Socio-demographic and lifestyle determinants of the micronutrients status during pregnancy

Key messages

In the case of a high proportion of the women the intake of majority of the analyzed micronutrients was below recommendations for the pregnancy period. More effort should be taken to educational programs and interventions that focus on healthy diet recommendations during pregnancy.

Early life environmental exposure in relation to new onset and remission of allergic diseases in school children: Polish Mother and Child Cohort Study

Background: This study was based on data from the Polish Mother and Child Cohort Study. Objective: The aim was to study associations between home environment factors and allergic diseases at 1 year of life and new onset and remission of children's allergy diagnosis at ages 7-9 years. Methods: Children's health status was assessed at ∼12 months of age and then at ages between 7-9 years by using a questionnaire administered to the mothers. Children were assessed by pediatrician/allergists. The patients, who were 7-9 years old, underwent skin-prick tests. Exposure to tobacco smoke was evaluated with a questionnaire addressed to parents and/or caregivers and cotinine measurements were taken of mother's saliva during pregnancy and in children's urine at ages 7-9 years. Incidence and remission were calculated by comparing symptoms in the first year of life with symptoms at 7-9 years. We studied the associations among demographic data, home environment, and new onset and remission of food allergy, atopic dermatitis, and asthma and allergic rhinitis in logistic regression analysis. All associations were adjusted for independent risk factors of dependent variables. Results: Data from 211 participants were included in the analysis. During the first year of life, food allergy was the most common symptom (39%), followed by atopic dermatitis (35%) and asthma (12%). When comparing diagnoses at ages 7-9 years with the first year of life, food allergy had decreased by as much as 18.6%, atopic dermatitis decreased by as much as 23.8%, and asthma decreased by as much as 8%, whereas asthma and allergic rhinitis had increased from 6% to 14.8%. More frequent house cleaning negatively correlated with the new onset of atopic dermatitis and of asthma and allergic rhinitis. Hypersensitivity to seasonal allergens and mites and to any other allergen positively correlated with new onset of food allergy, atopic dermatitis, and asthma and allergic rhinitis. Parental atopy positively correlated with the new onset of asthma and negatively correlated with asthma remission. Conclusion: Analysis of our findings indicated that new onset and/or remission of allergic diseases was linked with hypersensitivity to house-dust mites in children who were polysensitized and with parental atopy. In addition, children who had food allergy, allergic rhinitis, or atopic dermatitis at the age of 1 year had more of a chance developing other atopic disease (except asthma) at ages 7-9 years and less of a chance of having a remission of the disease.

Impact of maternal body mass index and gestational weight gain on pregnancy complications: an individual participant data meta-analysis of European, North American and Australian cohorts

OBJECTIVE

To assess the separate and combined associations of maternal pre-pregnancy body mass index (BMI) and gestational weight gain with the risks of pregnancy complications and their population impact.

DESIGN

Individual participant data meta-analysis of 39 cohorts.

SETTING

Europe, North America, and Oceania.

POPULATION

265 270 births.

METHODS

Information on maternal pre-pregnancy BMI, gestational weight gain, and pregnancy complications was obtained. Multilevel binary logistic regression models were used.

MAIN OUTCOME MEASURES

Gestational hypertension, pre-eclampsia, gestational diabetes, preterm birth, small and large for gestational age at birth.

RESULTS

Higher maternal pre-pregnancy BMI and gestational weight gain were, across their full ranges, associated with higher risks of gestational hypertensive disorders, gestational diabetes, and large for gestational age at birth. Preterm birth risk was higher at lower and higher BMI and weight gain. Compared with normal weight mothers with medium gestational weight gain, obese mothers with high gestational weight gain had the highest risk of any pregnancy complication (odds ratio 2.51, 95% CI 2.31- 2.74). We estimated that 23.9% of any pregnancy complication was attributable to maternal overweight/obesity and 31.6% of large for gestational age infants was attributable to excessive gestational weight gain.

CONCLUSIONS

Maternal pre-pregnancy BMI and gestational weight gain are, across their full ranges, associated with risks of pregnancy complications. Obese mothers with high gestational weight gain are at the highest risk of pregnancy complications. Promoting a healthy pre-pregnancy BMI and gestational weight gain may reduce the burden of pregnancy complications and ultimately the risk of maternal and neonatal morbidity.

TWEETABLE ABSTRACT

Promoting a healthy body mass index and gestational weight gain might reduce the population burden of pregnancy complications.

Associations between maternal physical activity in early and late pregnancy and offspring birth size: remote federated individual level meta-analysis from eight cohort studies

OBJECTIVE

Evidence on the impact of leisure time physical activity (LTPA) in pregnancy on birth size is inconsistent. We aimed to examine the association between LTPA during early and late pregnancy and newborn anthropometric outcomes.

DESIGN

Individual level meta-analysis, which reduces heterogeneity across studies.

SETTING

A consortium of eight population-based studies (seven European and one US) comprising 72 694 participants.

METHODS

Generalised linear models with consistent inclusion of confounders (gestational age, sex, parity, maternal age, education, ethnicity, BMI, smoking, and alcohol intake) were used to test associations between self-reported LTPA at either early (8-18 weeks gestation) or late pregnancy (30+ weeks) and the outcomes. Results were pooled using random effects meta-analyses.

MAIN OUTCOME MEASURES

Birth weight, large-for-gestational age (LGA), macrosomia, small-for-gestational age (SGA), % body fat, and ponderal index at birth.

RESULTS

Late, but not early, gestation maternal moderate to vigorous physical activity (MVPA), vigorous activity, and LTPA energy expenditure were modestly inversely associated with BW, LGA, macrosomia, and ponderal index, without heterogeneity (all: I2  = 0%). For each extra hour/week of MVPA, RR for LGA and macrosomia were 0.97 (95% CI: 0.96, 0.98) and 0.96 (95% CI: 0.94, 0.98), respectively. Associations were only modestly reduced after additional adjustments for maternal BMI and gestational diabetes. No measure of LTPA was associated with risk for SGA.

CONCLUSIONS

Physical activity in late, but not early, pregnancy is consistently associated with modestly lower risk of LGA and macrosomia, but not SGA.

TWEETABLE ABSTRACT

In an individual participant meta-analysis, late pregnancy moderate to vigorous physical activity modestly reduced birth size outcomes.

Prenatal and postnatal exposure to polycyclic aromatic hydrocarbons and allergy symptoms in city children

BACKGROUND

Studies indicate that exposure to polycyclic aromatic hydrocarbons (PAH) is associated with adverse respiratory and allergy outcomes. Exposure to PAH may impair the immune function of the foetus and, subsequently, be responsible for an increased susceptibility of children to allergic diseases.

OBJECTIVES

The aim of the present study was to assess the association between mother's exposure to PAH during pregnancy and allergy diseases in their infants. We also assessed the above associations using measured PAH exposure in children's urine during the first two years of life.

METHODS

The current analysis was restricted to 455 mothers and their children from Lodz district. The women were interviewed three times during the pregnancy in order to collect demographic, socio-economic and medical history data. Children's health status was assessed at the age of 10-18 months and repeated at two years of age. The associations between dependent dichotomous variables and urine concentrations of 1-hydroxypyrene (1-HP) were analysed using logistic regression.

RESULTS

We showed that higher urine concentrations of 1-HP in mothers at 20-24 weeks of pregnancy increased the risk of more frequent respiratory infections (p=0.02) in children during their first year of life. Higher 1-HP concentrations in children's urine increased the risk of food allergy (p=0.002) in children during their first two years of life.

CONCLUSIONS

This study suggests awareness of environmental factors, which may affect children's health since PAH showed to be a risk factor for airway infections and food allergy in children after adjustment for other risk factors.