Maternal Excessive Weight Gain Research Articles

The Nutritional Needs of Mothers and Babies: A Review

The aim is to assess the importance of measuring healthy habits by pregnant women, that enhance different factors of mother and fetus health. We evaluate the change and variations in dietary recommendations. A female went through a lot of physical and mental changes in different stages of pregnancy and there are some common symptoms such as vomiting, fatigue, nausea, frequent urination, dizziness, etc. Certain hormonal changes are there to balance the body’s fatigue, tiredness, and hormones, few dietary recommendations are mentioned and it has been concluded that diet plays an important role during pregnancy, and meeting all the nutrition needs is an essential factor in planning the diet. Many diseases/deficiencies are there such as goiter, iodine deficiency, folate deficiency, gestational diabetes mellitus, gestational weight gain, Neural tube defects, and much more. A detailed view is mentioned below in the following paper: On average, pregnancy lasts 40 to 42 weeks (Nine months). On average, weight gain for a pregnant woman is 12 to 14 kg, thus weight gain can lower the risk of complications during labor and also lower the risk of LBW (low birth weight). Low GWG increases the risk of having an LBW infant. The average weight of the baby should be 2.5–3 kg. A baby having this much body weight should be considered a healthy infant. We provide up-to-date advice for achieving optimal nutrition before conception, throughout breastfeeding, in the first two years of life, and for preschoolers, with an eye on long-term health benefits. These guidelines are intended to aid in the primary prevention of obesity and the non-communicable diseases it is linked to among economically privileged groups, such as European women and children. Medical professionals should be incentivized and educated to promote and advise patients on preconception nutrition, which includes enhancing adolescent nutrition and health. Women who are physically active, eat healthily, don’t smoke, don’t drink excessively, and have a good body mass index (BMI) have a higher chance of having a safe pregnancy. Women of childbearing age should have their consumption and status of specific micronutrients closely monitored, especially folate. Women at risk for insufficient dietary intake of certain micronutrients may benefit from taking dietary supplements containing iron, vitamin D, vitamin B12, iodine, and maybe others. Smoke and alcohol should be strictly eliminated from the diet. Yes, diet plays an important role during pregnancy but staying physically active is equally important for the mother and the baby to promote general health and well-being. Exercise and stretching can reduce the risk of excessive maternal weight gain or gestational weight gain(Obesity). A long walk can greatly help a pregnant woman after lunch or in the morning.

Investigating the Shape and Strength of the Relationship Between Maternal Weight Gain and Gestational Age at Delivery in Twin and Singleton Pregnancies.

Both inadequate and excessive maternal weight gain are correlated with preterm delivery in singleton pregnancies, yet this relationship has not been adequately studied in twins. We investigated the relationship between time-varying maternal weight gain and gestational age at delivery in twin pregnancies and compared it with that in singletons delivered in the same study population. We used serial weight measurements abstracted from charts for twin and singleton pregnancies delivered during 1998-2013 in Pittsburgh, Pennsylvania. Our exposure was time-varying weight gain z score, calculated using gestational age-standardized and prepregnancy body mass index-stratified twin- and singleton-specific charts, and our outcome was gestational age at delivery. Our analyses used a flexible extension of the Cox proportional hazards model that allowed for nonlinear and time-dependent effects. We found a U-shaped relationship between weight gain z score and gestational age at delivery among twin pregnancies (lowest hazard of delivery observed at z score= 1.2), which we attributed to increased hazard of early preterm spontaneous delivery among pregnancies with low weight gain and increased hazard of late preterm delivery without labor among pregnancies with high weight gain. Our findings may be useful for updating provisional guidelines for maternal weight gain in twin pregnancies.

Predictors of Human Milk Fatty Acids and Associations with Infant Growth in a Norwegian Birth Cohort.

Triglyceride-bound fatty acids constitute the majority of lipids in human milk and may affect infant growth. We describe the composition of fatty acids in human milk, identify predictors, and investigate associations between fatty acids and infant growth using data from the Norwegian Human Milk Study birth cohort. In a subset of participants (n = 789, 30% of cohort), oversampled for overweight and obesity, we analyzed milk concentrations of detectable fatty acids. We modelled percent composition of fatty acids in relation to maternal body mass index, pregnancy weight gain, parity, smoking, delivery mode, gestational age, fish intake, and cod liver oil intake. We assessed the relation between fatty acids and infant growth from 0 to 6 months. Of the factors tested, excess pregnancy weight gain was positively associated with monounsaturated fatty acids and inversely associated with stearic acid. Multiparity was negatively associated with monounsaturated fatty acids and n-3 fatty acids while positively associated with stearic acid. Gestational age was inversely associated with myristic acid. Medium-chain saturated fatty acids were inversely associated with infant growth, and mono-unsaturated fatty acids, particularly oleic acid, were associated with an increased odds of rapid growth. Notably, excessive maternal weight gain was associated with cis-vaccenic acid, which was further associated with a threefold increased risk of rapid infant growth (OR = 2.9, 95% CI 1.2–6.6), suggesting that monounsaturated fatty acids in milk may play a role in the intergenerational transmission of obesity.

Effect of maternal hypertensive disorders during pregnancy on offspring's early childhood body weight: A population-based cohort study

ObjectiveThe prevalence of hypertensive disorder during pregnancy (HDP) and childhood obesity is increasing worldwide. HDP or obesity in mothers can increase the risk of overweight/obesity (OWOB) in their children. Few longitudinal studies have examined the associations of maternal body weight with the growth and risk factors for overweight in infants born to mothers with HDP. This study examined the risk factors for childhood OWOB through the age of 66 months in children born to mothers with HDP. Materials and methodsIn total, 24,200 pairs of mothers and their children were selected from the Taiwan Birth Cohort Study. The children's body weights were classified and analyzed to determine infant growth at birth and at the ages of 12, 24, 36, and 66 months. Multiple logistic regression analyses with different model settings were performed to identify the factors affecting growth and childhood OWOB in the children of mothers with HDP. ResultsThe average birth weight of children was lower in the HDP group than in the non-HDP group. The catch-up phenomenon began at the age of 18 months. The incidence of OWOB was higher in the children in the HDP group than in those in the non-HDP group from the age of 24 months and increased with the children's age. At every age point, maternal overweight before pregnancy was the main risk factor for childhood OWOB, and this effect increased with the children's age (odds ratio [OR]: 1.83 at 66 months). The effect of excessive maternal gestational weight gain on childhood OWOB was significant (OR: 1.26–1.44 for various age points). ConclusionMaternal overweight is the main risk factor for OWOB in children born to mothers with HDP. After adjusting for related confounders, we determined that HDP did not exert a significant effect on the risk of childhood OWOB.

Polymorphic eruption of pregnancy.

Polymorphic eruption of pregnancy (PEP) is a benign self-limiting dermatoses that occurs during pregnancy and/or the postpartum period. Etiology is unknown and evidence suggest a relationship between excessive maternal weight gain, cesarean deliveries, skin overdistension, multiple gestation and male fetuses. We present a case of PEP in a 26-year-old woman with twin pregnancy. We recommend prompt evaluation and diagnosis of a pregnant woman with primary skin lesions and pruritus to differentiate between the benign polymorphic eruption of pregnancy and other dermatosis which are associated with increased fetal morbidity.

Exercise throughout Pregnancy Prevents Excessive Maternal Weight Gain during the COVID-19 Pandemic: A Randomized Clinical Trial.

The purpose of this study was to examine the effects of a virtual exercise program throughout pregnancy during the COVID-19 pandemic on maternal weight gain. A randomized clinical trial (NCT NCT04563065) was performed. In total, 300 pregnant individuals were assessed for eligibility, and a total of 157 were randomized, of which 79 were in the control group (CG), and 78 were in the intervention group (IG). Those in the intervention group participated in a virtual supervised exercise program throughout pregnancy, 3 days per week. Fewer pregnant participants exceeded the weight gain recommendations in the IG group than in the CG (n = 4/5.9% vs. n = 31/43.1%, p = 0.001). Weight gain during pregnancy was lower in the IG than in the CG (9.96 ± 3.27 kg vs. 12.48 ± 4.87 kg, p = 0.001). Analysis of subgroups based on pre-pregnancy body mass index, showed significant differences in excessive maternal weight gain between study groups in normal-weight (IG, n = 0/0% vs. CG, n = 10/25%, p = 0.001) and those with overweight (IG, n = 2/18% vs. CG, n = 12/60%, p = 0.025). A virtual supervised exercise program throughout pregnancy could be a clinical tool to manage maternal weight gain during the COVID-19 pandemic by controlling excessive gain.

Incidence and Risk Factors of Neonatal Sepsis in Preterm Premature Rupture of Membranes before 34 Weeks of Gestation

Objective: Early-onset neonatal sepsis (EONS) is a leading cause of newborn morbidity and mortality, particularly in preterm premature rupture of membranes (PPROM) before 34 weeks of gestation, in which expectant management was performed until reaching 34 weeks of gestation, evidence of maternal chorioamnionitis, or unfavorable fetal conditions. The interval between membrane rupture and delivery has a positive correlation with neonatal sepsis. The purpose of this study was to investigate the incidence and risk factors of EONS in PPROM.Materials and Methods: This was a retrospective cross-sectional study. The medical records of pregnant women who gave birth between 2005 and 2018 and their newborns were reviewed. The inclusion criterion was singleton pregnancies complicated by PPROM between 24 and 33+6 weeks of gestation. Multifetal pregnancies, fetal malformation, stillbirths, and records with incomplete data were excluded. PPROM was diagnosed by obstetricians while EONS was diagnosed by neonatologist.Results: The incidence of EONS in with PPROM was 24%. Risk factors included excessive maternal weight gain based on IOM (OR = 2.40, 95% CI = 1.16-4.94), extremely preterm at admission (before 28 weeks of gestation) (OR = 3.38, 95% CI 1.12-10.21) and very low birth weight (≤ 1,500 g) (OR 3.68, 95% CI = 1.86-7.30). Maternal hematologic laboratory results were not associated with neonatal sepsis.Conclusion: The incidence of EONS in PPROM was similar to data provided by other studies. Obstetricians and pediatricians should be cautious about neonatal sepsis, especially in cases of excessive maternal weight gain, extremely preterm admissions, and very low birth weight.

Therapeutic Aquatic Exercise in Pregnancy: A Systematic Review and Meta-Analysis.

This systematic review and meta-analysis aimed to assess evidence on the effects of aquatic exercise in pregnant women. The search included the following databases: Medline-PubMed, Web of science, PEDro, Scopus and SPORTDiscus databases. Seventeen randomized controlled trials were included (n = 2439, age 20–39 years; 31.30 ± 1.30 years). The systematic review carried out has indicated that aquatic exercise in pregnant women appears to have positive effects on preventing excessive maternal weight gain, improving maternal body image, as well as promoting healthy behavior, decreasing medical leave due to lower back pain during pregnancy, preventing gestational depression by improving maternal glucose tolerance levels, and reducing O’Sullivan test values. The Physiotherapy Evidence Database was used to evaluate the quality of the methodology of the selected studies, which were found to present an average methodological quality (PEDro scale: 5.05 points). Meta-analysis showed that aquatic exercise in pregnant women appears to have positive effects in the prevention of excessive maternal weight gain (mean difference −1.66 kg, 95% CI −2.67 to −0.66) and also to reduce birth weight mean differences (−89.13 g, 95% CI −143.18 to −35.08). The practice of aquatic exercise is appropriate throughout pregnancy. However, more research is needed to build more solid knowledge on the benefits of aquatic physical exercise on physical fitness (endurance, flexibility, agility and strength).

Long-Chain Polyunsaturated Fatty Acid Concentrations and Association with Weight Gain in Pregnancy.

Lower concentrations of omega-3 (ω-3) and higher concentrations of omega-6 (ω-6) have been associated with excess weight in adults; however, the information on this relationship in pregnancy remains in its infancy. This study aimed to investigate the association between plasma levels of ω-3 and ω-6 long-chain polyunsaturated fatty acids (PUFAs) and weight gain during the gestational period. This is a prospective cohort study involving 185 pregnant women registered with the prenatal services of a municipality in the northeast of Brazil. The dosage of the serum concentration of fatty acids and the anthropometric measurements were carried out at the baseline, and the women’s weight information in the first, second, and third trimesters was collected from their pregnancy cards. Serum fatty acids were determined with the help of gas chromatography. The response variable of this study is the latent variable weight gain in pregnancy, derived from three variables: gestational weight in the first, second, and third trimesters. The main exposure was the plasma concentrations of PUFAs. Structural equation modeling was used for the data analysis. The mean age of the pregnant women was 26.74 years old (SD: 5.96 years). Most of the women had not completed high school (84%) and had a low income (70.86%). It was observed that the ω-3 PUFAs, represented by ALA plasm (alpha-linolenic acid), DHA (docosahexaenoic acid), and the EPA/ALA ratio (eicosapentaenoic acid to alpha-linolenic acid ratio), were negatively associated with the weight gain during pregnancy construct (−0.20, −0.12, and −0.14, respectively). Meanwhile, the PUFAs represented by the ratio between the ω-6 category acids ARA and LA (arachidonic acid and linoleic acid) had a direct and positive association (0.22) with that construct. Excess maternal weight gain was associated with ω-3 and ω-6 plasma levels. The women with the greatest gestational weight gain were the ones that presented the highest ARA/LA ratio (ω-6) and the lowest plasma concentrations of ALA, DHA, and EPA/ALA ratio (ω-3).

Insufficient maternal gestational weight gain and infant neurodevelopment at 12\xa0months of age: the Japan Environment and Children\u2019s Study

Abnormal maternal gestational weight gain (GWG) increases the risk of obstetric-related complications. This investigation examined the impact of GWG on infant neurodevelopmental abnormalities at 12 months of age using the data of a nationwide Japanese cohort study. Questionnaire data were obtained from the ongoing Japan Environment and Children’s Study cohort study. Maternal GWG was subdivided as below, within, or above the reference values of the Institution of Medicine pregnancy weight guidelines. The Ages and Stages Questionnaire, third edition (ASQ-3) is a parent-reported developmental screening instrument for children across five domains: communication, gross motor, fine motor, problem-solving, and personal–social. Multiple logistic regression analysis was employed to identify correlations between GWG and developmental delay defined as ASQ-3 scores of less than two standard deviations below the mean. A total of 30,694 mothers with singleton live births and partners who completed the questionnaire were analyzed. The prevalence of mothers below, within, and above the GWG guidelines was 60.4% (18,527), 32.1% (9850), and 7.5% (2317), respectively. We recorded 10,943 infants (35.7%) who were outliers in at least one ASQ-3 domain. After controlling for covariates, GWG below established guidelines was associated with a significantly higher risk of developmental delay for the communication (odds ratio [OR] 1.21, 95% confidence interval [CI] 1.09–1.34), gross motor (OR 1.14, 95% CI 1.05–1.24), fine motor (OR 1.13, 95% CI 1.04–1.24), problem-solving (OR 1.09, 95% CI 1.01–1.18), and personal–social (OR 1.15, 95% CI 1.07–1.24) domains.Conclusion: This large survey revealed a possible deleterious effect of insufficient maternal GWG on infant neurodevelopment.Trial registration: The Japan Environment and Children’s Study (JECS) was registered in the UMIN Clinical Trials Registry on January 15, 2018 (number UMIN000030786).What is Known:• Inappropriate maternal gestational weight gain may cause obstetric complications and adverse birth outcomes.• Excess maternal weight gain may result in gestational diabetes, hypertension, eclampsia, caesarean delivery, and macrosomia, while insufficient maternal weight gain has been associated with pre-term birth and small for gestational age.What is New:• This study provides important information on a possible adverse effect of insufficient maternal gestational weight gain on offspring neurodevelopment at 12 months of age.• Our findings indicate a need to reconsider the optimal body mass index and gestational weight gain for women desiring pregnancy.

Exercise versus Metformin to Improve Pregnancy Outcomes among Overweight Pregnant Women: A Systematic Review and Network Meta-Analysis.

Being overweight is associated with pregnancy-related disorders such as gestational diabetes mellitus (GDM), hypertensive disorders of pregnancy (HDP), and excessive maternal weight gain (MWG). Exercise and metformin reduce the risk of these disorders. This network meta-analysis (NMA) aims to compare the effect of metformin and different types of exercise (aerobic, resistance and combined) on the risk of GDM, HDP, and MWG among overweight/obese pregnant women. Medline, EMBASE, Web of Science and Cochrane Library were searched from inception to June 2021. Meta-analyses and NMAs were performed. Sixteen randomized controlled trials were included. In the NMA, aerobic exercise showed an effect on GDM (RR = 0.51, 95% CI = 0.26, 0.97), and metformin a reduction in MWG (MWG = −2.93 kg, 95% CI = −4.98, −0.87). No intervention showed any effect on the reduction of HDP. Our study suggests that aerobic exercise may have the greatest effect in reducing the risk of GDM, and perhaps, the MWG. Strategies should be developed to increase adherence to this type of intervention among overweight women without contraindications. Although metformin could reduce MWG, medicalization of pregnancy in healthy women is not justified with the present results. More research is needed on the effect of the intensity and frequency of exercise sessions and the length of interventions.

Obesity and pregnancy, the perfect metabolic storm.

Pregnancy is a physiological stress that requires dynamic, regulated changes affecting maternal and fetal adiposity. Excessive accumulation of dysfunctional adipose tissue defined by metabolic and molecular alterations cause severe health consequences for mother and fetus. When subjected to sustained overnutrition, the cellular and lipid composition of the adipose tissue changes predisposing to insulin resistance, diabetes, and other metabolic disorders compromising the outcome of the pregnancy. Moreover, excessive maternal weight gain, usually in the context of obesity, predisposes to an increased flux of nutrients from mother to fetus throughout the placenta. The fetus of an obese mother will accumulate more adiposity and may increase the risk of future metabolic disorder later in life. Thus, further understanding of the interaction between maternal metabolism, epigenetic regulation of the adipose tissue, and their transgenerational transfer are required to mitigate the adverse health outcomes for the mother and the fetus associated with maternal obesity.

Exercise and outcomes in macrosomic pregnancies

Objective Pregnancy is generally known to be a period when physical activity is partially or totally restricted to avoid negative outcomes such as miscarriage or premature birth. The aim of this study was to evaluate the effect on maternal and fetal outcomes of exercise in pregnancies complicated by macrosomia. Material and Method In this retrospective study, the data were retrospectively screened of women who gave birth at ≥38 weeks with infant birthweight of ≥4000 gr. The patients were separated into two groups as those who followed an exercise program of walking regularly for 30–60 mins at least 1 day a week throughout pregnancy and those who did not. The maternal and fetal complications were compared between the groups. A total of 252 patients were included in the study as 84 women who exercised during pregnancy and 168 women selected at random in the ratio of 2:1 who did not exercise. Results When the gestational week at birth was examined, a statistically significantly higher rate of patients in the non-exercise group gave birth at ≥40 gestational weeks. Although not at a statistically significant level, maternal and fetal complications were observed more in the non-exercise group. Conclusions The results of this study showed that excessive maternal weight gain was statistically significantly reduced, and although not at a statistically significant level, maternal and fetal trauma were reduced in macrosomic pregnancies with regular exercise. As recommended by ACOG, for pregnant women at risk of macrosomic fetus, exercise of walking for 30–60 mins several days a week will have positive effects on both the mother and infant.

Glucose Abnormalities and Inappropriate Weight Gain Predict Negative Pregnancy Outcomes After Gastric Bypass Surgery.

Pregnancy after gastric bypass (RYGB) surgery remains at high risk for gestational diabetes mellitus, prematurity, and small for gestational age infants (SGA). Our objective was to describe the interstitial glucose (IG) profiles and weight changes during such pregnancies, and the association of these factors with adverse pregnancy outcomes. One hundred twenty two pregnancies were analyzed in a monocentric retrospective study. IG profiles were evaluated by continuous glucose monitoring for 4 days. Maternal (hypertension, hospitalizations, and caesarean section) and neonatal outcomes (prematurity, weight for gestational age, hospitalizations, and malformations) were recorded. A logistic stepwise regression model assessed the influence of weight gain and impaired IG on pregnancy outcomes. Pregnancies occurred 33 (SD 21 months) after surgery. 73% of the women had IG abnormalities (55% with an increased % of time >140 mg/dl and 69% with an increased % of time <60 mg/dl). Five (4%) children were large for gestational age (LGA), 24 (20%) were SGA and 16 (13%) were born prematurely. There were 3 malformations but no stillbirth. LGA was associated with a high % of time >140 mg/dl and an excessive maternal weight gain. Prematurity was associated with a high % of time <60 mg/dl and an insufficient maternal weight gain. In the multivariate analysis, inappropriate weight gain explained LGA and prematurity independently. SGA was associated with a shorter % of time <60 mg/dl. The relationship between IG abnormalities and/or maternal weight gain and neonatal outcomes in pregnancies after RYGB, suggests a careful monitoring of these parameters.

Excess pregnancy weight gain in latinas: Impact on infant's adiposity and growth hormones at birth.

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±4.5kg/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±481.5g 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.

Maternal plant-based diet during gestation and pregnancy outcomes.

We aimed to explore the association of vegetarian-vegan diets and pregnancy outcomes. A retrospective, web-based study conducted in 2017. Women who delivered < 4years prior to enrolment where eligible to participate. Participants were allocated to 3 groups based on their self-reported diet during pregnancy: omnivores, vegetarians or vegans. Outcomes of interest including birthweight centile, small for gestational age (SGA), large for gestational age (LGA), preterm birth (PTB), maternal excessive weight gain (EWG) and gestational diabetes (GDM) were compared between the groups. Overall, 1419 women of which 234 vegans (16.5%), 133 vegetarian (9.4%) and 1052 omnivores (74.1%) were included in final analysis. Maternal vegan diet during pregnancy was associated with a lower birth weight centile as compared to omnivores (42.6 ± 25.9 vs. 52.5 ± 27.0 P < 0.001), a greater adjusted odds ratio (aOR) for SGA (aOR = 1.74; 95% CI 1.05, 2.86) but not with the risk of LGA (aOR = 0.55; 95% CI 0.30, 1.00). Further adjustment for BMI showed similar but nonsignificant associations for SGA and LGA as compared to the omnivore group. Vegan diet was associated with lower risk for maternal EWG (aOR = 0.61; 95% CI 0.44, 0.86) and modest nonsignificant association with GDM (aOR = 0.54 95% CI 0.28, 1.03) which was further attenuated by adjustment for pre-pregnancy BMI. Maternal diet group was not associated with the risk of PTB or low birth weight. Maternal vegan diet is a protective factor from EWG but associated with a higher risk for SGA and lower birth weight centile. The association between vegan diet and fetal growth was mediated by maternal BMI.

Influence of Excessive Maternal Weight in Pregnancy on Mother’s and Newborn Health

Excessive weight gain during pregnancy is associated with higher risks of complications in the mother and in the newborn. We carried out this work, the objective of which was to study the influence of excessive maternal weight gain during pregnancy. This was a prospective study carried out in Dakar over a period of 5 months. We included all women with a normal body mass index in early pregnancy. These parturients were divided into two groups: the first group consisted of women whose weight gain during pregnancy was normal between 11.5 and 16 kg and the second group were those who had an excessive weight gain greater than 16 kg. We analyzed maternal data and neonatal parameters. During the period, 194 women had a normal weight gain (PNP) and 104 an excessive weight gain (PEP), i.e., a prevalence of PEP of 10.5%. There were no differences in the two groups for marital status, geographic origin, level of education, drinking habits, maternal size and pathologies during pregnancy (p>0.05). On the other hand, maternal age, parity and absence of a professional activity were significantly associated with excessive weight gain during pregnancy. Regarding neonatal data, we did not note any significant difference with regard to gender, trophicity, Apgar score, stillbirth, postnatal transfer and neonatal mortality between the 2 groups.

Systemic and oral conditions of pregnant women with excessive weight assisted in a private health system

This observational cross-sectional study aimed to evaluate systemic and oral conditions in pregnant women with excessive pre-pregnancy weight (PEW) and normal pre-pregnancy weight (PNW) who underwent follow-up in the private healthcare system during the third trimester of pregnancy. Fifty pregnant women were evaluated from August 2017 to February 2018 and divided into two groups: women with PEW (n=25); and those with PNW (n=25). Their weight and body mass index (BMI), periodontal disease status, stimulated salivary flow, and systemic condition were evaluated. Statistical analyses were conducted using t-test, Mann-Whitney test, chi-square test and binary logistic regression (P<0.05). The groups did not differ in age, educational level or monthly household income (P>0.05). The PEW group had a higher frequency of arterial hypertension (P=0.019) and excessive weight gain during gestation (P=0.010), sought dental services less frequently, and had increased severity of periodontitis (P<0.0001). Both groups presented low salivary flow, with no intergroup difference. In the final binary logistic regression models, high maternal pre-pregnancy BMI was a significant predictor of arterial hypertension and periodontitis during the third trimester of gestation; maternal excessive weight gain was also a significant predictor of periodontitis during pregnancy. Women with PEW who underwent follow-up in a private healthcare system had a higher prevalence of arterial hypertension and worse periodontal status during the third trimester of pregnancy as compared to women with normal weight.

Predictors of Large-for-Gestational-Age Birthweight Among Pregnant Women With Type 1 and Type 2 Diabetes: A Retrospective Cohort Study.

Our aim in this study was to compare the effects of risk factors for large-for-gestational-age (LGA) birthweight between women with type 1 and type 2 diabetes mellitus (TIDM and T2DM, respectively). A retrospective cohort study was conducted for women with T1DM (n=152) and T2DM (n=255) attending a diabetes/pregnancy clinic during the period from 2009 to 2016. Multiple logistic regression analysis was used to identify variables associated with LGA birthweight. LGA was significantly higher in those with T1DM (39%) than T2DM (17%) (p<0.001). Among those with T1DM, there was a nonsignificant association between LGA and continuous subcutaneous insulin infusion (odds ratio, 1.17; 95% confidence interval, 0.99 to 1.39; p=0.06) and excess maternal weight gain (T1DM odds ratio, 1.19; 95% confidence interval, 0.99 to 1.43; p=0.069). In those with T2DM, there was an association between LGA and glycated hemoglobin at delivery (T2DM odds ratio, 1.10; 95% confidence interval, 1.02 to 1.19; p=0.01). In the study population, glycemic control at delivery was predictive of LGA in women with T2DM, and there was a trend toward an association of maternal weight gain and continuous subcutaneous insulin infusion with LGA infants in T1DM. Further study is warranted to better guide targeted interventions to reduce high rates of LGA birthweight in T1DM/T2DM.

Association between both maternal pre-pregnancy body mass index/gestational weight gain and overweight/obesity children at preschool stage

Objective: To investigate the association of both maternal pre-pregnancy body mass index (BMI) and gestational weight gain (GWG) with childhood overweight and adiposity in preschool children. Methods: A total of 4 303 preschool children aged 3-5 years were enrolled in our study during June and November 2016 in Guangzhou. Children defined as overweight and obesity were according to the criteria of WHO while weight status during maternal pre-pregnancy was using the China Adult Reference. Gestational weight gain was defined according to the Institute of Medicine guidelines. Results: After adjusting the possible confounding factors, results from the logistic regression analysis showed that both maternal pre-pregnancy overweight and obesity would increase the risk for both childhood overweight and obesity (OR=1.820, 95%CI: 1.368-2.422). The analysis of covariance results also showed that both maternal overweight and obesity before pregnancy and excessive maternal weight gain during pregnancy increased the BMI Z-score in children. Maternal GWG over the recommended level were associated with both the childhood overweight and obesity (OR=1.296, 95%CI: 1.007-1.667). Joint associations of pre-pregnancy BMI and inappropriate GWG were also noticed in the study. Stratified analysis was conducted in three groups according to the pre-pregnancy BMI of the mothers. Result showed that there was no statistical difference in the risks of either overweight or obesity in children (P>0.05). However, when compared to mothers with adequate pre-pregnancy higher BMI and adequate GWG, under the combination of high pre-pregnancy BMI and excessive GWG, their adverse effects on childhood overweight and obesity were much higher (OR=1.574, 95%CI: 1.029-2.409). Conclusions: Both high pre-pregnancy BMI and inappropriate GWG were associated with greater BMI of their offspring. Pregnant women should follow the appropriate weight gain program and help their children to prevent from becoming obese.