The effects of pre-pregnancy obesity and gestational weight gain on maternal lipid profiles, fatty acids and insulin resistance

2021 ◽  
Vol 0 (0) ◽  
Author(s):  
Muge Gul Gulecoglu Onem ◽  
Canan Coker ◽  
Kemal Baysal ◽  
Sabahattin Altunyurt ◽  
Pembe Keskinoglu
Keyword(s):  
Insulin Resistance ◽  
Fatty Acids ◽  
Lipid Metabolism ◽  
Weight Gain ◽  
Pregnant Women ◽  
Total Cholesterol ◽  
Gestational Weight Gain ◽  
Hdl Cholesterol ◽  
Second Trimester ◽  
Gestational Weight

Abstract Objectives Pregnancy is associated with physiological alterations in insulin sensitivity and lipid metabolism. This study investigates the associations between pregestational body mass index (pBMI) and the rate of gestational weight gain (rGWG) in the second trimester with the biomarkers of lipid, fatty acids metabolism and insulin resistance. Methods Sixty nine pregnant women followed. The body weights of the pregnant women were measured and blood samples were obtained at 11–14th and 24–28th weeks of pregnancy. Glucose, total cholesterol, triglyceride, HDL cholesterol, LDL cholesterol, insulin levels and fatty acids were measured. Rate of GWG (kg/week) and The Homeostasis Model Assessment for Insulin Resistance (HOMA-IR) were calculated. The pregnant women were stratified according to their pBMI and the 2nd trimester rGWG. Results The rate of GWG was significantly higher for the group with pBMI<25, compared to the group with pBMI≥25 (p=0.024). Triglyceride, total cholesterol, LDL and HDL cholesterol were significantly increased in the second trimester compared with the first trimester. Palmitic acid, oleic acid, linoleic acid, myristic acid, docosahexaenoic acid (DHA), arachidonic acid (AA), total omega-6 (n − 6) and omega-3 (n − 3) fatty acid levels and n − 6/n − 3 ratio were significantly higher in the second trimester. Glucose was significantly decreased and insulin was increased in the second trimester. In the overweight/obese group; HOMA-IR, insulin, AA, palmitoleic acid and stearic acid were found to be high in comparison to the group with low/normal pBMI. No parameters were associated with rGWG. Conclusions The changes in lipid parameters, free fatty acids, insulin and HOMA-IR in the second trimester were compatible with the changes in lipid metabolism and the development of insulin resistance. Pregestational BMI was shown to have a stronger influence on lipid profile, insulin resistance, and fatty acids than rGWG.

scholarly journals DYNAMICS OF MATERNAL SERUM BLOOD LEPTIN LEVEL DURING PREGNANCY COMPLICATED WITH HYPEREMESIS GRAVIDARUM

2021 ◽  
pp. 52-57
Author(s):  
S. O. Ostafiichuk
Keyword(s):  
Weight Gain ◽  
Pregnant Women ◽  
Gestational Weight Gain ◽  
Hyperemesis Gravidarum ◽  
Multiple Pregnancy ◽  
Control Group ◽  
Institute Of Medicine ◽  
Second Trimester ◽  
Gestational Weight ◽  
Increased Risk

Hyperemesis gravidarum, a pregnancy-related condition characterized by severe nausea and vomiting, occurs in 0.5 % to 2 % of all pregnancies. Hyperemesis gravidarum causes dehydration, electrolyte and metabolic disorders, nutritional deficiency, leading to ketonuria and/or ketonemia. Progressive deterioration requires hospitalization and drug therapy, associated with decreased patient quality of life and depression, increased risk of preterm delivery and the birth of small for gestational age children. There are studies that indicate the effect of hyperemesis gravidarum on insufficient gestational weight gain (GWG), but the metabolic support of this relationship requires further study. Aim. To determine the dynamics of serum blood leptin level in women during pregnancy, complicated by hyperemesis gravidarum, in relation to gestational weight gain. Materials and methods. A prospective study was carried out at the Ivano-Frankivsk City Clinical Perinatal Center, Ukraine. 109 pregnant women with hyperemesis gravidarum were included and 54 pregnant without hyperemesis gravidarum as a control group. Prepregnancy body mass index (BMI) was 20.2±1.8 kg/m2, which corresponded to the normal weight due to recommendations of the Institute of medicine in the USA (2009) and the Order of the ministry of health of Ukraine № 417 (2011). Exclusion criteria: age up to 18 years, multiple pregnancy, pregnant women with delivery before 37 weeks, vomiting after 22 weeks of pregnancy, the presence of severe chronic somatic diseases. Examination of women was performed in each trimester of pregnancy (9-12, 22-24, 37-40 weeks). BMI was calculated by the Kettle formula (1865): the ratio of body weight (kg) to the square of height (m2). Quantitative determination of leptin in serum was performed by ELISA Kit (CAN-L-4260, Canada).  Statistical analyses were carried out using "Statistica 6.0" (StatSoft Inc., USA) and a Microsoft Excel-based statistical analysis package. The differences between the selections were considered statistically reliable at p<0.05 (Tukey’s test). Results. Serum blood leptin level of the patients with hyperemesis gravidarum was found to be significantly higher in 1.3 times in the second trimester (p<0.01) and in 1.5 times in the third trimester (p<0.05) compared to early terms, but in mid-pregnancy the concentration of leptin was 1.2 times significantly lower those in the control group (p<0.05). In the second trimester in the group with hyperemesis gravidarum the chances of insufficient GWG in 3 times (OR=3,01; 95% CI: 1,34-6,80; p<0,05) were diagnosed higher (in 41 (37.6%) pregnant women against 9 (16.7%) in the control group). A positive correlation was found between the concentration of leptin in the second trimester and GWG in patients with hyperemesis gravidarum (r=0.83, p<0.001). Conclusions. Decreased maternal leptin levels in the second trimester with hyperemesis gravidarum may be a predictor of insufficient gestational weight gain.

scholarly journals 231 The effect of antiretroviral therapy regimens on gestational weight gain in pregnant women with HIV

2021 ◽  
Vol 224 (2) ◽  
pp. S152-S153
Author(s):  
Naima T. Joseph ◽  
Glen Satten ◽  
Rachel Williams ◽  
Martina Badell ◽  
Anandi Sheth
Keyword(s):  
Weight Gain ◽  
Antiretroviral Therapy ◽  
Pregnant Women ◽  
Gestational Weight Gain ◽  
Gestational Weight ◽  
Women With Hiv

scholarly journals Psychosocial Characteristics and Gestational Weight Change among Overweight, African American Pregnant Women

2012 ◽  
Vol 2012 ◽  
pp. 1-9 ◽  
Author(s):  
Kelly C. Allison ◽  
Brian H. Wrotniak ◽  
Emmanuelle Paré ◽  
David B. Sarwer
Keyword(s):  
African American ◽  
Weight Gain ◽  
Binge Eating ◽  
Pregnant Women ◽  
Gestational Weight Gain ◽  
Depressed Mood ◽  
Psychosocial Variable ◽  
Night Eating ◽  
Gestational Weight ◽  
Cognitive Restraint

Objectives. To describe psychosocial factors identified as contributors of weight gain in the general population and to examine the relationship between these factors and gestational weight gain among low socioeconomic status, African American, overweight pregnant women.Methods. African American women (n=120) with a pregravid body mass index≥25 kg/m2completed measures of eating, sleep, and depressed mood between 14 and 24 weeks of gestation. Weight was tracked. Descriptive statistics, correlations, and linear regression modeling were used to characterize the sample and examine predictors of gestational weight gain.Results. Four percent screened positive for night eating syndrome, with 32% consuming at least 25% of their daily caloric intake after dinner (evening hyperphagia). None met criteria for binge eating disorder; 4% reported occasional binge episodes. Cognitive restraint over eating was low. Participants slept 7.1 (SD=1.9) h per night and reported 4.3 (SD=3.6) awakenings per week; 18% reported some level of depressed mood. Night and binge eating were related to each other, sleep quality, and depressed mood. Eating due to cravings was the only psychosocial variable to predict gestational weight gain.Conclusions. Depressed mood, night eating, and nighttime awakenings were common in this cohort, while cognitive restraint over eating was low. Most psychosocial variables were not predictive of excess gestational weight gain.

Abstract P250: Insulin Resistance During Pregnancy is Inversely Associated With Gynoid Fat Distribution Postpartum

Circulation ◽  
2018 ◽  
Vol 137 (suppl_1) ◽  
Author(s):  
Katherine H Ingram ◽  
Roxanna Lopez
Keyword(s):  
Insulin Resistance ◽  
Weight Gain ◽  
Insulin Sensitivity ◽  
Gestational Weight Gain ◽  
Body Fat ◽  
Visceral Fat ◽  
Post Partum ◽  
Lower Body ◽  
Negatively Associated ◽  
Gestational Weight

An association between abdominal adiposity and insulin resistance is well-established. Recent research indicates that subcutaneous fat accumulation in the lower body may be associated with higher levels of insulin sensitivity. Hypothesis: This pilot study tested the hypothesis that the distribution of body fat in the lower body after pregnancy is negatively associated with gestational insulin resistance. Methods: In 32 nulliparous pregnant women (age 27±4.5, BMI 29.5±7.9, 69% non-hispanic white), the Homeostasis Model Assessment of Insulin Resistance (HOMA-IR) was computed from fasting glucose and insulin at 24-28 weeks gestation. Body composition was assessed at mid-gestation (18-20 weeks) and at four weeks post-partum. Total body fat was estimated via bioelectrical impedance (InBody 720) and skinfold thicknesses were measured at seven sites. Dual-energy xray absorptiometry (DXA) measures of regional fat (gynoid, visceral, and leg) were obtained post-partum only. Gestational weight gain was monitored by medical records. Partial correlation analyses were controlled for age and race and then analyses were repeated controlling for baseline (mid-gestation) body fat percent. HOMA-IR was log-transformed for normality. Results: HOMA-IR was associated with post-partum body fat ( r =0.45, p < .05) and adiposity in the trunk region ( r =0.58, 0.57 and 0.52 for DXA visceral fat, suprailiac skinfold, and abdominal skinfold, respectively, p < .01), but not with gestational weight gain ( r =.07, p = ns), DXA gynoid region ( r = 0.26, p = ns), or any other leg measure. When analyses were further controlled for baseline body fat, post-partum measures of lower-body adiposity were strongly and negatively correlated with HOMA-IR ( r = -0.66, -0.48, and -0.48 for thigh skinfold, DXA gynoid, and DXA leg, respectively, p < .05 for all). Neither DXA visceral fat ( r = .23; p = ns) nor any other post-partum fat measures were associated with HOMA-IR when controlling for baseline body fat. Conclusions: Gestational insulin resistance was negatively associated with post-partum thigh fat accumulation, independent of overall body fat. These data indicate that insulin sensitivity may be associated with the ability to store fat in the lower body and should warrant further study of subcutaneous leg fat as a metabolically “healthy” storage depot.

Development and Evaluation of a Theory-Based App for Managing Gestational Weight Gain for Overweight and Obese Pregnant Women: A Mixed-Method Pilot Study (Preprint)

2021 ◽  
Author(s):  
Ching-Fang Lee ◽  
Li-Kang Chi ◽  
Yvonne Hsiung ◽  
Jian-Pei Huang ◽  
Chun-Wei Chang
Keyword(s):  
Physical Activity ◽  
Weight Gain ◽  
Pregnant Women ◽  
Gestational Weight Gain ◽  
Mixed Method ◽  
Moderate Intensity ◽  
Obese Women ◽  
Healthy Behavior ◽  
Gestational Weight ◽  
Methodological Guidelines

BACKGROUND Overweight and obese women’s excessive gestational weight gain (GWG) may be a health risk for both the mother and the fetus; excessive GWG leads to the retention of weight postpartum and thus obesity. Given the overwhelming number of existing pregnancy-related applications (apps), we lack only a few methodological guidelines for integrating theory, evidence and previously validated apps to help overweight and obese women manage their GWG during pregnancy. OBJECTIVE This two-phase study aimed to develop the MyHealthyWeight (MHW) app based on social-cognitive theory (SCT) and evaluate its effectiveness for overweight and obese women in helping prevent excessive GWG by enhancing adherence to optimal GWG goals and healthy behavior during pregnancy. METHODS First, we constructed and developed the MHW app based on SCT theory, and we later employed a mixed-method study to evaluate the effects of the app on overweight and obese pregnant women. RESULTS All participating overweight and obese pregnant women (100%) achieved their optimal GWG through increased self-efficacy and physical activity. Their total and moderate-intensity physical activity expenditures improved, while their sedentary and light-intensity levels of physical activity decreased. CONCLUSIONS This theory-based MHW app for weight management was greatly valued by the pregnant users. Its usefulness for health-care professionals in assisting overweight and obese pregnant women in preventing excessive GWG by promoting healthy behavior, in particular through physical exercise and a healthy diet, during pregnancy was also confirmed. CLINICALTRIAL NCT04553718

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