Dietary Pattern Influences Gestational Weight Gain: Results from the ProcriAr Cohort Study-São Paulo, Brazil

Adherence to a Mediterranean-style dietary pattern during pregnancy in relation to gestational weight gain: the Mutaba'ah study

BACKGROUND

Excessive gestational weight gain (EGWG) is associated with increased risk of adverse pregnancy outcomes. We examined associations between the alternate Mediterranean diet (aMED) index and its components with gestational weight gain (GWG) and EGWG among pregnant women in the United Arab Emirates (UAE).

METHODS

The analysis involved 576 pregnant women from the dietary subcohort of the Mutaba'ah Study conducted from 2019 to 2022. A self-administered semi-quantitative food frequency questionnaire was completed during pregnancy, and aMED index score was calculated. Body weights throughout pregnancy and height were obtained from medical records. GWG was calculated as the difference in weight between the last (gestational week ≥37) and the first (gestational week ≤14) recorded weight. EGWG was defined, according to the Institute of Medicine guidelines, based on the first trimester body mass index. Multivariable linear and logistic regression analyses assessed the relationship between aMED and its components with GWG and EGWG.

RESULTS

In total, 29% of the pregnant women had EGWG. No significant associations between aMED and GWG or EGWG were found. GWG was inversely associated with the intake ratio of monounsaturated fatty acids to saturated fatty acids (β= -0.84, 95% CI: -1.51, -0.17) and positively associated with the intake of fruit (β = 0.04, 95% CI: 0.003, 0.07). The odds of EGWG were inversely associated with the intake of vegetables (OR = 0.93, 95% CI: 0.88, 0.99, per 25 g/d) and positively associated with the intake of fruit (OR = 1.02, 95% CI: 1.00, 1.03, per 25 g/d).

CONCLUSIONS

Increasing intake of vegetables and consuming high-quality fat may promote healthy GWG. Further investigations are needed to clarify the role of fruit intake in relation to GWG.

Association of maternal dietary patterns in early pregnancy with gestational weight gain: Yazd Birth Cohort

Background

Abnormal gestational weight gain (GWG) can carry risks for both the mother and the baby. Diet imbalances are the determining factor in the weight gain of pregnant women.

Objective

This study aimed to assess the relationship between nutritional patterns and the weight of pregnant mothers living in Yazd, Iran from 2021-2022.

Materials and Methods

In this cohort study, data from 1497 pregnant women aged 18-45 yr with singleton pregnancy who completed the food frequency questionnaire in the Yazd Birth Cohort Study were extracted. This data included demographic variables, GWG (difference between initial weight at 13-15 wk and 1 wk before the expected delivery date), and food intake information before the 13  th wk of pregnancy. The women were categorized into 3 groups based on GWG: inadequate, normal, and excessive. Dietary patterns were extracted from the food frequency questionnaire using principal component analysis, and multinomial logistic regression was used to evaluate the relationship between dietary patterns and GWG categories.

Results

According to the frequency of food consumption, 3 dietary patterns were obtained: the traditional pattern (cabbage vegetables, fruits, and dried fruits), the unhealthy pattern (processed meats and sweetened drinks), and the vegetable/fruit/olive pattern. The analysis results showed that pregnant women who followed the fruit/vegetable/olive pattern had a lower chance of insufficient weight gain during pregnancy (OR: 0.66, 95% CI: 0.45-0.98).

Conclusion

Consuming various fruits and vegetables can help regulate GWG in the population of pregnant women lived in Yazd, Iran. Diet can be considered one of the most effective and safe interventions.

Predictors of inadequate gestational weight gain according to iom recommendations and intergrowth-21st standards: the araraquara cohort study

BACKGROUND

Gestational weight gain (GWG) is a critical factor for maternal and fetal health.

OBJECTIVE

To identify maternal predictors of inadequate GWG according to the 2009 Institute of Medicine (IOM) recommendations and Intergrowth-21st standards.

METHODS

A prospective epidemiological cohort study conducted from 2017 to 2023 in southeastern Brazil assessed 1,557 women at three different stages of pregnancy (≤ 18, 20-26, and 30-36 weeks of gestation) and at delivery. Sociodemographic, obstetric, lifestyle, nutritional, and maternal morbidity characteristics were collected, along with biochemical parameters.

RESULTS

Among the participants, 38.7% had GWG above IOM recommendations, while 67.5% had GWG above the Intergrowth-21st standards. Multinomial logistic regression analysis showed that women with pre-pregnancy obesity and women with the highest body fat percentage had, respectively, a 95% (OR = 1.95; 95% CI: 1.08-3.51) and 1% (OR = 1.01; 95% CI: 1.01-1.05) higher chance of GWG above IOM recommendations. Pregnant women in the lowest tertile of height, smokers, number of previous pregnancies, and women living in crowded homes had, respectively, a 57% (OR = 0.57; 95% CI: 0.41-0.80), 36% (OR = 0.64; 95% CI: 0.37-0.86), 35% (OR = 0.65; 95% CI: 0.43-0.97), and 14% (OR = 0.86; 95% CI: 0.59-0.86) lower chance of GWG above IOM recommendations. Women with diabetes were 2.53 times more likely (OR = 2.53; 95% CI: 1.32-4.83) to have GWG below IOM recommendations. Using the Intergrowth-21st standards, women with the highest body fat percentage had a 12% (OR = 1.12; 95% CI: 1.02-1.24) higher chance of GWG above the 90th percentile. Pregnant women in the lowest tertile of height were 2.82 times more likely (OR = 2.82; 95% CI: 1.08-8.13) and women with the lowest hemoglobin concentrations had a 41% lower chance (OR = 0.59; 95% CI: 0.39-0.88) of having GWG below the 10th percentile. While both guidelines identified body fat percentage and pre-pregnancy obesity as significant predictors of excessive GWG, the Intergrowth-21st standards captured a higher percentage of women exceeding GWG limits.

CONCLUSION

The findings underscore the importance of comparing two instruments for assessing the adequacy of GWG. The IOM and Intergrowth-21st standards provide complementary insights, which can help implement targeted interventions for specific groups of women based on their nutritional and socioeconomic status, lifestyle, and obstetric factors to prevent pregnancy-related complications.

Pre-Pregnancy Obesity and Infants' Motor Development within the First Twelve Months of Life: Who Is Expected to Be the Ultimate Carrier of the Obesity Burden?

INTRODUCTION

Pre-pregnancy obesity is a significant public health concern with profound implications for maternal and child health. The burgeoning evidence suggests that maternal obesity prior to conception is intricately linked with an increased risk of gestational complications, as well as with adverse neonatal outcomes. Furthermore, the long and short-term health of offspring, including the risk of early motor development impairment, obesity, and metabolic syndrome in childhood and adulthood, may be adversely affected as well. Addressing pre-pregnancy obesity is critical for improving overall maternal and child health outcomes, and therefore, the aim of this study was to evaluate the connections linking pre-pregnancy obesity with infants' motor development within the first twelve months of infants' lives.

MATERIAL AND METHODS

This study included 200 mother-infant pairs divided into two groups based on their pre-pregnancy body mass index values. To assess infants' early motor development, we used the Alberta Infant Motor Scale (AIMS) and evaluated the parameters of infants' early motor development at the ages of three, six, nine, and twelve months.

RESULTS

Pre-pregnancy overweight/obesity was significantly associated with excessive gestational weight gain (p < 0.001), fetal macrosomia (p = 0.022), and a family history of diabetes and cardiovascular diseases (p = 0.048 and p = 0.041, respectively), as well as with all observed parameters of early motor development at the ages of three, six, nine, and twelve months: AIMS 3 months total (p < 0.001), AIMS 6 months total (p < 0.001), AIMS 9 months total (p < 0.001), and AIMS 12 months total (p < 0.001). Furthermore, pre-pregnancy overweight/obesity was a significant predictor for AIMS 6 months total (p = 0.043) and AIMS 6 months supination (p = 0.017).

CONCLUSIONS

Pre-pregnancy obesity is a critical determinant of pregnancy outcomes and offspring early motor development, with possible far-reaching implications for children's long-term well-being. Addressing this issue requires a comprehensive approach that includes preconception weight management, targeted interventions during the pregnancy and postpartum periods, and ongoing research to better understand the underlying mechanisms and develop effective strategies for prevention and management.

Recent Insights and Recommendations for Preventing Excessive Gestational Weight Gain

Recommendations for weight gain during pregnancy are based on pre-pregnancy body mass index (BMI). Pregnancy is a risk factor for excessive weight gain and many endocrine problems, making it difficult to return to pre-pregnancy weight and increasing the risk of postpartum obesity and, consequently, type 2 diabetes and metabolic syndrome. Both excessive gestational weight gain (EGWG) and obesity are associated with an increased risk of gestational hypertension, pre-eclampsia, gestational diabetes, cesarean section, shoulder dystocia, and neonatal macrosomia. In the long term, EGWG is associated with increased morbidity and mortality, particularly from diabetes, cardiovascular disorders, and some cancers. This study aims to present recommendations from various societies regarding weight gain during pregnancy, dietary guidance, and physical activity. In addition, we discuss the pathophysiology of this complication and the differential diagnosis in pregnant women with EGWG. According to our research, inadequate nutrition might contribute more significantly to the development of EGWG than insufficient physical activity levels in pregnant women. Telehealth systems seem to be a promising direction for future EGWG prevention by motivating women to exercise. Although the importance of adequate pre-pregnancy weight and weight gain during pregnancy is well known, an increasing number of women gain excessive weight during pregnancy.

Association of dietary patterns of pregnant women with pregnancy outcomes: A hospital-based study

Diet is one of the main factors influencing pregnancy outcomes. Maternal and child health both seem to be related to dietary patterns. So far, no study on dietary pattern has been performed on pregnant women and its association with pregnancy outcomes in Rasht. Therefore, the present study aimed to investigate the association between dietary patterns and pregnancy outcomes in Rasht. In this cross-sectional study, 300 healthy pregnant women were included from three public hospitals in Rasht. Data on demographic, dietary intake, physical activity (PA), and anthropometric measurements of mothers were recorded. Outcomes of newborns were also gathered. Dietary patterns were identified using principal component analysis. General linear model was used for data analysis. Prior to pregnancy, only 40% of women had a normal body mass index (BMI). More than half of them (52.3%) had a gestational weight gain in excess of the guidelines. The dominant dietary patterns among pregnant women were traditional, Western, and healthy, respectively. High adherence to the Western pattern had a direct association with gestational weight gain (B = 1.48, p = .046) and inverse association with birth length (B = -0.71, p = .043). However, the results did not remain significant after adjusting for covariates. The present study indicated that several factors can affect the association of the Western diet with pregnancy outcomes. Therefore, making policies for interventional programs to improve maternal lifestyle factors along with their diet quality is recommended.

Diet Quality and Nutritional Risk Based on the FIGO Nutrition Checklist among Greek Pregnant Women: A Cross-Sectional Routine Antenatal Care Study

The International Federation of Gynecology and Obstetrics (FIGO) nutrition checklist is a tool for everyday antenatal clinical practice, easy to use by most healthcare professionals, aiming to initiate a conversation regarding gestational weight gain (GWG) and nutrition and identify women who might require further assessment. The present cross-sectional study aimed to apply the FIGO nutrition checklist to pregnant women attending routine antenatal care and identify nutritional risk factors. Pregnant women (n = 200) were recruited from the outpatient pregnancy clinics of two hospitals in Thessaloniki and completed the checklist. The FIGO-diet quality score and the FIGO-nutritional risk score (NRS) were calculated. The results revealed that 99% of the women exhibited at least one nutritional risk factor based on the checklist. The median FIGO diet quality score of the sample was 4.0 (3.0-5.0), with 95% of the participants responding negatively to at least one question, indicating the need for improving diet quality. Improved diet quality was noted in cases of hyperemesis gravidarum and among those receiving vitamin D supplements. A large percentage of the participants (36%) exhibited five or more nutritional risk factors, as indicated by a total FIGO-NRS below 5. Women with low middle-upper arm circumference, indicative of protein-energy malnutrition (20.6% of the sample), exhibited more nutritional risk factors compared with the rest. On the other hand, being in the third trimester of pregnancy was associated with lower nutritional risk and, subsequently, better diet quality.