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Santos SFMD, Costa ACCD, Araújo RGPDS, Silva LAT, Gama SGND, Fonseca VDM. Factors associated with the adequacy of gestational weight gain among Brazilian teenagers. CIENCIA & SAUDE COLETIVA 2022; 27:2629-2642. [PMID: 35730834 DOI: 10.1590/1413-81232022277.17812021] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2021] [Accepted: 12/03/2021] [Indexed: 11/21/2022] Open
Abstract
The scope of this article is to evaluate the adequacy of total gestational weight gain (GWG) according to maternal characteristics of Brazilian adolescents. It involved a cross-sectional, hospital-based study. A total of 3,904 teenagers with a single fetus gestation and gestational age (GA) at birth ≥ 37 weeks were included. A hierarchical model was built to analyze the dependent and independent variables adequacy of GWG: sociodemographic, care, obstetric and behavioral characteristics. The chances of insufficient GWG were higher for adolescents from the North (OR = 1.50, 95%CI: 1.07-2.10) and Northeast (OR = 1.68, 95%CI: 1.27-2.21). Paid work increased the chances of insufficient (95%CI: 1.15-2.39) and excessive (95%CI: 1.01-1.86) GWG. The pre-pregnancy body mass index of overweight or obese adolescents was associated with excessive GWG (OR = 1.86, 95%CI: 1.19-2.92 and OR = 3.06, 95%CI: 2.10-4.45, respectively), as well as GA ≥ 42 weeks (OR = 2.23, 95%CI: 1.03-4.81). Living in the North and Northeast regions increases the chances of adolescents having insufficient GWG. Having paid work was associated with a greater chance of excessive and insufficient GWG. Furthermore, pre-pregnancy excess weight or obesity and GA ≥ 42 weeks increased the chances of excessive GWG.
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Affiliation(s)
- Samira Fernandes Morais Dos Santos
- Instituto Nacional de Saúde da Mulher, da Criança e do Adolescente Fernandes Figueira, Fundação Oswaldo Cruz. Av. Rui Barbosa 716, Flamengo. 22250-020 Rio de Janeiro RJ Brasil.
| | - Ana Carolina Carioca da Costa
- Instituto Nacional de Saúde da Mulher, da Criança e do Adolescente Fernandes Figueira, Fundação Oswaldo Cruz. Av. Rui Barbosa 716, Flamengo. 22250-020 Rio de Janeiro RJ Brasil.
| | | | - Laís Araújo Tavares Silva
- Instituto Nacional de Saúde da Mulher, da Criança e do Adolescente Fernandes Figueira, Fundação Oswaldo Cruz. Av. Rui Barbosa 716, Flamengo. 22250-020 Rio de Janeiro RJ Brasil.
| | | | - Vania de Matos Fonseca
- Instituto Nacional de Saúde da Mulher, da Criança e do Adolescente Fernandes Figueira, Fundação Oswaldo Cruz. Av. Rui Barbosa 716, Flamengo. 22250-020 Rio de Janeiro RJ Brasil.
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Mello LDRD, Marano D, Moreira MEL, Domingues RMSM, Costa ACCD, Dias MAB. Assessment of the completeness of filling the pregnant woman's card from the Ministry of Health: a national, cross-sectional study. CIENCIA & SAUDE COLETIVA 2022; 27:2337-2348. [PMID: 35649021 DOI: 10.1590/1413-81232022276.14292021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2021] [Accepted: 09/09/2021] [Indexed: 11/21/2022] Open
Abstract
This article aims to evaluate the completeness of the pregnant woman's card filling according to a model standardized by the Ministry of Health. Hospital based, nationwide, cross-sectional study conducted between 2011 and 2012, evaluated data from pregnant women's cards. Variables related to personal, obstetric history and current pregnancy data were used to assess completeness. We used the Kotelchuck index for quantitative evaluation. We analysed 6,577 cards, equivalent to 39% of the cards presented at the time of delivery. The mean completeness was overall "bad" in Brazil and macro-regions, except in the Southern region. Nationwide, the mean completion was "regular" for personal antecedents, "good" for obstetric history, and "bad" for fields related to the current pregnancy. Prenatal care was adequate for 58% of pregnant women. We observed a reduced use of the card recommended by the Ministry of Health and failures in the completeness of filling valuable information of the pregnant woman's card, related to the current pregnancy.
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Affiliation(s)
- Lívia de Rezende de Mello
- Instituto Nacional de Saúde da Mulher, da Criança e do Adolescente Fernandes Figueira, Fundação Oswaldo Cruz (Fiocruz). Av. Rui Barbosa 716, Flamengo. 22250-020 Rio de Janeiro RJ Brasil.
| | - Daniele Marano
- Instituto Nacional de Saúde da Mulher, da Criança e do Adolescente Fernandes Figueira, Fundação Oswaldo Cruz (Fiocruz). Av. Rui Barbosa 716, Flamengo. 22250-020 Rio de Janeiro RJ Brasil.
| | - Maria Elisabeth Lopes Moreira
- Instituto Nacional de Saúde da Mulher, da Criança e do Adolescente Fernandes Figueira, Fundação Oswaldo Cruz (Fiocruz). Av. Rui Barbosa 716, Flamengo. 22250-020 Rio de Janeiro RJ Brasil.
| | | | - Ana Carolina Carioca da Costa
- Instituto Nacional de Saúde da Mulher, da Criança e do Adolescente Fernandes Figueira, Fundação Oswaldo Cruz (Fiocruz). Av. Rui Barbosa 716, Flamengo. 22250-020 Rio de Janeiro RJ Brasil.
| | - Marcos Augusto Bastos Dias
- Instituto Nacional de Saúde da Mulher, da Criança e do Adolescente Fernandes Figueira, Fundação Oswaldo Cruz (Fiocruz). Av. Rui Barbosa 716, Flamengo. 22250-020 Rio de Janeiro RJ Brasil.
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Damasceno AADA, Mosquera PS, Malta MB, Matijasevich A, Cardoso MA. Agreement between information recorded during antenatal care and in the MINA-Brazil study. CIENCIA & SAUDE COLETIVA 2022; 27:1619-1628. [PMID: 35475840 DOI: 10.1590/1413-81232022274.04502021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2021] [Accepted: 06/01/2021] [Indexed: 11/22/2022] Open
Abstract
This article aims to examine agreement of pre-pregnancy weight, pregnancy weight, height and systolic (SBP) and diastolic (DBP) blood pressure measurements recorded on antenatal record cards with the same information obtained in the MINA-Brazil longitudinal study. 428 pregnant women who participated in the MINA-Brazil study and had an antenatal card at time of childbirth were selected. Concordance analysis of the data used Lin's correlation coefficient and Bland-Altman analysis. There was moderate agreement on self-reported pre-pregnancy weight (0.935) and height (0.913) information, and substantial agreement on the pregnant women's weight in the second (0.993) and third (0.988) trimesters of pregnancy. Little agreement was found on SBP and DBP measured in the second (SBP = 0.447; DBP = 0.409) and third (SBP = 0.436; DBP = 0.332) trimesters of pregnancy. Anthropometric measurements showed strong agreement. There was weak agreement between blood pressure measurements, which may relate both to the variability and the standardisation of these measurements, suggesting the need for continued training of antenatal teams in primary health care.
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Affiliation(s)
| | - Paola Soledad Mosquera
- Departamento de Nutrição, Faculdade de Saúde Pública, Universidade de São Paulo. Av. Dr. Arnaldo 715, 01246-904. São Paulo SP Brasil.
| | - Maíra Barreto Malta
- Departamento de Nutrição, Faculdade de Saúde Pública, Universidade de São Paulo. Av. Dr. Arnaldo 715, 01246-904. São Paulo SP Brasil. .,Programa de Pós-Graduação em Saúde Coletiva, Universidade Católica de Santos. Santos SP Brasil
| | | | - Marly Augusto Cardoso
- Departamento de Nutrição, Faculdade de Saúde Pública, Universidade de São Paulo. Av. Dr. Arnaldo 715, 01246-904. São Paulo SP Brasil.
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Santos SFMD, Costa ACCD, Araújo RGPDS, Silva LAT, Gama SGND, Fonseca VDM. Factors associated with the adequacy of gestational weight gain among Brazilian teenagers. CIENCIA & SAUDE COLETIVA 2022. [DOI: 10.1590/1413-81232022277.17812021en] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Abstract The scope of this article is to evaluate the adequacy of total gestational weight gain (GWG) according to maternal characteristics of Brazilian adolescents. It involved a cross-sectional, hospital-based study. A total of 3,904 teenagers with a single fetus gestation and gestational age (GA) at birth ≥ 37 weeks were included. A hierarchical model was built to analyze the dependent and independent variables adequacy of GWG: sociodemographic, care, obstetric and behavioral characteristics. The chances of insufficient GWG were higher for adolescents from the North (OR = 1.50, 95%CI: 1.07-2.10) and Northeast (OR = 1.68, 95%CI: 1.27-2.21). Paid work increased the chances of insufficient (95%CI: 1.15-2.39) and excessive (95%CI: 1.01-1.86) GWG. The pre-pregnancy body mass index of overweight or obese adolescents was associated with excessive GWG (OR = 1.86, 95%CI: 1.19-2.92 and OR = 3.06, 95%CI: 2.10-4.45, respectively), as well as GA ≥ 42 weeks (OR = 2.23, 95%CI: 1.03-4.81). Living in the North and Northeast regions increases the chances of adolescents having insufficient GWG. Having paid work was associated with a greater chance of excessive and insufficient GWG. Furthermore, pre-pregnancy excess weight or obesity and GA ≥ 42 weeks increased the chances of excessive GWG.
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Brandão T, de Carvalho Padilha P, de Barros DC, Dos Santos K, Nogueira da Gama SG, Leal MDC, da Silva Araújo RGP, Esteves Pereira AP, Saunders C. Gestational weight gain adequacy for favourable obstetric and neonatal outcomes: A nationwide hospital-based cohort gestational weight gain for favourable obstetric and neonatal outcomes. Clin Nutr ESPEN 2021; 45:374-380. [PMID: 34620343 DOI: 10.1016/j.clnesp.2021.02.024] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2020] [Revised: 11/17/2020] [Accepted: 02/05/2021] [Indexed: 11/28/2022]
Abstract
BACKGROUND & AIMS Most Brazilian women fail to gain weight within recommendations during pregnancy but current guidelines about gestational weight gain was based on North American population analysis. There are no standardized recommendations developed from Brazilian population data, which should be particularly analysed due to ethnic and sociodemographic characteristics. This study analyses the gestational weight gain of Brazilian women with favourable obstetric and neonatal outcomes according to the pre-pregnancy body mass index, considering maternal sociodemographic characteristics. METHODS We analysed data from the Birth in Brazil: national survey into labour and birth study, a nationwide hospital-based cohort carried out in 266 Brazilian hospitals from February/2011 to July 2012, including adult pregnant women who have no chronic diseases and who have single foetal gestation, born alive and without malformation. Favourable obstetric and neonatal outcomes considered were gestational age at birth greater than or equal to 37 and less than 42 weeks, birthweight between 2500 g and 4000 g, and birthweight suitable for gestational age. Sociodemographic characteristics were obtained from medical records and interviews. Weight and height information was obtained from the prenatal card or self-reported. The pre-pregnancy BMI was classified in low weight, normal weight, overweight, obesity I, obesity II, and obesity III. For the missing cases on pre-pregnancy weight or height, body mass index was imputed by multiple imputation prediction model. Gestational weight gain was the difference between the last weight before delivery and the pre-pregnancy weight and was presented as mean and confidence interval, mean and standard deviation, and percentiles distribution (10th to 90th) for each pre-pregnancy body mass index, thus compared to Institute of Medicine recommendations. RESULTS The analysis included 8184 Brazilian women. The gestational weight gain was lower in women with less favoured social conditions. The mean gestational weight gain according to pre-pregnancy body mass index was within the Institute of Medicine recommendations, except for women with overweight or obesity class I, who have the mean weight gain higher than upper limit of the Institute of Medicine range. Gestational weight gain decreased with an increase in the categories of body mass index; the mean (±standard deviation) were: 15.41 kg (±5.53), 13.54 kg (±4.97), 12.45 kg (±5.86), 9.38 kg (±6.31), 7.15 kg (±6.43), and 5.04 kg (±7.10), for low weight, normal weight, overweight, and obesity I, II and III, respectively. Women had favourable obstetric and neonatal outcomes gaining less, within or more than the recommendations with higher range of variation amongst obesity classes I, II, and III which do not have specific ranges stated in Institute of Medicine guidelines. CONCLUSION Brazilian women had favourable obstetric and neonatal outcomes gaining less, within or more than the Institute of Medicine recommendations. We highlight the need of population-based high-quality research to investigate the optimal GWG recommendations for this population.
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Affiliation(s)
- Thelma Brandão
- Programa de Pós-graduação em Nutrição. Instituto de Nutrição Josué de Castro, Universidade Federal do Rio de Janeiro, UFRJ/RJ, (Graduate Program in Nutrition. Josué de Castro Nutrition Institute, Federal University of Rio de Janeiro), Avenida Carlos Chagas Filho 373 - bloco J, 2º Andar, Cidade Universitária, Rio de Janeiro, RJ, 21941-902, Brazil
| | - Patricia de Carvalho Padilha
- Programa de Pós-graduação em Nutrição. Instituto de Nutrição Josué de Castro, Universidade Federal do Rio de Janeiro, UFRJ/RJ, (Graduate Program in Nutrition. Josué de Castro Nutrition Institute, Federal University of Rio de Janeiro), Avenida Carlos Chagas Filho 373 - bloco J, 2º Andar, Cidade Universitária, Rio de Janeiro, RJ, 21941-902, Brazil
| | - Denise Cavalcante de Barros
- Escola Nacional de Saúde Pública. Fundação Oswaldo Cruz, FIOCRUZ/RJ, (National School of Public Health, Oswaldo Cruz Foundation), Rua Leopoldo Bulhões 1480 - Manguinhos, Rio de Janeiro, RJ, 21041-210, Brazil
| | - Karina Dos Santos
- Programa de Pós-graduação em Nutrição. Instituto de Nutrição Josué de Castro, Universidade Federal do Rio de Janeiro, UFRJ/RJ, (Graduate Program in Nutrition. Josué de Castro Nutrition Institute, Federal University of Rio de Janeiro), Avenida Carlos Chagas Filho 373 - bloco J, 2º Andar, Cidade Universitária, Rio de Janeiro, RJ, 21941-902, Brazil.
| | - Silvana Granado Nogueira da Gama
- Escola Nacional de Saúde Pública. Fundação Oswaldo Cruz, FIOCRUZ/RJ, (National School of Public Health, Oswaldo Cruz Foundation), Rua Leopoldo Bulhões 1480 - Manguinhos, Rio de Janeiro, RJ, 21041-210, Brazil
| | - Maria do Carmo Leal
- Escola Nacional de Saúde Pública. Fundação Oswaldo Cruz, FIOCRUZ/RJ, (National School of Public Health, Oswaldo Cruz Foundation), Rua Leopoldo Bulhões 1480 - Manguinhos, Rio de Janeiro, RJ, 21041-210, Brazil
| | - Roberta Gabriela Pimenta da Silva Araújo
- Escola Nacional de Saúde Pública. Fundação Oswaldo Cruz, FIOCRUZ/RJ, (National School of Public Health, Oswaldo Cruz Foundation), Rua Leopoldo Bulhões 1480 - Manguinhos, Rio de Janeiro, RJ, 21041-210, Brazil
| | - Ana Paula Esteves Pereira
- Escola Nacional de Saúde Pública. Fundação Oswaldo Cruz, FIOCRUZ/RJ, (National School of Public Health, Oswaldo Cruz Foundation), Rua Leopoldo Bulhões 1480 - Manguinhos, Rio de Janeiro, RJ, 21041-210, Brazil
| | - Cláudia Saunders
- Programa de Pós-graduação em Nutrição. Instituto de Nutrição Josué de Castro, Universidade Federal do Rio de Janeiro, UFRJ/RJ, (Graduate Program in Nutrition. Josué de Castro Nutrition Institute, Federal University of Rio de Janeiro), Avenida Carlos Chagas Filho 373 - bloco J, 2º Andar, Cidade Universitária, Rio de Janeiro, RJ, 21941-902, Brazil
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Rangel Bousquet Carrilho T, M Rasmussen K, Rodrigues Farias D, Freitas Costa NC, Araújo Batalha M, E Reichenheim M, O Ohuma E, Hutcheon JA, Kac G. Agreement between self-reported pre-pregnancy weight and measured first-trimester weight in Brazilian women. BMC Pregnancy Childbirth 2020; 20:734. [PMID: 33243188 PMCID: PMC7690094 DOI: 10.1186/s12884-020-03354-4] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2020] [Accepted: 10/23/2020] [Indexed: 11/16/2022] Open
Abstract
Background Self-reported pre-pregnancy weight and weight measured in the first trimester are both used to estimate pre-pregnancy body mass index (BMI) and gestational weight gain (GWG) but there is limited information on how they compare, especially in low- and middle-income countries, where access to a weight scale can be limited. Thus, the main goal of this study was to evaluate the agreement between self-reported pre-pregnancy weight and weight measured during the first trimester of pregnancy among Brazilian women so as to assess whether self-reported pre-pregnancy weight is reliable and can be used for calculation of BMI and GWG. Methods Data from the Brazilian Maternal and Child Nutrition Consortium (BMCNC, n = 5563) and the National Food and Nutritional Surveillance System (SISVAN, n = 393,095) were used to evaluate the agreement between self-reported pre-pregnancy weight and weights measured in three overlapping intervals (30–94, 30–60 and 30–45 days of pregnancy) and their impact in BMI classification. We calculated intraclass correlation and Lin’s concordance coefficients, constructed Bland and Altman plots, and determined Kappa coefficient for the categories of BMI. Results The mean of the differences between self-reported and measured weights was < 2 kg during the three intervals examined for BMCNC (1.42, 1.39 and 1.56 kg) and about 1 kg for SISVAN (1.0, 1.1 and 1.2 kg). Intraclass correlation and Lin’s coefficient were > 0.90 for both datasets in all time intervals. Bland and Altman plots showed that the majority of the difference laid in the ±2 kg interval and that the differences did not vary according to measured first-trimester BMI. Kappa coefficient values were > 0.80 for both datasets at all intervals. Using self-reported pre-pregnancy or measured weight would change, in total, the classification of BMI in 15.9, 13.5, and 12.2% of women in the BMCNC and 12.1, 10.7, and 10.2% in the SISVAN, at 30–94, 30–60 and 30–45 days, respectively. Conclusion In Brazil, self-reported pre-pregnancy weight can be used for calculation of BMI and GWG when an early measurement of weight during pregnancy is not available. These results are especially important in a country where the majority of woman do not initiate prenatal care early in pregnancy. Supplementary Information Supplementary information accompanies this paper at 10.1186/s12884-020-03354-4.
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Affiliation(s)
- Thaís Rangel Bousquet Carrilho
- Nutritional Epidemiology Observatory, Josué de Castro Nutrition Institute, Federal University of Rio de Janeiro. Avenida Carlos Chagas Filho 373/CCS, bloco J, 2 andar, sala 29. Cidade Universitária, Ilha do Fundão, Rio de Janeiro, RJ, 21941-902, Brazil
| | - Kathleen M Rasmussen
- Division of Nutritional Sciences, Cornell University, 227 Savage Hall, Ithaca, NY, 14850, USA
| | - Dayana Rodrigues Farias
- Nutritional Epidemiology Observatory, Josué de Castro Nutrition Institute, Federal University of Rio de Janeiro. Avenida Carlos Chagas Filho 373/CCS, bloco J, 2 andar, sala 29. Cidade Universitária, Ilha do Fundão, Rio de Janeiro, RJ, 21941-902, Brazil
| | - Nathalia Cristina Freitas Costa
- Nutritional Epidemiology Observatory, Josué de Castro Nutrition Institute, Federal University of Rio de Janeiro. Avenida Carlos Chagas Filho 373/CCS, bloco J, 2 andar, sala 29. Cidade Universitária, Ilha do Fundão, Rio de Janeiro, RJ, 21941-902, Brazil
| | - Mônica Araújo Batalha
- Nutritional Epidemiology Observatory, Josué de Castro Nutrition Institute, Federal University of Rio de Janeiro. Avenida Carlos Chagas Filho 373/CCS, bloco J, 2 andar, sala 29. Cidade Universitária, Ilha do Fundão, Rio de Janeiro, RJ, 21941-902, Brazil
| | - Michael E Reichenheim
- Department of Epidemiology, Institute of Social Medicine, Rio de Janeiro State University, Rua São Francisco Xavier, 524, 7 andar, Bloco D, Sala 7018, Maracanã, Rio de Janeiro, RJ, 20550-013, Brazil
| | - Eric O Ohuma
- Maternal, Adolescent, Reproductive & Child Health (MARCH) Centre, London School of Hygiene & Tropical Medicine, Keppel Street, London, WC1E 7HT, UK.,Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Peter Medawar Building for Pathogen Research (PMB), South Parks Road, Oxford, OX1 3SY, UK
| | - Jennifer A Hutcheon
- Department of Obstetrics and Gynaecology, University of British Columbia, Faculty of Medicine, Suite 930, 1125 Howe Street, Vancouver, BC, V6Z 2K8, Canada
| | - Gilberto Kac
- Nutritional Epidemiology Observatory, Josué de Castro Nutrition Institute, Federal University of Rio de Janeiro. Avenida Carlos Chagas Filho 373/CCS, bloco J, 2 andar, sala 29. Cidade Universitária, Ilha do Fundão, Rio de Janeiro, RJ, 21941-902, Brazil.
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Spann MN, Scheinost D, Feng T, Barbato K, Lee S, Monk C, Peterson BS. Association of Maternal Prepregnancy Body Mass Index With Fetal Growth and Neonatal Thalamic Brain Connectivity Among Adolescent and Young Women. JAMA Netw Open 2020; 3:e2024661. [PMID: 33141162 PMCID: PMC7610195 DOI: 10.1001/jamanetworkopen.2020.24661] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2020] [Accepted: 09/08/2020] [Indexed: 12/17/2022] Open
Abstract
Importance Higher maternal prepregnancy body mass index (BMI; calculated as weight in kilograms divided by height in meters squared) is associated with adverse long-term outcomes for offspring, including obesity, poorer cognitive and social abilities, and increased risk of psychiatric disorders. Less clear is whether higher maternal BMI disrupts fetal growth and brain development. Objective To investigate the association of maternal prepregnancy BMI with fetal growth and neonatal functional connectivity. Design, Setting, and Participants This prospective longitudinal cohort study was conducted from 2012 to 2017. Participants included nulliparous pregnant adolescent and young adult women, aged 14 to 19 years who were recruited in the second trimester through Columbia University Irving Medical Center and Weill Cornell Medical College. Women received routine prenatal care and had no major health problems at the time of recruitment. Data were analyzed from January 2018 to March 2020. Exposures Maternal prepregnancy BMI. Main Outcomes and Measures The main outcomes were fetal growth, measured as estimated fetal weight, and neonatal functional connectivity, measured using magnetic resonance imaging. Prepregnancy BMI and fetal ultrasonographic measurements were obtained from electronic health record review. Resting-state brain imaging data were acquired in infants within the first month of postnatal life. Functional connectivity was measured using intrinsic functional distribution and seed-based methods. Results Among 129 women recruited, 105 had ultrasonographic data from at least 2 points and were included in analyses. The mean (SD) age at delivery was 17.82 (1.31) years. Maternal prepregnancy BMI was positively associated with the slope of estimated fetal weight (β = 0.668; 95% CI, 0.163 to 1.175; P = .01) but not with fetal head circumference (β = -0.004; 95% CI, -0.024 to 0.016; P = .70). In a subsample of 45 infants with magnetic resonance imaging data, maternal prepregnancy BMI was positively correlated with global connectivity in the left thalamus. Using this thalamic region as a seed, higher maternal BMI was associated with greater local thalamic (both hemispheres) and lower frontothalamic connectivity. Conclusions and Relevance These results suggest that maternal prepregnancy BMI was associated with the development of regulation of body weight and thalamic functional brain connectivity in offspring even during fetal development.
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Affiliation(s)
- Marisa N. Spann
- Columbia University Irving Medical Center, New York, New York
| | | | | | | | - Seonjoo Lee
- Columbia University Irving Medical Center, New York, New York
- New York State Psychiatric Institute, New York
| | - Catherine Monk
- Columbia University Irving Medical Center, New York, New York
- New York State Psychiatric Institute, New York
| | - Bradley S. Peterson
- Children’s Hospital Los Angeles, Los Angeles, California
- Department of Psychiatry, Keck School of Medicine, University of Southern California, Los Angeles
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Hernandez-Trejo M, Sámano R, Chico-Barba G, Pizano-Zarate ML, Herrera-González NE. Neonatal adiposity may increase plasmatic cytokines. PLoS One 2020; 15:e0238370. [PMID: 32886687 PMCID: PMC7473588 DOI: 10.1371/journal.pone.0238370] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2020] [Accepted: 08/15/2020] [Indexed: 11/18/2022] Open
Abstract
Maternal health and nutritional status before and during gestation may affect neonates' immune system and energy balance as they develop. The objective of this study was to associate certain clinical markers of maternal adiposity (body mass index and gestational weight gain) and neonatal adiposity (birth weight, abdominal circumference, and waist/height index) with the levels of pro- and anti-inflammatory cytokines in umbilical cord blood at birth: IL-1β, IL-1Rα, IL-4, IL-6, IL-10, IFN-γ, and TNF-α. An exploratory cross-sectional study was conducted with a convenience sample of women from one hospital recruited shortly before giving birth through scheduled cesarean section. Of 31 the pregnant women who agreed to participate and met the inclusion criteria, twenty-nine newborns from these women were analyzed. Three cases of tobacco smoking during pregnancy were identified as an unexpected maternal risk factor and were included in the analysis. Typical of the population treated at this hospital, ten of our participants had diabetes during pregnancy, and nine of them had a pre-pregnancy BMI> 25. Non-parametric statistical analyses and a generalized linear model with gamma scale response with a log link were performed. Results: Correlation analyses, differences in medians, and a prediction model all showed positive and significant results between cytokine levels in cord blood and neonatal abdominal circumference, birth weight, and waist-height index. For maternal variables, smoking during pregnancy showed significant associations with cytokine levels in cord blood. Conclusion: This study found a variety of associations suggesting that increased neonatal adiposity increases pro-inflammatory cytokine levels at birth.
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Affiliation(s)
- Maria Hernandez-Trejo
- Neurobiología del Desarrollo, Instituto Nacional de Perinatología, Secretaría de Salud, Ciudad de México, México
- * E-mail:
| | - Reyna Sámano
- Nutrición y Bioprogramación, Instituto Nacional de Perinatología, Secretaría de Salud, Ciudad de México, México
| | - Gabriela Chico-Barba
- Nutrición y Bioprogramación, Instituto Nacional de Perinatología, Secretaría de Salud, Ciudad de México, México
| | - Maria Luisa Pizano-Zarate
- Nutrición y Bioprogramación, Instituto Nacional de Perinatología, Secretaría de Salud, Ciudad de México, México
| | - Norma Estela Herrera-González
- Sección de Posgrado e Investigación, Escuela Superior de Medicina del Instituto Politécnico Nacional, Plan de San Luis y Díaz Mirón s/n, Casco de Santo Tomás, Ciudad de México, México
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9
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Brandão T, de Carvalho Padilha P, Granado Nogueira da Gama S, Leal MDC, Gabriela Pimenta da Silva Araújo R, Cavalcante de Barros D, Esteves Pereira AP, Dos Santos K, Belizán JM, Saunders C. Gestational weight gain and adverse maternal outcomes in Brazilian women according to body mass index categories: An analysis of data from the Birth in Brazil survey. Clin Nutr ESPEN 2020; 37:114-120. [PMID: 32359732 DOI: 10.1016/j.clnesp.2020.03.009] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2019] [Revised: 03/08/2020] [Accepted: 03/12/2020] [Indexed: 11/26/2022]
Abstract
BACKGROUND & AIMS Monitoring gestational weight gain (GWG) is relevant for perinatal outcomes, especially in the context of increasing obesity and overweight in the female population. This study analyses the association between GWG in Brazilian women, according to different body mass index (BMI) categories, and different outcomes, including hypertensive disorders of pregnancy (HDP), gestational diabetes (GD) and caesarean section. METHODS Data on women from all the major regions of Brazil with a single pregnancy of a gestational age of 28 weeks or more and information available for anthropometric evaluation were included in the Birth in Brazil survey. Adequacy of GWG was assessed according to the percentile distribution of GWG of women with favourable neonatal outcomes, with the median of the distribution referred to as 100% adequacy in the GWG evaluation. RESULTS The study consisted of 18,953 women, 58.3% of whom were normal weight and 35.1% were overweight. The adequacy of GWG was better amongst the normal weight women (91.1%) and worse amongst those with class III obesity (46.0% with excessive GWG), with the latter showing the highest occurrence of adverse outcomes. Results of the multivariate logistic regression analysis revealed that weight gain above 200% of the median in the normal weight, overweight and obese women was positively associated with HDP and caesarean section, but not with GD. CONCLUSIONS The proposed ranges of appropriate GWG associated with favourable neonatal outcomes based on the data from the Birth in Brazil survey proved good predictors of HDP and caesarean section amongst the women included in the study.
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Affiliation(s)
- Thelma Brandão
- Instituto de Nutrição Josué de Castro, Universidade Federal do Rio de Janeiro, UFRJ/RJ, Avenida Carlos Chagas Filho 373, Bloco J, 2º Andar, Rio de Janeiro, RJ, 21941-902, Brazil
| | - Patricia de Carvalho Padilha
- Instituto de Nutrição Josué de Castro, Universidade Federal do Rio de Janeiro, UFRJ/RJ, Avenida Carlos Chagas Filho 373, Bloco J, 2º Andar, Rio de Janeiro, RJ, 21941-902, Brazil
| | - Silvana Granado Nogueira da Gama
- Escola Nacional de Saúde Pública, Fundação Oswaldo Cruz, FIOCRUZ/RJ, Rua Leopoldo Bulhões, 1480, Manguinhos, Rio de Janeiro, RJ, 21041-210, Brazil
| | - Maria do Carmo Leal
- Escola Nacional de Saúde Pública, Fundação Oswaldo Cruz, FIOCRUZ/RJ, Rua Leopoldo Bulhões, 1480, Manguinhos, Rio de Janeiro, RJ, 21041-210, Brazil
| | | | - Denise Cavalcante de Barros
- Escola Nacional de Saúde Pública, Fundação Oswaldo Cruz, FIOCRUZ/RJ, Rua Leopoldo Bulhões, 1480, Manguinhos, Rio de Janeiro, RJ, 21041-210, Brazil
| | - Ana Paula Esteves Pereira
- Escola Nacional de Saúde Pública, Fundação Oswaldo Cruz, FIOCRUZ/RJ, Rua Leopoldo Bulhões, 1480, Manguinhos, Rio de Janeiro, RJ, 21041-210, Brazil
| | - Karina Dos Santos
- Instituto de Nutrição Josué de Castro, Universidade Federal do Rio de Janeiro, UFRJ/RJ, Avenida Carlos Chagas Filho 373, Bloco J, 2º Andar, Rio de Janeiro, RJ, 21941-902, Brazil.
| | - José M Belizán
- Departamento de Investigación en Salud de la Madre y el Niño, Instituto de Efectividad Clínica y Sanitaria, (IECS-CONICET), Ravignani 2024, (1414), Buenos Aires, Argentina
| | - Cláudia Saunders
- Instituto de Nutrição Josué de Castro, Universidade Federal do Rio de Janeiro, UFRJ/RJ, Avenida Carlos Chagas Filho 373, Bloco J, 2º Andar, Rio de Janeiro, RJ, 21941-902, Brazil
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Neves PAR, Gatica-Domínguez G, Santos IS, Bertoldi AD, Domingues M, Murray J, Silveira MF. Poor maternal nutritional status before and during pregnancy is associated with suspected child developmental delay in 2-year old Brazilian children. Sci Rep 2020; 10:1851. [PMID: 32024929 PMCID: PMC7002477 DOI: 10.1038/s41598-020-59034-y] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2019] [Accepted: 01/23/2020] [Indexed: 01/17/2023] Open
Abstract
Inadequate pre-pregnancy BMI and gestational weight gain (GWG) have been associated with sub-optimal child development. We used data from the 2015 Pelotas (Brazil) Birth Cohort Study. Maternal anthropometry was extracted from antenatal/hospital records. BMI (kg/m2) and GWG (kg) adequacy were classified according to WHO and IOM, respectively. Development was evaluated using the INTER-NDA assessment tool for 3,776 children aged 24 months. Suspected developmental delay (SDD) was defined as <10th percentile. Associations between maternal exposures and child development were tested using linear and logistic regressions. Mediation for the association between BMI and child development through GWG was tested using G-formula. Sex differences were observed for all child development domains, except motor. Maternal pre-pregnancy underweight increased the odds of SDD in language (OR: 2.75; 95%CI: 1.30-5.80), motor (OR: 2.28; 95%CI: 1.20-4.33), and global (OR: 2.14; 95% CI: 1.05-4.33) domains for girls; among boys, excessive GWG was associated with SDD in language (OR: 1.59; 95%CI: 1.13-2.24) and cognition (OR: 1.59; 95%CI: 1.15-2.22). Total GWG suppressed the association of pre-pregnancy BMI with percentiles of global development in the entire sample. Maternal underweight and excessive GWG were negatively associated with development of girls and boys, respectively. The association of pre-pregnancy BMI with global child development was not mediated by GWG, irrespective of child's sex.
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Affiliation(s)
- Paulo A R Neves
- Postgraduate Program in Epidemiology, School of Medicine, Universidade Federal de Pelotas. Rua Marechal Deodoro, 1160, Centro, 96020-220, Pelotas, Brazil.
| | - Giovanna Gatica-Domínguez
- Postgraduate Program in Epidemiology, School of Medicine, Universidade Federal de Pelotas. Rua Marechal Deodoro, 1160, Centro, 96020-220, Pelotas, Brazil
| | - Iná S Santos
- Postgraduate Program in Epidemiology, School of Medicine, Universidade Federal de Pelotas. Rua Marechal Deodoro, 1160, Centro, 96020-220, Pelotas, Brazil
| | - Andréa D Bertoldi
- Postgraduate Program in Epidemiology, School of Medicine, Universidade Federal de Pelotas. Rua Marechal Deodoro, 1160, Centro, 96020-220, Pelotas, Brazil
| | - Marlos Domingues
- Postgraduate Program in Epidemiology, School of Medicine, Universidade Federal de Pelotas. Rua Marechal Deodoro, 1160, Centro, 96020-220, Pelotas, Brazil
- Postgraduate Program in Physical Education, School of Physical Education, Universidade Federal de Pelotas. Rua Luís de Camões, 625, Três Vendas, 96055-630, Pelotas, Brazil
| | - Joseph Murray
- Postgraduate Program in Epidemiology, School of Medicine, Universidade Federal de Pelotas. Rua Marechal Deodoro, 1160, Centro, 96020-220, Pelotas, Brazil
| | - Mariângela F Silveira
- Postgraduate Program in Epidemiology, School of Medicine, Universidade Federal de Pelotas. Rua Marechal Deodoro, 1160, Centro, 96020-220, Pelotas, Brazil
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