JV, Stone JM, Scannell EC, Moore Simas TA. Comparison of Self-reported and Measured Pre-pregnancy Weight: Implications for Gestational Weight Gain Counseling. Matern Child Health J 2017; 21:1469-78. [PMID: 28155023 DOI: 10.1007/s10995-017-2266-3] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Objectives To examine clinical and demographic characteristics associated with availability of self-reported and measured pre-pregnancy weight, differences in these parameters, and characteristics associated with self-report accuracy. Methods Retrospective cohort of 7483 women who delivered at a large academic medical center between 2011 and 2014. Measured pre-pregnancy weights recorded within a year of conception and self-reported pre-pregnancy weights reported anytime during pregnancy were abstracted from electronic medical records. Difference in weights was calculated as self-reported minus measured pre-pregnancy weight. Logistic and linear regression models estimated associations between demographic and clinical characteristics, and presence of self-reported and measured weights, and weight differences. Results 42.2% of women had both self-reported and measured pre-pregnancy weight, 49.7% had only self-reported, and 2.8% had only measured. Compared to white women, black women and women of other races/ethnicities were less likely to have self-reported weight, and black, Asian, and Hispanic women, and women of other races/ethnicities were less likely to have measured weights. For 85%, pre-pregnancy BMI categorized by self-reported and measured weights were concordant. Primiparas and multiparas were more likely to underreport their weight compared to nulliparas (b = -1.32 lbs, 95% CI -2.24 to -0.41 lbs and b = -2.74 lbs, 95% CI -3.82 to -1.67 lbs, respectively). Discussion Utilization of self-reported or measured pre-pregnancy weight for pre-pregnancy BMI classification results in identical categorization for the majority of women. Providers may wish to account for underreporting for patients with a BMI close to category cutoff by recommending a range of gestational weight gain that falls within recommendations for both categories where feasible.
Collapse
|
37
|
Shao Y, Qiu J, Huang H, Mao B, Dai W, He X, Cui H, Lin X, Lv L, Wang D, Tang Z, Xu S, Zhao N, Zhou M, Xu X, Qiu W, Liu Q, Zhang Y. Pre-pregnancy BMI, gestational weight gain and risk of preeclampsia: a birth cohort study in Lanzhou, China. BMC Pregnancy Childbirth 2017; 17:400. [PMID: 29191156 PMCID: PMC5709979 DOI: 10.1186/s12884-017-1567-2] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2016] [Accepted: 11/06/2017] [Indexed: 02/04/2023] Open
Abstract
BACKGROUND To evaluate the independent and joint effects of maternal pre-pregnancy BMI and gestational weight gain (GWG) on the risk of preeclampsia and its subtypes. METHODS A birth cohort study was conducted from 2010 to 2012 in Lanzhou, China. Three hundred fourty seven pregnant women with preeclampsia and 9516 normotensive women at Gansu Provincial Maternity and Child Care Hospital were included in the present study. Unconditional logistic regression models were used to evaluate the associations between pre-pregnancy BMI, GWG, and risk of preeclampsia and its subtypes. RESULTS Compared to women with normal pre-pregnancy BMI, those who were overweight/obese had an increased risk of preeclampsia (OR = 1.81; 95%CI: 1.37-2.39). Women with excessive GWG had an increased risk of preeclampsia (OR = 2.28; 95%CI: 1.70-3.05) compared to women with adequate GWG. The observed increased risk was similar for mild-, severe- and late-onset preeclampsia. No association was found for early-onset preeclampsia. Overweight/obese women with excessive GWG had the highest risk of developing preeclampsia compared to normal weight women with no excessive weight gain (OR = 3.78; 95%CI: 2.65-5.41). CONCLUSIONS Our results suggested that pre-pregnancy BMI and GWG are independent risk factors for preeclampsia and that the risk might vary by preeclampsia subtypes. Our study also proposed a potential synergistic effect of pre-pregnancy BMI and GWG that warrants further investigation.
Collapse
Affiliation(s)
- Yawen Shao
- Gansu Provincial Maternity and Child Care Hospital, 143 North Road, Qilihe District, Lanzhou, Gansu Province 730050 China
| | - Jie Qiu
- Gansu Provincial Maternity and Child Care Hospital, 143 North Road, Qilihe District, Lanzhou, Gansu Province 730050 China
| | - Huang Huang
- Yale University School of Public Health, 60 College Street, New Haven, CT 06520 USA
| | - Baohong Mao
- Gansu Provincial Maternity and Child Care Hospital, 143 North Road, Qilihe District, Lanzhou, Gansu Province 730050 China
| | - Wei Dai
- Gansu Provincial Maternity and Child Care Hospital, 143 North Road, Qilihe District, Lanzhou, Gansu Province 730050 China
| | - Xiaochun He
- Gansu Provincial Maternity and Child Care Hospital, 143 North Road, Qilihe District, Lanzhou, Gansu Province 730050 China
| | - Hongmei Cui
- Gansu Provincial Maternity and Child Care Hospital, 143 North Road, Qilihe District, Lanzhou, Gansu Province 730050 China
| | - Xiaojuan Lin
- Gansu Provincial Maternity and Child Care Hospital, 143 North Road, Qilihe District, Lanzhou, Gansu Province 730050 China
| | - Ling Lv
- Gansu Provincial Maternity and Child Care Hospital, 143 North Road, Qilihe District, Lanzhou, Gansu Province 730050 China
| | - Dennis Wang
- Yale University School of Public Health, 60 College Street, New Haven, CT 06520 USA
| | - Zhongfeng Tang
- Gansu Provincial Maternity and Child Care Hospital, 143 North Road, Qilihe District, Lanzhou, Gansu Province 730050 China
| | - Sijuan Xu
- Gansu Provincial Maternity and Child Care Hospital, 143 North Road, Qilihe District, Lanzhou, Gansu Province 730050 China
| | - Nan Zhao
- Yale University School of Public Health, 60 College Street, New Haven, CT 06520 USA
| | - Min Zhou
- Gansu Provincial Maternity and Child Care Hospital, 143 North Road, Qilihe District, Lanzhou, Gansu Province 730050 China
| | - Xiaoying Xu
- Gansu Provincial Maternity and Child Care Hospital, 143 North Road, Qilihe District, Lanzhou, Gansu Province 730050 China
| | - Weitao Qiu
- Gansu Provincial Maternity and Child Care Hospital, 143 North Road, Qilihe District, Lanzhou, Gansu Province 730050 China
| | - Qing Liu
- Gansu Provincial Maternity and Child Care Hospital, 143 North Road, Qilihe District, Lanzhou, Gansu Province 730050 China
| | - Yawei Zhang
- Yale University School of Public Health, 60 College Street, New Haven, CT 06520 USA
- Yale School of Medicine, New Haven, CT USA
| |
Collapse
|
38
|
Kair LR, Colaizy TT. Obese Mothers have Lower Odds of Experiencing Pro-breastfeeding Hospital Practices than Mothers of Normal Weight: CDC Pregnancy Risk Assessment Monitoring System (PRAMS), 2004-2008. Matern Child Health J 2016; 20:593-601. [PMID: 26515471 DOI: 10.1007/s10995-015-1858-z] [Citation(s) in RCA: 35] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
OBJECTIVES This study examines the extent to which a mother's pre-pregnancy body mass index (BMI) category is associated with her exposure to pro-breastfeeding hospital practices. METHODS Data from the 2004-2008 CDC PRAMS were analyzed for three states (Illinois, Maine, and Vermont) that had administered an optional survey question about hospital pro-breastfeeding practices. RESULTS Of 19,145 mothers surveyed, 19 % were obese (pre-pregnancy BMI ≥ 30). Obese mothers had lower odds than mothers of normal weight of initiating breastfeeding [70 vs. 79 % (unweighted), p < 0.0001]. Compared with women of normal weight, obese mothers had lower odds of being exposed to pro-breastfeeding hospital practices during the birth hospitalization. Specifically, obese mothers had higher odds of using a pacifier in the hospital [odds ratio (OR) 1.31, 95 % confidence interval (CI) (1.17-1.48), p < 0.0001] and lower odds of: a staff member providing them with information about breastfeeding [OR 0.71, 95 % CI (0.57-0.89), p = 0.002], a staff member helping them breastfeed [OR 0.69, 95 % CI (0.61-0.78), p < 0.0001], breastfeeding in the first hour after delivery [OR 0.55, 95 % CI (0.49-0.62), p < 0.0001], being given a telephone number for breastfeeding help [OR 0.65, 95 % CI (0.57-0.74), p < 0.0001], rooming in [OR 0.84, 95 % CI (0.73-0.97), p = 0.02], and being instructed to breastfeed on demand [OR 0.66, 95 % CI (0.58-0.75), p < 0.0001]. Adjusting for multiple covariates, all associations except rooming in remained significant. CONCLUSIONS Obesity stigma may be a determinant of breastfeeding outcomes for obese mothers. Breastfeeding support should be improved for this at-risk population.
Collapse
|
39
|
Yan J. Maternal pre-pregnancy BMI, gestational weight gain, and infant birth weight: A within-family analysis in the United States. Econ Hum Biol 2015; 18:1-12. [PMID: 25863988 DOI: 10.1016/j.ehb.2015.03.002] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/15/2014] [Revised: 03/10/2015] [Accepted: 03/11/2015] [Indexed: 06/04/2023]
Abstract
In the United States, the high prevalence of unhealthy preconception body weight and inappropriate gestational weight gain among pregnant women is an important public health concern. However, the relationship among pre-pregnancy BMI, gestational weight gain, and newborn birth weight has not been well established. This study uses a very large dataset of sibling births and a within-family design to thoroughly address this issue. The baseline analysis controlling for mother fixed effects indicates maternal preconception overweight, preconception obesity, and excessive gestational weight gain significantly increase the risk of having a high birth weight baby, respectively, by 1.3, 3 and 3.9 percentage points, while underweight before pregnancy and inadequate gestational weight gain increase the low birth weight incidence by 1.4 and 2 percentage points. The benchmark results are robust in a variety of sensitivity checks. Since poor birth outcomes especially high birth weight and low birth weight have lasting adverse impacts on one's health, education, and socio-economic outcomes later in life, the findings of this research suggest promoting healthy weight among women before pregnancy and preventing inappropriate weight gain during pregnancy can generate significant intergenerational benefits.
Collapse
Affiliation(s)
- Ji Yan
- Appalachian State University, Department of Economics, 416 Howard Street, Boone, NC 28607, United States.
| |
Collapse
|