scholarly journals Association of Gestational Weight Gain with Cesarean Section: A Prospective Birth Cohort Study in Southwest China

2020 ◽  
Author(s):  
Lujiao Huang ◽  
Ju Zhang ◽  
Hong Sun ◽  
Hongli Dong ◽  
Run Li ◽  
...  
Keyword(s):  
Weight Gain ◽  
Cesarean Section ◽  
Birth Cohort ◽  
Gestational Weight Gain ◽  
Southwest China ◽  
Public Health Issue ◽  
Birth Cohort Study ◽  
Institute Of Medicine ◽  
Gestational Weight ◽  
Prospective Birth Cohort

Abstract Background: Cesarean section (CS) is a rising public health issue globally, which is even worse in China. Numerous studies have suggested that gestational weight gain (GWG) control may be an effective way to reduce the rate of CS. However, rare study has examined the association between GWG and CS among women in Southwest China. We proposed to examine their association based on a prospective birth cohort, and further to explore the optimal GWG range.Methods: We retrieved data from a prospective birth cohort conducted in Sichuan Provincial Hospital for Women and Children, Southwest China. Unconditional multivariable logistic regression was used to examine the association between GWG and CS by adjusting for potential confounders. In one analysis, we incorporated the GWG as categorical variable according to the Institute of Medicine (IOM) recommendation, just as the majority of previous studies did. In the other analysis, we directly incorporated the GWG as continuous variable and natural cubic splines was used to characterize the potential nonlinear exposure-response relationship, aiming to identify the optimal GWG. We further stratified the above analysis by pre-pregnancy BMI and GDM, and then a heterogeneity test based on multivariate meta-analysis was conducted to examine whether the stratum specific estimation agreed with each other.Results: A total of 1363 participants were included. By adopting the IOM recommendation, the adjusted OR of CS was 0.63 (0.47, 0.84) for insufficient GWG and 1.42 (1.06, 1.88) for excessive GWG respectively. When stratified by pre-pregnancy BMI, we further found that BMI may be an effect modifier with a higher risk of excessive GWG seen in the underweight women. By applying a flexible spline regression, the optimal GWG in term of reducing CS based on our data were more stringent than that of IOM recommendation, which were 9-12 kg for underweight women, <20 kg for normal weight women and <10 kg for overweight/obese women. Conclusion: These results suggested a more stringent recommendation should be applied in Southwest China, and more attention should be given to those underweight women.

scholarly journals Association of gestational weight gain with cesarean section: a prospective birth cohort study in Southwest China

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Lujiao Huang ◽  
Ju Zhang ◽  
Hong Sun ◽  
Hongli Dong ◽  
Run Li ◽  
...  
Keyword(s):  
Weight Gain ◽  
Cesarean Section ◽  
Birth Cohort ◽  
Gestational Weight Gain ◽  
Southwest China ◽  
The Other ◽  
Public Health Issue ◽  
Birth Cohort Study ◽  
Gestational Weight ◽  
Prospective Birth Cohort

Abstract Background Cesarean section (CS) is a rising public health issue globally, and is particularly serious in China. Numerous studies have suggested that gestational weight gain (GWG) control may be an effective way to reduce the rate of CS. However, rare study has examined the association between GWG and CS among women in Southwest China. We proposed to examine their association based on a prospective birth cohort, and further to explore the optimal GWG range. Methods We retrieved data from a prospective birth cohort from Sichuan Provincial Hospital for Women and Children, Southwest China. Unconditional multivariable logistic regression was used to examine the association between GWG and CS by adjusting for potential confounders. In one analysis, we incorporated the GWG as a categorical variable according to the Institute of Medicine (IOM) recommendation, similar to the method used in the majority of previous studies. In the other analysis, we directly incorporated GWG as a continuous variable and natural cubic splines were used to characterize the potential nonlinear exposure-response relationship, aiming to identify the optimal GWG. We further stratified the above analysis by pre-pregnancy BMI and GDM, and then a heterogeneity test based on a multivariate meta-analysis was conducted to examine whether the stratum specific estimations agreed with each other. Results A total of 1363 participants were included. By adopting the IOM recommendation, the adjusted OR of CS was 0.63 (0.47, 0.84) for insufficient GWG and 1.42 (1.06, 1.88) for excessive GWG. After stratification by pre-pregnancy BMI, we found a higher risk of CS in associated with excessive GWG in the stratum of underweight compared with the other strata, which implied that pre-pregnancy BMI may be an effect modifier. By applying a flexible spline regression, the optimal GWG levels in terms of reducing the CS rate based on our data were more stringent than those of IOM recommendation, which were 9–12 kg for underweight women, < 19 kg for normal weight women and < 10 kg for overweight/obese women. Conclusions These results suggested that a more stringent recommendation should be applied in Southwest China, and that more attention should be given to underweight women.

scholarly journals Association of Maternal Gestational Weight Gain With Left Ventricle Geometry and Function in Offspring at 4 Years of Age: A Prospective Birth Cohort Study

2021 ◽  
Vol 9 ◽  
Author(s):  
Jian Wang ◽  
Bowen Du ◽  
Yujian Wu ◽  
Zhuoyan Li ◽  
Qian Chen ◽  
...  
Keyword(s):  
Weight Gain ◽  
Left Ventricle ◽  
Birth Cohort ◽  
Gestational Weight Gain ◽  
Interventricular Septum ◽  
Birth Cohort Study ◽  
Gestational Weight ◽  
Concentric Hypertrophy ◽  
Septal Thickness ◽  
And Function

Background: Maternal gestational weight gain (GWG) may be associated with cardiovascular diseases in the offspring from childhood to adulthood. We aimed to investigate the association between maternal GWG and the left ventricle (LV) geometry and function in the offspring, and explore the influence of the intrauterine environment on early childhood cardiac change.Methods: Data of 981 mother-offspring pairs from the Shanghai Birth Cohort was used. Maternal pre-pregnancy weight and height, weight in the first trimester (≤ 12 weeks), and before delivery were measured. The echocardiography, blood pressure, and anthropometry assessment were evaluated in the offspring at 4 years of age.Results: Interventricular septal thickness during diastole had a significantly positive correlation with total GWG [β = 0.009, (0.001, 0.017)]. In the second and third trimesters, LV mass index [β = 0.149, (0.015,0.282)], interventricular septal thickness in systole [β = 0.027, (0.011,0.043)], and in diastole [β = 0.014, (0.005,0.023)] were positively associated with GWG. The risks of eccentric [OR = 1.115, (1.232, 1.010)] and concentric hypertrophy [OR = 1.133, (1.259,1.018)] increased with the elevation of maternal GWG.Conclusions: This study suggested that the excessive maternal GWG was associated with the thickening of the interventricular septum in the offspring, especially during the second and third trimesters. Excessive GWG in the second and third trimesters was a risk factor for LV eccentric and concentric hypertrophy in the offspring.

scholarly journals Non-Linear Relationships Between Maternal Pre-Pregnancy Body Mass Index, Gestational Weight Gain and Duration of Breastfeeding

2020 ◽  
Author(s):  
Yijing Zhang ◽  
Yanfen Lin ◽  
Jian Xu ◽  
Zhong-cheng Luo ◽  
Sirui Cao ◽  
...  
Keyword(s):  
Body Mass Index ◽  
Weight Gain ◽  
Gestational Weight Gain ◽  
Body Mass ◽  
Chinese Women ◽  
Breastfeeding Duration ◽  
Birth Cohort Study ◽  
Institute Of Medicine ◽  
Linear Regression Models ◽  
Gestational Weight

Abstract Background:Considering the potential inappropriateness of the 2009 Institute-of-Medicine criteria to Chinese women, we investigated the associations between pre-pregnancy body-mass-index (BMI), gestational-weight-gain (GWG) and breastfeeding-duration among Chinese women.Methods:This birth-cohort study included 225 mother-child pairs in Shanghai from 2010 to 2012. Mothers were interviewed during mid-to-late pregnancy and at 24-36 months postpartum. Information on pre-pregnancy BMI/GWG and breastfeeding-duration was collected during pregnancy and at 24-36 months postpartum, respectively. Using a data-driven approach based on spline-smoothing-fitting of the data, two-piecewise linear regression models were used to assess the relations between pre-pregnancy BMI, GWG and breastfeeding-duration. Results:Mothers being younger, longer daily working hours, and less time living with children per week were associated with shorter duration (P<0.05). The "inverted-U"-shaped and "flat-then-declining"-shaped associations between pre-pregnancy BMI, GWG and breastfeeding-duration were observed, respectively. Adjusting for related confounders, the increases in pre-pregnancy BMI below and above 22.5 kg/m2 were associated with an increase (P=0.044) and a marginal decrease (P=0.077) in breastfeeding-duration, respectively. One-kilogram increase in GWG was associated with 0.4-month decrease (95% CI: -0.7, -0.1) in breastfeeding-duration when GWG ≥ 17.5 kilograms, however, with nonsignificant changes when GWG <17.5 kilograms. Conclusion:Appropriate pre-pregnancy BMI (around 22.5 kg/m2) and GWG (< 17.5 kilograms) were favorable to sustained breastfeeding.

scholarly journals Impact of Gestational Weight Gain on Perinatal Outcomes:Appropriateness of IOM Recommendations in Mainland China

2020 ◽  
Author(s):  
Jing Hu ◽  
Jinsong Gao ◽  
Juntao Liu ◽  
Xietong Wang ◽  
Jing He ◽  
...  
Keyword(s):  
Weight Gain ◽  
Cesarean Section ◽  
Gestational Weight Gain ◽  
Mainland China ◽  
Perinatal Outcomes ◽  
Institute Of Medicine ◽  
Birth Registry ◽  
Gestational Weight ◽  
Increased Risk ◽  
Iom Recommendations

Abstract Abstract The study was conducted to evaluate the clinical feasibility of Institute of Medicine (IOM) recommendations on gestational weight gain (GWG) in mainland China. 88,297 singleton pregnancies from a nationwide birth registry study were included. GWG per week was calculated and grouped into within, below and above IOM (IOM) guidelines based on first trimester Chinese body weight index (BMI) status. Univariable and multivariable analyses were performed to determine the relationship between GWG category and perinatal outcomes. We found that excessive GWG was associated with increased risk in pregnancy induced hypertensive disorders (aOR 2.41, 95%CI 2.16-2.69), cesarean section (aOR 1.55, 95%CI 1.47–1.63 for nulliparas, aOR 1.51, 95%CI 1.38–1.65 for multiparas with no prior cesarean section), severe postpartum hemorrhage (aOR 1.15, 95%CI 1.06-1.26), large for gestational neonates (aOR1.76, 95%CI 1.69-1.85) and macrosomia (aOR 1.83, 95%CI 1.72-1.96), while inadequate GWG was correlated with higher risk in placenta abruption (aOR 1.54, 95%CI 1.29-1.85) , fetal distress (aOR 1.19, 95%CI 1.12-1.26), and small for gestational neonates (aOR 1.50, 95%CI 1.41-1.60). Either GWG above or below was associated with increased risk in preterm birth (aOR 1.48, 95%CI 1.38-1.58 for above, aOR 1.47, 95%CI 1.31–1.64 for below), and neonatal asphyxia (aOR 2.28, 95%CI 2.00-2.61 for above, aOR 1.42, 95%CI 1.25-1.61 for below). GWG within IOM recommendations may help prevent various adverse perinatal outcomes and seemed suitable in Chinese population.

scholarly journals Pre-pregnancy BMI, gestational weight gain and breast-feeding: a cohort study in China

2016 ◽  
Vol 20 (6) ◽  
pp. 1001-1008 ◽  
Author(s):  
Xing-Yong Tao ◽  
Kun Huang ◽  
Shuang-Qin Yan ◽  
A-Zhu Zuo ◽  
Rui-Wen Tao ◽  
...  
Keyword(s):  
Cohort Study ◽  
Weight Gain ◽  
Birth Cohort ◽  
Gestational Weight Gain ◽  
Breast Feeding ◽  
Early Termination ◽  
Birth Cohort Study ◽  
Exclusive Breast Feeding ◽  
Gestational Weight ◽  
Urban City

AbstractObjectiveThe purpose of the present study was to examine the influence of maternal pre-pregnancy BMI and gestational weight gain (GWG) on initiation and duration of infant breast-feeding in a prospective birth cohort study.DesignBreast-feeding information was collected at 1, 3, 6 and 12 months postpartum. The association of pre-pregnancy BMI and GWG with delayed lactogenesis II and termination of exclusive breast-feeding was assessed with logistic regression analysis. The risk of early termination of any breast-feeding during the first year postpartum was assessed with Cox proportional hazards models.SettingUrban city in China.SubjectsWomen with infants from the Ma’anshan Birth Cohort Study (n 3196).ResultsThe median duration of any breast-feeding in this cohort was 7·0 months. Pre-pregnancy obese women had higher risks of delayed lactogenesis II (risk ratio=1·89; 95 % CI 1·04, 3·43) and early termination of any breast-feeding (hazard ratio=1·38; 95 % CI 1·09, 1·75) adjusted for potential maternal and infant confounders, when compared with normal-weight women. No differences in breast-feeding initiation or duration of exclusive breast-feeding according to pre-pregnancy BMI were found. Moreover, GWG was not associated with any poor breast-feeding outcomes.ConclusionsThe present study indicated that pre-pregnancy obesity increases the risks of delayed lactogenesis II and early termination of any breast-feeding in Chinese women.

scholarly journals Maternal nutrition, inadequate gestational weight gain and birth weight: results from a prospective birth cohort

2016 ◽  
Vol 16 (1) ◽  
Author(s):  
Anke Diemert ◽  
Susanne Lezius ◽  
Mirja Pagenkemper ◽  
Gudula Hansen ◽  
Alina Drozdowska ◽  
...  
Keyword(s):  
Weight Gain ◽  
Birth Weight ◽  
Birth Cohort ◽  
Gestational Weight Gain ◽  
Maternal Nutrition ◽  
Gestational Weight ◽  
Prospective Birth Cohort

scholarly journals Risk factors for excessive gestational weight gain in a UK population: a biopsychosocial model approach

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
S. M. Garay ◽  
L. A. Sumption ◽  
R. M. Pearson ◽  
R. M. John
Keyword(s):  
Risk Factors ◽  
Weight Gain ◽  
Gestational Weight Gain ◽  
Biopsychosocial Model ◽  
Elective Caesarean Section ◽  
Depression Symptoms ◽  
Institute Of Medicine ◽  
Contributing Factors ◽  
Gestational Weight ◽  
The Uk

Abstract Background Gestational weight gain (GWG) can have implications for the health of both mother and child. However, the contributing factors remain unclear. Despite the advantages of using a biopsychosocial approach, this approach has not been applied to study GWG in the UK. This study aimed to investigate the risk factors of excessive GWG in a UK population, employing a biopsychosocial model. Methods This study utilised data from the longitudinal Grown in Wales (GiW) cohort, which recruited women in late pregnancy in South Wales. Specifically, data was collected from midwife recorded notes and an extensive questionnaire completed prior to an elective caesarean section (ELCS) delivery. GWG was categorised according to Institute of Medicine (IOM) guidelines. The analysis was undertaken for 275 participants. Results In this population 56.0% of women had excessive GWG. Increased prenatal depression symptoms (Exp(B)=1.10, p=.019) and an overweight (Exp(B)=4.16, p<.001) or obese (Exp(B)=4.20, p=.010) pre-pregnancy BMI, consuming alcohol in pregnancy (Exp(B)=.37, p=.005) and an income of less than £18,000 (Exp(B)=.24, p=.043) and £25–43,000 (Exp(B)=.25, p=.002) were associated with excessive GWG. Conclusion GWG is complex and influenced by a range of biopsychosocial factors, with the high prevalence of excessive weight gain in this population a cause for concern. Women in the UK may benefit from a revised approach toward GWG within the National Health Service (NHS), such as tracking weight gain throughout pregnancy. Additionally, this research provides evidence for potential targets for future interventions, and potentially at-risk populations to target, to improve GWG outcomes.

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

Sign in / Sign up

Export Citation Format

Share Document