Pregnancy Gain Research Articles

Maternal anthropometric determinants as risk markers of suicidality and severity of illness in women with postnatal depression.

Context:Studies have shown nutrition to play a role in etiology of postnatal depression, but few risk markers have been developed for the same. Anthropometric determinants have not been sufficiently researched in relation to suicidality and severity of illness in women with postnatal depression.Aim:The present study assesses the efficacy of anthropometric determinants as risk markers of severity of illness and suicidal ideations in postnatal depression.Methods and Materials:100 women were screened at 6 weeks postnatal for the presence of postnatal depression and suicidal ideation using the Edinburgh Postnatal Depression Scale. Anthropometric determinants assessed were height, weight, weight gain in pregnancy, weight at first antenatal visit, body mass index and waist-to-hip ratio. Univariate and multivariate analysis were done for risk estimation using Spearman's rank correlation and multiple regression analysis, respectively.Results:In total, 39% of the women showed the presence of postnatal depression. Out of these 39 women, 31% had suicidal ideations. The waist-to-hip ratio was the most significant factor in all the models, having a negative correlation with suicidality and severity of depression (P < 0.05). The multiple regression model using anthropometric determinants could significantly assess risk of both suicidality (P = 0.03, adjusted R2 = 0.08) and postnatal depression (P = 0.04, adjusted R2 = 0.07).Conclusions:The study concludes that anthropometric determinants can be used effectively as risk markers for suicidality and severity of illness in women with postnatal depression. The most significant risk factor was found to be waist-to-hip ratio in both the models.

335: Weight gain in pregnancy: can metformin steady the scales?

335: Weight gain in pregnancy: can metformin steady the scales?

Body Composition During Pregnancy Differs by Obesity Class.

The aim of this study is to characterize changes in body composition during pregnancyin women with obesity. Fifty-four healthy women with obesity (class 1, 30-34.9 kg/m2 : n = 25; class 2, 35-39.9 kg/m2 : n = 21; class 3, ≥ 40.0 kg/m2 : n = 8) expecting a singleton pregnancy were studied. Body composition was measured in earlypregnancy (13-16 weeks), midpregnancy (24-27 weeks), and late pregnancy (35-37 weeks) using air displacement plethysmography, stable isotopes, and skinfold thickness measurements. Fasting glucose, insulin, and leptin were measured. The gain in fat-free mass was lower in the second trimester compared with the third (2.7 ± 0.2 to 5.3 ± 0.2 kg; P < 0.001), whereas fat mass accumulation declined over time (0.6 ± 0.3 to -0.7 ± 0.4 kg; P = 0.005). Women with class 1 and 2 obesity gained 1.1 ± 0.7 kg offat mass during pregnancy, while women with class 3 obesity lost 4.1 ± 0.6 kg (both P < 0.001). The difference in fat accumulation between obesity classes was observed only in the second trimester (P = 0.02). Gestational weight gainwas associated positively with changes in plasma concentrations of insulin, leptin, and insulin resistance (all P < 0.01). Gestational weight gain in pregnancy differs by obesity class and trimester. Women with class 3 obesity gain less body weight and fat mass. Fat mass gain is most likely preventable in the second trimester.

561: Gestational weight gain video module increases patients’ knowledge of pregnancy weight gain goals

Maternal weight gain counseling is an important, but often overlooked, component of prenatal care counseling. As many as one third of women receive no counseling, leading to knowledge deficits regarding weight gain guidelines. We set out to determine if utilization of a gestational weight gain (GWG) video module can improve patients’ knowledge about weight gain goals. A prospective cohort study of women presenting for routine care was performed at a university hospital from April 2019-August 2019. Excluded were those less than 18 years of age, non-English speaking, or with multifetal gestations. Eligible women were approached at outpatient clinic sites and given a 15-item questionnaire regarding their knowledge on weight gain in pregnancy. Women were then advised to watch a 5-minute video that addressed weight gain goals specific to their body mass index, how to gain a healthy amount of weight, and what the risks of inappropriate weight gain are. Four weeks later, participants completed the same questionnaire. Participants were allotted a knowledge score based on the number of questions answered correctly. Maternal characteristics were collected from the electronic medical record. To determine the effectiveness of the gestational weight gain video module on patients’ knowledge, a paired t-test was used. A p value of < 0.05 was deemed statistically significant. A total of 26 women were included in the study. Women were approximately 30 years old, primarily Caucasian, multiparous and obese, Table 1. The mean gestational weight gain knowledge score of women prior to and after viewing the video module were 11.3 ± 2.1 and 12.5 ± 2.3 respectively. Compared to baseline gestational weight gain knowledge, women who had a viewed the video module had a statistically significant increase in gestational weight gain knowledge (t(26)=1.2, p< 0.001). Utilization of a gestational weight gain module provides an interactive, convenient means to increase knowledge of individualized weight gain goals in pregnancy.

Influencing variables for fetal growth in malnourished mothers: A nested case-control study

ObjectiveMaternal malnutrition, inadequate weight gain in pregnancy, and maternal anemia are the modifiable variables commonly implicated for intrauterine growth retardation in the community. We aimed to evaluate the frequency of growth retardation and iron deficiency among babies born to malnourished mothers and its association with maternal anthropometry, hemoglobin, and ferritin. MethodsA nested case-control study was carried out as analysis of subset data with subjects enrolled for a randomized controlled trial(CTRI Trial no.2018/04/013096)in government facilities of Kasturba Medical College, Mangalore, affiliated to Manipal Academy of Higher Education from May to August 2018. Eighty-eight newborns born to malnourished primigravidae by vaginal delivery were included. Neonatal anthropometry and cord blood ferritin along with maternal hemoglobin and ferritin was measured. The maternal pre-pregnancy body mass index (BMI) and weight gain in pregnancy were calculated using documented pre-pregnancy weight, height, and present weight. ResultsThe average birth weight was 2.6 kg. (95% CI, SD = 0.5). Fifty-eight percent of babies were appropriate for gestational age(AGA). The number of AGA babies born to mothers who had weight gain 7 kg, and above was significantly higher.[Correlation:0.41,p = 0.0001]. Nine babies had depleted iron stores, three babies being small for gestational age(SGA). (RR:0.77,95% CI = 0.29–2.05,p = 0.72).Thirty-four percent mothers were anemic who had higher chance of having SGA babies.[RR = 1.47,95% CI 0.91–2.38,p = 0.12].Thirteen mothers had low ferritin levels and 5 of them had SGA babies[RR = 1.51,95% CI = 0.68–3.4,p = 0.33]. Fifty mothers had pre-pregnancy BMI <18.5, out of which 19 had SGA babies. [RR:0.80,95% CI = 0.49–1.31,p = 0.38]. ConclusionAdequate weight gain in pregnancy can help achieve desired fetal growth in malnourished and anemic mothers.

Length of labour in mothers and their daughters: A matched cohort study

ObjectivePhysiological length of labour is highly variable and population norms have low sensitivity and specificity for individuals. The birth history of mothers may provide a basis for personalized assessment of labour progress in their nulliparous daughters. This study was designed to investigate the relationship between length of labour in nulliparous daughters and in their mother's first birth, as a basis for constructing individualised labour prediction models in future. Study designA mother-daughter matched cohort study was conducted in two Israeli maternity hospitals. Recruitment took place between September 2014 and June 2015 via antenatal clinics. Inclusion criteria were nulliparous daughters with singleton pregnancies at ≥32 weeks' gestation and mothers of included daughters who had a first birth in hospital prior to 1997. Data were collected prospectively for daughters by questionnaire and from electronic hospital records, and through retrospective recall questionnaires for mothers. Mother-daughter length of labour data were analysed using parametric and non-parametric tests and logistic regression. Length of labour was categorized as ≤10 h and >10 h. Other factors influencing daughters' length of labour were also examined. ResultsData from 323 mother-daughter pairs were analysed. Univariate logistic regression analysis showed that daughters of mothers who were in active labour for more than 10 h showed increased likelihood of having a longer labour [OR1.91 (95 % CI 1.19, 3.05, P = 0.007)]. Controlling for infant gender increased the effect size [OR3.23 (95 % CI 1.55, 6.74, P = 0.002)]. Multivariable logistic regression indicated that mothers' length of labour [OR1.88 (95 % CI 1.12, 3.17)] and daughters' age [OR1.08 (95 % CI 1.02, 1.14)], weight gain in pregnancy [OR1.10 (95 % CI 1.04, 1.16)] and use of anesthesia, were statistically significant factors for daughters' length of labour, with sensitivity, specificity, and positive and negative predictive values of 74 %, 56 %, 66 %, and 64 %, respectively. ConclusionsA strong positive association between mother and daughter lengths of labour was found. A model that includes length of labour in their mother's first birth might be useful for labour progress prediction for nulliparous women. Practitioners could inquire about maternal first birth patterns as an additional heuristic to guide practice and increase precision in the clinical management of nullipara women's labour and delivery.

Psychological Distress and Weight Gain in Pregnancy: a Population-Based Study

BackgroundPsychological distress and inappropriate or excessive weight gain are common in pregnancy and are associated with adverse maternal and offspring outcomes. Psychological well-being and weight status of women during pregnancy might be interrelated. We aimed to examine whether psychological distress during pregnancy is associated with gestational weight gain.MethodIn a population-based cohort of 3393 pregnant women, information about psychological distress, depressive and anxiety symptoms was assessed at 20 weeks of gestation using the Brief Symptom Inventory questionnaire. Weight was repeatedly measured during pregnancy and obtained by questionnaire before and after pregnancy. Linear regression and multinomial logistic regression models were used. Weight gain in the second half of pregnancy, total weight gain, and the risks of inadequate and excessive total weight gain were the main outcome measures.ResultsIn total, 7.0% of all women experienced psychological distress. Overall psychological distress and anxiety were associated with lower weight gain in the second half of pregnancy (differences − 1.00 kg (95% confidence interval (CI) − 1.62, − 0.37) and − 0.68 kg (95% CI - 1.24, -0.11), respectively). These associations fully attenuated into non-significance after taking account for socio-demographic variables. Similar results were observed for total weight gain. Only women with anxiety symptoms had, independently of potential confounders, a lower risk of excessive weight gain (odds ratio (OR) 0.61 (95% CI 0.48, 0.91)).ConclusionsIn this large prospective cohort study, the observed associations of psychological distress with weight gain during pregnancy seem to be largely explained by common socio-demographic factors.

Obstetrics Outcome after a Nutritional Health Education Program for Pregnant Females at Zagazig University Hospitals; An Interventional Study

Background: Nutrition during pregnancy is an important element for the pregnant women and their developing fetus, they must take enough calories and nutrients to provide the essential requirements for both themselves and their fetus and to prevent complications of abnormal weight gain in pregnancy. Objectives: To determine the effect of the nutritional health education program on changing knowledge, attitude, and practice towards a healthy lifestyle during pregnancy, obtaining optimal weight gain and consequently its effect on maternal and fetal outcomes. Subjects and Methods: An interventional study (pre-post test), in Zagazig university antenatal care outpatient clinic was conducted. Subjects' Criteria: 135 pregnant females in the first trimester aged 18-35 years who did not have any chronic medical disorder with Body Mass Index between 18.5 and 24.9 kg/m2 were enrolled. Methods: Data collection was done using a semi-structured questionnaire about females’ socio-demographic characteristics, obstetric, family and clinical history. Health education sessions were applied to the pregnant females and their knowledge, attitude, and practice about healthy nutrition were assessed before and after the intervention. Ultrasound was performed, maternal and fetal outcomes were detected. Results: This study was conducted on 135 pregnant females from whom 9 cases had excluded at the time of delivery due to the detection of ultrasound abnormalities and 16 women were dropped out during the follow-up period. After the nutritional education program, the proportions of adequate knowledge, attitude, and practice were increased from (28.2% to 77.3%), (8.2% to 75.5%) and (32.7% to 77.3%) respectively (p-value &lt;0.001). There was a statistically significant higher cesarean section, Intra and post-partum complications (85.7%vs 42.9%p&lt;0.001), (71.4% vs17.2% p&lt;0.001) and (25.7%vs7.1% p=0.008) [Odds (95% C.I); 8 (6.7-11.3), 12.1(11.7-13.9) and 4.5(1.2-8.7)], higher neonatal weight and neonatal blood glucose (p&lt;0.001&amp; 0.009) in over-weight versus optimal weight gain groups respectively. Conclusion: The intervention was effective in increasing pregnant females’ knowledge, attitude, and practice towards healthy nutrition during pregnancy, obtaining optimal weight gain and improving maternal and fetal outcomes.

Prevalence of rectovaginal colonization by group B Streptococcus in pregnant women seen at prenatal care program of a health organization.

ABSTRACTObjectiveTo evaluate the prevalence of group B Streptococci in pregnant women of a corporate health program, as well as the epidemiological correlations.MethodsThis retrospective study used medical records of patients who participated of the prenatal care program at a private hospital in the city of São Paulo (SP), Brazil, from 2015 to 2016. Those who abandoned the program or had incomplete data in their medical records were excluded. Quantitative variables were described by means, standard deviations, median, minimal and maximal values. Parity and socioeconomic status were described by absolute frequency and percentages. We used logistic regression models in the software (SPSS) to analyze correlations of variables according to vaginal-rectal culture, considering a 95%CI and p-values. Variables were age, number of pregnancies, weight gain in pregnancy and gestational age at delivery.ResultsA total of 347 medical records were included, and after applying the exclusion criteria, 287 medical records composed the final sample. Patients’ age ranged between 17 and 44 years. Mean age was 30.6 years, 67 patients had positive result for group B Streptococcus (prevalence of 23.3%; 95%CI: 18.7-28.5).ConclusionConsidering the high prevalence of group B Streptococcus in our service, the antibiotic prophylaxis strategy based on rectovaginal culture screening approach seems to be cost-effective.

Factors associated with fetal macrosomia.

ABSTRACTOBJECTIVE To evaluate the clinical factors, as well as weight gain, in a group of pregnant women, associating them with fetal macrosomia in a public institution in Antioquia, Colombia, from 2010-2017.METHODS A case-control study, using secondary information registries. Cases were defined using newborn weight of ≥ 4000g, while controls were defined as newborn weight between 3000–3999g. A proportion ratio (PR) was established to evaluate factors associated with macrosomia, and a generalized linear model (GLM) of Poisson regression with robust variance was used to evaluate the aspects that best explained macrosomia in the neonate.RESULTS 122 pregnant women participated in the study, of which 611 were cases and 61 were controls. Of the participants, 44.3% had pre-pregnancy overweight and 48.4% had excess gestational weight gain. Statistically significant differences were found between the groups in the following variables: pre-pregnancy BMI (p = 0.004), gestational weight gain (p = 0.000), gestational diabetes (p = 0.000), and type of delivery (p = 0.004). According to the regression model, a macrosomic newborn is 3.5 times more likely in women with excessive gestational weight gain (95%CI 1.78-7.18) and twice more likely in women who have gestational diabetes (95%CI 1.51-2.76). Of women with pre-pregnancy excess weight, 63% had excess gestational weight gain.CONCLUSIONS Within this cohort, pre-pregnancy BMI, excess weight gain in pregnancy, and the presence of gestational diabetes were associated with an increased risk of neonatal macrosomia. pre-pregnancy BMI and weight gain in pregnancy are modifiable risk factors that are responsive to nutrition interventions, which can minimize adverse perinatal outcomes.

Weight gain and pregnancy outcomes in overweight or obese women with twin gestations

Background While adequate weight gain in twin pregnancies with normal prepregnancy BMI has been associated with improved pregnancy outcomes, it remains unclear whether adequate weight gain in patients with overweight or obese prepregnancy BMI is associated with similarly improved pregnancy outcomes, and whether this comes at the expense of maternal health risks such as increased risk for gestational diabetes or hypertension. Objective To estimate the association between adherence to weight gain recommendations and pregnancy outcomes in overweight and obese women with twin pregnancies. Methods This is a retrospective cohort study of women with overweight (BMI 25.0–29.9 kg/m2) and obese prepregnancy BMI (≥30.0 kg/m2) and twin pregnancies delivered >24 weeks by a single MFM practice between 2005 and 2017. Baseline characteristics, weight gain patterns, and pregnancy outcomes were compared between women who met or exceeded, and who did not meet gestational weight gain requirements, as recommended by the Institute of Medicine (IOM) in 2009. Since total weight gain is also dependent on gestational age at delivery, we used weight gain per week to define adequate weight gain for overweight (0.85 lb/week) and obese (0.68 lb/week) women. Results A total of 252 overweight and obese women with twin pregnancies met inclusion criteria, 171 (67.9%) of whom met or exceeded weight gain requirements and 81 (32.1%) of whom did not. There were no differences in baseline clinical and demographic characteristics between the two groups. Women with inadequate weight gain had significantly less weight gain in each trimester, as well as less total weight gain for the whole pregnancy. Women with inadequate average gestational weight gain had significantly lower birthweights of the larger twin (2440 versus 2675 g, p = .001) and the smaller twin (2212 versus 2398 g, p = .005), higher incidence of spontaneous preterm birth <37 weeks (33.3 versus 21.1%, p = .03), higher incidence of premature rupture of membranes (24.7 versus 11.7%, p = .008), and greater likelihood of any twin birthweight < 10th percentile for gestational age (51.9 versus 35.5%, p = .01). There were no differences in the likelihood of cesarean delivery, preeclampsia, or gestational diabetes between the two groups. These results did not differ after excluding the 24 women in the cohort with excessive weight gain. Conclusions For overweight and obese women with twin gestations, meeting the IOM recommendations for weight gain in pregnancy is associated with improved pregnancy outcomes. Condensation Women with overweight or obese prepregnancy BMI in twin gestations who gain the recommended amount of weight in pregnancy have improved pregnancy outcomes.

Association of pre-pregnancy BMI and gestational weight gain with fat mass distribution and accretion during pregnancy and early postpartum: a prospective study of Albertan women

ObjectivesTo examine the patterns of fat mass gain in pregnancy and fat loss in the early postpartum period relative to women’s pre-pregnancy body mass index (BMI) and by adherence to...

Incidence and Risk Factors of Excess Gestational Weight Gain in Indian Women

&lt;p&gt;Excess Gestational Weight Gain (EGWG) increases risks of adverse obstetric outcomes, long-term obesity and metabolic disorders in mothers and children. The objective was to identify the incidence and risk factors of EGWG in the Indian context in order to develop effective preventative measures. A prospective cohort study was done to evaluate Gestational Weight Gain (GWG) in pregnant women who have completed a validated knowledge survey on GWG in 4 urban maternity tertiary centres and subsequently delivered at the same centres. Chi square test and Fisher’s exact test were used to identify risk factors associated with EGWG. 245 women completed the study. Gestational weight gain was classified as per the Institute of Medicine BMI-specific recommendations. Of the total women surveyed, 37.5% exceeded the GWG recommendation. The overweight and obese women constituted 50.2% of the entire population. In the overweight-obese category, 52% of women exceeded GWG recommendations. Risk factors for EGWG were high pre-pregnancy BMI (P&amp;lt;0.001), underestimation of pre-pregnancy weight category (P=0.003) and overestimation of GWG recommendations (P&amp;lt;0.001). In overweight-obese women, primiparity also increased risk of EGWG (P=0.04). Maternal age, education and perception of EGWG associated risks did not influence GWG. Ensuring women begin their pregnancies at a normal weight and provision of individualised GWG related counselling, either pre-conception or in the early stages of pregnancy may help foster appropriate weight gain in pregnancy. A modification in the current model of care involving detailed screening and nutritional counselling at the first visit itself could ensure effectiveness.&lt;/p&gt;

"Baby Wants Tacos": Analysis of Health-Related Facebook Posts from Young Pregnant Women.

Objectives Pregnant young women gain more weight than recommended by the National Academy of Medicine, increasing the likelihood of adverse maternal and fetal outcomes. The purpose of this study is to use online social media to understand beliefs and practices surrounding weight gain, diet and exercise during pregnancy among young women. Methods Facebook posts were mined from young women ages 16 to 24 during pregnancy who were consented from two Midwest primary care clinics serving low-income communities. Natural language processing was used to identify posts related to weight gain, exercise and diet by keyword searching. Two investigators iteratively coded the mined posts and identified major themes around health behaviors. Outcome measures included the frequency of posts and major themes regarding health behaviors during pregnancy. Results Participants (n = 43) had a mean age of 21 (SD 2.3), and the largest subgroups identified as black (49%; 26% white, 16% Hispanic, 9% other) and having graduated from high school (49%; 24% completed some high school and 24% completed at least some post-secondary education). Among the 2899 pregnancy posts analyzed, 311 were related to weight. Major themes included eating behaviors and cravings (58% of identified posts), body image (24%), the influence of family, partners and friends (14%), and the desire to exercise (4%). Conclusionsfor practice Facebook posts revealed that young women often frame their thoughts and feelings regarding weight gain in pregnancy in the context of food cravings and body image and that friends and family are important influencers to these behaviors.

The return of weighing in pregnancy: A discussion of evidence and practice

BackgroundInadequate or excessive gestational weight gain is associated with both short and long-term adverse maternal and infant health outcomes. The practice of routine maternal weight monitoring has been suggested as an effective health promotion intervention, both as a screening tool for adverse maternal and infant outcomes and as a weight management strategy for addressing gestational weight gain. DiscussionThe effectiveness of routine maternal weighing as part of maternity care has been debated for more than 30 years. The National Health and Medical Research Council of Australia have recently revised their pregnancy care clinical practice guidelines recommending maternal weight monitoring (clinician and/or self-weighing) be reintroduced into clinical practice. This paper presents a timely discussion of the topic that will contribute new insights to the debate. ConclusionWeight gain in pregnancy is complex. Evaluation of the translation, implementation, acceptability and uptake of the newly revised guidelines is warranted, given that evidence on the practice remains inconclusive. Future research exploring social ecological interventions to assist pregnant women achieve optimal gestational weight gains are suggested to expand the evidence base.

Chitotriosidase Levels in the Colostrum from Mothers of Term and Preterm Infants.

Background: Breast milk Chitotriosidase (Chit 1) shows antifungal effect and has an active role in the natural immune response against certain pathogens. The aim of this study was to compare colostrum Chit 1 levels from mothers of term and preterm infants. Materials and Methods: The study included 72 mothers of 32 preterm and 40 term infants (gestational age; 33.7 ± 1.8 vs. 39.1 ± 1.1 weeks, birth weight; 1931.7 ± 539.8 vs. 3350.9 ± 419.7 g). Breast milk samples were taken at postnatal 24-48 hours. Chit 1 level was evaluated with the quantitative calorimetric method. Results: No significant difference was determined between the term and preterm groups in terms of maternal age, education level, weight gain in pregnancy, and body mass index (BMI). The median colostrum Chit 1 level was higher in the preterm group, but the difference was not statistically significant between two groups (p = 0.43). There is no association between colostrum Chit 1 level, maternal age, gravida, BMI, infant gender, income level, and pre-eclampsia. The colostrum Chit 1 level of mothers who had weight gain exceeding the recommended limits was significantly lower than mothers with weight gain within the recommended limits in the term group (4346.2 vs. 4914.2, p = 0.021). A negative correlation was determined between the birthweight of term infants and the colostrum Chit 1 levels (p = 0.045, r = -0.319). Conclusion: Although the data need to be validated by further investigation, the observations made in this study seem to indicate that colostrum Chit-1 may have role in the protection of preterm infants.

Arcuate Uterus as an Independent Risk Factor for Adverse Pregnancy Outcomes [17B

INTRODUCTION: Mullerian anomalies are associated with adverse pregnancy outcomes. However, it is unclear if arcuate uterus, a milder abnormality, is also associated with adverse outcomes. The objective of our study is to estimate the association between arcuate uterus and adverse pregnancy outcomes using a similarly high risk control cohort. METHODS: Retrospective cohort study of women with an arcuate uterus cared for by a single maternal-fetal medicine practice from 2005 to 2018. We included all women with a singleton pregnancy and an arcuate uterus and randomly selected (3:1) patients with singleton pregnancies and no uterine anomalies from the same practice as controls. Baseline characteristics and pregnancy outcomes were compared. Chi-square test, Fisher's exact test, and Student's t-test were used, as appropriate. IRB approval was obtained. RESULTS: A total of 32 women with an arcuate uterus and 96 controls were included. There were no differences in baseline characteristics between the groups. Women with arcuate uterus had lower birthweights (2992+/-600 vs. 3238+/-560 g, p=0.037) and a higher likelihood of IUGR (25.0% vs. 9.4%, p=0.024), despite similar starting BMI and weight gain in pregnancy. There was a higher rate of malpresentation (21.9% vs. 5.2%, p=0.005), but not an overall increased risk of cesarean delivery. CONCLUSION: Having an arcuate uterus is significantly associated with lower birthweight and IUGR, as compared to high-risk controls. This suggests that arcuate uterus is itself a risk factor for poor fetal growth, as opposed to simply being a marker for a higher risk pregnancy.

Uncontrolled Eating during Pregnancy Predicts Fetal Growth: The Healthy Mom Zone Trial.

Excess maternal weight gain during pregnancy elevates infants’ risk for macrosomia and early-onset obesity. Eating behavior is also related to weight gain, but the relationship to fetal growth is unclear. We examined whether Healthy Mom Zone, an individually tailored, adaptive gestational weight gain intervention, and maternal eating behaviors affected fetal growth in pregnant women (n = 27) with a BMI > 24. At study enrollment (6–13 weeks gestation) and monthly thereafter, the Three-Factor Eating Questionnaire was completed. Ultrasounds were obtained monthly from 14–34 weeks gestation. Data were analyzed using multilevel modeling. Higher baseline levels of uncontrolled eating predicted faster rates of fetal growth in late gestation. Cognitive restraint was not associated with fetal growth, but moderated the effect of uncontrolled eating on fetal growth. Emotional eating was not associated with fetal growth. Among women with higher baseline levels of uncontrolled eating, fetuses of women in the control group grew faster and were larger in later gestation than those in the intervention group (study group × baseline uncontrolled eating × gestational week interaction, p = 0.03). This is one of the first intervention studies to use an individually tailored, adaptive design to manage weight gain in pregnancy to demonstrate potential effects on fetal growth. Results also suggest that it may be important to develop intervention content and strategies specific to pregnant women with high vs. low levels of disinhibited eating.

“You will face discrimination”: Fatness, motherhood, and the medical profession

ABSTRACT This is an autoethnographic article that explores the intersection of fatness, pregnancy, motherhood, health and diabetes, and interaction with the medical profession. The autoethnographic approach used includes both written stories and photographic narrative. There have been times when my fat body has been seen by the medical profession as barren, incapable, and excessive and also times when I didn’t know whether I could trust a medical opinion to be objective, because I inhabit a fat body. I discuss medical and cultural assumptions about a fat woman’s ability to conceive, oppressive medical policies, such as how much weight a fat woman “should” gain in pregnancy and what she “should” eat according to medical guidelines. In addition, I document the complicating factor of having diabetes and the hypermonitoring of blood sugar and “dieting” to keep a baby safe, and the return of guilt about eating “the wrong things.” I tell these stories to illuminate what the medicalization of fatness, pregnancy, and early motherhood have been like, including the effect it had on my ability to practice fat acceptance. The article is framed by both scholarly and fat activist approaches to the discussion of fat embodiment, pregnancy, childbirth, and breastfeeding, in an attempt to expose discrimination and oppression of fat women’s bodies within the medical field. I consider the question: How can a fat woman have a voice during pregnancy and into motherhood?

Commentary: Obesity and Weight Gain in Pregnancy and Postpartum: an Evidence Review of Lifestyle Interventions to Inform Maternal and Child Health Policies.

Funding for this research has been provided from the Australian Government's Medical Research Future Fund (MRFF).