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Zangão MOB, Poeira AF, Branco M, Santos-Rocha R. Changes in Foot Biomechanics during Pregnancy and Postpartum: Scoping Review. Int J Environ Res Public Health 2024; 21:638. [PMID: 38791852 DOI: 10.3390/ijerph21050638] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/08/2024] [Revised: 05/11/2024] [Accepted: 05/15/2024] [Indexed: 05/26/2024]
Abstract
(1) Background: During pregnancy, changes in foot biomechanics affect structural stability and gait. (2) Objective: To map the available evidence for changes in foot biomechanics during pregnancy and the postpartum period. (3) Methods: Scoping review according to the methodology of the Joanna Briggs Institute through the relevant databases via EBSCO, MEDLINE with full text, BioOne Complete, CINAHL Plus with full text, Academic Search Complete, and SPORT Discus with full text. The search was conducted in SCOPUS and PubMed. (4) Results: Eight studies were included in the scoping review. Two independent reviewers performed data extraction and synthesized data in narrative form. We found that changes in the length and volume of the foot occur during pregnancy and remain in the postpartum period. (5) Conclusions: During pregnancy, anatomical and biomechanical changes occur in the pregnant woman's foot, potentially contributing to the risk of musculoskeletal disorders. However, more research is needed to determine whether these biomechanical changes can lead to the risk of musculoskeletal disorders.
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Affiliation(s)
- Maria Otília Brites Zangão
- Comprehensive Health Research Centre, Department of Nursing, Higher School of Nursing, University of Évora, 7000-811 Évora, Portugal
| | - Ana Filipa Poeira
- Comprehensive Health Research Centre, Department of Nursing, Higher School of Nursing, University of Évora, 7000-811 Évora, Portugal
- Instituto Politécnico de Setúbal, Escola Superior de Saúde, Campus do IPS-Estefanilha, 2910-761 Setúbal, Portugal
| | - Marco Branco
- Sport Sciences School of Rio Maior, Department of Physical Activity and Health, Santarem Polytechnic University, 2040-413 Rio Maior, Portugal
- Sport Physical Activity and Health Research & Innovation Center, Santarem Polytechnic University, 2040-413 Rio Maior, Portugal
- Interdisciplinary Centre for the Study of Human Performance, Faculty of Human Kinetics, University of Lisbon, 1499-002 Lisboa, Portugal
| | - Rita Santos-Rocha
- Sport Sciences School of Rio Maior, Department of Physical Activity and Health, Santarem Polytechnic University, 2040-413 Rio Maior, Portugal
- Sport Physical Activity and Health Research & Innovation Center, Santarem Polytechnic University, 2040-413 Rio Maior, Portugal
- Interdisciplinary Centre for the Study of Human Performance, Faculty of Human Kinetics, University of Lisbon, 1499-002 Lisboa, Portugal
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2
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Murguía-Vázquez M, Salgado-Bustamante M, Lima-Rogel V, Flores-García JA, Pierdant-Pérez M. Association Between Pro-inflammatory Cytokine Levels (IL-1β, IL-6, and TNF-α) in Human Colostrum and Maternal Body Composition Components. Breastfeed Med 2024; 19:349-356. [PMID: 38469624 DOI: 10.1089/bfm.2023.0263] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/13/2024]
Abstract
Background: Obesity is characterized as a low-grade chronic inflammatory state, marked by elevated inflammatory biomarkers. Breast milk (BM) is rich in nutritional elements, vitamins, minerals, immunological factors, and bioactive components. These bioactive components, capable of influencing biological processes, may vary in concentration based on maternal body composition. Research Aim/Question(s): This study aimed to explore the association between pro-inflammatory cytokine levels (interleukin-1 beta [IL-1β], interleukin-6 [IL-6], and tumor necrosis factor-alpha [TNF-α]) in human colostrum and maternal body composition, as analyzed through bioelectrical impedance vector analysis (BIVA). Method: In this cross-sectional study, 117 healthy postpartum participants were included, with each group (normal weight, overweight, and obese) comprising 39 individuals, as classified by BIVA. Colostrum samples were collected within the first 24 hours postpartum. Results: IL-1β levels did not significantly differ across the groups, with concentrations of 69.5 ± 103 pg/mL in normal-weight, 79.7 ± 97.9 pg/mL in overweight, and 68.7 ± 108 pg/mL in obese women. IL-6 levels were significantly higher in the overweight group (55 ± 72.4 pg/mL) than in the normal-weight (48.1 ± 74.1 pg/mL) and obese groups (28.9 ± 36.2 pg/mL) (p = 0.02). Similarly, TNF-α levels were higher in the overweight group, with concentrations of 58.7 ± 74.9 pg/mL, than in the normal-weight group, with concentrations of 38.6 ± 95.4 pg/mL, and 52.6 ± 115 pg/mL in obese women (p = 0.02). Conclusion: This study shows that IL-6 and TNF-α concentrations were statistically higher in the colostrum of overweight women, suggesting that maternal body composition may influence the inflammatory profile of BM.
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Affiliation(s)
- María Murguía-Vázquez
- Facultad de Medicina, Universidad Autónoma de San Luis Potosí, San Luis Potosi, Mexico
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van Gendt J, Emaus R, Visschedijk MC, Touw DJ, Bouwknegt DG, de Leeuw K, Prins JR, Malik P, Mian P. Pharmacokinetics of Monoclonal Antibodies Throughout Pregnancy: A Systematic Literature Review. Clin Pharmacokinet 2024; 63:589-622. [PMID: 38583128 PMCID: PMC11106164 DOI: 10.1007/s40262-024-01370-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/12/2024] [Indexed: 04/08/2024]
Abstract
BACKGROUND AND OBJECTIVE Although little information is available on the pharmacokinetics (PK) of monoclonal antibodies (mAbs) during pregnancy, multiple mAbs are being used during pregnancy for various indications. The aim of this systematic literature review was to characterize the PK of mAbs throughout pregnancy. METHODS A systematic literature search was carried out in PubMed and Embase on 21 April 2023. Articles were included when information on PK or exposure parameters of mAbs in pregnant women was available. RESULTS A total of 42 relevant articles were included, of which eight discussed adalimumab, three certolizumab pegol, five eculizumab, one golimumab, 12 infliximab (IFX), two natalizumab, one canakinumab, one omalizumab, five tocilizumab, eight ustekinumab, and five vedolizumab. One of the 42 studies reported information on clearance (CL) and volume of distribution (VD) of IFX; all other studies only reported on serum concentrations in the pre-pregnancy state, different trimesters, and the postpartum period. For all of the assessed mAbs except IFX, serum concentrations were similar to concentrations in the pre-pregnancy state or modestly decreased. In contrast, IFX trough concentrations generally increased in the second and third trimesters in comparison to the non-pregnant state. CONCLUSION Available information suggests that the anatomical and physiological changes throughout pregnancy may have meaningful effects on the PK of mAbs. For most mAbs (not IFX), modestly higher dosing (per mg) maybe needed during pregnancy to sustain a similar serum exposure compared to pre-pregnancy.
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Affiliation(s)
- J van Gendt
- Department of Clinical Pharmacy and Pharmacology, University Medical Center Groningen and University of Groningen, Hanzeplein 1, 9713 GZ, Groningen, The Netherlands
| | - R Emaus
- Department of Clinical Pharmacy and Pharmacology, University Medical Center Groningen and University of Groningen, Hanzeplein 1, 9713 GZ, Groningen, The Netherlands
| | - M C Visschedijk
- Department of Gastroenterology and Hepatology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - D J Touw
- Department of Clinical Pharmacy and Pharmacology, University Medical Center Groningen and University of Groningen, Hanzeplein 1, 9713 GZ, Groningen, The Netherlands
- Department of Pharmaceutical Analysis, Groningen Research Institute for Pharmacy, University of Groningen, Groningen, The Netherlands
| | - D G Bouwknegt
- Department of Gastroenterology and Hepatology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - K de Leeuw
- Department of Rheumatology and Clinical Immunology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - J R Prins
- Department of Obstetrics and Gynaecology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - P Malik
- Calico Life Sciences, South San Francisco, USA
| | - Paola Mian
- Department of Clinical Pharmacy and Pharmacology, University Medical Center Groningen and University of Groningen, Hanzeplein 1, 9713 GZ, Groningen, The Netherlands.
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4
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Naidoo K, Perumal R, Cox H, Mathema B, Loveday M, Ismail N, Omar SV, Georghiou SB, Daftary A, O'Donnell M, Ndjeka N. The epidemiology, transmission, diagnosis, and management of drug-resistant tuberculosis-lessons from the South African experience. Lancet Infect Dis 2024:S1473-3099(24)00144-0. [PMID: 38527475 DOI: 10.1016/s1473-3099(24)00144-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/03/2023] [Revised: 01/29/2024] [Accepted: 02/20/2024] [Indexed: 03/27/2024]
Abstract
Drug-resistant tuberculosis (DR-TB) threatens to derail tuberculosis control efforts, particularly in Africa where the disease remains out of control. The dogma that DR-TB epidemics are fueled by unchecked rates of acquired resistance in inadequately treated or non-adherent individuals is no longer valid in most high DR-TB burden settings, where community transmission is now widespread. A large burden of DR-TB in Africa remains undiagnosed due to inadequate access to diagnostic tools that simultaneously detect tuberculosis and screen for resistance. Furthermore, acquisition of drug resistance to new and repurposed drugs, for which diagnostic solutions are not yet available, presents a major challenge for the implementation of novel, all-oral, shortened (6-9 months) treatment. Structural challenges including poverty, stigma, and social distress disrupt engagement in care, promote poor treatment outcomes, and reduce the quality of life for people with DR-TB. We reflect on the lessons learnt from the South African experience in implementing state-of-the-art advances in diagnostic solutions, deploying recent innovations in pharmacotherapeutic approaches for rapid cure, understanding local transmission dynamics and implementing interventions to curtail DR-TB transmission, and in mitigating the catastrophic socioeconomic costs of DR-TB. We also highlight globally relevant and locally responsive research priorities for achieving DR-TB control in South Africa.
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Affiliation(s)
- Kogieleum Naidoo
- SAMRC-CAPRISA HIV/TB Pathogenesis and Treatment Research Unit, Centre for the AIDS Programme of Research in South Africa, Nelson R Mandela School of Medicine, University of KwaZulu-Natal, Durban, South Africa.
| | - Rubeshan Perumal
- SAMRC-CAPRISA HIV/TB Pathogenesis and Treatment Research Unit, Centre for the AIDS Programme of Research in South Africa, Nelson R Mandela School of Medicine, University of KwaZulu-Natal, Durban, South Africa
| | - Helen Cox
- Institute of Infectious Diseases and Molecular Medicine, Wellcome Centre for Infectious Disease Research and Division of Medical Microbiology, University of Cape Town, Cape Town, South Africa
| | - Barun Mathema
- Mailman School of Public Health, Columbia University, New York City, NY, USA
| | - Marian Loveday
- South African Medical Research Council, Durban, South Africa
| | - Nazir Ismail
- School of Pathology, University of Witwatersrand, Johannesburg, South Africa
| | - Shaheed Vally Omar
- Centre for Tuberculosis, National & WHO Supranational TB Reference Laboratory, National Institute for Communicable Diseases, Division of the National Health Laboratory Service, Johannesburg, South Africa
| | | | - Amrita Daftary
- SAMRC-CAPRISA HIV/TB Pathogenesis and Treatment Research Unit, Centre for the AIDS Programme of Research in South Africa, Nelson R Mandela School of Medicine, University of KwaZulu-Natal, Durban, South Africa; School of Global Health and Dahdaleh Institute of Global Health Research, York University, Toronto, ON, Canada
| | - Max O'Donnell
- SAMRC-CAPRISA HIV/TB Pathogenesis and Treatment Research Unit, Centre for the AIDS Programme of Research in South Africa, Nelson R Mandela School of Medicine, University of KwaZulu-Natal, Durban, South Africa; Division of Pulmonary, Allergy, and Critical Care Medicine, Columbia University Irving Medical Center, New York City, NY, USA; Department of Epidemiology, Columbia University Irving Medical Center, New York City, NY, USA
| | - Norbert Ndjeka
- TB Control and Management, Republic of South Africa National Department of Health, Pretoria, South Africa
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Mikołajczyk-Stecyna J, Zuk E, Seremak-Mrozikiewicz A, Kurzawińska G, Wolski H, Drews K, Chmurzynska A. Genetic risk score for gestational weight gain. Eur J Obstet Gynecol Reprod Biol 2024; 294:20-27. [PMID: 38184896 DOI: 10.1016/j.ejogrb.2023.12.031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Revised: 12/15/2023] [Accepted: 12/20/2023] [Indexed: 01/09/2024]
Abstract
Gestational weight gain (GWG) involves health consequences for both mother and offspring. Genetic factors seem to play a role in the GWG trait. For small effect sizes of a single genetic polymorphism (SNP), a genetic risk score (GRS) summarizing risk-associated variation from multiple SNPs can serve as an effective approach to genetic association analysis. The aim of the study was to analyze the association between genetic risk score (GRS) and gestational weight gain (GWG). GWG was calculated for a total of 342 healthy Polish women of Caucasian origin, aged 19 to 45 years. The SNPs rs9939609 (FTO), rs6548238 (TMEM18), rs17782313 (MC4R), rs10938397 (GNPDA2), rs10913469 (SEC16B), rs1137101 (LEPR), rs7799039 (LEP), and rs5443 (GNB3) were genotyped using commercial TaqMan SNP assays. A simple genetic risk score was calculated into two ways: GRS1 based on the sum of risk alleles from each of the SNPs, while GRS2 based on the sum of risk alleles of FTO, LEPR, LEP, and GNB3. Positive association between GRS2 and GWG (β = 0.12, p = 0.029) was observed. Genetic risk variants of TMEM18 (p = 0.006, OR = 2.6) and GNB3 (p < 0.001, OR = 3.3) are more frequent in women with increased GWG, but a risk variant of GNPDA2 (p < 0.001, OR = 2.7) is more frequent in women with adequate GWG, and a risk variant of LEPR (p = 0.011, OR = 3.1) in women with decreased GWG. GRS2 and genetic variants of TMEM18, GNB3, GNPDA2, and LEPR are associated with weight gain during pregnancy.
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Affiliation(s)
- Joanna Mikołajczyk-Stecyna
- Department of Human Nutrition and Dietetics, Poznań University of Life Sciences, Wojska Polskiego 31, 60-624 Poznań, Poland
| | - Ewelina Zuk
- Department of Human Nutrition and Dietetics, Poznań University of Life Sciences, Wojska Polskiego 31, 60-624 Poznań, Poland
| | - Agnieszka Seremak-Mrozikiewicz
- Division of Perinatology and Women's Diseases, Poznań University of Medical Sciences, Polna 33, 60-535 Poznań, Poland; Laboratory of Molecular Biology, Division of Perinatology and Women's Diseases, Poznań University of Medical Sciences, Polna 33, 60-535 Poznań, Poland
| | - Grażyna Kurzawińska
- Division of Perinatology and Women's Diseases, Poznań University of Medical Sciences, Polna 33, 60-535 Poznań, Poland; Laboratory of Molecular Biology, Division of Perinatology and Women's Diseases, Poznań University of Medical Sciences, Polna 33, 60-535 Poznań, Poland
| | - Hubert Wolski
- Division of Perinatology and Women's Diseases, Poznań University of Medical Sciences, Polna 33, 60-535 Poznań, Poland; Podhale State College of Applied Sciences in Nowy Targ, Kokoszków 71, 34-400 Nowy Targ, Poland
| | - Krzysztof Drews
- Division of Perinatology and Women's Diseases, Poznań University of Medical Sciences, Polna 33, 60-535 Poznań, Poland; Laboratory of Molecular Biology, Division of Perinatology and Women's Diseases, Poznań University of Medical Sciences, Polna 33, 60-535 Poznań, Poland
| | - Agata Chmurzynska
- Department of Human Nutrition and Dietetics, Poznań University of Life Sciences, Wojska Polskiego 31, 60-624 Poznań, Poland.
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Yu D, Wan H, Tong C, Guang L, Chen G, Su J, Zhang L, Wang Y, Xiao Z, Zhai J, Yan L, Ma W, Liang K, Liu T, Wang Y, Peng Z, Luo L, Yu R, Li W, Qi H, Wang H, Shyh-Chang N. A multi-tissue metabolome atlas of primate pregnancy. Cell 2024; 187:764-781.e14. [PMID: 38306985 DOI: 10.1016/j.cell.2023.11.043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2022] [Revised: 08/08/2023] [Accepted: 11/29/2023] [Indexed: 02/04/2024]
Abstract
Pregnancy induces dramatic metabolic changes in females; yet, the intricacies of this metabolic reprogramming remain poorly understood, especially in primates. Using cynomolgus monkeys, we constructed a comprehensive multi-tissue metabolome atlas, analyzing 273 samples from 23 maternal tissues during pregnancy. We discovered a decline in metabolic coupling between tissues as pregnancy progressed. Core metabolic pathways that were rewired during primate pregnancy included steroidogenesis, fatty acid metabolism, and arachidonic acid metabolism. Our atlas revealed 91 pregnancy-adaptive metabolites changing consistently across 23 tissues, whose roles we verified in human cell models and patient samples. Corticosterone and palmitoyl-carnitine regulated placental maturation and maternal tissue progenitors, respectively, with implications for maternal preeclampsia, diabetes, cardiac hypertrophy, and muscle and liver regeneration. Moreover, we found that corticosterone deficiency induced preeclampsia-like inflammation, indicating the atlas's potential clinical value. Overall, our multi-tissue metabolome atlas serves as a framework for elucidating the role of metabolic regulation in female health during pregnancy.
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Affiliation(s)
- Dainan Yu
- Key Laboratory of Organ Regeneration and Reconstruction, State Key Laboratory of Stem Cell and Reproductive Biology, Institute of Zoology, Chinese Academy of Sciences, Beijing 100101, China; Institute for Stem Cell and Regeneration, Chinese Academy of Sciences, Beijing 100101, China; University of Chinese Academy of Sciences, Beijing 100049, China; Beijing Institute for Stem Cell and Regenerative Medicine, Beijing 100101, China
| | - Haifeng Wan
- Key Laboratory of Organ Regeneration and Reconstruction, State Key Laboratory of Stem Cell and Reproductive Biology, Institute of Zoology, Chinese Academy of Sciences, Beijing 100101, China; Institute for Stem Cell and Regeneration, Chinese Academy of Sciences, Beijing 100101, China; University of Chinese Academy of Sciences, Beijing 100049, China; Beijing Institute for Stem Cell and Regenerative Medicine, Beijing 100101, China
| | - Chao Tong
- State Key Laboratory of Maternal and Fetal Medicine of Chongqing Municipality, The First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, China
| | - Lu Guang
- Key Laboratory of Organ Regeneration and Reconstruction, State Key Laboratory of Stem Cell and Reproductive Biology, Institute of Zoology, Chinese Academy of Sciences, Beijing 100101, China; Institute for Stem Cell and Regeneration, Chinese Academy of Sciences, Beijing 100101, China; University of Chinese Academy of Sciences, Beijing 100049, China; Beijing Institute for Stem Cell and Regenerative Medicine, Beijing 100101, China
| | - Gang Chen
- Key Laboratory of Organ Regeneration and Reconstruction, State Key Laboratory of Stem Cell and Reproductive Biology, Institute of Zoology, Chinese Academy of Sciences, Beijing 100101, China; Institute for Stem Cell and Regeneration, Chinese Academy of Sciences, Beijing 100101, China; University of Chinese Academy of Sciences, Beijing 100049, China; Beijing Institute for Stem Cell and Regenerative Medicine, Beijing 100101, China
| | - Jiali Su
- Key Laboratory of Organ Regeneration and Reconstruction, State Key Laboratory of Stem Cell and Reproductive Biology, Institute of Zoology, Chinese Academy of Sciences, Beijing 100101, China; Institute for Stem Cell and Regeneration, Chinese Academy of Sciences, Beijing 100101, China; University of Chinese Academy of Sciences, Beijing 100049, China; Beijing Institute for Stem Cell and Regenerative Medicine, Beijing 100101, China
| | - Lan Zhang
- State Key Laboratory of Maternal and Fetal Medicine of Chongqing Municipality, The First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, China
| | - Yue Wang
- Key Laboratory of Organ Regeneration and Reconstruction, State Key Laboratory of Stem Cell and Reproductive Biology, Institute of Zoology, Chinese Academy of Sciences, Beijing 100101, China; Institute for Stem Cell and Regeneration, Chinese Academy of Sciences, Beijing 100101, China; University of Chinese Academy of Sciences, Beijing 100049, China; Beijing Institute for Stem Cell and Regenerative Medicine, Beijing 100101, China
| | - Zhenyu Xiao
- Key Laboratory of Organ Regeneration and Reconstruction, State Key Laboratory of Stem Cell and Reproductive Biology, Institute of Zoology, Chinese Academy of Sciences, Beijing 100101, China; Institute for Stem Cell and Regeneration, Chinese Academy of Sciences, Beijing 100101, China; University of Chinese Academy of Sciences, Beijing 100049, China; Beijing Institute for Stem Cell and Regenerative Medicine, Beijing 100101, China
| | - Jinglei Zhai
- Key Laboratory of Organ Regeneration and Reconstruction, State Key Laboratory of Stem Cell and Reproductive Biology, Institute of Zoology, Chinese Academy of Sciences, Beijing 100101, China; Institute for Stem Cell and Regeneration, Chinese Academy of Sciences, Beijing 100101, China; University of Chinese Academy of Sciences, Beijing 100049, China; Beijing Institute for Stem Cell and Regenerative Medicine, Beijing 100101, China
| | - Long Yan
- Key Laboratory of Organ Regeneration and Reconstruction, State Key Laboratory of Stem Cell and Reproductive Biology, Institute of Zoology, Chinese Academy of Sciences, Beijing 100101, China; Institute for Stem Cell and Regeneration, Chinese Academy of Sciences, Beijing 100101, China; University of Chinese Academy of Sciences, Beijing 100049, China; Beijing Institute for Stem Cell and Regenerative Medicine, Beijing 100101, China
| | - Wenwu Ma
- Key Laboratory of Organ Regeneration and Reconstruction, State Key Laboratory of Stem Cell and Reproductive Biology, Institute of Zoology, Chinese Academy of Sciences, Beijing 100101, China; Institute for Stem Cell and Regeneration, Chinese Academy of Sciences, Beijing 100101, China; University of Chinese Academy of Sciences, Beijing 100049, China; Beijing Institute for Stem Cell and Regenerative Medicine, Beijing 100101, China
| | - Kun Liang
- Key Laboratory of Organ Regeneration and Reconstruction, State Key Laboratory of Stem Cell and Reproductive Biology, Institute of Zoology, Chinese Academy of Sciences, Beijing 100101, China; Institute for Stem Cell and Regeneration, Chinese Academy of Sciences, Beijing 100101, China; University of Chinese Academy of Sciences, Beijing 100049, China; Beijing Institute for Stem Cell and Regenerative Medicine, Beijing 100101, China
| | - Taoyan Liu
- Key Laboratory of Organ Regeneration and Reconstruction, State Key Laboratory of Stem Cell and Reproductive Biology, Institute of Zoology, Chinese Academy of Sciences, Beijing 100101, China; Institute for Stem Cell and Regeneration, Chinese Academy of Sciences, Beijing 100101, China; University of Chinese Academy of Sciences, Beijing 100049, China; Beijing Institute for Stem Cell and Regenerative Medicine, Beijing 100101, China
| | - Yuefan Wang
- Key Laboratory of Organ Regeneration and Reconstruction, State Key Laboratory of Stem Cell and Reproductive Biology, Institute of Zoology, Chinese Academy of Sciences, Beijing 100101, China; Institute for Stem Cell and Regeneration, Chinese Academy of Sciences, Beijing 100101, China; University of Chinese Academy of Sciences, Beijing 100049, China; Beijing Institute for Stem Cell and Regenerative Medicine, Beijing 100101, China
| | - Zehang Peng
- Key Laboratory of Organ Regeneration and Reconstruction, State Key Laboratory of Stem Cell and Reproductive Biology, Institute of Zoology, Chinese Academy of Sciences, Beijing 100101, China; Institute for Stem Cell and Regeneration, Chinese Academy of Sciences, Beijing 100101, China; University of Chinese Academy of Sciences, Beijing 100049, China; Beijing Institute for Stem Cell and Regenerative Medicine, Beijing 100101, China
| | - Lanfang Luo
- Key Laboratory of Organ Regeneration and Reconstruction, State Key Laboratory of Stem Cell and Reproductive Biology, Institute of Zoology, Chinese Academy of Sciences, Beijing 100101, China; Institute for Stem Cell and Regeneration, Chinese Academy of Sciences, Beijing 100101, China; University of Chinese Academy of Sciences, Beijing 100049, China; Beijing Institute for Stem Cell and Regenerative Medicine, Beijing 100101, China
| | - Ruoxuan Yu
- Key Laboratory of Organ Regeneration and Reconstruction, State Key Laboratory of Stem Cell and Reproductive Biology, Institute of Zoology, Chinese Academy of Sciences, Beijing 100101, China; Institute for Stem Cell and Regeneration, Chinese Academy of Sciences, Beijing 100101, China; University of Chinese Academy of Sciences, Beijing 100049, China; Beijing Institute for Stem Cell and Regenerative Medicine, Beijing 100101, China
| | - Wei Li
- Key Laboratory of Organ Regeneration and Reconstruction, State Key Laboratory of Stem Cell and Reproductive Biology, Institute of Zoology, Chinese Academy of Sciences, Beijing 100101, China; Institute for Stem Cell and Regeneration, Chinese Academy of Sciences, Beijing 100101, China; University of Chinese Academy of Sciences, Beijing 100049, China; Beijing Institute for Stem Cell and Regenerative Medicine, Beijing 100101, China.
| | - Hongbo Qi
- Department of Obstetrics and Gynecology, Women and Children's Hospital of Chongqing Medical University, Chongqing 401120, China.
| | - Hongmei Wang
- Key Laboratory of Organ Regeneration and Reconstruction, State Key Laboratory of Stem Cell and Reproductive Biology, Institute of Zoology, Chinese Academy of Sciences, Beijing 100101, China; Institute for Stem Cell and Regeneration, Chinese Academy of Sciences, Beijing 100101, China; University of Chinese Academy of Sciences, Beijing 100049, China; Beijing Institute for Stem Cell and Regenerative Medicine, Beijing 100101, China.
| | - Ng Shyh-Chang
- Key Laboratory of Organ Regeneration and Reconstruction, State Key Laboratory of Stem Cell and Reproductive Biology, Institute of Zoology, Chinese Academy of Sciences, Beijing 100101, China; Institute for Stem Cell and Regeneration, Chinese Academy of Sciences, Beijing 100101, China; University of Chinese Academy of Sciences, Beijing 100049, China; Beijing Institute for Stem Cell and Regenerative Medicine, Beijing 100101, China.
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7
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Kirchengast S, Fellner J, Haury J, Kraus M, Stadler A, Schöllauf T, Hartmann B. The Impact of Higher Than Recommended Gestational Weight Gain on Fetal Growth and Perinatal Risk Factors-The IOM Criteria Reconsidered. Int J Environ Res Public Health 2024; 21:147. [PMID: 38397638 PMCID: PMC10887580 DOI: 10.3390/ijerph21020147] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/30/2023] [Revised: 01/22/2024] [Accepted: 01/26/2024] [Indexed: 02/25/2024]
Abstract
A too-high gestational weight gain, in combination with steadily increasing obesity rates among women of reproductive age, represents an enormous obstetrical problem, as obesity and high gestational weight gain are associated with enhanced fetal growth, low vital parameters, and increased cesarean section rates. This medical record-based study investigates the association patterns between too-low as well as too-high gestational weight gain, according to the 2009 Institute of Medicine (IOM) guidelines, and fetal growth, as well as birth mode and pregnancy outcome. The data of 11,755 singleton births that had taken place between 2010 and 2020 at the Public Clinic Donaustadt in Vienna, Austria, were analyzed. Birth weight, birth length, head circumference, APGAR scores, and pH values of the arterial umbilical cord blood described fetal growth as well as the vital parameters after birth. Gestational weight gain was classified as too low, recommended, or too high according to the different weight status categories of the IOM guidelines. Birth weight, birth length, and head circumference of the newborn were significantly increased (p < 0.001) among underweight, normal-weight, and overweight women who gained more weight than recommended. Among obese women, only birthweight was significantly (p < 0.001) higher among women who gained more weight than recommended. Furthermore, a too-high gestational weight gain was significantly associated with an increased risk of macrosomia and emergency cesarean sections among underweight, normal-weight, and overweight women, but not among obese ones. Obese and morbidly obese women experiencing excessive gestational weight gain showed no significantly increased risk of macrosomia or emergency cesarean section. However, among obese mothers, a too-low gestational weight gain reduced the risk of emergency cesarean sections significantly (p = 0.010). Consequently, the IOM recommendations for gestational weight gain fit only partly for pregnant women in Austria. In the case of obese and morbidly obese women, new guidelines for optimal pregnancy weight gain should be considered.
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Affiliation(s)
- Sylvia Kirchengast
- Department of Evolutionary Anthropology, University of Vienna, 1030 Vienna, Austria (J.H.); (M.K.)
| | - Josef Fellner
- Department of Evolutionary Anthropology, University of Vienna, 1030 Vienna, Austria (J.H.); (M.K.)
| | - Julia Haury
- Department of Evolutionary Anthropology, University of Vienna, 1030 Vienna, Austria (J.H.); (M.K.)
| | - Magdalena Kraus
- Department of Evolutionary Anthropology, University of Vienna, 1030 Vienna, Austria (J.H.); (M.K.)
| | - Antonia Stadler
- Department of Evolutionary Anthropology, University of Vienna, 1030 Vienna, Austria (J.H.); (M.K.)
| | - Teresa Schöllauf
- Department of Evolutionary Anthropology, University of Vienna, 1030 Vienna, Austria (J.H.); (M.K.)
| | - Beda Hartmann
- Department of Gynecology and Obstetrics, Clinic Donaustadt, 1030 Vienna, Austria;
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8
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Costa SMB, Hallur RLS, Reyes DRA, Floriano JF, de Barros Leite Carvalhaes MA, de Carvalho Nunes HR, Sobrevia L, Valero P, Barbosa AMP, Rudge MCV. Role of dietary food intake patterns, anthropometric measures, and multiple biochemical markers in the development of pregnancy-specific urinary incontinence in gestational diabetes mellitus. Nutrition 2024; 117:112228. [PMID: 37948994 DOI: 10.1016/j.nut.2023.112228] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2023] [Revised: 09/04/2023] [Accepted: 09/16/2023] [Indexed: 11/12/2023]
Abstract
OBJECTIVES The aim of this study was to assess maternal dietary food intake patterns, anthropometric measures, and multiple biochemical markers in women with gestational diabetes mellitus and pregnancy-specific urinary incontinence and to explore whether antedating gestational diabetes mellitus environment affects the pregnancy-specific urinary incontinence development in a cohort of pregnant women with gestational diabetes mellitus and pregnancy-specific urinary incontinence. METHODS Maternal dietary information and anthropometric measurements were collected. At 24 wk of gestation, with a fasting venipuncture sample, current blood samples for biochemical markers of hormones, vitamins, and minerals were analyzed. The groups were compared in terms of numerical variables using analysis of variance for independent samples followed by multiple comparisons. RESULTS Of the 900 pregnant women with complete data, pregnant women in the gestational diabetes mellitus pregnancy-specific urinary incontinence group had higher body mass index during pregnancy, arm circumference, and triceps skinfold than the non-gestational diabetes mellitus continent and non-gestational diabetes mellitus pregnancy-specific urinary incontinence groups, characterizing an obesogenic maternal environment. Regarding dietary food intake, significant increases in aromatic amino acids, branched-chain amino acids, dietary fiber, magnesium, zinc, and water were observed in pregnancy-specific urinary incontinence group compared with the non-gestational diabetes mellitus continent group. Serum vitamin C was reduced in the gestational diabetes mellitus pregnancy-specific urinary incontinence group compared with the non-gestational diabetes mellitus pregnancy-specific urinary incontinence group. CONCLUSIONS This study emphasizes the necessity for a comprehensive strategy for gestational diabetes mellitus women with pregnancy-specific urinary incontinence in terms of deviation in maternal adaptation trending toward obesity and maternal micronutrients deficiencies.
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Affiliation(s)
- Sarah Maria Barneze Costa
- Department of Gynecology and Obstetrics, Botucatu Medical School, São Paulo State University, Botucatu, Brazil
| | - Raghavendra Lakshmana Shetty Hallur
- Department of Gynecology and Obstetrics, Botucatu Medical School, São Paulo State University, Botucatu, Brazil; College of Biosciences and Technology, Pravara Institute of Medical Sciences (DU), Loni-413736, Rahata Taluka, Ahmednagar District, Maharashtra State, India
| | - David Rafael Abreu Reyes
- Department of Gynecology and Obstetrics, Botucatu Medical School, São Paulo State University, Botucatu, Brazil
| | - Juliana Ferreira Floriano
- Department of Gynecology and Obstetrics, Botucatu Medical School, São Paulo State University, Botucatu, Brazil
| | | | | | - Luis Sobrevia
- Botucatu Medical School, São Paulo State University, São Paulo, Brazil; Cellular and Molecular Physiology Laboratory, Division of Obstetrics and Gynecology, Department of Obstetrics, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile; Centre for Clinical Research, Faculty of Medicine and Biomedical Sciences, University of Queensland, Herston, Australia; Department of Pathology and Medical Biology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands; Institute for Obesity Research, School of Medicine and Health Sciences, Monterrey Institute of Technology and Higher Education, Monterrey, Mexico
| | - Paola Valero
- Botucatu Medical School, São Paulo State University, São Paulo, Brazil; Faculty of Health Sciences, Universidad de Talca, Talca, Chile
| | - Angélica Mércia Pascon Barbosa
- Department of Gynecology and Obstetrics, Botucatu Medical School, São Paulo State University, Botucatu, Brazil; Department of Physiotherapy and Occupational Therapy, School of Philosophy and Sciences, São Paulo State University, Marília, Brazil
| | - Marilza Cunha Vieira Rudge
- Department of Gynecology and Obstetrics, Botucatu Medical School, São Paulo State University, Botucatu, Brazil.
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Stewart BC, Dai S, Havens KL, Eggleston JD, Bagwell JJ, Deering RE, Little EE, Catena RD. Determining fall risk change throughout pregnancy: the accuracy of postpartum survey and relationship to fall efficacy. Ergonomics 2023:1-10. [PMID: 38131152 DOI: 10.1080/00140139.2023.2296827] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Accepted: 12/13/2023] [Indexed: 12/23/2023]
Abstract
All epidemiological studies on pregnancy fall risk to date have relied on postpartum recall. This study investigated the accuracy of postpartum recall of falls that were reported during pregnancy, including assessment of fall efficacy as a possible reason for recall inaccuracy. Twenty participants reported fall experiences weekly during pregnancy, but one participant was excluded as an outlier. A fall efficacy questionnaire was completed every six weeks during pregnancy. A postpartum survey to mimic previous studies (Dunning, Lemasters, and Bhattacharya 2010; Dunning et al. 2003) was delivered to determine recall accuracy. Postpartum recall of fall events each gestational month matches the previous study (Dunning, Lemasters, and Bhattacharya 2010). However, recall of falls is 16% underestimated and recall of all fall events is 30% overestimated in postpartum survey. There is a slight relationship between fall efficacy and true falls, but not between fall efficacy and fall recall. Our study suggests fall risk needs to be intermittently surveyed throughout pregnancy rather than assessed via postpartum survey.Practitioner summary: This study investigated the accuracy of postpartum survey of fall risk during pregnancy and the possibility of fall efficacy as a covariate. We used three corresponding surveys. We found inaccuracies in postpartum survey, not explain by fall efficacy.
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Affiliation(s)
| | - Shenghai Dai
- Washington State University, Pullman, Washington, USA
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10
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Miele MJ, Souza RT, Vieira MC, Pacagnella RC, Cecatti JG. Maternal diet and interactions with nutritional evaluation during pregnancy. Int J Gynaecol Obstet 2023; 163:782-789. [PMID: 37401116 DOI: 10.1002/ijgo.14974] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2023] [Revised: 06/06/2023] [Accepted: 06/15/2023] [Indexed: 07/05/2023]
Abstract
This narrative review aims to describe the knowledge regarding nutritional evaluation and monitoring in pregnant women. We discuss care provided by non-specialists in nutrition, regarding dietary information and risks during pregnancy, from a theoretical or conceptual viewpoint. A narrative review was conducted following a literature search when scientific databases were investigated, including SciELO, LILACS, Medline, PubMed, theses, government reports, books, and chapters in books. Finally, the material was fully read, categorized, and critically analyzed. National and international protocols of prenatal nutritional care were included and discussed. Different protocols describe the complexity of evaluating and monitoring nutrition among pregnant women during the prenatal period according to each country. The understanding of social conditions and eating habits has an important role in providing nutritional advice during pregnancy. The lack of dietitians in care overwhelms the healthcare workers and characterizes a missed opportunity. Therefore, it is important to consider rapid support tools that can track adverse nutritional status, and ways to recommend a diet that meets eating habit dynamics, according to the reality of each public health system.
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Affiliation(s)
- Maria J Miele
- Department of Obstetrics and Gynecology, School of Medicine, University of Campinas (UNICAMP), Campinas, Brazil
| | - Renato T Souza
- Department of Obstetrics and Gynecology, School of Medicine, University of Campinas (UNICAMP), Campinas, Brazil
| | - Matias C Vieira
- Department of Obstetrics and Gynecology, School of Medicine, University of Campinas (UNICAMP), Campinas, Brazil
- Division of Women and Children's Health, School of Life Course Sciences, Faculty of Life Sciences and Medicine, London, UK
| | - Rodolfo C Pacagnella
- Department of Obstetrics and Gynecology, School of Medicine, University of Campinas (UNICAMP), Campinas, Brazil
| | - José G Cecatti
- Department of Obstetrics and Gynecology, School of Medicine, University of Campinas (UNICAMP), Campinas, Brazil
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11
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Acire PV, Bagonza A, Opiri N. The misbeliefs and food taboos during pregnancy and early infancy: a pitfall to attaining adequate maternal and child nutrition outcomes among the rural Acholi communities in Northern Uganda. BMC Nutr 2023; 9:126. [PMID: 37932846 PMCID: PMC10629057 DOI: 10.1186/s40795-023-00789-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2023] [Accepted: 10/31/2023] [Indexed: 11/08/2023] Open
Abstract
BACKGROUND In developing countries, the practice of food taboo is pervasive. The types of foods considered as taboos and the reasons attached to taboos vary from society to society. Food taboos have been recognized as one of the factors contributing to maternal undernutrition in pregnancy, especially in rural settings. In the rural Acholi community where malnutrition is prevalent, very little is known about these food taboos and misbeliefs. This study, therefore, aims to explore various misbeliefs and food taboos in the time of pregnancy that can influence maternal and child nutrition outcomes in Acholi. METHODS A community-based qualitative cross-sectional study was conducted between April and May 2022 in five districts in the Acholi subregion. Focus group discussions (FGDs) and key informant interviews (KIIs) were used to collect data. Data transcription was done verbatim, organised into themes, assigned unique color codes, and manually analysed thematically. RESULTS Upon scrutiny of the transcripts, three themes were eminent. The first theme focused on foods that are considered taboos in Acholi community and the reasons linked to them. Participants indicated offals, chicken, wild birds, smoked meat and fish, sugarcane, garden egg ('Tula'), groundnut, bush meat, mushrooms, honey, sour fruits, or meals (oranges, mango, passion fruits, lemon, tamarind, 'Malakwang'), goat's meat, 'Lalaa' (the bitter green leafy vegetable), and 'Lamola' (Hyptis spicigera) as the major taboo foods. The second theme was the reasons underlying the adherence to the food taboos and misconceptions. Cultural dictates, individual characteristics, and societal context were the main reasons for the adherence to food taboos. The third theme looked at the misconceptions and other taboos during pregnancy. It was found that pregnant women are not allowed to touch grave soil, shave their hair, walk over an anthill, slaughter chicken or birds, have sex during pregnancy, sit on animal's hide or skin, and/or touch needles. CONCLUSIONS Nutritional counseling and education should focus more on addressing food taboos. The mode of delivery of the nutrition message should be inclusive, targeting pregnant women and their spouses, school-going children, adolescent girls, and cultural leaders at their respective points of contact.
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Affiliation(s)
- Peter Vivian Acire
- Department of Community Health and Behavioral Sciences, Makerere University School of Public Health, Kampala, Uganda.
| | - Arthur Bagonza
- Department of Community Health and Behavioral Sciences, Makerere University School of Public Health, Kampala, Uganda
| | - Nicolas Opiri
- College of Health Sciences, Makerere University, Kampala, Uganda
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12
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Kumari A, Ranjan P, Anwar W, Kaur D, Upadhyay AD, Malhotra A, Vikram NK. A Cross-Sectional Survey of 505 Postpartum Women to Assess Lifestyle-Related Behaviour, Barriers, and Myths Affecting Postpartum Weight Retention and Its Management. J Obstet Gynaecol India 2023; 73:397-405. [PMID: 37916057 PMCID: PMC10616021 DOI: 10.1007/s13224-023-01748-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2022] [Accepted: 03/03/2023] [Indexed: 11/03/2023] Open
Abstract
Background/Purpose This study aims to assess lifestyle-related factors such as diet, physical activity and sleep along with common myths, beliefs, and barriers to a healthy lifestyle and resultant postpartum weight retention. It has also explored the association of the aforementioned factors with socio-demographic variables. Methods A cross-sectional survey was conducted using a comprehensive pre-validated questionnaire on a convenience sample of postpartum women using a telephonic interview schedule. Results A total of 505 postpartum women were recruited with median postpartum weight retention of 5 kg. More than half of the participants had incorrect dietary practices with less than one-tenth of women indulging in low/moderate-intensity physical activity. Postpartum women had poorer diet (p < 0.05) and sleep (p < 0.01) in the initial phase postpartum as compared to late postpartum. These women were also less physically active in the initial months and as the postpartum period progressed their physical activity also improved significantly (p < 0.001). Socio-demographic variables such as socio-economic status, education, and employment status were significantly associated with unhealthy lifestyle practices. Common barriers were lack of knowledge, time constraints, lack of childcare support and cultural myths and beliefs. Conclusion The findings of the study will help in developing a comprehensive women-centric weight management module focusing on practical guidelines for lifestyle, breastfeeding and other confounding factors associated with postpartum weight management.
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Affiliation(s)
- Archana Kumari
- Department of Obstetrics and Gynaecology, AIIMS, New Delhi, India
| | - Piyush Ranjan
- Department of Medicine, All India Institute of Medical Sciences, Ansari Nagar, , New Delhi, 110029 India
| | - Wareesha Anwar
- Scholar, Department of Home Science, University of Delhi, New Delhi, India
| | - Divjyot Kaur
- Scholar, Department of Home Science, University of Delhi, New Delhi, India
| | | | - Anita Malhotra
- Department of Home Science, Laxmi Bai College, University of Delhi, New Delhi, India
| | - Naval Kishore Vikram
- Department of Medicine, All India Institute of Medical Sciences, Ansari Nagar, , New Delhi, 110029 India
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Szczuko M, Golańska J, Palma J, Ziętek M. Impact of Selected Eicosanoids in Normal and Pathological Pregnancies. J Clin Med 2023; 12:5995. [PMID: 37762934 PMCID: PMC10532391 DOI: 10.3390/jcm12185995] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2023] [Revised: 09/12/2023] [Accepted: 09/14/2023] [Indexed: 09/29/2023] Open
Abstract
BACKGROUND Pregnancy is a physiological state in which the female body undergoes a series of changes and adaptations to provide the best possible conditions for the growth and development of the forming baby. The internal adaptations that take place lead to the production of inflammation, which is necessary for the initial and final stages of pregnancy (embryo implantation and induction of labor). Gestational diabetes mellitus is considered to be the most common pathology during this period. However, many more serious health complications can arise, which include pre-eclampsia, fetal stunting, and preterm labor. The purpose of this study was to analyze the impact of the levels of individual eicosanoids on the course of normal pregnancy and the possibility of pathologies including gestational diabetes and pre-eclampsia. METHODS Sixty-nine pregnant women who were overweight or obese before and during pregnancy were studied. Eicosanoids were extracted as appropriate and then determined using liquid chromatography. The levels of eicosanoids studied in pregnant women differed not only according to the week of pregnancy but also in relation to individual anthropometric and biochemical parameters. RESULTS There was a significant correlation between being overweight and having a high BMI before pregnancy-as well as biochemical parameters of lipid and carbohydrate profiles-and the occurrence of pathological conditions in pregnancy. CONCLUSIONS Eicosanoids are involved in the pathology of pregnancy associated with the occurrence of gestational diabetes and pre-eclampsia. Salicylic acid may find use in the treatment of pregnant women exposed to both phenomena, as well as in overweight and obese women found before pregnancy. Diets rich in natural salicylates, methods of administration, and pharmacotherapy and dosage need further study. Some of the mediators (lipoxin, prostaglandin and leucotrien) may be new diagnostic markers in pregnancy pathology and intervention pathways in the future.
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Affiliation(s)
- Małgorzata Szczuko
- Department of Human Nutrition and Metabolomics, Pomeranian Medical University in Szczecin, W. Broniewskiego 24, 71-460 Szczecin, Poland
| | - Justyna Golańska
- Department of Human Nutrition and Metabolomics, Pomeranian Medical University in Szczecin, W. Broniewskiego 24, 71-460 Szczecin, Poland
| | - Joanna Palma
- Department of Biochemical Sciences, Pomeranian Medical University, 70-204 Szczecin, Poland;
| | - Maciej Ziętek
- Department of Perinatology, Obstetrics and Gynecology Pomeranian Medical University in Szczecin, Siedlecka 2, 72-010 Police, Poland;
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Young MF, Nguyen PH, Tran LM, Khuong LQ, Hendrix S, Martorell R, Ramakrishnan U. Maternal preconception BMI and gestational weight gain are associated with weight retention and maternal and child body fat at 6-7 years postpartum in the PRECONCEPT cohort. Front Nutr 2023; 10:1114815. [PMID: 37305082 PMCID: PMC10254082 DOI: 10.3389/fnut.2023.1114815] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2022] [Accepted: 04/03/2023] [Indexed: 06/13/2023] Open
Abstract
Background There is limited evidence from prospective cohorts in low-resource settings on the long-term impact of pre-pregnancy body mass index (PPBMI) and gestational weight gain (GWG) on postpartum weight retention (PPWR) and maternal and child body composition. Objectives We examined the associations between PPBMI and timing of GWG on PPWR at 1, 2, and 6-7 years and maternal and child percent body fat at 6-7 years. Methods We used data from the PRECONCEPT study (NCT01665378) that included prospectively collected data on 864 mother-child pairs from preconception through 6-7 years postpartum. The key outcomes were PPWR at 1, 2, and 6-7 years, and maternal and child percent body fat at 6-7 years that was measured using bioelectric impedance. Maternal conditional GWG (CGWG) was defined as window-specific weight gains (< 20wk, 21-29wk, and ≥ 30wk), uncorrelated with PPBMI and all prior body weights. PPBMI and CGWG were calculated as standardized z-scores to allow for relative comparisons of a 1 standard deviation (SD) increase in weight gain for each window. We used multivariable linear regressions to examine the associations, adjusting for baseline demographic characteristics, intervention, breastfeeding practices, diet and physical activity. Results Mean (SD) PPBMI and GWG were 19.7 (2.1) kg/m2 and 10.2 (4.0) kg, respectively. Average PPWR at 1, 2, and 6-7 years was 1.1, 1.5 and 4.3 kg, respectively. A one SD increase in PPBMI was associated with a decrease in PPWR at 1 year (β [95% CI]: -0.21 [-0.37, -0.04]) and 2 years (-0.20 [-0.39, -0.01]); while a one SD in total CGWG was associated with an increase in PPWR at 1 year (1.01 [0.85,1.18]), 2 years (0.95 [0.76, 1.15]) and 6-7 years (1.05 [0.76, 1.34]). Early CGWG (< 20 weeks) had the greatest association with PPWR at each time point as well as with maternal (0.67 [0.07, 0.87]) and child (0.42 [0.15, 0.69]) percent body fat at 6-7 years. Conclusion Maternal nutrition before and during pregnancy may have long-term implications for PPWR and body composition. Interventions should consider targeting women preconception and early in pregnancy to optimize maternal and child health outcomes.
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Affiliation(s)
- Melissa F. Young
- Hubert Department of Global Health, Emory University, Atlanta, GA, United States
- Doctoral Program in Nutrition and Health Sciences, Laney Graduate School, Emory University, Atlanta, GA, United States
| | - Phuong Hong Nguyen
- Poverty, Health and Nutrition Division, International Food Policy Research Institute (IFPRI), Washington, DC, United States
- Thai Nguyen University of Pharmacy and Medicine, Thai Nguyen, Vietnam
| | - Lan Mai Tran
- Hubert Department of Global Health, Emory University, Atlanta, GA, United States
- Doctoral Program in Nutrition and Health Sciences, Laney Graduate School, Emory University, Atlanta, GA, United States
| | | | - Sara Hendrix
- Hubert Department of Global Health, Emory University, Atlanta, GA, United States
| | - Reynaldo Martorell
- Hubert Department of Global Health, Emory University, Atlanta, GA, United States
- Doctoral Program in Nutrition and Health Sciences, Laney Graduate School, Emory University, Atlanta, GA, United States
| | - Usha Ramakrishnan
- Hubert Department of Global Health, Emory University, Atlanta, GA, United States
- Doctoral Program in Nutrition and Health Sciences, Laney Graduate School, Emory University, Atlanta, GA, United States
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15
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Maugans C, Loveday M, Hlangu S, Waitt C, Van Schalkwyk M, van de Water B, Salazar-Austin N, McKenna L, Mathad JS, Kalk E, Hurtado R, Hughes J, Eke AC, Ahmed S, Furin J. Best practices for the care of pregnant people living with TB. Int J Tuberc Lung Dis 2023; 27:357-366. [PMID: 37143222 PMCID: PMC10171489 DOI: 10.5588/ijtld.23.0031] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2023] [Accepted: 01/27/2023] [Indexed: 05/06/2023] Open
Abstract
BACKGROUND: Each year more than 200,000 pregnant people become sick with TB, but little is known about how to optimize their diagnosis and therapy. Although there is a need for further research in this population, it is important to recognize that much can be done to improve the services they currently receive.METHODS: Following a systematic review of the literature and the input of a global team of health professionals, a series of best practices for the diagnosis, prevention and treatment of TB during pregnancy were developed.RESULTS: Best practices were developed for each of the following areas: 1) screening and diagnosis; 2) reproductive health services and family planning; 3) treatment of drug-susceptible TB; 4) treatment of rifampicin-resistant/multidrug-resistant TB; 5) compassionate infection control practices; 6) feeding considerations; 7) counseling and support; 8) treatment of TB infection/TB preventive therapy; and 9) research considerations.CONCLUSION: Effective strategies for the care of pregnant people across the TB spectrum are readily achievable and will greatly improve the lives and health of this under-served population.
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Affiliation(s)
- C Maugans
- Sentinel Project on Pediatric Drug Resistant Tuberculosis, Boston, MA, USA
| | - M Loveday
- HIV and other Infectious Diseases Research Unit (HIDRU), South African Medical Research Council, Durban, South Africa
| | - S Hlangu
- HIV and other Infectious Diseases Research Unit (HIDRU), South African Medical Research Council, Durban, South Africa
| | - C Waitt
- Department of Pharmacology and Therapeutics, University of Liverpool, UK, and the Infectious Diseases Institute, Makerere University College of Health Sciences, Kampala, Uganda
| | - M Van Schalkwyk
- Division of Adult Infectious Diseases, Department of Medicine, Faculty of Medicine and Health Sciences, Stellenbosch University and Tygerberg Hospital, Cape Town, South Africa
| | - B van de Water
- Boston College Connell School of Nursing, Chestnut Hill, MA, USA
| | - N Salazar-Austin
- Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - L McKenna
- Treatment Action Group, New York, NY, USA
| | - J S Mathad
- Departments of Medicine and Obstetrics & Gynecology, Center for Global Health, Weill Cornell Medicine, New York, NY, USA
| | - E Kalk
- Centre for Infectious Disease Epidemiology & Research, School of Public Health, University of Cape Town, South Africa
| | - R Hurtado
- Division of Infectious Diseases, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA, Global Health Committee, Boston, MA, USA
| | - J Hughes
- Desmond Tutu TB Centre, Department of Paediatrics and Child Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - A C Eke
- Division of Maternal Fetal Medicine, Department of Gynecology & Obstetrics, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - S Ahmed
- Interactive Research and Development, Karachi, Pakistan
| | - J Furin
- Harvard Medical School, Department of Global Health and Social Medicine, Boston, MA, USA
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16
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Widen EM, Burns N, Kahn LG, Grewal J, Backlund G, Nichols AR, Rickman R, Foster S, Nhan-Chang CL, Zhang C, Wapner R, Wing DA, Owen J, Skupski DW, Ranzini AC, Newman R, Grobman W, Daniels MJ. Prenatal weight and regional body composition trajectories and neonatal body composition: The NICHD Foetal Growth Studies. Pediatr Obes 2023; 18:e12994. [PMID: 36605025 PMCID: PMC9924063 DOI: 10.1111/ijpo.12994] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2022] [Accepted: 11/30/2022] [Indexed: 01/07/2023]
Abstract
BACKGROUND Gestational weight gain (GWG) and anthropometric trajectories may affect foetal programming and are potentially modifiable. OBJECTIVES To assess concomitant patterns of change in weight, circumferences and adiposity across gestation as an integrated prenatal exposure, and determine how they relate to neonatal body composition. METHODS Data are from a prospective cohort of singleton pregnancies (n = 2182) enrolled in United States perinatal centres, 2009-2013. Overall and by prepregnancy BMI group (overweight/obesity and healthy weight), joint latent trajectory models were fit with prenatal weight, mid-upper arm circumference (MUAC), triceps (TSF) and subscapular (SSF) skinfolds. Differences in neonatal body composition by trajectory class were assessed via weighted least squares. RESULTS Six trajectory patterns reflecting co-occurring changes in weight and MUAC, SSF and TSF across pregnancy were identified overall and by body mass index (BMI) group. Among people with a healthy weight BMI, some differences were observed for neonatal subcutaneous adipose tissue, and among individuals with overweight/obesity some differences in neonatal lean mass were found. Neonatal adiposity measures were higher among infants born to individuals with prepregnancy overweight/obesity. CONCLUSIONS Six integrated trajectory patterns of prenatal weight, subcutaneous adipose tissue and circumferences were observed that were minimally associated with neonatal body composition, suggesting a stronger influence of prepregnancy BMI.
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Affiliation(s)
- Elizabeth M Widen
- Department of Nutritional Sciences, University of Texas at Austin, Austin, Texas, USA
- Department of Women's Health & Pediatrics, Dell Medical School, University of Texas at Austin, Austin, Texas, USA
| | - Natalie Burns
- Department of Statistics, University of Florida, Gainesville, Florida, USA
| | - Linda G Kahn
- Departments of Pediatrics and Population Health, New York University Grossman School of Medicine, New York, New York, USA
| | - Jagteshwar Grewal
- Division of Population Health Research, Division of Intramural Research, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, Maryland, USA
| | - Grant Backlund
- Department of Statistics, University of Florida, Gainesville, Florida, USA
| | - Amy R Nichols
- Department of Nutritional Sciences, University of Texas at Austin, Austin, Texas, USA
| | - Rachel Rickman
- Department of Nutritional Sciences, University of Texas at Austin, Austin, Texas, USA
| | - Saralyn Foster
- Department of Nutritional Sciences, University of Texas at Austin, Austin, Texas, USA
| | - Chia-Ling Nhan-Chang
- Department of Obstetrics and Gynecology, Columbia University Medical Center, Columbia, South Carolina, USA
| | - Cuilin Zhang
- Division of Population Health Research, Division of Intramural Research, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, Maryland, USA
| | - Ronald Wapner
- Department of Obstetrics and Gynecology, Columbia University Medical Center, Columbia, South Carolina, USA
| | - Deborah A Wing
- Division of Maternal-Fetal Medicine, Department of Obstetrics-Gynecology, University of California, Irvine, School of Medicine, Irvine, and Fountain Valley Regional Hospital and Medical Center, Fountain Valley, California, USA
| | - John Owen
- Division of Maternal and Fetal Medicine, Department of Obstetrics and Gynecology, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Daniel W Skupski
- Department of Obstetrics and Gynecology, New York-Presbyterian Queens Hospital, Queens, New York, USA
| | - Angela C Ranzini
- Division of Maternal and Fetal Medicine, Department of Obstetrics and Gynecology, St Peter's University Hospital, New Brunswick, New Jersey, USA
| | - Roger Newman
- Department of Obstetrics and Gynecology, Medical University of South Carolina, Columbia, South Carolina, USA
| | - William Grobman
- Department of Obstetrics and Gynecology, Feinberg School of Medicine, Northwestern University (WAG), New Rochelle, New York, USA
| | - Michael J Daniels
- Department of Statistics, University of Florida, Gainesville, Florida, USA
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Showkat I, Khanday FA, Beigh MR. A review of bio-impedance devices. Med Biol Eng Comput 2023; 61:927-950. [PMID: 36637716 DOI: 10.1007/s11517-022-02763-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2022] [Accepted: 12/27/2022] [Indexed: 01/14/2023]
Abstract
Bio-impedance measurement analysis primarily refers to a safe and a non-invasive technique to analyze the electrical changes in living tissues on the application of low-value alternating current. It finds applications both in the biomedical and the agricultural fields. This paper concisely reviews the origin and measurement approaches for concepts and fundamentals of bio-impedance followed by a critical review on bio-impedance portable devices with main emphasis on the embedded system approach which is in demand due to its miniature size and present lifestyle preference of monitoring health in real time. The paper also provides a comprehensive review of various bio-impedance circuits with emphasis on the measurement and calibration techniques.
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Affiliation(s)
- Insha Showkat
- Department of Electronics and Instrumentation Technology, University of Kashmir, Hazratbal, Srinagar, Jammu and Kashmir, India
| | - Farooq A Khanday
- Department of Electronics and Instrumentation Technology, University of Kashmir, Hazratbal, Srinagar, Jammu and Kashmir, India.
| | - M Rafiq Beigh
- Department of Electronics, Govt. Degree College Sumbal, Sumbal, J&K, India
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Saros L, Lind A, Setänen S, Tertti K, Koivuniemi E, Ahtola A, Haataja L, Shivappa N, Hébert JR, Vahlberg T, Laitinen K. Maternal obesity, gestational diabetes mellitus, and diet in association with neurodevelopment of 2-year-old children. Pediatr Res 2023. [PMID: 36596942 DOI: 10.1038/s41390-022-02455-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2021] [Revised: 11/08/2022] [Accepted: 12/21/2022] [Indexed: 01/04/2023]
Abstract
BACKGROUND Maternal metabolic disturbances and diet may influence long-term infantile neurodevelopment. We investigated whether maternal gestational diabetes mellitus (GDM), obesity, and diet could affect the neurodevelopment of 2-year-old children. METHODS Neurodevelopment of children (n = 243) born to mothers with overweight or obesity was assessed with the Bayley Scales of Infant and Toddler Development-Third Edition, and the Hammersmith Infant Neurological Examination. Maternal adiposity was determined by air displacement plethysmography, and GDM with an oral glucose tolerance test. Dietary assessment included diet quality and fish consumption questionnaires, and three-day food diaries, from which dietary inflammatory index (DII®) scores were computed. RESULTS GDM was associated with weaker expressive language skills (adj.β = -1.12, 95% CI = -2.10;-0.15), and higher maternal adiposity with weaker cognitive, language, and motor skills in children (adj.p < 0.05). Maternal good dietary quality (adj.β = 0.87, 95% CI = 0.004;1.73) and higher fish consumption (adj.p = 0.02) were related to better expressive language skills. DII scores were not associated with children's neurodevelopment. CONCLUSIONS Findings suggest that GDM and higher maternal adiposity may lead to weaker neurodevelopmental skills, although still within the mean normative range in this population of children. Good dietary quality and higher fish consumption during pregnancy could benefit a child's language development. IMPACT Gestational diabetes mellitus and maternal higher adiposity may have unfavorable effects on a 2-year-old child's neurodevelopment. An overall good quality of diet and higher fish consumption during pregnancy may result in more favorable cognitive and language skills when the child is 2-year-old. Our findings reveal that women with overweight or obesity, a risk group for pregnancy complications, could benefit from dietary counseling to support their children's neurodevelopment.
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Versele V, Stas L, Aerenhouts D, Deliens T, Clarys P, Gucciardo L, Bogaerts A, Devlieger R. Changes in maternal and paternal body composition during the transition to parenthood (TRANSPARENTS). Obesity (Silver Spring) 2023; 31:225-233. [PMID: 36471905 DOI: 10.1002/oby.23586] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2022] [Revised: 07/27/2022] [Accepted: 08/10/2022] [Indexed: 12/12/2022]
Abstract
OBJECTIVE The transition to parenthood might negatively influence health-related behavior and can result in increased adiposity. The aim of this study was to investigate how body composition in mother-father dyads changes from pregnancy up to 6 months post partum. METHODS Anthropometrics were collected from 144 nulliparous couples at 12 weeks of gestation (PG12) and 6 weeks (PP6WK) and 6 months (PP6M) post partum. A longitudinal dyadic confirmatory factor analysis model was used to analyze changes in body composition. Body composition was treated as a latent variable using BMI, body fat percentage, and waist circumference as indicators. RESULTS For women, latent means increased at 6 weeks post partum (PP6WK - PG12: +1.115, SE: 0.117, p < 0.001), decreased again at 6 months post partum (PP6M - PP6WK: -0.368, SE: 0.107, p < 0.001), but remained above baseline levels (PP6M - PG12: +0.747; SE: 0.115, p < 0.001). For men, the latent means at follow-up were higher than at baseline (PP6WK-PG12: +0.370, SE: 0.075; PP6M-PG12: +0.366, SE: 0.084, both p < 0.001). CONCLUSIONS Increases in latent means correspond to unfavorable changes in BMI, body fat percentage, and waist circumference. These changes were observed from the beginning of pregnancy up to 6 months post partum. Weight management for both women and men during pregnancy and the early postpartum period is recommended and fathers should be included in pre- and postnatal standard care.
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Affiliation(s)
- Vickà Versele
- Faculty of Physical Education and Physiotherapy, Department of Movement and Sport Sciences, Vrije Universiteit Brussel, Brussels, Belgium
- Faculty of Medicine, Department of Development and Regeneration, KU Leuven, Leuven, Belgium
| | - Lara Stas
- Support for Quantitative and Qualitative Research (SQUARE), Core Facility, Vrije Universiteit Brussel, Brussels, Belgium
- Department of Biostatistics and Medical Informatics, Vrije Universiteit Brussel, Brussels, Belgium
| | - Dirk Aerenhouts
- Faculty of Physical Education and Physiotherapy, Department of Movement and Sport Sciences, Vrije Universiteit Brussel, Brussels, Belgium
| | - Tom Deliens
- Faculty of Physical Education and Physiotherapy, Department of Movement and Sport Sciences, Vrije Universiteit Brussel, Brussels, Belgium
| | - Peter Clarys
- Faculty of Physical Education and Physiotherapy, Department of Movement and Sport Sciences, Vrije Universiteit Brussel, Brussels, Belgium
| | - Leonardo Gucciardo
- Faculty of Medicine, Department of Obstetrics and Prenatal Medicine, Vrije Universiteit Brussel, Brussels, Belgium
- Obstetrics and Prenatal Medicine, University Hospital Brussel, Brussels, Belgium
| | - Annick Bogaerts
- Faculty of Medicine, Department of Development and Regeneration, KU Leuven, Leuven, Belgium
- Faculty of Medicine and Health Sciences, Centre for Research and Innovation in Care (CRIC), University of Antwerp, Antwerpen, Belgium
- Faculty of Health, University of Plymouth, Plymouth, UK
| | - Roland Devlieger
- Faculty of Medicine, Department of Development and Regeneration, KU Leuven, Leuven, Belgium
- Obstetrics and Gynaecology, University Hospital KU Leuven, Leuven, Belgium
- Department of Obstetrics, Gynaecology and Fertility, GZA Campus Wilrijk, Antwerp, Belgium
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Gianakos AL, Abdelmoneim A, Kerkhoffs GM, DiGiovanni CW. The Pregnant Patient - Why Do My Feet Hurt? J Foot Ankle Surg 2022; 61:1357-1361. [PMID: 35637071 DOI: 10.1053/j.jfas.2022.04.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Accepted: 04/06/2022] [Indexed: 02/03/2023]
Abstract
Although hormonal and anatomical changes that occur during pregnancy have been well documented, how these changes affect foot and ankle function are less understood. Changes during pregnancy in body mass, body-mass distribution, joint laxity, and muscle strength can all contribute to alterations in gait pattern that can lead to pain or injury to the foot and ankle. This review provides an overview of the various foot and ankle anatomic, biomechanic, and kinematic changes that occur during pregnancy. In addition, this article presents the most common causes of foot and ankle symptoms expressed by the pregnant patient population and discuss the management and treatment of each condition.
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Affiliation(s)
- Arianna L Gianakos
- Massachusetts General Hospital, Department of Orthopedic Surgery, Boston, MA; Amsterdam University Medical Centers, Department of Orthopedic Surgery, Amsterdam Movement Sciences, Amsterdam, the Netherlands.
| | | | - Gino M Kerkhoffs
- Amsterdam University Medical Centers, Department of Orthopedic Surgery, Amsterdam Movement Sciences, Amsterdam, the Netherlands; Academic Center of Evidence based Sports medicine (ACES), Amsterdam, the Netherlands; Amsterdam Collaboration for Health and Safety in Sports (ACHSS), IOC Research Center, Amsterdam, the Netherlands
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Versele V, Dieberger A, van Poppel M, Van De Maele K, Deliens T, Aerenhouts D, Clarys P, Devlieger R, Bogaerts A. The influence of parental body composition and lifestyle on offspring growth trajectories. Pediatr Obes 2022; 17:e12929. [PMID: 35578741 DOI: 10.1111/ijpo.12929] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2022] [Revised: 03/18/2022] [Accepted: 04/13/2022] [Indexed: 11/30/2022]
Abstract
BACKGROUND AND OBJECTIVES Parental body composition, physical activity (PA) and sedentary time (ST) have been linked with offspring body weight and health. However, independent contributions of body composition, PA and ST of both parents on growth trajectories of their offspring, taking into account sex differences, has not been investigated. METHODS A total of 114 mother-father-child triads were included for analyses. Parental weight, height, PA and ST were objectively measured at 12 weeks of gestation. Gestational weight gain (GWG) and birthweight and -length were obtained from medical records. Offspring weight and length were measured repeatedly until 1 year of age. Longitudinal linear mixed models, stratified by offspring sex, were used to analyse the association between parental characteristics and offspring growth. RESULTS GWG (positive association), maternal moderate-to-vigorous PA (negative association) and paternal ST (positive association) were associated with weight trajectories in girls but not in boys. Parental characteristics were not associated with offspring length trajectories. CONCLUSIONS This study highlights the contribution of parental lifestyle characteristics on weight trajectories of their daughters during the first year of life. The paternal impact stresses the need to further investigate health behaviours of expecting fathers in relation to offspring health. Family-based interventions are needed with a focus on increasing PA and limiting ST in both parents.
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Affiliation(s)
- Vickà Versele
- Faculty of Physical Education and Physiotherapy, Department of Movement and Sport Sciences, Vrije Universiteit Brussel, Brussels, Belgium.,Department of Development and Regeneration, Faculty of Medicine, KU Leuven, Leuven, Belgium
| | - Anna Dieberger
- Department of Obstetrics and Gynaecology, Medical University of Graz, Graz, Austria
| | - Mireille van Poppel
- Institute of Human Movement Science, Sport and Health, University of Graz, Austria
| | | | - Tom Deliens
- Faculty of Physical Education and Physiotherapy, Department of Movement and Sport Sciences, Vrije Universiteit Brussel, Brussels, Belgium
| | - Dirk Aerenhouts
- Faculty of Physical Education and Physiotherapy, Department of Movement and Sport Sciences, Vrije Universiteit Brussel, Brussels, Belgium
| | - Peter Clarys
- Faculty of Physical Education and Physiotherapy, Department of Movement and Sport Sciences, Vrije Universiteit Brussel, Brussels, Belgium
| | - Roland Devlieger
- Department of Development and Regeneration, Faculty of Medicine, KU Leuven, Leuven, Belgium.,Obstetrics and Gynaecology, University Hospital, KU Leuven, Leuven, Belgium.,Department of Obstetrics, Gynaecology and Fertility, Wilrijk, Belgium
| | - Annick Bogaerts
- Department of Development and Regeneration, Faculty of Medicine, KU Leuven, Leuven, Belgium.,Faculty of Medicine and Health Sciences, Centre for Research and Innovation in Care (CRIC), University of Antwerp, Antwerp, Belgium.,Faculty of Health, University of Plymouth, Plymouth, UK
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Mamidi RS, Banjara SK, Manchala S, Babu CK, Geddam JJB, Boiroju NK, Varanasi B, Neeraja G, Reddy GVR, Ramalakshmi BA, Hemalatha R, Meur G. Maternal Nutrition, Body Composition and Gestational Weight Gain on Low Birth Weight and Small for Gestational Age-A Cohort Study in an Indian Urban Slum. Children (Basel) 2022; 9:children9101460. [PMID: 36291396 PMCID: PMC9600910 DOI: 10.3390/children9101460] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/08/2022] [Revised: 09/10/2022] [Accepted: 09/13/2022] [Indexed: 01/16/2023]
Abstract
Maternal nutritional status and care during pregnancy are essential for adequate birth weight. In this prospective cohort study (N = 1061) in an urban slum, we investigated the association of maternal anthropometry, body composition, gestational weight gain and dietary intakes with low birthweight (LBW, <2.5 kg). About one-third of the women were short (<150 cm), 35% were underweight (<45 kg), 23% suffered from chronic energy deficiency (CED, BMI < 18.5 kg/m2) and another 30% were overweight/obese. The mean age and BMI were 23 years and 21.7 kg/m2, respectively, and haemoglobin was 10.73 g/dL. The mean birthweight (N = 605) was 2.81 ± 0.5 kg, and the average gestational age was 38 ± 2 weeks. About 15% of infants had LBW, and 48% were small for gestational age (SGA). Maternal body composition was assessed by skinfold thickness (SFT) in all trimesters. In the first trimester (N = 762), we found that mean fat-free mass (FFM), fat mass (FM) and body fat percentage (% BF) were 38.86 kg, 11.43 kg and 21.55%, respectively. Low birthweight was significantly associated with preterm deliveries (p < 0.001) and less fat free mass (p = 0.02) in the third trimester. Among other factors were age (p = 0.017), maternal anthropometry (height: p = 0.031; weight: p = 0.059) and fewer antenatal check-ups (p = 0.037). Small size (SGA) was consistently associated with maternal bodyweight at all trimesters (term I, p = 0.013, term II, p = 0.003 and term III, p < 0.001), fat mass in the third trimester (p < 0.001) and maternal height (p = 0.003).
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Affiliation(s)
- Raja Sriswan Mamidi
- Clinical Epidemiology Division, ICMR-National Institute of Nutrition, Hyderabad 500 007, India
| | | | - Sridevi Manchala
- Clinical Epidemiology Division, ICMR-National Institute of Nutrition, Hyderabad 500 007, India
| | - Ch Khadar Babu
- Clinical Epidemiology Division, ICMR-National Institute of Nutrition, Hyderabad 500 007, India
| | - J. J. Babu Geddam
- Clinical Epidemiology Division, ICMR-National Institute of Nutrition, Hyderabad 500 007, India
| | - Naveen Kumar Boiroju
- Clinical Epidemiology Division, ICMR-National Institute of Nutrition, Hyderabad 500 007, India
| | - Bhaskar Varanasi
- Public Health Nutrition, ICMR-National Institute of Nutrition, Hyderabad 500 007, India
| | - G. Neeraja
- Public Health Nutrition, ICMR-National Institute of Nutrition, Hyderabad 500 007, India
| | - G. Venkat Raji Reddy
- Clinical Epidemiology Division, ICMR-National Institute of Nutrition, Hyderabad 500 007, India
| | - B. A. Ramalakshmi
- Clinical Division, ICMR-National Institute of Nutrition, Hyderabad 500 007, India
| | - R. Hemalatha
- Clinical Division, ICMR-National Institute of Nutrition, Hyderabad 500 007, India
- Correspondence: (R.H.); (G.M.); Tel.: +91-4027197200 (R.H.); +91-4027197472 (G.M.)
| | - Gargi Meur
- Clinical Epidemiology Division, ICMR-National Institute of Nutrition, Hyderabad 500 007, India
- Correspondence: (R.H.); (G.M.); Tel.: +91-4027197200 (R.H.); +91-4027197472 (G.M.)
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Rush EC, Plank LD, Lubree H, Bhat DS, Ganpule A, Yajnik CS. Gains in body mass and body water in pregnancy and relationships to birth weight of offspring in rural and urban Pune, India. J Nutr Sci 2022; 11:e75. [PMID: 36304819 DOI: 10.1017/jns.2022.75] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Revised: 07/29/2022] [Accepted: 08/09/2022] [Indexed: 12/14/2022] Open
Abstract
Maternal size, weight gain in pregnancy, fetal gender, environment and gestational age are known determinants of birth weight. It is not clear which component of maternal weight or gained weight during pregnancy influences birth weight. We evaluated the association of maternal total body water measured by the deuterium dilution technique (TBW-D2O) at 17 and 34 weeks of gestation with birth weight. A secondary aim was to examine the utility of bioimpedance spectroscopy (BIS) to determine total body water (TBW-BIS) in pregnancy. At 17 and 34 weeks of pregnancy, ninety-nine women (fifty-one rural and forty-eight urban) from Pune, India had measurements of body weight, TBW-D2O, TBW-BIS and offspring birth weight. At 17 weeks of gestation, average weights for rural and urban women were 45⋅5 ± 4⋅8 (sd) and 50⋅7 ± 7⋅8 kg (P < 0⋅0001), respectively. Maternal weight gains over the subsequent 17 weeks for rural and urban women were 6⋅0 ± 2⋅2 and 7⋅5 ± 2⋅8 kg (P = 0⋅003) and water gains were 4⋅0 ± 2⋅4 and 4⋅8 ± 2⋅8 kg (P = 0⋅092), respectively. In both rural and urban women, birth weight was positively, and independently, associated with gestation and parity. Only for rural women, between 17 and 34 weeks, was an increase in dry mass (weight minus TBW-D2O) or a decrease in TBW-D2O as a percentage of total weight associated with a higher birth weight. At both 17 and 34 weeks, TBW-BIS increasingly underestimated TBW-D2O as the water space increased. Differences in body composition during pregnancy between rural and urban environments and possible impacts of nutrition transition on maternal body composition and fetal growth were demonstrated.
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Rahnemaei FA, Abdi F, Pakzad R, Sharami SH, Mokhtari F, Kazemian E. Association of body composition in early pregnancy with gestational diabetes mellitus: A meta-analysis. PLoS One 2022; 17:e0271068. [PMID: 35969611 PMCID: PMC9377632 DOI: 10.1371/journal.pone.0271068] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2022] [Accepted: 06/22/2022] [Indexed: 01/10/2023] Open
Abstract
INTRODUCTION Body composition as dynamic indices constantly changes in pregnancy. The use of body composition indices in the early stages of pregnancy has recently been considered. Therefore, the current meta-analysis study was conducted to investigate the relationship between body composition in the early stages of pregnancy and gestational diabetes. METHOD Valid databases searched for papers published from 2010 to December 2021 were based on PRISMA guideline. Newcastle Ottawa was used to assess the quality of the studies. For all analyses, STATA 14.0 was used. Mean difference (MD) of anthropometric indices was calculated between the GDM and Non-GDM groups. Pooled MD was estimated by "Metan" command, and heterogeneity was defined using Cochran's Q test of heterogeneity, and I 2 index was used to quantify heterogeneity. RESULTS Finally, 29 studies with a sample size of 56438 met the criteria for entering the meta-analysis. Pooled MD of neck circumference, hip circumference, waist hip ratio, and visceral adipose tissue depth were, respectively, 1.00 cm (95% CI: 0.79 to 1.20) [N = 5; I^2: 0%; p: 0.709], 7.79 cm (95% CI: 2.27 to 13.31) [N = 5; I2: 84.3%; P<0.001], 0.03 (95% CI: 0.02 to 0.04) [N = 9; I2: 89.2%; P<0.001], and 7.74 cm (95% CI: 0.11 to 1.36) [N = 4; I^2: 95.8%; P<0.001]. CONCLUSION Increased neck circumference, waist circumference, hip circumference, arm circumference, waist to hip ratio, visceral fat depth, subcutaneous fat depth, and short stature increased the possibility of developing gestational diabetes. These indices can accurately, cost-effectively, and affordably assess the occurrence of gestational diabetes, thus preventing many consequences with early detection of gestational diabetes.
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Affiliation(s)
- Fatemeh Alsadat Rahnemaei
- Department of Obstetrics & Gynecology, Midwifery, Reproductive Health Research Center, Al-zahra Hospital, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran
| | - Fatemeh Abdi
- Non-communicable Diseases Research Center, Alborz University of Medical Sciences, Karaj, Iran
| | - Reza Pakzad
- Epidemiology, Faculty of Health, Ilam University of Medical Sciences, Ilam, Iran
| | - Seyedeh Hajar Sharami
- Department of Obstetrics & Gynecology, Reproductive Health Research Center, Al-zahra Hospital, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran
| | - Fatemeh Mokhtari
- Department of Midwifery, Reproductive Health, Faculty of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Elham Kazemian
- Department of Medicine, Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center, Los Angeles, CA, Unites States of America
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Thomas L, Raju AP, Chaithra, M SS, Varma M, Saravu K, Banerjee M, Sv CS, Mallayasamy S, Rao M. Influence of N-acetyltransferase 2 (NAT2) genotype/single nucleotide polymorphisms on clearance of isoniazid in tuberculosis patients: a systematic review of population pharmacokinetic models. Eur J Clin Pharmacol. [PMID: 35852584 PMCID: PMC9482569 DOI: 10.1007/s00228-022-03362-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2022] [Accepted: 06/29/2022] [Indexed: 11/19/2022]
Abstract
Purpose Significant pharmacokinetic variabilities have been reported for isoniazid across various populations. We aimed to summarize population pharmacokinetic studies of isoniazid in tuberculosis (TB) patients with a specific focus on the influence of N-acetyltransferase 2 (NAT2) genotype/single-nucleotide polymorphism (SNP) on clearance of isoniazid. Methods A systematic search was conducted in PubMed and Embase for articles published in the English language from inception till February 2022 to identify population pharmacokinetic (PopPK) studies of isoniazid. Studies were included if patient population had TB and received isoniazid therapy, non-linear mixed effects modelling, and parametric approach was used for building isoniazid PopPK model and NAT2 genotype/SNP was tested as a covariate for model development. Results A total of 12 articles were identified from PubMed, Embase, and hand searching of articles. Isoniazid disposition was described using a two-compartment model with first-order absorption and linear elimination in most of the studies. Significant covariates influencing the pharmacokinetics of isoniazid were NAT2 genotype, body weight, lean body weight, body mass index, fat-free mass, efavirenz, formulation, CD4 cell count, and gender. Majority of studies conducted in adult TB population have reported a twofold or threefold increase in isoniazid clearance for NAT2 rapid acetylators compared to slow acetylators. Conclusion The variability in disposition of isoniazid can be majorly attributed to NAT2 genotype. This results in a trimodal clearance pattern with a multi-fold increase in clearance of NAT2 rapid acetylators compared to slow acetylators. Further studies exploring the generalizability/adaptability of developed PopPK models in different clinical settings are required.
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Zhang J, Zhang N, Du S, Liu S, Ma G. Acute Water Supplementation Improved the Body Composition of Young Female Adults After Water Restriction of 12 h in Baoding, China: A Randomized Controlled Trial (RCT). Front Nutr 2022; 9:880630. [PMID: 35795583 PMCID: PMC9251362 DOI: 10.3389/fnut.2022.880630] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2022] [Accepted: 04/27/2022] [Indexed: 12/15/2022] Open
Abstract
Insufficient intake of water may influence the balance of water in the human body. In this study, we explore the impacts of water supplementation on body composition indices among young adults after 12 h of water restriction, with the aim to determine the optimum volume of water for improving body water composition. A randomized controlled trial study was conducted among 64 young men and women in Baoding, China. After fasting overnight for 12 h, anthropometric measurements and urine and blood samples were collected as a baseline test at 8:00 a.m. of Day 2. Body composition was determined by measuring the ECW (extracellular water), ICW (intracellular water), and TBW (total body water) through bioelectrical impedance analysis (BIA). The participants were randomly divided into four groups, including water supplementation (WS) groups 1, 2, and 3, with 500, 200, and 100 mL of water, respectively, and a no water supplementation (NW) group. After 90 min, they were reassessed in a rehydration test (at 10:00 a.m. of Day 2). Repeated measurement ANOVA was used to assess the impact of water supplementation on body composition. Comparing the baseline and rehydration tests, interactions between time and volume were not significant among the men (all p > 0.05). Among women, a significant interaction was only found in ECW (p = 0.043), with TBW tending toward being significant (p = 0.055). Comparing the baseline and rehydration tests, the ECW in WS group 1, WS group 3, and the NW group all decreased (p = 0.028, p = 0.001, and p = 0.029), with reductions of 0.1, 0.3, and 0.2 kg, respectively; however, no significant decrease was observed in WS group 2 (p = 0.329). Furthermore, comparing the WS groups with the NW group in the rehydration test, the differences were not significant (p = 1.000, p = 1.000, and p = 0.288, respectively). Between men and women within groups, all of the body composition indices differed significantly, both at baseline and rehydration tests (all p < 0.05). Water supplementation led to changes in the distribution of the water content in young female adults in this study-but not men-after 12 h of water restriction, with no decrease in ECW. Finally, we found that 200 mL was the minimum volume capable of improving the water content distribution in participants in this study. Trial Registration [www.chictr.org.cn], identifier [ChiCTR-IOR-17011568].
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Affiliation(s)
- Jianfen Zhang
- Department of Nutrition and Food Hygiene, School of Public Health, Peking University, Beijing, China
- Laboratory of Toxicological Research and Risk Assessment for Food Safety, Peking University, Beijing, China
| | - Na Zhang
- Department of Nutrition and Food Hygiene, School of Public Health, Peking University, Beijing, China
- Laboratory of Toxicological Research and Risk Assessment for Food Safety, Peking University, Beijing, China
| | | | - Shufang Liu
- School of Public Health, Health Science Center, Hebei University, Baoding, China
| | - Guansheng Ma
- Department of Nutrition and Food Hygiene, School of Public Health, Peking University, Beijing, China
- Laboratory of Toxicological Research and Risk Assessment for Food Safety, Peking University, Beijing, China
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Goyal RK, Moffett BS, Gobburu JVS, Al Mohajer M. Population Pharmacokinetics of Vancomycin in Pregnant Women. Front Pharmacol 2022; 13:873439. [PMID: 35734401 PMCID: PMC9207242 DOI: 10.3389/fphar.2022.873439] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2022] [Accepted: 05/23/2022] [Indexed: 11/22/2022] Open
Abstract
Objective: Vancomycin is a glycopeptide antibacterial indicated for serious gram-positive infections. Pharmacokinetics (PK) of vancomycin have not been described in pregnant women. This study aims to characterize the PK disposition of vancomycin in pregnant women based on data acquired from a database of routine hospital care for therapeutic drug monitoring to better inform dosing decisions. Methods: In this study, plasma drug concentration data from 34 pregnant hospitalized women who were administered intravenous vancomycin was analyzed. A population pharmacokinetic (PPK) model was developed using non-linear mixed effects modeling. Model selection was based on statistical criterion, graphical analysis, and physiologic relevance. Using the final model AUC0-24 (PK efficacy index of vancomycin) was compared with non-pregnant population. Results: Vancomycin PK in pregnant women were best described by a two-compartment model with first-order elimination and the following parameters: clearance (inter individual variability) of 7.64 L/hr (32%), central volume of 67.35 L, inter-compartmental clearance of 9.06 L/h, and peripheral volume of 37.5 L in a typical patient with 175 ml/min creatinine clearance (CRCL) and 45 kg fat-free mass (FFM). The calculated geometric mean of AUC0-24 for the pregnant population was 223 ug.h/ ml and 226 ug.h/ ml for the non-pregnant population. Conclusion: Our analysis suggests that vancomycin PK in pregnant women is consistent with non-pregnant adults and the dosing regimens used for non-pregnant patients may also be applicable to pregnant patients.
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Affiliation(s)
| | - Brady S. Moffett
- Texas Children’s Hospital, Houston, TX, United States
- Baylor College of Medicine, Houston, TX, United States
| | - Jogarao V. S. Gobburu
- University of Maryland, Baltimore, MD, United States
- *Correspondence: Jogarao V. S. Gobburu,
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Maran A, Atkinson SA, Bertram V, Vanniyasingam T, Thabane L, Mottola MF, Phillips SM. Exploring comparative assessment of adiposity measures during pregnancy and postpartum. Clin Nutr ESPEN 2022; 49:365-371. [PMID: 35623838 DOI: 10.1016/j.clnesp.2022.03.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2021] [Revised: 02/28/2022] [Accepted: 03/14/2022] [Indexed: 10/18/2022]
Abstract
BACKGROUND & AIMS Excessive adiposity in pregnancy is associated with an altered cardiometabolic profile and adverse maternal and offspring outcomes. Pre-pregnancy body mass index (pBMI) is a proxy measure for adiposity that is most often used in clinical settings; however, it may not identify at-risk pregnancies caused by adiposity-related cardiometabolic dysfunction. The challenge is that validated direct adiposity measures are limited due to the dynamic nature of pregnancy. This exploratory analysis aimed to, 1) evaluate longitudinal changes in % body fat (BF) and the agreement between skinfold thickness (SFT) and bioelectrical impedance analysis (BIA) across pregnancy and in postpartum; 2) compare the discrimination power of SFT, BIA, and pBMI regarding adiposity status; and 3) assess agreement between SFT and BIA with dual-energy X-ray absorptiometry (DXA) in the postpartum. METHODS Participants enrolled in the Be Healthy in Pregnancy (BHIP) RCT (NCT01693510) had demographic data and pBMI collected at enrollment and adiposity measured at 12-17, 26-28, and 36-38 weeks gestation by BIA (%BF) and SFT (sum and %BF), and also by DXA at 6 months postpartum. Agreement between methods was assessed by Bland Altman plots and McNemar's test and C-statistic for discriminative power. RESULTS In 181 women with mean pBMI of 25.1 kg/m2 (min: 17.4 kg/m2, max: 39.6 kg/m2) and age 31.6 (SD: 4.0 yr), maternal adiposity increased significantly (p < 0.001) across pregnancy when measured by the sum of SFT or %BF by BIA, but not %BF by SFT. In early pregnancy, BF by BIA and SFT showed good agreement, with BIA values 1.8% greater than SFT, but low agreement in late pregnancy, with BIA values 7.1% greater than SFT. However, in the postpartum, agreement was similar to early pregnancy, and both BIA and SFT demonstrated good agreement with DXA. By pBMI, 45.5% of participants were categorized as overweight/obese, compared to 66.5% by BIA (p < 0.0001) and 54.5% by SFT (p < 0.0001). CONCLUSIONS In comparison to SFT and BIA, the results suggest that pBMI is less sensitive in identifying participants with excessive adiposity, limiting its use as a screening tool for adiposity-related adverse outcomes in pregnancy. It would be preferable to use a direct measure of adiposity to screen for at-risk pregnancies. Both %BF by BIA and sum of SFT can quantify the change in adiposity across pregnancy and in the postpartum and thus could be adopted as clinical practice tools. Future research efforts should further refine and validate adiposity techniques for use, particularly in mid and late pregnancy. CLINICAL TRIAL The BHIP clinical trial (NCT01693510). REGISTRATION SITE: https://clinicaltrials.gov/ct2/show/NCT01693510.
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Affiliation(s)
- Atherai Maran
- Department of Pediatrics, McMaster University, Hamilton, Ontario, L8S 4L8, Canada
| | - Stephanie A Atkinson
- Department of Pediatrics, McMaster University, Hamilton, Ontario, L8S 4L8, Canada.
| | - Valerie Bertram
- Department of Pediatrics, McMaster University, Hamilton, Ontario, L8S 4L8, Canada
| | - Thuva Vanniyasingam
- Biostatistics Unit, St. Joseph's Healthcare Hamilton, Hamilton, Ontario, L8N 4A6, Canada
| | - Lehana Thabane
- Biostatistics Unit, St. Joseph's Healthcare Hamilton, Hamilton, Ontario, L8N 4A6, Canada
| | - Michelle F Mottola
- School of Kinesiology, Western University, London, Ontario, N6A 3K7, Canada
| | - Stuart M Phillips
- Department of Kinesiology, McMaster University, Hamilton, Ontario, L8S 4K1, Canada
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Biddulph C, Holmes M, Kuballa A, Carter RJ, Maher J. Beyond the BMI: Validity and Practicality of Postpartum Body Composition Assessment Methods during Lactation: A Scoping Review. Nutrients 2022; 14:2197. [PMID: 35683995 DOI: 10.3390/nu14112197] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2022] [Revised: 05/20/2022] [Accepted: 05/24/2022] [Indexed: 11/17/2022] Open
Abstract
The assessment of body composition during lactation is an important indicator of maternal nutritional status, which is central to the overall health of the mother and child. The lactating woman’s nutritional status potentially impacts on breastmilk composition and the process of lactation itself. The purpose of this scoping review was to synthesize comparative studies that sought to validate various body composition assessment techniques for use in lactating women in the postpartum period. Using the PRISMA-ScR guidelines, a comprehensive, systematic literature search was conducted using Scopus, Web of Science, and PubMed. Eight comparative studies were included in the review, with data from 320 postpartum women. The design methodologies varied substantially across studies, and included a range of simple techniques to advanced multi-compartment models for assessing body composition. The validity and reliability of measurement tools must be considered alongside issues of safety, practicality, and appropriateness to guide the research design when applied to lactating women.
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Stevens DR, Rohn MCH, Hinkle SN, Williams AD, Kumar R, Lipsky LM, Grobman W, Sherman S, Kanner J, Chen Z, Mendola P. Maternal body composition and gestational weight gain in relation to asthma control during pregnancy. PLoS One 2022; 17:e0267122. [PMID: 35442986 PMCID: PMC9020691 DOI: 10.1371/journal.pone.0267122] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2021] [Accepted: 04/02/2022] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Poor asthma control is common during pregnancy and contributes to adverse pregnancy outcomes. Identification of risk factors for poor gestational asthma control is crucial. OBJECTIVE Examine associations of body composition and gestational weight gain with asthma control in a prospective pregnancy cohort (n = 299). METHODS Exposures included pre-pregnancy body mass index (BMI), first trimester skinfolds, and trimester-specific gestational weight gain. Outcomes included percent predicted forced expiratory volumes (FEV1, FEV6), forced vital capacity (FVC), peak expiratory flow (PEF), FEV1/FVC, symptoms (activity limitation, nighttime symptoms, inhaler use, and respiratory symptoms), and exacerbations (asthma attacks, medical encounters). Linear and Poisson models examined associations with lung function (β (95% confidence interval (CI)), asthma symptom burden (relative rate ratio (RR (95%CI)), and exacerbations (RR (95%CI)). RESULTS Women with a BMI ≥ 30 had lower percent predicted FVC across pregnancy (βThirdTrimester: -5.20 (-8.61, -1.78)) and more frequent night symptoms in the first trimester (RR: 1.66 (1.08, 2.56)). Higher first trimester skinfolds were associated with lower FEV1, FEV6, and FVC, and more frequent night symptoms and inhaler use across pregnancy. Excessive first trimester gestational weight gain was associated with more frequent activity limitation in the first trimester (RR: 3.36 (1.15, 9.80)) and inhaler use across pregnancy (RRThirdTrimester: 3.49 (1.21, 10.02)). CONCLUSIONS Higher adiposity and first trimester excessive gestational weight gain were associated with restrictive changes in lung function and symptomology during pregnancy.
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Affiliation(s)
- Danielle R. Stevens
- Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, MD, United States of America
| | - Matthew C. H. Rohn
- Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, MD, United States of America
| | - Stefanie N. Hinkle
- Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, MD, United States of America
| | - Andrew D. Williams
- UND School of Medicine and Health Sciences, University of North Dakota, Grand Forks, ND, United States of America
| | - Rajesh Kumar
- Northwestern University Feinberg School of Medicine, Chicago, IL, United States of America
| | - Leah M. Lipsky
- Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, MD, United States of America
| | - William Grobman
- Northwestern University Feinberg School of Medicine, Chicago, IL, United States of America
| | - Seth Sherman
- The Emmes Company, Rockville, MD, United States of America
| | - Jenna Kanner
- Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, MD, United States of America
| | - Zhen Chen
- Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, MD, United States of America
| | - Pauline Mendola
- Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, MD, United States of America
- School of Public Health and Health Professions, University at Buffalo, Buffalo NY, United States of America
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Widen EM, Burns N, Daniels M, Backlund G, Rickman R, Foster S, Nichols AR, Hoepner LA, Kinsey EW, Ramirez-Carvey J, Hassoun A, Perera FP, Bukowski R, Rundle AG. Gestational weight change and childhood body composition trajectories from pregnancy to early adolescence. Obesity (Silver Spring) 2022; 30:707-717. [PMID: 35137558 PMCID: PMC8957403 DOI: 10.1002/oby.23367] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/30/2021] [Revised: 12/03/2021] [Accepted: 12/10/2021] [Indexed: 11/09/2022]
Abstract
OBJECTIVE A mother-child dyad trajectory model of weight and body composition spanning from conception to adolescence was developed to understand how early life exposures shape childhood body composition. METHODS African American (49.3%) and Dominican (50.7%) pregnant mothers (n = 337) were enrolled during pregnancy, and their children (47.5% female) were followed from ages 5 to 14. Gestational weight gain (GWG) was abstracted from medical records. Child weight, height, percentage body fat, and waist circumference were measured. GWG and child body composition trajectories were jointly modeled with a flexible latent class model with a class membership component that included prepregnancy BMI. RESULTS Four prenatal and child body composition trajectory patterns were identified, and sex-specific patterns were observed for the joint GWG-postnatal body composition trajectories with more distinct patterns among girls but not boys. Girls of mothers with high GWG across gestation had the highest BMI z score, waist circumference, and percentage body fat trajectories from ages 5 to 14; however, boys in this high GWG group did not show similar growth patterns. CONCLUSIONS Jointly modeled prenatal weight and child body composition trajectories showed sex-specific patterns. Growth patterns from childhood though early adolescence appeared to be more profoundly affected by higher GWG patterns in females, suggesting sex differences in developmental programming.
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Affiliation(s)
- Elizabeth M Widen
- Department of Nutritional Sciences, School of Human Ecology, College of Natural Sciences, University of Texas at Austin, Austin, Texas, USA
- Department of Women's Health, Dell Medical School, University of Texas at Austin, Austin, Texas, USA
- Dell Pediatric Research Institute, Dell Medical School, University of Texas at Austin, Austin, Texas, USA
- Columbia Center for Children's Environmental Health, Mailman School of Public Health, Columbia University Medical Center, New York, New York, USA
| | - Natalie Burns
- Department of Statistics, University of Florida, Gainesville, Florida, USA
| | - Michael Daniels
- Department of Statistics, University of Florida, Gainesville, Florida, USA
| | - Grant Backlund
- Department of Statistics, University of Florida, Gainesville, Florida, USA
| | - Rachel Rickman
- Department of Nutritional Sciences, School of Human Ecology, College of Natural Sciences, University of Texas at Austin, Austin, Texas, USA
- Dell Pediatric Research Institute, Dell Medical School, University of Texas at Austin, Austin, Texas, USA
| | - Saralyn Foster
- Department of Nutritional Sciences, School of Human Ecology, College of Natural Sciences, University of Texas at Austin, Austin, Texas, USA
- Dell Pediatric Research Institute, Dell Medical School, University of Texas at Austin, Austin, Texas, USA
| | - Amy R Nichols
- Department of Nutritional Sciences, School of Human Ecology, College of Natural Sciences, University of Texas at Austin, Austin, Texas, USA
| | - Lori A Hoepner
- Columbia Center for Children's Environmental Health, Mailman School of Public Health, Columbia University Medical Center, New York, New York, USA
- Department of Environmental and Occupational Health Sciences, School of Public Health, SUNY Downstate Health Sciences University, Brooklyn, New York, USA
| | - Eliza W Kinsey
- Columbia Center for Children's Environmental Health, Mailman School of Public Health, Columbia University Medical Center, New York, New York, USA
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, New York, USA
| | - Judyth Ramirez-Carvey
- Columbia Center for Children's Environmental Health, Mailman School of Public Health, Columbia University Medical Center, New York, New York, USA
| | - Abeer Hassoun
- Columbia Center for Children's Environmental Health, Mailman School of Public Health, Columbia University Medical Center, New York, New York, USA
| | - Frederica P Perera
- Columbia Center for Children's Environmental Health, Mailman School of Public Health, Columbia University Medical Center, New York, New York, USA
| | - Radek Bukowski
- Department of Women's Health, Dell Medical School, University of Texas at Austin, Austin, Texas, USA
| | - Andrew G Rundle
- Columbia Center for Children's Environmental Health, Mailman School of Public Health, Columbia University Medical Center, New York, New York, USA
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, New York, USA
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Murhima’Alika CC, Balemba GM, Lyabayungu PMB, Mulume’oderhwa GM, Munthali G, Owino V, Tambwe AM, Dramaix M, Donnen P, Balaluka GB. Human Milk output among mothers previously treated for severe acute malnutrition in childhood in Democratic Republic of Congo. BMC Nutr 2021; 7:61. [PMID: 34689835 PMCID: PMC8543795 DOI: 10.1186/s40795-021-00467-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2021] [Accepted: 07/15/2021] [Indexed: 01/17/2023] Open
Abstract
BACKGROUND Malnutrition is a public health problem, as wasting affects 7.5% of children worldwide. The harmful effects of severe acute malnutrition (SAM) can last a lifetime, but how SAM in childhood affects later breastfeeding ability is not clear. In the present study, we assessed the human milk output and body composition among mothers with a history of childhood SAM. METHODS This retrospective cohort study was carried out in Miti-Murhesa Health Zone (Democratic Republic of Congo) from January 15 to March 17, 2020. We selected lactating mothers with breastfed infants aged 2-12 months. Two categories of mothers were included: those who had been treated for SAM during their childhood (years 1988-2003; n = 39) and a community control with no history of SAM (n = 40). The weight, height, and mid-upper arm circumference were measured and body mass index (BMI) calculated as weight/height2. Body composition and human milk output were assessed using standard deuterium dilution methods. Student t and chi2 tests ware applied to compare two groups. RESULTS The mean age ± standard deviation of the mothers was 24.4 ± 5.1 and 26.0 ± 6.1 years for the SAM and control groups, respectively (p = 0.186). The age of their infants was 5.4 ± 2.3 months in both groups (p = 0.962). In the SAM and control groups, the mean maternal BMI was 23.8 ± 2.3 and 23.6 ± 3.7 kg/m2 (p = 0.849), mean Fat Mass 27.1% ± 5.0 and 27.1% ± 5.8% (p = 0.708), and the mean Fat Free mass 72.9% ± 5.0 and 72.9% ± 5.8% (p = 0.998), respectively. Human milk output was 833.7 ± 152.1 g/d in SAM group and 827.4 ± 171.4 g/d in the control group (p = 0.864). CONCLUSIONS We found no significant difference in human milk output and body composition in mothers treated for SAM during childhood compared to community controls.
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Affiliation(s)
- Christine Chimanuka Murhima’Alika
- Ecole Régionale de Santé Publique, Université Catholique de Bukavu, Bukavu, Democratic Republic of Congo
- Centre de Recherche en Sciences Naturelles de Lwiro, Lwiro, Democratic Republic of Congo
| | - Ghislain Maheshe Balemba
- Ecole Régionale de Santé Publique, Université Catholique de Bukavu, Bukavu, Democratic Republic of Congo
- Faculty of Medicine, Hôpital Provincial Général de Référence de Bukavu, Université Catholique de Bukavu, Bukavu, Democratic Republic of Congo
| | - Pacifique Mwene-Batu Lyabayungu
- Ecole Régionale de Santé Publique, Université Catholique de Bukavu, Bukavu, Democratic Republic of Congo
- Centre de Recherche en Sciences Naturelles de Lwiro, Lwiro, Democratic Republic of Congo
- Faculty of Medicine, Hôpital Provincial Général de Référence de Bukavu, Université Catholique de Bukavu, Bukavu, Democratic Republic of Congo
- Ecole de Santé Publique, Université Libre de Bruxelles, Brussels, Belgium
| | - Guy Mulinganya Mulume’oderhwa
- Faculty of Medicine, Hôpital Provincial Général de Référence de Bukavu, Université Catholique de Bukavu, Bukavu, Democratic Republic of Congo
| | - Grace Munthali
- National Institute for Scientific and Industrial Research of Zambia (NISIR), Lusaka, Zambia
| | - Victor Owino
- Nutritional and Health Related Studies Section, Division of Human Health, International Atomic Energy Agency, Vienna, Austria
| | - Albert Mwembwo Tambwe
- Ecole de Santé Publique de l’Université de Lubumbashi, Lubumbashi, Democratic Republic of Congo
| | - Michèle Dramaix
- Ecole de Santé Publique, Université Libre de Bruxelles, Brussels, Belgium
| | - Philippe Donnen
- Ecole de Santé Publique, Université Libre de Bruxelles, Brussels, Belgium
| | - Ghislain Bisimwa Balaluka
- Ecole Régionale de Santé Publique, Université Catholique de Bukavu, Bukavu, Democratic Republic of Congo
- Centre de Recherche en Sciences Naturelles de Lwiro, Lwiro, Democratic Republic of Congo
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Kurniawati EM, Irwanto S, Muhdi N. The Sexual Function of Primiparous Women after Normal Delivery and Cesarean Section According to the Female Sexual Function Index. Open Access Maced J Med Sci 2021. [DOI: 10.3889/oamjms.2021.6139] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
BACKGROUND: Various anatomical and physiological changes occur to provide a suitable environment for fetal development during pregnancy. Changes in body shape and other physical changes also undergo changes and are associated with postpartum sexual dysfunction.
AIM: This study aims to measure and determine the difference in female sexual function index scores for primiparous women post normal delivery and post-cesarean section.
METHODS: An observational analytic study with a cross-sectional study design conducted in a hospital. This study involved 60 women with inclusion criteria aged 20–35 years, primiparous women with post-term pregnancy, primiparous women after normal delivery and cesarean section at 3–4 months, women who were married and living with their husbands and were willing to participate in this study. Data were analyzed descriptively and statistically.
RESULTS: The results showed that the cause of perineal damage was mostly due to the mediolateral episiotomy, the degree of perineal damage with Grade II status, and there was variation in the indication of an elective cesarean section. The statistical test results show that there was no difference in the type of delivery, both normal delivery and cesarean delivery on desire, arousal, satisfaction, lubrication, orgasm, and dyspareunia and the total female sexual index in primiparous (P > 0.05).
CONCLUSION: This study recommends that in primiparous women care, it is not advisable to choose one type of delivery as a form of prevention of postpartum sexual dysfunction. In addition, in the management of complaints of sexual dysfunction in primiparous it is not required to consider the type of delivery as the main cause.
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Marcinkowska UM, Ziomkiewicz-wichary A, Nowak-szczepanska N, Kornafel D, Kozieł S, Danel DP. Changes in Facial Shape throughout Pregnancy—A Computational Exploratory Approach. Symmetry (Basel) 2021; 13:1944. [DOI: 10.3390/sym13101944] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Facial cognition serves an important role in human daily interactions. It has been suggested that facial shape can serve as a signal for underlining biological condition, and that it is correlated with, among others, health, fertility, and attractiveness. In this study, 14 women were photographed during three consecutive trimesters of pregnancy, and the levels of their facial sexual dimorphism, asymmetry, and averageness were computed. Facial sexual dimorphism in first trimester was higher than in the second trimester (F(2, 22) = 5.77; p = 0.01; ηp2 = 0.34, post-hoc Tukey HSD test p = 0.007). Similar pattern was visible for asymmetry (F(2, 22) = 3.67; p = 0.04; ηp2 = 0.25, post-hoc Tukey HSD test p = 0.05). No statistically significant changes in measurement of averageness were observed. Results from Bayesian complementary analyses confirmed the observed effects for sexual dimorphism. The evidence for trimester differences in asymmetry and averageness was inconsequential. Based on the preliminary results of this exploratory study, we suggest that previously found decrease in observed facial attractiveness during pregnancy can be related to the decrease in computed facial femininity (possibly mediated by the changes in facial adiposity).
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Malary M, Moosazadeh M, Keramat A, Sabetghadam S. Factors influencing low sexual desire and sexual distress in pregnancy: A cross-sectional study. Int J Reprod Biomed 2021; 19:909-920. [PMID: 34805731 PMCID: PMC8595906 DOI: 10.18502/ijrm.v19i10.9823] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2020] [Revised: 10/22/2020] [Accepted: 01/24/2021] [Indexed: 12/04/2022] Open
Abstract
BACKGROUND Sexual desire and sexual distress are determined by emotional, psychosocial, hormonal, and anatomical factors during pregnancy. OBJECTIVE To identify the factors contributing to female low sexual desire and sexual distress during pregnancy separately and concurrently. MATERIALS AND METHODS Overall, 295 pregnant women were enrolled in this cross-sectional study. Sexual desire and distress were assessed by the sexual interest and desire inventory-female (score ≤ 33.0 indicates low sexual desire) and the female sexual distress scale-revised (score ≥ 11 indicates sexual distress). RESULTS 56.3% and 17.3% of pregnant women met the clinical cut-off for low sexual desire and sexual distress, respectively. After adjusting for the effect of the confounding variables by logistic regression multivariate analysis, satisfaction with body image before and during pregnancy, frequency of sexual intercourse, and satisfaction with foreplay were found to be significantly associated with low sexual desire. Factors related to sexual distress were similar to those noted for common sexual desire, except for satisfaction with foreplay. Other factors related to sexual distress included increased age, fear of abortion, and pregnancy trimester. Factors linked to concurrent low sexual desire and sexual distress were similar to those found for sexual distress, except for pregnancy trimester. CONCLUSION Low sexual desire and sexual distress are relatively common sexual experiences during pregnancy. Several factors could predict low sexual desire but were not associated with sexual distress, and conversely. Comprehensive attention to all of these factors is essential while screening for sexual health during pregnancy.
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Affiliation(s)
- Mina Malary
- Student Research Committee, School of Nursing and Midwifery, Shahroud University of Medical Sciences, Shahroud, Iran
| | - Mahmood Moosazadeh
- Health Sciences Research Center, Faculty of Health, Mazandaran University of Medical Sciences, Sari, Iran
- Gastrointestinal Cancer Research Center, Non-communicable Diseases Institute, Mazandaran University of Medical Sciences, Sari, Iran
| | - Afsaneh Keramat
- Department of Reproductive Health and Midwifery, School of Nursing and Midwifery, Shahroud University of Medical Sciences, Shahroud, Iran
| | - Shadi Sabetghadam
- Student Research Committee, School of Nursing and Midwifery, Shahroud University of Medical Sciences, Shahroud, Iran
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Gómez-Carrascosa I, Sánchez-Ferrer ML, de la Cruz-Sánchez E, Arense-Gonzalo JJ, Prieto-Sánchez MT, Alfosea-Marhuenda E, Iniesta MA, Mendiola J, Torres-Cantero AM. Analysis and Reliability of Anthropometric Measurements during Pregnancy: A Prospective Cohort Study in 208 Pregnant Women. J Clin Med 2021; 10:3933. [PMID: 34501380 PMCID: PMC8432171 DOI: 10.3390/jcm10173933] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2021] [Accepted: 08/30/2021] [Indexed: 11/28/2022] Open
Abstract
Anthropometric assessment during pregnancy is a widely used, low-technology procedure that has not been rigorously evaluated. Our objective is to investigate fat mass distribution during pregnancy by examining changes in anthropometrics measures, in order to evaluate the reliability of these measures. An observational, longitudinal, prospective cohort study was performed in 208 pregnant women. Anthropometric measurements were taken following the ISAK protocol during the three trimesters and a generalized linear model for repeated measures was used to evaluate differences. Variability was assessed using the coefficient of variation, and Propagated Error (PE) was used to sum of skinfold thicknesses (SFT). SFT showed a general increase in fat mass during the three trimesters of pregnancy (∑SFT7 p = 0.003), and was observed in specific anatomical locations as well: arms (∑Arm SFT, p = 0.046), trunk (∑Trunk SFT, p = 0.019), legs (∑Leg SFT, p = 0.001) and appendicular (∑Appendicular SFT, p = 0.001). Anthropometric measures for skinfold thickness were taken individually during pregnancy and were reliable and reproducible during the three trimesters, which could help to prevent adverse pregnancy outcomes.
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Affiliation(s)
- Inmaculada Gómez-Carrascosa
- Department of Obstetrics & Gynecology, “Virgen de la Arrixaca” University Clinical Hospital, EI Palmar, 30120 Murcia, Spain; (I.G.-C.); (M.L.S.-F.); (M.T.P.-S.); (E.A.-M.); (M.A.I.)
| | - María L. Sánchez-Ferrer
- Department of Obstetrics & Gynecology, “Virgen de la Arrixaca” University Clinical Hospital, EI Palmar, 30120 Murcia, Spain; (I.G.-C.); (M.L.S.-F.); (M.T.P.-S.); (E.A.-M.); (M.A.I.)
- Institute for Biomedical Research of Murcia, IMIB-Arrixaca, El Palmar, 30120 Murcia, Spain; (J.M.); (A.M.T.-C.)
| | - Ernesto de la Cruz-Sánchez
- Division of Preventive Medicine and Public Health, Department of Physical Activity, Faculty of Sport Sciences, University of Murcia, 30100 Murcia, Spain;
| | - Julián J. Arense-Gonzalo
- Institute for Biomedical Research of Murcia, IMIB-Arrixaca, El Palmar, 30120 Murcia, Spain; (J.M.); (A.M.T.-C.)
- Division of Preventive Medicine and Public Health, Department of Public Health Sciences, University of Murcia School of Medicine, 30100 Murcia, Spain
| | - María T. Prieto-Sánchez
- Department of Obstetrics & Gynecology, “Virgen de la Arrixaca” University Clinical Hospital, EI Palmar, 30120 Murcia, Spain; (I.G.-C.); (M.L.S.-F.); (M.T.P.-S.); (E.A.-M.); (M.A.I.)
- Institute for Biomedical Research of Murcia, IMIB-Arrixaca, El Palmar, 30120 Murcia, Spain; (J.M.); (A.M.T.-C.)
| | - Emilia Alfosea-Marhuenda
- Department of Obstetrics & Gynecology, “Virgen de la Arrixaca” University Clinical Hospital, EI Palmar, 30120 Murcia, Spain; (I.G.-C.); (M.L.S.-F.); (M.T.P.-S.); (E.A.-M.); (M.A.I.)
| | - Miguel A. Iniesta
- Department of Obstetrics & Gynecology, “Virgen de la Arrixaca” University Clinical Hospital, EI Palmar, 30120 Murcia, Spain; (I.G.-C.); (M.L.S.-F.); (M.T.P.-S.); (E.A.-M.); (M.A.I.)
| | - Jaime Mendiola
- Institute for Biomedical Research of Murcia, IMIB-Arrixaca, El Palmar, 30120 Murcia, Spain; (J.M.); (A.M.T.-C.)
- Division of Preventive Medicine and Public Health, Department of Public Health Sciences, University of Murcia School of Medicine, 30100 Murcia, Spain
| | - Alberto M. Torres-Cantero
- Institute for Biomedical Research of Murcia, IMIB-Arrixaca, El Palmar, 30120 Murcia, Spain; (J.M.); (A.M.T.-C.)
- Division of Preventive Medicine and Public Health, Department of Public Health Sciences, University of Murcia School of Medicine, 30100 Murcia, Spain
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Groth SW, Fernandez ID, Block RC, Thurston SW, Wong E, Brunner J, Mayo N, Kapula N, Yu Y, Meng Y, Yeh KL, Kinkade CW, Thornburg LL, O’Connor TG, Barrett ES. Biological changes in the pregnancy-postpartum period and subsequent cardiometabolic risk-UPSIDE MOMS: A research protocol. Res Nurs Health 2021; 44:608-619. [PMID: 33993510 PMCID: PMC8378197 DOI: 10.1002/nur.22141] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2020] [Revised: 04/05/2021] [Accepted: 05/02/2021] [Indexed: 01/21/2023]
Abstract
Multiple physiological changes occur in pregnancy as a woman's body adapts to support the growing fetus. These pregnancy-induced changes are essential for fetal growth, but the extent to which they reverse after pregnancy remains in question. For some women, physiological changes persist after pregnancy and may increase long-term cardiometabolic disease risk. The National Institutes of Health-funded study described in this protocol addresses a scientific gap by characterizing weight and biological changes during pregnancy and an extended postpartum period in relation to cardiometabolic risk. We use a longitudinal repeated measures design to prospectively examine maternal health from early pregnancy until 3 years postpartum. The aims are: (1) identify maternal weight profiles in the pregnancy-postpartum period that predict adverse cardiometabolic risk profiles three years postpartum; (2) describe immune, endocrine, and metabolic biomarker profiles in the pregnancy-postpartum period, and determine their associations with cardiometabolic risk; and (3) determine how modifiable postpartum health behaviors (diet, physical activity, breastfeeding, sleep, stress) (a) predict weight and cardiometabolic risk in the postpartum period; and (b) moderate associations between postpartum weight retention and downstream cardiometabolic risk. The proposed sample is 250 women. This study of mothers is conducted in conjunction with the Understanding Pregnancy Signals and Infant Development study, which examines child health outcomes. Biological and behavioral data are collected in each trimester and at 6, 12, 24, and 36 months postpartum. Findings will inform targeted health strategies that promote health and reduce cardiometabolic risk in childbearing women.
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Affiliation(s)
- Susan W Groth
- University of Rochester, School of Nursing, Rochester NY
| | - I Diana Fernandez
- University of Rochester School of Medicine and Dentistry, Department of Public Health Sciences
| | - Robert C Block
- University of Rochester, Departments of Public Health Sciences, Cardiology, and Medicine
| | - Sally W Thurston
- University of Rochester, Department of Biostatistics and Computational Biology
| | - Eunyoung Wong
- University of Rochester, School of Nursing, Rochester NY
| | - Jessica Brunner
- University of Rochester Medical Center, Department of Obstetrics and Gynecology
| | - Nicole Mayo
- University of Rochester School of Medicine and Dentistry, Department of Public Health Sciences
| | - Ntemena Kapula
- University of Rochester Medical Center, Department of Obstetrics and Gynecology
| | - Yang Yu
- University of Rochester, School of Nursing, Rochester NY
| | - Ying Meng
- University of Rochester, School of Nursing, Rochester NY
| | - Kuan-Lin Yeh
- University of Rochester, School of Nursing, Rochester NY
| | - Carolyn W Kinkade
- Rutgers University, Exposure Science and Epidemiology, Environmental and Occupational Health Sciences Institute
| | - Loralei L Thornburg
- University of Rochester Medical Center, Department of Obstetrics and Gynecology
| | - Thomas G O’Connor
- University of Rochester, Departments of Psychiatry, Psychology, Neuroscience, Obstetrics and Gynecology, and Wynne Center for Family Research
| | - Emily S Barrett
- University of Rochester Medical Center, Department of Obstetrics and Gynecology
- Rutgers University, Exposure Science and Epidemiology, Environmental and Occupational Health Sciences Institute
- Rutgers School of Public Health, Biostatistics and Epidemiology
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Delgadillo-Velázquez JA, Nambo-Venegas R, Patiño N, Meraz-Cruz N, Razo-Azamar M, Guevara-Cruz M, Fonseca M, Pale Montero LE, Ibarra-González I, Vela-Amieva M, Vadillo-Ortega F, Palacios-González B. Metabolic flexibility during normal pregnancy allows appropriate adaptation during gestation independently of BMI. Clin Nutr ESPEN 2021; 44:254-262. [PMID: 34330475 DOI: 10.1016/j.clnesp.2021.06.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2020] [Revised: 02/22/2021] [Accepted: 06/08/2021] [Indexed: 11/27/2022]
Abstract
BACKGROUND & AIMS Overweight and obesity in reproductive-age women hasten the development of insulin resistance and increase risk for deterioration of pregnancy metabolism. These pregnancy-associated metabolic changes are similar to those of the metabolic syndrome. Thus, some metabolic flexibility must allow appropriate adaptation to the metabolic load that pregnancy imposes. We evaluated metabolic flexibility during uncomplicated pregnancy in women with pre-gestational normal weight or overweight. METHODS In 20 women with singleton pregnancies, pre-pregnancy BMI was categorized as normal-weight (Nw) or overweight (Ow). The women were seen quarterly, and fasting and postprandial blood samples were collected at each visit. Indirect fasting and/postprandial calorimetry was performed to evaluate metabolic flexibility (Δrespiratory quotient (RQ) = RQpostprandial - RQfasting). RESULTS In the first trimester, metabolic flexibility was lower in the Ow group compared to the Nw group (0.031 ± 0.0131 vs 0.077 ± 0.018, respectively) without a statistically significant difference (p = 0.053). In the second trimester, the Ow group was significantly more flexible than the Nw group (0.190 ± 0.016 vs 0.077 ± 0.015, respectively (p = 0.004)). For the third trimester, the Ow and Nw groups did not differ in metabolic flexibility (0.074 ± 0.013 vs 0.087 ± 0.021, respectively) (p = 0.40). The most influential variables for metabolic flexibility during pregnancy were lactate, leptin, β-hydroxybutyrate, glycerol, aromatic amino acids, medium and long chain acylcarnitine's. CONCLUSIONS Our findings indicate that metabolic flexibility changes throughout pregnancy, independently of pre-pregnancy BMI. These changes maintain metabolic homeostasis between the mother and foetus, allowing for appropriate adjustments during pregnancy.
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Affiliation(s)
- Jaime A Delgadillo-Velázquez
- Unidad de Vinculación Científica de La Facultad de Medicina UNAM-INMEGEN, Instituto Nacional de Medicina Genómica, Mexico City, Mexico; Facultad de Química, Universidad Nacional Autónoma de México, México City, Mexico
| | - Rafael Nambo-Venegas
- Laboratorio de Bioquímica de Enfermedades Crónicas, Instituto Nacional de Medicina Genómica, Mexico City, Mexico
| | - Nayelli Patiño
- Unidad de Vinculación Científica de La Facultad de Medicina UNAM-INMEGEN, Instituto Nacional de Medicina Genómica, Mexico City, Mexico; Escuela de Dietética y Nutrición Del ISSSTE, Mexico City, Mexico
| | - Noemí Meraz-Cruz
- Unidad de Vinculación Científica de La Facultad de Medicina UNAM-INMEGEN, Instituto Nacional de Medicina Genómica, Mexico City, Mexico
| | - Melissa Razo-Azamar
- Unidad de Vinculación Científica de La Facultad de Medicina UNAM-INMEGEN, Instituto Nacional de Medicina Genómica, Mexico City, Mexico
| | - Martha Guevara-Cruz
- Fisiología de La Nutrición, Instituto Nacional de Ciencias Médicas y Nutrición "Salvador Zubirán", Mexico City, Mexico
| | - Mayali Fonseca
- Escuela de Dietética y Nutrición Del ISSSTE, Mexico City, Mexico
| | | | | | - Marcela Vela-Amieva
- Laboratorio de Errores Innatos Del Metabolismo, Instituto Nacional de Pediatría, Mexico City, Mexico
| | - Felipe Vadillo-Ortega
- Unidad de Vinculación Científica de La Facultad de Medicina UNAM-INMEGEN, Instituto Nacional de Medicina Genómica, Mexico City, Mexico
| | - Berenice Palacios-González
- Unidad de Vinculación Científica de La Facultad de Medicina UNAM-INMEGEN, Instituto Nacional de Medicina Genómica, Mexico City, Mexico.
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Obuchowska A, Standyło A, Kimber-Trojnar Ż, Leszczyńska-Gorzelak B. The Possibility of Using Bioelectrical Impedance Analysis in Pregnant and Postpartum Women. Diagnostics (Basel) 2021; 11:1370. [PMID: 34441305 DOI: 10.3390/diagnostics11081370] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2021] [Revised: 07/22/2021] [Accepted: 07/29/2021] [Indexed: 12/14/2022] Open
Abstract
Pregnancy is a time of significant changes occurring in the composition of a woman’s body in order to provide support for the growth and development of the foetus. Bioelectrical impedance analysis (BIA) is used to assess the body composition and hydration status. This technique represents a non-invasive, reliable, and fast clinical approach, which is well tolerated by patients. A segmental impedance measurement might be advantageous in pregnant women, particularly in late pregnancy. The purpose of this paper is to provide a review of different applications of BIA in pregnant and postpartum women. It seems that BIA has a better prognostic potential for gestational and post-partum outcomes than body mass index. The BIA method can be successfully used to study the effect of excessive gestational weight gain in pregnancy on the development of obstetric complications. Studying the mother’s body composition and correlating it with her energy balance could facilitate the development of dietary recommendations for women. Evaluation of the body composition can provide important clues for diagnosis of gestational diabetes mellitus in pregnant women with a low risk of this disease. BIA is also used as one of the additional tests in assessing the risk of developing gestational hypertension and preeclampsia.
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Versele V, Stok FM, Aerenhouts D, Deforche B, Bogaerts A, Devlieger R, Clarys P, Deliens T. Determinants of changes in women's and men's eating behavior across the transition to parenthood: a focus group study. Int J Behav Nutr Phys Act 2021; 18:95. [PMID: 34253197 DOI: 10.1186/s12966-021-01137-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Accepted: 05/07/2021] [Indexed: 12/16/2022] Open
Abstract
Background During the pregnancy and postpartum period, both women and men experience physiological and psychological changes, which may negatively impact their eating behavior. A clear understanding of determinants of changes in eating behavior during this period is needed to facilitate the development of targeted family-based interventions countering unfavorable dietary changes during this critical life period. Methods Thirteen focus group discussions targeting determinants of changes in eating behavior during pregnancy and postpartum were conducted, involving a total of 74 expecting and first-time parents. A semi-structured question guide was used to facilitate the discussions. An inductive thematic approach was used to derive main and sub-categories of determinants from the data. The Determinants of Nutrition and Eating (DONE)-framework was employed to systematically organize and label the categories and determinants. Results Two frameworks were developed; one for the pregnancy and one for the postpartum period, comprising determinants of changes in eating behavior in both women and men. Three main levels of determinants were identified: (1) the individual level, including psychological (e.g., ‘health consciousness’), situational (e.g., ‘effort and convenience’) and biological (e.g., ‘discomfort’); (2) the interpersonal level (e.g., ‘social influence’) and (3) the environmental level, including micro- and meso/macro (e.g., ‘home/environment food availability’). Determinants acting as barriers (e.g., ‘time constraints’) or facilitators (e.g., ‘being a role model’) were identified. Many determinants were mentioned during both (e.g., ‘food knowledge’) or just one investigated period (e.g., ‘physiological changes’ during pregnancy, ‘influence of the baby’ postpartum). Finally, some were described by both parents (e.g., ‘self-regulation’), whereas others were mentioned by women (e.g., ‘(perceived) food safety’) or men (e.g., ‘other priorities’) only. Conclusion The developed frameworks set the foundation for the development of future family-based interventions and may be used already by healthcare providers to provide dietary guidance and support for women and men transitioning into parenthood. A focus on the interplay of individual factors at the biological and psychological level together with situational difficulties during pregnancy is recommended. Postpartum, focus should go to support first-time parents to obtain balance of both maintaining one’s own health and taking care of the baby, on improving self-regulation skills, and on coping with related situational constraints. Supplementary Information The online version contains supplementary material available at 10.1186/s12966-021-01137-4.
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Eckland CB, Vasavada A, Catena RD. Shoulder and elbow requirements during sagittal reach as a result of changing anthropometry throughout pregnancy. Appl Ergon 2021; 94:103411. [PMID: 33725557 DOI: 10.1016/j.apergo.2021.103411] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/26/2020] [Revised: 02/22/2021] [Accepted: 03/02/2021] [Indexed: 06/12/2023]
Abstract
During pregnancy, anthropometric and physiological changes can result in difficulty reaching for and lifting everyday objects. The aims of this study were to determine the changes in sagittal plane anterior reach space (SPARS) and shoulder/elbow strength requirements throughout pregnancy. Seventeen participants were tested through a longitudinal observational cohort study between 16 and 36 weeks gestation in four-week intervals. A 25% decrease in SPARS was observed at the L3-4 torso height. Combined with arm mass increases, shoulder and elbow moment requirements at the minimum and maximum static reach distances significantly increased. However, inverse dynamics analysis determined that mass gains in the arm alone only minimally impact dynamic shoulder moments. Additionally, torso flexion increases throughout pregnancy demonstrates that women are attempting to compensate for decreased SPARS, possibly indicating the additional perceptual importance of reach space in accommodations for pregnant workers.
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Affiliation(s)
- Chantel B Eckland
- Washington State University, 19 Smith Gym, Pullman, WA, 99164-1410, USA.
| | - Anita Vasavada
- Washington State University, 205 Wegner Hall, Pullman, WA, 99164-1565, USA.
| | - Robert D Catena
- Washington State University, 113F Smith Gym, Pullman, WA, 99164-1410, USA.
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Tinius RA, Yoho K, Blankenship MM, Maples JM. Postpartum Metabolism: How Does It Change from Pregnancy and What are the Potential Implications? Int J Womens Health 2021; 13:591-599. [PMID: 34168507 PMCID: PMC8216742 DOI: 10.2147/ijwh.s314469] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2021] [Accepted: 05/25/2021] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Metabolic dysfunction after pregnancy may have serious consequences for a new mother. The purpose of the study was to characterize basic changes that occur in metabolic profiles from late pregnancy through 4-6 months postpartum. A secondary purpose was to determine metabolic factors that may be contributing to postpartum weight retention. METHODS Participants (n=25) came in for 2 visits: late pregnancy (~34 weeks gestation) and postpartum (4-6 months). Resting metabolic rate (RMR), respiratory quotient (RQ), and substrate oxidation values were assessed for 15 minutes during fasted conditions. Blood was drawn and skinfold anthropometry was performed to assess additional outcomes (inflammation, insulin resistance, lipid profiles, body composition). The participants completed a number of surveys that examined other lifestyle and demographic data of interest. At the postpartum visit, additional assessments regarding sleep and breastfeeding habits were administered. RESULTS RMR was lower during postpartum (1517.2±225.1 kcal/day) compared to pregnancy (1867.9±302.6 kcal/day) (p<0.001), and remained lower when expressing RMR per kg body weight (postpartum: 22.3±2.7 vs pregnant: 23.7±3.4 kcal/kg, (p=0.034). Relative RMR (RMR per kg body weight) was negatively correlated to insulin resistance (HOMA-IR) during postpartum (r=-.463, p=0.034). Maternal HOMA-IR, inflammation (CRP), triglycerides (TAG), and carbohydrate oxidation were all positively correlated to postpartum weight retention (HOMA-IR: r=0.617, p=0.004; CRP: r=0.477, p=0.039, TAG: r=0.463, p=0.040; Carbohydrate Oxidation: (r=0.469, p=0.018). CONCLUSION Metabolic rate is lower during postpartum compared to pregnancy, and may be connected to insulin resistance. Maternal insulin resistance, inflammation, blood lipids, and substrate metabolism are all related to postpartum weight retention.
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Affiliation(s)
- Rachel A Tinius
- School of Kinesiology, Recreation, and Sport, Western Kentucky University, Bowling Green, KY, 42101, USA
| | - Kristin Yoho
- School of Kinesiology, Recreation, and Sport, Western Kentucky University, Bowling Green, KY, 42101, USA
| | - Maire M Blankenship
- School of Nursing and Allied Health, Western Kentucky University, Bowling Green, KY, 42101, USA
| | - Jill M Maples
- Department of Obstetrics and Gynecology, University of Tennessee Graduate School of Medicine, Knoxville, TN, 37920, USA
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Redfern KM, Hollands HJ, Hosking J, Welch CR, Pinkney JH, Rees GA. The relationship between gestational weight gain, maternal upper-body subcutaneous fat changes and infant birth size: A pilot observational study amongst women with obesity. Early Hum Dev 2021; 154:105307. [PMID: 33453458 DOI: 10.1016/j.earlhumdev.2021.105307] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/23/2020] [Revised: 12/18/2020] [Accepted: 12/22/2020] [Indexed: 11/22/2022]
Abstract
BACKGROUND It is widely acknowledged that maternal obesity and excessive gestational weight gain (GWG) are associated with increased risk of fetal macrosomia and recent studies have suggested a role for the timing and composition of GWG. AIMS To examine the effect of the rate of change in GWG and maternal upper-body subcutaneous fat on neonatal anthropometric outcomes in a pilot observational study amongst women with obesity. STUDY DESIGN Expectant women with a body mass index (BMI) > 30 kg/m2 at first antenatal appointment were recruited at 12 weeks gestation. Maternal height, weight and skinfold thickness (SFT) measurements were collected at baseline and repeated at 28 and 36 weeks gestation. Following delivery, World Health Organisation (WHO)-UK infant birthweight z-scores were calculated, and infant anthropometric measurements were obtained. RESULTS The sum of upper body SFT measurements increased in mid-pregnancy (0.08 ± 0.71 mm/week) and decreased in late pregnancy (-0.04 ± 1.17 mm/week). After adjustment for maternal age, BMI and parity, mid- but not late- pregnancy GWG was positively associated with infant birthweight z-score (p<0.05), while mid- but not late-pregnancy changes in the sum of SFT were inversely associated with infant birthweight z-score (p<0.01). CONCLUSIONS The present study suggests that mid- rather than late-pregnancy changes in weight and upper-body subcutaneous fat are associated with infant birthweight. Further research is required in larger, more diverse populations to explore whether pregnancy interventions aiming to improve maternal and offspring health can be personalised beyond BMI and GWG.
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Parrettini S, Caroli A, Torlone E. Nutrition and Metabolic Adaptations in Physiological and Complicated Pregnancy: Focus on Obesity and Gestational Diabetes. Front Endocrinol (Lausanne) 2020; 11:611929. [PMID: 33424775 PMCID: PMC7793966 DOI: 10.3389/fendo.2020.611929] [Citation(s) in RCA: 85] [Impact Index Per Article: 21.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2020] [Accepted: 11/02/2020] [Indexed: 12/14/2022] Open
Abstract
Pregnancy offers a window of opportunity to program the future health of both mothers and offspring. During gestation, women experience a series of physical and metabolic modifications and adaptations, which aim to protect the fetus development and are closely related to both pre-gestational nutritional status and gestational weight gain. Moreover, pre-gestational obesity represents a challenge of treatment, and nowadays there are new evidence as regard its management, especially the adequate weight gain. Recent evidence has highlighted the determinant role of nutritional status and maternal diet on both pregnancy outcomes and long-term risk of chronic diseases, through a transgenerational flow, conceptualized by the Development Origin of Health and Diseases (Dohad) theory. In this review we will analyse the physiological and endocrine adaptation in pregnancy, and the metabolic complications, thus the focal points for nutritional and therapeutic strategies that we must early implement, virtually before conception, to safeguard the health of both mother and progeny. We will summarize the current nutritional recommendations and the use of nutraceuticals in pregnancy, with a focus on the management of pregnancy complicated by obesity and hyperglycemia, assessing the most recent evidence about the effects of ante-natal nutrition on the long-term, on either maternal health or metabolic risk of the offspring.
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Affiliation(s)
- Sara Parrettini
- S. Maria della Misericordia Hospital, Division of Endocrinology and Metabolism, Perugia, Italy
- Department of Medicine, University of Perugia, Perugia, Italy
| | - Antonella Caroli
- S. Maria della Misericordia Hospital, Division of Endocrinology and Metabolism, Perugia, Italy
- Department of Medicine, University of Perugia, Perugia, Italy
| | - Elisabetta Torlone
- S. Maria della Misericordia Hospital, Division of Endocrinology and Metabolism, Perugia, Italy
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Prado-Nóvoa O, Rodríguez J, Martín García A, Mateos A. Body composition helps: Differences in energy expenditure between pregnant and nonpregnant females. Am J Hum Biol 2020; 33:e23518. [PMID: 33155733 DOI: 10.1002/ajhb.23518] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2020] [Revised: 09/28/2020] [Accepted: 09/29/2020] [Indexed: 01/22/2023] Open
Abstract
OBJECTIVES Human pregnancy is associated with important physiological changes that usually increase energetic requirements. However, great variability exists in the costs and mechanisms required to bear pregnancy. Since body mass (BM) and composition are modified during gestation, it is of great interest to compare the influence of BM on energy expenditure (EE) in pregnant and nonpregnant females. METHODS BM, body composition, and EE of 77 volunteers (35 pregnant and 42 nonpregnant females) were measured. The pregnant volunteers completed two measurement rounds at 28 and 32 gestation weeks. Differences on the measured parameters were sought, and comparison of regression lines was computed to test how BM affected the EE of the volunteers. RESULTS BM and body composition parameters are significantly higher in pregnant females, but EE is not statistically different. Pregnant females have a larger percentage of fat mass, but lower percentage of fat-free mass (FFM). The EE per kg of FFM is similar in both groups. Comparison of regression lines shows that pregnancy does not change the relationship between BM and EE, but for similar BM pregnant females expend less energy than nonpregnant females. CONCLUSIONS We propose that their larger percentage of passive body tissues is the reason why pregnant females expend less energy than nonpregnant females of similar BM, without changing the scaling of EE on BM. Thus, pregnancy could not be as energetically constraining as usually assumed, with important consequences for human reproductive ecology.
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Affiliation(s)
- Olalla Prado-Nóvoa
- Postgraduate School of Human Evolution, University of Burgos, Burgos, Spain
| | - Jesús Rodríguez
- Paleobiology Program, National Research Center on Human Evolution (CENIEH), Burgos, Spain
| | - Adrián Martín García
- Gynecology and Obstetrics Department, Complejo Asistencial Universitario de Burgos, Burgos, Spain
| | - Ana Mateos
- Paleobiology Program, National Research Center on Human Evolution (CENIEH), Burgos, Spain
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Guzman-Ortiz E, Bueno-Hernandez N, Melendez-Mier G, Roldan-Valadez E. Quantitative systematic review: Methods used for the in vivo measurement of body composition in pregnancy. J Adv Nurs 2020; 77:537-549. [PMID: 33058345 DOI: 10.1111/jan.14594] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2020] [Revised: 08/04/2020] [Accepted: 08/27/2020] [Indexed: 02/05/2023]
Abstract
AIMS Because of the increased overall prevalence of pre-pregnancy obesity among racial-ethnic groups, we conducted a review of published methods for body composition measurement during pregnancy considering at present there is no consensus on the best practices and type of study design that researchers should use for this purpose. DESIGN Quantitative systematic review. DATA SOURCES PubMed, EMBASE, Scopus, Web of Science, and Virtual Library of Health. Search dates from 1997-2016. REVIEW METHODS Search of articles indexed in selected databases from 1997-2016. Studies were published in English, Spanish, and Portuguese. Graphs were carried out using data visualization software. RESULTS From the 112 included studies, 70 were prospective cohorts, 30 cross-sectional studies, 10 randomized controlled trial, and two retrospective studies. Cross-sectional studies and randomized controlled trial depicted a positive correlation with significant trend. CONCLUSIONS Although several methods for body composition measurement exist, only bioelectrical impedance analysis, displacement plethysmography, and displacement plethysmography show a significant growing trend. Use of data visualization allows understanding various associations among categorical variables, with a graphical display of their multidimensional behaviour. IMPACT Public and private health-care institution evaluating pregnancy women. Health-care personnel, including nursing professional, dealing with measurements of body composition during pregnancy will find reading this manuscript beneficial.
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Affiliation(s)
| | - Nallely Bueno-Hernandez
- Laboratory for Proteomics and Metabolomics, Research Division, General Hospital of Mexico, Mexico City, Mexico
| | | | - Ernesto Roldan-Valadez
- Directorate of Research, Hospital General de Mexico "Dr. Eduardo Liceaga", Mexico City, Mexico.,Department of Radiology, I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
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Kretzer DC, Matos S, Von Diemen L, de Azevedo Magalhães JA, Schöffel AC, Goldani MZ, da Silva Rocha A, Bernardi JR. Anthropometrical measurements and maternal visceral fat during first half of pregnancy: a cross-sectional survey. BMC Pregnancy Childbirth 2020; 20:576. [PMID: 32993577 PMCID: PMC7526141 DOI: 10.1186/s12884-020-03258-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2019] [Accepted: 09/15/2020] [Indexed: 12/05/2022] Open
Abstract
Background Determining anthropometric measures that indicate different fat deposits can be useful to predict metabolic risk and set specific treatment goals, reducing negative consequences for maternal and fetal health. In cases where pre-gestational weight measure and subsequent body mass index (BMI) values cannot be determined, other anthropometric measurements may be ideal for measuring the nutritional status of pregnant women, especially in low- and middle-income countries. This study aims to identify which anthropometric measurements correlate better with the maternal fat deposits measured by ultrasound. Methods A cross-sectional study was conducted with pregnant women from the city of Porto Alegre (city), capital of Rio Grande do Sul (state), southern Brazil, from October 2016 until January 2018. Anthropometrical variables (weight, height, mid-upper arm circumference [MUAC], circumferences of calf and neck and triceps skinfolds [TSF] and subscapular skinfolds [SBSF]), and ultrasound variables (visceral adipose tissue [VAT] and total adipose tissue [TAT]) were collected. To verify the correlation of anthropometric and ultrasound measurements, a non-adjusted and adjusted Spearman correlation was used. The study was approved by the ethics committees. Results The age median of the 149 pregnant women was 25 years [21–31], pre-pregnancy BMI was 26.22 kg/m² [22.16–31.21] and gestational age was 16.2 weeks [13.05–18.10]. The best measurements correlated with VAT and TAT were MUAC and SBSF, both of which showed a higher correlation than pre-pregnancy BMI. Conclusions It is possible to provide a practical and reliable estimate of VAT and TAT from the anthropometric evaluation (MUAC or SBSF) that is low cost, efficient and replicable in an outpatient clinic environment, especially in low- and middle-income countries.
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Affiliation(s)
- Daniela Cortés Kretzer
- Faculty of Medicine, Postgraduate Program in Child and Adolescent Health, Universidade Federal do Rio Grande do Sul (UFRGS), Rua Ramiro Barcelos, 2400, Santa Cecilia, Rio Grande do Sul, 90035-003, Porto Alegre, Brazil.
| | - Salete Matos
- Faculty of Medicine, Postgraduate Program in Child and Adolescent Health, Universidade Federal do Rio Grande do Sul (UFRGS), Rua Ramiro Barcelos, 2400, Santa Cecilia, Rio Grande do Sul, 90035-003, Porto Alegre, Brazil
| | - Lisia Von Diemen
- Postgraduate Program in Psychiatry and Behavioral Sciences, Universidade Federal do Rio Grande do Sul (UFRGS), 90035-003, Porto Alegre, Brazil
| | - José Antônio de Azevedo Magalhães
- Maternal-Fetal Division (Head), Hospital de Clínicas de Porto Alegre, School of Medicine, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Alice Carvalhal Schöffel
- Department of Social and Behavioural Health Sciences, Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
| | - Marcelo Zubaran Goldani
- Department of Pediatrics, Hospital de Clínicas de Porto Alegre, School of Medicine, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Alexandre da Silva Rocha
- Postgraduate Program in Psychiatry and Behavioral Sciences, Universidade Federal do Rio Grande do Sul (UFRGS), 90035-003, Porto Alegre, Brazil
| | - Juliana Rombaldi Bernardi
- Department of Nutrition, Graduate program in Child and Adolescent Health and Graduate Program in Food, Nutrition and Health, Hospital de Clínicas de Porto Alegre, School of Medicine, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
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Bai M, Susic D, O'Sullivan AJ, Henry A. Reproducibility of Bioelectrical Impedance Analysis in Pregnancy and the Association of Body Composition with the Risk of Gestational Diabetes: A Substudy of MUMS Cohort. J Obes 2020; 2020:3128767. [PMID: 33029392 PMCID: PMC7528004 DOI: 10.1155/2020/3128767] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/08/2020] [Revised: 07/28/2020] [Accepted: 09/10/2020] [Indexed: 01/10/2023] Open
Abstract
Introduction Bioelectrical impedance analysis (BIA) is a rapid and noninvasive method of body composition analysis; however, reproducibility between BIA instruments in pregnancy is uncertain. Adverse maternal body composition has been linked to pregnancy complications including gestational diabetes mellitus (GDM). This study aimed to evaluate the reproducibility of three BIA instruments in pregnancy and analyse the relationship between the body composition and the GDM risk. Methods A prospective cohort (n = 117) of women with singleton pregnancies participating in the Microbiome Understanding in Maternity Study (MUMS) at St. George Hospital, Sydney, Australia. Anthropometric measurements and BIA body composition were measured at ≤13 weeks (T1), 20-24 weeks (T2), and 32-36 weeks (T3) of gestation. Body fat percentage (BFP), total body water (TBW), and impedance were estimated by three BIA instruments: Bodystat 1500, RJL Quantum III, and Tanita BC-587. GDM status was recorded after 75 g oral glucose tolerance test was performed at 28 weeks or earlier. Agreement between BIA instruments was assessed using Bland-Altman analysis. Logistic regression modelling explored associations of BFP with GDM. Results Method comparison reproducibility between Bodystat and RJL was stronger than between Bodystat and Tanita for both BFP and TBW% at all three time points. RJL overestimated BFP on average by 3.3% (p < 0.001), with limits of agreement within ±5% for all trimesters. Average BFP was not significantly different between Tanita and Bodystat although limits of agreement exceeded ±5%. GDM diagnosis was independently associated with increased BFP in T1 (adjusted OR 1.117 per 1% increase; 95% CI 1.020-1.224; p=0.017) and in T2 (adjusted OR 1.113 per 1% increase; 95% CI 1.010-1.226; p=0.031) and with Asian ethnicity in all models (OR 7.4-8.1). Conclusion Reproducibility amongst instruments was moderate; therefore, interchangeability between instruments, particularly for research purposes, cannot be assumed. In this cohort, GDM risk was modestly associated with increasing BFP and strongly associated with Asian ethnicity.
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Affiliation(s)
- Michelle Bai
- School of Women's and Children's Health, UNSW Medicine, Sydney, Australia
| | - Daniella Susic
- School of Women's and Children's Health, UNSW Medicine, Sydney, Australia
- Department of Women's and Children's Health, St. George Hospital, Sydney, Australia
| | - Anthony J. O'Sullivan
- Department of Endocrinology, St. George Hospital, Sydney, Australia
- St. George and Sutherland Clinical School, UNSW Medicine, Sydney, Australia
| | - Amanda Henry
- School of Women's and Children's Health, UNSW Medicine, Sydney, Australia
- Department of Women's and Children's Health, St. George Hospital, Sydney, Australia
- The George Institute for Global Health, UNSW Medicine, Sydney, Australia
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49
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Hill C, Lipsky LM, Betts GM, Siega-Riz AM, Nansel TR. A Prospective Study of the Relationship of Sleep Quality and Duration with Gestational Weight Gain and Fat Gain. J Womens Health (Larchmt) 2020; 30:405-411. [PMID: 32945728 DOI: 10.1089/jwh.2020.8306] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Objective/Background: Fewer than one-third of U.S. women meet the Institute of Medicine guidelines for healthy gestational weight gain (GWG). While poor sleep quality and short sleep duration have been associated with weight gain and obesity in the general population, the relationship of sleep with pregnancy weight and body composition changes is unclear. This study aimed to examine associations of sleep duration and quality with pregnancy-related changes in body weight and fat. Participants: Pregnant women obtaining obstetric care through the University of North Carolina at Chapel Hill Healthcare System (UNC) (n = 339 who reported any sleep data) participating in the Pregnancy Eating Attributes Study. Materials and Methods: Participants were recruited at ≤12 weeks gestation and followed through delivery. The Pittsburgh Sleep Quality Index measured sleep duration and quality in early and late pregnancy. Weight was measured at each pregnancy medical visit and skinfolds were measured each trimester. t-tests examined sleep changes from early to late pregnancy and regression analyses estimated associations of sleep quality and duration with GWG and gestational fat gain (GFG). Results: Sleep quality and duration declined across pregnancy. A greater proportion of women with high early pregnancy body mass index (>25) reported low sleep quality and short sleep duration. Sleep quality was not associated with GWG adequacy, whereas longer late pregnancy sleep duration was associated with greater odds of inadequate GWG. Shorter sleep duration and lower sleep quality in late, but not early, pregnancy were associated with greater GFG. Conclusions: Lower sleep quality and shorter sleep duration in late pregnancy were associated with greater GFG. Experimental studies are needed to test the direction of causality between GFG and sleep attributes. ClinicalTrials.gov ID: NCT02217462.
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Affiliation(s)
- Christine Hill
- Social and Behavioral Sciences Branch, Eunice Kennedy Shriver National Institute for Child Health and Human Development, Bethesda, Maryland, USA
| | - Leah M Lipsky
- Social and Behavioral Sciences Branch, Eunice Kennedy Shriver National Institute for Child Health and Human Development, Bethesda, Maryland, USA
| | - Grace M Betts
- Social and Behavioral Sciences Branch, Eunice Kennedy Shriver National Institute for Child Health and Human Development, Bethesda, Maryland, USA
| | - Anna Maria Siega-Riz
- Departments of Nutrition, and Biostatistics and Epidemiology, School of Public Health and Health Sciences, University of Massachusetts, Amherst, Massachusetts, USA
| | - Tonja R Nansel
- Social and Behavioral Sciences Branch, Eunice Kennedy Shriver National Institute for Child Health and Human Development, Bethesda, Maryland, USA
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Orsso CE, Colin-Ramirez E, Field CJ, Madsen KL, Prado CM, Haqq AM. Adipose Tissue Development and Expansion from the Womb to Adolescence: An Overview. Nutrients 2020; 12:E2735. [PMID: 32911676 PMCID: PMC7551046 DOI: 10.3390/nu12092735] [Citation(s) in RCA: 38] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2020] [Revised: 08/29/2020] [Accepted: 09/02/2020] [Indexed: 02/07/2023] Open
Abstract
Prevalence rates of pediatric obesity continue to rise worldwide. Adipose tissue (AT) development and expansion initiate in the fetus and extend throughout the lifespan. This paper presents an overview of the AT developmental trajectories from the intrauterine period to adolescence; factors determining adiposity expansion are also discussed. The greatest fetal increases in AT were observed in the third pregnancy trimester, with growing evidence suggesting that maternal health and nutrition, toxin exposure, and genetic defects impact AT development. From birth up to six months, healthy term newborns experience steep increases in AT; but a subsequent reduction in AT is observed during infancy. Important determinants of AT in infancy identified in this review included feeding practices and factors shaping the gut microbiome. Low AT accrual rates are maintained up to puberty onset, at which time, the pattern of adiposity expansion becomes sex dependent. As girls experience rapid increases and boys experience decreases in AT, sexual dimorphism in hormone secretion can be considered the main contributor for changes. Eating patterns/behaviors and interactions between dietary components, gut microbiome, and immune cells also influence AT expansion. Despite the plasticity of this tissue, substantial evidence supports that adiposity at birth and infancy highly influences its levels across subsequent life stages. Thus, a unique window of opportunity for the prevention and/or slowing down of the predisposition toward obesity, exists from pregnancy through childhood.
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Affiliation(s)
- Camila E. Orsso
- Department of Agricultural, Food and Nutritional Science, University of Alberta, Edmonton, AB T6G 2E1, Canada; (C.E.O.); (C.J.F.); (C.M.P.)
| | | | - Catherine J. Field
- Department of Agricultural, Food and Nutritional Science, University of Alberta, Edmonton, AB T6G 2E1, Canada; (C.E.O.); (C.J.F.); (C.M.P.)
| | - Karen L. Madsen
- Department of Medicine, University of Alberta, Edmonton, AB T6G 2C2, Canada;
| | - Carla M. Prado
- Department of Agricultural, Food and Nutritional Science, University of Alberta, Edmonton, AB T6G 2E1, Canada; (C.E.O.); (C.J.F.); (C.M.P.)
| | - Andrea M. Haqq
- Department of Pediatrics and Department of Agricultural, Food and Nutritional Science, University of Alberta, Edmonton, AB T6G 2R7, Canada
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