Predictors of Postpartum Exercise According to Prepregnancy Body Mass Index and Gestational Weight Gain

2017 ◽  
Vol 14 (10) ◽  
pp. 797-807 ◽  
Author(s):  
Danielle Symons Downs ◽  
Krista S. Leonard ◽  
Jessica S. Beiler ◽  
Ian M. Paul
Keyword(s):  
Depressive Symptoms ◽  
Weight Gain ◽  
Gestational Weight Gain ◽  
Normal Weight ◽  
Overweight Women ◽  
Telephone Interviews ◽  
Gestational Weight ◽  
Psychological Correlates ◽  
Prepregnancy Weight ◽  
Early Postpartum

Background:The study purposes were to examine (1) differences in postpartum exercise (EX) and related personal/psychological correlates in women according to prepregnancy weight and pregnancy gestational weight gain (GWG) status and (2) predictors of EX at 2 weeks, 2 months, and 6 months postpartum.Methods:Participants (N = 891) were recruited at maternity hospitalization and completed interviews to assess EX (Leisure-Time Exercise Questionnaire) and personal correlates (demographics, anxiety/depressive symptoms) before/during pregnancy. Telephone interviews were conducted to assess postpartum EX/psychological correlates. Women were categorized according to prepregnancy weight (normal and overweight) and pregnancy GWG status (above or within weight gain guidelines): normal-above, normal-within, overweight-above, and overweight-within.Results:Low levels of EX minutes were observed in all women with significant differences for strenuous EX minutes (overweight-within women had the lowest strenuous EX; normal-weight women had more strenuous EX than overweight women regardless of GWG). Correlates explained 14%–37% of the variance in postpartum EX; prepregnancy EX and pregnancy EX were strong determinants of early postpartum EX, and early postpartum EX predicted 6-month postpartum EX. Unique predictors of EX also emerged (eg, depressive symptoms for women with GWG above guidelines).Conclusions:These study findings highlight the benefits of EX before/during pregnancy for promoting postpartum EX and suggest tailoring postpartum EX interventions based on personal/psychological correlates to maximize effectiveness.

scholarly journals Comparison of Three International Charts Used to Monitor Gestational Weight Gain: Results from a Brazilian Multiple Cohort Dataset (P11-128-19)

2019 ◽  
Vol 3 (Supplement_1) ◽  
Author(s):  
Dayana Farias ◽  
Thais Carrilho ◽  
Ronaldo Alves ◽  
Nathalia Costa ◽  
Monica Batalha ◽  
...  
Keyword(s):  
Weight Gain ◽  
Gestational Weight Gain ◽  
Linear Prediction ◽  
Normal Weight ◽  
Obese Women ◽  
Overweight Women ◽  
Gestational Weight ◽  
Moderate Agreement ◽  
The Mean

Abstract Objectives To compare gestational weight gain (GWG) trajectories of Brazilian women with three international charts used to monitor GWG, and to test whether there are differences in the classification of total GWG centiles between these charts. Methods This is a multiple combined cohort dataset with data from 10 Brazilian studies with repeated measures (mean of 6.9 measures) of GWG. Total GWG was obtained by the difference between the weight measured up to 14 days before delivery and the weight measured in the 1st trimester [Intergrowth-21st, I-chart] or the pre-pregnancy self-reported weight [Life-cycle project, L-charts; and Hutcheon, H-charts]. A total of 3,423 (23,340 observations) adult women with singleton pregnancies and free of hypertension and diabetes were included. We compared graphically the mean linear prediction (linear mixed-effect models) of Brazilian women GWG with the 50th centile of three international charts. The agreement of total GWG classification in < 10th, 10th–90th and > 90th centiles was tested using Cohen's kappa coefficient according to Landis & Koch classification. Results Women had a mean total GWG of 12.2 kg (SD: 5.8) and were, on average, 27.4 (SD: 5.8) years old. Pre-pregnancy normal weight women had a different pattern of GWG compared to I-chart, and the mean GWG of this group was slightly higher than the 50th centile of the L-chart. Underweight and obese women presented a different slope of GWG compared with the 50th centiles of H and L-charts. Pre-pregnancy overweight women presented a linear prediction that overlaps the 50th centile of the L-chart in the second half of pregnancy (Figure). It was observed a moderate agreement (kappa = 0.56) comparing the 10th, 10th–90th and 90th centiles classification between L and I-charts for normal weight women. L and H-charts presented a substantial agreement for underweight (kappa = 0.71), and moderate for overweight (kappa = 0.52) and obese women (kappa = 0.59). Conclusions L-charts are the ones that most closely resemble the Brazilian GWG distribution, especially for overweight women. We observed moderate agreement in the GWG classification of women in the 10th and 90th centiles between charts, which may lead to different diagnosis of GWG depending on which chart is used. This is a first step to create new Brazilian GWG recommendations. Funding Sources The Brazilian National Council for Scientific and Technological Development and Bill and Melinda Gates Foundation (Grand Challenges Exploration). Supporting Tables, Images and/or Graphs

scholarly journals The influence of pre-pregnancy body mass index and gestational weight gain on pregnancy outcomes in two-child women

2019 ◽  
Author(s):  
Hanqing Chen ◽  
Suhua Zou ◽  
Zhuyu Li ◽  
Jianbo Yang ◽  
Jian Cai ◽  
...  
Keyword(s):  
Body Mass Index ◽  
Weight Gain ◽  
Gestational Weight Gain ◽  
Body Mass ◽  
Perinatal Outcomes ◽  
Normal Weight ◽  
Excessive Weight Gain ◽  
Gestational Weight ◽  
Excessive Weight ◽  
Weight Gain During Pregnancy

Abstract Background Pre-pregnancy body mass index and gestational weight gain were related to perinatal outcomes. It was not know the changes of pre-pregnancy body mass index, weight gain during pregnancy and its effect on perinatal outcomes in two-child women.Methods This was a retrospective study. Data of single term women delivered in the First Affiliated Hospital of Sun Yat-sen University were collected from July 2017 to June 2018. Gestational weight gain criteria of the American Institute of Medical Research and pre-pregnancy body mass index classes were used to evaluate the effects on pregnancy outcomes.Results A total of 3049 cases were enrolled in the study. Overweight cases was 9.0% and obesity was 2.4%. The weight gain of the two-child women was less than that of primipara(12.4±3.9vs13.3±4.0kg, P<0.001). The proportion of primipara with excessive weight gain was higher compared to two-child women(20.1%versus17.3%, P<0.001). There were 40.0% overweight primipara and 55.2% of two-child women had excessive weight gain. And 40.5% primipara and 54.5% two-child women of obesity had excessive weight gain during pregnancy. Obese primipara increased the risk of pre-eclampsia (aOR2.38, 95%CI 0.76-7.46). And the odds of diabetes mellitus and large for gestational age also increased in this group (aOR3.49, 95%CI 1.46-8.35 and aOR7.65, 95%CI 1.83-31.97, respectively). Two-child women had similar results. Underweight primipara with excessive weight gain increased the pre-eclampsia risk (aOR2.26, 95%CI 0.29-17.46). Normal weight and overweight/obese primipara also had similar results. But in two-child women, only overweight/obesity increased the risk of pre-eclampsia (aOR2.01, 95%CI 0.41-9.98). Underweight two-child women with less weight gain increased the risk of diabetes(aOR2.06, 95%CI 0.43-9.8). Two-child women with overweight/obese increased the odds of LGA even if they had less weight gain(aOR2.58, 95%CI 0.11-63.22). Normal weight primipara and two-child women with overweight and obese with excessive weight gain had similar results. On the other way, underweight primipara with less weight gain increased the risk of SGA(aOR1.74, 95%CI 0.81-3.76).Conclusions Gestational weight gain of two-child women was less than primipara. Overweight/obese women with excessive weight gain of two-child women increased the risk of adverse outcomes.

Examining the Effection of Second-and Third-trimester Rate of Gestational Weight Gain on Perinatal Outcomes Among Chinese Twin Gestations Based on the Provisional Guidelines: A Retrospective Cohort Study

2020 ◽  
Author(s):  
Li-hua Lin ◽  
Yi-lin Weng ◽  
Ying-ying Lin ◽  
Xiu-xian Huang ◽  
Yang Lin ◽  
...  
Keyword(s):  
Regression Analysis ◽  
Weight Gain ◽  
Gestational Weight Gain ◽  
Normal Weight ◽  
Premature Delivery ◽  
Third Trimester ◽  
Gestational Weight ◽  
Gain Rate ◽  
Twin Pregnancies ◽  
Weight Gain Rate

Abstract Background: This paper investigated how second and third trimester gestational weight gain relates toperinatal outcomes among normal weight women with twin pregnancies in Fujian, China. Methods: A retrospective study on the medical records of 931 normal weight twin pregant women was conducted in Fujian Maternity and Child Health Hospital from 2014 to 2018.The 2nd and 3rd trimester weekly weight gain rate were calculated and categorized women as gaining below, within, or above the 2009 Institute of Medicine (IOM) recommended rates . The association between trimester-specific weight gain rate and perinatal outcome was performed by traditional regression analysis among groups.Results:A total of 931 pregnant women and 1862 neonates were included for analysis. 25.9% ,19.8% and 54.3%% of women had less than, greater than and within the recommended rates of gain in the 2nd and 3rd trimester, respectively. Multivariate Logistic regression analysis showed that greater than recommended rates of weight gain in 2nd trimester decreased the risks of preeclampsia (adjusted OR:0.458,95% CI:0.255~0.824). Less than recommended rates of weight gain in 3rd trimester increased the risk of premature delivery（adjusted OR=1.926,95%CI:1.403~2.644）, gestational diabetes mellitus (adjusted OR = 2.052,95%CI:1.417~2.972), intrahepatic cholestasis syndrome (adjusted OR = 3.016,95%CI:1.057~8.606), premature rupture of the membrane (adjusted OR = 1.722,95%CI:1.180~2.512) and neonatal respiratory distress syndrome (adjusted OR = 5.135,95%CI:1.701~15.498) and decreased the risk of cesarean section (adjusted OR = 0.587,95%CI:0.385~0.893) .In addition, greater than recommended rates of weight gain in 3rd trimester was associated with increased risks in premature delivery (adjusted OR=1.818,95%CI:1.307~2.527), and gestational hypertension (adjusted OR=2.098,95%CI:1.018~4.324) as well as preeclampsia(adjusted OR:2.029, 95%CI:1.331~3.093). The stratified analysis of weight gain in 3rd trimester showed that there was no significant difference in the incidence of adverse pregnancy outcomes compared to weight gain rate groups in 2nd trimester.Conclusions: While this study showed gestational weight gain rate less than or greater than in 3rd trimester were associated with some adverse maternal and neonatal outcomes, further studies of prospective and multi-center researches are required to explore alternate ranges of gestational weight gain rate in twin pregnancies.

scholarly journals The Behavioral Wellness in Pregnancy study: a randomized controlled trial of a multi-component intervention to promote appropriate weight gain

2019 ◽  
Vol 109 (4) ◽  
pp. 1071-1079
Author(s):  
Lyndi M Buckingham-Schutt ◽  
Laura D Ellingson ◽  
Spyridoula Vazou ◽  
Christina G Campbell
Keyword(s):  
Weight Gain ◽  
Gestational Weight Gain ◽  
Behavioral Intervention ◽  
Controlled Trial ◽  
Institute Of Medicine ◽  
Weight Retention ◽  
Gestational Weight ◽  
Randomized Controlled ◽  
Prepregnancy Weight ◽  
The Face

ABSTRACT Background Adequate weight gain during pregnancy is important to both maternal and fetal outcomes. To date, randomized controlled trials have not been effective at increasing the proportion of women meeting gestational weight-gain guidelines. Objectives The aim of this study was to determine whether a multi-component behavioral intervention with a Registered Dietitian Nutritionist significantly improves the proportion of women who adhere to the 2009 Institute of Medicine weight-gain guidelines. Methods Participants were randomly assigned to usual care (UC; n = 24) or intervention (n = 23) between 8 and 14 weeks of gestation. The intervention included a minimum of 6 one-on-one counseling sessions over ∼30 wk focusing on healthy diet and physical activity (PA) goals. In addition to the face-to-face visits, weekly communication via email supported healthy eating, PA, and appropriate weight gain. Gestational weight gain, PA, and diet were assessed at 8–14, 26–28, and 34–36 weeks of gestation; weight retention was measured 2 mo postpartum. Results The proportion of women meeting the guidelines was significantly greater in those receiving the intervention than UC (60.8% compared with 25.0%, OR: 4.7; 95% CI: 1.3, 16.2; P = 0.019). Furthermore, 36.4% of the intervention women were at or below their prepregnancy weight at 2 mo postpartum compared with 12.5% in the UC group (P = 0.05). Conclusions A multi-component behavioral intervention improved adherence to the 2009 Institute of Medicine weight-gain guidelines. This trial was registered with clinicaltrials.gov as NCT02168647.

scholarly journals Association between maternal gestational weight gain and preterm birth according to body mass index and maternal age in Quzhou, China

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Ying Hu ◽  
Qi Wu ◽  
Luyang Han ◽  
Yuqing Zou ◽  
Die Hong ◽  
...  
Keyword(s):  
Body Mass Index ◽  
Weight Gain ◽  
Preterm Birth ◽  
Gestational Weight Gain ◽  
Body Mass ◽  
Maternal Age ◽  
Preterm Births ◽  
Normal Weight ◽  
Live Births ◽  
Gestational Weight

Abstract The aim of this study is to investigate the association between maternal gestational weight gain (GWG) and preterm birth according to pre-pregnancy body mass index (BMI) and maternal age. We did a cohort, hospital-based study in Quzhou, South China, from 1 Jan 2018 to 30 June 2019. We selected 4274 singleton live births in our analysis, 315 (7.4%) of which were preterm births. In the overall population, excess GWG was significantly associated with a decreased risk of preterm birth compared with adequate GWG (adjusted OR 0.81 [95% CI 0.72–0.91]), and the risk varied by increasing maternal age and pre-pregnancy BMI. Interestingly, underweight women who older than 35 years with excess GWG had significantly increased odds of preterm birth compared with adequate GWG in underweight women aged 20–29 years (2.26 [1.06–4.85]) and normal weight women older than 35 years (2.23 [1.13–4.39]). Additionally, low GWG was positively and significantly associated with preterm birth overall (1.92 [1.47–2.50]). Among normal weight women category, compared with adequate GWG women aged 20–29 years did, those older than 20 years with low GWG, had significantly higher odds of preterm birth, which increased with maternal age (1.80 [1.16–2.79] in 20–29 years, 2.19 [1.23–3.91] in 30–34 years, 3.30 [1.68–6.46] in ≫ 35 years). In conclusion, maternal GWG was significantly associated with the risk of preterm birth, but the risk varied by pre-pregnancy BMI and maternal age.

Total gestational weight gain and the risk of preeclampsia by pre-pregnancy body mass index categories: a population-based cohort study from 2013 to 2017

2019 ◽  
Vol 47 (6) ◽  
pp. 585-591 ◽  
Author(s):  
Tanja Premru-Srsen ◽  
Zorana Kocic ◽  
Vesna Fabjan Vodusek ◽  
Ksenija Geršak ◽  
Ivan Verdenik
Keyword(s):  
Body Mass Index ◽  
Weight Gain ◽  
Gestational Weight Gain ◽  
Body Mass ◽  
Odds Ratio ◽  
Protective Factor ◽  
Population Based ◽  
Normal Weight ◽  
Obese Women ◽  
Gestational Weight

Abstract Background Identifying the risk factors for preeclampsia (PE) is essential for the implementation of preventive actions. In the present study, we aimed at exploring the association between total gestational weight gain (GWG) and PE. Methods We performed a population-based cohort survey of 98,820 women with singleton pregnancies who delivered in Slovenia from 2013 to 2017. Aggregated data were obtained from the National Perinatal Information System (NPIS). The main outcome measure was the incidence of PE. The main exposure variable was total GWG standardized for the gestational duration by calculating the z-scores. The associations between total GWG and PE stratified by pre-pregnancy body mass index (BMI) categories adjusted for a variety of covariates were determined using multivariable logistic regression. We calculated the crude odds ratio (OR) and adjusted odds ratio (aOR) with a 95% confidence interval using a two-way test. Results Excessive GWG was associated with increased odds of PE in all pre-pregnancy BMI categories. The increase in the odds of PE by 445% was the highest in underweight women and by 122% was the lowest in obese women. Low GWG was associated with decreased odds of PE in all pre-pregnancy BMI categories except in normal-weight women with a GWG below −2 standard deviation (SD) and underweight women. The decrease in the odds of PE by 67% was the highest in obese women and by 41% was the lowest in normal-weight women. Conclusion Excessive GWG is a significant risk factor for PE, especially in underweight women, while low GWG is an important protective factor against PE, especially in obese women.

Size for gestational age at birth according to offspring sex and gestational weight gain in underweight women

2019 ◽  
Vol 10 (5) ◽  
pp. 536-541 ◽  
Author(s):  
Y. Kasuga ◽  
D. Shigemi ◽  
M. Tamagawa ◽  
T. Suzuki ◽  
S.-H. Kim ◽  
...  
Keyword(s):  
Weight Gain ◽  
Gestational Weight Gain ◽  
Gestational Age ◽  
Normal Weight ◽  
Weight Group ◽  
Normal Weight Group ◽  
Gestational Weight ◽  
Offspring Sex ◽  
Gestational Age At Birth ◽  
Age At Birth

AbstractAlthough maternal pre-pregnancy body mass index (BMI) and gestational weight gain (GWG) are related to fetal growth, there is a paucity of data regarding how offspring sex affects the relationship between maternal BMI in underweight mothers (pre-pregnancy BMI <18.5 kg/m2) and size for gestational age at birth. The aim of this study was to investigate the effect of offspring sex on the relationships among maternal pre-pregnancy BMI, GWG and size for gestational age at birth in Japanese underweight mothers. Records of women with full-term pregnancies who underwent perinatal care at Kawasaki Municipal Hospital (Kawasaki, Japan) between January 2013 and December 2017 were retrospectively reviewed. The study cohort included underweight (n=566) and normal-weight women (18.5 kg/m2⩽pre-pregnancy BMI<25 kg/m2; n=2671). The incidence of small for gestational age (SGA) births in the underweight group was significantly higher than that in the normal-weight group (P<0.01). Additionally, SGA incidence in the underweight group was significantly higher than that in the normal-weight group (P<0.01) in female, but not male (P=0.30) neonates. In the women with female neonates, pre-pregnancy underweight was associated with a significantly increased probability of SGA (odds ratio [OR]: 1.80; P<0.01), but inadequate GWG was not (OR: 1.38; P=0.11). In contrast, in women with male neonates, inadequate GWG was associated with a significantly increased probability of SGA (OR: 1.53; P=0.03), but not with pre-pregnancy underweight (OR: 1.30; P=0.10). In conclusion, the present results suggest that pre-pregnancy underweight is associated with SGA in female offspring but not in male offspring.

scholarly journals Limiting Excess Weight Gain in Healthy Pregnant Women: Importance of Energy Intakes, Physical Activity, and Adherence to Gestational Weight Gain Guidelines

2013 ◽  
Vol 2013 ◽  
pp. 1-6 ◽  
Author(s):  
Tamara R. Cohen ◽  
Kristine G. Koski
Keyword(s):  
Physical Activity ◽  
Weight Gain ◽  
Gestational Weight Gain ◽  
Normal Weight ◽  
Weight Retention ◽  
Gestational Weight ◽  
Daily Energy ◽  
Postpartum Weight ◽  
Logistic Regressions ◽  
Activity Questionnaire

Few studies have investigated if compliance with energy intakes, physical activity, and weight gain guidelines attenuate postpartum weight retention (PPWR) in mothers attending prenatal classes. We investigated whether (a) daily energy intakes within 300 kcal of estimated energy requirements (EERs), (b) walking more than 5000 steps/day, (c) targeting the recommended weight gain goals for prepregnancy BMI, and/or (d) achieving weekly or total gestational weight gain (GWG) recommendations minimized PPWR in 54 women attending prenatal classes in Montreal/Ottawa, Canada. Participants completed a validated pregnancy physical activity questionnaire (PPAQ), 3 telephone-validated 24-hr dietary recalls, and wore a pedometer for one week. PPWR was measured 6 weeks after delivery. Results showed that 72% had healthy prepregnancy BMIs. However, 52% consumed>300 kcal/day in excess of their EER, 54% exceeded recommended GWG, and more overweight (93%) than normal weight women (38%) cited nonrecommended GWG targets. Following delivery, 33% were classified as overweight, and 17% were obese. Multiple logistic regressions revealed that women targeting “recommended weight gain advice” were 3 times more likely to meet total GWG recommendations (OR: 3.2,P<0.05); women who complied with weekly GWG goals minimized PPWR (OR: 4.2,P<0.02). In conclusion, appropriate GWG targets, lower energy intakes, and physical activity should be emphasized in prenatal education programs.

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