Gestational Weight Gain, Pregnancy Related Complications and the Short-Term Risks for the Offspring

BACKGROUND AND OBJECTIVES

Maternal obesity influences pregnancy course in several different manners, and imbalanced nutrition during pregnancy may lead to various adverse pregnancy outcomes. Additionally, nutritional status during pregnancy may have implications for the health of the offspring and may possibly influence early motor development in children. The aim of this study was to assess the impact of excessive gestational weight gain (EGWG) on pregnancy outcomes and infant's motor development within the first twelve months of life.

MATERIALS AND METHODS

The study included 200 participants divided in two groups based on their gestational weight gain. Maternal, perinatal, and neonatal factors were analyzed, and early motor development was assessed using the Alberta infant motor scale (AIMS).

RESULTS

EGWG was significantly associated with: pre-pregnancy BMI (p < 0.001), family history for cardiovascular diseases (p = 0.013) and diabetes mellitus (p = 0.045), hypertensive disorder of pregnancy (p = 0.003), gestational diabetes mellitus (p < 0.001), gestational anemia (p = 0.001), vitamin D deficiency (p = 0.001), metformin use (p = 0.045), pre-labor premature rupture of membranes (p = 0.031), amniotic fluid index (p = 0.047), and APGAR score in the first five min of life (p = 0.007). Scored by AIMS, EGWG was significantly associated with parameters of early motor development at the age of three AIMS total (p < 0.001), six AIMS total (p < 0.001), nine AIMS total (p < 0.001), and twelve AIMS total (p < 0.001) months of infant's life.

CONCLUSIONS

The link between EGWG and adverse neurodevelopmental outcomes in offspring is a complex and multifaceted issue. Our results imply significant alterations in early motor development in the group of infants born from mothers who gained weight excessively during pregnancy. Further studies are needed to unravel the intricacies of this relationship and inform strategies for preventive interventions and supportive care during pregnancy and infancy.

Mobile phone use screening test: Development, validation, and implications for screening excessive mobile use

BACKGROUND

Early identification for the addictive use of smartphones would enable timely intervention to minimize suffering from compromised functioning and associated psychological problems. This study is the first such attempt to develop a test for addictive/excessive use of the mobile phone in the Indian context. The present study aims to develop and validate the mobile phone use screening test (MUST) for the Indian subcontinent.

MATERIALS AND METHODS

Five hundred individuals aged 18-40 years, residing in the South Indian city of Bangalore participated in the study. The sociodemographic datasheet and the newly developed test were administered on these individuals to gather demographic information and patterns of excessive mobile phone use.

RESULTS

The developed test has 18-items which use a self-report Likert-type scale format. The test-retest reliability was 0.93 and the Cronbach's alpha was found to be 0.86. The scoring criterion for the overall score was: <30 = mild use; 31-49 = moderate use; and 50 and above = excessive/addictive smartphone use. The scale has four components: craving, loss of control, coping, and consequences.

CONCLUSIONS

The MUST can be used for the identification of addictive/excessive use of mobile phone among adolescents and young adult groups.

Occlusion of right coronary artery by microembolization caused by excessive diagnostic catheter manipulation

With advancing technology and newer therapeutic and diagnostic techniques, physicians are now encountering new complications or increasing frequency of known complications than before. left cardiac catheterization and coronary angiography is not an exception. As transradial cardiac catheterization is now becoming more popular, operators should be more aware of related challenges and limitations associated. Tortuous right bracheocephalic artery is an anatomical variance that makes radial catheterization more difficult, and may indeed add additional time and risk to the procedure and patient, respectively. Hence, we present this case report.

Timing of Excessive Weight Gain During Pregnancy Modulates Newborn Anthropometry

OBJECTIVE

Excessive gestational weight gain (GWG) is associated with increased birth weight and neonatal adiposity. However, timing of excessive GWG may have a differential impact on birth outcomes. The objective of this study was to compare the effect of early and mid/late excessive GWG on newborn anthropometry in the context of the Canadian clinical recommendations that are specific for first trimester and for second/third trimesters based on maternal pre-pregnancy BMI.

METHODS

We included 607 glucose-tolerant women in our main analyses, after excluding women who had less than the recommended total GWG. Maternal body weight was measured in early pregnancy, mid-pregnancy, and late pregnancy. Maternal and fetal clinical outcomes were collected, including newborn anthropometry. Women were divided into four groups according to the Canadian guidelines for GWG in the first and in the second/third trimesters: (1) "overall non-excessive" (reference group); (2) "early excessive GWG"; (3) "mid/late excessive GWG"; and (4) "overall excessive GWG." Differences in newborn anthropometry were tested across GWG categories.

RESULTS

Women had a mean (±SD) pre-pregnancy BMI of 24.7 ± 5.2 kg/m(2) and total GWG of 15.3 ± 4.4 kg. Women with mid/late excessive GWG gave birth to heavier babies (gestational age-adjusted birth weight z-score 0.33 ± 0.91) compared with women in the reference group (0.00 ± 0.77, P = 0.007), whereas women with early excessive GWG gave birth to babies of similar weight (gestational age-adjusted z-score 0.01 ± 0.86) to the reference group (0.00 ± 0.77, P = 0.84). When we stratified our analyses and investigated women who gained within the recommendations for total GWG, mid/late excessive GWG specifically was associated with greater newborn size, similar to our main analyses.

CONCLUSION

Excessive GWG in mid/late pregnancy in women who did not gain weight excessively in early pregnancy is associated with increased birth size, even in those who gained within the Canadian recommendations for total GWG.

The effects of culture on guideline discordant gestational weight gain: a systematic review protocol

BACKGROUND

A significant proportion of women exceeds or does not meet the Institute of Medicine's gestational weight gain (GWG) guidelines. Inadequate, excessive GWG or weight loss during pregnancy is associated with an increased risk of negative maternal and fetal outcomes. Among the many determinants of GWG identified in the 2009 Institute of Medicine guidelines, culture was named as one of the few whose influence has not been fully explored. Some cultural beliefs may erroneously promote overeating as "eating for two" and discourage physical activity during pregnancy, but there is lack of empirical evidence on how culture affects GWG. The purpose of this systematic review is to examine the effects of culture on GWG.

METHODS/DESIGN

Ten electronic databases will be searched to identify studies reporting on the effects of culture on GWG. Grey literature, published conference abstracts, websites of relevant organizations and reference lists of included studies will also be searched. Studies that report on effects of culture, acculturation, ethnicity, race, nationality, ancestry and identity on GWG in adult women will be included. Quality of evidence will be evaluated using the grading of recommendations, assessment, development and evaluations (GRADE) approach to rating evidence. Study selection, data extraction and risk of bias assessment will be conducted by two independent reviewers, with disagreements being resolved by consensus or third party adjudication as needed. Formal meta-analyses will be conducted among included studies that are sufficiently statistically and clinically homogeneous.

DISCUSSION

This review will provide a comprehensive assessment and synthesis of current evidence and will draw attention to potential gaps where future research on the effects of culture on guideline discordant gestational weight gain remains to be conducted.

SYSTEMATIC REVIEW REGISTRATION

PROSPERO CRD42015023399.

Lip repositioning surgery: A pioneering technique for perio-esthetics

In our esthetic conscious society people are now demanding all types of treatments possible to have a pleasing and attractive personality. A dazzling and beautiful smile can work wonders for anyone's personality. Our smile mirrors our persona, our unique being. However, a beautiful smile comprises of a perfect balance of the white and pink. This imbalance of excessive gingival display (EGD) can be managed by a variety of treatment modalities, depending on accurate diagnosis. This case report demonstrates the successful management of EGD with a lip-repositioning procedure in a patient with incompetent short upper lip. This was accomplished by removing a partial thickness strip of mucosa from the maxillary buccal vestibule and suturing the lip mucosa to the mucogingival line. This resulted in a narrower vestibule and restricted muscle pull, thereby resulting in competent lips and reduced gingival display during smiling.

Vitamins and minerals: issues associated with too low and too high population intakes

There is an ongoing increase in the availability of foods fortified with micronutrients and dietary supplements. This may result in differing intakes of micronutrients within the population and perhaps larger differences in intakes. Insight into population micronutrient intakes and evaluation of too low or too high intakes is required to see whether there are potential problems regarding inadequacy or excessive intakes. Too low population intakes are evaluated against an estimated average requirement; potential too high population intakes are evaluated against a tolerable upper intake level (UL). Additional health effects, seriousness, and incidence of these health effects are not considered but these can be taken into account in a benefit-risk assessment. Furthermore, authorities would like to regulate food fortification and supplementation in such a way that most of the population is not at risk of potentially high intakes. Several models are available for estimating maximum levels of micronutrients for food fortification and dietary supplements. Policy makers and risk managers need to decide how to divide the 'free space' between food fortification and/or dietary supplements, while protecting populations from adverse health effects.

Can physical activity reduce excessive gestational weight gain? Findings from a Chinese urban pregnant women cohort study

BACKGROUND

Excessive gestational weight gain (GWG) poses negative impact on mothers and their children. It is important to understand the modifiable lifestyle factors associated with excessive GWG during pregnancy to guide future public health practice.

AIM

To investigate the association between physical activity during pregnancy and GWG of Chinese urban pregnant women.

METHODS

A pregnant women cohort was established between 2005 and 2007 in Changzhou, China. Physical activity levels of pregnant women were assessed using pedometer in the 2nd and 3rd trimester, respectively. According to step counts, pregnant women were categorized into 4 different physical activity groups: Sedentary, Low Active, Somewhat Active and Active. The pregnant women were followed for eligibility and data collection from the 2nd trimester to delivery. Multiple linear regression and multiple binary logistic model were applied to determine the association between physical activity and GWG.

RESULTS

Physical activity levels and GWG of 862 pregnant women were assessed, among them 473 (54.9%) experienced excessive GWG. The adjusted odds ratio (OR) was 0.59 (95%CI: 0.36 ~ 0.95) for excessive GWG in the Active group during the 2nd trimester and 0.66 (95%CI: 0.43 ~ 1.00) in the Somewhat Active group during the 3rd trimester, compared with the Sedentary group respectively. In the last two trimesters, the Active group had 1.45 kg less GWG, than the Sedentary group. The ORs of excessive GWG decreased with the increased level of physical activity (P < 0.05).

CONCLUSION

This study suggests that pregnant women being physically active have less weight gain during pregnancy.