Plasma Acylcarnitines During Pregnancy and Neonatal Anthropometry: A Longitudinal Study in a Multiracial Cohort

Abstract Objectives Plasma profile of acylcarnitines has been suggested to associate with adverse maternal outcomes such as gestational diabetes. However, data on their associations with neonatal outcomes are sparse. Therefore, this study aimed to examine the prospective profile of acylcarnitines across gestation and its association with neonatal anthropometry, including birthweight (BW), BW z-score, the sum of skinfolds (SSF), length, and circumferences. Methods Among 321 pregnant women from the NICHD Fetal Growth Studies-Singletons cohort, we quantified 28 acylcarnitines using electrospray ionization tandem mass spectrometry in the plasma at gestational weeks 10–14, 15–26, 23–31 and 33–39, accordingly. We firstly applied a latent-class trajectory approach to identify trajectories of acylcarnitines across gestation, and secondly examined associations of individual acylcarnitine and distinct trajectory groups with neonatal anthropometry using weighted linear models with robust standard errors, adjusting for maternal age, race/ethnicity, education, parity, gestational week of blood collection, and pre-pregnancy body mass index. Results We identified three distinct trajectory groups of C2, C3 and C4, and two trajectory groups of C5, C10, C5-DC, C8:1, C10:1 and C12, respectively. Newborns of women with nonlinear decline of C12 levels across gestation (5.7%) had significantly smaller BW (−475 g; 95% CI: −942, −6.79 g), BW z-score (−0.39; −0.71, −0.06), and length (−1.38 cm; −2.49, −0.27 cm) than those with persistently stable C12 levels (94.3%). Newborns of women with consistently higher levels of C10 (6.1%) had greater sum of skinfolds (4.91 mm; 0.85, 8.98 mm) than those with lower levels (93.9%) across pregnancy, whereas newborns of women with declining C10:1 levels (12.6%) had larger sum of skinfolds (3.23 mm; 0.19, 6.27 mm) than those with abruptly increasing levels (87.4%). Conclusions In conclusion, gestational trajectories of C10, C10:1, and C12 acylcarnitine levels were significantly associated with neonatal anthropometry. Further studies are needed to verify and further explore the potential clinical utility of these findings. Funding Sources Eunice Kennedy Shriver National Institute of Child Health and Human Development intramural funding; American Recovery and Reinvestment Act funding.

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Plasma Acylcarnitines during Pregnancy and Neonatal Anthropometry: A Longitudinal Study in a Multiracial Cohort

Metabolites ◽

10.3390/metabo11120885 ◽

2021 ◽

Vol 11 (12) ◽

pp. 885

Author(s):

Yiqing Song ◽

Chen Lyu ◽

Ming Li ◽

Mohammad L. Rahman ◽

Zhen Chen ◽

...

Keyword(s):

Latent Class ◽

Linear Models ◽

P Value ◽

Blood Collection ◽

Z Score ◽

Cardiometabolic Disorders ◽

Trajectory Approach ◽

Body Circumferences ◽

Lower Birthweight

As surrogate readouts reflecting mitochondrial dysfunction, elevated levels of plasma acylcarnitines have been associated with cardiometabolic disorders, such as obesity, gestational diabetes, and type 2 diabetes. This study aimed to examine prospective associations of acylcarnitine profiles across gestation with neonatal anthropometry, including birthweight, birthweight z score, body length, sum of skinfolds, and sum of body circumferences. We quantified 28 acylcarnitines using electrospray ionization tandem mass spectrometry in plasma collected at gestational weeks 10–14, 15–26, 23–31, and 33–39 among 321 pregnant women from the National Institute of Child Health and Human Development (NICHD) Fetal Growth Studies-Singletons. A latent-class trajectory approach was applied to identify trajectories of acylcarnitines across gestation. We examined the associations of individual acylcarnitines and distinct trajectory groups with neonatal anthropometry using weighted generalized linear models adjusting for maternal age, race/ethnicity, education, parity, gestational age at blood collection, and pre-pregnancy body mass index (BMI). We identified three distinct trajectory groups in C2, C3, and C4 and two trajectory groups in C5, C10, C5–DC, C8:1, C10:1, and C12, respectively. Women with nonlinear decreasing C12 levels across gestation (5.7%) had offspring with significantly lower birthweight (−475 g; 95% CI, −942, −6.79), birthweight z score (−0.39, −0.71, −0.06), and birth length (−1.38 cm, −2.49, −0.27) than those with persistently stable C12 levels (94.3%) (all nominal p value < 0.05). Women with consistently higher levels of C10 (6.1%) had offspring with thicker sum of skinfolds (4.91 mm, 0.85, 8.98) than did women with lower levels (93.9%) during pregnancy, whereas women with lower C10:1 levels (12.6%) had offspring with thicker sum of skinfolds (3.23 mm, 0.19, 6.27) than did women with abruptly increasing levels (87.4%) (p < 0.05). In conclusion, this study suggests that distinctive trajectories of C10, C10:1, and C12 acylcarnitine levels throughout pregnancy were significantly associated with neonatal anthropometry.

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Abstract P166: Plasma Acylcarnitines During Pregnancy And Neonatal Anthropometry: A Prospective And Longitudinal Study

Circulation ◽

10.1161/circ.143.suppl_1.p166 ◽

2021 ◽

Vol 143 (Suppl_1) ◽

Author(s):

Yiqing Song ◽

Chen Lyu ◽

Ming Li ◽

Mohammad Rahman ◽

Yeyi Zhu ◽

...

Keyword(s):

Generalized Linear Models ◽

Clinical Utility ◽

Latent Class ◽

Linear Models ◽

Distinct Group ◽

Blood Collection ◽

Z Score ◽

Cardiometabolic Disorders ◽

Trajectory Approach

As surrogate readouts reflecting tissue acyl-CoA pools, elevated levels of plasma acylcarnitines have been associated with cardiometabolic disorders, such as obesity, gestational diabetes, and type 2 diabetes. This study aimed to examine prospective associations of acylcarnitine profiles across gestation with neonatal anthropometry, including birthweight (BW), BW z-score, the sum of skinfolds (SS), body length, and head circumference. We quantified 28 acylcarnitines using electrospray ionization tandem mass spectrometry in plasma collected at gestational weeks 10-14, 15-26, 23-31 and 33-39 among 321 pregnant women from the NICHD Fetal Growth Studies-Singletons and performed latent-class trajectory approach to identify trajectories of acylcarnitines across gestation. We examined the associations of individual acylcarnitines and distinct trajectory groups with neonatal outcomes using weighted generalized linear models adjusting for maternal age, race, education, parity, gestational age of blood collection, and pre-pregnancy BMI. Women showed changes in plasma levels of all acylcartinines across gestation and had at least two significantly distinct group-based trajectories for 32% of acylcartinines. Longitudinally, women with increased C12 levels across gestation (5.7%) had significantly smaller BW (-475 g; 95% CI, -942, -6.79), BW z-score (-0.39, 95% CI, -0.71, -0.06), and length (-1.38, 95% CI, -2.49, -0.27) than those with persistently stable C12 levels during pregnancy (all FDR<0.05). Women with persistently higher levels of C10 (6.1%) or C10:1 (87.4%) had greater sum of skinfolds (4.91, 95%, 0.85, 8.98) than those with lower levels during pregnancy (P<0.05). In conclusion, this study identified that gestational trajectories of C10, C10:1, and C12 acylcarnitine levels were significantly associated with neonatal anthropometry. Further studies are needed to replicate and assess clinical utility of these findings.

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Longitudinal Maternal Vitamin D Status during Pregnancy Is Associated with Neonatal Anthropometric Measures

Nutrients ◽

10.3390/nu10111631 ◽

2018 ◽

Vol 10 (11) ◽

pp. 1631 ◽

Cited By ~ 5

Author(s):

Ellen Francis ◽

Stefanie Hinkle ◽

Yiqing Song ◽

Shristi Rawal ◽

Sarah Donnelly ◽

...

Keyword(s):

Vitamin D ◽

Linear Models ◽

Z Score ◽

Anthropometric Measures ◽

Hydroxyvitamin D ◽

Prepregnancy Bmi ◽

Z Scores ◽

Gestational Week ◽

25 Hydroxyvitamin D ◽

Lower Birthweight

Findings on maternal 25-hydroxyvitamin D (25[OH]D) and neonatal anthropometry are inconsistent, and may at least be partly due to variations in gestational week (GW) of 25(OH)D measurement and the lack of longitudinal 25(OH)D measurements across gestation. The aim of the current study was to examine the associations of longitudinal measures of maternal 25(OH)D and neonatal anthropometry at birth. This study included 321 mother–offspring pairs enrolled in the Eunice Kennedy Shriver National Institute of Child Health and Human Development Fetal Growth Studies–Singletons. This study was a prospective cohort design without supplementation and without data on dietary supplementation. Nevertheless, measurement of plasma 25(OH)D reflects vitamin D from different sources, including supplementation. Maternal concentrations of total 25(OH)D were measured at 10–14, 15–26, 23–31, and 33–39 GW and categorized as <50 nmol/L, 50–75 nmol/L, and >75 nmol/L. Generalized linear models were used to examine associations of 25(OH)D at each time-point with neonate birthweight z-score, length, and sum of skinfolds at birth. At 10–14 GW, 16.8% and 49.2% of women had 25(OH)D <50 nmol/L and between 50–75 nmol/L, respectively. The association of maternal 25(OH)D with neonatal anthropometry differed by GW and women’s prepregnancy BMI (normal (<25.0 kg/m2), overweight/obese (25.0–44.9 kg/m2)). All analyses were stratified by prepregnancy BMI status. Among women with an overweight/obese BMI, 25(OH)D <50 nmol/L at 10–14 GW was associated with lower birthweight z-score (0.56; 95% CI: −0.99, −0.13) and length (−1.56 cm; 95% CI: −3.07, −0.06), and at 23–31 GW was associated with shorter length (−2.77 cm; 95% CI: −13.38, −4.98) and lower sum of skinfolds (−9.18 mm; 95% CI: −13.38, −4.98). Among women with a normal BMI, 25(OH)D <50 nmol/L at 10–14 GW was associated with lower sum of skinfolds (−2.64 mm; 95% CI: −5.03, −0.24), at 23–31 GW was associated with larger birthweight z-scores (0.64; 95% CI: 0.03, 1.25), and at 33-39 GW with both higher birthweight z-score (1.22; 95% CI: 0.71, 1.73) and longer length (1.94 cm; 95% CI: 0.37, 3.52). Maternal 25(OH)D status during pregnancy was associated with neonatal anthropometric measures, and the associations were specific to GW of 25(OH)D measurement and prepregnancy BMI.

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Abstract P171: A Longitudinal Study Of Maternal Thyroid Hormone Trajectories And Neonatal Anthropometric Measures

Circulation ◽

10.1161/circ.143.suppl_1.p171 ◽

2021 ◽

Vol 143 (Suppl_1) ◽

Author(s):

Shristi Rawal ◽

Lauren Berube ◽

Stefanie Hinkle ◽

Jing Wu ◽

Cuilin Zhang

Keyword(s):

Thyroid Hormones ◽

Fetal Growth ◽

Latent Class ◽

Blood Collection ◽

Z Score ◽

Linear Regression Models ◽

Anthropometric Measures ◽

Infant Sex ◽

Maternal Thyroid ◽

In Pregnancy

Introduction: Maternal thyroid hormones (TH) are essential for fetal growth and development. While prior studies have examined associations of TH with birthweight (BW), data on other neonatal anthropometric measures are scarce. Here we aimed to examine relations between TH and its trajectory across pregnancy with neonatal anthropometrics in a multi-racial pregnancy cohort. Hypothesis: We hypothesized that distinct TH trajectories across gestation would explain differences in neonatal anthropometrics including BW, length and sum of skinfolds (SSF). Methods: We used longitudinal data from 321 women who were included in a gestational diabetes (GDM) case-control study nested within the NICHD Fetal Growth Studies-Singletons Cohort (n=2802). Plasma free triiodothyronine (fT3), free thyroxine (fT4) and thyroid-stimulating hormone (TSH) were measured, and fT3/fT4 ratio was derived, using blood samples collected at gestational weeks (GW) 10-14, 15-26, 23-31 and 33-39. TH trajectories were identified using a latent class trajectory approach. BW was abstracted from medical records. Neonatal length and SSF were measured. To examine associations between TH levels and neonatal outcomes, we used weighted linear regression models, adjusted for maternal age, race/ethnicity, GW at blood collection, pre-pregnancy BMI, education, parity, infant sex, GDM diagnosis (33-39 GW only) and number of days post-delivery (length and SSF only). Results: Overall, neonates of women in the highest fT3 tertile at 33-39 GW had marginally higher BW (β: 205.5 g, 95% CI -23.4, 434.4) and BW z-score (β: 0.4, 95% CI 0.0, 0.8) than neonates of women in the lowest tertile. Significant interactions were observed by infant sex for associations of fT4 and BW, BW z-score and neonatal length (all p for interactions <0.05). Specifically, female neonates of women in the highest fT4 tertile had lower BW, BW z-score and length than those in the lowest tertile at 15-26 (β BW -416.3 g, 95% CI -753.7, -79.0; β BW zscore -0.5, 95% CI -0.9, -0.1; β length -1.5 cm, 95% CI -2.8, -0.1, respectively) and 23-31 GW (β BW -357.0 g, 95% CI -635.6, -78.4; β BW zscore -0.7, 95% CI -1.3, -0.1; β length -1.8 cm, 95% CI -3.3, -0.2, respectively). Across gestation, a low fT3 trajectory (class size 5.5%) was associated with lower neonatal SSF (β: -3.2 mm, 95% CI -6.0, -0.5) than an intermediate/referent trajectory (60.1%). A high fT3/fT4 ratio trajectory (16.2%) was associated with higher BW (β: 300.5 g, 95% CI 41.7, 559.4), BW z-score (β: 0.6, 95% CI 0.3, 0.8), and neonatal SSF (β: 3.3 mm, 95% CI 0.7, 5.9) than an intermediate/referent trajectory (44.3%). Conclusions: Our study suggests that both overall TH trajectory across gestation and TH levels at specific timepoints in pregnancy may be related to neonatal anthropometrics, with associations varying by infant sex. These novel data support the significance of monitoring thyroid hormones longitudinally in pregnancy.

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Maternal Proinflammatory Adipokines Throughout Pregnancy and Neonatal Size and Body Composition: A Prospective Study

Current Developments in Nutrition ◽

10.1093/cdn/nzab113 ◽

2021 ◽

Author(s):

Ellen C Francis ◽

Mengying Li ◽

Stefanie N Hinkle ◽

Jinbo Chen ◽

Jing Wu ◽

...

Keyword(s):

Prospective Study ◽

Fetal Growth ◽

Linear Models ◽

Blood Collection ◽

Fatty Acid Binding ◽

Race Ethnicity ◽

A Prospective Study ◽

Insight Into ◽

Maternal Adiposity ◽

In Pregnancy

ABSTRACT BACKGROUND Increased maternal adiposity and inflammation have impacts on fetal growth. OBJECTIVES The purpose of this prospective study was to investigate the associations of three proinflammatory adipokines in pregnancy with neonatal anthropometry. METHODS In a sample of 321 U.S pregnant women from the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) Fetal Growth Studies-Singleton Cohort (NCT00912132), plasma interleukin (IL)-6, fatty acid binding protein-4 (FABP4), and chemerin were measured in plasma samples collected at 10–14, 15–26, 23–31, and 33–39 gestational weeks (GW). Generalized linear models were used to estimate associations of adipokines with neonatal weight, thigh and crown-heel length, and skinfolds at birth. Models adjusted for age, race/ethnicity, education, nulliparity, prepregnancy body mass index (BMI), and GW at blood collection. RESULTS At each time-point, higher IL-6 was associated with lower neonatal birthweight and thigh length. At 15–26 GWs, a one standard deviation pg/ml increase in IL-6 was associated with -84.46 g lower neonatal birthweight (95% Confidence Interval [CI]: -150.70, -18.22), -0.17 cm shorter thigh length (95% CI: -0.27, -0.07), -0.43 cm shorter crown-heel length (95% CI: -0.75, -0.10), and -0.75 mm smaller sum of skinfolds (95% CI: -1.19, -0.31), with similar associations at 23–31 and 33–39 GWs. There were no associations of FABP4 and chemerin with neonatal anthropometry. CONCLUSIONS Starting as early as 15 GWs, higher maternal IL-6 concentrations in pregnancy were associated with smaller neonatal birthweight, thigh and crown-heel length, and skinfolds. These data provide insight into the relevance of maternal inflammatory markers with neonatal anthropometry.

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Associations of Maternal Non-Nutritive Sweetener Intake During Pregnancy with Childhood BMI Trajectory

Current Developments in Nutrition ◽

10.1093/cdn/nzaa054_130 ◽

2020 ◽

Vol 4 (Supplement_2) ◽

pp. 1058-1058

Author(s):

Jasmine Plows ◽

Izzuddin Aris ◽

Sheryl Rifas-Shiman ◽

Michael Goran ◽

Emily Oken

Keyword(s):

Smoking Status ◽

National Institutes Of Health ◽

Z Score ◽

Linear Regression Models ◽

Funding Sources ◽

Diet Soda ◽

Pregnancy Smoking ◽

Race Ethnicity ◽

Clinical Measures ◽

Bmi Trajectory

Abstract Objectives To examine the extent to which non-nutritive sweetener (NNS; e.g., aspartame) intake during pregnancy is associated with offspring BMI z-score trajectory from birth to 15 years. Methods We included 1683 mother-child pairs from Project Viva, a prospective pre-birth-cohort recruited in 1999–2002 in Massachusetts. The main exposure was maternal NNS intake assessed in the 1st and 2nd trimesters of pregnancy using a food frequency questionnaire. We defined NNS as servings/day of diet soda + NutraSweet (aspartame packets) averaged across 1st and 2nd trimesters. We used linear regression models to examine associations of maternal NSS intake with offspring BMI z-score at each in-person research visit (birth, 6 months, 3 years, 7 years, and 12 years). We also used mixed-effects models to examine associations with BMI z-score trajectory from birth to 15 years, including both research and clinical measures of BMI for 1570 participants with ≥3 BMI z-score values. We adjusted all models for maternal pre-pregnancy BMI, age, race/ethnicity, education, parity, and pregnancy smoking status. Results 70% of mothers were white and mean (SD) pre-pregnancy BMI was 24.6 (5.2) kg/m2. Mean (SD; IQR) intake of NNS was 0.23 (0.55; 0.22) servings/day. While maternal NNS intake (per servings/day) was not associated with BMI z-score at birth (β −0.03 units; 95% CI −0.14, 0.08), NNS was associated with higher BMI z-score at 6 months (β 0.17; 0.06, 0.28), 3 years (β 0.13; 0.03, 0.24), 7 years (β 0.16; 0.04, 0.29) and 12 years (β 0.16; 0.01, 0.31). Based on the BMI z-score trajectory, the associations of NNS intake (Q4 vs. Q1) with BMI z-score became stronger with increasing age from 3–14 years (pinteraction with age: <0.01); e.g., 3 years (β 0.13; 0.02, 0.23), 7 years (β 0.24; 0.11, 0.37) and 12 years (β 0.38; 0.20, 0.57). Conclusions Our findings showed higher maternal NNS intake during pregnancy was associated with higher BMI z-score from childhood to early adolescence, and the associations strengthened with increasing age. Funding Sources US National Institutes of Health (R01 HD034568, UH3 OD023286).

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Neurogenic Bladder in Patients with Mylomeningocele in Pediatric Age

10.53350/pjmhs211551348 ◽

2021 ◽

Vol 15 (5) ◽

pp. 1348-1352

Author(s):

M. S. M. Albayati ◽

A. A. Rasheed ◽

A. A. Sulaiman

Keyword(s):

Physical Activity ◽

Renal Function ◽

Neurogenic Bladder ◽

Medical Records ◽

Social Situation ◽

Pediatric Age ◽

Z Score ◽

Process Failure ◽

Function Preservation ◽

Race Ethnicity

Myelomeningocele (MMC) is congenital nervous system malformation caused by neurulation process failure during pregnancy. The prevalence varies by the continent, region, race, ethnicity and the time when assessed and patients present abnormalities of different organs. One of the most severe complications is renal failure. Aim: Clinical evaluation of patients with MMC in Iraq and answering the question whether our treatment methods lead to renal function preservation. Material and methods: Medical records of 28 patients in the period 2014.2019were evaluated retrospectively. The data included: age, sex, BMI Z-score WHO, place of residence, perinatal history, social situation, physical activity, urodynamic diagnosis, renal function, hydrocephalus diagnosis, and functioning of shunting procedures. Results: They were no statistically significant differences in most studied parameters between boys and girls. Keywords: Meningomyelocele, Epidemiological study, Neurogenic bladder, Renal function

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Maternal Exposure to Indoor Air Pollution and Birth Outcomes

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph16081364 ◽

2019 ◽

Vol 16 (8) ◽

pp. 1364 ◽

Cited By ~ 5

Author(s):

Peter Franklin ◽

Mark Tan ◽

Naomi Hemy ◽

Graham L. Hall

Keyword(s):

Air Pollution ◽

Pregnant Women ◽

Birth Outcomes ◽

Indoor Air ◽

Indoor Air Pollution ◽

Linear Models ◽

Ambient Air ◽

Ambient Air Pollution ◽

Z Score ◽

Birth Records

There is a growing body of research on the association between ambient air pollution and adverse birth outcomes. However, people in high income countries spend most of their time indoors. Pregnant women spend much of that time at home. The aim of this study was to investigate if indoor air pollutants were associated with poor birth outcomes. Pregnant women were recruited prior to 18 weeks gestation. They completed a housing questionnaire and household chemical use survey. Indoor pollutants, formaldehyde (HCHO), nitrogen dioxide (NO2) and volatile organic compounds (VOCs), were monitored in the women’s homes at 34 weeks gestation. Gestational age (GA), birth weight (BW) and length (BL) and head circumference (HC) were collected from birth records. The associations between measured pollutants, and pollution surrogates, were analysed using general linear models, controlling for maternal age, parity, maternal health, and season of birth. Only HCHO was associated with any of the birth outcomes. There was a 0.044 decrease in BW z-score (p = 0.033) and 0.05 decrease in HC z-score (p = 0.06) for each unit increase in HCHO. Although HCHO concentrations were very low, this finding is consistent with other studies of formaldehyde and poor birth outcomes.

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Clostridioides Difficile Colonization Is Differentially Associated with Gut Microbiota Composition in Breastfed versus Formula Fed Infants (OR01-02-19)

Current Developments in Nutrition ◽

10.1093/cdn/nzz040.or01-02-19 ◽

2019 ◽

Vol 3 (Supplement_1) ◽

Author(s):

Kelsea Drall ◽

Hein Tun ◽

Meghan B Azad ◽

David Guttman ◽

Malcolm Sears ◽

...

Keyword(s):

Gut Microbiota ◽

Fecal Sample ◽

Pathogenic Bacteria ◽

Linear Models ◽

Microbiota Composition ◽

Breastfed Infants ◽

Funding Sources ◽

Child Study ◽

Clostridioides Difficile ◽

Gut Microbiota Composition

Abstract Objectives Colonization with Clostridioides difficile occurs in up to half of infants and is predicted by formula feeding. Although this microbe does not appear to pose any immediate risks for infants, its presence has been associated with susceptibility to chronic disease later in childhood, perhaps by promoting changes in the gut microbiome that may increase opportunity for colonization of pathogenic bacteria. We explored these compositional changes in exclusively breastfed, partially breastfed and exclusively formula fed infants to describe the microbial community and C. difficile colonization in infants with distinct diets. Methods This study includes 1562 infants enrolled in the Canadian Healthy Infant Longitudinal Development (CHILD) Study. Infants provided a fecal sample at 3–4 months of age (Mean: 3.56, SD: 1.00) which was analyzed using 16S rRNA sequencing and targeted qPCR for C. difficile. Mode of feeding was recorded in a questionnaire at a 3 month follow-up visit. C. difficile colonization was defined as positive detection (CD+) in the fecal sample (reference: not present, CD-). Multivariate association with linear models (MaAslin) was used to determine changes in microbiota composition following arsine-square root transformation of relative abundances and FDR correction. Results The prevalence of C. difficile colonization among all infants was 30.9%. Colonization rates differed among feeding groups: 22.63% of exclusively breastfed infants, 35.96% of partially breastfed infants and 49.63% of exclusively formula fed infants (P < 0.001). Microbes of the genus Bifidobacterium were decreased in CD + exclusively breastfed infants compared to non-carriers of the same diet (q = 0.02). Additionally, Blautia, Coprococcus and Clostridium, of the Lachnospiraceae family, and microbes of the Bacteroidetes phylum were of higher relative abundance (all q < 0.01) in breastfed CD + infants (both partial and exclusive). In exclusively formula fed infants, C. difficile colonization was not significantly associated with microbiota composition. Conclusions C. difficile colonization may have a dysbiotic effect on the gut microbiota composition of breastfed infants, changes which have previously been associated with childhood atopy and obesity. Funding Sources Canadian Institutes of Health Research (CIHR). AllerGen Network of Centres of Excellence (NCE)

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The Relationship Between Gestational Weight Gain, Pre-pregnancy BMI, and Prenatal Diet Quality (P18-039-19)

Current Developments in Nutrition ◽

10.1093/cdn/nzz039.p18-039-19 ◽

2019 ◽

Vol 3 (Supplement_1) ◽

Author(s):

Haley Parker ◽

Karen McCurdy ◽

Alison Tovar ◽

Maya Vadiveloo

Keyword(s):

Weight Gain ◽

Gestational Weight Gain ◽

Diet Quality ◽

Linear Models ◽

Maternal Diet ◽

Normal Weight ◽

Sensitivity Analyses ◽

Gestational Weight ◽

Funding Sources ◽

The Relationship

Abstract Objectives Gestational weight gain (GWG) may reflect dynamic changes to prenatal diet quality, however, this relationship has been understudied. This study explored the relationship between GWG, pre-pregnancy BMI, and prenatal diet quality. Methods A secondary analysis examined a subset of 1268 women in the longitudinal Infant Feeding Practices Study (IFPS II) with 3rd trimester Diet History Questionnaire data. Diet quality was assessed with the Alternative Health Eating Index for Pregnancy (AHEI-P). Self-reported pre-pregnancy BMI, and total GWG (72% response rate) were used to classify GWG as inadequate (I), adequate (A), and excessive (E) according to the Institute of Medicine's recommendations. Tukey-adjusted generalized linear models, adjusting for sociodemographic factors, Women, Infants, and Children participation, parity, and energy intake, compared GWG groups on mean AHEI-P scores. The interaction between pre-pregnancy BMI and GWG group was tested and if significant, models were stratified by BMI group. Sensitivity analyses using multiply imputed GWG data were conducted. Results On average, AHEI-P scores were 61.3 (of 130), women were 28.9 years, higher socioeconomic status (40% college graduates) and mostly non-Hispanic White (84%). Pre-pregnancy BMI and GWG were inversely associated with AHEI-P scores (P < 0.0001). The association between GWG and diet quality was modified by BMI group (P = 0.04). In stratified adjusted analyses, GWG was associated with AHEI-P scores (P < 0.05) among women with pre-pregnancy underweight (I = 54.4 ± 3.9, A = 59.7 ± 3.6, E = 63.5 ± 3.5), normal weight (I = 59.2 ± 1.5, A = 61.0 ± 1.2, E = 59.3 ± 1.2), overweight (I = 62.3 ± 2.9, A = 60.7 ± 1.6, E = 59.4 ± 1.5), and obesity (I = 59.2 ± 1.8, A = 57.8 ± 2.0, E = 60.6 ± 1.5). However, no significant post-hoc differences between GWG groups were observed among any of the pre-pregnancy BMI groups. Findings from the multiple imputation analysis did not differ from complete case analysis findings. Conclusions GWG and prenatal diet quality differed according to pre-pregnancy BMI in this study. Adherence to GWG recommendations during pregnancy is an important predictor of maternal diet quality and should be examined in conjunction with pre-pregnancy BMI. Funding Sources There are no funding sources to disclose.

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