Normal Weight Pregnant Women Research Articles

Mechanisms of Gait Adaptation in Overweight Pregnant Women

Pregnancy is a period when a woman's body undergoes changes. The purpose of this study was to analyze the mechanisms of gait adaptation in overweight pregnant women regarding spatiotemporal gait parameters, ground reaction forces, and plantar pressure distribution. The tests were performed in 29 normal-weight pregnant women and 26 pregnant women who were overweight before pregnancy. The measurements included spatiotemporal gait parameters, in-shoe plantar pressure distribution, and ground reaction forces during gestation. The results indicate that both normal-weight and overweight pregnant women make use of the same spatiotemporal gait parameters to increase body stability and safety of movement during pregnancy. The double-step duration in the third trimester of pregnancy was higher in normal-weight and overweight pregnant women compared with in the first trimester (P < .05). A significant change in pressure amplitude was found under all anatomical parts of the foot in the third trimester (P < .05). The results also suggest a higher increase in the maximum amplitude of force in overweight pregnant women in the third trimester compared with the normal-weight group. This study suggests that both normal-weight and overweight pregnant women use different mechanisms of gait adaptation during pregnancy. In practice, understanding the biomechanical changes in women's gait can protect the musculoskeletal system during gestation.

The association of human milk oligosaccharides with glucose metabolism in overweight and obese pregnant women

Human milk oligosaccharides (HMOs) were recently found in serum of normal-weight pregnant women, with concentrations increasing from early to mid- and late pregnancy. Whether HMOs have effects on maternal metabolism is unknown. We aimed to study the presence and changes in HMOs throughout pregnancy and assess associations with maternal glucose metabolism throughout pregnancy. The study was a prospective longitudinal cohort study including 87 overweight or obese women. Blood samples were taken at 15, 24, and 32 wk of pregnancy. In serum, 4 HMOs [2'-fucosyllactose (2'FL), lactodifucotetraose (LDFT), 3'-sialyllactose (3'SL), and 3'-sialyllactosamine (3'SLN)] were measured. In linear regression models, the associations between HMOs and (changes in) maternal metabolic parameters were assessed. All 4 HMOs showed a significant increase from 15 to 32 weeks of gestation. 3'SL and 3'SLN, but not 2'FL or LDFT, at 15 wk were positively associated with (changes in) fasting glucose at 24 and 32 wk. LDFT was positively associated with (changes in) insulin and HOMA-index at 24 but not 32 wk. A model to predict the development of gestational diabetes mellitus (GDM) that included fasting glucose, prepregnancy BMI, gestational weight gain, age, parity, smoking, and history of macrosomia resulted in an area under the curve (AUC) of 0.81 (95% CI: 0.70, 0.92). Adding 3'SL to this model increased the AUC to 0.91 (95% CI: 0.84, 0.97). The sialylated HMOs 3'SL and 3'SLN were associated with fasting glucose; LDFT was associated with fasting insulin and HOMA-index. Furthermore, 3'SL was more predictive of future GDM diagnoses than was fasting glucose in early pregnancy. Causal relations are unclear and need further investigation.

Serum level of 25-hydroxyvitamin D and obesity among early pregnant women.

To assess serum 25-hydroxyvitamin D 25(OH)D level in obese pregnant Sudanese women in early pregnancy. A match case-control study was conducted in Saad Abualila Hospital (Khartoum, Sudan). The cases were obese (body mass index [BMI] ≥ 30.0 kg/m2 ) women. Controls were women with normal BMI (18.5-24.9 kg/m2 ) matched for age, parity and gestational age. The 25(OH)D level was measured using ELISA. There was no significant difference between the two groups in their age, parity or gestational age. There was no significant difference in the median (interquartile) level of the serum (25(OH)D between obese pregnant women and normal weight pregnant women (3.05 [11.100-15.937] ng/ml vs 13.05 [10.950-17.362] ng/ml, P = 0.237). There was no significant correlation between BMI and 25(OH)D level (r = -0.133, P = 0.149). There was no significant difference in the 25(OH)D level between the obese pregnant women and normal weight pregnant women in this study.

Healthy Life Trajectories Initiative: Summary of the evidence base for pregnancy‐related interventions to prevent overweight and obesity in children

This overview of systematic reviews (SRs) aimed to identify dietary and lifestyle interventions in pregnant women that reduce the prevalence of overweight, obesity, and/or risk factors thereof, in their children. Following identification of eligible SRs, a matrix of all included studies identified overlap between SRs. The most recent, comprehensive, high-quality SRs were selected for further dissagregation. We developed a Grading of Recommendations, Assessment, Development and Evaluations (GRADE)-based effectiveness matrix incorporating effect size and study quality to prioritise interventions as (1) beneficial or harmful, (2) possibly beneficial or possibly harmful, (3) no effect, (4) possibly no effect, or (5) uncertain effect. Of the 27 SRs identified, 16 SRs were excluded due to overlap. From 11 remaining SRs, five discrete interventions were ranked "beneficial" or "possibly beneficial" for reducing risk factors for childhood obesity: (1) balanced energy/protein supplements, (2) dietary counseling alone, (3) low glycemic index dietary advice, (4) diet and exercise counseling, (5) diet counseling and supervised exercise. High protein supplementation was ranked "harmful" as it increased the risk of small-for-gestational age (SGA) infants in normal-weight pregnant women. Evidence of the impact of pregnancy-related diet or lifestyle interventions, on childhood obesity was limited. Five dietary interventions, alone or in combination with exercise, showed beneficial effects on the risk factors for childhood obesity.

The Interplay Between Diet Quality and Pre-pregnancy Body Mass Index on Glycemic Parameters in Pregnancy: A Comparison of Various Diet Quality Scores (OR35-02-19)

ObjectivesNutrition in pregnancy plays an important role in maintaining glycemic control but there is no consensus on how to characterize maternal diet quality with respect to glycemic outcomes. The objective of this study is to compare the associations between 4 indices of diet quality with biomarkers of glycemic control (insulin, homeostasis model of insulin resistance (HOMA-IR)) in pregnancy, and to determine whether associations vary as a function of pre-pregnancy body mass index (pBMI). MethodsIn a prospective longitudinal study of N = 220 pregnant women, dietary intakes were assessed at 3 time points across gestation by 3 × 24h-diet recalls per assessment, from which 4 validated diet quality scores were derived: Dietary Approaches to Stop Hypertension (DASH), Alternative Healthy Eating Index for Pregnancy (AHEI-P), Mediterranean Diet Score (MDS), Dietary Inflammatory Index (DII). Fasting blood samples collected at each assessment were assayed for insulin and glucose and HOMA-IR was computed. pBMI was computed from self-reported pre-pregnancy weight and measured height. Linear regression models predicting mean pregnancy values of insulin and HOMA-IR by diet quality score and pBMI and the diet quality*pBMI interaction term were computed. ResultspBMI is strongly predictive of insulin and HOMA-IR and each diet quality score exerts similar significant main effects on glycemic parameters (Table 1). Only the DII*pBMI interaction term was significantly associated with insulin and HOMA-IR (Table 2). Figures 1A and 1B depict that the effect of DII on glycemic control is most pronounced for women with a pBMI < 25.0 Kg/m2, while levels among overweight and obese women remain relatively stable regardless of the inflammatory profile of the diet. Neither DASH, MDS or AHEI-P showed a significant effect on glycemic markers when analyzed as a function of pBMI. ConclusionsAlthough each of the examined diet quality scores may serve as crude predictors of glycemic control in pregnancy, only the DII detected significant differential effects as a function of pBMI. A more pro-inflammatory diet in normal weight pregnant women may exert a stronger influence on glycemic control compared to overweight and obese women, likely attributed to the overriding effects of excess adiposity on dysglycemia. Funding SourcesNational Institutes of Health: NICHD, NIMHD, NIMH. Supporting Tables, Images and/or Graphs▪▪▪▪

Morphometric Response of Overweight and Obese Women to Resistance Training during Pregnancy

Resistance exercise (RE) has increased in popularity among pregnant women being the third most popular activity in previously active women. However, most of the RE interventions have been focused on birth outcomes from normal weight (NW) pregnant women or in overweight or obese (OWOB) pregnant women with pregnancy-related disease. Currently, we do not know how RE can influence morphometric measures in healthy OWOB pregnant women. PURPOSE: To determine the effect of RE during pregnancy of OWOB women on maternal morphometric measures. METHODS: 33 OWOB (25-Control group (CG) vs 8-RE group (REG)) healthy, low-risk, women with a singleton pregnancy have been analyzed for this study. All women signed an informed consent and agreed to participate in the study, which involves 3-exercise protocols (aerobics, resistance and aerobics+resistance) and a CG. Participants in the REG trained 3x/week, 50min, moderate intensity for ~20 weeks using machines, free weights and swiss balls. Maternal skinfolds and anthropometric measures were collected at 16 and 36 weeks of gestation. Student t test was performed to determine differences between groups. RESULTS: Analysis does not show significant differences in most variables measured at 16 and 36weeks (p>0,05): weight16 (CG=86,9kg vs REG=85kg), weight36 (CG=96,7kg vs REG=94,1kg),percentage of body fat16 (%BF) (CG=36,2 vs REG=36,3), %BF36 (CG=37,1 vs REG=39,2), gestational weight gain (GWG) (CG=10kg vs REG=9,2kg), waist to hip ratio (WHR) at 16 (CG=0,79 vs REG=0,82). Significant differences were found in WHR36 weeks (CG=0,84 vs REG=0,77). 40% percent of the women in the CG exceeded their GWG recommendation vs 37,5% of REG women (p>0,05). Birth weight was not significantly different between groups (p>0,05): (CG=3,6kg vs REG=3,5kg). CONCLUSION: RE was not effective to prevent excessive GWG or to decrease %BF for OWOB pregnant women. The data suggest that, another exercise protocols should be evaluated between this population to test for the best efficacy. American Heart Association #15GRNT24470029

Evaluation of neonatal and obstetric outcomes according to increased or decreased body mass index of the pregnant woman

AimsThe present study aims to evaluate the neonatal obstetric outcomes from the increased or decreased body mass index of the pregnant woman. MethodsThe collection was between November 2016 and March 2017 in a public maternity hospital in the south of Brazil. Different categories of pregnant women were included according to their respective body mass indexes. ResultsThe primary endpoint analyzed was maternal overweight and neonatal outcomes. A multinomial logistic regression model was constructed and adjusted for confounding factors, established confidence interval (CI) of 95%. There were 1464 pregnant women, 69 (4.7%) underweight, 771 (52.7%) normal weight, 397 (27.1%) overweight and 227 (15.5%) obese women. The categories differed according to maternal age, marital status, gestation number (primigravida and multigesta) and abortion number for primigravidae (p < 0.01). Compared to normal-weight pregnant women, the cesarean delivery method presented a better chance for obese pregnant women, being (OR = 1,86, 95% CI 1.32–2.62) and those with a low birth weight, (OR = 2.3, 95% CI 1.67–3.15) ConclusionsThe occurrence of macrosomic newborns in overweight pregnant women was 1.82 times (95% CI 1.08–3.06) and giving birth to a large baby for gestational age was 2.18 times (95% CI 1,46-3,24) and in obese mothers, 16.8 times (95% CI 2.22–123.34). Increasing BMI above normal patterns suggests an association with increased neonatal weight.

Fetal weight estimation at term \u2013 ultrasound versus clinical examination with Leopold\u2019s manoeuvres: a prospective blinded observational study

BackgroundFetal weight estimation is of key importance in the decision-making process for obstetric planning and management. The literature is inconsistent on the accuracy of measurements with either ultrasound or clinical examination, known as Leopold’s manoeuvres, shortly before term. Maternal BMI is a confounding factor because it is associated with both the fetal weight and the accuracy of fetal weight estimation. The aim of our study was to compare the accuracy of fetal weight estimation performed with ultrasound and with clinical examination with respect to BMI.MethodsIn this prospective blinded observational study we investigated the accuracy of clinical examination as compared to ultrasound measurement in fetal weight estimation, taking the actual birth weight as the gold standard.In a cohort of all consecutive patients who presented in our department from January 2016 to May 2017 to register for delivery at ≥37 weeks, examination was done by ultrasound and Leopold’s manoeuvres to estimate fetal weight. All examiners (midwives and physicians) had about the same level of professional experience.The primary aim was to compare overall absolute error, overall absolute percent error, absolute percent error > 10% and absolute percent error > 20% for weight estimation by ultrasound and by means of Leopold’s manoeuvres versus the actual birth weight as the given gold standard, namely separately for normal weight and for overweight pregnant women.ResultsFive hundred forty-three patients were included in the data analysis. The accuracy of fetal weight estimation was significantly better with ultrasound than with Leopold’s manoeuvres in all absolute error calculations made in overweight pregnant women. For all error calculations performed in normal weight pregnant women, no statistically significant difference was seen in the accuracy of fetal weight estimation between ultrasound and Leopold’s manoeuvres.ConclusionsData from our prospective blinded observational study show a significantly better accuracy of ultrasound for fetal weight estimation in overweight pregnant women only as compared to Leopold’s manoeuvres with a significant difference in absolute error. We did not observe significantly better accuracy of ultrasound as compared to Leopold’s manoeuvres in normal weight women. Further research is needed to analyse the situation in normal weight women.

Influence of maternal obesity on the accuracy of ultrasonography birth weight prediction

Objective: The aim of the study was to investigate whether the accuracy of ultrasound estimates of fetal weight (EFW) was dependent on maternal obesity.Study design: A prospective cross-sectional study of 1064 singleton pregnant women classified according to body mass index (BMI) into two categories: normal (BMI < 25 kg/m2, n = 863) and obese (BMI ≥ 35 kg/m2, n = 201) was conducted. EFW were calculated using Hadlock’s formula, and the difference between EFW and the actual birthweight (absolute percent error) was analyzed in both groups. Spearman’s correlation was used to assess the relationship between ultrasound performance (absolute error), maternal BMI, and actual birth weight.Results: Median absolute error of sonographic EFW was 5.90 and 6.47% for the normal and obese groups, respectively (p .38). A correlation between EFW and birth weight (BW) was found in both groups, r = 0.755 (p < .001) and r = 0.753 (p < .001), respectively. The correlation between absolute error, maternal BMI, and fetal birth weight was poor.Conclusions: Maternal obesity is unrelated to the accuracy of sonographic EFW, and regardless of maternal or fetal size, ultrasound is currently an accurate method of prediction for both obese and normal weight pregnant women.

A Prospective Examination of Physical Activity Predictors in Pregnant Women with Normal Weight and Overweight/Obesity.

Scant research has examined the relationship between exercise behavior and weight status in pregnant women. A prospective study was conducted in which pregnant women (N=332) completed self-report measures at each trimester. Repeated measures multivariate analysis of covariance (controlling for race, education, and parity) examined changes in the motivational determinants of exercise over time and by weight status. Regression analyses were conducted to understand how the motivational determinants predicted exercise behavior and to examine the impact of prepregnancy weight status. A significant main effect for time was observed, with an increase in early pregnancy followed by a decrease in late pregnancy for the motivational determinants of exercise and exercise behavior. A significant main effect for weight status was observed such that normal weight pregnant women had significantly greater attitude and intention for exercise when compared with pregnant women with overweight/obesity. The primary predictors of intention were perceived behavioral control (first to second trimester) and attitude (second to third trimester). The primary predictor of exercise behavior was intention. Prepregnancy weight status provided no unique contributions. Findings from this study suggest that interventions designed to promote exercise in pregnancy should consider targeting perceived behavioral control in early pregnancy and attitude in later pregnancy. Improving exercise attitude in women with overweight or obesity may further strengthen their motivation to be active in pregnancy. Customized interventions may need to be designed to address the unique needs of women because their motivational determinants change over the course of pregnancy.

Screening and Management of Gestational Diabetes Mellitus after Bariatric Surgery.

Gestational diabetes mellitus (GDM) is a frequent medical complication during pregnancy. This is partly due to the increasing prevalence of obesity in women of childbearing age. Since bariatric surgery is currently the most successful way to achieve maintained weight loss, increasing numbers of obese women of childbearing age receive bariatric surgery. Bariatric surgery performed before pregnancy significantly reduces the risk to develop GDM but the risk is generally still higher compared to normal weight pregnant women. Women after bariatric surgery therefore still require screening for GDM. However, screening for GDM is challenging in pregnant women after bariatric surgery. The standard screening tests such as an oral glucose tolerance test are often not well tolerated and wide variations in glucose excursions make the diagnosis difficult. Capillary blood glucose measurements may currently be the most acceptable alternative for screening in pregnancy after bariatric surgery. In addition, pregnant women after bariatric surgery have an increased risk for small neonates and need careful nutritional and foetal monitoring. In this review, we address the risk to develop GDM after bariatric surgery, the challenges to screen for GDM and the management of women with GDM after bariatric surgery.

Influence of distribution of mother’s abdominal body fat on first trimester fetal growth

Objective: Fetal growth in the first trimester is estimated by measuring the crown to rump length of the fetus (CRL). There are no data on the relation between fetal growth and fat distribution in pregnant women. The objective was to investigate the influence of fat distribution in pregnant women on fetal growth in the first trimester of pregnancy.Methods: This was a controlled observation using a random sampling method. Newly registered pregnant women were included in the sample during a 12–18-month period. The study included 400 pregnant women from Bjelovarsko-bilogorska County, Croatia. Participants were divided into three groups according to their pregravid BMI values, normal weight (n = 254), overweight (n = 103), and obese (n = 43). In the 12th week of pregnancy, the CRL was measured by transvaginal ultrasound. The subcutaneous and preperitoneal fat was measured by transabdominal ultrasound, using the Suzuki method. The correlation was tested by the Pearson’s coefficient, and a linear regression analysis was performed on the variables with good correlation.Results: In normal weight pregnant women, there is no correlation between the adipose tissue and fetal length, but there is a significant correlation between overweight and obese ones.Conclusion: The distribution of adipose tissue in obese and overweight pregnant women is associated with fetal length in the first trimester of pregnancy, with a stronger correlation between visceral fat and fetal length. The influence of this correlation on the overall fetal growth should be investigated by longitudinal monitoring of these variables during the entire pregnancy.

Associations between maternal physical activity and fitness during pregnancy and infant birthweight

Prenatal physical activity (PA) reduces the risk of delivering infants with a birthweight ≥4000 g among normal-weight pregnant women, but evidence on the impact of maternal cardiorespiratory fitness (CRF) on birthweight remains equivocal among overweight or obese (OW/OB) pregnant women. The purpose of this study was to evaluate the relationship between maternal prenatal PA and CRF and birthweight in OW/OB pregnant women.Data from a randomized controlled exercise intervention trial in sedentary, OW/OB pregnant women were used. Women with complete data (n = 89) on birthweight, peak oxygen consumption (at 17 weeks), and daily PA were selected for analyses. Multiple linear regression models were performed to determine the independent and joint associations of maternal PA and CRF with birthweight while adjusting for gestational age, weight gain, and group allocation.On average, participants were 32 years old, OW/OB (BMI 29.97 ± 7.14 kg/m2), unfit (VO2peak: 19.85 ± 3.35 ml O2 kg−1 min−1), and led low active lifestyles (6579.91 ± 2379.17 steps/day). Analyses showed that maternal PA (steps·day−1·month−1) (β = 0.03 g, 95% CI: -0.03, 0.08 g) and CRF (ml O2·kg−1·min−1) (β = −8.8 g, 95%CI: −42.2, 24.5 g) were neither independently nor jointly (β = 0.006 g, 95%CI: −0.005, 0.02 g) associated with birthweight.Maternal PA and CRF during pregnancy were not related to birthweight in OW/OB pregnant women. The limited variability in maternal PA and CRF and low dose of PA may explain the null findings of this study. Given the paucity of studies examining these relationships in OW/OB pregnant women, more research is warranted.

625: The intricate interface between metabolic and inflammation regulation: Placental expression of Semaphorin 3E and its receptor, PlexinD1, are associated with obesity and insulin resistance in normal pregnancy and gestational diabetes mellitus

Semaphorin 3E (Sema3E) is a novel adipokine implicated in the crosstalk between inflammation, obesity and insulin resistance. The aims of this study were to determine whether there is placental expression of Sema3E and its receptor, PlexinD1, in human placenta, and whether the expression is different in pregnancies complicated by gestational diabetes mellitus. This was a cross sectional study. Placental mRNA expression for Sema3E and its receptor, PlexinD1, was determined in two groups: 1. uncomplicated pregnant women (n=24) and 2. pregnant women with gestational diabetes mellitus (GDM) requiring insulin treatment (n=9). Non-parametric statistical methods were employed. 1. Placental mRNA expression of PlexinD1 was significantly higher in patients with GDM compared to women with normal gestation (1.32 vs. 0.82, p=0.02), but no difference was found in placental mRNA expression of Sema3E between these two groups (1.33 vs. 1.11, p=0.28); 2. In pooled analysis (normal pregnant women and patients with GDM), placental mRNA expression of both PlexinD1 and Sema3E were higher in obese versus lean/normal weight women (1.25 vs. 0.68, p=0.001; 1.43 vs. 0.98, p=0.04, respectively); 3. Among women with normal gestation, obese women had a higher placental mRNA expression of both PlexinD1 (p=0.001) and Sema3E (p=0.05) than normal weight women, while among patients with GDM, placental mRNA expression of both PlexinD1 and Sema3E (p=0.9 for both comparisons) was comparable between obese and normal weight women. The results of this study indicate that the human placenta constitutively expresses Sema3E and its high-affinity receptor, PlexinD1. Higher placental mRNA expression of PlexinD1 in patients with GDM compared to women with normal gestation, as well as higher placental mRNA expression of both PlexinD1 and Sema3E in obese compared to normal weight pregnant women, suggest that higher placental mRNA expression of PlexinD1 and Sema3E might be associated with increased insulin resistance, and that Sema3E and its receptor may be considered a regulatory mediators involved in metabolic adaptations to normal pregnancy as well as in the pathophysiology of pregnancy-related metabolic complications.

Depression and Anxiety: Lack of Associations with an Inadequate Diet in a Sample of Pregnant Women with a History of Bariatric Surgery-a Multicenter Prospective Controlled Cohort Study.

Anxiety and depression levels are higher in obese compared to those in normal weight pregnant women. The aims of this study are to examine anxiety and depression in pregnancy following bariatric surgery and to compare with obese pregnant controls considering the dietary intake of polyunsaturated fatty acids (PUFA), folate, and vitamin B12. Anxiety (State-Trait Anxiety Inventory) and depression (Edinburgh Postnatal Depression Scale) were examined in the first (T1) and third (T3) pregnancy trimester in 54 women with bariatric surgery and 25 obese. T1 and T3 dietary intake of PUFA, folate, and vitamin B12 intake was assessed using a 3-day food record. Mixed models with a compound symmetry covariance structure and regression models were applied. About half of the women with surgery had high state and trait anxiety scores (≥ 40), which did not significantly change during pregnancy. Every 10-kg postoperative weight loss was associated with an increase in T1 state and trait anxiety with respectively 2.7 and 2.3 points. A smoking woman had a 8.6-point higher state anxiety score than a non-smoking woman in T1. In T3, every additional hour of sleep was associated with a decrease in trait anxiety score with 1.59 points. Anxiety and depression scores were not associated with and could not be explained by inadequate PUFAs, folate, and vitamin B12 intakes. Anxiety scores were higher following surgery than those in untreated obesity at both time points. Pregnancy following bariatric surgery induces high levels of anxiety that are not associated with an inadequate maternal diet.

Indications of caesarean section in overweight and obese versus normal-weight pregnant women: a retrospective cohort study

Purpose: The aim of this study was to test the hypothesis that indications of c-section in overweight or obese pregnant women are different from those with normal-weight.Methods: Retrospective cohort study at University Hospital of Puerto Real (Cádiz-Spain). We compared frequency distribution of c-section indications in overweight and obese versus normal-weight. The risk of c-section by different indications was calculated as relative risk.Results: A total of 4685 births were included in the study. There are significant differences in the frequency distribution of caesarean indications among normal weight and overweight or obese women. In overweight, we found an increased risk of c-section due to previous c-section (RR: 1.73; confidence interval [CI] 95% 1.24–2.42), obstructed/non-progressive labour (RR: 1.34; CI 95% 1.03–1.75), failed induction of labour (RR: 2.38; CI 95% 1.30–4.34) and foetal distress (RR: 1.73; CI 95% 1.21–2.49). This risk was even higher in obese women: previous c-section (RR: 3.25; CI 95% 2.24–4.71), obstructed/non-progressive labour (RR: 2; CI 95% 1.45–2.77), failed induction (RR: 2.52; CI 95% 1.15–5.51) and foetal distress (RR: 2.35; CI 95% 1.51–3.65).Conclusions: The risk of caesarean section due to previous caesarean section, obstructed/non-progressive labour, failed induction of labour or foetal distress is greater in overweight and obese than in normal-weight. This increase in risk also increases progressively as maternal BMI increases.

22: ASSOCIATION BETWEEN ANTENATAL AND POSTPARTUM ANXIETY WITH WEIGHT RETENTION 1 YEAR AFTER CHILDBIRTH

Background and aims:Anxiety disorders during pregnancy are of great significance. Few studies have examined the association of psychosocial factors, particularly anxiety, with weight retention and obesity postpartum. This study is...

Quality of Life during Third Trimester of Pregnant Women with Normal Pre-pregnant Weight and Obese Pre-pregnant Women by Asia-specific BMI Criteria

Objective : To compare quality of life between pre-pregnant normal weight and obese women during third trimester of pregnancy in Phramongkutklao Hospital. Method : This is a cross-sectional study. Pregnant women during third trimester who seek for antenatal care (ANC) at Phramongkutklao Hospital from August 2014 to March 2015 were enrolled to this research by convenience selection. The participants were classified into 2 groups, normal pre-pregnant weight (105 persons) and obese pregnant women (105 persons). All participants was reviewed demographic data, obstetrical and gynecologic history from and ANC record form and a self-administered SF-12 questionnaire was done. Higher score means better quality of life and each group were compared in both physiological and mental component, including 8 dimensions. Results : Median pre-pregnant BMI of normal pregnant women is 20.4 kg/m 2 while obese pregnant women is 26 kg/m 2 Weight gaining between normal weight and obese pregnant women group were 13.8 and 10.7 kg, respectively. Only underlying hypertension and diabetes mellitus showed significant difference (p=0.008). Meanwhile, familial hypertension and diabetic mellitus history were found significant higher in obese pregnant than normal weight group. In physiological and mental components of both groups were not different significantly (p=0.181) but bodily pain dimension was higher in the obese women than the normal weight group significantly (p=0.044) Conclusion : In conclusion, the quality of life during third trimester of the obese pregnant women were not different from the normal weight pregnant women in both physical and mental component. But the obese pregnant women had statistically significant less quality of life only in bodily pain dimension than the normal weight women.

Breastfeeding attitude, health-related quality of life and maternal obesity among multi-ethnic pregnant women: A multi-group structural equation approach

BackgroundIdentifying the factors influencing breastfeeding attitude is significant for the implementation of effective promotion policies and counselling activities. To our best knowledge, no previous studies have modelled the relationships among breastfeeding attitude, health-related quality of life and maternal obesity among multi-ethnic pregnant women; the current study attempts to fill this research gap. ObjectivesThis study investigated the relationships among maternal characteristics, health-related quality of life and breastfeeding attitude amidst normal weight and overweight/obese pregnant women using a multi-group structural equation modelling approach. DesignExploratory cross-sectional design was used. SettingAntenatal clinics of a university-affiliated hospital ParticipantsPregnant women were invited to participate; 708 (78.8%) agreed to participate in the study. MethodsWe examined a hypothetical model on the basis of integrating the concepts of a breastfeeding decision-making model, theory of planned behaviour-based model for breastfeeding and health-related quality of life model among 708 multi-ethnic pregnant women in Singapore. The Iowa Infant Feeding Attitude Scale and Medical Outcomes Study Short Form Health Survey were used to measure breastfeeding attitude and health-related quality of life, respectively. ResultsTwo structural equation models demonstrated that better health-related quality of life, higher monthly household income, planned pregnancy and previous exclusive breastfeeding experience were significantly associated with positive breastfeeding attitude among normal and overweight/obese pregnant women. Among normal weight pregnant women, those who were older with higher educational level were more likely to have positive breastfeeding attitude. Among overweight/obese pregnant women, Chinese women with confinement nanny plan were less likely to have positive breastfeeding attitude. No significant difference existed between normal weight and overweight/obese pregnant women concerning estimates of health-related quality of life on breastfeeding attitude (Critical Ratio=−0.193). The model satisfactorily fitted the data (Incremental Fit Index=0.924, Tucker–Lewis Index=0.905, Comparative Fit Index=0.921 and Root Means Square Error of Approximation=0.025). Health-related quality of life was found to affect breastfeeding attitude in multi-ethnic pregnant women. ConclusionsThis relationship implied the importance of early culturally specific interventions to enhance health-related quality of life for improving positive breastfeeding attitude among pregnant women across different ethnic groups.

Adherence to Mediterranean Diet and Prevention of Excessive Weight Gain during Pregnancy: Study in a Cohort of Normal Weight Caucasian Women

&lt;p&gt;&lt;em&gt;This study investigated the association between &lt;/em&gt;&lt;em&gt;adherence to Mediterranean Diet (MD) and the risk of excessive Gestational Weight Gain (GWG).&lt;/em&gt;&lt;em&gt;&lt;/em&gt;&lt;/p&gt;&lt;p&gt;&lt;em&gt;Ninety five &lt;/em&gt;&lt;em&gt;Caucasian normal weight pregnant women were recruited within the 16thgestational week. &lt;/em&gt;&lt;em&gt;We evaluated the adherence to MD at recruitment (T0) and at third trimester (T1) by validated food frequency questionnaire. Adherence to MD was indicated by a score between 0 and 13. Adequate GWG was defined in according with IOM (Institute of Medicine, 2009) recommendations.&lt;/em&gt;&lt;em&gt;&lt;/em&gt;&lt;/p&gt;&lt;p&gt;&lt;em&gt;The 26.3% dropped out, then the completer participants were&lt;/em&gt;&lt;em&gt; 70 (33.2±3.5 ys, 74.3% nulliparous).&lt;/em&gt;&lt;em&gt;&lt;/em&gt;&lt;/p&gt;&lt;p&gt;&lt;em&gt;MD score at T0 was 7.2±1.5 and it did not significantly change at T1. Mean MD score between T0 and T1 was 7.3±1.3: a good adherence to MD, defined by MD score≥8, was satisfied by 27.1%. The GWG at T1 was adequate in 64.3%, while exceed in 35.7%. &lt;/em&gt;&lt;em&gt;Women with adequate GWG showed a MD score significantly higher than women with excessive GWG (MD score: 7.5±1.3 vs 6.8±1.0, p=0.02). &lt;/em&gt;&lt;/p&gt;&lt;p&gt;&lt;em&gt;A good adherence to MD&lt;/em&gt;&lt;em&gt; &lt;/em&gt;&lt;em&gt;was associated with a significantly lower risk ratio of excessive GWG (RR 0.24, 95% CI 0.1-0.9, p=0.04).&lt;/em&gt;&lt;em&gt;&lt;/em&gt;&lt;/p&gt;&lt;p&gt;&lt;em&gt;MD could be a dietary pattern able to prevent excessive GWG in normal weight women.&lt;/em&gt;&lt;em&gt;&lt;/em&gt;&lt;/p&gt;