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Niyi JL, Li Z, Zumah F. Association between Gestational Weight Gain and Maternal and Birth Outcomes in Northern Ghana. BIOMED RESEARCH INTERNATIONAL 2024; 2024:5526942. [PMID: 38726293 PMCID: PMC11081748 DOI: 10.1155/2024/5526942] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/11/2023] [Revised: 02/01/2024] [Accepted: 04/22/2024] [Indexed: 05/12/2024]
Abstract
Background Although inappropriate gestational weight gain is considered closely related to adverse maternal and birth outcomes globally, little evidence was found in low- and middle-income countries. Study Objectives. This study is aimed at identifying the determinants of gestational weight gain and examine the association between gestational weight gain and maternal and birth outcomes in the Northern Region of Ghana. Study Methods. The study used a facility-based cross-sectional study design involving 611 antenatal and delivery records in Tatale district, Tamale west, and Gushegu municipal hospitals. A two-stage sampling method involving cluster and simple random sampling was employed. Descriptive statistical analysis and measures of central tendency were used to describe the sample. The multinomial logistic regression model was used to determine the determinants of gestational weight gain and its association with maternal and birth outcomes. Results Among the 611 women included in the study, 516 (84.45%) had inadequate gestational weight gain, and 19 (3.11%) had excessive gestational weight gain. The gestational weight gain ranged from 2 kg to 25 kg with a mean of 7.26 ± 3.70 kg. The risk factor for inadequate gestational weight gain was low prepregnancy BMI (adjusted odds ratio (AOR) = 1.33, 95% CI = 1.18 - 2.57, P = 0.002). Pregnant women who had inadequate gestational weight gain were significantly less likely to deliver through caesarean section (AOR = 0.27, 95% CI = 0.12 - 0.61, P = 0.002), and those who had excessive weight gain were more likely to undergo caesarean section (AOR = 19.81, 95% CI = 5.38 - 72.91, P = 0.001). The odds of premature delivery (birth < 37 weeks) among pregnant women with inadequate weight gain were 2.88 (95% CI = 1.27 - 6.50, P = 0.011). Furthermore, subjects who had excessive weight gain were 43.80 times more likely to give birth to babies with macrosomia (95% CI = 7.07 - 271.23, P = 0.001). Conclusion Inappropriate gestational weight gain is prevalent in Ghana, which is associated with caesarean section, preterm delivery, delivery complications, and macrosomia. Urgent policy interventions are needed to improve on the frequent monitoring and management of gestational weight gain of pregnant women till term.
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Affiliation(s)
- John Lapah Niyi
- Ghana Health Service, Gushegu Municipal Health Directorate, Gushegu, Ghana
| | - Zhihui Li
- Vanke School of Public Health, Tsinghua University, 100084 Beijing, China
- Institute for Health China, Tsinghua University, 100084 Beijing, China
| | - Fidelis Zumah
- School of Collective Intelligence, Mohammed VI Polytechnic University (UM6P), Rabat, Morocco
- University of Ghana Medical Centre Ltd, Legon, Accra, Ghana
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Nguyen G, Bell Z, Andreae G, Scott S, Sermin-Reed L, Lake AA, Heslehurst N. Food insecurity during pregnancy in high-income countries, and maternal weight and diet: A systematic review and meta-analysis. Obes Rev 2024:e13753. [PMID: 38693587 DOI: 10.1111/obr.13753] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2023] [Revised: 02/15/2024] [Accepted: 03/26/2024] [Indexed: 05/03/2024]
Abstract
Food insecurity is a well-established obesity driver. Less is known about food insecurity during pregnancy. This review (PROSPERO:CRD42022311669) aimed to explore associations between food insecurity, maternal obesity, gestational weight gain (GWG), and nutrition. Searches included seven databases, gray literature, references, citations, and contacting authors. Observational studies reporting data from January 1st, 2008 to 21 November 2023 in high-income countries were included. Duplicate screening, data extraction, and quality assessments were performed. Random effects meta-analysis estimated odds ratios (OR), mean difference (MD), and 95% confidence intervals (CI). Narrative synthesis was conducted when data could not be pooled. Database searches identified 22,272 results; 20 studies were included (n = 19 North America, n = 1 Europe; n = 32,803 women). Food insecurity significantly increased obesity (OR 1.53 95%CI 1.39, 1.66), but not underweight (OR 1.12 95%CI 0.89, 1.34) or overweight (OR 1.18 95%CI 0.90, 1.46). Food insecurity significantly reduced GWG (MD -0.42 kg 95%CI -0.62, -0.22) and increased inadequate GWG (OR 1.16 95%CI 1.05, 1.28), but not excessive GWG (OR 1.04 95%CI 0.96, 1.13). Diet outcomes were inconsistent, with some evidence of reduced vitamin E and diet quality and increased red/processed meat consumption. Further studies outside of North America are needed to inform practice and policy to support maternal health.
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Affiliation(s)
- Giang Nguyen
- Population Health Science Institute, Faculty of Medical Sciences, Newcastle University, Newcastle Upon Tyne, UK
| | - Zoë Bell
- Population Health Science Institute, Faculty of Medical Sciences, Newcastle University, Newcastle Upon Tyne, UK
- Department of Nutritional Sciences, King's College London, London, UK
| | - Gemma Andreae
- Population Health Science Institute, Faculty of Medical Sciences, Newcastle University, Newcastle Upon Tyne, UK
| | - Stephanie Scott
- Population Health Science Institute, Faculty of Medical Sciences, Newcastle University, Newcastle Upon Tyne, UK
- Fuse, The Centre for Translational Research in Public Health, Newcastle Upon Tyne, UK
| | - Letitia Sermin-Reed
- Population Health Science Institute, Faculty of Medical Sciences, Newcastle University, Newcastle Upon Tyne, UK
| | - Amelia A Lake
- Fuse, The Centre for Translational Research in Public Health, Newcastle Upon Tyne, UK
- School of Health and Life Sciences, Teesside University, Middlesbrough, UK
| | - Nicola Heslehurst
- Population Health Science Institute, Faculty of Medical Sciences, Newcastle University, Newcastle Upon Tyne, UK
- Fuse, The Centre for Translational Research in Public Health, Newcastle Upon Tyne, UK
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Kranjac AW, Kranjac D, Kain ZN, Ehwerhemuepha L, Jenkins BN. Obesity Heterogeneity by Neighborhood Context in a Largely Latinx Sample. J Racial Ethn Health Disparities 2024; 11:980-991. [PMID: 36997832 PMCID: PMC10933170 DOI: 10.1007/s40615-023-01578-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2022] [Revised: 02/27/2023] [Accepted: 03/19/2023] [Indexed: 04/01/2023]
Abstract
Neighborhood socioeconomic context where Latinx children live may influence body weight status. Los Angeles County and Orange County of Southern California both are on the list of the top ten counties with the largest Latinx population in the USA. This heterogeneity allowed us to estimate differential impacts of neighborhood environment on children's body mass index z-scores by race/ethnicity using novel methods and a rich data source. We geocoded pediatric electronic medical record data from a predominantly Latinx sample and characterized neighborhoods into unique residential contexts using latent profile modeling techniques. We estimated multilevel linear regression models that adjust for comorbid conditions and found that a child's place of residence independently associates with higher body mass index z-scores. Interactions further reveal that Latinx children living in Middle-Class neighborhoods have higher BMI z-scores than Asian and Other Race children residing in the most disadvantaged communities. Our findings underscore the complex relationship between community racial/ethnic composition and neighborhood socioeconomic context on body weight status during childhood.
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Affiliation(s)
- Ashley W Kranjac
- Department of Sociology, Chapman University, Orange, CA, USA
- Center for Stress & Health, University of California School of Medicine, Irvine, CA, USA
| | - Dinko Kranjac
- Department of Psychology, Institute for Mental Health and Psychological Well-Being, University of La Verne, La Verne, CA, USA
| | - Zeev N Kain
- Center for Stress & Health, University of California School of Medicine, Irvine, CA, USA
- Department of Anesthesiology and Perioperative Care, University of California, Irvine, CA, USA
- Yale Child Study Center, Yale University, New Haven, CT, USA
| | | | - Brooke N Jenkins
- Center for Stress & Health, University of California School of Medicine, Irvine, CA, USA.
- Department of Anesthesiology and Perioperative Care, University of California, Irvine, CA, USA.
- Department of Psychology, Chapman University, One University Drive, Orange, CA, 92866, USA.
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Mehta-Lee SS, Echevarria GC, Brubaker SG, Yaghoubian Y, Long SE, Dolin CD. The Association between Psychosocial Stressors and Gestational Weight Gain: Analysis of the National Pregnancy Risk Assessment Monitoring System (PRAMS) Results from 2012 to 2015. Matern Child Health J 2024:10.1007/s10995-024-03923-5. [PMID: 38427279 DOI: 10.1007/s10995-024-03923-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/15/2024] [Indexed: 03/02/2024]
Abstract
OBJECTIVE Both psychosocial stress and gestational weight gain are independently associated with adverse maternal and fetal outcomes. Studies of the association between psychosocial stress and gestational weight gain (GWG) have yielded mixed results. The objective of this study was to evaluate the association between psychosocial stress and GWG in a large population-based cohort. METHODS Data from the nationally representative Pregnancy Risk Assessment Monitoring System (PRAMS) Phase 7 questionnaire 2012-2015 was utilized. Maternal psychosocial stress was assessed through response to questions designed to examine four domains of psychosocial stress (i.e., traumatic, financial, emotional, partner-related) three months prior to or during pregnancy. GWG was categorized using pre-pregnancy BMI and total GWG into inadequate, adequate, or excessive according to the Institute of Medicine's GWG guidelines. Multinomial logistic regression was used to evaluate the association between psychosocial stressors and adequacy of GWG. Analyses took into account complex survey design. RESULTS All respondents who delivered ≥ 37 weeks gestation with GWG information available were included in the analysis (n = 119,183). After adjusting for confounders, patients who reported financial stress were more likely to experience excessive versus adequate GWG (RRR 1.09 [95%CI: 1.02-1.17]). Exposure to any of the stressor groups did not significantly increase the risk of inadequate GWG. CONCLUSIONS This large, population-based study revealed that among pregnant people in the US, exposure to financial stress is associated with higher risk of excessive GWG. Understanding the role stress plays in GWG will help to inform initiatives targeting this important aspect of prenatal care.
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Affiliation(s)
- Shilpi S Mehta-Lee
- Department of Obstetrics and Gynecology, New York University Langone Health/NYU Grossman School of Medicine, New York, NY, USA.
| | - Ghislaine C Echevarria
- Department of Anesthesiology, Perioperative and Pain Medicine, Icahn School of Medicine at Mount Sinai West, New York, NY, USA
| | - Sara G Brubaker
- Department of Obstetrics and Gynecology, New York University Langone Health/NYU Grossman School of Medicine, New York, NY, USA
| | - Yasaman Yaghoubian
- Department of Obstetrics and Gynecology, Zucker School of Medicine at Hofstra, NorthwellHempstead, USA
| | - Sara E Long
- Department of Pediatrics, Division of Environmental Pediatrics, NYU Langone Medical Center, New York, NY, USA
| | - Cara D Dolin
- Division of Maternal-Fetal Medicine, Department of Reproductive Biology, Cleveland Clinic Lerner College of Medicine, Case Western Reserve University, Cleveland, OH, USA
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Chalifour BN, Trifonova DI, Holzhausen EA, Bailey MJ, Schmidt KA, Babaei M, Mokhtari P, Goran MI, Alderete TL. Characterizing alterations in the gut microbiota following postpartum weight change. mSystems 2023; 8:e0080823. [PMID: 37905810 PMCID: PMC10734492 DOI: 10.1128/msystems.00808-23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2023] [Accepted: 09/21/2023] [Indexed: 11/02/2023] Open
Abstract
IMPORTANCE Previous research has reported differences in the gut microbiome associated with varying body compositions. More specifically, within populations of mothers, the focus has been on the impact of gestational weight gain. This is the first study to examine postpartum weight change and its association with changes in the gut microbiome, similarly, it is the first to use a Latina cohort to do so. The results support the idea that weight gain may be an important factor in reducing gut microbiome network connectivity, diversity, and changing abundances of specific microbial taxa, all measures thought to impact host health. These results suggest that weight gain dynamically alters mothers' gut microbial communities in the first 6 months postpartum, with comparatively little change in mothers who lost weight; further research is needed to examine the health consequences of such changes.
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Affiliation(s)
- Bridget N. Chalifour
- Department of Integrative Physiology, University of Colorado Boulder, Boulder, Colorado, USA
| | - Diana I. Trifonova
- Department of Integrative Physiology, University of Colorado Boulder, Boulder, Colorado, USA
| | - Elizabeth A. Holzhausen
- Department of Integrative Physiology, University of Colorado Boulder, Boulder, Colorado, USA
| | - Maximilian J. Bailey
- Stanford University School of Medicine, Leland Stanford Junior University, Stanford, California, USA
| | - Kelsey A. Schmidt
- Children’s Hospital Los Angeles, University of Southern California, Los Angeles, California, USA
| | - Mahsa Babaei
- Children’s Hospital Los Angeles, University of Southern California, Los Angeles, California, USA
| | - Pari Mokhtari
- Children’s Hospital Los Angeles, University of Southern California, Los Angeles, California, USA
| | - Michael I. Goran
- Children’s Hospital Los Angeles, University of Southern California, Los Angeles, California, USA
| | - Tanya L. Alderete
- Department of Integrative Physiology, University of Colorado Boulder, Boulder, Colorado, USA
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Prasad A, Lin J, Jelliffe-Pawlowski L, Coleman-Phox K, Rand L, Wojcicki JM. Sub-optimal maternal gestational gain is associated with shorter leukocyte telomere length at birth in a predominantly Latinx cohort of newborns. Matern Health Neonatol Perinatol 2023; 9:14. [PMID: 37919818 PMCID: PMC10623801 DOI: 10.1186/s40748-023-00167-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Accepted: 09/20/2023] [Indexed: 11/04/2023] Open
Abstract
OBJECTIVE To assess in utero exposures associated with leukocyte telomere length (LTL) at birth and maternal LTL in a primarily Latinx birth cohort. STUDY DESIGN Mothers and newborns were recruited postnatally before 24 h of life. Newborn LTL was collected via heelstick at birth and maternal LTL was collected postnatally. LTL was determined by quantitative PCR. Using a longitudinal design, we evaluated associations between neonatal and maternal LTL and appropriate maternal gestational gain as indicated by the American College of Obstetrics and Gynecology (ACOG). RESULT Mean infant LTL was 2.02 ± 0.30 T/S (n = 386) and maternal LTL was 1.54 ± 0.26 T/S (n = 58). Independent risk factors for shorter LTL at birth included longer gestational duration (Coeff:-0.03, 95%CI: -0.05-0.01;p < 0.01) and maternal gestational weight gain below ACOG recommendations (Coeff:-0.10, 95%CI: -0.18 - -0.02; p = 0.01). CONCLUSION Gestational weight gain below ACOG recommendations may adversely impact neonatal health in Latinx infants as indicated by shorter LTL at birth.
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Affiliation(s)
- Apurva Prasad
- Division of Pediatric Gastroenterology, Hepatology and Nutrition, Department of Pediatrics, University of California, San Francisco, USA
| | - Jue Lin
- Department of Biochemistry and Biophysics, University of California, San Francisco, USA
| | - Laura Jelliffe-Pawlowski
- Preterm Birth Initiative, University of California, San Francisco, USA
- Department of Epidemiology and Biostatistics, University of California, San Francisco, USA
| | - Kimberley Coleman-Phox
- Department of Obstetrics, Gynecology and Reproductive Health Sciences, University of California, San Francisco, USA
| | - Larry Rand
- Department of Obstetrics, Gynecology and Reproductive Health Sciences, University of California, San Francisco, USA
| | - Janet M Wojcicki
- Division of Pediatric Gastroenterology, Hepatology and Nutrition, Department of Pediatrics, University of California, San Francisco, USA.
- Department of Epidemiology and Biostatistics, University of California, San Francisco, USA.
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Chairat T, Ratinthorn A, Limruangrong P, Boriboonhirunsarn D. Prevalence and related factors of inappropriate gestational weight gain among pregnant women with overweight/ obesity in Thailand. BMC Pregnancy Childbirth 2023; 23:319. [PMID: 37147586 PMCID: PMC10163776 DOI: 10.1186/s12884-023-05635-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2022] [Accepted: 04/22/2023] [Indexed: 05/07/2023] Open
Abstract
BACKGROUND An inappropriate gestational weight gain (GWG) among pregnant women with overweight/obesity is a crucial health problem. Its prevalence remains high worldwide, particularly in urban areas. The prevalence and predicting factors in Thailand are lack of evidence. This study aimed to investigate prevalence rates, antenatal care (ANC) service arrangement, predictive factors, and impacts of inappropriate GWG among pregnant women with overweight/obesity in Bangkok and its surrounding metropolitan area. METHODS This cross-sectional, retrospective study used four sets of questionnaires investigating 685 pregnant women with overweight/obesity and 51 nurse-midwives (NMs) from July to December 2019 in ten tertiary hospitals. Multinomial logistic regression identified predictive factors with a 95% confidence interval (CI). RESULT The prevalence rates of excessive and inadequate GWG were 62.34% and 12.99%. Weight management for pregnant women with overweight/obesity are unavailable in tertiary cares. Over three-fourths of NMs have never received weight management training for this particular group. ANC service factors, i.e., GWG counseling by ANC providers, quality of general ANC service at an excellent and good level, NMs' positive attitudes toward GWG control, significantly decreased the adjusted odds ratio (AOR) of inadequate GWG by 0.03, 0.01, 0.02, 0.20, times, respectively. While maternal factors, sufficient income, and easy access to low-fat foods reduce AOR of inadequate GWG by 0.49, and 0.31 times. In contrast, adequate maternal GWG knowledge statistically increased the AOR of inadequate GWG 1.81 times. Meanwhile, easy access to low-fat foods and internal weight locus of control (WLOC) decreased the AOR of excessive GWG by 0.29 and 0.57 times. Finally, excessive GWG significantly increased the risk of primary C/S, fetal LGA, and macrosomia 1.65, 1.60, and 5.84 times, respectively, while inadequate GWG was not associated with adverse outcomes. CONCLUSION Prevalence rates of inappropriate GWG, especially excessive GWG remained high and affected adverse outcomes. The quality of ANC service provision and appropriate GWG counseling from ANC providers are significant health service factors. Thus, NMs should receive gestational weight counseling and management training to improve women's knowledge and practice for gestational weight (GW) control.
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Affiliation(s)
| | | | | | - Dittakarn Boriboonhirunsarn
- Department of Obstetrics and Gynecology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, 10400, Thailand
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Cliffer I, Darling AM, Madzorera I, Wang D, Perumal N, Wang M, Liu E, Pembe AB, Urassa W, Fawzi WW. Associations of Diet Quality, Socioeconomic Factors, and Nutritional Status with Gestational Weight Gain among Pregnant Women in Dar es Salaam, Tanzania. Curr Dev Nutr 2023; 7:100041. [PMID: 37181931 PMCID: PMC10111583 DOI: 10.1016/j.cdnut.2023.100041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2022] [Revised: 01/12/2023] [Accepted: 01/30/2023] [Indexed: 02/05/2023] Open
Abstract
Background Gestational weight gain (GWG) is a modifiable factor associated with maternal and child health outcomes, but the relationship between diet quality and GWG has not been evaluated using metrics validated for low-income and middle-income countries (LMICs). Objective This study aimed to investigate relationships between diet quality, socioeconomic characteristics, and GWG adequacy using the novel Global Diet Quality Score (GDQS), the first diet quality indicator validated for use across LMIC. Methods Weights of pregnant women enrolled between 12 and 27 wk of gestation (N = 7577) were recorded in Dar es Salaam, Tanzania, from 2001 to 2005 during a prenatal micronutrient supplementation trial. GWG adequacy was the ratio of measured GWG to Institute of Medicine-recommended GWG, categorized into severely inadequate (<70%), inadequate (70 to <90%), adequate (90 to <125%), or excessive (≥125%). Dietary data were collected using 24-h recalls. Multinomial logit models were used to estimate relationships between GDQS tercile, macronutrient intake, nutritional status, and socioeconomic characteristics and GWG. Results GDQS scores in the second [relative risk (RR): 0.82; 95% confidence interval (CI): 0.70, 0.97] tercile were associated with lower risk of inadequate weight gain than those in the first tercile. Increased protein intake was associated with higher risk of severely inadequate GWG (RR: 1.06; 95% CI: 1.02, 1.09). Nutritional status and socioeconomic factors were associated with GWG: underweight prepregnancy BMI (in kg/m2) with a higher risk of severely inadequate GWG (RR: 1.49; 95% CI: 1.12, 1.99), overweight or obese BMI with a higher risk of excessive GWG (RR: 6.80; 95% CI: 5.34, 8.66), and a higher education (RR: 0.61; 95% CI: 0.42, 0.89), wealth (RR: 0.68; 95% CI: 0.48, 0.80), and height (RR: 0.96; 95% CI: 0.95, 0.98) with a lower risk of severely inadequate GWG. Conclusions Dietary indicators showed few associations with GWG. However, stronger relationships were revealed between GWG, nutritional status, and several socioeconomic factors.This trial was registered at clinicaltrials.gov as NCT00197548.
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Affiliation(s)
- Ilana Cliffer
- Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Harvard University, Boston, MA, USA
| | - Anne Marie Darling
- Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Harvard University, Boston, MA, USA
| | - Isabel Madzorera
- Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Harvard University, Boston, MA, USA
- Division of Community Health Sciences, School of Public Health, University of California, Berkeley, CA, USA
| | - Dongqing Wang
- Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Harvard University, Boston, MA, USA
- Department of Global and Community Health, College of Public Health, George Mason University, Fairfax, VA, USA
| | - Nandita Perumal
- Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Harvard University, Boston, MA, USA
| | - Molin Wang
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Harvard University, Boston, MA, USA
| | - Enju Liu
- Institutional Centers for Clinical and Translational Research, Boston Children’s Hospital, Boston, MA, USA
| | - Andrea B. Pembe
- Department of Obstetrics and Gynaecology, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
| | - Willy Urassa
- Department of Microbiology and Immunology, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
| | - Wafaie W. Fawzi
- Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Harvard University, Boston, MA, USA
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Harvard University, Boston, MA, USA
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Harvard University, Boston, MA, USA
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Depression during pregnancy and gestational weight gain: A study of Brazilian pregnant women. Nutrition 2023; 106:111883. [PMID: 36435089 DOI: 10.1016/j.nut.2022.111883] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2022] [Revised: 10/06/2022] [Accepted: 10/10/2022] [Indexed: 11/25/2022]
Abstract
OBJECTIVES The relationship between psychosocial factors/mental health/depressive symptoms and inadequate gestational weight (GW) change remains poorly understood. Thus, the aim of this study was to evaluate the association between depressive symptoms and inadequate GW change according to the criteria established by the Institute of Medicine in 2009. METHODS This cross-sectional study was part of a prospective cohort, and conducted in Botucatu, São Paulo, Brazil. Pregnant women who received prenatal care at basic health care units in the city participated in the study (n = 297). The Edinburgh Postnatal Depression Scale was used to assess depressive symptoms during pregnancy, and the cutoff point used for the positive screening of depressive symptoms was ≥13. The association between depressive symptoms and two outcomes (insufficient and excessive weight change during second and third trimesters) was investigated using logistic regression models with adjustment for potential confounders. Crude and adjusted effect measures (odds ratios) and their relevant 95% confidence intervals were estimated. RESULTS There was an association between a positive score for depression during pregnancy and insufficient GW gain. No association was observed between depressive symptoms and excessive GW gain. CONCLUSIONS The presence of depressive symptoms significantly increased the chance of insufficient GW change. This finding enhances the need for screening for depression in prenatal care.
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Zhang L, Zhu S, Wu Y, Chen D, Liang Z. Association between maternal second-trimester stress and adverse pregnancy outcomes according to pre-pregnancy body mass index and gestational weight gain. Front Psychiatry 2023; 14:1129014. [PMID: 37032953 PMCID: PMC10076625 DOI: 10.3389/fpsyt.2023.1129014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Accepted: 03/09/2023] [Indexed: 04/11/2023] Open
Abstract
Objective To investigate the impact of maternal second-trimester stress on pregnancy outcomes according to pre-pregnancy body mass index (BMI) and gestational weight gain (GWG). Methods We did a prospective study in Women's Hospital, School of Medicine, Zhejiang University and included 960 pregnant women in our final analysis. Obstetric characteristics and the incidence of adverse pregnancy outcomes were examined in stressed and non-stressed women. The associations between maternal prenatal stress with adverse pregnancy outcomes were analyzed by logistic regression. Results The incidence of premature rupture of membranes (PROM) was significantly higher in stressed pregnant women than non-stressed pregnant women (p = 0.035), whereas no significant difference in the incidence rates of gestational diabetes mellitus (GDM), pregnancy-induced hypertension (PIH), primary cesarean delivery, preterm birth, macrosomia, low birth weight, fetal stress, admission into neonatal intensive care unit (NICU) or neonatal jaundice was found between two groups. Maternal second-trimester stress was an independent risk factor for the development of PROM (aOR = 1.468, 95% CI 1.037-2.079). Moreover, maternal second-trimester stress was significantly associated with PROM in pregnant women with normal pre-pregnancy BMI (aOR = 1.587, 95% CI 1.068-2.357) while no association was observed in either underweight or overweight and obese pregnant women. Meanwhile, no difference was found in the odds of PROM with maternal second-trimester stress in all GWG subgroups. Conclusion Maternal second-trimester stress is associated with a higher risk of PROM and it is significant in pregnant women with normal pre-pregnancy BMI. Therefore, interventions to reduce stress during second-trimester of pregnancy might be essential for lowering the prevalence of PROM in pregnant women with normal pre-pregnancy BMI.
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Health Behaviors and Behavior Change during Pregnancy: Theory-Based Investigation of Predictors and Interrelations. SEXES 2022. [DOI: 10.3390/sexes3030027] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
(1) Background: Preventing pregnancy complications and maternal deaths and helping women stay healthy before, during, and after pregnancy by means of sexual health and behavior is imperative. Previous research demonstrated that a lack of social support and perceived discrimination have adverse effects on pregnancy outcomes. These determinants may impact health behavior as an important mediator of pregnancy outcomes. To better understand this relation, the Compensatory Carry-Over Action Model (CCAM) was applied. The research question was: how do predictors of health behavior, specifically intention, planning, self-efficacy, social support, and discrimination, interrelate with different health behaviors during pregnancy? (2) Methods: By means of qualitative interviews with ten pregnant women (20–39 years, mean = 28.6) from different cultural backgrounds, the predictors of health behaviors and experiences with pregnancy, including racial discrimination, were investigated. (3) Results: Not all women changed their unhealthy behaviors even though their higher-level goal was to ensure their baby’s and their own health. This appeared partially due to lack of social support, racial discrimination, and unexpected pregnancy side effects. The women who previously performed health behaviors revealed a healthier pattern with maintaining or even expanding their health behaviors, while those performing no health behavior in the past reported more obstacles with a healthy lifestyle. (4) Conclusions: Pregnant women appear to be having difficulties translating good intentions into behavior. The reasons include lack of support, fear, and insecurity, which impact self-efficacy and planning. Improvements in health behaviors were facilitated by specific circumstances, such as working from home. Policy and practice should take these aspects into account and help mobilize support and overcome discrimination by means of more rights and support for pregnant women while also empowering the individuals.
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Arzhang P, Ramezan M, Borazjani M, Jamshidi S, Bavani NG, Rahmanabadi A, Bagheri A. The association between food insecurity and gestational weight gain: A systematic review and meta-analysis. Appetite 2022; 176:106124. [PMID: 35714821 DOI: 10.1016/j.appet.2022.106124] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2021] [Revised: 05/13/2022] [Accepted: 06/02/2022] [Indexed: 11/27/2022]
Abstract
Gestational weight gain has been one of the most important risk factors for adverse maternal, perinatal, and long-term outcomes. Our systematic review and meta-analysis aimed to incorporate the evidence regarding the association between gestational weight gain and food insecurity (FI). We performed a systematic review and meta-analysis on the possible association between FI and insufficient or excessive gestational weight gain by conducting a systematic search in PubMed, Scopus, ISI, and Google Scholar from January 1, 1990 until February 1, 2022. Odds Ratio (OR) was pooled using a random-effects model. Standard methods were used for the assessment of heterogeneity and publication bias. Data included fifteen studies with 7651 individual participants from different countries pooled for the meta-analysis. Of the fifteen studies included in the final meta-analysis, seven had a cross-sectional and eight had a longitudinal design. In the pooled analysis, FI had significant relationship with both inadequate (OR = 1.49; 95% CI = 1.26 to 1.76) and excessive weight gain in pregnancy (OR = 1.27; 95% CI = 1.05 to 1.54). In conclusion, FI during pregnancy was directly associated with both inadequate and excessive gestational weight gain. Therefore, changes at a policy level should be considered to increase food security in pregnant women.
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Affiliation(s)
- Pishva Arzhang
- Qods Hospital, Kermanshah University of Medical Sciences, Kermanshah, Iran.
| | - Marjan Ramezan
- Department of Nutritional Sciences, College of Human Sciences, Texas Tech University, Lubbock, TX, 79409, USA.
| | - Mohadeseh Borazjani
- School of Nutrition and Food Sciences, Shiraz University of Medical Sciences, Shiraz, Iran.
| | - Sanaz Jamshidi
- Department of Nutrition, School of Public Health, Iran University of Medical Sciences, Tehran, Iran.
| | - Narges Ghorbani Bavani
- Department of Community Nutrition, School of Nutrition and Food Science, Isfahan University of Medical Sciences, Isfahan, Iran.
| | - Alireza Rahmanabadi
- Student Research Committee, Faculty of Nutrition and Food Sciences, Tabriz University of Medical Sciences, Tabriz, Iran.
| | - Amir Bagheri
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran.
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Yamada P, Paetow A, Chan M, Arslan A, Landberg R, Young BK. Pregnancy outcomes with differences in grain consumption: a randomized controlled trial. J Perinat Med 2022; 50:411-418. [PMID: 34981703 DOI: 10.1515/jpm-2021-0479] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/16/2021] [Accepted: 12/13/2021] [Indexed: 12/12/2022]
Abstract
OBJECTIVES Contemporary obstetrics has begun to appreciate the importance of diet in pregnancy, but guidelines are not based on robust data. The hypothesis that a whole grains diet improves pregnancy outcomes is tested in this study. We compared maternal and neonatal outcomes for a pregnancy diet containing 75% of total carbohydrates as refined grains with outcomes for a diet with 75% of total carbohydrates as whole grains. METHODS This was a randomized interventional study in a clinic population over the last 4-7 months of normal pregnancy with extensive compliance measures. Besides obstetrical and neonatal outcomes, anthropometric measurements were done. In addition to food frequency questionnaires (FFQs), total plasma alkyl resorcinols, a unique quantitative measure of whole grains, were used as a measure of whole grain consumption. RESULTS The data show effective compliance and no difference in outcomes between the diets with regard to maternal weight gain, birth weights, subcutaneous fat and glucose tolerance. CONCLUSIONS Ensuring compliance to a proper pregnancy diet resulted in satisfactory weight gain and normal outcomes even when the proportion of whole grains consumed is only 25% of total carbohydrates.
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Affiliation(s)
- Pamella Yamada
- Department of Obstetrics and Gynecology, New York University Langone Health, New York, USA
| | - Alexandra Paetow
- Department of Obstetrics and Gynecology, New York University Langone Health, New York, USA
| | - Michael Chan
- Department of Obstetrics and Gynecology, New York University Langone Health, New York, USA
| | - Alan Arslan
- Department of Obstetrics and Gynecology, New York University Langone Health, New York, USA
| | - Rikard Landberg
- Division of Food and Nutrition Science, Department of Biological Engineering, Chalmers University of Technology, Gothenburg, Sweden
| | - Bruce K Young
- Department of Obstetrics and Gynecology, New York University Langone Health, New York, USA
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Zhou M, Peng X, Yi H, Tang S, You H. Determinants of excessive gestational weight gain: a systematic review and meta-analysis. Arch Public Health 2022; 80:129. [PMID: 35505415 PMCID: PMC9066815 DOI: 10.1186/s13690-022-00864-9] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2021] [Accepted: 03/23/2022] [Indexed: 11/20/2022] Open
Abstract
Background The prevalence of excessive gestational weight gain (EGWG) during pregnancy is increasing, and it is extremely harmful to pregnant women and newborns. Previous studies have suggested that EGWG is associated with various factors. We conducted a systematic review and meta-analysis to identify, quantify and analyze determinants of EGWG and evaluate the effect of these determinants on EGWG. Methods We searched for articles, from January 2009 to November 2020, related to the determinants of EGWG during pregnancy using four Chinese and four English databases. The Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) statement was utilized to guide the systematic review and meta-analysis process. Results Seventy studies, which identified EGWG factors in pregnant women (58 factors, 3 themes: individual [7 aspects, 37 factors]; family [4 aspects, 8 factors]; and social [4 aspects, 13 factors]), were included and analyzed in the systematic review. A meta-analysis was conducted for 13 factors (including 10 individual factors, 2 family factors, and 1 social factor) and revealed that pre-pregnancy overweight (including obesity), younger age (≤ 30 years old), unemployed, primiparity, smoking, and being unmarried (including divorced) were risk factors for EGWG, while prepregnancy underweight and inadequate antenatal care were protective factors for EGWG. There was no significant correlation between EGWG and education level, alcohol consumption, planning pregnancy, food security, and whether access to nutrition guidance during pregnancy. Conclusions EGWG was prevalent in pregnant women, and its prevalence seemed to be high and similar in many countries. Based on observational studies with medium-level and high-level evidence, some individual, family, and social factors were found to be associated with EGWG using qualitative and quantitative methods. In the future, exposure of pregnant women to risk factors for EGWG should be avoided, and interventions should be developed around the identified factors. Supplementary Information The online version contains supplementary material available at 10.1186/s13690-022-00864-9.
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Affiliation(s)
- Meng Zhou
- Nanjing Medical University, Nanjing, Jiangsu, China
| | - Xueqing Peng
- Nanjing Medical University, Nanjing, Jiangsu, China
| | - Honggang Yi
- Nanjing Medical University, Nanjing, Jiangsu, China
| | - Shaowen Tang
- Nanjing Medical University, Nanjing, Jiangsu, China.
| | - Hua You
- Nanjing Medical University, Nanjing, Jiangsu, China.
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Kominiarek MA, Cordero C, Stuebe AM, Simon M, Evenson KR, Perreira KM, Gallo LC, Castañeda SF, Potter JE, Wu D, Isasi CR, Daviglus ML. Pre-pregnancy Health Behaviors and Gestational Weight Gain Among Hispanic/Latino Women: Hispanic Community Health Study/Study of Latinos. Matern Child Health J 2021; 25:2002-2013. [PMID: 34647266 PMCID: PMC9830652 DOI: 10.1007/s10995-021-03252-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/30/2021] [Indexed: 01/13/2023]
Abstract
OBJECTIVE To examine the association between preconception diet quality, sedentary behavior, and physical activity with gestational weight gain (GWG) among Hispanic/Latina women. METHODS This was a retrospective cohort study of participants from visits 1 and 2 of the Hispanic Community Health Study/Study of Latinos and singleton pregnancies between the 2 visits. Diet quality (alternative healthy eating index/AHEI-2010), sedentary behaviors, and physical activity (global physical activity questionnaire) were measured at visit 1 and accounted for preconception health behaviors. GWG was evaluated as a continuous and categorical variable according to the 2009 Institute of Medicine guidelines (inadequate, adequate, excessive). Linear and generalized logit survey regressions were used to study the association between health behaviors and GWG, using adequate GWG as the reference. RESULTS Of the 457 women included, deliveries occurred at 3.2 years (mean) from visit 1; 48.7% of women had excessive GWG. Mean AHEI-2010 scores were < 45% for women of all Hispanic/Latina backgrounds. There was no association between each 10-unit increase in AHEI-2010 or a 500 kcal/day increase in energy intake for mean and categorical GWG. There was no association between 30 min/day higher sedentary behavior, 30 min/day higher physical activity, or meeting the 2008 US physical activity guidelines for mean and categorical GWG. CONCLUSIONS We did not find any association between diet quality, sedentary behavior, and physical activity at visit 1 with GWG in pregnancies occurring between visits 1 and 2. We noted widespread poor diet quality as measured by the AHEI-2010 and low levels of physical activity among Hispanic/Latina women.
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Affiliation(s)
- Michelle A Kominiarek
- Department of Obstetrics and Gynecology, Northwestern Memorial, Prentice Hospital, Northwestern University, 250 East Superior Street, Suite 05-2154, Chicago, IL, 60611, USA.
| | - Christina Cordero
- Department of Psychology, University of Miami, Coral Gables, FL, USA
| | - Alison M Stuebe
- Department of Obstetrics and Gynecology, University of North Carolina School of Medicine, Chapel Hill, NC, USA
| | - Melissa Simon
- Department of Obstetrics and Gynecology, Northwestern Memorial, Prentice Hospital, Northwestern University, 250 East Superior Street, Suite 05-2154, Chicago, IL, 60611, USA
| | - Kelly R Evenson
- Department of Epidemiology, Gillings School of Global Public Health, UNC, Chapel Hill, NC, USA
| | - Krista M Perreira
- Department of Social Medicine, UNC School of Medicine, Chapel Hill, NC, 27599, USA
| | - Linda C Gallo
- Department of Psychology, San Diego State University, San Diego, USA
| | | | - JoNell E Potter
- Department of Obstetrics, Gynecology and Reproductive Sciences, University of Miami Miller School of Medicine, Miami, FL, 33101, USA
| | - Donghong Wu
- Institute for Minority Health Research, University of Illinois at Chicago, Chicago, USA
| | - Carmen R Isasi
- Department of Epidemiology & Population Health, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Martha L Daviglus
- Institute for Minority Health Research, University of Illinois at Chicago, Chicago, USA
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Gamble A, Beech BM, Blackshear C, Herring SJ, Welsch MA, Moore JB. Changes in Physical Activity and Television Viewing From Pre-pregnancy Through Postpartum Among a Socioeconomically Disadvantaged Perinatal Adolescent Population. J Pediatr Adolesc Gynecol 2021; 34:832-838. [PMID: 34271198 PMCID: PMC8578293 DOI: 10.1016/j.jpag.2021.06.009] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2021] [Revised: 06/16/2021] [Accepted: 06/29/2021] [Indexed: 11/30/2022]
Abstract
STUDY OBJECTIVE Adolescent pregnancy contributes to accelerated trajectories of adiposity and cardiometabolic diseases. Two potentially low-cost prevention strategies include promoting physical activity (PA) and limiting television (TV) viewing. Few studies have explored these behavior patterns in perinatal adolescents. This study sought to characterize PA and TV viewing in a socioeconomically disadvantaged perinatal adolescent population. DESIGN, SETTING, PARTICIPANTS, AND INTERVENTIONS A cross-sectional, retrospective, 10-item survey was used to explore behavior patterns in 79 predominantly Black (86%) postpartum adolescents. MAIN OUTCOME MEASURES Outcomes included self-reported changes in PA from pre-pregnancy through pregnancy, and 7-day recall of PA and TV viewing in postpartum. RESULTS The majority of adolescents (66%) reported being active on ≥3 days/week in pre-pregnancy; however, many reported low PA (≤2 days/wk) in their first (59%), second (66%), and third (54%) trimesters. Adolescents who reported being active on ≥5 days/wk in pre-pregnancy (19%) experienced first trimester PA decline, which subsequently plateaued. This group remained the most active throughout pregnancy. In postpartum, over half (54%) of all adolescents reported low PA and irrespective of PA, spent considerable time watching TV (median = 1680.0 minutes, inerquartile range = 2940). CONCLUSION Interventions promoting PA coupled with reducing TV viewing during pregnancy and in postpartum may benefit perinatal adolescents. The findings from this study suggest that PA history is a predictor of gestational PA, and low PA and high TV viewing in postpartum underscore the need for behavioral intervention. Conducting a brief assessment of PA history in early gestation may offer important insight.
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Affiliation(s)
- A Gamble
- Department of Preventive Medicine, University of Mississippi Medical Center, Jackson, Mississippi; Department of Pediatrics, University of Mississippi Medical Center, Jackson, Mississippi.
| | - B M Beech
- Office of the Provost, University of Houston, Houston, Texas; College of Medicine, University of Houston, Houston, Texas
| | - C Blackshear
- Department of Data Science, University of Mississippi Medical Center, Jackson, Mississippi
| | - S J Herring
- Program for Maternal Health Equity, Center for Urban Bioethics, Lewis Katz School of Medicine at Temple University, Philadelphia, Pennsylvania
| | - M A Welsch
- Department of Population Health Science, University of Mississippi Medical Center, Jackson, Mississippi
| | - J B Moore
- Department of Implementation Science, Division of Public Health Sciences, Wake Forest School of Medicine, Winston-Salem, North Carolina
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17
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Farias DR, Carrilho TRB, Freitas-Costa NC, Batalha MA, Gonzalez M, Kac G. Maternal mental health and gestational weight gain in a Brazilian Cohort. Sci Rep 2021; 11:10787. [PMID: 34031477 PMCID: PMC8144604 DOI: 10.1038/s41598-021-90179-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2021] [Accepted: 04/20/2021] [Indexed: 11/08/2022] Open
Abstract
Depression and anxiety are common during pregnancy, but little is known about the influence of these disorders on gestational weight gain (GWG). Data from a prospective cohort of pregnant women followed in a public healthcare center in Rio de Janeiro, Brazil, were used to evaluate the association of depression, anxiety, and suicide risk with GWG. GWG was evaluated at 5-13, 20-26, 30-36, and 37-42 weeks, and GWG adequacy was determined. Statistical analyses included linear mixed-effect models and Poisson regression. We evaluated 206 women, in which 15% (n = 31) presented major depressive disorder, 19.4% (n = 34) suicide risk and 10% (n = 21) generalized anxiety disorder at baseline. Women with depression at the first trimester, persistent depressive symptoms, and anxiety symptoms at the second trimester presented significantly lower rates of GWG per week compared to those without depression or anxiety, respectively. Persistent depressive symptoms represented a 2.40 (95% CI 1.20; 4.81; p = 0.013) increase in the risk of insufficient GWG. There was no significant association between generalized anxiety disorder or suicide risk with GWG. The presence of depression, depressive symptoms, and anxiety during pregnancy were associated with lower GWG rates. Persistent depressive symptoms during pregnancy were directly associated with insufficient GWG.
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Affiliation(s)
- Dayana Rodrigues Farias
- Nutritional Epidemiology Observatory, Department of Social and Applied Nutrition, Josué de Castro Institute of Nutrition, Federal University of Rio de Janeiro, Avenida Carlos Chagas Filho, 373, CCS, Bloco J, 2º andar, sala 29. Cidade Universitária - Ilha do Fundão, Rio de Janeiro, RJ, 21941-902, Brazil.
| | - Thais Rangel Bousquet Carrilho
- Nutritional Epidemiology Observatory, Department of Social and Applied Nutrition, Josué de Castro Institute of Nutrition, Federal University of Rio de Janeiro, Avenida Carlos Chagas Filho, 373, CCS, Bloco J, 2º andar, sala 29. Cidade Universitária - Ilha do Fundão, Rio de Janeiro, RJ, 21941-902, Brazil
| | - Nathalia C Freitas-Costa
- Nutritional Epidemiology Observatory, Department of Social and Applied Nutrition, Josué de Castro Institute of Nutrition, Federal University of Rio de Janeiro, Avenida Carlos Chagas Filho, 373, CCS, Bloco J, 2º andar, sala 29. Cidade Universitária - Ilha do Fundão, Rio de Janeiro, RJ, 21941-902, Brazil
| | - Mônica Araújo Batalha
- Nutritional Epidemiology Observatory, Department of Social and Applied Nutrition, Josué de Castro Institute of Nutrition, Federal University of Rio de Janeiro, Avenida Carlos Chagas Filho, 373, CCS, Bloco J, 2º andar, sala 29. Cidade Universitária - Ilha do Fundão, Rio de Janeiro, RJ, 21941-902, Brazil
| | - Mylena Gonzalez
- Nutritional Epidemiology Observatory, Department of Social and Applied Nutrition, Josué de Castro Institute of Nutrition, Federal University of Rio de Janeiro, Avenida Carlos Chagas Filho, 373, CCS, Bloco J, 2º andar, sala 29. Cidade Universitária - Ilha do Fundão, Rio de Janeiro, RJ, 21941-902, Brazil
| | - Gilberto Kac
- Nutritional Epidemiology Observatory, Department of Social and Applied Nutrition, Josué de Castro Institute of Nutrition, Federal University of Rio de Janeiro, Avenida Carlos Chagas Filho, 373, CCS, Bloco J, 2º andar, sala 29. Cidade Universitária - Ilha do Fundão, Rio de Janeiro, RJ, 21941-902, Brazil
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Hu F, Xi X, Yu R, Xiang R, Zhang Y, Ren Z, Wang X, Xie J. Does the Price Support Policy Drive a Balanced Distribution of Profits in the Chinese Dairy Supply Chain? Implications for Supplier and Consumer Psychology. Front Psychol 2021; 12:632355. [PMID: 33732193 PMCID: PMC7956991 DOI: 10.3389/fpsyg.2021.632355] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2020] [Accepted: 02/05/2021] [Indexed: 11/13/2022] Open
Abstract
Evaluating the price policy of raw milk is of great significance to the sustainable development of an industry supply chain. In this context, our study used the multi-period difference-in-difference method to systematically examine the impact of the policy implementation on product price and profit distribution in the supply chain. The results showed the following: (1) the price of raw milk in the implementation area of the price support policy is 13.54% higher than that of the unimplemented area; (2) the effect of price increase in the western region (15.5%) is higher than that in the eastern region (13%), and the central region (10.73%); (3) furthermore, the purchase price guidance policy of raw milk drives price increase or price suppression in the links of the supply chain to promote a balanced distribution of profits among the participants in the chain. These conclusions all have good stability and have reference significance for further improving and adjusting the price support policy of raw milk to realize the sustainable development of the Chinese dairy industry. This will enhance the production confidence of Chinese raw milk producers and improve Chinese consumers' expectations and consumer psychology regarding domestic dairy products.
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Affiliation(s)
- Feng Hu
- Global Value Chain Research Center, Zhejiang Gongshang University, Hangzhou, China
| | - Xun Xi
- Global Value Chain Research Center, Zhejiang Gongshang University, Hangzhou, China
| | - Rongjian Yu
- Global Value Chain Research Center, Zhejiang Gongshang University, Hangzhou, China
| | - Rong Xiang
- Global Value Chain Research Center, Zhejiang Gongshang University, Hangzhou, China
| | - Yueyue Zhang
- Global Value Chain Research Center, Zhejiang Gongshang University, Hangzhou, China
| | - Zhimin Ren
- Global Value Chain Research Center, Zhejiang Gongshang University, Hangzhou, China
| | - Xiaoping Wang
- Zhejiang Postdoctoral Station, NingboTech University, Ningbo, China
| | - Jie Xie
- School of Economics, Zhejiang Gongshang University, Hangzhou, China
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19
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Higher Parity, Pre-Pregnancy BMI and Rate of Gestational Weight Gain Are Associated with Gestational Diabetes Mellitus in Food Insecure Women. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18052694. [PMID: 33800084 PMCID: PMC7967418 DOI: 10.3390/ijerph18052694] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/27/2021] [Revised: 03/04/2021] [Accepted: 03/04/2021] [Indexed: 11/16/2022]
Abstract
Food insecurity may exacerbate adverse maternal health outcomes during pregnancy, however, this association has not been well established, particularly in the context of developing countries. This study aimed to identify the associations between household food insecurity and gestational diabetes mellitus (GDM) risk among urban pregnant women. Household food insecurity was assessed using the translated 10-item Radimer/Cornell hunger scale. Logistic regression models were used to estimate the associations between food insecurity status and GDM risk. About 35.6% of women experienced food insecurity, with 25.2% reported household food insecurity, 8.0% individual food insecurity, and 2.4% child hunger. Food insecure women were at significantly higher risk of developing GDM compared to food secure women (AOR = 16.65, 95% CI = 6.17–24.98). The significant association between food insecurity and GDM risk was influenced by pre-pregnancy BMI, parity and rate of GWG at second trimester. Food insecure women with parity ≥ 2 (AOR = 4.21, 95% CI = 1.98–8.92), overweight/obese BMI prior to pregnancy (AOR = 12.11, 95% CI = 6.09–24.10) and excessive rate of GWG in the second trimester (AOR = 9.66, 95% CI = 4.27–21.83) were significantly more likely to develop GDM compared to food secure women. Food insecurity showed strong association with GDM risk in that the association was influenced by maternal biological and physical characteristics. Multipronged interventions may be necessary for food insecure pregnant women who are not only at risk of overweight/obesity prior to pregnancy but also may have excessive gestational weight gain, in order to effectively reduce GDM risk.
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20
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Elwan D, Olveda R, Medrano R, Wojcicki JM. Excess pregnancy weight gain in latinas: Impact on infant's adiposity and growth hormones at birth. Prev Med Rep 2021; 22:101341. [PMID: 33898205 PMCID: PMC8053797 DOI: 10.1016/j.pmedr.2021.101341] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2020] [Revised: 02/17/2021] [Accepted: 02/20/2021] [Indexed: 01/03/2023] Open
Abstract
Immigrant Latinas with overweight and obesity have excessive gestational gain. Excessive gestational weight gain is associated with high birthweight percentiles. Higher IGF-1 and lower PYY in cord blood in context of excessive gestational gain. Gestational weight counseling in pregnancy may help prevent childhood obesity.
Excess maternal weight gain during pregnancy has been associated with childhood overweight and obesity both in mothers with and without obesity. Latinx children are at higher risk for earlier obesity compared with other population groups. A cohort of 82 self-identified pregnant Latina women were recruited at the prenatal clinics of Zuckerberg San Francisco General Hospital (ZSFG) prior to delivery during the second and third trimesters of pregnancy in 2011 and 2012. Maternal pre-pregnancy weight and weight prior to delivery were collected by self-report to calculate maternal pre-pregnancy body mass index (BMI) and weight gain in pregnancy. At delivery, anthropometric measurements of infants were obtained and cord blood and maternal finger stick blood samples were collected for hormonal assays. Fifty-three point seven percent of women had excessive weight gain in pregnancy. A high percentage of the cohort was overweight and obese prior to pregnancy (67.1%) with mean pre-pregnancy BMI 27.4 ± 4.5 kg/m2 and greater pre-pregnancy weight was independently associated with weight gain during pregnancy (OR 1.05, 95%CI 1.002–1.09). Mean infant birthweight was 3377.2 ± 481.5 g and excessive weight gain in pregnancy was independently associated with birthweight percentile (OR 13.46, 95%CI 2.43–34.50). Excessive gestational gain was positively associated with cord blood insulin-like growth factor-1 (IGF-1) and negatively with Peptide YY (PYY) levels. Latina women with pre-pregnancy overweight and obesity have a high rate of excessive gestational gain in pregnancy and could benefit from early counseling about appropriate gain in pregnancy. Excessive gestational weight impacts the intrauterine environment in high-risk infants impacting fetal growth and development.
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Affiliation(s)
- Deena Elwan
- University of Hawai'i, Honolulu, Hawai'I, United States.,Department of Pediatrics (GI and Nutrition), University of California, San Francisco, San Francisco 94116, United States
| | - Rebecca Olveda
- Department of Pediatrics (GI and Nutrition), University of California, San Francisco, San Francisco 94116, United States
| | - Rosalinda Medrano
- Department of Pediatrics (GI and Nutrition), University of California, San Francisco, San Francisco 94116, United States
| | - Janet M Wojcicki
- Department of Pediatrics (GI and Nutrition), University of California, San Francisco, San Francisco 94116, United States
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21
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Athar U, Daud NUA, Khan WA, Khalid A, Gill SI. Caught Between External Pressures and Internal Battles: Psychosocial Factors Affecting Gestational Weight Gain - A Scoping Review. Cureus 2021; 13:e13487. [PMID: 33777574 PMCID: PMC7989722 DOI: 10.7759/cureus.13487] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Many physical factors (including maternal comorbidities) affecting gestational weight gain (GWG) have been widely studied; however, the psychosocial aspects pertaining to this need to be put under the microscope, especially in countries characterized by low indicators of socioeconomic development. Gaining and maintaining an adequate amount of weight during pregnancy is important to prevent premature deliveries, fetal demise, fetal macrosomia, shoulder dystocia during delivery, emergency cesarean sections, postpartum weight retention, childhood obesity, etc. A scoping review of the articles published in the last five years has revealed that perinatal outcomes like gestational weight are influenced by certain psychosocial factors, including, but not limited to, intimate partner violence, lack of social support and recognition, financial distress, household food insecurity, chronic stress and depression related to pregnancy, eating pathologies, and low self-esteem. Employing a multi-disciplinary approach, which involves seeking the help of psychiatrists/psychologists, obstetricians, nutritionists, and public health specialists, can help us mitigate undesirable outcomes related to inadequate and excessive weight gain during pregnancy. More intervention-based research focusing on psychosocial factors relating to GWG is needed in regions like South Asia, which is associated with low indicators of socioeconomic development.
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Affiliation(s)
- Unsa Athar
- Community Health Sciences, Shalamar Medical and Dental College, Lahore, PAK
| | - Noor Ul Ain Daud
- Community Health Sciences, Shalamar Medical and Dental College, Lahore, PAK
| | - Warda A Khan
- Community Health Sciences, Shalamar Medical and Dental College, Lahore, PAK
| | - Amna Khalid
- Community Health Sciences, Shalamar Medical and Dental College, Lahore, PAK
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22
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Hu F, Xi X, Zhang Y, Wu RT. Co-opetition Relationships and Evolution of the World Dairy Trade Network: Implications for Policy-Maker Psychology. Front Psychol 2021; 11:632465. [PMID: 33603694 PMCID: PMC7884635 DOI: 10.3389/fpsyg.2020.632465] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2020] [Accepted: 12/21/2020] [Indexed: 11/30/2022] Open
Abstract
This study conducted a social network analysis of the evolutionary characteristics of the world dairy trade network based on the overall trade pattern. In addition, the evolution of trade blocs and the co-opetition relationships involving dairy products in major countries were analyzed in terms of supply and demand. The results show that continuous and complex changes have taken place in the world’s dairy trade network since 2001. The number of trade entities in dairy products has stabilized since 2012. At present, approximately 94% of countries (regions) are involved in dairy product trade, such that the world dairy trade network exhibits the small-world effect and scale-free property. The world import pattern for dairy products has changed. While export centers have not changed, import centers have shifted from Europe, America, and East Asia to North America, East Asia, and the Middle East. The world dairy trade network consists of the EU trade bloc headed by Germany, the former Soviet Union–Brazil trade bloc, and the Asia–Australia–America trade bloc. The trade blocs have evolved due to geographical positions, historical cultures, and political relations. In a trade bloc, the diversification of import sources is more prominent in demand countries. European and Asian markets have become the main markets of the major exporters. In this study, the evolutionary characteristics of the world dairy trade network and the co-opetition relationships were analyzed to provide scientific support to inform the development of dairy trade policies. The results can provide technical and psychological support to policy-makers in various countries in their dairy trade decision-making.
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Affiliation(s)
- Feng Hu
- Global Value Chain Research Center, Zhejiang Gongshang University, Hangzhou, China
| | - Xun Xi
- Global Value Chain Research Center, Zhejiang Gongshang University, Hangzhou, China
| | - Yueyue Zhang
- Global Value Chain Research Center, Zhejiang Gongshang University, Hangzhou, China
| | - Rung-Tai Wu
- Department of Business Administration, College of Management, University of Providence, Taichung, Taiwan
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23
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Mitchell ES, Yang Q, Behr H, Ho A, DeLuca L, May CN, Michaelides A. Psychosocial Characteristics by Weight Loss and Engagement in a Digital Intervention Supporting Self-Management of Weight. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18041712. [PMID: 33578975 PMCID: PMC7916717 DOI: 10.3390/ijerph18041712] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/22/2020] [Revised: 02/03/2021] [Accepted: 02/04/2021] [Indexed: 01/01/2023]
Abstract
There is substantial variability in weight loss outcomes. Psychosocial characteristics underlying outcomes require better understanding, particularly on self-managed digital programs. This cross-sectional study examines differences in psychosocial characteristics by weight loss and engagement outcome, and which characteristics are most associated with weight loss, on a self-managed digital weight loss program. Some underexplored psychosocial characteristics are included, such as flourishing, or a sense of meaning and purpose in life. A questionnaire was emailed to a random sample of 10,000 current users at week 5 in the program and 10,000 current users at week 17. The questionnaire was completed by 2225 users, and their self-reported weight and recorded program engagement data were extracted from the program’s database. Multiple comparison tests indicated that mental health quality of life, depression, anxiety, work-life balance, and flourishing differed by weight loss outcome at program end (week 17; ≥5%, 2–5%, below 2%) and by engagement tertile at program beginning and end (weeks 5 and 17). Only anxiety was associated with weight loss in a backward stepwise regression controlling for engagement and sociodemographic characteristics. Flourishing did not predict weight loss overall but predicted the weight loss outcome group. Our findings have implications for creating more effective interventions for individuals based on psychosocial characteristics and highlight the potential importance of anxiety in underexplored self-managed digital programs.
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Affiliation(s)
- Ellen S. Mitchell
- Academic Research, Noom, 229 W 28th St., New York, NY 10001, USA; (Q.Y.); (H.B.); (A.H.); (L.D.); (C.N.M.); (A.M.)
- Correspondence:
| | - Qiuchen Yang
- Academic Research, Noom, 229 W 28th St., New York, NY 10001, USA; (Q.Y.); (H.B.); (A.H.); (L.D.); (C.N.M.); (A.M.)
| | - Heather Behr
- Academic Research, Noom, 229 W 28th St., New York, NY 10001, USA; (Q.Y.); (H.B.); (A.H.); (L.D.); (C.N.M.); (A.M.)
- Department of Integrative Health, Saybrook University, 55 W Eureka St, Pasadena, CA 91103, USA
| | - Annabell Ho
- Academic Research, Noom, 229 W 28th St., New York, NY 10001, USA; (Q.Y.); (H.B.); (A.H.); (L.D.); (C.N.M.); (A.M.)
| | - Laura DeLuca
- Academic Research, Noom, 229 W 28th St., New York, NY 10001, USA; (Q.Y.); (H.B.); (A.H.); (L.D.); (C.N.M.); (A.M.)
- Ferkauf Graduate School of Psychology, Yeshiva University, 1165 Morris Park Ave, Bronx, NY 10461, USA
| | - Christine N. May
- Academic Research, Noom, 229 W 28th St., New York, NY 10001, USA; (Q.Y.); (H.B.); (A.H.); (L.D.); (C.N.M.); (A.M.)
| | - Andreas Michaelides
- Academic Research, Noom, 229 W 28th St., New York, NY 10001, USA; (Q.Y.); (H.B.); (A.H.); (L.D.); (C.N.M.); (A.M.)
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24
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Harvey MW, Braun B, Ertel KA, Pekow PS, Markenson G, Chasan-Taber L. Stress and Anxiety are Associated with Lower Gestational Weight Gain in Hispanic Women. Womens Health Issues 2020; 30:409-415. [PMID: 32994129 PMCID: PMC7704913 DOI: 10.1016/j.whi.2020.08.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2020] [Revised: 08/12/2020] [Accepted: 08/18/2020] [Indexed: 12/18/2022]
Abstract
OBJECTIVE Prior studies indicate that inadequate and excessive gestational weight gain (GWG) are associated with poor maternal and infant outcomes, and that stress and anxiety may contribute to GWG. However, these studies often failed to use validated measures of stress and anxiety, measured only total GWG, and were limited to largely non-Hispanic White populations. We explored the association between stress and anxiety and GWG. METHODS We used data from 1,308 participants in Proyecto Buena Salud, a prospective cohort of predominantly Puerto Rican women 18-40 years of age (2006-2012). We measured stress with the Perceived Stress Scale and anxiety with the State-Trait Anxiety Scale, and abstracted GWG from medical records. RESULTS The average GWG was 31.0 ± 16.1 pounds. More than one-half of participants (51.8%) exceeded Institute of Medicine guidelines for GWG. After adjusting for age and pre-pregnancy body mass index, women in the highest quartiles of stress and anxiety in early pregnancy had approximately 4 lbs lower GWG (β = -3.89; SE = 1.54; p = .012 and β = -4.37; SE = 1.54; p = .005, respectively) as compared with those in the lowest quartiles. Similarly, women in the highest quartiles of mid/late pregnancy stress and anxiety had lower GWG (β = -3.84 lbs; SE = 1.39; p = .006, and β = -3.51 lbs; SE = 1.38; p = .011, respectively) and a lower rate of GWG in the second and third trimesters (β = -0.117 lbs/week; SE = 0.044; p = .008 and β = -0.116 lbs/week; SE = 0.043; p = .007, respectively), compared with those in the lowest quartiles. CONCLUSIONS High stress and anxiety were associated with lower GWG. Interventions to decrease stress and anxiety during pregnancy should include counseling on maintaining healthy GWG.
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Affiliation(s)
- Megan W Harvey
- Department of Health Sciences, Springfield College, Springfield, Massachusetts.
| | - Barry Braun
- Department of Health and Exercise Science, Colorado State University, Fort Collins, Colorado
| | - Karen A Ertel
- Department of Biostatistics and Epidemiology, University of Massachusetts, Amherst, Massachusetts
| | - Penelope S Pekow
- Department of Biostatistics and Epidemiology, University of Massachusetts, Amherst, Massachusetts
| | - Glenn Markenson
- Obstetrics & Gynocology, Boston University School of Medicine, Boston, Massachusetts
| | - Lisa Chasan-Taber
- Department of Biostatistics and Epidemiology, University of Massachusetts, Amherst, Massachusetts
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