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

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.

Author(s):  
Kristen S. GIBBONS ◽  
Allan M.Z. CHANG ◽  
Ronald C.W. MA ◽  
Wing Hung TAM ◽  
Patrick M. CATALANO ◽  
...  

2012 ◽  
Vol 5 (2) ◽  
pp. 58-64 ◽  
Author(s):  
Linda A Barbour

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.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Despina Pampaka ◽  
Stefania I. Papatheodorou ◽  
Mohammad AlSeaidan ◽  
Rihab Al Wotayan ◽  
Rosalind J. Wright ◽  
...  

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.


Nutrients ◽  
2018 ◽  
Vol 10 (8) ◽  
pp. 1032 ◽  
Author(s):  
Laura Forbes ◽  
Jocelyn Graham ◽  
Casey Berglund ◽  
Rhonda Bell

Women often make dietary changes during pregnancy; however, dietary modifications and reasons for changes are not well studied. We aimed to describe the dietary changes made during pregnancy, describe reasons for dietary changes, and determine what changes aligned with recommendations. Pregnant women (n = 379) recruited to the Alberta Pregnancy Outcomes and Nutrition (APrON) study in 2009/2010 completed a questionnaire in which they described dietary changes made during pregnancy and reasons for those changes. Changes and reasons were coded into categories. Women commonly reported increasing their intake of milk products, fruit, and sweet items and commonly decreased or eliminated intake of caffeine, alcohol, and meats. Women frequently reduced intake of foods for the baby’s health and increased foods to satisfy cravings. Changes made commonly aligned with recommendations for caffeine, alcohol intake, food safety, milk and alternatives, and fruit. Changes contrary to recommendations were common for fish and meats. The dietary changes women make during pregnancy appear to reflect women’s efforts to balance physiological changes accompanying pregnancy with the desire for healthy pregnancy outcomes. Understanding the reasons behind dietary change during pregnancy will help researchers and health professionals design effective strategies and public health messages to promote healthier pregnancies.


Author(s):  
Sir Peter Gluckman ◽  
Mark Hanson ◽  
Chong Yap Seng ◽  
Anne Bardsley

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.


Author(s):  
Imasha Upulini Jayasinghe ◽  
Iresha Sandamali Koralegedara ◽  
Suneth Buddhika Agampodi

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.


2021 ◽  
Author(s):  
Amber L. Cathey ◽  
Deborah J. Watkins ◽  
Zaira Y. Rosario ◽  
Carmen M. Vélez Vega ◽  
Bhramar Mukherjee ◽  
...  

Abstract Adverse birth outcomes remain significant public health problems that can have long-lasting impacts on mother and child. Understanding biological mechanisms underlying these outcomes, including altered endocrine function, can inform prevention efforts. The aim of this study was to evaluate associations between hormones at two times points during mid-gestation and adverse birth outcomes, and to assess effect modification by fetal sex. Repeated gestational hormone measurements (at 18 and 26 weeks) and birth outcomes were assessed among 976 women in PROTECT, a longitudinal prospective birth cohort in northern Puerto Rico, from 2011 to 2018. Birth outcomes assessed included preterm and spontaneous preterm birth (PTB), preeclampsia, gestational diabetes mellitus (GDM), small/large for gestational age (SGA, LGA), birthweight z-score, and gestational age at birth. Multivariate logistic and linear regressions were fit using visit-specific concentrations of hormones. We also conducted sensitivity analyses assessing impacts of fetal sex on observed associations. All models were adjusted for maternal age and education, and other confounders were assessed separately between birth outcomes based on a priori knowledge and observed associations with exposure and outcome measures. We observed increased odds of spontaneous PTB with IQR increases in progesterone (OR: 2.12, 95% CI: 1.29, 3.47), fT4 (OR: 1.73, 95% CI: 1.04, 2.86), and the ratio of progesterone to estriol (OR: 1.63, 95% CI: 1.05, 2.54) at 26 weeks. Elevated estriol was protective against preeclampsia at 26 weeks (OR: 0.42, 95% CI: 0.17, 0.99). Increases in TSH and T3 conferred greater risk of GDM at 18 weeks. Many associations were modified by fetal sex, with hormone alterations during male pregnancies conferring greater risk of PTB, spontaneous PTB, and GDM. In conclusion, associations between hormones and birth outcomes vary based on timing of hormone measurement and fetal sex. Future studies are needed to understand mechanisms involved in adverse birth outcomes and fetal sex differences.


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