Obesity as a Predictor of Delayed Lactogenesis II

2017 ◽  
Vol 33 (4) ◽  
pp. 684-691 ◽  
Author(s):  
Irma Preusting ◽  
Jessica Brumley ◽  
Linda Odibo ◽  
Diane L. Spatz ◽  
Judette M. Louis
Keyword(s):  
Weight Gain ◽  
Gestational Weight Gain ◽  
Singleton Pregnancy ◽  
Targeted Interventions ◽  
Gestational Weight ◽  
Prepregnancy Bmi ◽  
Increased Risk ◽  
Prepregnancy Obesity ◽  
Observational Cohort ◽  
Breastfeeding Cessation

Background: Lactogenesis II is the onset of copious milk production. A delay in this has been associated with an increased risk of formula supplementation and early cessation of breastfeeding. Prepregnancy obesity has also been associated with decreased breastfeeding rates and early cessation. Research aim: This study aimed to evaluate the effect of prepregnancy obesity on self-reported delayed lactogenesis II. Methods: We conducted a prospective observational cohort study of 216 women with a singleton pregnancy and who planned to breastfeed. We compared the onset of lactogenesis II between women with a body mass index (BMI) < 30 kg/m2 and women with a BMI ≥ 30 kg/m2. Using multivariate logistic regression analyses, we assessed the relationship between maternal BMI and delay of lactogenesis II. Results: The prevalence of delayed lactogenesis II among women with prepregnancy BMI < 30 kg/m2 and BMI ≥ 30 kg/m2 was 46.4% and 57.9%, respectively. Delayed lactogenesis II occurred more frequently among women who were obese at the time of delivery ( p < .05). After controlling for the covariates, age, prepregnancy BMI, and gestational weight gain were positively associated with delayed lactogenesis II. Conclusion: Prepregnancy obesity and excessive gestational weight gain are associated with an increased risk of delayed lactogenesis II. Women who are at risk for delay in lactogenesis II and early breastfeeding cessation will need targeted interventions and support for them to achieve their personal breastfeeding goals.

scholarly journals Independent effect of gestational weight gain and prepregnancy obesity on pregnancy outcomes among Saudi women: A sub-cohort analysis from Riyadh mother and baby cohort study (RAHMA)

PLoS ONE ◽  
2022 ◽  
Vol 17 (1) ◽  
pp. e0262437
Author(s):  
Amel Fayed ◽  
Hayfaa A. Wahabi ◽  
Samia Esmaeil ◽  
Roaa Elkouny ◽  
Hala Elmorshedy ◽  
...  
Keyword(s):  
Cohort Study ◽  
Weight Gain ◽  
Gestational Weight Gain ◽  
Pregnancy Outcomes ◽  
Cohort Analysis ◽  
Adverse Outcomes ◽  
Independent Effect ◽  
Gestational Weight ◽  
Increased Risk ◽  
Prepregnancy Obesity

Background Gestational weight gain (GWG) and prepregnancy obesity are garnering more attention as determining factors of pregnancy outcomes when it comes to the wellbeing of both the mother and her baby. This study was conducted to describe the pattern of GWG among participants of Riyadh Mother and Baby Multicenter Cohort Study (RAHMA) and to investigate the detrimental effects of excessive GWG and prepregnancy obesity on pregnancy outcomes. Methods RAHMA is a multicentre cohort study conducted in three hospitals in Riyadh, Saudi Arabia. Participants were categorized according to the Institute of Medicine into inadequate, adequate, and excessive GWG, and stratified by body mass index (BMI) into under/normal weight, overweight, and obese. To examine the independent effect of maternal prepregnancy obesity and GWG, a multivariate regression model was used and adjusted odds ratio (AOR) and 95% Confidence Interval (CI) for each outcome were calculated. Results A total of 7029 participants were included in this study; 31.8% had adequate GWG, 25.9% had excessive GWG and 42.3% had inadequate GWG, while 29.7% had normal BMI, 33.3% were overweight, 34.8% were obese, and 2.2% were underweight. Excessive GWG was independently associated with increased risk of hypertensive events, (AOR = 1.77, 95% CI 1.20–2.63). Obesity was associated with higher risk of gestational diabetes (AOR 2.11, 95% CI 1.76–2.53), hypertensive events (AOR 2.06, 95% CI 1.48–3.01), and delivery by emergency caesarean section (AOR = 1.63, 95% CI 1.35–1.97). Infants of obese women had increased odds of macrosomia (AOR 3.11, 95% CI 1.94–4.99) and lower odds of low birth weight (AOR = 0.68, 95% CI 0.53–0.88). Conclusion In comparison to excessive GWG, which increases the risk of hypertensive events during pregnancy, prepregnancy obesity is associated with more adverse outcomes including GDM, hypertensive events in pregnancy and emergency CS.

scholarly journals Review of Trimester-Specific Gestational Weight Gain and Childhood Adiposity

2014 ◽  
Vol 34 (1) ◽  
pp. 48-53
Author(s):  
K Thapa
Keyword(s):  
Weight Gain ◽  
Childhood Obesity ◽  
Gestational Weight Gain ◽  
Future Research ◽  
Institute Of Medicine ◽  
Short Term ◽  
Global Epidemic ◽  
Targeted Interventions ◽  
Gestational Weight ◽  
Childhood Adiposity

Childhood obesity is a global epidemic and a major public health challenge. There has been increasing evidence that intrauterine exposures, such as alcohol, smoking, and maternal nutritional status, may affect both the long and short term health consequences of the mother and offspring. Childhood adiposity may be affected by the mother’s pre-pregnancy weight and her weight gain during pregnancy. Consequently, interventions may need to start before conception of the child to prevent childhood obesity. In 2009, the Institute of Medicine updated its gestational weight gain recommendations by incorporating rates of gestational weight gain in the second and third trimesters based on the mother’s pre-pregnancy Body Mass Index. There is extensive research on the association between total gestational weight gain and short-term offspring adiposity. However, this review focuses on the association between trimester-specific gestational weight gain and childhood adiposity for singleton pregnancies with respect to the Institute of Medicine’s newly defined weight gain recommendations as very few studies have examined the association between the gestational weight gain during each trimester and childhood adiposity. Identifying the trimester that is most associated with childhood adiposity may help in the development of targeted interventions, guide physician’s nutritional and weight-gain recommendations for child-bearing mothers, and direct future research. DOI: http://dx.doi.org/10.3126/jnps.v34i1.8429   J Nepal Paediatr Soc 2014;34(1):48-53

Patient Report of Guideline-Congruent Gestational Weight Gain Advice From Prenatal Care Providers: Differences by Prepregnancy BMI

Birth ◽  
2014 ◽  
Vol 41 (4) ◽  
pp. 353-359 ◽  
Author(s):  
Molly E. Waring ◽  
Tiffany A. Moore Simas ◽  
Katharine C. Barnes ◽  
Daniel Terk ◽  
Inna Baran ◽  
...  
Keyword(s):  
Weight Gain ◽  
Prenatal Care ◽  
Gestational Weight Gain ◽  
Care Providers ◽  
Patient Report ◽  
Gestational Weight ◽  
Prepregnancy Bmi ◽  
Prenatal Care Providers

scholarly journals Gestational Weight Gain Influences Neonatal Outcomes in Women With Obesity and Gestational Diabetes

2021 ◽  
Author(s):  
Ana M Ramos-Levi ◽  
Gemma Rodriguez-Carnero ◽  
Cristina Garcia-Fontao ◽  
Antia Fernandez-Pombo ◽  
Paula Andújar-Plata ◽  
...  
Keyword(s):  
Weight Gain ◽  
Birth Weight ◽  
Gestational Diabetes ◽  
Gestational Weight Gain ◽  
Gestational Age ◽  
Perinatal Outcomes ◽  
Large For Gestational Age ◽  
Gestational Weight ◽  
Increased Risk ◽  
The Impact

Abstract Background. Obesity and gestational diabetes mellitus (GDM) are associated to increased risk of perinatal complications and obesity in the offspring. However, the impact of gestational weight gain (GWG) on maternal and fetal outcomes has led to controversial results. Research design and methods. Retrospective study of 220 women with GDM and pre-pregnancy body mass index (BMI) ≥ 30 kg/m2. Pregnant women were classified according to the Institute of Medicine (IOM) recommendations regarding prior BMI and GWG. We evaluated the impact of GWG on birth weight and perinatal outcomes. Results. Mean maternal age was 34.7±5.3 years. Pre-pregnancy obesity was classified as grade I in 55.3% of cases, grade II in 32.0%, and grade III in 12.7%. GWG was adequate (5-9kg) in 24.2%, insufficient (< 5kg) in 41.8% and excessive (> 9kg) in 34.2%. Birthweight was within normal range in 81.9%, 3.6% were small for gestational age (SGA) and 14.4% were large for gestational age (LGA). Insufficient GWG was associated to a higher rate of SGA offspring, excessive GWG was associated to LGA and adequate GWG to normal birth weight. Conclusion. GWG in women with pre-pregnancy obesity and GDM impacts neonatal birthweight. Insufficient GWG is associated to SGA and excessive GWG is associated to LGA. Women with adequate GWG according to IOM guidelines obtained better perinatal outcomes.

Association between Gestational Weight Gain Adequacy and Adverse Maternal and Neonatal Outcomes

2018 ◽  
Vol 36 (06) ◽  
pp. 615-623 ◽  
Author(s):  
Han-Yang Chen ◽  
Suneet Chauhan
Keyword(s):  
Weight Gain ◽  
Gestational Weight Gain ◽  
Neonatal Morbidity ◽  
Error Variance ◽  
Normal Weight ◽  
Adverse Outcomes ◽  
Live Births ◽  
Gestational Weight ◽  
Increased Risk ◽  
Regression Adjustment

Objectives To estimate the prevalence of gestational weight gain (GWG) adequacy according to the 2009 guidelines, and to examine the association between GWG adequacy and the adverse outcomes, stratified by prepregnancy body mass index (BMI). Study Design A retrospective cohort study, using the 2011 to 2013 U.S. linked birth/infant death datasets, restricted to nonanomalous singleton live births at 37 to 41 weeks. The adverse outcomes included composite maternal morbidity (CMM), composite neonatal morbidity (CNM), and neonatal and infant mortalities. We used multivariable Poisson's regression models with robust error variance to examine the association between GWG adequacy and adverse outcomes. Results Of 8,656,791 singleton live births, 20, 32, and 48% had inadequate, adequate, and excessive GWG, respectively. After multivariable regression adjustment, compared with adequate GWG, excessive GWG had 1.10 (1.08–1.13) and 1.12 (1.10–1.14) times higher risk of CMM and CNM, respectively; similar findings were observed in BMI subgroups. Compared with adequate GWG, inadequate GWG had 1.14 (1.03–1.26) and 1.12 (1.07–1.18) times higher risk of neonatal and infant mortalities, respectively. Similar results were noted among women with normal weight. Conclusion Excessive GWG was associated with an increased risk of CMM and CNM, while inadequate GWG was associated with a higher risk of neonatal and infant mortalities.

scholarly journals Diet during Pregnancy and Gestational Weight Gain in a Michigan Pregnancy Cohort

2020 ◽  
Vol 4 (8) ◽  
Author(s):  
Kelly A Hirko ◽  
Sarah S Comstock ◽  
Rita S Strakovsky ◽  
Jean M Kerver
Keyword(s):  
Weight Gain ◽  
Child Health ◽  
Gestational Weight Gain ◽  
Fruits And Vegetables ◽  
Vegetable Intake ◽  
Fruit And Vegetable Intake ◽  
Added Sugar ◽  
Gestational Weight ◽  
Prepregnancy Bmi ◽  
Dietary Components

ABSTRACT Background Gestational weight gain (GWG) has important health implications for both the mother and offspring. Maternal diet during pregnancy may play an important role in achieving adequate GWG, although its precise role is unclear. Objectives Associations between maternal dietary components (fruits and vegetables, added sugar, percentage energy from fat, dairy) and GWG were examined in 327 pregnant women from the Archive for Research on Child Health cohort. Methods Self-reported usual dietary intake was assessed with validated dietary screening tools at the first prenatal visit. GWG was obtained from the birth certificate and was categorized as inadequate, adequate, or excessive according to the Institute of Medicine recommendations. Associations between dietary components and GWG were assessed using multivariable regression models, stratified by maternal prepregnancy BMI category. Results Only 31.5% of women had adequate GWG, with 24.8% gaining insufficient weight and 43.7% gaining excessively. Women who consumed more fruits and vegetables were suggestively less likely to have excessive GWG (OR: 0.86; 95% CI: 0.75, 1.00) in the minimally adjusted model, but the association became nonsignificant after adjusting for covariates (OR: 0.89; 95% CI: 0.77, 1.03). In stratified models, higher fruit and vegetable intake was linked to lower likelihood of excessive GWG among women with obesity (OR: 0.77; 95% CI: 0.60, 0.97), whereas higher added sugar intake was linked to a slight reduction in likelihood of excessive GWG (OR: 0.91; 95% CI: 0.84, 0.99) among women with a prepregnancy BMI in the normal range. Other dietary components were not significantly associated with GWG. Conclusions These results suggest that consuming fruits and vegetables during pregnancy may reduce risk of excessive GWG among women with obesity. With the rising prevalence of obesity among women of reproductive age, interventions to increase fruit and vegetable intake during pregnancy may have broad public health impact by improving maternal and child health outcomes.

scholarly journals The Influence of Increased Prepregnancy Body Mass Index and Excessive Gestational Weight Gain on Pregnancy Course and Fetal and Maternal Perinatal Outcomes

Healthcare ◽  
2020 ◽  
Vol 8 (4) ◽  
pp. 362
Author(s):  
Milan Lackovic ◽  
Dejan Filimonovic ◽  
Sladjana Mihajlovic ◽  
Biljana Milicic ◽  
Ivana Filipovic ◽  
...  
Keyword(s):  
Body Mass Index ◽  
Weight Gain ◽  
Gestational Weight Gain ◽  
Body Mass ◽  
Perinatal Period ◽  
Close Monitoring ◽  
Gestational Weight ◽  
Prepregnancy Bmi ◽  
Prepregnancy Body Mass Index ◽  
Excessive Gestational Weight Gain

Background: The aim of our study was to assess the influence of prepregnancy Body Mass Index (BMI) changes as well as excessive gestational weight gain (GWG) on maternal and fetal perinatal parameters. Furthermore, we aimed to analyze the influence of increased prepregnancy BMI values and excessive GWG on neonatal early motoric development. Methods: The 203 eligible female participants were evaluated. Prepregnancy Body Mass Index (BMI) and excessive gestational weight gain (GWG) defined according to Institute of Medicine 2009 guidelines in the USA were assessed with tested maternal and fetal perinatal parameters and infants early motoric development (Alberta Infant Motor Scale—AIMS). Results: Significant predictors of increased prepregnancy BMI in perinatal period include: weight at delivery (p = 0.001), GWG (p = 0.002) and BMI at delivery (p < 0.001), while significant predictors of excessive GWG in perinatal period are: prepregnancy BMI (p = 0.029) and BMI at delivery (p < 0.001). In the group of participants with both increased prepregnancy BMI and excessive GWG versus others, significant predictors were: hypertension (HTA) (p = 0.019), amniotic fluid index (AFI) (p = 0.047), Pronation (AIMS) (p = 0.028) and Supination (AIMS) (p = 0.029). Conclusion: Increased prepregnancy BMI and excessive GWG are significantly associated with numerous perinatal factors that could alter the pregnancy course, pregnancy outcome and early motoric development of newborn. Moreover, increased prepregnancy BMI is shown to be a significant predictor of excessive GWG; thus, early selection of pregnant women for close monitoring of weight gain during pregnancy will have positive effects on reducing the risk of less favorable pregnancy course and early motoric development of newborn.

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