Effects of single and combined gestational phthalate exposure on blood pressure, blood glucose and gestational weight gain: A longitudinal analysis

OBJECTIVE: To evaluate whether weekly gestational weight gain is associated with anemia, vitamin A insufficiency, and blood pressure levels in the third trimester of pregnancy. METHODS: A prospective study with 457 pregnant women attending primary care in Cruzeiro do Sul, Acre. The weekly gestational weight gain rate measured between the second and third trimesters was classified as insufficient, adequate, and excessive according to the recommendations of the Institute of Medicine 2009. The outcomes at the beginning of the third gestational trimester were: anemia (Hb < 110 g/L), vitamin A insufficiency (serum retinol<1.05 μmol/L) and blood pressure levels (continuous values, in mmHg). Age-adjusted prevalence ratios, schooling, and use of vitamin and mineral supplements were calculated in Poisson regression models with robust variance. RESULTS: A total of 18.6% of pregnant women had insufficient weekly weight gain, and 59.1% had excessive weight gain. The frequencies of anemia, vitamin A insufficiency and hypertension (systolic blood pressure ≥ 140 mmHg or diastolic ≥ 90 mmHg) were 17.5%, 13.4%, and 0.6%, respectively. The prevalence ratios for anemia among pregnant women with insufficient and excessive weight gain were 0.41 (95%CI 0.18–0.93) and 1.00 (95%CI 0.63–1.59), respectively, when compared to pregnant women with adequate weight gain. For vitamin A insufficiency, the adjusted prevalence ratio was significantly higher among pregnant women with insufficient weight gain (2.85, 95%CI 1.55–5.24) and no difference for excessive weight gain (1.53, 95%CI 0.84–2.74) when compared to pregnant women with adequate weight gain. Pregnant women with excessive weight gain had higher mean systolic blood pressure (111.10; 95%CI 109.9–112.2) when compared to pregnant women with insufficient weight gain (107.50; 95%CI 105.4–109.6) and adequate (106.20; 95%CI 104.3–108.20). CONCLUSIONS: Insufficient weekly gestational weight gain was associated with the risk of vitamin A insufficiency. Excessive weight gain, in turn, was associated with higher blood pressure values at the beginning of the third gestational trimester.

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No Association of Maternal Gestational Weight Gain with Offspring Blood Pressure and Hypertension at Age 18 Years in Male Sibling-Pairs: A Prospective Register-Based Cohort Study

PLoS ONE ◽

10.1371/journal.pone.0121202 ◽

2015 ◽

Vol 10 (3) ◽

pp. e0121202 ◽

Cited By ~ 2

Author(s):

Elina Scheers Andersson ◽

Per Tynelius ◽

Ellen Aagaard Nohr ◽

Thorkild I. A. Sørensen ◽

Finn Rasmussen

Keyword(s):

Blood Pressure ◽

Cohort Study ◽

Weight Gain ◽

Gestational Weight Gain ◽

Sibling Pairs ◽

Gestational Weight ◽

Male Sibling

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Associations of Gestational Weight Gain With Maternal Body Mass Index, Waist Circumference, and Blood Pressure Measured 16 Years After Pregnancy: The Avon Longitudinal Study of Parents and Children

Obstetrical & Gynecological Survey ◽

10.1097/ogx.0b013e31823d84c4 ◽

2011 ◽

Vol 66 (10) ◽

pp. 599-600 ◽

Cited By ~ 6

Author(s):

Abigail Fraser ◽

Kate Tilling ◽

Corrie Macdonald-Wallis ◽

Rachael Hughes ◽

Naveed Sattar ◽

...

Keyword(s):

Blood Pressure ◽

Body Mass Index ◽

Weight Gain ◽

Longitudinal Study ◽

Waist Circumference ◽

Gestational Weight Gain ◽

Maternal Body Mass Index ◽

Gestational Weight ◽

Parents And Children ◽

Avon Longitudinal Study

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Maternal pregnancy weight or gestational weight gain and offspring's blood pressure: A systematic review

Nutrition Metabolism and Cardiovascular Diseases ◽

10.1016/j.numecd.2021.11.011 ◽

2021 ◽

Author(s):

Helena Ludwig-walz ◽

Juliana Nyasordzi ◽

Katharina S. Weber ◽

Anette E. Buyken ◽

Anja Kroke

Keyword(s):

Systematic Review ◽

Blood Pressure ◽

Weight Gain ◽

Gestational Weight Gain ◽

Gestational Weight ◽

Pregnancy Weight

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The effect of pre-pregnancy weight and gestational weight gain on blood pressure in children at 6 years of age

Journal of Public Health ◽

10.1093/pubmed/fdaa044 ◽

2020 ◽

Author(s):

Camila Honorato A Torres ◽

Lidiane F Schultz ◽

Paul J Veugelers ◽

Silmara S B S Mastroeni ◽

Marco F Mastroeni

Keyword(s):

Blood Pressure ◽

Weight Gain ◽

Gestational Weight Gain ◽

Cross Sectional Study ◽

Normal Weight ◽

Reproductive Age ◽

Cross Sectional ◽

Gestational Weight ◽

Binomial Regression ◽

Pregnancy Weight

Abstract Background We evaluated the effect of maternal gestational weight gain (GWG) and pre-pregnancy weight on blood pressure (BP) of children 6 years after delivery. Methods Cross-sectional study that compared the anthropometric measurements of 181 mothers and their children’s BP 6 years after delivery. The BP was measured by the auscultatory method. We used log-binomial regression to investigate the association of pre-pregnancy body mass index (BMI) and GWG categories with BP in mid-childhood. Results The prevalence of elevated BP in children was 26.5%. Maternal pre-pregnancy overweight and concurrent excessive GWG were positively associated with elevated BP at 6 years of age. Mothers with pre-pregnancy overweight and excessive GWG were more likely to have children with elevated BP at 6 years of age (OR = 2.05; P = 0.018) compared to mothers who were of normal weight pre-pregnancy and experienced appropriate GWG. We also found that mothers with pre-pregnancy BMI ≥25 kg/m2 and concurrent excessive GWG were more likely to have children with elevated diastolic blood pressure (OR = 2.72; P = 0.005). Conclusions Pre-pregnancy overweight/obesity had impact on BP in mid-childhood. Interventions aimed at reducing cardiovascular diseases in children should promote weight loss in women of reproductive age rather than in pregnant women.

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The Effects of Insulin Therapy on Mothers’ Blood Pressure and Weight in Women with Gestational Diabetes Mellitus

10.21203/rs.3.rs-330032/v1 ◽

2021 ◽

Author(s):

Tiange Sun ◽

Fanhua Meng ◽

Shufei Zang ◽

Yue Li ◽

Rui Zhang ◽

...

Keyword(s):

Diabetes Mellitus ◽

Blood Pressure ◽

Logistic Regression ◽

Weight Gain ◽

Blood Glucose ◽

Gestational Diabetes ◽

Insulin Therapy ◽

Gestational Hypertension ◽

Short Term ◽

Gestational Weight

Abstract BackgroundThe primary mechanism of gestational diabetes mellitus (GDM) was insulin resistance. Effects of insulin as the first - line medicine for GDM women was blurring. This work aims to investigate influences of insulin therapy on GDM mothers. MethodsThis retrospective cohort study recruited 616 GDM women with lifestyle intervention (diet and physician alone) and 92 GDM women with insulin therapy. Comparing the differences of variables (BMI, blood pressure, gestational weight gain, the incidence of macrosomia and so on) between GDM women with insulin and with lifestyle alone with univariate analysis. Employed paired sample test to evaluate the changes of BP from the time of intervention to one week before delivery, and used logistic regression to analyze the relationship between insulin therapy and gestational hypertension (GH).ResultsThere were no significant differences in delivery mode, newborn weight and the incidence of macrosomia between GDM women with insulin and with lifestyle alone. Insulin therapy slightly increased mothers’ weight despite there were no significant statistically differences in the rate of excessive weight gain comparing to the intervention of lifestyle alone which was attributed to short - term administration (about 12 weeks). In addition, the injection of insulin remarkably enhanced the incidence of gestational hypertension (GH). furthermore, the effect still existed after matching the time of insulin therapy, and from starting insulin usage to delivery systolic blood pressure significantly elevated 6mmHg (vs 4mmHg lifestyle alone, P = 0.529) and diastolic blood pressure 9mmHg (vs 5mmHg lifestyle alone, P = 0.032). Correlation analysis implied blood pressure near the delivery had significant positive correlation with BMI, 1 hour blood glucose, HbA1c, area under the blood glucose curve and gestational weight gain. Logistic regression analysis with enter selection confirmed that insulin therapy was an independent risk factor for the development of GH.ConclusionsThis work suggested that insulin therapy for short - term usage might slightly increase mothers’ weight, but had the marked risk of raising mothers’ BP, especially DBP.

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GESTATIONAL WEIGHT GAIN AS AN INDEPENDENT RISK FACTOR FOR MACROSOMIA IN WOMEN WITH INTERMEDIATE STATE GESTATIONAL BLOOD GLUCOSE

Endocrine Practice ◽

10.4158/ep-2018-0558 ◽

2019 ◽

Vol 25 (11) ◽

pp. 1158-1165 ◽

Cited By ~ 2

Author(s):

Xinmei Huang ◽

Xiaoya Li ◽

Cuijun Gao ◽

Jun Liu ◽

Zaoping Chen ◽

...

Keyword(s):

Risk Factor ◽

Weight Gain ◽

Blood Glucose ◽

Glucose Tolerance ◽

Gestational Weight Gain ◽

Intermediate State ◽

Independent Risk Factor ◽

Density Lipoprotein ◽

Lipoprotein Cholesterol ◽

Gestational Weight

Objective: Macrosomia is closely associated with gestational diabetes mellitus (GDM) but its relationship with maternal intermediate state gestational blood glucose (ISGBG; normal fasting blood glucose and 7.8 mmol/L <1 hour blood glucose [BG] <10 mmol/L or 6.7 mmol/L <2 hour BG <8.5 mmol/L) is unclear. Here, we analyzed the clinical characteristics and pregnancy outcomes and explored risk factors for macrosomia in women with ISGBG. Methods: A total of 847 women with normal glucose tolerance gestation, 330 with ISGBG, and 99 with GDM were included. Maternal and fetal clinical data were collected and 3-point BG following oral glucose tolerance test, fasting insulin, glycated hemoglobin, and blood lipids profile were measured. Results: The incidence rate of macrosomia among the neonates of women with ISGBG was as high as 10.9%. In the ISGBG group, prepregnancy body mass index (BMI), gestational weight gain (GWG) and the proportion of women with excessive GWG (eGWG) were significantly higher in women with macrosomia compared with those who delivered a normal weight neonate. In women with ISGBG, neonate weight was positively correlated with maternal prepregnancy weight ( r = 0.183, P<.01), prepregnancy BMI ( r = 0.135, P<.01), and GWG ( r = 0.255, P<.01), and negatively correlated with high-density lipoprotein cholesterol ( r = −0.172, P<.01). Nonetheless, only eGWG was an independent risk factor (odds ratio = 3.18, 95% confidence interval = 1.26 to 7.88, P<.05) for macrosomia. The risk of macrosomia in pregnant women with prepregnancy BMI <25 kg/m2 or BMI ≥25 kg/m2 and eGWG was 3.39 and 3.27 times, respectively. Conclusion: The incidence rate of macrosomia is increased in women with ISGBG and eGWG is the strongest independent risk factor. In order to reduce the risk for macrosomia, timely lifestyle intervention to promote appropriate weight gain during pregnancy deserves evaluation. Abbreviations: AUC = area under the curve; BG = blood glucose; 1 hour BG = 1 hour blood glucose after OGTT; 2 hour BG = 2 hour blood glucose after OGTT; BMI = body mass index; CI = confidence interval; eGWG = excessive gestational weight gain; FBG = fasting blood glucose; FINS = fasting insulin; GDM = gestational diabetes mellitus; HbA1c = glycated hemoglobin; HDL-C = high-density lipoprotein cholesterol; HOMA-IR = homeostasis model assessment of insulin resistance index; ISGBG = intermediate state gestation blood glucose; LDL-C = low-density lipoprotein cholesterol; Ln = natural logarithm; MLBW = mature low birth weight; NGTG = normal glucose tolerance gestation; OGTT = oral glucose tolerance test; OR = odds ratio; SD = standard deviation

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