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Stadler JT, van Poppel MNM, Christoffersen C, Hill D, Wadsack C, Simmons D, Desoye G, Marsche G. Gestational Hypertension and High-Density Lipoprotein Function: An Explorative Study in Overweight/Obese Women of the DALI Cohort. Antioxidants (Basel) 2022; 12:68. [PMID: 36670930 PMCID: PMC9854490 DOI: 10.3390/antiox12010068] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2022] [Revised: 12/23/2022] [Accepted: 12/28/2022] [Indexed: 12/30/2022] Open
Abstract
Gestational hypertension (GHTN) is associated with an increased cardiovascular risk for mothers and their offspring later in life. High-density lipoproteins (HDL) are anti-atherogenic by promoting efflux of cholesterol from macrophages and suppression of endothelial cell activation. Functional impairment of HDL in GHTN-complicated pregnancies may affect long-term health of both mothers and offspring. We studied functional parameters of maternal and neonatal HDL in 192 obese women (pre-pregnancy BMI ≥ 29), who were at high risk for GHTN. Maternal blood samples were collected longitudinally at <20 weeks, at 24−28 and 35−37 weeks of gestation. Venous cord blood was collected immediately after birth. Maternal and cord blood were used to determine functional parameters of HDL, such as HDL cholesterol efflux capacity, activity of the vaso-protective HDL-associated enzyme paraoxonase-1, and levels of the HDL-associated anti-inflammatory apolipoprotein (apo)M. In addition, we determined serum anti-oxidative capacity. Thirteen percent of the women were diagnosed with GHTN. While we found no changes in measures of HDL function in mothers with GHTN, we observed impaired HDL cholesterol efflux capacity and paraoxonase-1 activity in cord blood, while serum antioxidant capacity was increased. Of particular interest, increased maternal paraoxonase-1 activity and apoM levels in early pregnancy were associated with the risk of developing GHTN. GHTN significantly impairs HDL cholesterol efflux capacity as well as HDL PON1 activity in cord blood and could affect vascular health in offspring. Maternal paraoxonase-1 activity and apoM levels in early pregnancy associate with the risk of developing GHTN.
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Affiliation(s)
- Julia T. Stadler
- Division of Pharmacology, Otto Loewi Research Center for Vascular Biology, Immunology and Inflammation, Medical University of Graz, Universitätsplatz 4, 8010 Graz, Austria
| | - M. N. M. van Poppel
- Institute of Human Movement Science, Sport and Health, University of Graz, 8010 Graz, Austria
| | - Christina Christoffersen
- Department of Biomedical Science, University of Copenhagen, 2200 Copenhagen, Denmark
- Department of Biochemistry, Rigshospitalet, University Hospital of Copenhagen, 2200 Copenhagen, Denmark
| | - David Hill
- Lawson Health Research Institute, London, ON N6C 2R5, Canada
| | - Christian Wadsack
- Research Unit, Department of Obstetrics and Gynecology, Medical University of Graz, 8036 Graz, Austria
- BioTechMed-Graz, 8010 Graz, Austria
| | - David Simmons
- Macarthur Clinical School, Western Sydney University, Sydney, NSW 2560, Australia
| | - Gernot Desoye
- Research Unit, Department of Obstetrics and Gynecology, Medical University of Graz, 8036 Graz, Austria
| | - Gunther Marsche
- Division of Pharmacology, Otto Loewi Research Center for Vascular Biology, Immunology and Inflammation, Medical University of Graz, Universitätsplatz 4, 8010 Graz, Austria
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Immanuel J, Simmons D, Harreiter J, Desoye G, Corcoy R, Adelantado JM, Devlieger R, Lapolla A, Dalfra MG, Bertolotto A, Wender-Ozegowska E, Zawiejska A, Dunne FP, Damm P, Mathiesen ER, Jensen DM, Andersen LLT, Hill DJ, Jelsma JGM, Kautzky-Willer A, Galjaard S, Snoek FJ, van Poppel MNM. Metabolic phenotypes of early gestational diabetes mellitus and their association with adverse pregnancy outcomes. Diabet Med 2021; 38:e14413. [PMID: 32991758 DOI: 10.1111/dme.14413] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/13/2020] [Revised: 09/10/2020] [Accepted: 09/23/2020] [Indexed: 12/14/2022]
Abstract
AIMS To describe the metabolic phenotypes of early gestational diabetes mellitus and their association with adverse pregnancy outcomes. METHODS We performed a post hoc analysis using data from the Vitamin D And Lifestyle Intervention for gestational diabetes prevention (DALI) trial conducted across nine European countries (2012-2014). In women with a BMI ≥29 kg/m2 , insulin resistance and secretion were estimated from the oral glucose tolerance test values performed before 20 weeks, using homeostatic model assessment of insulin resistance and Stumvoll first-phase indices, respectively. Women with early gestational diabetes, defined by the International Association of Diabetes and Pregnancy Study Groups criteria, were classified into three groups: GDM-R (above-median insulin resistance alone), GDM-S (below-median insulin secretion alone), and GDM-B (combination of both) and the few remaining women were excluded. RESULTS Compared with women in the normal glucose tolerance group (n = 651), women in the GDM-R group (n = 143) had higher fasting and post-load glucose values and insulin levels, with a greater risk of having large-for-gestational age babies [adjusted odds ratio 3.30 (95% CI 1.50-7.50)] and caesarean section [adjusted odds ratio 2.30 (95% CI 1.20-4.40)]. Women in the GDM-S (n = 37) and GDM-B (n = 56) groups had comparable pregnancy outcomes with those in the normal glucose tolerance group. CONCLUSIONS In overweight and obese women with early gestational diabetes, higher degree of insulin resistance alone was more likely to be associated with adverse pregnancy outcomes than lower insulin secretion alone or a combination of both.
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Affiliation(s)
- J Immanuel
- Macarthur Clinical School, Western Sydney University, Sydney, NSW, Australia
| | - D Simmons
- Macarthur Clinical School, Western Sydney University, Sydney, NSW, Australia
- Institute of Metabolic Science, Addenbrookes Hospital, Cambridge, UK
| | - J Harreiter
- Department of Medicine III, Division of Endocrinology, Gender Medicine Unit, Medical University of Vienna, Vienna, Austria
| | - G Desoye
- Department of Obstetrics and Gynecology, Medizinische Universitaet Graz, Graz, Austria
| | - R Corcoy
- Department of Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain
- Institut de Recerca de l´Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
- CIBER Bioengineering, Biomaterials and Nanotechnology, Instituto de Salud Carlos III, Madrid, Spain
| | - J M Adelantado
- Department of Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - R Devlieger
- KU Leuven Department of Development and Regeneration: Pregnancy, Fetus and Neonate, Leuven, Belgium
- Gynaecology and Obstetrics, University Hospitals Leuven, Belgium
| | - A Lapolla
- Universita Degli Studi di Padova, Padua, Italy
| | - M G Dalfra
- Universita Degli Studi di Padova, Padua, Italy
| | - A Bertolotto
- Azienda Ospedaliero-Universitaria Pisana, Pisa, Italy
| | - E Wender-Ozegowska
- Department of Reproduction, Poznan University of Medical Sciences, Poland
| | - A Zawiejska
- Department of Reproduction, Poznan University of Medical Sciences, Poland
| | - F P Dunne
- National University of Ireland, Galway, Ireland
| | - P Damm
- Centre for Pregnant Women with Diabetes, Departments of Endocrinology and Obstetrics, Rigshospitalet, Copenhagen, Denmark
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - E R Mathiesen
- Centre for Pregnant Women with Diabetes, Departments of Endocrinology and Obstetrics, Rigshospitalet, Copenhagen, Denmark
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - D M Jensen
- Steno Diabetes Center Odense, Odense University Hospital, Odense, Denmark
- Department of Gynecology and Obstetrics, Odense University Hospital, Odense, Denmark
- Department of Clinical Research, Faculty of Health Science, University of Southern Denmark, Odense, Denmark
| | - L L T Andersen
- Department of Gynecology and Obstetrics, Odense University Hospital, Odense, Denmark
- Department of Clinical Research, Faculty of Health Science, University of Southern Denmark, Odense, Denmark
| | - D J Hill
- Recherche en Santé Lawson SA, St. Gallen, Switzerland
- Lawson Health Research Institute, London, Ontario, Canada
| | - J G M Jelsma
- Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam
| | - A Kautzky-Willer
- Department of Medicine III, Division of Endocrinology, Gender Medicine Unit, Medical University of Vienna, Vienna, Austria
- Gender Institute Gars am Kamp, Vienna, Austria
| | - S Galjaard
- KU Leuven Department of Development and Regeneration: Pregnancy, Fetus and Neonate, Leuven, Belgium
- Gynaecology and Obstetrics, University Hospitals Leuven, Belgium
- Department of Obstetrics and Gynaecology, Division of Obstetrics and Prenatal Medicine, Erasmus MC, University Medical Centre, Rotterdam, The Netherlands
| | - F J Snoek
- Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Medical Psychology, Amsterdam, The Netherlands
| | - M N M van Poppel
- Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam
- Institute of Sport Science, University of Graz, Graz, Austria
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Novak B, Holler P, Jaunig J, Ruf W, van Poppel MNM, Sattler MC. Do we have to reduce the recall period? Validity of a daily physical activity questionnaire (PAQ24) in young active adults. BMC Public Health 2020; 20:72. [PMID: 31948416 PMCID: PMC6966869 DOI: 10.1186/s12889-020-8165-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2019] [Accepted: 01/07/2020] [Indexed: 01/14/2023] Open
Abstract
Background Combining the strengths of physical activity (PA) diaries and questionnaires may be needed to improve the unsatisfying measurement quality of existing PA questionnaires. This study investigated the construct validity of a short PA questionnaire (Physical Activity Questionnaire for 24 h [PAQ24]) with a recall period of one day. Methods In this cross-sectional study, participants completed the PAQ24 on seven consecutive days while wearing an accelerometer (GENEActiv). Thereafter, the Global Physical Activity Questionnaire (GPAQ) was completed. Spearman correlation coefficients and Bland-Altman analysis were used to assess construct validity. Results Overall, 50 active adults (11 women, mean age = 25.1 ± 2.5) participated. Relative agreements between Total PA of PAQ24 and accelerometer were 0.37 ≤ ρ ≤ 0.72 for each day with satisfying agreement on five out of seven days. Weekly relative agreement for Total PA was moderate (ρ = 0.44). Relative agreements between PAQ24 and GPAQ were ρ = 0.43 for Total PA. Daily and weekly absolute agreements were poor indicated by wide limits of agreement. Conclusions In contrast to weekly Total PA, the majority of daily results of the PAQ24 showed satisfying construct validity. A short recall period may improve the measurement quality of PA questionnaires, but measurement errors and the costs of multiple administrations must be considered in future studies.
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Affiliation(s)
- B Novak
- Institute of Sport Science, University of Graz, Graz, Austria
| | - P Holler
- Institute of Sport Science, University of Graz, Graz, Austria.,Department of Public Health, Institute for Health Promotion and Disease Prevention (IfGP), Graz, Austria
| | - J Jaunig
- Institute of Sport Science, University of Graz, Graz, Austria
| | - W Ruf
- Institute of Sport Science, University of Graz, Graz, Austria.,Institute of Sport Science, German University of Health and Sports, Berlin, Germany
| | | | - M C Sattler
- Institute of Sport Science, University of Graz, Graz, Austria.
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Mintjens S, Menting MD, Gemke RJBJ, van Poppel MNM, van Wely M, Bensdorp AJ, Tjon Kon Fat RI, Mol BWJ, Painter RC, van de Beek C, Roseboom TJ. The effects of intrauterine insemination and single embryo transfer or modified natural cycle in vitro fertilization on offspring's health-Follow-up of a randomized clinical trial. Eur J Obstet Gynecol Reprod Biol 2019; 242:131-138. [PMID: 31586879 DOI: 10.1016/j.ejogrb.2019.09.026] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2019] [Revised: 09/16/2019] [Accepted: 09/23/2019] [Indexed: 01/07/2023]
Abstract
OBJECTIVE Does ovarian hyperstimulation and/or the in vitro procedure of assisted reproduction affect neurodevelopmental and physical health of the offspring? STUDY DESIGN Infertile couples were randomly allocated to intrauterine insemination with controlled ovarian hyperstimulation (IUI-COH), modified natural cycle in vitro fertilization (IVF-MNC) or single embryo transfer IVF (IVF-SET). We compared neurodevelopmental and physical health in childhood (4-7 years). We used age-appropriate questionnaires to assess behavioral problems (Child Behavior Check List (CBCL)) and executive functioning (Behavior Rating Inventory of Executive Function (BRIEF)). We measured body mass index Z-score, waist- and hip-circumference, body fat percentage, blood pressure Z-scores, pulse wave velocity, glucose, insulin, insulin resistance, total cholesterol, high- and low-density lipoprotein cholesterol, triglycerides, and high sensitivity c-reactive protein. We compared groups by analysis of variance. RESULTS We examined 191 (57%) of the 333 children born in the study at a mean age of 5.5 years (range 4.0-7.6 years). We found no statistically significant differences between randomization groups in children's neurodevelopmental or physical health indices (all p-values > 0.05). Comparing the outcomes between actual method of conception, including a naturally conceived group, also did not show statistically significant differences. CONCLUSIONS Although this follow-up study was not powered on childhood outcomes and limited power due to attrition may have hampered detection of subtle effects, we found no indications of differences in neurodevelopmental and physical health between ovarian hyperstimulation and/or the in vitro procedure of assisted reproduction. Future trials should be powered on child outcomes, and aim to optimize follow-up rates to provide answers that are more definitive.
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Affiliation(s)
- S Mintjens
- Emma Children's Hospital, Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Paediatrics, Department of Gynaecology and Obstetrics, Amsterdam Reproduction and Development Research Institute, Amsterdam Public Health Research Institute, De Boelelaan 1117, P.O. Box 7057, 1007 MB Amsterdam, the Netherlands; NYC Health and Hospitals/Lincoln, Department of Pediatrics, Room 4-20, 234 East 149(th) Street, Bronx, NY, 10451, United States.
| | - M D Menting
- Amsterdam UMC, University of Amsterdam, Department of Obstetrics and Gynaecology, Department of Clinical Epidemiology, Biostatistics and Bioinformatics, Amsterdam Reproduction and Development Research Institute, Amsterdam Public Health Research Institute, Meibergdreef 9, 1105 AZ Amsterdam, the Netherlands.
| | - R J B J Gemke
- Emma Children's Hospital, Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Paediatrics, Department of Gynaecology and Obstetrics, Amsterdam Reproduction and Development Research Institute, Amsterdam Public Health Research Institute, De Boelelaan 1117, P.O. Box 7057, 1007 MB Amsterdam, the Netherlands.
| | - M N M van Poppel
- Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Public Health Research Institute, Van der Boechorststraat 7, 1081 BT Amsterdam, the Netherlands; University of Graz, Institute of Sport Science, Mozartgasse 14, 8010 Graz, Austria.
| | - M van Wely
- Amsterdam UMC, University of Amsterdam, Department of Obstetrics and Gynaecology, Amsterdam Reproduction and Development Research Institute, Meibergdreef 5, 1105 AZ Amsterdam, the Netherlands.
| | - A J Bensdorp
- Utrecht UMC, University of Utrecht, Department of General Health, Julius Center, Broederplein 43, 3703 CD Zeist, the Netherlands
| | - R I Tjon Kon Fat
- Amsterdam UMC, University of Amsterdam, Department of Obstetrics and Gynaecology, Amsterdam Reproduction and Development Research Institute, Meibergdreef 5, 1105 AZ Amsterdam, the Netherlands
| | - B W J Mol
- Department of Obstetrics and Gynecology, Monash University, Monash Medical Centre, 246 Clayton Road, Clayton Victoria 3168, Australia.
| | - R C Painter
- Amsterdam UMC, University of Amsterdam, Department of Obstetrics and Gynaecology, Amsterdam Reproduction and Development Research Institute, Meibergdreef 5, 1105 AZ Amsterdam, the Netherlands.
| | - C van de Beek
- Amsterdam UMC, University of Amsterdam, Department of Obstetrics and Gynaecology, Department of Clinical Epidemiology, Biostatistics and Bioinformatics, Amsterdam Reproduction and Development Research Institute, Amsterdam Public Health Research Institute, Meibergdreef 9, 1105 AZ Amsterdam, the Netherlands.
| | - T J Roseboom
- Amsterdam UMC, University of Amsterdam, Department of Obstetrics and Gynaecology, Department of Clinical Epidemiology, Biostatistics and Bioinformatics, Amsterdam Reproduction and Development Research Institute, Amsterdam Public Health Research Institute, Meibergdreef 9, 1105 AZ Amsterdam, the Netherlands.
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5
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van Elten TM, Karsten MDA, Geelen A, Gemke RJBJ, Groen H, Hoek A, van Poppel MNM, Roseboom TJ. Preconception lifestyle intervention reduces long term energy intake in women with obesity and infertility: a randomised controlled trial. Int J Behav Nutr Phys Act 2019; 16:3. [PMID: 30621789 PMCID: PMC6325811 DOI: 10.1186/s12966-018-0761-6] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2018] [Accepted: 12/05/2018] [Indexed: 12/16/2022] Open
Abstract
Background The preconceptional period may be an optimal window of opportunity to improve lifestyle. We previously showed that a 6 month preconception lifestyle intervention among women with obesity and infertility was successful in decreasing the intake of high caloric snacks and beverages, increasing physical activity and in reducing weight in the short term. We now report the effects of the preconception lifestyle intervention on diet, physical activity and body mass index (BMI) at 5.5 years (range = 3.7–7.0 years) after the intervention. Methods We followed women who participated in the LIFEstyle study, a multicentre RCT in which women with obesity and infertility were assigned to a six-month lifestyle intervention program or prompt infertility treatment (N = 577). Diet and physical activity 5.5 years later were assessed with an 173-item food frequency questionnaire (N = 175) and Actigraph triaxial accelerometers (N = 155), respectively. BMI was calculated from self-reported weight and previously measured height (N = 179). Dietary intake, physical activity, and BMI in the intervention and control group were compared using multivariate regression models. Additionally, dietary intake, physical activity and BMI of women allocated to the intervention arm with successful weight loss during the intervention (i.e. BMI < 29 kg/m2 or ≥ 5% weight loss), unsuccessful weight loss and the control group were compared with ANCOVA. Results Although BMI did not differ between the intervention and control group 5.5 years after the intervention (− 0.5 kg/m2 [− 2.0;1.1]; P = 0.56), the intervention group did report a lower energy intake (− 216 kcal/day [− 417;-16]; P = 0.04). Women in the intervention arm who successfully lost weight during the intervention had a significantly lower BMI at follow-up compared to women in the intervention arm who did not lose weight successfully (− 3.4 kg/m2 [− 6.3;-0.6]; P = 0.01), and they reported a significantly lower energy intake compared to the control group (− 301 kcal [− 589;-14]; P = 0.04). Macronutrient intake, diet quality, and physical activity did not differ between the intervention and control group, irrespective of successful weight loss during the intervention. Conclusions In our study population, a preconception lifestyle intervention led to reduced energy intake 5.5 years later. Additionally, women allocated to the intervention group who were successful in losing weight during the intervention also had a lower BMI at follow-up. This shows the potential sustainable effect of a preconception lifestyle intervention. Trial registration This trial was registered on 16 November 2008 in the Dutch trial register; clinical trial registry number NTR1530. Electronic supplementary material The online version of this article (10.1186/s12966-018-0761-6) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- T M van Elten
- Department of Public and Occupational Health, Amsterdam UMC, Vrije Universiteit Amsterdam, VU University medical centre, de Boelelaan 1117, Amsterdam, The Netherlands. .,Department of Clinical Epidemiology, Biostatistics and Bioinformatics, Amsterdam UMC, University of Amsterdam, Academic Medical Centre, Meibergdreef 9, Amsterdam, The Netherlands. .,Department of Obstetrics and Gynaecology, Amsterdam UMC, University of Amsterdam, Academic Medical Centre, Meibergdreef 9, Amsterdam, The Netherlands. .,Amsterdam Public Health Research Institute, Amsterdam, The Netherlands. .,Amsterdam Reproduction and Development, Amsterdam, The Netherlands.
| | - M D A Karsten
- Department of Clinical Epidemiology, Biostatistics and Bioinformatics, Amsterdam UMC, University of Amsterdam, Academic Medical Centre, Meibergdreef 9, Amsterdam, The Netherlands. .,Department of Obstetrics and Gynaecology, Amsterdam UMC, University of Amsterdam, Academic Medical Centre, Meibergdreef 9, Amsterdam, The Netherlands. .,Amsterdam Public Health Research Institute, Amsterdam, The Netherlands. .,Amsterdam Reproduction and Development, Amsterdam, The Netherlands. .,Department of Obstetrics and Gynaecology, University of Groningen, University Medical Centre Groningen, Groningen, the Netherlands.
| | - A Geelen
- Division of Human Nutrition, Wageningen University & Research, Wageningen, The Netherlands
| | - R J B J Gemke
- Amsterdam Public Health Research Institute, Amsterdam, The Netherlands.,Amsterdam Reproduction and Development, Amsterdam, The Netherlands.,Department of Paediatrics, Amsterdam UMC, Vrije Universiteit Amsterdam, VU University medical centre, de Boelelaan 1117, Amsterdam, The Netherlands
| | - H Groen
- Department of Epidemiology, University of Groningen, University Medical Centre Groningen, Groningen, the Netherlands
| | - A Hoek
- Department of Obstetrics and Gynaecology, University of Groningen, University Medical Centre Groningen, Groningen, the Netherlands
| | - M N M van Poppel
- Department of Public and Occupational Health, Amsterdam UMC, Vrije Universiteit Amsterdam, VU University medical centre, de Boelelaan 1117, Amsterdam, The Netherlands.,Amsterdam Public Health Research Institute, Amsterdam, The Netherlands.,University of Graz, Institute of Sport Science, Graz, Austria
| | - T J Roseboom
- Department of Clinical Epidemiology, Biostatistics and Bioinformatics, Amsterdam UMC, University of Amsterdam, Academic Medical Centre, Meibergdreef 9, Amsterdam, The Netherlands.,Department of Obstetrics and Gynaecology, Amsterdam UMC, University of Amsterdam, Academic Medical Centre, Meibergdreef 9, Amsterdam, The Netherlands.,Amsterdam Public Health Research Institute, Amsterdam, The Netherlands.,Amsterdam Reproduction and Development, Amsterdam, The Netherlands
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Ruifrok AE, van Poppel MNM, van Wely M, Rogozińska E, Khan KS, de Groot CJM, Thangaratinam S, Mol BW. Association between weight gain during pregnancy and pregnancy outcomes after dietary and lifestyle interventions: a meta-analysis. Am J Perinatol 2014; 31:353-64. [PMID: 23918523 DOI: 10.1055/s-0033-1352484] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
OBJECTIVES Lifestyle interventions in obese pregnant women reduce adverse maternal outcomes of pregnancy. However, the association between weight change due to interventions and the actual reduction in complications is unknown. The objective of this study was to determine the association between gestational weight gain (GWG) and the rate of pregnancy complications. STUDY DESIGN The authors included randomized controlled trials (RCTs) assessing the effect of lifestyle interventions during pregnancy on GWG and adverse maternal and fetal outcomes. For each outcome they assessed the association between GWG and the risk of adverse pregnancy outcomes. RESULTS They analyzed data of 23 RCTs (4,990 women). Increased GWG was associated with a nonsignificant increase in the incidence of preeclampsia (PE) (0.2% per gained kg, 95% confidence interval [CI] 0.5 to 0.9%, p > 0.05), gestational diabetes (GDM) (0.3% per gained kg, 95% CI -0.5 to 1.0%, p > 0.05), and induction of labor (IOL) (1.5% per gained kg, 95% CI -0.9 to 3.9%, p > 0.05). CONCLUSIONS Reduction in GWG due to lifestyle interventions in pregnancy had statistically nonsignificant effects on lowering the incidence of PE, GDM, and IOL. Possibly, the beneficial effect of lifestyle interventions on pregnancy outcomes is due to an effect independent of the reduction of GWG.
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Affiliation(s)
- A E Ruifrok
- Department of Obstetrics and Gynaecology, The Academic Medical Centre, Amsterdam, The Netherlands
| | - M N M van Poppel
- Department of Public and Occupational Health and EMGO+ Institute for Health and Care Research, VU University Medical Centre, Amsterdam, The Netherlands
| | - M van Wely
- Department of Obstetrics and Gynaecology, The Academic Medical Centre, Amsterdam, The Netherlands
| | - E Rogozińska
- Women's Health Research Unit, Centre for Primary Care and Public Health, Blizard Institute, Barts and The London School of Medicine and Dentistry, London, United Kingdom
| | - K S Khan
- Women's Health Research Unit, Centre for Primary Care and Public Health, Blizard Institute, Barts and The London School of Medicine and Dentistry, London, United Kingdom
| | - C J M de Groot
- Department of Obstetrics and Gynecology, VU University Medical Centre, Amsterdam, The Netherlands
| | - S Thangaratinam
- Women's Health Research Unit, Centre for Primary Care and Public Health, Blizard Institute, Barts and The London School of Medicine and Dentistry, London, United Kingdom
| | - B W Mol
- Department of Obstetrics and Gynaecology, The Academic Medical Centre, Amsterdam, The Netherlands
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van der Wijden CL, Delemarre-van der Waal HA, van Mechelen W, van Poppel MNM. The concurrent validity between leptin, BMI and skin folds during pregnancy and the year after. Nutr Diabetes 2013; 3:e86. [PMID: 24018614 PMCID: PMC3789130 DOI: 10.1038/nutd.2013.27] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/20/2013] [Revised: 06/27/2013] [Accepted: 07/24/2013] [Indexed: 12/11/2022] Open
Abstract
Background: From a public health perspective it is important to know which of the currently used methods to estimate changes in maternal body fat during pregnancy and the year thereafter is the most adequate. Objectives: To evaluate the concurrent validity between leptin and surrogates of fat measures: body mass index (BMI) and the sum of four skin folds. Design: Data from the New Life(style) intervention study were analysed as a cohort study. Setting: Midwife practices in The Netherlands. Population: Healthy pregnant nulliparous women. Methods: Anthropometric measurements were done and blood was collected at 15, 25 and 35 weeks of pregnancy and at 6, 26 and 52 weeks after delivery. Data were used if at least 4 out of the 6 measurements were available, leaving 87 women in the analyses. Spearman's correlation coefficients between leptin and BMI and between leptin and the sum of skin folds were calculated for each time point and for the changes between the time points. Results: Correlations between leptin and BMI varied from 0.69 to 0.81. Correlations between leptin and the sum of skin folds were comparable, varying between 0.65 and 0.81. Correlations between changes in leptin and changes in BMI and the sum of skin folds, respectively, were much lower compared with cross-sectional correlations. Conclusion: Because of the high correlation among the three methods and because of the overlapping intervals, all methods seem to be equally adequate to estimate changes in maternal body fat during pregnancy and the year thereafter.
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Affiliation(s)
- C L van der Wijden
- 1] Department of Public and Occupational Health, EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands [2] Department of Gynaecology, Medisch Centrum Jan van Goyen, Amsterdam, The Netherlands
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8
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Abstract
BACKGROUND Lumbar supports are used in the treatment of low-back pain patients, to prevent the onset of low-back pain (primary prevention) or to prevent recurrences of a low-back pain episode (secondary prevention). OBJECTIVES To assess the effects of lumbar supports for prevention and treatment of non-specific low-back pain. SEARCH STRATEGY We updated the search in the Cochrane Central Register of Controlled Trials, PubMed, EMBASE, and CINAHL to December 2006. We also screened references given in relevant reviews and identified trials, and contacted experts to identify additional RCTs. SELECTION CRITERIA Randomized controlled trials that reported on any type of lumbar supports as preventive or therapeutic intervention for non-specific low-back pain. DATA COLLECTION AND ANALYSIS One review author generated the electronic search. Two review authors independently identified trials that met the inclusion criteria. One review author extracted data on the study population, interventions, and final results. The methodological quality and the clinical relevance were independently assessed by two review authors. Because it was not possible to perform a quantitative analysis, we performed a qualitative analysis in which the strength of evidence on the effectiveness of lumbar supports was classified as strong, moderate, limited, conflicting, or no evidence. MAIN RESULTS Seven preventive studies (14,437 people) and eight treatment studies (1361 people) were included in this updated review. Overall, the methodological quality of the studies was rather low. Only five of the fifteen studies met 50% or more of the internal validity items. There was moderate evidence that lumbar supports are not more effective than no intervention or training in preventing low-back pain, and conflicting evidence whether lumbar supports are effective supplements to other preventive interventions. It is still unclear if lumbar supports are more effective than no or other interventions for the treatment of low-back pain. AUTHORS' CONCLUSIONS There is moderate evidence that lumbar supports are not more effective than no intervention or training in preventing low-back pain, and conflicting evidence whether they are effective supplements to other preventive interventions. It remains unclear whether lumbar supports are more effective than no or other interventions for treating low-back pain. There is still a need for high quality randomized trials on the effectiveness of lumbar supports. One of the most essential issues to tackle in these future trials seems to be the realization of an adequate compliance. Special attention should be paid to different outcome measures, types of patients and types of lumbar support.
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Affiliation(s)
- I C D van Duijvenbode
- Hogeschool van Amsterdam, Amsterdam School for Health Professions (ASHP), Tafelbergweg 51, Amsterdam-Zuidoost, Netherlands, 1105 BD.
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9
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Abstract
BACKGROUND Lumbar supports are used in the treatment of low back pain patients to make the impairment and disability vanish or decrease. Lumbar supports are also used to prevent the onset of low back pain (primary prevention) or to prevent recurrences of a low back pain episode (secondary prevention). OBJECTIVES The objective of this systematic review was to assess the effects of lumbar supports for prevention and treatment of non-specific low back pain. SEARCH STRATEGY We searched the Medline, Cinahl and Current Contents databases and the Cochrane Controlled Trials Register up to September 1999, and the Embase database up to September 1998. We also screened references given in relevant reviews and identified controlled trials, and used Science Citation Index to identify additional controlled trials. SELECTION CRITERIA Controlled clinical trials that reported on any type of lumbar supports as preventive or therapeutic intervention for non-specific low back pain were included. DATA COLLECTION AND ANALYSIS One author extracted data from the trials considering characteristics of the study population, characteristics of the interventions and the final results for each outcome measure. The author compared these findings to data regarding the same characteristics of the same studies published already in other reviews. The methodological quality was independently assessed by two authors. Because it was not possible to perform a quantitative analysis, a qualitative meta-analysis was performed in which the strength of evidence on the effectiveness of lumbar supports was classified as being strong, moderate, limited or conflicting, and no evidence. MAIN RESULTS Five randomized and two nonrandomized controlled preventive trials and six randomized therapeutic trials were included in our review. Overall the methodological quality of the studies included in our review was rather low. Only four of the thirteen studies scored positive on 50% or more of the the internal validity items. There was moderate evidence that for primary prevention lumbar supports are not more effective than other types of treatment or no intervention. No evidence was found on the effectiveness of lumbar supports for secondary prevention. The systematic review of therapeutic trials showed that there is limited evidence that lumbar supports are more effective than no treatment, while it is still unclear if lumbar supports are more effective than other interventions for treatment of low back pain. AUTHORS' CONCLUSIONS There is still a need for high quality randomised trials on the effectiveness of lumbar supports. One of the most essential issues to tackle in these future trials seems to be the realisation of an adequate compliance.
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Affiliation(s)
- M W van Tulder
- VU University Medical Centre, Institute for Research in Extramural Medicine, van der Boechorststraat 7, Amsterdam, Netherlands, 1081 BT.
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10
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Engbers LH, van Poppel MNM, van Mechelen W. Measuring stair use in two office buildings: a comparison between an objective and a self-reported method. Scand J Med Sci Sports 2007; 17:165-71. [PMID: 17394478 DOI: 10.1111/j.1600-0838.2006.00533.x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
INTRODUCTION/PURPOSE Measuring stair use reliably and objectively is complicated and difficult. In this study, stair use was measured at an individual level by using an innovative registration system and was compared with self-reported data. The purpose of this study was to gain an insight into the comparability of self-reported stair use vs objectively measured stair use. METHODS Self-reported and objective stair use was measured in two worksites and was operationalized as how often a subject uses the stairs per week (i.e., stair-use frequency) and the number of floors covered (up or down) in a week with each use. Analyses were performed by means of the intraclass correlation coefficients (ICCs). RESULTS A number of significant differences in stair use between worksites were found. ICCs of 0.55 and 0.24 for stair-use frequency were found in worksites 1 and 2, respectively. The ICCs for the number of floors covered were lower at 0.39 and 0.19 for worksites 1 and 2, respectively. CONCLUSION The comparability of self-reported and objectively measured stair use is moderate to poor, and given the independent measurement errors of both methods, this might have been expected. Comparability seemed to be dependent on worksite characteristics.
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Affiliation(s)
- L H Engbers
- Department of Public and Occupational Health, EMGO-Instituut, VU University Medical Center, Amsterdam, The Netherlands
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11
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van Poppel MNM, de Vet HCW, Koes BW, Smid T, Bouter LM. Measuring sick leave: a comparison of self-reported data on sick leave and data from company records. Occup Med (Lond) 2002; 52:485-90. [PMID: 12488520 DOI: 10.1093/occmed/52.8.485] [Citation(s) in RCA: 119] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
The objective of this study was to compare sick leave data obtained from questionnaires with data from company records. During a period of 12 months, questionnaires were completed monthly for 6 months and then at 9 and 12 months. The sensitivity and specificity of questionnaires for detecting an episode of sick leave were determined, using the company records as a reference standard. In addition, the duration of sick leave episodes reported in the two data sets was compared. In this analysis, company records were not assumed to be superior, and agreement was assessed with intraclass correlation coefficients (ICCs). The sensitivity of questionnaires for detecting an episode of sick leave was 55% (95% CI = 0.50-0.60) and the specificity 83% (95% CI = 0.72-0.94). The ICC for all episodes was 0.58 (95% CI = 0.47-0.67). The only satisfactory ICC (0.87; 95% CI = 0.74-0.93) was found for the questionnaires at 9 and 12 months. No large systematic differences were found between the duration of episodes reported in the two data sets. In conclusion, in our study, the sensitivity of questionnaires for detecting an episode of sick leave was very low. Furthermore, when episodes were recalled, there was little agreement on the duration of the episode between questionnaire data and data in the company records. Based on these results and considering the risk of missing questionnaires, data on sick leave gathered from company records are clearly preferable as an outcome measure in research.
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Affiliation(s)
- M N M van Poppel
- Institute for Research in Extramural Medicine, VU University Medical Center, Amsterdam, The Netherlands.
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