Abstract
Different intrauterine environments may influence the maternal prepregnancy body weight (BW) variation up to 6 months postpartum. The objective of the present study was to verify the association of sociodemographic, obstetric, nutritional, and behavioral factors with weight variation in women divided into four groups: hypertensive (HM), diabetic (DM), smokers (SM), and control mothers (CM). It was a convenience sample of 124 postpartum women recruited from 3 public hospitals in the city of Porto Alegre, state of Rio Grande do Sul, Brazil, between 2011 and 2016. Multiple linear regressions and generalized estimating equations (GEE) were conducted to identify the factors associated with maternal weight variation. For all GEE, the maternal weight measurements were adjusted for maternal height, parity, educational level, and the type of delivery, and 3 weight measurements (prepregnancy, preceding delivery, and 15 days postpartum) were fixed. A hierarchical model closely associated the maternal diagnosis of hypertension and a prepregnancy body mass index (BMI) classified as overweight with maternal weight gain measured up to the 6th month postpartum (the difference between the maternal weight at 6 months postpartum and the prepregnancy weight). These results showed that the BW of the HM group and of overweight women increased ∼ 5.2 kg 6 months postpartum, compared with the other groups. Additionally, women classified as overweight had a greater BW variation of 3.150 kg. This evidence supports the need for specific nutritional guidelines for gestational hypertensive disorders, as well as great public attention for overweight women in the fertile age.
Highlights
Epidemiological reported the influence of certain environmental factors, in the beginning of life, with changes in the genetic load expression of the subject, determining a pattern of health and disease in a peculiar form during lifetime.1 Likewise, preclinical and clinical data point in the same direction, suggesting a strong association between adverse environments in the fetal life and/or in the postnatal life and the emergence of non-communicable lifelong chronic diseases2 and the inference that developmental and fetal growth conditions determine the metabolic adjustments involved in particular outcomes.3Following this rationale, Barker et al4 proposed the hypothesis that adverse intrauterine conditions increased the risk of developing cardiovascular diseases in adulthood, and demonstrated that low birthweight newborns remained persistently biologically different from those with proper weight until adulthood
The present study aims at understanding some maternal influences in order to contribute to the knowledge of how prepregnancy, gestational, and postpartum maternal weight variation may be modulated by maternal stress perception, depressive symptoms, physical activity, and feeding behavior
The Food Frequency Questionnaire (FFQ) is a widely instrument used in epidemiological studies, and our results revealed no influence of this estimative on the maternal weight variation, but the highest calorie intake was observed in the Hypertensive mothers (HM) group, with a median value estimated at > 5611.4 Kcal/day
Summary
Preclinical and clinical data point in the same direction, suggesting a strong association between adverse environments in the fetal life and/or in the postnatal life and the emergence of non-communicable lifelong chronic diseases and the inference that developmental and fetal growth conditions determine the metabolic adjustments involved in particular outcomes.. Preclinical and clinical data point in the same direction, suggesting a strong association between adverse environments in the fetal life and/or in the postnatal life and the emergence of non-communicable lifelong chronic diseases and the inference that developmental and fetal growth conditions determine the metabolic adjustments involved in particular outcomes.3 Following this rationale, Barker et al proposed the hypothesis that adverse intrauterine conditions increased the risk of developing cardiovascular diseases in adulthood, and demonstrated that low birthweight newborns remained persistently biologically different from those with proper weight until adulthood. An appropriate gestational weight gain, for example, displays a direct relation to several outcomes in maternal and child health. The prepregnancy maternal weight is important to trace the direction of gestational weight gain, since an insufficient weight gain is related to preterm birth, to low birthweight, or to small newborn for the gestational age, as well as being a risk factor for late onset of breastfeeding. On the other hand, excessive maternal weight gain demonstrated an association with the development of gestational diabetes mellitus, of preterm birth, of cesarean section, of large newborn for the gestational age, of postpartum maternal weight retention and, of maternal and child overweight and obesity.
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Schedule a callMore From: Revista Brasileira de Ginecologia e Obstetrícia / RBGO Gynecology and Obstetrics
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