Prediction of large-for-gestational age infants in relation to hyperglycemia in pregnancy – a comparison of statistical models

2021 ◽  
pp. 108975
Author(s):  
Kristen S. GIBBONS ◽  
Allan M.Z. CHANG ◽  
Ronald C.W. MA ◽  
Wing Hung TAM ◽  
Patrick M. CATALANO ◽  
...  
Keyword(s):  
Gestational Age ◽  
Statistical Models ◽  
Large For Gestational Age ◽  
In Pregnancy

scholarly journals Weight gain in pregnancy: is less truly more for mother and infant?

2012 ◽  
Vol 5 (2) ◽  
pp. 58-64 ◽  
Author(s):  
Linda A Barbour
Keyword(s):  
Weight Gain ◽  
Gestational Weight Gain ◽  
Gestational Age ◽  
Neonatal Morbidity ◽  
Current Data ◽  
Large For Gestational Age ◽  
Institute Of Medicine ◽  
Gestational Weight ◽  
The Relationship ◽  
In Pregnancy

SUMMARY Although more than 50% of women gain weight above the Institute of Medicine (IOM) guidelines for weight gain in pregnancy and excessive weight gain is an independent risk factor for significant maternal and neonatal morbidity and offspring obesity, there is little consensus over the ideal weight gain during pregnancy. Surprisingly, the 2009 IOM guidelines varied minimally from the 1990 IOM guidelines, and many critics advocate lower weight gain recommendations. This review explores the energy costs of pregnancy, the relationship between gestational weight gain and birth weight, and considers what gestational weight gain minimizes both large-for-gestational age as well as small-for-gestational age infants. An extensive examination of the current data leads this author to question whether the current weight gain recommendations are too liberal, especially for obese pregnant women.

scholarly journals Antenatal depressive symptoms and adverse perinatal outcomes

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Despina Pampaka ◽  
Stefania I. Papatheodorou ◽  
Mohammad AlSeaidan ◽  
Rihab Al Wotayan ◽  
Rosalind J. Wright ◽  
...  
Keyword(s):  
Depressive Symptoms ◽  
Preterm Birth ◽  
Gestational Age ◽  
Small For Gestational Age ◽  
Statistical Significance ◽  
Depression Scale ◽  
Large For Gestational Age ◽  
Antenatal Depressive Symptoms ◽  
Adverse Pregnancy ◽  
In Pregnancy

Abstract Background The association of antenatal depression with adverse pregnancy, birth, and postnatal outcomes has been an item of scientific interest over the last decades. However, the evidence that exists is controversial or limited. We previously found that one in five women in Kuwait experience antenatal depressive symptoms. Therefore, the aim of this study was to examine whether antenatal depressive symptoms are associated with preterm birth (PTB), small for gestational age (SGA), or large for gestational age (LGA) babies in this population. Methods This was a secondary analysis based on data collected in the Transgenerational Assessment of Children’s Environmental Risk (TRACER) Study that was conducted in Kuwait. Logistic regression analysis was used to examine whether antenatal depressive symptoms assessed using the Edinburgh Depression Scale (EDS) were associated with preterm birth, small for gestational age, and large for gestational age babies. Results A total of 1694 women had complete information about the outcomes of interest. Women with depressive symptoms in pregnancy had increased, albeit non-significant, odds of having PTB (OR = 1.41; 95%CI: 0.81, 2.45), SGA babies (OR = 1.26; 0.80, 1.98), or LGA babies (OR = 1.27; 0.90, 1.79). Antenatal depressive symptoms had similar increased odds for the three outcomes even after adjusting for several covariates though none of these reached statistical significance. Conclusions In the present study, the depressive symptoms in pregnancy did not predict adverse birth outcomes, such as PTB, SGA, and LGA, which adds to the currently non-conclusive literature. However, further research is needed to examine these associations, as the available evidence is quite limited.

Exercise and physical activity in pregnancy

2015 ◽  
Author(s):  
Sir Peter Gluckman ◽  
Mark Hanson ◽  
Chong Yap Seng ◽  
Anne Bardsley
Keyword(s):  
Physical Activity ◽  
Gestational Age ◽  
Late Gestation ◽  
Large For Gestational Age ◽  
Healthy Weight ◽  
Fitness Level ◽  
Beneficial Effects ◽  
Aerobic Conditioning ◽  
In Pregnancy

Exercise has many beneficial effects for pregnant women and their offspring, reducing insulin resistance and blood pressure and supporting angiogenesis, while also helping to maintain a healthy weight and body composition. Exercise/physical activity also been reported to reduce the risks of large for gestational age/small for gestational age babies and of preterm birth. Moderate exercise of 30 minutes or more on most days is recommended. Reasonable goals of aerobic conditioning in pregnancy should be to maintain a good fitness level throughout pregnancy without trying to reach peak fitness level or train for athletic competition. However, extreme exercise in late gestation is cautioned against, as it is associated with lower birth weights and the possibility of long-term adverse consequences on the offspring.

scholarly journals Changes in dietary preferences reported in pregnancy: associations with later pregnancy complications in a sample of 55,087 women

2020 ◽  
Vol 79 (OCE2) ◽  
Author(s):  
Anne Ahrendt Bjerregaard ◽  
Ann-Marie Hellerung Christiansen ◽  
Dirk Lund Christensen ◽  
Sjurdur Frodi Olsen
Keyword(s):  
Gestational Age ◽  
Pregnancy Complications ◽  
Maternal Nutrition ◽  
A Priori ◽  
Dietary Change ◽  
Large For Gestational Age ◽  
Food Groups ◽  
Dietary Changes ◽  
Milk Products ◽  
In Pregnancy

AbstractIntroductionDietary changes in pregnancy may be a marker for later pregnancy complications. This study aims to investigate if there is a difference in the proportion of women who experience specific pregnancy related complications vs those who do not, in relation to specific dietary changes made during pregnancy.Materials and methodsWithin the Danish National Birth Cohort, established during 1996 and 2003, dietary changes from 70,053 pregnancies were assessed in gestational week (GW) 25 using two open-ended questions (q1 and q2) on aversions or preferences appended to a 350-item food frequency questionnaire; “did you stop(q1) or start(q2) consuming a specific food during pregnancy?” After restricting to the firstborn child enrolled, born at term (GW 37 + 1–42 + 0) with a birth weight between 1,0 and 6,0 kilograms, excluding multiple pregnancies and abortions, dietary change answers from 55,087 women were coded into 65 food groups. Using chi-X2 test, we compared proportions of women with and without three pregnancy complications: preeclampsia (obtained via linkage to the Danish National Patient Registry), children born small-for-gestational-age (SGA, < 10th percentile) or children born large-for-gestational-age (LGA, > 90th percentile) with respect to their answers about aversions/preferences.ResultsAmong the 55,087 women, 49% and 31% reported any aversions or preferences, respectively. Most frequent were women reporting aversion of alcohol (22.7%) or coffee (15.4%), and preference of milk products (7.9%) or fruits and berries (6.9%), which were selected a priori for analyses. 8.3% of women experienced preeclampsia, and 9.7% and 9.3% of children were characterizes as being born SGA or LGA, respectively. Compared with no dietary change: avoiding alcohol or coffee was associated with smaller proportion of SGA (10% vs 8%, p = 0.01 and 10% vs 7%, p < 0.0001) and avoiding coffee was also associated with greater proportion of LGA (9% vs 11%, p = 0.01). Increasing milk products or fruit/berries was associated with smaller proportions of SGA (14% vs 10% in both conditions, p < 0.009). No significant association in reported aversions/preferences was detected for preeclampsia.DiscussionThe results lead to additional questions, such as “Why do women who increase consumption of milk products or fruits/berries tend to deliver SGA infants and why do women who stop drinking coffee tend to deliver LGA infants?” The presented results and further analyses are important to public health initiatives for optimizing maternal nutrition with long-term influence to offspring Health.

scholarly journals Early pregnancy hyperglycaemia as a significant predictor of large for gestational age neonates

2022 ◽  
Author(s):  
Imasha Upulini Jayasinghe ◽  
Iresha Sandamali Koralegedara ◽  
Suneth Buddhika Agampodi
Keyword(s):  
Diabetes Mellitus ◽  
Birth Weight ◽  
Early Pregnancy ◽  
Gestational Age ◽  
First Trimester ◽  
World Health ◽  
Large For Gestational Age ◽  
Evaluation Procedure ◽  
Who Criteria ◽  
In Pregnancy

Abstract Aims We aimed to determine the effect of early pregnancy hyperglycaemia on having a large for gestational age (LGA) neonate. Methods A prospective cohort study was conducted among pregnant women in their first trimester. One-step plasma glucose (PG) evaluation procedure was performed to assess gestational diabetes mellitus (GDM) and diabetes mellitus (DM) in pregnancy as defined by the World Health Organization (WHO) criteria with International Association of Diabetes in Pregnancy Study Group (IADPSG) thresholds. The main outcome studied was large for gestational age neonates (LGA). Results A total of 2,709 participants were recruited with a mean age of 28 years (SD = 5.4) and a median gestational age (GA) of eight weeks (interquartile range [IQR] = 2). The prevalence of GDM in first trimester (T1) was 15.0% (95% confidence interval [CI] = 13.7–16.4). Previously undiagnosed DM was detected among 2.5% of the participants. Out of 2,285 live births with a median delivery GA of 38 weeks (IQR = 3), 7.0% were LGA neonates. The cumulative incidence of LGA neonates in women with GDM and DM was 11.1 and 15.5 per 100 women, respectively. The relative risk of having an LGA neonate among women with DM and GDM was 2.30 (95% CI = 1.23–4.28) and 1.80 (95% CI = 1.27–2.53), respectively. The attributable risk percentage of a LGA neonate for hyperglycaemia was 15.01%. T1 fasting PG was significantly correlated with both neonatal birth weight and birth weight centile. Conclusions The proposed WHO criteria for hyperglycaemia in pregnancy are valid, even in T1, for predicting LGA neonates. The use of IADPSG threshold for Fasting PG, for risk assessment in early pregnancy in high-risk populations is recommended.

Antibiotic Use in Pregnancy, Abnormal Fetal Growth, and Development of Gestational Diabetes Mellitus

2018 ◽  
Vol 36 (03) ◽  
pp. 243-251 ◽  
Author(s):  
Janet Catov ◽  
Tiffany Deihl ◽  
Maisa Feghali ◽  
Christina Scifres ◽  
John Mission
Keyword(s):  
Diabetes Mellitus ◽  
Birth Weight ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Gestational Age ◽  
Academic Medical Center ◽  
Antibiotic Use ◽  
Large For Gestational Age ◽  
The Impact ◽  
In Pregnancy

Objective Antibiotics are commonly used in pregnancy. Prior studies have indicated that antibiotic use in pregnancy may affect birth weight, whereas data in nonpregnant individuals suggest that antibiotic exposure may increase diabetes risk. We evaluated the impact of antibiotic prescriptions during pregnancy on the prevalence of small for gestational age (SGA) and large for gestational age (LGA) birth weight and gestational diabetes mellitus (GDM). Study Design This retrospective cohort study of 12,551 women who delivered at a large academic medical center between 2012 and 2014 assessed the number and type of antibiotic prescriptions prior to GDM testing using the electronic medical record. SGA and LGA birth weight and GDM rates were compared among women who were or were not prescribed antibiotics. Results Overall, 3,991 (31.8%) of 12,551 patients received at least one antibiotic prescription. After covariate adjustment, no differences existed in risk of SGA (adjusted odds ratio [aOR]: 1; 95% confidence interval [CI]: 0.88–1.15; p = 0.94), LGA (aOR: 1; 95% CI: 0.86–1.17; p = 0.97), or GDM (aOR: 0.90; 95% CI: 0.72–1.13; p = 0.36) between women who were or were not prescribed antibiotics. Conclusion Antibiotic use does not affect the risk of SGA or LGA birth weight or GDM in pregnant women. These results provide reassurance regarding the use of antibiotics when clinically indicated in pregnancy.

scholarly journals Prognosis Associated with Sub-Types of Hyperglycaemia in Pregnancy

2021 ◽  
Vol 10 (17) ◽  
pp. 3904
Author(s):  
Emmanuel Cosson ◽  
Sid Ahmed Bentounes ◽  
Charlotte Nachetergaele ◽  
Narimane Berkane ◽  
Sara Pinto ◽  
...  
Keyword(s):  
Weight Gain ◽  
Gestational Weight Gain ◽  
Gestational Age ◽  
Pregnancy Outcomes ◽  
Insulin Requirement ◽  
Large For Gestational Age ◽  
Gestational Weight ◽  
Hypertensive Disorders ◽  
Increased Risk ◽  
In Pregnancy

We aimed to compare pregnancy outcomes in 4665 women according to the following types of hyperglycaemia in pregnancy sub-types: (i) normoglycaemia, (ii) gestational diabetes mellitus (GDM), (iii) diabetes in pregnancy (DIP), (iv) early-diagnosed (i.e., <22 weeks of gestation) GDM (eGDM), and (v) early-diagnosed DIP (eDIP). The prevalence of normoglycaemia, eGDM, eDIP, GDM, and DIP was 76.4%, 10.8%, 0.6%, 11.7%, and 0.6%, respectively. With regard to pregnancy outcomes, gestational weight gain (11.5 ± 5.5, 9.0 ± 5.4, 8.3 ± 4.7, 10.4 ± 5.3, and 10.1 ± 5.0 kg, p < 0.0001) and insulin requirement (none, 46.0%, 88.5%, 25.5%, and 51.7%; p < 0.001) differed according to the glycaemic sub-types. eGDM and eDIP were associated with higher rates of infant malformation. After adjustment for confounders, with normoglycaemia as the reference, only GDM was associated with large-for-gestational-age infant (odds ratio 1.34 (95% interval confidence 1.01–1.78) and only DIP was associated with hypertensive disorders (OR 3.48 (1.26–9.57)). To conclude, early-diagnosed hyperglycaemia was associated with an increased risk of malformation, suggesting that it was sometimes present at conception. Women with GDM, but not those with eGDM, had an increased risk of having a large-for-gestational-age infant, possibly because those with eGDM were treated early and therefore had less gestational weight gain. Women with DIP might benefit from specific surveillance for hypertensive disorders.

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