Pre-pregnancy Normal Weight Research Articles

Trimester-specific rate of gestational weight loss or gain and birth size: differences by prepregnancy BMI.

The objective of this study was to estimate the effects of trimester-specific gestational weight gain (GWG) on small and large (compared with appropriate) for gestational age (i.e., SGA, LGA, and AGA) by prepregnancy BMI classifications. We conducted a cohort study of pregnancies in a national network of community health care organizations, stratifying by prepregnancy BMI (n = 20,676 with normal weight; 19,156 with overweight; 11,647 with obesity class I; 5124 with obesity class II; and 3197 with obesity class III). SGA and LGA (vs. AGA) were modeled as a function of trimester 1, 2, or 3 GWG rate, previous trimester(s) GWG rate, and maternal characteristics using modified Poisson regression. GWG rates ranged from weight loss to substantial gains. GWG-LGA associations were strongest in trimester 1 (risk ratio [RR] range for 10th vs. 50th percentile GWG, across BMI categories: 0.60-0.73). GWG-SGA associations were strongest in lower BMI categories and in trimester 2; RRs were 1.62, 1.40, and 1.17 for prepregnancy normal weight, obesity class I, and obesity class III, respectively, with curvilinear associations for class II and III. Among people with prepregnancy obesity class II or III, GWG rate is associated with higher LGA risk in a dose-dependent manner, including understudied ranges of weight loss, but with weak associations with SGA.

PP-018 Body mass index change in pre-pregnancy normal weight women and fetal growth

PP-018 Body mass index change in pre-pregnancy normal weight women and fetal growth

Pre-pregnancy body mass index and caesarean section in Andean women in Peru: a prospective cohort study

BackgroundDuring the last two decades, Caesarean section rates (C-sections), overweight and obesity rates increased in rural Peru. We examined the association between pre-pregnancy body mass index (BMI) and C-section in the province of San Marcos, Northern Andes-Peru.MethodsThis is a prospective cohort study. Participants were women receiving antenatal care in public health establishments from February 2020 to January 2022, who were recruited and interviewed during pregnancy or shortly after childbirth. They answered a questionnaire, underwent a physical examination and gave access to their antenatal care card information. BMI was calculated using maternal height, measured by the study team and self-reported pre-pregnancy weight measured at the first antenatal care visit. For 348/965 (36%) women, weight information was completed using self-reported data collected during the cohort baseline. Information about birth was obtained from the health centre’s pregnancy surveillance system. Regression models were used to assess associations between C-section and BMI. Covariates that changed BMI estimates by at least 5% were included in the multivariable model.ResultsThis study found that 121/965 (12.5%) women gave birth by C-section. Out of 495 women with pre-pregnancy normal weight, 46 (9.3%) had C-sections. Among the 335 women with pre-pregnancy overweight, 53 (15.5%) underwent C-sections, while 23 (18.5%) of the 124 with pre-pregnancy obesity had C-sections. After adjusting for age, parity, altitude, food and participation in a cash transfer programme pre-pregnancy overweight and obesity increased the odds of C-section by more than 80% (aOR 1.82; 95% CI 1.16–2.87 and aOR 1.85; 95% CI 1.02–3.38) compared to women with a normal BMI.ConclusionsHigh pre-pregnancy BMI is associated with an increased odds of having a C-section. Furthermore, our results suggest that high BMI is a major risk factor for C-section in this population. The effect of obesity on C-section was partially mediated by the development of preeclampsia, suggesting that C-sections are being performed due to medical reasons.

Combined effects of pre-pregnancy BMI and gestational weight gain on preterm birth: comparison between spontaneous and ART conception.

Inappropriate pre-pregnancy body mass index (BMI) and gestational weight gain (GWG) are both linked to preterm birth (PTB); however, which one plays a dominant role in PTB risk is not yet sure. We aimed to evaluate the combined effect of pre-pregnancy BMI and GWG on the risk of PTB in singleton pregnancies conceived both spontaneously and through assisted reproductive technology (ART). The data included all mothers (n = 17,540,977) who had a live singleton birth from the US National Vital Statistics System (NVSS) 2015-2019. Logistic regression models, quantile-g-computation, and generalized additive model were used to analyze the combined association of pre-pregnancy BMI and GWG with PTB. The singleton PTB rate was significantly higher in ART pregnancies (11.5%) than in non-ART pregnancies (7.9%). When compared to those women with pre-pregnancy normal weight and GWG within Institute of Medicine (IOM) guidelines, the highest PTB risk was observed in non-ART women with pre-pregnancy underweight and GWG below IOM guidelines (aOR 2.56; 95% CI 2.53-2.60) and in ART women with pre-pregnancy obese and GWG below IOM guidelines (aOR 2.56; 95%CI 2.36-2.78). GWG dominated the combined effect with its joint effect coefficient of - 0.281 (P < 0.05) in non-ART women and - 0.108 (P < 0.05) in ART women. Inappropriate GWG played a dominant role in increasing the risk of PTB in both non-ART and ART populations. Counseling regarding pre-pregnancy BMI and especially GWG appears to be even more crucial for pregnancies conceived via ART, given their impact on PTB.

Gestational weight change in a diverse pregnancy cohort and mortality over 50 years: a prospective observational cohort study

High weight gain in pregnancy is associated with greater postpartum weight retention, yet long-term implications remain unknown. We aimed to assess whether gestational weight change was associated with mortality more than 50 years later. The Collaborative Perinatal Project (CPP) was a prospective US pregnancy cohort (1959-65). The CPP Mortality Linkage Study linked CPP participants to the National Death Index and Social Security Death Master File for vital status to 2016. Adjusted hazard ratios (HRs) with 95% CIs estimated associations between gestational weight gain and loss according to the 2009 National Academy of Medicine recommendations and mortality by pre-pregnancy BMI. The primary endpoint was all-cause mortality. Secondary endpoints included cardiovascular and diabetes underlying causes of mortality. Among 46 042 participants, 20 839 (45·3%) self-identified as Black and 21 287 (46·2%) as White. Median follow-up time was 52 years (IQR 45-54) and 17 901 (38·9%) participants died. For those who were underweight before pregnancy (BMI <18·5 kg/m2; 3809 [9·4%] of 40 689 before imputation for missing data]), weight change above recommendations was associated with increased cardiovascular mortality (HR 1·84 [95% CI 1·08-3·12]) but not all-cause mortality (1·14 [0·86-1·51]) or diabetes-related mortality (0·90 [0·13-6·35]). For those with a normal pre-pregnancy weight (BMI 18·5-24·9 kg/m2; 27 921 [68·6%]), weight change above recommendations was associated with increased all-cause (HR 1·09 [1·01-1·18]) and cardiovascular (1·20 [1·04-1·37]) mortality, but not diabetes-related mortality (0·95 [0·61-1·47]). For those who were overweight pre-pregnancy (BMI 25·0-29·9 kg/m2; 6251 [15·4%]), weight change above recommendations was associated with elevated all-cause (1·12 [1·01-1·24]) and diabetes-related (1·77 [1·23-2·54]) mortality, but not cardiovascular (1·12 [0·94-1·33]) mortality. For those with pre-pregnancy obesity (≥30·0 kg/m2; 2708 [6·7%]), all associations between gestational weight change and mortality had wide CIs and no meaningful relationships could be drawn. Weight change below recommended levels was associated only with a reduced diabetes-related mortality (0·62 [0·48-0·79]) in people with normal pre-pregnancy weight. This study's novel findings support the importance of achieving healthy gestational weight gain within recommendations, adding that the implications might extend beyond the pregnancy window to long-term health, including cardiovascular and diabetes-related mortality. National Institutes of Health.

1385-P: Maternal Gestational Weight Gain and Children’s Genetic Susceptibility on Childhood Adiposity—A Longitudinal Cohort Study

Few studies have assessed the association of early-life environmental and genetic factors with the risk of childhood adiposity. The aim of the present study was to investigate the interaction between maternal gestational weight gain (GWG) and children’s genetic susceptibility on childhood adiposity. The present study included 1038 mother-child pairs. Body mass index (BMI) for age Z-score (BMI-Z) and childhood overweight were evaluated according to the World Health Organization (WHO) growth reference. Genetic risk score (GRS) was established by aggregating alleles of 10 BMI susceptibility single-nucleotide polymorphisms identified from a recent study. Children born to mothers with excessive GWG had higher BMI-Z (P&amp;lt;0.001), percentage of body fat (P&amp;lt;0.001), and prevalence of overweight (28.4% vs 15.9%, P&amp;lt;0.001) than those born to mothers with adequate GWG. Children’s BMI GRS was significantly and positively associated with BMI-Z, percentage of body fat and overweight risk (all P&amp;lt;0.05). Stratified analyses showed the positive association of children’s BMI GRS with adiposity risk was especially concentrated among mothers with pre-pregnancy normal weight but excessive GWG. The present study identified an interactive effect between maternal GWG and children’s genetic susceptibility on childhood adiposity risk. The findings provided new insight into the etiology of childhood obesity and highlighted the importance of GWG management. Disclosure H.Liu: None. W.Li: None. L.Wang: None. S.Zhang: None. W.Li: None. X.Yang: None. J.Leng: None. G.Hu: None. S.Wang: None. Funding European Foundation for the Study of Diabetes/Chinese Diabetes Society/Lilly Programme for Collaborative Research between China and Europe; National Institute of Diabetes and Digestive and Kidney Diseases (R01DK100790, R01DK132011); National Institute of General Medical Sciences (U54GM104940)

Association between pre-pregnancy weight status and dietary patterns during pregnancy: results from the Japan Environment and Children's Study.

Pre-pregnancy weight status is related to offspring health and may influence dietary patterns during pregnancy. We aimed to evaluate the link between pre-pregnancy weight status and dietary patterns during pregnancy. Dietary data were collected using a FFQ during middle or late pregnancy. Dietary patterns were identified using principal component analysis. Anthropometric data were extracted from medical charts. Multiple linear regression was used to assess associations between pre-pregnancy weight status (severely or moderately underweight, mildly underweight, normal weight, overweight and obese) and dietary patterns during pregnancy after adjusting for socio-demographic characteristics. Nationwide Japan. Pregnant Japanese women enrolled in the Japan Environment and Children's Study, a prospective birth cohort study (n 90 765). We identified three dietary patterns. Compared with women with pre-pregnancy normal weight, those with pre-pregnancy obesity were less likely to habitually consume 'fruits and vegetables' pattern (coefficient, -0·18; 95 % CI, -0·21, -0·14) and 'confectionery' pattern (coefficient, -0·18; 95 % CI, -0·21, -0·14) and more likely to consume 'white rice and soy products' pattern (coefficient, 0·08; 95 % CI, 0·04, 0·11), and those with severely or moderately pre-pregnancy underweight were more likely to consume 'confectionery' pattern (coefficient, 0·06; 95 % CI, 0·03, 0·09) during pregnancy, after adjusting for confounders. We found that moderately and severely pre-pregnancy underweight women and those with obesity had unhealthy dietary patterns compared to those with pre-pregnancy normal weight. Our findings suggest that prenatal dietary advice is important and should be based on the pre-pregnancy weight status.

The investigation of the association of pregnancy weight gain on maternal and neonatal gut microbiota composition and abundance using 16sRNA sequencing

ObjectiveTo investigate the association of pregnancy weight gain on gut microbiota in pregnant women and newborns.MethodsPregnant women who had regular antenatal check-ups and were hospitalised for delivery at Shanxi Maternal and Child Health Hospital from September 2020 to December 2020 were selected as the study subjects. They were divided into the normal pre-pregnancy weight-normal pregnancy weight gain group (N-NG group), the normal pregnancy weight-excessive pregnancy weight gain group (N-EG group), the pre-pregnancy overweight/obese-normal pregnancy weight gain group (O-NG group) and the pre-pregnancy overweight/obese-excessive pregnancy weight gain group (O-EG group). Faecal samples of the pregnant women before delivery (37–41+ 6 weeks of gestation) and the first meconium samples of their newborns were collected, sequenced for 16S rRNA gut microbiota and analysed. The results of different gut microbiota were compared separately. χ2 test, a one-way analysis of variance or the rank sum test were performed according to data type and distribution. The differences in the Alpha diversity between the groups were analysed using the Kruskal–Wallis rank sum test. The differences in the Beta diversity between the groups were analysed using the Adonis method.ResultsA total of 126 pre-delivery faecal samples from pregnant women and the first faecal samples from their newborns were collected. Seven species with significant abundance differences between the maternal O-NG and N-EG groups and 27 species with significant abundance differences in the newborns were analysed by LEfSe. In the Alpha diversity analysis, the differences in the maternal observed species index and the Chao1 index were statistically significant (p < 0.05) when compared between the groups (O-EG group versus the O-NG group, N-EG group and N-NG group), and the differences in the Shannon index and Simpson index were not statistically significant (p > 0.05) when compared between the groups. The neonatal observed species index, Chao1 index, Shannon index and Simpson index showed statistically significant differences in the comparison between the N-EG and O-EG groups (p < 0.05). In the Beta diversity analysis, the maternal samples did not differ Significantly between the four groups (p > 0.05), while the neonatal samples differed Significantly between the N-EG and N-NG, O-NG, and O-EG groups (p < 0.05).ConclusionPregnancy weight gain affects the composition and abundance of maternal and neonatal gut microbiota species as well as the diversity of neonatal gut microbiota.

Effect of Gestational Weight Gain during the First Half of Pregnancy on the Incidence of GDM, Results from a Pregnant Cohort in Northern Greece.

The aim of this study was to evaluate the effect of gestational weight gain (GWG) up to 23+6 weeks of gestation on the incidence of Gestational Diabetes Mellitus (GDM). A pregnant cohort of 5948 women in Northern Greece was recruited. Anthropometric features before and during pregnancy were recorded, the GWG by 23+6 weeks was calculated and a Generalized Linear Regression Model (GLM) with subgroup analyses based on weight status were computed. GDM was diagnosed in 5.5% of women. GLM results showed that GDM likelihood increased with maternal age (MA) and pre-pregnancy BMI (aOR: 1.08, 95%CI: [1.06, 1.11] and aOR: 1.09, 95%CI: [1.09, 1.11], respectively). Ιn the normal pre-pregnancy weight group, when the extra weight gain was >8 kgs, the odds of GDM increased (OR: 2.13, 95%CI: [0.98, 4.21], p = 0.03). Women with pre-pregnancy level 2 clinical obesity (OB2 pre) (BMI > 35 and <40 kg/m2) that shifted to OB3 category (BMI ≥ 40 kg/m2) had an increased GDM likelihood (OR: 4.85, 95%CI: [1.50, 15.95]). Women of higher MA may require stricter monitoring for GDM from early pregnancy, while in obese women, recommended GWG may need to be re-evaluated, since refraining from any weight gain may have a preventive effect for GDM.

Inappropriate gestational weight gain impact on maternofetal outcomes in gestational diabetes

Objective To evaluate the association between the dimension of deviation from appropriate gestational weight gain (GWG) and adverse maternofetal outcomes in women with gestational diabetes mellitus (GDM). Methods We performed a multicentric retrospective study based on the Portuguese GDM Database. Women were classified as within GWG, insufficient (IGWG) or excessive (EGWG) than the Institute of Medicine recommendations. EGWG and IGWG were calculated for each prepregnancy BMI category. Large-for-gestational-age (LGA) and macrosomia were defined as a birthweight more than the 90th percentile for the gestational age and newborn weight greater than 4000 g, respectively. Logistic regression models (adjusted odds ratio [aOR] plus 95% confidence interval [95%CI]) were derived to evaluate the association between EGWG or IGWG and adverse maternofetal outcomes. Results A total of 18961 pregnant women were included: 39.7% with IGWG and 27.8% with EGWG. An EGWG over 3 kg was associated with a higher risk of LGA infants (aOR 1.95, 95%CI 1.17–3.26) and macrosomia (aOR 2.01, 95%CI 1.23–3.27) in prepregnancy normal weight women. An EGWG greater than 4 kg was associated with a higher risk of LGA infants (aOR 1.67, 95%CI 1.23–2.23) and macrosomia (aOR 1.90, 95%CI 1.38–2.61) in obese women. In overweight women, an EGWG above 3.5 kg was associated with a higher risk of LGA infants (aOR 1.65, 95%CI 1.16–2.34), macrosomia (aOR 1.85, 95%CI 1.30–2.64), preeclampsia (aOR 2.40, 95%CI 1.45–3.98) and pregnancy-induced hypertension (aOR 2.21, 95%CI 1.52–3.21). An IGWG below −3.1 kg or −3kg was associated with a higher risk of small-for-gestational-age [SGA] infants in women with normal (OR 1.40, 95%CI 1.03–1.90) and underweight (OR 2.29, 95%CI 1.09–4.80), respectively. Conclusions Inappropriate gestational weight gain seems to be associated with an increased risk for adverse maternofetal outcomes, regardless of prepregnancy BMI. Beyond glycemic control, weight management in women with GDM must be a focus of special attention to prevent adverse pregnancy outcomes. KEY MESSAGES The dimension of deviation from appropriate gestational weight gain was associated with an increased risk for adverse maternofetal outcomes among women with gestational diabetes. Weight management must be a focus of special attention in women with gestational diabetes to prevent adverse pregnancy outcomes.

Non-Linear and Sex-Specific Effect of Maternal Pre-Pregnancy BMI on Emotional and Behavioral Development of Preschool Children: A Population-Based Cohort Study.

(1) Background: The aim was to examine the non-linear and sex-specific outcomes of maternal pre-pregnancy BMI on emotional and behavioral development of preschool children; (2) Methods: This study was based on the China-Anhui Birth Cohort (C-ABCS), including 3648 mother–child pairs. Maternal pre-pregnancy BMI was calculated from the maternal pre-pregnancy height and weight measured at the first antenatal checkup. Main caregivers completed the Strengths and Difficulties Questionnaire (SDQ) to assess children’s preschool emotional and behavioral development. A restricted cubic spline model was drawn using Stata version 15.1 to analyze the association between maternal pre-pregnancy BMI and preschoolers’ SDQ scores by sex; (3) Results: Among boys, maternal pre-pregnancy underweight was associated with the increased risk of conduct problems and pro-social behaviors, and pre-pregnancy overweight/obesity related with the increased risk of peer problems. Interestingly, when maternal pre-pregnancy BMI was between 18.50 kg/m2 and 18.67 kg/m2, boys had the increased risk of conduct problems. When pre-pregnancy BMI was between 18.50 kg/m2 and 19.57 kg/m2, boys had the increased risk of pro-social problems. No significant associations were observed; (4) Conclusions: A non-linear effect of maternal pre-pregnancy BMI on emotional and behavioral development has been found in preschool boys. In particular, pre-pregnancy normal weight may still affect boys’ emotional and behavioral development.

Nonalcoholic Fatty Liver Disease and Adverse Pregnancy Outcomes in Women With Normal Prepregnant Weight.

Existing studies focusing on the effects of nonalcoholic fatty liver disease (NAFLD) combined with normal prepregnant weight on pregnancy outcomes are limited. This study aimed to explore the relationship between maternal NAFLD and adverse pregnancy outcomes in different body mass index (BMI) groups. Using an antenatal care and delivery database, we retrospectively analyzed women who delivered in Minhang Hospital affiliated to Fudan University, Shanghai, China from January 1, 2013, to June 30, 2020. NAFLD was confirmed by ultrasound in early pregnancy. A logistic regression model with adjustment for confounders was used to examine potential associations between NAFLD and pregnancy outcomes. A total of 14 708 pregnant women (mean prepregnant BMI 21.0 [SD, 2.8] kg/m2) were included in our final study, of whom 554 (3.8%) had NAFLD. After fully adjusting for potential confounders, NAFLD significantly increased the risk of gestational diabetes mellitus (adjusted odds ratio 2.477; 95% CI, 1.885-3.254), gestational hypertension (3.054; 2.191-4.257), preeclampsia/eclampsia (3.994; 2.591-6.005), cesarean section (1.569; 1.315-1.872), preterm births (1.831; 1.229-2.727), and macrosomia (1.691; 1.300-2.198). It is notable that 83.9% (12 338) of women were of normal weight at the start of pregnancy (prepregnant 18.5 ≤ BMI < 24 kg/m2), and they still had higher odds of adverse pregnancy outcomes. Women with NAFLD and a normal weight have a higher risk for adverse pregnancy outcomes. Pregnant women with NAFLD, regardless of obesity status, should be offered a more qualified surveillance to optimize pregnancy outcomes.

Maternal pre-pregnancy body mass index and mental health problems in early adolescents from the 2004 Pelotas birth cohort

Possible mechanisms by which maternal pre-pregnancy body mass index (BMI) programs offspring mental disorders in late childhood are not fully clarified. To assess the association between maternal BMI and mental health problems at 11 years old, we used data from the 2004 Pelotas birth cohort which comprised 4231 newborns. Maternal pre-pregnancy BMI was analyzed as underweight (< 18.5), normal (18.5–24.9), overweight (25.0–29.9), and obesity (≥ 30.0). Mental health problems were assessed at the child’s age of 11 years by the Strengths and Difficulties Questionnaire, total difficulties score and subscale scores (emotional symptoms, conduct problems, hyperactivity/inattention, and peer relationship problems), dichotomized into normal/borderline and abnormal category. The associations between maternal pre-pregnancy BMI and mental health problems in the whole sample and stratified by sex were estimated using crude and adjusted linear and logistic regression. Both linear and logistic regression showed that pre-pregnancy weight was associated with mental problems in early adolescents. Maternal pre-pregnancy obesity was associated with increased odds of total difficulty score among the whole sample. Boys whose mothers were pre-pregnancy overweight had higher odds of conduct problems (OR = 1.56; 95% CI: 1.13, 1.95), when compared to children of normal pre-pregnancy weight mothers, even after adjustments. Maternal pre-pregnancy obesity was associated with mental health problems in early adolescents; specifically, pre-pregnancy overweight increased the risk for conduct problems in 11 years old boys.

Impact of Supportive Information-Based Guidelines in Gaining the Recommended Gestational Weight among Low-risk Women: A Quasi-Experiment

Better adherence to dietary guidelines during pregnancy is supposed to result in healthier perinatal outcomes. We aimed to examine the impact of supportive information-based guidelines in gaining the recommended gestational weight among low-risk pregnant women in Egypt. The main objectives were to; 1) modify pregnant women's lifestyle behavior to achieve optimal weight gain in pregnancy, 2) add evidence to the utilization of the ACOG &amp; WHO dietary pregnancy guidelines in the antenatal care, and 3) establish clear antenatal routine care strategy for gaining an optimal gestational weight among low-risk pregnant women. The analysis included 60 first trimester primiparous pregnant women with normal pre-pregnancy weight with a BMI between 18.5 and 24.9 kg/m2. The total sample was divided into the intervention and control groups. The intervention group received an educational session; the content mainly included supportive information based on WHO dietary pregnancy guidelines and the American College of Obstetricians and Gynecologists, followed by text messages twice a week during the second and third trimesters antenatal follow-up of gestational weight. At the same time, women in the control group received standard outpatient antenatal follow-up. This study’s findings shed light on gained gestational weight in the second and third trimesters, with observable differences between both groups related to the second-trimester weight gain. Our study adds to the existing body of knowledge and fills an important gap by investigating the implementation of international guidelines in Egypt's maternal health care practice. In addition, we innovatively used a simple and cost-effective method, namely supportive information, to enhance weight gain management during pregnancy. Further studies are needed to validate the effectiveness of adopting the guidelines as a part of antenatal follow-up.

Maternal pre-pregnancy body mass index, gestational weight gain, and pubertal timing in daughters: A systematic review and meta-analysis of cohort studies.

The timing of daughter's puberty onset is constantly earlier. It is still unclear about the maternal pre-pregnancy body mass index (BMI) and gestational weight gain (GWG) as important prenatal factors that may affect offspring's onset of puberty. Thus, we evaluated the association among maternal pre-pregnancy BMI, GWG, and daughters' early pubertal development based on the existing literature. Literature review was conducted in different databases, including Web of Science, Pubmed, Wiley, ScienceDirect, Web of Science, and Chinese National Knowledge Infrastructure databases up to June 2021. We selected random effects model or fixed effects model for meta-analysis according to the I2 statistics value to obtain the summary measurement. A total of 12 cohort studies were included. Compared to maternal pre-pregnancy normal weight, maternal pre-pregnancy overall overweight/obesity (RR = 1.24; 95% CI 1.17 to 1.32), obesity (RR = 1.35; 95% CI 1.23 to 1.48), and overweight (RR = 1.17; 95% CI 1.09 to 1.26) were significantly associated with the increased risk of earlier timing of pubertal onset in daughters. Daughters born of mothers with pre-pregnancy overall overweight/obesity, obesity, and overweight had earlier pubertal onset compared to those born of mothers with normal weight ([mean difference = -3.03, 95% CI: -3.97 to -2.10], [mean difference = -3.50, 95% CI: -5.38 to -1.62], and [mean difference = -2.89, 95% CI: -4.07 to -1.71], respectively). The effects were also significant in the assessed three milestones (menarche, breast development, and pubic hair development). Maternal excessive GWG increased the risk of early pubertal timing in daughters (RR = 1.19; 95% CI 1.09 to 1.30).

The effect of gestational weight gain on serum total oxidative stress, total antioxidant capacity and gut microbiota.

This study aimed to investigate the effect of gestational weight gain on total oxidative stress (TOS), total antioxidant capacity (TAC), oxidative stress index (OSI), dietary antioxidant intake, and the gut microbiome. The study was carried out on 40 pregnant women divided as follows: a) normal prepregnancy weight and gestational weight gain of 11.5−16.0 kg (n=10) b) normal prepregnancy weight and gestational weight gain of >16.0 kg (n=10) c) obese before pregnancy and gestational weight gain of 5−9 kg (n=10) and d) obese before pregnancy and gestational weight gain of >9.0 kg (n=10). Serum TOS and TAC levels, dietary antioxidant intake, and microbiome diversity of the gut microbiome were evaluated during the third trimester of pregnancy. A positive correlation was found between body mass index (BMI) in the third trimester and serum TOS levels and OSI. In women with normal prepregnancy weight, an increase in the Firmicutes and Bacteroidetes phyla was observed when gestational weight gain was above the recommended values (p<0.05). In women who were obese before pregnancy, an increase only in the Bacteroidetes phylum was observed when gestational weight gain was above the recommended values (p<0.05). A positive correlation was found between Firmicutes/Bacteroidetes and OSI, and a negative correlation was found between Firmicutes/Bacteroidetes and dietary antioxidant intake (p<0.05). Prepregnancy body weight, high serum TOS level, and dietary antioxidant intake are determinant factors for microbial diversity, with increased serum TOS levels caused by increased gestational weight gain.

Pre-pregnancy body mass index and parent and teacher-reported behavioral outcomes among offspring in childhood

ObjectivePre-pregnancy obesity has been linked to childhood neurodevelopmental outcomes, including autism and attention-deficit hyperactivity disorder. The aim of our study was to examine the association between pre-pregnancy body mass index (BMI) and scores on behavioral scales according to both mother and teacher report. MethodsWe conducted a longitudinal study of 469 mother-child pairs. Information on pre-pregnancy body mass index (BMI) was collected from standardized maternal interviews conducted after delivery and assessment of childhood behavioral problems was measured at 5–12 years of age according to maternal-report using the Child Behavior Checklist (CBCL) and teacher-report using the Teacher Report Form (TRF). Using normal pre-pregnancy BMI (18.5–24.9 kg/m2) as the reference (n = 305), we calculated adjusted mean differences (MD) for t-scores on broadband and syndrome scales of behavior for children of mothers with pre-pregnancy overweight (n = 101) or obese (n = 63) BMI. We also examined associations with scores in the clinical range using risk ratios (RR) and compared results across informants. To account for loss to follow-up between the initial interview and the childhood behavioral assessment, we weighted models using stabilized inverse probability weights. ResultsPre-pregnancy obesity was associated with a mean increase in child's total behavior problem t-scores according to both mother and teacher report, after adjustment for confounders and weighted for loss to follow-up (MD: 0.7, 95% CI: −2.2, 3.6 on CBCL; MD: 3.1, 95% CI: 0.5, 5.7 on TRF), indicating poorer behavioral outcomes. Comparing the magnitude of associations between mother and teacher-report, mean differences for pre-pregnancy obesity and most behavioral problem scales were larger for teacher-reported outcomes than mother-reported outcomes. Pre-pregnancy obesity was associated with increased risks of externalizing behaviors in the clinical range regardless of informant (CBCL RR: 1.6, 95% CI: 0.8, 3.2 and TRF RR: 1.7, 95% CI: 0.8, 3.5). Pre-pregnancy obesity was also associated with increased risks of internalizing behaviors according to teacher-report (TRF RR: 2.6, 95% CI:1.5, 4.6). ConclusionsPre-pregnancy obesity, compared to pre-pregnancy normal weight, is associated with generally higher scores on both mother and teacher reported childhood behavioral assessments, indicating an increased likelihood of behavioral problems.

Sociodemographic determinants of prepregnancy body mass index and gestational weight gain: The Mutaba'ah study.

ObjectiveThis study examined the associations of sociodemographic and lifestyle factors with prepregnancy body mass index (BMI) and gestational weight gain (GWG).MethodsIn the Mutaba'ah Study in the United Arab Emirates, repeated measurements throughout pregnancy from medical records were used to determine prepregnancy BMI and GWG. Associations of sociodemographic and lifestyle factors with prepregnancy BMI and GWG (separately by normal weight, overweight, and obesity status) were tested using multivariable regression models, adjusted for maternal age at delivery.ResultsAmong 3536 pregnant participants, more than half had prepregnancy overweight (33.2%) or obesity (26.9%), and nearly three‐quarters had inadequate (34.2%) or excessive (38.2%) GWG. Higher parity (β for 1–2 to ≥5 children = 0.94 to 1.73 kg/m2), lower maternal education (β for tertiary = −1.42), infertility treatment (β = 0.69), and maternal prepregnancy active smoking (β = 1.95) were independently associated with higher prepregnancy BMI. Higher parity was associated with a lower risk for excessive GWG among women with prepregnancy normal weight (odds ratios (ORs) for 1–2 to ≥5 children = 0.61 to 0.39). Higher maternal education was negatively associated with inadequate GWG among women with normal weight and overweight (ORs for tertiary education = 0.75 and 0.69, respectively).ConclusionsSociodemographic factors, especially parity and maternal education, were differentially associated with prepregnancy BMI and GWG adequacy across weight status.

Gestational weight gain and the risk of gestational diabetes mellitus: A latent class trajectory analysis using birth cohort data

AimsTo explore trajectories of gestational weight gain (GWG) before diagnosis and its association with risk of gestational diabetes mellitus (GDM). MethodsA population-based retrospective cohort study including 37,060 women with live singleton was conducted between 2013 and 2019 in China. Latent class trajectory model (LCTM) was used to identify GWG trajectories, and Poisson regression with robust error estimates was used to estimate risk ratio (RR) of GDM. ResultsAmong total 37,060 participants, 25.47% of women were developed with GDM. Two trajectories of GWG were identified as non-excessive weight gain (94.31%) and excessive weight gain (5.69%) before diagnosis of GDM. Women with excessive GWG trajectory before diagnosis had significantly 32.8% (aRR = 1.328, 95 %CI: 1.252 ∼ 1.409, P < 0.001) increased risk of developing GDM compared with non-excessive GWG trajectory. Women with excessive GWG trajectory also had higher risk of macrosomia (aRR = 1.476, 95 %CI: 1.307 ∼ 1.666, P < 0.001) and cesarean delivery (aRR = 1.126, 95 %CI: 1.081 ∼ 1.174, P < 0.001). The impact of excessive GWG trajectory on GDM was greater among pre-pregnancy normal weight women compared with overweight/obese or underweight women. ConclusionWomen with excessive GWG trajectory before diagnosis had significantly higher risk of GDM and GDM-related adverse outcomes, and pre-pregnancy normal weight women with excessive GWG trajectory should also be concerned.

Maternal vitamin D intake and BMI during pregnancy in relation to child’s growth and weight status from birth to 8 years: a large national cohort study

ObjectivesTo examine the associations between maternal vitamin D intake and childhood growth and risk of overweight up to 8 years. We further examined the effect modification by maternal prepregnancy body...