Factors influencing foetal growth in pregnancy complicated by diabetes

2017 ◽  
Vol 4 (6) ◽  
pp. 2136
Author(s):  
Sathish Kumar S. ◽  
Anandhi A. ◽  
Luke Ravi Chelliah ◽  
Karthick A. R.
Keyword(s):  
Weight Gain ◽  
Birth Weight ◽  
Pregnant Women ◽  
Fetal Growth ◽  
Gestational Age ◽  
Growth Pattern ◽  
Abdominal Circumference ◽  
Large For Gestational Age ◽  
Maternal Weight ◽  
In Pregnancy

Background: Gestational diabetes mellitus represents a metabolically altered fetal environment due to an increased maternal supply of carbohydrates. It leads to fetal hyperinsulinemia and stimulates insulin-sensitive tissue, predominantly of the abdomen, resulting in increased fetal growth and delivering large-for-gestational-age newborns. Implications of fetal hyperinsulinemia reach far beyond delivery. Children of mothers with diabetes in pregnancy are predisposed to develop obesity and glucose intolerance through a non-genetic “fuel-mediated” mechanism. The objective of the present study was to study the “fetal growth pattern at different periods of pregnancy complicated by diabetes” and to identify the factors that influence the fetal growth pattern in pregnancy complicated by diabetesMethods: 69 pregnant women with diabetes and 34 pregnant women without diabetes were included in the study by random sampling. Maternal parameters such as age, parity, height, weight at registration, and weight gain during pregnancy, BMI at the time of registration of pregnancy and at the time of delivery, detailed diabetic profile and management including meal plan, insulin administration and dosage were recorded. The fetuses were monitored for Biparietal diameter, abdomen circumference, femur length by 2 ultrasound examinations, one at 18-22 weeks and another at 28-32 weeks were performed. Soon after delivery, sex, gestational age, birth weight, length, head circumference and chest circumference of the newborn were recorded and infants were classified as LGA/SGA/AGA.Results: Maternal age, parity, BMI at the time of delivery and maternal weight gain had significant influence on the birth weight. The abdominal circumference of the fetus detected at 18-20 and 28-32 ultrasound scans had a very significant correlation with neonatal mean birth weight percentile. Conclusions: Not all babies born to diabetic mothers are macrosomic. SGA babies were not uncommon in pregnancies with diabetes especially in those who did not have significant micro vasculopathy. Maternal nutrition plays a significant key role in determining birth weight of babies even in pregnancies complicated by diabetes.

scholarly journals Maternal Weight Gain and its Relationship with Birth Weight of Baby at Term

2020 ◽  
Vol 32 (2) ◽  
pp. 79-83
Author(s):  
Shiffin Rijvi ◽  
Sharmin Abbasi ◽  
Farhana Dewan ◽  
Sehereen Farhad Siddiqua ◽  
Anuradha Karmakar
Keyword(s):  
Weight Gain ◽  
Birth Weight ◽  
Pregnant Women ◽  
Cross Sectional Study ◽  
Large For Gestational Age ◽  
Maternal Weight Gain ◽  
Maternal Weight ◽  
College Hospital ◽  
Cross Sectional ◽  
Medical College

Background: Perinatal health is influenced by maternal weight gain. Increase in obesity in population and excess weight during pregnancy may be different complications including large for gestational age fetus. As a result cesarean delivery has increased in prevalence. Maternal weight gain during the 2nd and 3rd trimesters is an important determinant of fetal growth Objective: To determine the relationship between maternal weight gain and birth weight of baby at term. Methodology : A cross sectional study was carried among 50 pregnant women at term in the Department of Obstetrics and Gynaecology, Shaheed Suhrawardy Medical College and Hospital and Anwer Khan Modern Medical College Hospital during the period of January 2013 to July 2013. Data were collected in pre-designed data collection sheet. Results: This study found maximum (36%) were age group 21-25 years followed by 28% were ≤20 years, 24% were between 26-30 years, 8% were between 31-35 years and only 4% were of 36-40 years. The average age was 25 years. Among these 50 pregnant women, 2 cases (4%) had BMI < 18.5, 15 cases (30%) had a BMI 18.5-24.9, 19 cases (38%) had a BMI 25-29.9 and 14 cases (28%) had a BMI ≥30. The mean birth weight was 2.77±0.33. kg. Mean weight gain was 10.72±3.72 Kg. Conclusion: This study showed that reasonable maternal weight gain significantly increased birth weight of the baby at term. Bangladesh J Obstet Gynaecol, 2017; Vol. 32(2) : 79-83

scholarly journals Fetal Head Growth during Early to Mid-Gestation Associated with Weight Gain in Mothers with Hyperemesis Gravidarum: A Retrospective Cohort Study

Nutrients ◽  
2020 ◽  
Vol 12 (6) ◽  
pp. 1664 ◽  
Author(s):  
Mitsue Muraoka ◽  
Koichiro Takagi ◽  
Mariko Ueno ◽  
Yoshihiro Morita ◽  
Hiroaki Nagano
Keyword(s):  
Weight Gain ◽  
Birth Weight ◽  
Gestational Age ◽  
Hyperemesis Gravidarum ◽  
Abdominal Circumference ◽  
Control Group ◽  
Maternal Weight Gain ◽  
Maternal Weight ◽  
Fetal Head ◽  
Head Growth

The epigenetic impact of malnutrition in mothers with hyperemesis gravidarum (HG) on their offspring has not been fully elucidated. Recently, several reports have demonstrated that children born to mothers with HG were small for gestational age and had low birth weight, reduced insulin sensitivity, and neurodevelopmental delays during childhood. Therefore, we examined the relationship between fetal growth and changes in the maternal body weight in HG cases. A total of 34 patients with HG were hospitalized and delivered at term between 2009 and 2012. The records of 69 cases of pregnant women without a history of HG were extracted after matching their maternal age, parity, pregestational body mass index (BMI), gestational age, and fetal sex ratio with those of the HG group for comparison. The maternal weight gain at term was less in the HG than in the control group. There was no statistical difference in birth weight, placental weight, and ultrasonic fetometric parameters expressed in standard deviation (SD) scores, including biparietal diameter, abdominal circumference, and femur length, between the HG and the control group. Whereas fetal head growth in the HG group was positively associated with maternal weight gain at 20 weeks of gestation only, this association was not observed in the control group. We herein demonstrate that maternal weight gain from the nadir is associated with fetal head growth at mid-gestation. Thus, maternal undernutrition in the first trimester of pregnancy could affect fetal brain growth and development, leading to an increased risk of neurodevelopmental delays in later life.

Interaction of Maternal and Neonatal Obesity

PEDIATRICS ◽  
1978 ◽  
Vol 62 (1) ◽  
pp. 17-21
Author(s):  
John N. Udall ◽  
Gail G. Harrison ◽  
Yvonne Vaucher ◽  
Philip D. Walson ◽  
Grant Morrow
Keyword(s):  
Weight Gain ◽  
Birth Weight ◽  
Gestational Age ◽  
Subcutaneous Fat ◽  
Large For Gestational Age ◽  
Maternal Weight ◽  
Muscle Area ◽  
Cross Sectional ◽  
Skin Fold ◽  
Weight Gain During Pregnancy

Maternal weight and height before pregnancy and weight gain during pregnancy were recorded for each of 109 mothers who were delivered of normal infants after gestations of 37 to 43 weeks. Infant parameters obtained included gestational age, birth weight, bilateral mid-arm circumference, and eight skin fold thickness measurements. The eight skin fold thicknesses were summed (SSFT) for each infant. Infants with SSFTs greater than 40 mm (N = 8) for the group were classified as "fatter" infants. All of the fatter infants were large for gestational age (LGA), but accounted for only one third of the LGA infants in the study. Birth weight, length, and cross-sectional mid-arm fat area were significantly increased in the fatter LGA group when compared to other LGA infants. Cross-sectional mid-arm muscle area was not significantly different for the fatter LGA infants compared to the other LGA group. Mothers were defined as obese or nonobese according to pregnant weight for height. Obese mothers had infants with significantly increased SSFTs when compared with infants of nonobese mothers. Multiple regression analysis showed that both prepregnant weight for height and weight gain during pregnancy were associated with increased subcutaneous fat in the neonate. Weight gain during pregnancy was associated with increased neonatal fatness and length, while prepregnant weight for height was associated with neonatal fatness independent of neonatal length.

scholarly journals Effect of maternal weight gain according to the Institute of Medicine recommendations on pregnancy outcomes in a Chinese population

2019 ◽  
Vol 47 (9) ◽  
pp. 4397-4412 ◽  
Author(s):  
Ping Guan ◽  
Fei Tang ◽  
Guoqiang Sun ◽  
Wei Ren
Keyword(s):  
Weight Gain ◽  
Birth Weight ◽  
Preterm Birth ◽  
Low Birth Weight ◽  
Gestational Age ◽  
Pregnancy Outcomes ◽  
Adverse Outcomes ◽  
Large For Gestational Age ◽  
Maternal Weight ◽  
Increased Risk

Objective This study aimed to analyze the effects of maternal weight on adverse pregnancy outcomes. Methods Data were retrospectively collected from a hospital in Wuhan, China. A total of 1593 pregnant women with singletons were included. Adverse outcomes during pregnancy, such as small for gestational age (SGA), large for gestational age (LGA), and hypertensive disorders in pregnancy (HDP) were analyzed. Results The risks of low birth weight, SGA, and preterm birth were significantly higher in the inadequate gestational weight gain (GWG) group compared with the adequate GWG group. GWG over the guidelines was related to a higher risk of macrosomia, LGA, cesarean section, and HDP than GWG within the guidelines. The risks of low birth weight (OR = 5.082), SGA (OR = 3.959), preterm birth (OR = 3.422), and gestational diabetes mellitus (OR = 1.784) were significantly higher in women with a normal pre-pregnancy body mass index (BMI) and inadequate GWG compared with women with a normal pre-pregnancy BMI and adequate GWG. The risks of macrosomia (OR = 3.654) and HDP (OR = 1.992) were increased in women with normal pre-pregnancy BMI and excessive GWG. Conclusion Women with an abnormal BMI and inappropriate GWG have an increased risk of adverse maternal and infant outcomes. Weight management during the perinatal period is required.

scholarly journals Caffeine consumption during pregnancy and the underweight newborn

2016 ◽  
Vol 1 (1) ◽  
pp. 53
Author(s):  
ANA MARIA BAPTISTA OLIVEIRA DIAS MALVA VAZ
Keyword(s):  
Weight Gain ◽  
Birth Weight ◽  
Pregnant Women ◽  
Fetal Growth ◽  
Gestational Age ◽  
Coffee Consumption ◽  
Maximum Amount ◽  
Negative Effects ◽  
Caffeine Consumption ◽  
Significant Difference

There is a great controversy about the ingestion of caffeine during pregnancy, with some conclusive results suggesting that higher levels of caffeine consumption might have negative effects on pregnant women and babies.A low birth weight has been associated with caffeine consumption during pregnancy. However, not all studies share the same opinion. The mechanism by which caffeine appears to influence fetal growth is not yet defined. Verena (2013) refers in his research that for every 100mg of daily caffeine consumption, the weight of the baby would decrease between 21 to 28 grams and the gestation period was extended in five hours.Considering this, the goal of our study is to investigate the extent to which caffeine consumption in pregnant women can lead to the occurrence of low birth weight.To do this we have conducted a study of descriptive, transversal and quantitative type, consisting of 87 recent mothers, with an average age of 31.2 years, with a weight gain of 10,1Kg during pregnancy, gestational age of 38.8 weeks and birth weight of 3,003Kg, of which 75.86% ingested coffee during pregnancy, an average of 1.3 cups per day.After analysing the data, this study has found that there is no statistically significant difference between coffee consumption during pregnancy and the weight of the newborn.However the small size of the sample is considered the major limitation of the study.Based on the results of other conducted studies, the recommendations related to the maximum amount of caffeine consumption per day should be reviewed.Keywords: Caffeine; Pregnancy; Gestation; Newborn; Underweight newborn

scholarly journals Fish Oil Supplementation in Pregnancy Increases Gestational Age, Size for Gestational Age, and Birth Weight in Infants: A Randomized Controlled Trial

2018 ◽  
Vol 149 (4) ◽  
pp. 628-634 ◽  
Author(s):  
Rebecca Kofod Vinding ◽  
Jakob Stokholm ◽  
Astrid Sevelsted ◽  
Bo L Chawes ◽  
Klaus Bønnelykke ◽  
...  
Keyword(s):  
Randomized Controlled Trial ◽  
Birth Weight ◽  
Pregnant Women ◽  
Gestational Age ◽  
Controlled Trial ◽  
Growth Curves ◽  
Vitamin D Supplementation ◽  
Double Blind ◽  
Randomized Controlled ◽  
In Pregnancy

ABSTRACT Background Randomized trials have reported that supplementation with n–3 long-chain polyunsaturated fatty acids (LCPUFAs) in pregnancy can prolong pregnancy and thereby increase birth weight. Objective We aimed to examine the relations of n–3 LCPUFA supplementation in pregnancy with duration of pregnancy, birth weight, and size for gestational age (GA). Methods This was a double-blind randomized controlled trial conducted in 736 pregnant women and their offspring, from the Copenhagen Prospective Studies on Asthma in Childhood2010cohort. They were recruited between weeks 22 and 26 in pregnancy and randomly assigned to either of 2.4 g n–3 LCPUFA or control (olive oil) daily until 1 wk after birth. Exclusion criteria were endocrine, cardiovascular, or nephrologic disorders and vitamin D supplementation intake >600 IU/d. In this study we analyzed secondary outcomes, and further excluded twin pregnancies and extrauterine death. The primary outcome for the trial was persistent wheeze or asthma. Results The random assignment ran between 2008 and 2010. Six hundred and ninety-nine mother-infant pairs were included in the analysis. n–3 LCPUFA compared with control was associated with a 2-d prolongation of pregnancy [median (IQR): 282 (275–288) d compared with 280 (273–286) d, P = 0.02], a 97-g higher birth weight (mean ± SD: 3601 ± 534 g compared with 3504 ± 528 g, P = 0.02), and an increased size for GA according to the Norwegian population-based growth curves-Skjærven (mean ± SD: 49.9 ± 28.3 percentiles compared with 44.5 ± 27.6 percentiles, P = 0.01). Conclusion Supplementing pregnant women with n–3 LCPUFAs during the third trimester is associated with prolonged gestation and increased size for GA, leading to a higher birth weight in this randomized controlled trial. This trial was registered at clinicaltrials.gov as NCT00798226.

Attenuation of maternal weight gain impacts infant birthweight: systematic review and meta-analysis

2018 ◽  
Vol 10 (4) ◽  
pp. 387-405 ◽  
Author(s):  
C. J. Bennett ◽  
R. E. Walker ◽  
M. L. Blumfield ◽  
J. Ma ◽  
F. Wang ◽  
...  
Keyword(s):  
Weight Gain ◽  
Gestational Age ◽  
Weighted Mean Difference ◽  
Meta Analysis ◽  
Adverse Outcomes ◽  
Large For Gestational Age ◽  
Maternal Weight ◽  
Clinical Trial Registry ◽  
Meta Analyses ◽  
The Impact

AbstractDespite many interventions aiming to reduce excessive gestational weight gain (GWG), it is currently unclear the impact on infant anthropometric outcomes. The aim of this review was to evaluate offspring anthropometric outcomes in studies designed to reduce GWG. A systematic search of seven international databases, one clinical trial registry and three Chinese databases was conducted without date limits. Studies were categorised by intervention type: diet, physical activity (PA), lifestyle (diet + PA), other, gestational diabetes mellitus (GDM) (diet, PA, lifestyle, metformin and other). Meta-analyses were reported as weighted mean difference (WMD) for birthweight and birth length, and risk ratio (RR) for small for gestational age (SGA), large for gestational age (LGA), macrosomia and low birth weight (LBW). Collectively, interventions reduced birthweight, risk of macrosomia and LGA by 71 g (WMD: −70.67, 95% CI −101.90 to −39.43,P<0.001), 16% (RR: 0.84, 95% CI 0.73–0.98,P=0.026) and 19% (RR: 0.81, 95% CI 0.69–0.96,P=0.015), respectively. Diet interventions decreased birthweight and LGA by 99 g (WMD −98.80, 95% CI −178.85 to −18.76,P=0.016) and 65% (RR: 0.35, 95% CI 0.17–0.72,P=0.004). PA interventions reduced the risk of macrosomia by 51% (RR: 0.49, 95% CI 0.26–0.92,P=0.036). In women with GDM, diet and lifestyle interventions reduced birthweight by 211 and 296 g, respectively (WMD: −210.93, 95% CI −374.77 to −46.71,P=0.012 and WMD:−295.93, 95% CI −501.76 to −90.10,P=0.005, respectively). Interventions designed to reduce excessive GWG lead to a small reduction in infant birthweight and risk of macrosomia and LGA, without influencing the risk of adverse outcomes including LBW and SGA.

scholarly journals Gestational Weight Gain and Pregnancy Outcomes among Nulliparous Women

2019 ◽  
Author(s):  
Annie M. Dude ◽  
William Grobman ◽  
David Haas ◽  
Brian M. Mercer ◽  
Samuel Parry ◽  
...  
Keyword(s):  
Weight Gain ◽  
Birth Weight ◽  
Gestational Weight Gain ◽  
Gestational Age ◽  
Small For Gestational Age ◽  
Pregnancy Outcomes ◽  
Large For Gestational Age ◽  
Gestational Weight ◽  
Excessive Gestational Weight Gain ◽  
Hypertensive Disorders

Abstract Objective To determine the association between total gestational weight gain and perinatal outcomes. Study Design Data from the Nulliparous Pregnancy Outcomes Study: Monitoring Mothers-To-Be (NuMoM2b) study were used. Total gestational weight gain was categorized as inadequate, adequate, or excessive based on the 2009 Institute of Medicine guidelines. Outcomes examined included hypertensive disorders of pregnancy, mode of delivery, shoulder dystocia, large for gestational age or small for-gestational age birth weight, and neonatal intensive care unit admission. Results Among 8,628 women, 1,666 (19.3%) had inadequate, 2,945 (34.1%) had adequate, and 4,017 (46.6%) had excessive gestational weight gain. Excessive gestational weight gain was associated with higher odds of hypertensive disorders (adjusted odds ratio [aOR] = 2.05, 95% confidence interval [CI]: 1.78–2.36) Cesarean delivery (aOR = 1.24, 95% CI: 1.09–1.41), and large for gestational age birth weight (aOR = 1.49, 95% CI: 1.23–1.80), but lower odds of small for gestational age birth weight (aOR = 0.59, 95% CI: 0.50–0.71). Conversely, inadequate gestational weight gain was associated with lower odds of hypertensive disorders (aOR = 0.75, 95% CI: 0.62–0.92), Cesarean delivery (aOR = 0.77, 95% CI: 0.65–0.92), and a large for gestational age birth weight (aOR = 0.72, 95% CI: 0.55–0.94), but higher odds of having a small for gestational age birth weight (aOR = 1.64, 95% CI: 1.37–1.96). Conclusion Both excessive and inadequate gestational weight gain are associated with adverse maternal and neonatal outcomes.

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