Maternal body mass index modifies the impact of negative energy balance during lactation on infant weight and length gain in HIV‐exposed, uninfected Malawian females

Background: The incidence of obesity has increased to pandemic proportions over the last 20 years. Maternal obesity is associated with a wide array of adverse maternal pregnancy outcomes and increased risks in the offspring. The aim of the study was to find the effect of obesity on maternal and perinatal outcome in obese women in comparison to those of normal weight women.Methods: The study was designed as a case-control study. Antenatal women with first trimester body mass index (BMI) of more than 30 kg/m2 constituted the cases and those with BMI between 18 and 24.9 kg/m2 formed the controls.Results: There was increased incidence of antepartum complications in obese women. Obese women had a significant history of prior treatment for infertility (p<0.00001). The incidence of gestational diabetes (OR 4.76, 95%CI 1.267-17.72 p=0.014), gestational hypertension (OR 3.05, 95%CI 1.01-9.20 p=0.04), induction of labor (OR 2.5, 95%CI 1.0-6.28 p=0.04), preeclampsia (OR 2.38, 95%CI 1.0-5.64 p=0.04, Caesarean section (OR 1.98, 95%CI 1.24-3.14 p=0.003), postpartum haemorrhage (OR 8.57, 95%CI 1.07-76.15 p=0.04) and wound infection (OR 8.57, 95%CI 1.07-76.15 p=0.04) and adverse neonatal outcomes such as higher mean birth weight (p<0.0001) and requirement of NICU (OR 2.79, 95%CI 1.33 -5.84 p=0.006) was higher in obese women.Conclusions: Obesity is an independent risk factor for adverse pregnancy outcomes and hence, interventions directed towards weight loss and prevention of excessive weight gain must begin in the preconception period.

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Preconception Micronutrient Supplementation Affects Maternal Body Mass Index Post-Partum: A Randomized Controlled Trial in Vietnam

Current Developments in Nutrition ◽

10.1093/cdn/nzaa053_097 ◽

2020 ◽

Vol 4 (Supplement_2) ◽

pp. 892-892

Author(s):

Usha Ramakrishnan ◽

Melissa Young ◽

Long Khuong ◽

Lan Mai Tran ◽

Thai Hong Duong ◽

...

Keyword(s):

Body Mass Index ◽

Randomized Controlled Trial ◽

Body Mass ◽

Post Partum ◽

Controlled Trial ◽

Intervention Group ◽

Anthropometric Measurements ◽

Maternal Body Mass Index ◽

Randomized Controlled ◽

The Impact

Abstract Objectives While there is growing evidence on the role of preconception nutrition for birth outcomes, very few studies have evaluated the effects of nutrition interventions during the preconception period on maternal health. This study evaluates the impact of preconception weekly multiple micronutrients (MM) or iron and folic acid (IFA) supplementation compared to FA alone on maternal nutritional status through 6–7y post-partum (PP). Methods We followed women who participated in a randomized controlled trial of preconception supplementation in Vietnam and delivered live offspring (n = 1599). Women received weekly supplements containing either 2800 μg FA only, 60 mg iron and 2800 μg FA, or MM (15 micronutrients including IFA), from baseline until conception; followed by daily prenatal IFA supplements until delivery. Anthropometric measurements were obtained at recruitment and at 2 and 6–7 y PP. Group comparisons were done using ANOVA or chi-square tests. Results The groups were similar for baseline (preconception) maternal and offspring birth characteristics. Mean (SD) Body Mass Index (BMI; kg/m2) increased from 19.6 (2.1) at baseline, to 20.4 (2.4) and 21.6 (2.8) at 2 and 6–7 y PP (n = 931). The prevalence of overweight (BMI ≥ 23.5 kg/m2) also increased from 4.7% to 9% and 21%, at baseline, 2, and 6–7 years PP respectively, while underweight (BMI < 18.5 kg/m2) declined from 31.4% to 21.4% and 10%, respectively. At 6–7 y PP, we found significant differences (P < 0.01) by intervention group for mean BMI (MM: 22.0 (2.4), IFA: 21.6 (2.7); FA:21.4 (2.9)), and the prevalence of underweight (MM: 5.1%, IFA: 10.1%; FA:14.4%), but no differences in overweight (MM: 21.3%, IFA:20.3%; FA:21.3%), or other anthropometric measurements (weight to hip ratio, arm circumference and skinfold thickness). Conclusions Preconception supplementation with MM resulted in higher BMI and greater reductions in maternal underweight when compared to IFA and FA only. The prevalence of overweight increased dramatically over time but there with no differences by intervention group at 6–7 y PP. These findings suggest that preconception micronutrient interventions may have long term effects on maternal BMI that need to be further examined. Funding Sources The Nestle Foundation, the Mathile Institute, and the Micronutrient Initiative.

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Evidence of negative energy balance using doubly labelled water in elite Kenyan endurance runners prior to competition

British Journal Of Nutrition ◽

10.1079/bjn20051608 ◽

2006 ◽

Vol 95 (1) ◽

pp. 59-66 ◽

Cited By ~ 51

Author(s):

Barry W. Fudge ◽

Klaas R. Westerterp ◽

Festus K. Kiplamai ◽

Vincent O. Onywera ◽

Michael K. Boit ◽

...

Keyword(s):

Energy Balance ◽

Energy Intake ◽

Body Mass ◽

Negative Energy ◽

Negative Energy Balance ◽

Endurance Running ◽

Doubly Labelled Water ◽

Endurance Runners ◽

Intense Training ◽

Heavy Training

Previous studies have found Kenyan endurance runners to be in negative energy balance during training and prior to competition. The aim of the present study was to assess energy balance in nine elite Kenyan endurance runners during heavy training. Energy intake and expenditure were determined over 7d using weighed dietary intake and doubly labelled water, respectively. Athletes were on average in negative energy balance (mean energy intake 13 241 (SD 1330) kJ/d v. mean energy expenditure 14 611 (SD 1043) kJ/d; P=0·046), although there was no loss in body mass (mean 56·0 (SD 3·4) kg v. 55·7 (SD 3·6) kg; P=0·285). The calculation of underreporting was 13; (range −24 to +9%) and almost entirely accounted for by undereating (9% (range −55 to +39%)) as opposed to a lack of significant underrecording (i.e. total water intake was no different from water loss (mean 4·2 (SD 0·6) l/d v. 4·5 (SD 0·8) l/d; P=0·496)). Fluid intake was modest and consisted mainly of water (0·9 (SD 0·5) l/d) and milky tea (0·9 (SD 0·3) l/d). The diet was high in carbohydrate (67·3 (SD 7·8) %) and sufficient in protein (15·3 (SD 4·0) %) and fat (17·4 (SD 3·9) %). These results confirm previous observations that Kenyan runners are in negative energy balance during periods of intense training. A negative energy balance would result in a reduction in body mass, which, when combined with a high carbohydrate diet, would have the potential in the short term to enhance endurance running performance by reducing the energy cost of running.

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Does Fetal Sex Influence the Risk of Preterm Delivery in Dichorionic Twin Pregnancies After Spontaneous Conception?

Twin Research and Human Genetics ◽

10.1375/twin.13.5.495 ◽

2010 ◽

Vol 13 (5) ◽

pp. 495-500 ◽

Cited By ~ 6

Author(s):

Katharina Klein ◽

Christof Worda ◽

Maria Stammler-Safar ◽

Peter Husslein ◽

Norbert Gleicher ◽

...

Keyword(s):

Body Mass Index ◽

Preterm Delivery ◽

Body Mass ◽

Maternal Age ◽

Maternal Body Mass Index ◽

Fetal Sex ◽

Spontaneous Conception ◽

Spontaneous Preterm Delivery ◽

The Impact ◽

Twin Pregnancies

Objective: The incidence of preterm delivery has been increasing, and our aim was to estimate the influence of fetal sex on the risk of preterm delivery in dichorionic twins after spontaneous conception.Methods: 125 spontaneously conceived dichorionic twin gestations, with viable fetuses, born after 24 weeks and delivered spontaneously before 37 weeks, were enrolled. The impact of fetal sex, previous preterm delivery, maternal age, body-mass-index, smoking, and parity on gestational age at birth were evaluated.Results: Despite similar baseline characteristics in all three groups, women with one or two male fetuses delivered significantly more often before 34 weeks than patients with two female fetuses, 48% (23/48) and 43% (19/44) vs 21% (7/33),p= .04. Regression analyses, including fetal sex, maternal age, maternal body-mass-index, smoking, previous preterm delivery and parity, revealed that only fetal sex was significantly associated with spontaneous preterm delivery (p= .03).Conclusion: Fetal sex appears to be a risk factor for preterm delivery in spontaneously conceived dichorionic twin gestations. Twin pregnancies with one or two male fetuses seem to be at higher risk for spontaneous preterm delivery than those with only females.

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The Impact of Obesity on Operative Time and Blood Loss during Cesarean Delivery

Gynecology and Women's Health Research ◽

10.16966/2689-3096.105 ◽

2019 ◽

Vol 1 (1) ◽

Author(s):

Roeckner JT ◽

Sanchez-Ramos L ◽

Kaunitz A

Keyword(s):

Body Mass Index ◽

Blood Loss ◽

Cesarean Delivery ◽

Body Mass ◽

Operative Time ◽

Maternal Body Mass Index ◽

Maternal Body ◽

Apgar Scores ◽

The Impact

Objective: To test the hypothesis that increased maternal body mass index (BMI) is associated with longer operative and anesthesia times, increasing blood loss, and lower APGAR scores.

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