scholarly journals Elevated lipid oxidation is associated with exceeding gestational weight gain recommendations and increased neonatal anthropometrics: a cross-sectional analysis

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Jill M. Maples ◽  
Samantha F. Ehrlich ◽  
Nikki B. Zite ◽  
Kevin J. Pearson ◽  
W. Todd Cade ◽  
...  

Abstract Background Deviations from gestational weight gain (GWG) recommendations are associated with unfavorable maternal and neonatal outcomes. There is a need to understand how maternal substrate metabolism, independent of weight status, may contribute to GWG and neonatal outcomes. The purpose of this study was to explore the potential link between maternal lipid oxidation rate, GWG, and neonatal anthropometric outcomes. Methods Women (N = 32) with a lean pre-pregnancy BMI were recruited during late pregnancy and substrate metabolism was assessed using indirect calorimetry, before and after consumption of a high-fat meal. GWG was categorized as follows: inadequate, adequate, or excess. Shortly after delivery (within 48 h), neonatal anthropometrics were obtained. Results Using ANOVA, we found that fasting maternal lipid oxidation rate (grams/minute) was higher (p = 0.003) among women with excess GWG (0.1019 ± 0.0416) compared to women without excess GWG (inadequate = 0.0586 ± 0.0273, adequate = 0.0569 ± 0.0238). Findings were similar when lipid oxidation was assessed post-meal and also when expressed relative to kilograms of fat free mass. Absolute GWG was positively correlated to absolute lipid oxidation expressed in grams/minute at baseline (r = 0.507, p = 0.003), 2 h post-meal (r = 0.531, p = 0.002), and 4 h post-meal (r = 0.546, p = 0.001). Fasting and post-meal lipid oxidation (grams/minute) were positively correlated to neonatal birthweight (fasting r = 0.426, p = 0.015; 2-hour r = 0.393, p = 0.026; 4-hour r = 0.540, p = 0.001) and also to neonatal absolute fat mass (fasting r = 0.493, p = 0.004; 2-hour r = 0.450, p = 0.010; 4-hour r = 0.552, p = 0.001). Conclusions A better understanding of the metabolic profile of women during pregnancy may be critical in truly understanding a woman’s risk of GWG outside the recommendations. GWG counseling during prenatal care may need to be tailored to women based not just on their weight status, but other metabolic characteristics.

Author(s):  
Daiane Sofia Morais Paulino ◽  
Maira Pinho-Pompeu ◽  
Fernanda Raikov ◽  
Juliana Vasconcellos Freitas-Jesus ◽  
Helymar Costa Machado ◽  
...  

Abstract Objective To evaluate the influence of health-related behaviors including food intake, physical activity, sleep time, smoking habits, stress, depression, and optimism on excessive gestational weight gain (GWG) among women with overweight and obesity. Methods A cross-sectional study was conducted at the Women's Hospital of the Universidade de Campinas, Campinas, state of São Paulo, Brazil, with 386 mediate postpartum women that fit the inclusion criteria of ≥ 19 years old, first prenatal care visit at or before 14 weeks, and single live baby. Dietary habits, physical exercise practice, sleep duration, smoking and alcohol habits were self-reported. Psychosocial history was evaluated using the Edinburgh Postpartum Depression Scale (EPDS), Perceived Stress Scale (PSS), and Life Orientation Test-Revised (LOT-R). Sociodemographic, obstetric, anthropometric, and neonatal data were retrieved from medical records. Descriptive statistics and stepwise logistic regression were performed. Results The prevalence of overweight and obesity was 29.27% and 24.61%, respectively, according to the body mass index (BMI). Excessive GWG was observed in 47.79% of women with overweight and in 45.26% of women with obesity. Excessive GWG among overweight and obese women was associated with inadequate vegetable and bean consumption (odds ratio [OR] = 2.95, 95% confidence interval [CI]: 1.35–6.46 and OR = 1.91; 95%CI: 1.01–3.63, respectively) and stress (OR = 1.63; 95%CI 1.01–2.64). After adjustment by maternal age, multiparity, sleep duration, smoking, and alcohol intake, we found that stress (PSS ≥ 20) was associated with excessive GWG in women with overweight or obesity (OR: 1.75; 95%CI: 1.03–2.96). Conclusion Among women with overweight and obesity, stress is the main variable associated with excessive GWG. Inadequate vegetables and beans consumption also showed association with excessive GWG.


2021 ◽  
pp. 1-41
Author(s):  
Ana Cristina Lindsay ◽  
Qun Le ◽  
Denise Lima Nogueira ◽  
Márcia M. T. Machado ◽  
Mary L. Greaney

Abstract Objectives: The objective of this study was to assess sources of information about gestational weight gain (GWG), diet, and exercise among first-time pregnant Brazilian women in the United States (US). Design: Cross-sectional survey. Setting: Massachusetts, United States. Participants: First-time pregnant Brazilian women. Results: Eighty-six women, the majority of whom were immigrants (96.5%) classified as having low-acculturation levels (68%), participated in the study. Approximately two-thirds of respondents had sought information about GWG (72.1%), diet (79.1%), and exercise (74.4%) via the internet. Women classified as having low acculturation levels were more likely to seek information about GWG via the internet (OR = 7.55; 95% CI: 1.41, 40.26) than those with high acculturation levels after adjusting for age and receiving information about GWG from healthcare provider (doctor or midwife). Moreover, many respondents reported seeking information about GWG (67%), diet (71%), and exercise (52%) from family and friends. Women who self-identified as being overweight pre-pregnancy were less likely to seek information about diet (OR = 0.32; 95% CI: 0.11, 0.93) and exercise (OR = 0.33; 95% CI: 0.11, 0.96) from family and friends than those who self-identified being normal weight pre-pregnancy. Conclusions: This is the first study to assess sources of information about GWG, diet, and exercise among pregnant Brazilian immigrants in the US. Findings have implications for the design of interventions and suggest the potential of mHealth intervention as low-cost, easy access option for delivering culturally and linguistically tailored evidence-based information about GWG incorporating behavioral change practices to this growing immigrant group.


Nutrients ◽  
2021 ◽  
Vol 13 (5) ◽  
pp. 1587
Author(s):  
Yasmin Amaral ◽  
Leila Silva ◽  
Fernanda Soares ◽  
Daniele Marano ◽  
Sylvia Nehab ◽  
...  

Background: To evaluate the potential factors associated with the nutritional composition of human milk of puerperal women. Methods: cross-sectional study, conducted between March 2016 and August 2017, with 107 women, selected in a Tertiary Health Care Tertiary Health Facility of the Unified Health System (SUS) in the Municipality of Rio de Janeiro. Data were collected two months after delivery. The dependent variable of the study was the nutritional composition of human milk. We divided the independent variables into hierarchical levels: distal (age, schooling, parity and pregestational nutritional status), intermediate (number of prenatal visits and gestational weight gain) and proximal (alcohol consumption, smoking, diabetes mellitus and hypertension). For data analysis, we applied the multiple linear regression, centered on the hierarchical model. Only the variables associated with the nutritional composition of breast milk remained in the final model at a 5% level of significance. Results: The nutritional composition of human milk yielded by women with pregestational overweight, smokers and hypertensive had higher amounts of lipids and energy. Conversely, women with gestational weight gain below the recommended had lower amounts of these components. Conclusion: The evaluation of factors associated with the nutritional composition of human milk is extremely important to assist post-partum care practices. In this study, we observed that lipid and energy contents were associated to pregestational nutritional status, gestational weight gain, smoking and hypertension.


Author(s):  
Rebecca E. Weiss ◽  
Nevert Badreldin ◽  
Kathleen Drexler ◽  
Charlotte Niznik ◽  
Lynn M. Yee

Objective The study aimed to evaluate perinatal outcomes associated with introduction of and adherence to early diabetes screening guidelines. Study Design Retrospective cohort study of all women who received prenatal care at a single, high-volume tertiary care center before (“preguidelines”) and after (“postguidelines”) American College of Obstetrics and Gynecology guidelines for early pregnancy diabetes screening for women at high risk for diabetes. Women with known pregestational diabetes, late entry to prenatal care, a fetus with a known anomaly, or multiple gestation were excluded. Multivariable linear and logistic regression models were constructed to compare maternal and neonatal outcomes between women in the preguidelines cohort to those in the postguidelines cohort. Similarly, adherence to screening guidelines was assessed, and among all women who were eligible for early diabetes screening, multivariable linear, and logistic models were created to compare outcomes between those women who were screened early to those who were not. Results Of the 2,069 women eligible for analysis, 64.6% (n = 1,337) were in the postguideline cohort. Women in the postguideline cohort were older, less likely to have a history of smoking, and more likely to be non-Hispanic white. On multivariable analysis, women in the postguideline cohort had significantly less gestational weight gain (aβ = −2.3; 95% confidence interval [CI]: −3.4 to −1.1), but a higher odds of 5-minute Apgar's score of <7 (adjusted odds ratio: 2.51; 95% CI: 1.11–5.66). Of 461 women who met ACOG early diabetes screening criteria, 58.7% (n = 270) were screened appropriately. Adherence to screening was associated with parity, race, insurance, and BMI. On multivariable analysis, there were no significant differences in neonatal outcomes between women meeting early screening criteria who were screened early and those who were not. Conclusion Introduction of early diabetes screening guidelines was associated with a significant decrease in gestational weight gain, but did not improve neonatal outcomes. Key Points


Author(s):  
Thelma Brandão ◽  
Patricia de Carvalho Padilha ◽  
Denise Cavalcante de Barros ◽  
Karina dos Santos ◽  
Silvana Granado Nogueira da Gama ◽  
...  

2021 ◽  
Author(s):  
Masoomeh Gholizadeh ◽  
Tohid Rouzitalab ◽  
Saeid Ghavamzadeh ◽  
Elnaz Daneshzad

Abstract Background: This study sought to evaluate the association between selected micronutrients (zinc, copper, and magnesium), pre-pregnancy BMI, and weight gain during pregnancy with the risk of gestational diabetes mellitus third-trimester pregnant women Urmia, Iran. Methods: This analytic cross-sectional study included 400 pregnant women. The nutritional, demographic, clinical data, and fasting blood samples (selected micronutrients and blood glucose) were evaluated. The data were analyzed using chi-square, independent t-test, and logistic regression tests. Results: The prevalence of gestational diabetes mellitus (GDM) was 18%. The OR for GDM was (OR: 0.329; 95% CI: 0.156-0.696) in normal-weight compared to mothers who were obese before pregnancy. Normal serum zinc concentration was associated with 0.413-fold lower rates of developing GDM (95% CI: 0.227-0.750). Magnesium supplementation was inversely associated with the risk of GDM (OR: 0.986; 95% CI: 0.979-0.994). Inadequate and excessive gestational weight gain was significantly associated with developing GDM in lean and obese women before pregnancy, respectively (p=0.01, p=0.003). Conclusions: Gestational diabetes is highly prevalent in Urmia, and it is likely related to excessive serum zinc concentrations, elevated pre-pregnancy BMI, and gestational weight gain.


2021 ◽  
Vol 4 (1) ◽  
pp. 74-81
Author(s):  
Alfitra Salam ◽  
Nadyah ◽  
Fhirastika Annisha Helvian

Background : Nutritional status could be used as an assessment of the risk of premature rupture of membranes. One way to determine the nutritional status of pregnant women is to calculate the gestational weight gain of women based on body mass index before pregnancy. Objective : The purpose of this study was to determine the relationship between gestational weight gain and the occurrences of premature rupture of membranes. Methodology : An observational analytic study with a cross sectional approach was adopted in this study. The data of this study were collected from the patients’ medical records at RSUD Lamaddukelleng of Wajo Regency in which the inclusion and exclusion sampling criteria were used. A total of 90 samples of patients’ medical record was obtained related to premature rupture of membranes. The collected data were processed and analyzed using the Chi-Square test with the p value of <0.05. Result : The results of the study indicated that there was a significant relationship between weight gain during pregnancy and the occurrence of premature rupture of membranes with the p value of 0.016. Conclusion : This study concluded that while there is a significant relationship between weight gain during pregnancy and premature rupture of membranes


Author(s):  
Reyna Sámano ◽  
Hugo Martínez-Rojano ◽  
Gabriela Chico-Barba ◽  
Bernarda Sánchez-Jiménez ◽  
Daniel Illescas-Zarate ◽  
...  

It has been proposed that, in the Mexican culture, family support can be a factor that contributes to protect the maternal and child health of pregnant adolescents. There may be complex associations between family support and the circumstances of a pregnancy during adolescence. The aim of the study was to analyze the association between the family support network (FSN) characteristic and the maternal and neonatal outcomes in Mexican adolescents. A cross-sectional study was conducted, and 352 pregnant adolescents participated; their FSN during pregnancy was assessed. The gestational weight gain and birth weight/length of newborns were registered. The size of the FSN was described and divided into quartiles; the main members for each quartile were identified. Then, sociodemographic and clinical variables were compared by FSN quartiles. Logistic regression models were performed to assess the association of FSN size and pregnancy and neonatal outcomes. Our results indicate that the mean age was 15 ± 1 year old. The primary support member in the FSN was the mother of the adolescent in each quartile, except for quartile 3, where the primary support was the mother-in-law. In quartile 3 there was a significantly lower gestational weight gain compared to quartile 4 (11.8 ± 5 vs. 13 ± 5 kg, p = 0.054). According to the regression model, a higher risk of small for gestational age (OR 2.99, CI 95% 1.25–7.15) newborns was found in quartile 3. We conclude that the maternal and neonatal outcomes did not differ between quartiles of FSN size, except for quartile 3. Small for gestational age newborns were observed when a non-blood relative was present in the FSN. The quality rather than the network size might be more important for improving pregnancy outcomes.


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