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

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.

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Maternal Weight Gain and Infant Birth Weight in Women with Class III Obesity

American Journal of Perinatology ◽

10.1055/s-0039-3402721 ◽

2019 ◽

Author(s):

Ann R. Tucker ◽

Haywood L. Brown ◽

Sarah K. Dotters-Katz

Keyword(s):

Weight Gain ◽

Birth Weight ◽

Gestational Age ◽

Morbidly Obese ◽

Maternal Weight Gain ◽

Class Iii ◽

Maternal Weight ◽

Class Iii Obesity ◽

Iom Recommendations ◽

Infant Birth

Abstract Objective The aim of this study is to describe the impact of maternal weight gain on infant birth weight among women with Class III obesity. Study Design Retrospective cohort of women with body mass index (BMI) ≥40 kg/m2 at initial prenatal visit, delivered from July 2013 to December 2017. Women presenting 14/0 weeks of gestational age (GA), delivering preterm, or had multiples or major fetal anomalies excluded. Maternal demographics and complications, intrapartum events, and neonatal outcomes abstracted. Primary outcomes were delivery of large for gestational age or small for gestational age (SGA) infant. Bivariate statistics used to compare women gaining less than Institute of Medicine (IOM) recommendations (LTR) and women gaining within recommendations (11–20 pounds/5–9.1 kg) (at recommended [AR]). Regression models used to estimate odds of primary outcomes. Results Of included women (n = 230), 129 (56%) gained LTR and 101 (44%) gained AR. In sum, 71 (31%) infants were LGA and 2 (0.8%) were SGA. Women gaining LTR had higher median entry BMI (46 vs. 43, p < 0.01); other demographics did not differ. LTR women were equally likely to deliver an LGA infant (29 vs. 34%, p = 0.5) but not more likely to deliver an SGA infant (0.8 vs. 1%, p > 0.99). After controlling for confounders, the AOR of an LGA baby for LTR women was 0.79 (95% CI: 0.4–1.4). Conclusion In this cohort of morbidly obese women, gaining less than IOM recommendations did not impact risk of having an LGA infant, without increasing risk of an SGA infant.

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Aquatic Activities During Pregnancy Prevent Excessive Maternal Weight Gain and Preserve Birth Weight: A Randomized Clinical Trial

American Journal of Health Promotion ◽

10.1177/0890117117697520 ◽

2017 ◽

Vol 32 (3) ◽

pp. 729-735 ◽

Cited By ~ 8

Author(s):

Mariano Bacchi ◽

Michelle F. Mottola ◽

Maria Perales ◽

Ignacio Refoyo ◽

Ruben Barakat

Keyword(s):

Clinical Trial ◽

Weight Gain ◽

Birth Weight ◽

Randomized Clinical Trial ◽

Intervention Program ◽

Statistical Significance ◽

Exercise Group ◽

Control Group ◽

Maternal Weight Gain ◽

Maternal Weight

Purpose: The aim of the present study was to examine the influence of a supervised and regular program of aquatic activities throughout gestation on maternal weight gain and birth weight. Design: A randomized clinical trial. Setting: Instituto de Obstetricia, Ginecología y Fertilidad Ghisoni (Buenos Aires, Argentina). Participants: One hundred eleven pregnant women were analyzed (31.6 ± 3.8 years). All women had uncomplicated and singleton pregnancies; 49 were allocated to the exercise group (EG) and 62 to the control group (CG). Intervention: The intervention program consisted of 3 weekly sessions of aerobic and resistance aquatic activities from weeks 10 to 12 until weeks 38 to 39 of gestation. Measures: Maternal weight gain, birth weight, and other maternal and fetal outcomes were obtained by hospital records. Analysis: Student unpaired t test and χ2 test were used; P values ≤.05 indicated statistical significance. Cohen’s d was used to determinate the effect size. Results: There was a higher percentage of women with excessive maternal weight gain in the CG (45.2%; n = 28) than in the EG (24.5%; n = 12; odds ratio = 0.39; 95% confidence interval: 0.17-0.89; P = .02). Birth weight and other pregnancy outcomes showed no differences between groups. Conclusion: Three weekly sessions of water activities throughout pregnancy prevents excessive maternal weight gain and preserves birth weight. Trial Registration: The clinicaltrial.gov identifier: NCT 02602106.

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Factors influencing foetal growth in pregnancy complicated by diabetes

International Journal of Contemporary Pediatrics ◽

10.18203/2349-3291.ijcp20174746 ◽

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.

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