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Tang ID, Mallia D, Yan Q, Pe'er I, Raja A, Salleb-Aouissi A, Wapner R. A Scoping Review of Preterm Birth Risk Factors. Am J Perinatol 2023. [PMID: 37748506 DOI: 10.1055/s-0043-1775564] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/27/2023]
Abstract
Preterm birth is a major cause of neonatal morbidity and mortality, but its etiology and risk factors are poorly understood. We undertook a scoping review to illustrate the breadth of risk factors for preterm birth that have been reported in the literature. We conducted a search in the PubMed database for articles published in the previous 5 years. We determined eligibility for this scoping review by screening titles and abstracts, followed by full-text review. We extracted odds ratios and other measures of association for each identified risk factor in the articles. A total of 2,509 unique articles were identified from the search, of which 314 were eligible for inclusion in our final analyses. We summarized risk factors and their relative impacts in the following categories: Activity, Psychological, Medical History, Toxicology, Genetics, and Vaginal Microbiome. Many risk factors for preterm birth have been reported. It is challenging to synthesize findings given the multitude of isolated risk factors that have been studied, inconsistent definitions of risk factors and outcomes, and use of different covariates in analyses. Novel methods of analyzing large datasets may promote a more comprehensive understanding of the etiology of preterm birth and ability to predict the outcome. KEY POINTS: · Preterm birth is difficult to predict.. · Preterm birth has many diverse risk factors.. · Holistic approaches may yield new insights..
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Affiliation(s)
- Irene D Tang
- Vagelos College of Physicians and Surgeons, Columbia University, New York, New York
| | - Daniel Mallia
- Department of Computer Science, Hunter College, New York, New York
| | - Qi Yan
- Department of Obstetrics and Gynecology, Columbia University Medical Center, New York, New York
| | - Itsik Pe'er
- Department of Computer Science, Columbia University, New York, New York
| | - Anita Raja
- Department of Computer Science, Hunter College, New York, New York
| | | | - Ronald Wapner
- Department of Obstetrics and Gynecology, Columbia University Medical Center, New York, New York
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Peeva M, Badeghiesh A, Baghlaf H, Dahan MH. Adverse obstetric outcomes in women with PCOS and multiple gestations. Reprod Biomed Online 2023; 46:379-389. [PMID: 36503681 DOI: 10.1016/j.rbmo.2022.10.009] [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: 02/22/2022] [Revised: 06/23/2022] [Accepted: 10/13/2022] [Indexed: 11/07/2022]
Abstract
RESEARCH QUESTION Does multiple gestation alter the risks for adverse obstetric outcomes in women with polycystic ovary syndrome (PCOS)? DESIGN Retrospective population-based cohort study using data from the HCUP-NIS from 2004 to 2014. A total of 14,882 women with PCOS, who delivered within that time period, were identified. The study group comprised women with PCOS who had had a multiple gestation (n = 880); the reference group was comprised of the remaining women with PCOS and singleton gestation (n = 14,002). RESULTS In women with PCOS, multiple gestation increased the risks of pregnancy complications including pregnancy-induced hypertension (adjusted odds ratio [aOR] 2.030; 95% confidence interval [CI] 1.676-2.460), pre-eclampsia (aOR 2.879; 95% CI 2.277-3.639), pre-eclampsia and eclampsia superimposed on pre-existing hypertension (aOR 1.917; 95% CI 1.266-2.903) and gestational diabetes (aOR 1.358; 95% CI 1.114-1.656). Multiple gestation increases the risk of preterm premature rupture of membranes (aOR 5.807; 95% CI 4.153-8.119), preterm delivery (aOR 8.466; 95% CI 7.071-10.135), Caesarean section (aOR 5.146; 95% CI 4.184-6.329), post-partum haemorrhage (aOR 1.540; 95% CI 1.065-2.228) and the need for transfusion (aOR 3.268; 95% CI 2.010-5.314), as well as wound complications (aOR 3.089; 95% CI 1.647-5.794). Neonates born to mothers with PCOS and having multiple gestations are more likely to be small for gestational age when compared to singleton neonates born to mothers with PCOS (aOR 4.606; 95% CI 3.480-6.095). Among PCOS women with multiple gestations, obesity increased the risks of developing pregnancy-induced hypertension (P < 0.001), pre-eclampsia (P < 0.001) and wound complications (P = 0.045). CONCLUSION These results highlight the importance of single embryo transfer and ovulation induction to develop a single follicle in women with PCOS. Obesity further increases obstetrical complications.
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Affiliation(s)
- Magdalena Peeva
- University of Ottawa, Department of Obstetrics and Gynecology, Ottawa Ontario K1H 8L6, Canada
| | - Ahmad Badeghiesh
- University of Western Ontario, Department of Obstetrics and Gynecology, London Ontario N6A 3K7, Canada
| | - Haitham Baghlaf
- University of Tabuk, Department of Obstetrics and Gynecology, Tabuk, Saudi Arabia
| | - Michael H Dahan
- McGill University, McGill University Health Center, Reproductive Center, Department of Obstetrics and Gynecology, Quebec H2L, Montreal 4S8, Canada.
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Isaku M, Vrapi E, Cala I, Perdja K, Bimbashi A. Macrosomia Risk Factors and Perinatal Outcomes: A 1-year Cohort Study. Open Access Maced J Med Sci 2023. [DOI: 10.3889/oamjms.2023.11396] [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: 02/19/2023] Open
Abstract
AIM: This study aims to identify possible risk factors and concurrently investigates how macrosomia impacts mothers and neonates.
STUDY DESIGN: The study is a retrospective cohort of data obtained in a large tertiary obstetrics and neonatal unit over 1 year, from anuary 1, 2019 to December 31, 2019. Data of all deliveries conducted at the institution were accessed. In addition, singleton and term pregnancies were included for further analysis. Multiple pregnancies, premature births, stillbirths, non-vertex presentations, and being lost to follow-up served as exclusion criteria. A database of the cases was constructed and data regarding maternal constitutional parameters, mode of delivery, shoulder dystocia, perineal trauma, and postpartum hemorrhage were collected. Further on, pregnancies were divided accordingly into two groups: Macrosomic fetuses (>4000 g) and non-macrosomic fetuses (<4000 g). The two groups were compared to assess possible macrosomia risk factors and maternal-neonatal outcomes. Statistical analysis is done using the Mann–Whitney-U and Chi-square tests. Significance was set as p < 0.05.
RESULTS: A total of 3408 deliveries met the inclusion criteria of the study. The macrosomia rate is 10.3%. The mean age (30.1 ± 5.17 years vs. 28.9 ± 8.4 years, p < 0.05) and, body mass index (29.2 ± 3.54 vs. 26.1 ± 2.78, p < 0.05) was significantly higher in the macrosomia group. Women that gained more than 12.5 kg have nearly twice the odds of delivering a big baby (odds ratio [OR] 1.86, confidence interval [CI] 1.47–2.36, p < 0.001). No statistically significant differences were noted regarding cases of gestational diabetes (p = 0.56). Cesarean sections were preferred to vaginal deliveries in the macrosomic group (39.3% vs. 29.7%, OR 1.53, CI 1.2–1.9, p = 0.001). The risk of undergoing an emergency procedure is 6-fold higher in pregnancies with macrosomic newborns (20.5% vs. 13.6%, OR 6.1, CI 4.45–8.36, p < 0.001). Both episiotomy rate (40.45% vs. 31.9%, OR 1.44, CI 1.15–1.81, p = 0.001) and lacerations (3.13 % vs. 1.44%, OR 2.21, CI 1.13–4.33, p = 0.02) were higher in the macrosomic group.
CONCLUSION: The study concludes that macrosomia is associated with an increase in maternal and neonatal adverse outcomes.
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Blewitt C, Savaglio M, Madden SK, Meechan D, O’Connor A, Skouteris H, Hill B. Using Intervention Mapping to Develop a Workplace Digital Health Intervention for Preconception, Pregnant, and Postpartum Women: The Health in Planning, Pregnancy and Postpartum (HiPPP) Portal. Int J Environ Res Public Health 2022; 19:15078. [PMID: 36429795 PMCID: PMC9690929 DOI: 10.3390/ijerph192215078] [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] [Figures] [Subscribe] [Scholar Register] [Received: 10/09/2022] [Revised: 11/11/2022] [Accepted: 11/14/2022] [Indexed: 06/16/2023]
Abstract
Digital health interventions that specifically target working women across the preconception, pregnancy and postpartum (PPP) life stages may address the unique barriers to engaging in healthy lifestyle behaviours and self-care during this life phase. This paper describes the development of a workplace digital health intervention to promote healthy lifestyles and wellbeing for PPP women working at a community service organization in Australia. Intervention Mapping is a framework that guides program development, implementation, and evaluation. Steps 1 to 5 of Intervention Mapping methodology (needs assessment through to program implementation) were used, including identification of determinants and change objectives across socioecological levels (i.e., individual, interpersonal, and organisational) and iterative co-design and stakeholder engagement processes. The workplace digital health intervention was successfully developed and implemented as an online portal. Content included key strategies, information, and supports to promote health and wellbeing across PPP, including supporting the return to work in the postpartum period. Examples of resource pages included a parental leave checklist, process flows, Pride resources, and Aboriginal and Torres Strait Islander resources. Findings from a pilot feasibility study indicate the portal was accessible and beneficial for women in PPP life stages. The Intervention Mapping protocol may offer a valuable roadmap for collaborative design of interventions targeting PPP women's behaviour and organisational work culture. Future work is needed to evaluate whether such interventions lead to improvements in women's health and wellbeing.
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Affiliation(s)
- Claire Blewitt
- Health and Social Care Unit, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC 3004, Australia
| | - Melissa Savaglio
- Health and Social Care Unit, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC 3004, Australia
| | - Seonad K. Madden
- Health and Social Care Unit, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC 3004, Australia
- School of Health Sciences, College of Health and Medicine, University of Tasmania, Launceston, TAS 7250, Australia
| | - Donna Meechan
- MacKillop Family Services, South Melbourne, VIC 3205, Australia
| | - Amanda O’Connor
- Health and Social Care Unit, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC 3004, Australia
| | - Helen Skouteris
- Health and Social Care Unit, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC 3004, Australia
| | - Briony Hill
- Health and Social Care Unit, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC 3004, Australia
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Abstract
IMPORTANCE The associations of gestational weight gain (GWG) with infant morbidity and mortality are unclear, and the existing recommendations for GWG have not been stratified by the severity of obesity. OBJECTIVES To identify optimal GWG ranges associated with reduced risks of infant morbidity and mortality across maternal body mass index (BMI) categories. DESIGN, SETTING, AND PARTICIPANTS This retrospective cohort study used US nationwide, linked birth and infant death data between 2011 and 2015 to assess the associations of GWG in 2.0-kg groups with infant morbidity and mortality and identified optimal GWG ranges associated with reduced risks of both outcomes, using multivariable logistic regression models. Statistical analysis was performed from February 11 to October 14, 2021. EXPOSURE Gestational weight gain equivalent to 40 weeks. MAIN OUTCOMES AND MEASURES The 2 main outcomes were (1) significant morbidity of the newborn infant, defined as any presence of assisted ventilation, admission to the neonatal intensive care unit, surfactant therapy, antibiotic therapy, or seizures; and (2) infant mortality younger than 1 year of age (<1 hour, 1-23 hours, 1-6 days, 7-27 days, or 28-365 days after birth). RESULTS In this study of 15 759 945 mother-infant dyads, the mean (SD) age of the women was 28.1 (5.9) years. Women gained a mean (SD) of 14.1 (7.3) kg during pregnancy, and the mean (SD) GWG decreased with BMI categories (underweight, 15.7 [6.4] kg; normal weight, 15.4 [6.2] kg; overweight, 14.2 [7.4] kg; obesity class 1, 12.2 [8.0] kg; obesity class 2, 10.3 [8.4] kg; obesity class 3, 8.2 [9.2] kg; P < .001). A total of 8.8% of the newborns experienced significant morbidity, with the lowest prevalence among infants delivered by women in the normal weight BMI class (8.0%) and the highest among infants delivered by women with class 3 obesity (12.4%); 0.34% of infants died within 1 year of birth, with the lowest prevalence among infants delivered by women in the normal weight BMI class (0.28%) and the highest among infants delivered by women with class 3 obesity (0.58%). Optimal GWG ranges were 12.0 to less than 24.0 kg for underweight and normal weight women, 10.0 to less than 20.0 kg for overweight women, 8.0 to less than 16.0 kg for women with class 1 obesity, 6.0 to less than 16.0 kg for class 2 obesity, and 6.0 to less than 10.0 kg for class 3 obesity. The lower bounds of the optimal GWG ranges appeared to be higher than the existing recommendations for overweight women (10.0 vs 7.0 kg) and for those with class 1 (8.0 vs 5.0 kg), class 2 (6.0 vs 5.0 kg), and class 3 (6.0 vs 5.0 kg) obesity. CONCLUSIONS AND RELEVANCE This study analyzed the associations of GWG with infant morbidity and mortality across BMI categories and found that inadequate GWG was associated with increased risks of adverse infant outcomes even for women with obesity. The results suggested that weight maintenance or weight loss should not be used as routine guidelines.
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Affiliation(s)
- Lijun Wang
- Department of Epidemiology and Biostatistics, School of Public Health, Guangxi Medical University, Nanning, China
- School of Public Health, University of Hong Kong, Hong Kong, China
| | - Xiaoyu Zhang
- School of Public Health, University of Hong Kong, Hong Kong, China
| | - Tingting Chen
- School of Public Health, University of Hong Kong, Hong Kong, China
| | - Jun Tao
- School of Public Health, University of Hong Kong, Hong Kong, China
| | - Yanduo Gao
- Ultrasound Diagnosis Department, Hubei Maternal and Child Health Hospital, Wuhan, China
| | - Li Cai
- Department of Maternal and Child Health, School of Public Health, Sun Yat-Sen University, Guangzhou, China
| | - Huijun Chen
- Department of Gynaecology and Obstetrics, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - Chuanhua Yu
- Department of Epidemiology and Biostatistics, School of Health Sciences , Wuhan University, Wuhan, China
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Nakandakare P, Nicoletti CF, Noronha NY, Nonino CB, Argentato PP, Dejani NN, Luzia LA, Rogero MM, Rondó PHC. Associations between obesity-related gene expression in maternal and cord blood and newborn adiposity: findings from the Araraquara Cohort study. Int J Obes (Lond) 2021; 45:1958-1966. [PMID: 34002037 DOI: 10.1038/s41366-021-00857-8] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2020] [Revised: 04/22/2021] [Accepted: 04/30/2021] [Indexed: 02/05/2023]
Abstract
BACKGROUND/OBJECTIVES Genes involved in the regulation of metabolism, adipose tissue deposition, inflammation, and the appetite-satiety axis may play an important role in fetal development, and possibly induce permanent metabolic changes and fat accumulation. In this study we investigated: (1) obesity-related gene expression in maternal and cord blood of overweight/obese and normal-weight pregnant women; (2) associations between obesity-related gene expression in maternal and cord blood; and (3) associations of gene expression in each of maternal and cord blood with newborn adiposity. SUBJECTS/METHODS Twenty-five overweight/obese and 32 normal-weight pregnant women were selected from the Araraquara Cohort Study according to their pre-pregnancy BMI. Maternal and cord blood gene expression of LEPR, STAT3, PPARG, TLR4, IL-6, IL-10, FTO, MC4R, TNF-α, and NFκB were investigated by relative real-time PCR quantification. The body composition of the newborns was assessed by air displacement plethysmography. Associations between maternal and cord blood gene expression and markers of newborn adiposity (weight, BMI, and fat mass%) were explored by linear regression models controlling for maternal age, pre-pregnancy BMI, maternal gestational weight gain, gestational age, and newborn sex. RESULTS There was higher TLR4, NFκB, and TNF-a expression, and lower IL-6 expression, in overweight/obese pregnant women and their respective newborns compared with normal-weight women and their newborns (p < 0.001). Maternal PPARG gene expression was associated with both weight and fat mass % of the newborns, and cord blood IL-10 expression was associated with BMI and fat mass %, controlling for confounders. CONCLUSION To our knowledge, this is the first study to evaluate the relationship of maternal and cord blood gene expression with adiposity markers of the newborn. Our results provide evidence for the contribution of maternal and cord blood gene expression-particularly maternal PPARG and TLR4 expression, and cord blood IL-10 expression-to newborn weight, BMI, and fat mass %.
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Affiliation(s)
- P Nakandakare
- Nutrition Department, School of Public Health, University of São Paulo, São Paulo, Brazil
| | - C F Nicoletti
- Laboratory of Nutrigenomics Studies, Department of Health Science, Ribeirão Preto Medical School, University of Sao Paulo, Ribeirão Preto, Brazil
| | - N Y Noronha
- Department of Internal Medicine, Ribeirão Preto Medical School, University of Sao Paulo, Ribeirão Preto, Brazil
| | - C B Nonino
- Laboratory of Nutrigenomics Studies, Department of Health Science, Ribeirão Preto Medical School, University of Sao Paulo, Ribeirão Preto, Brazil
| | - P P Argentato
- Nutrition Department, School of Public Health, University of São Paulo, São Paulo, Brazil
| | - N N Dejani
- Nutrition Department, School of Public Health, University of São Paulo, São Paulo, Brazil
| | - L A Luzia
- Nutrition Department, School of Public Health, University of São Paulo, São Paulo, Brazil
| | - M M Rogero
- Nutrition Department, School of Public Health, University of São Paulo, São Paulo, Brazil
| | - P H C Rondó
- Nutrition Department, School of Public Health, University of São Paulo, São Paulo, Brazil.
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Abstract
OBJECTIVE We aimed to explore the effect of individualized medical nutrition guidance on pregnancy outcomes among older pregnant women. METHODS This was a prospective study using a randomized controlled trial design. We selected 820 older pregnant women and randomly divided them into a study group and control group (410 women each). The control group was given routine health education and nutrition guidance; the study group was provided individualized medical nutrition guidance. Gestational diabetes mellitus, hypertensive disorders of pregnancy, vaginal delivery rate, postpartum hemorrhage rate, gestational body weight, neonatal birth weight, and neonate transfer to the neonatal intensive care unit (NICU) were compared between the groups. RESULTS The incidence of gestational diabetes in the study group was significantly lower and the rate of vaginal delivery was significantly higher than those in the control group. The incidence of macrosomia, rate of neonatal transfer to the NICU, and rate of neonatal hyperbilirubinemia were significantly lower in the study group than those in the control group. CONCLUSIONS Individualized nutritional intervention for older pregnant women can effectively reduce the incidence of complications during pregnancy and childbirth and improve maternal and child outcomes.
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Affiliation(s)
- Chun-Ling Li
- Health Care Department, Hebei Cangzhou Women And Children's Health, Cangzhou, China
| | - Ying-Hua Wang
- Health Care Department, Hebei Cangzhou Women And Children's Health, Cangzhou, China
| | - Jun-Li Wang
- Health Care Department, Hebei Cangxian Hospital, Cangzhou, China
| | - Ping Zhang
- Health Care Department, Hebei Cangzhou Women And Children's Health, Cangzhou, China
| | - Yan Sun
- Health Care Department, Hebei Cangzhou Women And Children's Health, Cangzhou, China
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Nordman H, Jääskeläinen J, Voutilainen R. Birth Size as a Determinant of Cardiometabolic Risk Factors in Children. Horm Res Paediatr 2021; 93:144-153. [PMID: 32846418 DOI: 10.1159/000509932] [Citation(s) in RCA: 51] [Impact Index Per Article: 17.0] [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: 12/02/2019] [Accepted: 07/06/2020] [Indexed: 11/19/2022] Open
Abstract
The association between birth size and cardiometabolic disease risk may be U-shaped. Being born small for gestational age (SGA) has a definitive association with later cardiovascular risk, but the impact of being born large for gestational age (LGA) on cardiometabolic health is more controversial. In addition to birth size, early postnatal growth pattern and later weight gain affect cardiometabolic risk in adulthood. Most SGA-born children have catch-up and LGA-born children have catch-down growth during the first years of life. The extent of this early compensatory growth may contribute to the adverse health outcomes. Both SGA- and LGA-born children are at an increased risk for overweight and obesity. This may have a long-term impact on cardiometabolic health as overweight tends to track to adulthood. Other cardiometabolic risk factors, including alterations in glucose metabolism, dyslipidemia, hypertension, and low-grade inflammation are associated with birth weight. Many of these risk factors are related to overweight or adverse fat distribution. Since later cardiometabolic risk is often mediated by early growth pattern and later overweight in SGA and LGA children, it is important to focus on staying normal weight throughout life. Hence, effective interventions to reduce cardiometabolic risk in LGA and SGA children should be developed.
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Affiliation(s)
- Henrikki Nordman
- Department of Pediatrics, University of Eastern Finland and Kuopio University Hospital, Kuopio, Finland,
| | - Jarmo Jääskeläinen
- Department of Pediatrics, University of Eastern Finland and Kuopio University Hospital, Kuopio, Finland
| | - Raimo Voutilainen
- Department of Pediatrics, University of Eastern Finland and Kuopio University Hospital, Kuopio, Finland
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Tersigni C, Neri C, D'Ippolito S, Garofalo S, Martino C, Lanzone A, Scambia G, Di Simone N. Impact of maternal obesity on the risk of preterm delivery: insights into pathogenic mechanisms. J Matern Fetal Neonatal Med 2020; 35:3216-3221. [PMID: 32942918 DOI: 10.1080/14767058.2020.1817370] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
PURPOSE Preterm delivery (PTD) represents the leading cause of neonatal death and disability. Among risk factors for PTD, maternal obesity (MO) is becoming an ever more relevant condition in developed countries, although the mechanisms relating this condition to higher risk of PTD is not clear. Aim of this narrative review is to summarize evidences from clinical and translational research showing how MO might negatively impact on pregnancy and neonatal outcomes, particularly, by increasing the risk of PTD. METHODS We performed comprehensive review of the literature in PubMed and Google Scholar databases for studies from 1998 to 2018 linking MO to PTD and inflammation. RESULTS Chronic inflammatory status associated to increased synthesis of adipokines and cytokines from fat tissue has been shown in obesity. Obese women have a higher risk of both spontaneous and medically induced PTD. In about 50% of cases of spontaneous PTD, an infection-induced chorion amnionitis can be detected while in the remaining 50% a sterile inflammatory response has been described. Activation of uterine innate immunity system in intra-amniotic cavity and in chorioamniotic membranes might represent the missing link between MO and the pathogenesis of PTD. CONCLUSION Tissue inflammation might represent the pathogenic link between MO and increased occurrence of PTD. The achievement of pre-pregnancy normal maternal weight and body mass index is a fundamental aim of public health to reduce the incidence of PTD and get optimal reproductive outcomes.
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Affiliation(s)
- Chiara Tersigni
- Dipartimento di Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, Fondazione Policlinico Universitario A. Gemelli IRCCS, U.O.C. di Ostetricia e Patologia Ostetrica, Rome, Italy.,Istituto di Clinica Ostetrica e Ginecologica, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Caterina Neri
- Dipartimento di Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, Fondazione Policlinico Universitario A. Gemelli IRCCS, U.O.C. di Ostetricia e Patologia Ostetrica, Rome, Italy
| | - Silvia D'Ippolito
- Dipartimento di Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, Fondazione Policlinico Universitario A. Gemelli IRCCS, U.O.C. di Ostetricia e Patologia Ostetrica, Rome, Italy
| | - Serafina Garofalo
- Dipartimento di Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, Fondazione Policlinico Universitario A. Gemelli IRCCS, U.O.C. di Ostetricia e Patologia Ostetrica, Rome, Italy
| | - Carmelinda Martino
- Dipartimento di Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, Fondazione Policlinico Universitario A. Gemelli IRCCS, U.O.C. di Ostetricia e Patologia Ostetrica, Rome, Italy
| | - Antonio Lanzone
- Dipartimento di Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, Fondazione Policlinico Universitario A. Gemelli IRCCS, U.O.C. di Ostetricia e Patologia Ostetrica, Rome, Italy.,Istituto di Clinica Ostetrica e Ginecologica, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Giovanni Scambia
- Istituto di Clinica Ostetrica e Ginecologica, Università Cattolica del Sacro Cuore, Rome, Italy.,Dipartimento di Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, Fondazione Policlinico Universitario A. Gemelli IRCCS, U.O.C. di Ginecologia Oncologica, Rome, Italy
| | - Nicoletta Di Simone
- Dipartimento di Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, Fondazione Policlinico Universitario A. Gemelli IRCCS, U.O.C. di Ostetricia e Patologia Ostetrica, Rome, Italy.,Istituto di Clinica Ostetrica e Ginecologica, Università Cattolica del Sacro Cuore, Rome, Italy
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Dagpo TD, Nolan CJ, Delghingaro-Augusto V. Exploring Therapeutic Targets to Reverse or Prevent the Transition from Metabolically Healthy to Unhealthy Obesity. Cells 2020; 9:E1596. [PMID: 32630256 DOI: 10.3390/cells9071596] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [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: 06/01/2020] [Revised: 06/24/2020] [Accepted: 06/30/2020] [Indexed: 12/14/2022] Open
Abstract
The prevalence of obesity and obesity-related metabolic comorbidities are rapidly increasing worldwide, placing a huge economic burden on health systems. Excessive nutrient supply combined with reduced physical exercise results in positive energy balance that promotes adipose tissue expansion. However, the metabolic response and pattern of fat accumulation is variable, depending on the individual’s genetic and acquired susceptibility factors. Some develop metabolically healthy obesity (MHO) and are resistant to obesity-associated metabolic diseases for some time, whereas others readily develop metabolically unhealthy obesity (MUO). An unhealthy response to excess fat accumulation could be due to susceptibility intrinsic factors (e.g., increased likelihood of dedifferentiation and/or inflammation), or by pathogenic drivers extrinsic to the adipose tissue (e.g., hyperinsulinemia), or a combination of both. This review outlines the major transcriptional factors and genes associated with adipogenesis and regulation of adipose tissue homeostasis and describes which of these are disrupted in MUO compared to MHO individuals. It also examines the potential role of pathogenic insulin hypersecretion as an extrinsic factor capable of driving the changes in adipose tissue which cause transition from MHO to MUO. On this basis, therapeutic approaches currently available and emerging to prevent and reverse the transition from MHO to MUO transition are reviewed.
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Simon A, Pratt M, Hutton B, Skidmore B, Fakhraei R, Rybak N, Corsi DJ, Walker M, Velez MP, Smith GN, Gaudet LM. Guidelines for the management of pregnant women with obesity: A systematic review. Obes Rev 2020; 21:e12972. [PMID: 31943650 PMCID: PMC7064940 DOI: 10.1111/obr.12972] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/16/2019] [Revised: 09/27/2019] [Accepted: 10/02/2019] [Indexed: 02/06/2023]
Abstract
Multiple clinical practice guidelines (CPGs) have been established for pregnant women with obesity. The quality and consistency of recommendations remain unknown. The objective of this study is to conduct a systematic review to synthesize and appraise evidence from CPGs, available worldwide, for pregnant women affected by obesity. An experienced information specialist performed a rigorous search of the literature, searching MEDLINE, Embase, grey literature, and guideline registries to locate CPGs that reported on pregnancy care relating to obesity. CPGs related to antenatal care of pregnant women with obesity (pre-pregnancy body mass index [BMI] ≥ 30 kg/m2 ) in low-risk (eg, care provider = family physician or midwife) or high-risk settings (eg, obstetrician or maternal fetal medicine) were included. CPGs were appraised for quality with independent data collection by two raters. Information was categorized into five domains: preconception care. care during pregnancy, diet and exercise during pregnancy, care immediately before, during, and after delivery, and postpartum care. The literature search yielded 2614 unique citations. Following screening of abstracts and full texts, 32 CPGs were included, with quality ranging between 0 and 100 on the AGREE II tool. The strongest evidence related to nutritional advice, exercise, and pregnancy risk counselling. Guidance was limited for timing of screening tests, antenatal visits and delivery, ideal postpartum care, and management of adverse pregnancy outcomes. Most guidelines in this population are not evidence based. Research is needed to bridge knowledge gaps pertaining to fetal antenatal surveillance, management of adverse outcomes and postpartum care, and enhance consistency across CPGs.
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Affiliation(s)
- Alexandre Simon
- OMNI Research Group, Clinical Epidemiology ProgramOttawa Hospital Research InstituteOttawaOntarioCanada
| | - Misty Pratt
- Knowledge Synthesis Group, Clinical Epidemiology ProgramOttawa Hospital Research InstituteOttawaOntarioCanada
| | - Brian Hutton
- Knowledge Synthesis Group, Clinical Epidemiology ProgramOttawa Hospital Research InstituteOttawaOntarioCanada
- Public Health and Preventive MedicineUniversity of Ottawa School of EpidemiologyOttawaOntarioCanada
| | - Becky Skidmore
- Knowledge Synthesis Group, Clinical Epidemiology ProgramOttawa Hospital Research InstituteOttawaOntarioCanada
| | - Romina Fakhraei
- OMNI Research Group, Clinical Epidemiology ProgramOttawa Hospital Research InstituteOttawaOntarioCanada
- Public Health and Preventive MedicineUniversity of Ottawa School of EpidemiologyOttawaOntarioCanada
| | - Natalie Rybak
- OMNI Research Group, Clinical Epidemiology ProgramOttawa Hospital Research InstituteOttawaOntarioCanada
| | - Daniel J. Corsi
- OMNI Research Group, Clinical Epidemiology ProgramOttawa Hospital Research InstituteOttawaOntarioCanada
- Public Health and Preventive MedicineUniversity of Ottawa School of EpidemiologyOttawaOntarioCanada
| | - Mark Walker
- OMNI Research Group, Clinical Epidemiology ProgramOttawa Hospital Research InstituteOttawaOntarioCanada
- Public Health and Preventive MedicineUniversity of Ottawa School of EpidemiologyOttawaOntarioCanada
- Department of Obstetrics, Gynecology& Newborn CareUniversity of OttawaOttawaOntarioCanada
| | - Maria P. Velez
- Department of Obstetrics and GynecologyQueen's UniversityKingstonOntarioCanada
- Department of Public Health SciencesQueen's UniversityKingstonOntarioCanada
| | - Graeme N. Smith
- Department of Obstetrics and GynecologyQueen's UniversityKingstonOntarioCanada
| | - Laura M. Gaudet
- OMNI Research Group, Clinical Epidemiology ProgramOttawa Hospital Research InstituteOttawaOntarioCanada
- Public Health and Preventive MedicineUniversity of Ottawa School of EpidemiologyOttawaOntarioCanada
- Department of Obstetrics, Gynecology& Newborn CareUniversity of OttawaOttawaOntarioCanada
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Lee S, Shin J, Hong Y, Shin SM, Shin HW, Shin J, Lee SK, Park HW. Sestrin2 alleviates palmitate-induced endoplasmic reticulum stress, apoptosis, and defective invasion of human trophoblast cells. Am J Reprod Immunol 2020; 83:e13222. [PMID: 31958198 DOI: 10.1111/aji.13222] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [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: 11/07/2019] [Revised: 01/07/2020] [Accepted: 01/13/2020] [Indexed: 12/16/2022] Open
Abstract
PROBLEM Maternal obesity induces elevated saturated fatty acid palmitate levels in the blood and causes pregnancy complications such as gestational diabetes, preeclampsia, fetal growth abnormalities, and stillbirth. Sestrin2, a highly conserved stress-inducible protein, is involved in the cellular responses of various stress conditions and homeostatic regulation. However, the effects of Sestrin2 on trophoblast cells have not yet been investigated. Here, we investigated the role of Sestrin2 in palmitate-induced lipotoxicity and its underlying mechanisms in human first-trimester trophoblast cells (Sw.71). METHOD OF STUDY Mouse placental tissues were obtained from low-fat diet-fed mice (n = 14) and high-fat diet-fed mice (n = 14) at gestation day 17.5. Sw.71 cells were treated with palmitate or bovine serum albumin as vehicle controls. The role of Sestrin2 in palmitate-induced lipotoxicity was examined by immunocytochemistry, immunoblot analysis, quantitative real-time PCR, and invasion assay. RESULTS Expression of placental Sestrin2 was elevated in high-fat diet-fed dams compared to that of low-fat diet-fed dams. Prolonged treatment of Sw.71 cells with palmitate-induced endoplasmic reticulum (ER) stress-dependent expressions of Sestrin2 protein and mRNA, and the treatment also triggered apoptosis. Knockdown of Sestrin2 increased palmitate-mediated ER stress, inflammatory signaling, and apoptosis. Furthermore, Sestrin2 suppressed impaired trophoblast invasion caused by palmitate and attenuated palmitate-induced ER stress and inflammation via AMPK/mTORC1 pathways. CONCLUSION Our study provides the relationship between Sestrin2, AMPK/mTORC1 pathway, and trophoblast function, suggesting that Sestrin2 may be a novel potential therapeutic target for the prevention of pregnancy complications.
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Affiliation(s)
- Solji Lee
- Department of Cell Biology, Konyang University College of Medicine, Daejeon, Korea
| | - Jiha Shin
- Department of Cell Biology, Konyang University College of Medicine, Daejeon, Korea
| | - Yeji Hong
- Department of Obstetrics and Gynecology, Konyang University Hospital, Daejeon, Korea
| | - Seong Min Shin
- Department of Cell Biology, Konyang University College of Medicine, Daejeon, Korea
| | - Hye Won Shin
- Department of Cell Biology, Konyang University College of Medicine, Daejeon, Korea
| | - Jongdae Shin
- Department of Cell Biology, Konyang University College of Medicine, Daejeon, Korea.,Myunggok Medical Research Institute, Konyang University College of Medicine, Daejeon, Korea
| | - Sung Ki Lee
- Department of Obstetrics and Gynecology, Konyang University Hospital, Daejeon, Korea.,Myunggok Medical Research Institute, Konyang University College of Medicine, Daejeon, Korea
| | - Hwan-Woo Park
- Department of Cell Biology, Konyang University College of Medicine, Daejeon, Korea.,Myunggok Medical Research Institute, Konyang University College of Medicine, Daejeon, Korea
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Abstract
OBJECTIVE To evaluate the clinical factors, as well as weight gain, in a group of pregnant women, associating them with fetal macrosomia in a public institution in Antioquia, Colombia, from 2010-2017. METHODS A case-control study, using secondary information registries. Cases were defined using newborn weight of ≥ 4000g, while controls were defined as newborn weight between 3000–3999g. A proportion ratio (PR) was established to evaluate factors associated with macrosomia, and a generalized linear model (GLM) of Poisson regression with robust variance was used to evaluate the aspects that best explained macrosomia in the neonate. RESULTS 122 pregnant women participated in the study, of which 611 were cases and 61 were controls. Of the participants, 44.3% had pre-pregnancy overweight and 48.4% had excess gestational weight gain. Statistically significant differences were found between the groups in the following variables: pre-pregnancy BMI (p = 0.004), gestational weight gain (p = 0.000), gestational diabetes (p = 0.000), and type of delivery (p = 0.004). According to the regression model, a macrosomic newborn is 3.5 times more likely in women with excessive gestational weight gain (95%CI 1.78-7.18) and twice more likely in women who have gestational diabetes (95%CI 1.51-2.76). Of women with pre-pregnancy excess weight, 63% had excess gestational weight gain. CONCLUSIONS Within this cohort, pre-pregnancy BMI, excess weight gain in pregnancy, and the presence of gestational diabetes were associated with an increased risk of neonatal macrosomia. pre-pregnancy BMI and weight gain in pregnancy are modifiable risk factors that are responsive to nutrition interventions, which can minimize adverse perinatal outcomes.
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Affiliation(s)
| | - Beatriz Elena Parra-Sosa
- Universidad de Antioquia. Escuela de Nutrición y Dietética. Grupo de Investigación Alimentación y Nutrición Humana. Magíster en Ciencias Básicas Biomédicas. Colombia
| | - Sandra L Restrepo-Mesa
- Universidad de Antioquia. Escuela de Nutrición y Dietética. Grupo de Investigación Alimentación y Nutrición Humana. Magíster en Salud Colectiva. Colombia
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Vander Wyst KB, Vercelli ME, O’Brien KO, Cooper EM, Pressman EK, Whisner CM. A social media intervention to improve nutrition knowledge and behaviors of low income, pregnant adolescents and adult women. PLoS One 2019; 14:e0223120. [PMID: 31647852 PMCID: PMC6812786 DOI: 10.1371/journal.pone.0223120] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [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: 05/09/2019] [Accepted: 09/13/2019] [Indexed: 11/26/2022] Open
Abstract
Pregnant adolescents are at increased risk of adverse pregnancy outcomes compared to adult women, necessitating a need for early and comprehensive health care. This study aimed to evaluate the effectiveness of a social media intervention (i.e. weekly prenatal health messages) on improving diet quality, and health beliefs and knowledge. Participants (10 adolescents and 12 adults) completed pre-post intervention interviews, nutrition knowledge and health belief questionnaires, and 24-hour diet recalls. Participants entering pregnancy as overweight or obese were more likely to experience excessive GWG during the intervention. The adults had greater participation during the study despite high levels of social media access among both groups. Participants were able to identify sugar-sweetened foods and acknowledged the benefits of whole grains; however, overall knowledge of MyPlate Guidelines was limited. Social media-based education was well received by participants but did not result in large changes in dietary intake and knowledge. Although larger studies are needed, social media appears to have the potential to reach high-risk women.
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Affiliation(s)
- Kiley B. Vander Wyst
- College of Health Solutions, Arizona State University, Phoenix, Arizona, United States of America
| | - Megan E. Vercelli
- College of Health Solutions, Arizona State University, Phoenix, Arizona, United States of America
| | - Kimberly O. O’Brien
- Division of Nutritional Sciences, Cornell University, Ithaca, New York, United States of America
| | - Elizabeth M. Cooper
- School of Medicine and Dentistry, University of Rochester, Rochester, New York, United States of America
- University of Rochester Medical Center Midwifery Group, Rochester, New York, United States of America
| | - Eva K. Pressman
- School of Medicine and Dentistry, University of Rochester, Rochester, New York, United States of America
| | - Corrie M. Whisner
- College of Health Solutions, Arizona State University, Phoenix, Arizona, United States of America
- Division of Nutritional Sciences, Cornell University, Ithaca, New York, United States of America
- * E-mail:
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Robinson DT, Josefson J, Van Horn L. Considerations for Preterm Human Milk Feedings When Caring for Mothers Who Are Overweight or Obese. Adv Neonatal Care 2019; 19:361-70. [PMID: 31651470 DOI: 10.1097/ANC.0000000000000650] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Mother's milk is the recommended source of nutrition for all newborns. Preterm infants may be further compromised by maternal factors that impede successful lactation and alter milk composition. PURPOSE To review and summarize the state of the science regarding implications of maternal overweight and obesity on successful lactation and associated alterations in preterm mother's milk composition. METHODS/SEARCH STRATEGY PubMed, EMBASE, and Web of Science searches were performed using relevant key words to identify references addressing maternal overweight or obesity, prematurity, human milk, and lactation. FINDINGS/RESULTS In the United States, more than half of women enter pregnancy with an overweight or obese body mass index. These women have increased risk of adverse pregnancy outcomes and obstetric complications that can undermine successful initiation and continuation of lactation, including preterm birth. Maternal overweight and obesity are also associated with alterations in mother's milk composition. IMPLICATIONS FOR PRACTICE Mother-preterm infant dyads affected by maternal overweight and obesity are at risk for barriers to initiation and continuation of lactation. Support for early initiation of milk expression is needed. Continued support, especially during the first weeks of lactation, can facilitate sustained milk production. IMPLICATIONS FOR RESEARCH Considerable knowledge gaps remain in this area of human milk science. Future research is needed to facilitate more comprehensive understanding of differences in milk composition associated with maternal overweight and obesity and their impact on clinical outcomes in the preterm infant.
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Mao Y, Wang S, Li M, Huang M, Mo M, Gu L, Muyiduli X, Lian H, Jiang S, Wang Z, Shao B, Pu L, Yu Y. Association of trimester-specific gestational weight gain with birth weight and fetal growth in a large community-based population. Arch Gynecol Obstet 2019; 300:313-22. [PMID: 31144024 DOI: 10.1007/s00404-019-05188-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2018] [Accepted: 05/06/2019] [Indexed: 12/17/2022]
Abstract
BACKGROUND Previous studies showed that the association of gestational weight gain (GWG) with fetal birthweight and offspring developmental growth was unclear. The aim of this study is to investigate the respective effect of 1 kg of GWG during three trimesters on birthweight and offspring growth from birth to 3 years of age. METHODS We extracted the decoded information from the Maternal and Child Health Information Management System of Zhoushan Maternal and Child Health Hospital in Zhejiang, China from October 2001 to March 2015, and used multiple linear and logistic regression models. RESULTS This study included 20,232 women with a full-term singleton birth and 15,557 newborns who took regular health check-ups. Compared to that in the 2nd and 3rd trimester, 1 kg GWG increasing in the 1st trimester had the strongest positive association with higher birthweight, body weight, and height from 1 to 36 months. Their associations with BMI after birth were similar among the three trimesters. In addition, some positive dose-response effects found between quartiles of GWG in the 1st trimester and offspring body weight, as well as BMI. The 1 kg GWG in 1st trimester played the strongest role in contributing to birth weight and benefiting to body growth among children aged up to 3 years. CONCLUSION The 1 kg GWG in 1st trimester contributed more to birth weight and body development from birth to 3 years compared to the 2nd and 3rd trimesters. The possible beneficial effects of GWG in the 1st trimester on birthweight and offspring development in under/normal weight mothers are found.
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Abstract
OBJECTIVE To examine the change in body mass index (BMI) categories between pregnancies and its effect on adverse pregnancy outcomes. STUDY DESIGN We performed a retrospective cohort study of women with two consecutive deliveries from 2005 to 2010. Analysis was limited to women with BMI recorded at <24 weeks for both pregnancies. Standard BMI categories were used. Adverse pregnancy outcomes included preterm birth at <37 weeks, intrauterine growth restriction (IUGR), pregnancy-related hypertension, and gestational diabetes mellitus (GDM). Women with increased BMI category between pregnancies were compared with those who remained in the same BMI category. RESULTS In total, 537 women were included, of whom 125 (23%) increased BMI category. There was no association between increase in BMI category and risk of preterm birth, IUGR, or pregnancy-related hypertension. Women who increased BMI category had an increased odds of GDM compared with women who remained in the same BMI category (6.4 vs. 2.2%; p = 0.018). The increased risk remained after controlling for age, history of GDM, and starting BMI (adjusted odds ratio: 8.2; 95% confidence interval: 2.1-32.7; p = 0.003). CONCLUSION Almost one-quarter of women increased BMI categories between pregnancies. This modifiable risk factor has a significant impact on the risk of GDM.
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Affiliation(s)
- Whitney Bender
- Department of Obstetrics and Gynecology, Maternal and Child Health Research Center, Perelman School of Medicine at the University of Pennsylvania
| | - Adi Hirshberg
- Department of Obstetrics and Gynecology, Maternal and Child Health Research Center, Perelman School of Medicine at the University of Pennsylvania
| | - Lisa D Levine
- Department of Obstetrics and Gynecology, Maternal and Child Health Research Center, Perelman School of Medicine at the University of Pennsylvania
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Czarnobay SA, Kroll C, Schultz LF, Malinovski J, Mastroeni SSDBS, Mastroeni MF. Predictors of excess birth weight in Brazil: a systematic review. J Pediatr (Rio J) 2019; 95:128-154. [PMID: 29787700 DOI: 10.1016/j.jped.2018.04.006] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [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: 03/13/2018] [Revised: 03/29/2018] [Accepted: 04/02/2018] [Indexed: 12/30/2022] Open
Abstract
OBJECTIVE To describe the main predictors for excess birth weight in Brazilian children. DATA SOURCES Systematic review carried out in the bibliographic databases: PubMed/MEDLINE, Cochrane, Scopus, Web of Science, and LILACS. The research in the gray literature was performed using the Google Scholar database. The bias risk analysis was adapted from the Downs and Black scale, used to evaluate the methodology of the included studies. DATA SYNTHESIS Using the classifications of fetal macrosomia (>4.000g or ≥4.000g) and large for gestational age (above the 90th percentile), 64 risk factors for excess birth weight were found in 33 scientific articles in the five regions of the country. Of the 64 risk factors, 31 were significantly associated with excess birth weight, with excess gestational weight gain, pre-gestational body mass index ≥25kg/m2, and gestational diabetes mellitus being the most prevalent. CONCLUSION The main predictors for excess birth weight in Brazil are modifiable risk factors. The implementation of adequate nutritional status in the gestational period and even after childbirth appears to be due to the quality and frequency of the follow-up of the mothers and their children by public health agencies.
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Affiliation(s)
- Sandra Ana Czarnobay
- Universidade da Região de Joinville (UNIVILLE), Programa de Pós-Graduação em Saúde e Meio Ambiente, Joinville, SC, Brazil
| | - Caroline Kroll
- Universidade da Região de Joinville (UNIVILLE), Programa de Pós-Graduação em Saúde e Meio Ambiente, Joinville, SC, Brazil
| | - Lidiane F Schultz
- Universidade da Região de Joinville (UNIVILLE), Programa de Pós-Graduação em Saúde e Meio Ambiente, Joinville, SC, Brazil
| | - Juliana Malinovski
- Universidade da Região de Joinville (UNIVILLE), Programa de Pós-Graduação em Saúde e Meio Ambiente, Joinville, SC, Brazil
| | | | - Marco Fabio Mastroeni
- Universidade da Região de Joinville (UNIVILLE), Programa de Pós-Graduação em Saúde e Meio Ambiente, Joinville, SC, Brazil.
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Czarnobay SA, Kroll C, Schultz LF, Malinovski J, Mastroeni SSDBS, Mastroeni MF. Predictors of excess birth weight in Brazil: a systematic review. Jornal de Pediatria (Versão em Português) 2019; 95:128-154. [DOI: 10.1016/j.jpedp.2018.06.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
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20
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Suliga E, Rokita W, Adamczyk-Gruszka O, Pazera G, Cieśla E, Głuszek S. Factors associated with gestational weight gain: a cross-sectional survey. BMC Pregnancy Childbirth 2018; 18:465. [PMID: 30509248 PMCID: PMC6276162 DOI: 10.1186/s12884-018-2112-7] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [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: 03/27/2018] [Accepted: 11/22/2018] [Indexed: 02/04/2023] Open
Abstract
BACKGROUND The aim of this study was to describe the dietary patterns in pregnant women and determine the association between diet factors, pre-pregnancy body mass index, socio-demographic characteristics and gestational weight gain. METHODS The analysis was conducted on a group of 458 women. Cut-off values of gestational weight gain adequacy were based on recommendations published by the US Institute of Medicine and were body mass index-specific. Logistic regression analysis was used to assess the risk of the occurrence of inadequate or excessive gestational weight gain. Dietary patterns were identified by factor analysis. RESULTS Three dietary patterns characteristic of pregnant women in Poland were identified: 'unhealthy', 'varied' and 'prudent'. The factor associated with increased risk of inadequate gestational weight gain was being underweight pre-pregnancy (OR = 2.61; p = 0.018). The factor associated with increased risk of excessive weight gain were being overweight or obese pre-pregnancy (OR = 7.00; p = 0.031) and quitting smoking (OR = 7.32; p = 0.019). The risk of excessive weight gain was decreased by being underweight pre-pregnancy (OR = 0.20; p = 0.041), being in the third or subsequent pregnancy compared to being in the first (OR = 0.37; p = 0.018), and having a high adherence to a prudent dietary pattern (OR = 0.47; p = 0.033). CONCLUSIONS Women who were overweight or obese pre-pregnancy and those who quit smoking at the beginning of pregnancy should be provided with dietary guidance to prevent excessive gestational weight gain.
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Affiliation(s)
- Edyta Suliga
- Department of Nutrition and Dietetics, Faculty of Medicine and Health Sciences, Jan Kochanowski University, Kielce, Poland.
| | - Wojciech Rokita
- Department of Gynecological and Obstetric Prophylaxis, Faculty of Medicine and Health Sciences, Jan Kochanowski University, Kielce, Poland
| | - Olga Adamczyk-Gruszka
- Department of Gynecological and Obstetric Prophylaxis, Faculty of Medicine and Health Sciences, Jan Kochanowski University, Kielce, Poland
| | - Grażyna Pazera
- Clinic of Neonatology at the Regional Polyclinic Hospital, Kielce, Poland
| | - Elżbieta Cieśla
- Department of Developmental Age Research, Faculty of Medicine and Health Sciences, Jan Kochanowski University, Kielce, Poland
| | - Stanisław Głuszek
- Department of Surgery and Surgical Nursing with the Scientific Research Laboratory, Faculty of Medicine and Health Sciences, Jan Kochanowski University, Kielce, Poland
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Kiani Asiabar A, Amin Shokravi F, Hajifaraji M, Zayeri F. The effect of an educational intervention in early pregnancy with spouse's participation on optimal gestational weight gain in pregnancy: a randomized controlled trial. Health Educ Res 2018; 33:535-547. [PMID: 30496409 DOI: 10.1093/her/cyy040] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/06/2017] [Accepted: 11/10/2018] [Indexed: 06/09/2023]
Abstract
Gaining weight above the Institute of Medicine recommended range contributes to the development of obesity, which increases risk for diseases. We evaluated the effectiveness of an educational program with the spouse's participation on the optimal gestational weight gain (GWG) in pregnancy. We conducted a randomized controlled trial on 128 nulliparous women attending Najmieh Hospital-Antenatal Clinic based in Tehran-Iran. Participants randomly allocated into two groups of interventions and one control group. In group A, the women received education with their spouse's participation. In group B, the women received education without the participation of the spouses. In the control group, women received only routine prenatal care. Data were analysed by the ANOVA and Chi-square coefficient. The mean of the total GWG in the groups A and B was significantly lower than the control group (13.50 ± 3.85, 13.55 ± 3.20 and 15.53 ± 4.20 kg, respectively, P > 0.05). The rate of optimal GWG in groups A and B was 1.97 and 1.77 times of the control group, respectively (P < 0.05). The percentage of non-optimal GWG significantly decreased (P < 0.05). Groups A and B were not significantly different indicating no effect of spousal presence.
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Affiliation(s)
- Azita Kiani Asiabar
- Department of Health Education and Health Promotion, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran
- Department of Midwifery, Faculty of Nursing and Midwifery, Shahed University, Tehran, Iran
| | - Farkhondeh Amin Shokravi
- Department of Health Educations and Health Promotion, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran
| | - Majid Hajifaraji
- National Nutrition and Food Technology Research Institute, School of Nutrition Sciences and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Farid Zayeri
- Department of Biostatistics, Faculty of Paramedical Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Gondwe A, Ashorn P, Ashorn U, Dewey KG, Maleta K, Nkhoma M, Mbotwa J, Jorgensen JM. Pre-pregnancy body mass index (BMI) and maternal gestational weight gain are positively associated with birth outcomes in rural Malawi. PLoS One 2018; 13:e0206035. [PMID: 30352100 PMCID: PMC6198955 DOI: 10.1371/journal.pone.0206035] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [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: 10/23/2017] [Accepted: 10/03/2018] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Whereas poor maternal nutritional status before and during pregnancy is widely associated with adverse birth outcomes, studies quantifying this association in low income countries are scarce. We examined whether maternal pre-pregnancy body mass index (BMI) and weight gain during pregnancy are associated with birth outcomes in rural Malawi. METHODS We analyzed the associations between pre-pregnancy BMI and average weekly gestational weight gain (WWG) and birth outcomes [duration of gestation, birth weight, length-for-age z-score (LAZ), and head circumference-for-age z-score (HCZ)]. We also determined whether women with low or high pre-pregnancy BMI or women with inadequate or excessive WWG were at increased risk of adverse birth outcomes. RESULTS The analyses included 1287 women with a mean BMI of 21.8 kg/m2, of whom 5.9% were underweight (< 18.5 kg/m2), 10.9% were overweight (≥ 25 kg/m2), 71.8% had low WWG [below the lower limit of the Institute of Medicine (IOM) recommendation], and 5.2% had high WWG (above IOM recommendation). In adjusted models, pre-pregnancy BMI was not associated with duration of pregnancy (p = 0.926), but was positively associated with birth weight and HCZ (<0.001 and p = 0.003, respectively). WWG was positively associated with duration of gestation (p = 0.031), birth weight (p<0.001), LAZ (p<0.001), and HCZ (p<0.001). Compared to normal weight women, underweight women were at increased risk of having stunted infants (p = 0.029). Women with low WWG were at increased risk of having infants with low birth weight (p = 0.006) and small head circumference (p = 0.024) compared to those with normal weight gain. Those with high BMI or high WWG were not at increased risk of adverse birth outcomes. CONCLUSIONS WWG is an important predictor of birth outcomes in rural Malawi. The high prevalence of inadequate WWG compared to low pre-pregnancy BMI highlights the need to investigate causes of inadequate weight gain in this region.
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Affiliation(s)
- Austrida Gondwe
- University of Tampere, Faculty of Medicine and Life Sciences, Centre for Child Health Research, Tampere, Finland
| | - Per Ashorn
- University of Tampere, Faculty of Medicine and Life Sciences, Centre for Child Health Research, Tampere, Finland
- Tampere University Hospital, Department of Paediatrics, Tampere, Finland
| | - Ulla Ashorn
- University of Tampere, Faculty of Medicine and Life Sciences, Centre for Child Health Research, Tampere, Finland
| | - Kathryn G. Dewey
- Department of Nutrition, University of California Davis, Davis, California, United States of America
| | - Kenneth Maleta
- University of Malawi College of Medicine, School of Public Health and Family Medicine, Blantyre, Malawi
| | - Minyanga Nkhoma
- University of Tampere, Faculty of Medicine and Life Sciences, Centre for Child Health Research, Tampere, Finland
| | - John Mbotwa
- University of Malawi College of Medicine, School of Public Health and Family Medicine, Blantyre, Malawi
| | - Josh M. Jorgensen
- Department of Nutrition, University of California Davis, Davis, California, United States of America
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Denize KM, Acharya N, Prince SA, da Silva DF, Harvey AL, Ferraro ZM, Adamo KB. Addressing cultural, racial and ethnic discrepancies in guideline discordant gestational weight gain: a systematic review and meta-analysis. PeerJ 2018; 6:e5407. [PMID: 30186674 PMCID: PMC6118200 DOI: 10.7717/peerj.5407] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2018] [Accepted: 07/18/2018] [Indexed: 12/12/2022] Open
Abstract
OBJECTIVE To systematically review the literature and describe the discrepancies in achieving the 2009 Institute of Medicine (IOM) gestational weight gain (GWG) guidelines across cultures. METHODS Ten databases were searched from inception to April 2018. Observational cohort studies were included that examined adult women; reported on a measure of culture; compared cultural groups, and reported on GWG. Articles were broken down into papers that used the current 2009 IOM GWG guidelines and those that used others. A meta-analysis was conducted for studies using the 2009 guidelines examining the prevalence of discordant GWG across cultural groups. RESULTS The review included 86 studies. Overall, 69% of women experienced discordant GWG irrespective of culture. White women experienced excessive GWG most often, and significantly more than Asian and Hispanic women; Black women had a higher prevalence of excessive GWG than Hispanic and Asian women; however, this difference was not significant. CONCLUSIONS The majority of women experience excessive GWG, with White women experiencing this most often. Culturally diverse GWG guidelines are needed to individualize antenatal care and promote optimal maternal-fetal health outcomes across cultural groups.
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Affiliation(s)
- Kathryn M. Denize
- School of Human Kinetics, Faculty of Health Science, University of Ottawa, Ottawa, Canada
| | - Nina Acharya
- School of Human Kinetics, Faculty of Health Science, University of Ottawa, Ottawa, Canada
| | - Stephanie A. Prince
- Division of Cardiac Prevention and Rehabilitation, University of Ottawa Heart Institute, Ottawa, Canada
| | - Danilo Fernandes da Silva
- Department of Physical Education, State University of Midwest/Parana (UNICENTRO), Guarapuava, Paraná, Brazil
| | - Alysha L.J. Harvey
- School of Human Kinetics, Faculty of Health Science, University of Ottawa, Ottawa, Canada
| | | | - Kristi B. Adamo
- School of Human Kinetics, Faculty of Health Science, University of Ottawa, Ottawa, Canada
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Abstract
BACKGROUND AND OBJECTIVES Former preterm infants are at increased risk of hypertension with increasing age. Our objective was to identify rates of high blood pressure (BP) (≥90th percentile) and hypertension (BP ≥95th percentile) and associated risk factors among extreme preterm (EPT) infants at 6 to 7 years of age. METHODS Assessment included BP and anthropometrics. Comparisons were made by BP ≥90th versus <90th percentile. Regressions were run to identify relative risk (RR) of factors associated with BP ≥90th percentile. RESULTS Among 379 EPT infants, 20.6% had systolic high BP, 10.8% systolic hypertension, 21.4% diastolic high BP, and 11.4% diastolic hypertension. Children with systolic high BP had higher rates of BMI, triceps skinfolds >85th percentile, and waist circumference >90th percentile. In regression analyses, weight gain velocity from 18 months to school age (RR = 1.36), and maternal gestational diabetes (MGD) (RR = 2.04) predicted systolic and either systolic and/or diastolic high BP (RR = 1.27 and RR = 1.67). Among children with BMI <85th percentile, 17% had systolic and 19% had diastolic high BP. Regression analysis for normal weight children indicated public insurance (RR = 2.46) and MGD (RR = 2.16) predicted systolic high BP, and MGD (RR = 2.08) predicted either systolic or diastolic high BP. CONCLUSIONS Both overweight and normal weight EPT children are at risk for high BP and hypertension. Public insurance, MGD, and weight gain velocity are risk factors. Findings of high BP among EPT children at early school age are worrisome and indicate a need for close follow-up.
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Affiliation(s)
- Betty R. Vohr
- Division of Neonatal Medicine, Department of Pediatrics, Warren Alpert Medical School, Brown University, Providence, Rhode Island
| | - Roy Heyne
- Department of Pediatrics, Division of Neonatal-Perinatal Medicine,University of Texas Southwestern Medical Center, Dallas, Texas
| | - Carla Bann
- Division of Statistical and Data Sciences, RTI International, Research Triangle Park, North Carolina
| | - Abhik Das
- Division of Biostatistics and Epidemiology, RTI International, Rockville, Maryland
| | - Rosemary D. Higgins
- Neonatal Research Network, National Institutes of Health and the Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, Maryland; and
| | - Susan R. Hintz
- Department of Pediatrics, Division of Neonatal and Developmental Medicine, Stanford University, Palo Alto, California
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Huang X, Tan H, Cai M, Shi T, Mi C, Lei J. Gestational weight gain in Chinese women -- results from a retrospective cohort in Changsha, China. BMC Pregnancy Childbirth 2018; 18:185. [PMID: 29843642 PMCID: PMC5975263 DOI: 10.1186/s12884-018-1833-y] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2018] [Accepted: 05/17/2018] [Indexed: 11/26/2022] Open
Abstract
Background The generalizability of the gestational weight gain (GWG) ranges recommended by the Institute of Medicine (IOM) to Chinese women is disputed. Methods In 2016, 16,780 pregnant women who gave birth to live singletons in Changsha, China, were enrolled. First, subjects with optimal pregnancy outcomes were identified for the GWG percentile distribution description and for comparison to the IOM recommendations. Second, all subjects with optimal GWG according to the IOM body mass index (BMI) cutoffs and those with optimal GWG according to the Asian BMI cutoffs were selected. Pregnancy outcomes were compared between those two groups. Results A total of 13,717 births with optimal pregnancy outcomes were selected to describe the GWG distribution. The height and central position of the GWG distributions determined by the Asian BMI cutoffs differed from those determined by the IOM BMI cutoffs among the overweight and obese groups. The recommended IOM GWG ranges were narrower than and shifted to the left of the observed distributions. In both BMI classification schemes, however, the IOM-recommended ranges were within the middle 70% (Pc 15th–85th) and 50% (Pc 25th–75th) of the observed distribution. A total of 6438 (38.37%) and 6110 (36.41%) women gained optimal GWG, according to the IOM and Asian BMI classifications, respectively. Compared with those with optimal GWG according to IOM BMI cutoffs, women with optimal GWG according to the Asian BMI cutoffs had lower risks of both macrosomia (adjusted OR = 0.79, 95%CI: 0.67–0.94) and large-for-gestational age (adjusted OR = 0.86, 95%CI: 0.76, 0.98). However, no significantly different risks of preterm, low birthweight, small-for-gestational age, pregnancy-induced hypertension, or gestational diabetes were found between them. Conclusions The IOM-recommended GWG ranges are within the middle 70% of the distributions in Chinese women, and pre-pregnancy weight status should be determined by the Asian BMI cut-off points for monitoring and making GWG recommendations to Chinese women. Electronic supplementary material The online version of this article (10.1186/s12884-018-1833-y) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Xin Huang
- Department of Preventive Medicine, School of Medicine, Hunan Normal University, Changsha, Hunan, China
| | - Hongzhuan Tan
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha, Hunan, China
| | - Ming Cai
- Maternity and Child Care Hospital of Yuelu District, Changsha, Hunan, China
| | - Ting Shi
- Maternity and Child Care Hospital of Tianxin District, Changsha, Hunan, China
| | - Chunmei Mi
- Department of Obstetrics and Gynecology, The Third Xiangya Hospital of Central South University, 138 Tongzipo Road, Yuelu District, Changsha, 410013, Hunan, Province, China.
| | - Jun Lei
- Department of Obstetrics and Gynecology, The Third Xiangya Hospital of Central South University, 138 Tongzipo Road, Yuelu District, Changsha, 410013, Hunan, Province, China.
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Ornaghi S, Algeri P, Todyrenchuk L, Vertemati E, Vergani P. Impact of excessive pre-pregnancy body mass index and abnormal gestational weight gain on pregnancy outcomes in women with chronic hypertension. Pregnancy Hypertens 2018; 12:90-95. [DOI: 10.1016/j.preghy.2018.04.005] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2017] [Revised: 04/05/2018] [Accepted: 04/07/2018] [Indexed: 01/19/2023]
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Homan GF, deLacey S, Tremellen K. Promoting healthy lifestyle in fertility clinics; an Australian perspective. Hum Reprod Open 2018; 2018:hox028. [PMID: 30895240 PMCID: PMC6276697 DOI: 10.1093/hropen/hox028] [Citation(s) in RCA: 3] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2017] [Revised: 12/10/2017] [Accepted: 12/18/2017] [Indexed: 01/10/2023] Open
Abstract
STUDY QUESTION Are Australian fertility clinics adequately addressing unhealthy lifestyle in patients seeking fertility treatment? SUMMARY ANSWER This study has highlighted deficiencies in practices and education around managing patients with unhealthy lifestyle undergoing fertility treatment. WHAT IS KNOWN ALREADY The association between lifestyle and fertility is well documented, with obesity and smoking being of particular concern to fertility and pregnancy outcomes. Guidelines recommend that unhealthy lifestyle is addressed prior to conception, yet anecdotal experience suggests this is not being addressed. Lifestyle modification programmes can be effective in improving pregnancy rates and outcomes, however, recruitment to such programmes can be challenging. STUDY DESIGN SIZE, DURATION A cohort study of Australian fertility clinics’ attitudes and practices regarding lifestyle modification to augment reproductive treatment outcomes was conducted between August and October 2015. PARTICIPANTS/MATERIALS, SETTING, METHOD An online survey was administered to senior fertility nurses, from all registered fertility clinics in Australia. Data were collated and subjected to a univariate data analysis, where frequency tables were produced for each question. A separate qualitative analysis was undertaken of data from open ended questions. MAIN RESULTS AND THE ROLE OF CHANCE Fifty-three out of 85 potential respondents (62.4%), all from different clincis, completed the survey, with almost all acknowledging the importance of addressing unhealthy lifestyle before offering ART treatment. However, most clinics did not offer internal resources to assist with lifestyle modification. Whilst the promotion of healthy lifestyle was recognised as a key component of the role of a fertility nurse, participants did not feel that nurses were best equipped to provide lifestyle modification programmes, owing to a lack of resources and specific skills in this area. Suggested areas for improved practice included prioritising general health prior to offering treatment, and further utilising and upskilling nurses to assist with lifestyle modification programmes. LIMITATIONS REASONS FOR CAUTION The survey was completed by only one nurse from each clinic and as such may not be entirely representative of all clinic practices. WIDER IMPLICATIONS OF THE FINDINGS Fertility clinics are likely to see an increasing number of patients with unhealthy lifestyle, resulting in health concerns such as obesity. The results of this study provide an insight into how unhealthy lifestyle is currently being addressed in fertility clinics and suggested areas that could be targeted for improving practice and outcomes. STUDY FUNDING/COMPETING INTERESTS No conflict of interest to declare. This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors. TRIAL REGISTRATION NUMBER NA
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Affiliation(s)
- G F Homan
- Flinders Fertility, FMC, 44, Flinders Drive, Bedford Park 5042, South Australia.,Faculty of Nursing & Health science, Flinders University, Bedford Park, 5042South Australia
| | - S deLacey
- Faculty of Nursing & Health science, Flinders University, Bedford Park, 5042South Australia
| | - K Tremellen
- Flinders Fertility, FMC, 44, Flinders Drive, Bedford Park 5042, South Australia.,College of Medicine and Public Health, Flinders University, Sturt Road, Bedford Park 5042South Australia
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Agarwal P, Morriseau TS, Kereliuk SM, Doucette CA, Wicklow BA, Dolinsky VW. Maternal obesity, diabetes during pregnancy and epigenetic mechanisms that influence the developmental origins of cardiometabolic disease in the offspring. Crit Rev Clin Lab Sci 2018; 55:71-101. [DOI: 10.1080/10408363.2017.1422109] [Citation(s) in RCA: 77] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Affiliation(s)
- Prasoon Agarwal
- Department of Pharmacology & Therapeutics, University of Manitoba, Winnipeg, Canada
- Diabetes Research Envisioned and Accomplished in Manitoba (DREAM) Research Theme of the Children’s Hospital Research Institute of Manitoba, University of Manitoba, Winnipeg, Canada
- Manitoba Developmental Origins of Chronic Diseases in Children Network (DEVOTION), University of Manitoba, Winnipeg, Canada
| | - Taylor S. Morriseau
- Department of Pharmacology & Therapeutics, University of Manitoba, Winnipeg, Canada
- Diabetes Research Envisioned and Accomplished in Manitoba (DREAM) Research Theme of the Children’s Hospital Research Institute of Manitoba, University of Manitoba, Winnipeg, Canada
- Manitoba Developmental Origins of Chronic Diseases in Children Network (DEVOTION), University of Manitoba, Winnipeg, Canada
| | - Stephanie M. Kereliuk
- Department of Pharmacology & Therapeutics, University of Manitoba, Winnipeg, Canada
- Diabetes Research Envisioned and Accomplished in Manitoba (DREAM) Research Theme of the Children’s Hospital Research Institute of Manitoba, University of Manitoba, Winnipeg, Canada
- Manitoba Developmental Origins of Chronic Diseases in Children Network (DEVOTION), University of Manitoba, Winnipeg, Canada
| | - Christine A. Doucette
- Diabetes Research Envisioned and Accomplished in Manitoba (DREAM) Research Theme of the Children’s Hospital Research Institute of Manitoba, University of Manitoba, Winnipeg, Canada
- Manitoba Developmental Origins of Chronic Diseases in Children Network (DEVOTION), University of Manitoba, Winnipeg, Canada
- Department of Physiology & Pathophysiology, University of Manitoba, Winnipeg, Canada
| | - Brandy A. Wicklow
- Diabetes Research Envisioned and Accomplished in Manitoba (DREAM) Research Theme of the Children’s Hospital Research Institute of Manitoba, University of Manitoba, Winnipeg, Canada
- Manitoba Developmental Origins of Chronic Diseases in Children Network (DEVOTION), University of Manitoba, Winnipeg, Canada
- Department of Pediatrics & Child Health, University of Manitoba, Winnipeg, Canada
| | - Vernon W. Dolinsky
- Department of Pharmacology & Therapeutics, University of Manitoba, Winnipeg, Canada
- Diabetes Research Envisioned and Accomplished in Manitoba (DREAM) Research Theme of the Children’s Hospital Research Institute of Manitoba, University of Manitoba, Winnipeg, Canada
- Manitoba Developmental Origins of Chronic Diseases in Children Network (DEVOTION), University of Manitoba, Winnipeg, Canada
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Cruz S, Matos A, da Cruz SP, Pereira S, Saboya C, Ramalho A. Relationship between the Nutritional Status of Vitamin A per Trimester of Pregnancy with Maternal Anthropometry and Anemia after Roux-en-Y Gastric Bypass. Nutrients 2017; 9:E989. [PMID: 28885564 PMCID: PMC5622749 DOI: 10.3390/nu9090989] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [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] [Subscribe] [Scholar Register] [Received: 07/19/2017] [Revised: 08/25/2017] [Accepted: 09/04/2017] [Indexed: 01/03/2023] Open
Abstract
The aim of this study was to compare the nutritional status of vitamin A per trimester of pregnancy, as well as to assess its influence on pre-pregnancy BMI, total gestational weight gain (TGWG) and presence of anemia in women who had previously undergone Roux-en-Y gastric bypass (RYGB). An analytical, longitudinal and retrospective study comprising 30 pregnant women who had previously undergone RYGB was undertaken. In all trimesters of pregnancy, the serum concentrations of retinol, β-carotene, stages of vitamin A deficiency (VAD), night blindness (NB), anemia and anthropometric variables were assessed. VAD in pregnancy affected 90% of women, 86.7% developed NB and 82.8% had mild VAD. TGWG above/below the recommended range was related to the low serum concentrations of β-carotene (p = 0.045) in the second trimester and women with TGWG above the recommended range showed 100% of inadequacy of this nutrient in the third trimester. Among the pregnant women with anemia, 90.9% had VAD and 86.4% had NB. This study highlights the importance of monitoring the nutritional status of vitamin A in prenatal care, due to its relationship with TGWG and the high percentage of VAD and NB found since the beginning of pregnancy. It also reaffirms the use of the cut-off <1.05 μmol/L for determining VAD.
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Affiliation(s)
- Sabrina Cruz
- School of Medicine, Federal University of Rio de Janeiro (UFRJ), Rio de Janeiro 21.941-902, Brazil.
- Center for Research on Micronutrients (NPqM), Institute of Nutrition Josué de Castro of UFRJ), Rio de Janeiro 21.941-902, Brazil.
| | - Andréa Matos
- School of Medicine, Federal University of Rio de Janeiro (UFRJ), Rio de Janeiro 21.941-902, Brazil.
- Center for Research on Micronutrients (NPqM), Institute of Nutrition Josué de Castro of UFRJ), Rio de Janeiro 21.941-902, Brazil.
- Fluminense Federal University (UFF), Rio de Janeiro 24.020-150, Brazil.
| | - Suelem Pereira da Cruz
- School of Medicine, Federal University of Rio de Janeiro (UFRJ), Rio de Janeiro 21.941-902, Brazil.
- Center for Research on Micronutrients (NPqM), Institute of Nutrition Josué de Castro of UFRJ), Rio de Janeiro 21.941-902, Brazil.
| | - Silvia Pereira
- School of Medicine, Federal University of Rio de Janeiro (UFRJ), Rio de Janeiro 21.941-902, Brazil.
- Center for Research on Micronutrients (NPqM), Institute of Nutrition Josué de Castro of UFRJ), Rio de Janeiro 21.941-902, Brazil.
- Multidisciplinary Center for Bariatric and Metabolic Surgery, Rio de Janeiro 22280-020, Brazil.
| | - Carlos Saboya
- Center for Research on Micronutrients (NPqM), Institute of Nutrition Josué de Castro of UFRJ), Rio de Janeiro 21.941-902, Brazil.
- Multidisciplinary Center for Bariatric and Metabolic Surgery, Rio de Janeiro 22280-020, Brazil.
- Escola Paulista de Medicina, Federal University of São Paulo (UNIFESP), São Paulo 04.021-001, Brazil.
| | - Andréa Ramalho
- Center for Research on Micronutrients (NPqM), Institute of Nutrition Josué de Castro of UFRJ), Rio de Janeiro 21.941-902, Brazil.
- Fundação Oswaldo Cruz (ENSP/FIOCRUZ), Rio de Janeiro 21040-900, Brazil.
- Department of Social and Applied Nutrition of the Institute of Nutrition, UFRJ, Rio de Janeiro 21.941-902, Brazil.
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Zablah JE, Gruber D, Stoffels G, Cabezas EG, Hayes DA. Subclinical Decrease in Myocardial Function in Asymptomatic Infants of Diabetic Mothers: A Tissue Doppler Study. Pediatr Cardiol 2017; 38:801-806. [PMID: 28197645 DOI: 10.1007/s00246-017-1584-y] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [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: 12/01/2016] [Accepted: 02/02/2017] [Indexed: 11/28/2022]
Abstract
Infants of diabetic mothers (IDMs) with hypertrophic cardiomyopathy are recognized to have impaired myocardial performance, but less is known about ventricular function in IDMs without hypertrophy. We hypothesized that in asymptomatic newborns with normal two-dimensional echocardiographic evaluations, pulsed wave tissue Doppler imaging (TDI) would suggest a subclinical decrease in the cardiac function of IDMs compared to infants of non-diabetics (nIDMs). This is a retrospective cohort study of asymptomatic neonates ≥36 weeks gestation, at 0-7 days of life, with normal standard echocardiograms. Systolic (S'), early diastolic (E'), and late diastolic (A') TDI velocities were measured at the mitral valve (MV) annulus, basal interventricular septum (IVS), and tricuspid valve (TV) annulus, and averaged from three consecutive cardiac cycles. Demographic, perinatal, and echocardiographic variables were compared between IDM and nIDM groups. Of 631 subjects, 75 IDMs were identified. The mean gestational age of the entire cohort was 39.33 weeks (±1.26), birth weight 3.44 kg (±0.56), and body surface area (BSA) 0.21 m2 (±0.02). IDMs had significantly greater birth weight and BSA, lower gestational age, older maternal age, and higher incidence of maternal obesity and hypertension than nIDMs (p < 0.001). On multivariable analysis, IDMs had significantly lower S' (p ≤ 0.03) and E' (p < 0.001) velocities, and higher E/E' ratios (p < 0.001) at the MV, IVS, and TV than nIDMs. In asymptomatic newborn IDMs without cardiac hypertrophy, pulsed wave TDI suggests a subclinical decrease in systolic and diastolic myocardial function compared to nIDMs.
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Affiliation(s)
- Jenny E Zablah
- Division of Pediatric Cardiology, Cohen Children's Medical Center at Northwell Health, 269-01 76th Ave, Suite 139, New Hyde Park, New York, NY, 11040, USA
| | - Dorota Gruber
- Division of Pediatric Cardiology, Cohen Children's Medical Center at Northwell Health, 269-01 76th Ave, Suite 139, New Hyde Park, New York, NY, 11040, USA
| | - Guillaume Stoffels
- Department of Biostatistics, Feinstein Institute for Medical Research, 350 Community Drive, Manhasset, New York, NY, 11030, USA
| | - Estefania G Cabezas
- Department of Biology, City College of New York, 160 Convent Ave, New York, NY, 10031, USA
| | - Denise A Hayes
- Division of Pediatric Cardiology, Cohen Children's Medical Center at Northwell Health, 269-01 76th Ave, Suite 139, New Hyde Park, New York, NY, 11040, USA.
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