Overweight Pregnant Women Research Articles

The effect of a period of combined exercise training on gestational weight gain in overweight pregnant women

The effect of a period of combined exercise training on gestational weight gain in overweight pregnant women

Comparison of health-promoting behaviours, eating behaviour patterns and perceived social support in normal-weight and overweight pregnant women: An unmatched case-control study.

AimThe interventions based on adopting a healthy lifestyle during pregnancy have conflicting results. This study aimed to compare health‐promoting, dietary patterns and social support in normal and overweight pregnant women.DesignAn unmatched case–control design was used.MethodsA total of 360 pregnant women were selected using multistage cluster sampling and divided into two groups of normal and overweight cases. Data were collected using demographic and obstetrics characteristics, health‐promoting lifestyle, perceived social support and eating behaviour questionnaires.ResultsThe evaluation of the health‐promoting behaviours and dietary patterns demonstrated a significant difference between the mean of total scores and their subdomains including self‐actualization, nutrition, consumption of healthy and low‐fat foods, fast food and sweets, as well as emotional eating and accidental planning. There was no significant difference between the two groups about social support.

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.

Gestational Diabetes in the Population Served by Brazilian Public Health Care. Prevalence and Risk Factors.

To assess the prevalence of gestational diabetes mellitus and the main associated risk factors in the population served by the Brazilian Unified Health System in the city of Caxias do Sul, state of Rio Grande do Sul. A descriptive, cross-sectional and retrospective study was conducted. Maternal variables were collected from the medical records of all pregnant women treated at the basic health units in 2016. Hyperglycemia during pregnancy (pregestational diabetes, overt diabetes and gestational diabetes mellitus) was identified by analyzing the results of a 75-g oral glucose tolerance test, as recommended by the Brazilian Ministry of Health. Based on the data, the women were allocated into two groups: the gestational diabetes group and the no gestational diabetes group. The estimated prevalence of gestational diabetes among 2,313 pregnant women was of 5.4% (95% confidence interval [95%CI]: 4.56-6.45). Pregnant women with 3 or more pregnancies had twice the odds of having gestational diabetes compared with primiparous women (odds ratio [OR] = 2.19; 95%CI: 1.42-3.37; p < 0.001). Pregnant women aged 35 years or older had three times the odds of having gestational diabetes when compared with younger women (OR = 3.01; 95%CI: 1.97-4.61; p < 0.001). Overweight pregnant women were 84% more likely to develop gestational diabetes than those with a body mass index lower than 25 kg/m2 (OR = 1.84; 95%CI: 1.25-2.71; p = 0.002). A multivariable regression analysis showed that being overweight and being 35 years old or older were independent variables. In this population, the prevalence of gestational diabetes mellitus was of 5.4%. Age and being overweight were predictive factors for gestational diabetes.

1132: Association of interleukin-6 and obesity across pregnancy

There is evidence that obesity is associated with a state of chronic inflammation. Interleukin-6 (IL-6) is an inflammatory mediator that has been linked to adverse pregnancy outcomes. IL-6 levels are elevated in non-pregnant obese individuals. The association between IL-6 and obesity in pregnancy has not been well established. The objective of this study was to evaluate the association between obesity and IL-6 in pregnancy across gestation. A prospective cohort study of 744 pregnant women was conducted from 2013-2015 at four US sites. Participants were ≥ 18 years old with a singleton pregnancy, English speaking without fetal anomalies or steroid use. Women with recent infection, fever, or antibiotic treatment were excluded. Participants had two blood draws during pregnancy, first between 12w0d-20w6d gestation and second between 32w0d-35w6d gestation. Pre-pregnancy body mass index (BMI) was obtained by self-report. Linear regression was used to model associations between BMI category and percent change in serum IL-6 across study visits. Models were adjusted for maternal age, parity, race, education, time between study visits, gestational age at first study visit, smoking, and study site. Among the 744 participants, 72.8% (n=545) completed both blood draws and had complete covariate information. The mean log-transformed IL-6 levels at the initial study visit were 0.16±0.08, 0.20±0.08, and 0.25±0.09 among normal weight, overweight, and obese subjects, respectively (p< 0.01). IL-6 levels generally increased across gestation in all weight categories, however obese and overweight women had a significantly lower percent change across gestation (Table 1, Figure 1). IL-6 levels are elevated in obese and overweight pregnant women compared to their normal weight counterparts. However, across gestation women with normal pre-pregnancy BMIs experience greater percent change in IL-6 levels. Future work should evaluate how change in inflammation across pregnancy mediates the relationship between obesity and adverse outcomes.View Large Image Figure ViewerDownload Hi-res image Download (PPT)

Inositol Supplementation in the Prevention of Gestational Diabetes Mellitus.

Inositol, an emerging novel therapy for the treatment of gestational diabetes mellitus (GDM), is a cyclic polyol that has insulin-like effects and plays an important role in glucose homeostasis. The conventional treatment of GDM with insulin and oral antihyperglycemic drugs usually comes with side effects, paving the way for and shedding spotlight on clinical trials involving inositol. This review analyzed a host of recent trials that involved inositol supplementation for preventing GDM and their positive outcomes in reducing the rate of GDM among obese and overweight pregnant women, as well as women with polycystic ovarian syndrome (PCOS) or a family history of type 2 diabetes mellitus.

Is maternal weight gain between pregnancies associated with risk of large-for-gestational age birth? Analysis of a UK population-based cohort

ObjectiveMaternal overweight and obesity during pregnancy increases the risk of large-for-gestational age (LGA) birth and childhood obesity. We aimed to investigate the association between maternal weight change between subsequent pregnancies...

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.

Maternal dietary glycaemic change during gestation influences insulin-related gene methylation in the placental tissue: a genome-wide methylation analysis

BackgroundStudies have shown that the effects of maternal nutrition exposure during gestation influence metabolic risk in early life through an epigenetic mechanism. Low glycaemic index (GI) diets benefit both maternal and neonatal gestational outcomes. We hypothesize that maternal dietary GI or glycaemic load (GL) changes during pregnancy impact placental DNA methylation, especially in insulin resistance-related genes.MethodsFrom a clinical trial of overweight pregnant women, 12 subjects who successfully reduced their GI and another 12 whose GI increased despite the intervention were selected. A genome-wide differential methylation analysis of placental tissue DNA was conducted, followed by bioinformatic annotation and validation analysis. The distribution of genome-wide differentially methylated regions (DMRs) and CpG sites was described. Six CpG sites in regulatory regions of four insulin-related genes (PLIN1, CPT1B, SSTR4, and CIDEA) were selectively validated by pyrosequencing. Pairwise Spearman correlation analysis was performed to test methylation–phenotype association in an additional 153 subjects from the same trial. Correlation between methylation of significant sites and placental mRNA expression of SSTR4 was also analysed.ResultsDietary GI decreased by 24.3 (26.2–20.1) in the group who responded appropriately to the intervention and increased by 19.6 (15.2–29.1) in the comparison group. Epigenome-wide analysis identified 108 DMRs and 365 CpG sites with P < 0.05 adjusted by false discovery rate, distributed over all chromosomes. The methylation level of cg05009389 in the 3′ UTR of PLIN1 was negatively correlated with maternal weight gain (ρ = − 0.21, P = 0.027) and increase in insulin levels (ρ = − 0.24, P = 0.015) during gestation. Methylation levels of cg17586860 and cg18197392 in the 5′ UTR region of SSTR4 were negatively correlated with changes in dietary carbohydrate intake (ρ = − 0.24, Ps ≤ 0.006) and GL across gestation (ρ = − 0.23, Ps ≤ .008). This correlation survived the adjustment for maternal factors such as dietary GI, body mass index, and gestational diabetes. Up to 89% of cg18197392 methylation was explained by GL change. Cg14631053 methylation correlated positively with mRNA expression of SSTR4 in the placenta (ρ = 0.20, P = 0.037).ConclusionsWe provide the first evidence that maternal dietary GI changes during gestation may impact placental DNA methylation of insulin regulation genes. This supports the hypothesis that placental methylation may be the epigenetic mechanism through which maternal diet influences the metabolic health of offspring.

Long-term effects of regular exercise during pregnancy on overweight and obese gravidas: one-year follow-up of a previous randomized controlled trial

Objective To investigate the long-term effects of regular exercise during pregnancy on overweight and obese gravidas. Methods This study was based on a previous randomized controlled trial (RCT) regarding Effect of Regular Exercise Commenced in Early Pregnancy on the Incidence of Gestational Diabetes Mellitus in Overweight and Obese Pregnant Women conducted at Peking University First Hospital from December 2014 to July 2016. Totally 265 women whose prepregnant body mass index (BMI) ≥24.0 kg/m2 were enrolled in the RCT and were randomly assigned to exercise group (n=132) and control group (n=133). This study was a follow-up of all the participants at one year after delivery from March 2016 to August 2017. Body weight, body fat, fasting and 2 h glucose level in 75 g oral glucose tolerance test (OGTT), insulin resistance index and lipid profiles were compared. We also evaluated their physical activities with International Physical Activity Questionnaire (IPAQ), their dietary habits with modified Adult Dietary Behavior Assessment Scale and depression condition with Postpartum Depression Screen Scale (PDSS). Two independent samples t-test, Mann-Whitney U test and Chi-square test were used for statistical analysis. Results The overall follow-up rate was 51.7% (137/265), while 64.4% (85/132) in the exercise group and 39.1% (52/133) in the control group. No significant difference in body weight loss [2.3 (-6.0 to 5.0) vs 1.0 (-1.3 to 4.7) kg], body fat percentage [(38.04±4.54)% vs (37.51±4.90) %], 2 h glucose level in 75 g OGTT [(7.30±2.80) vs (7.32±1.61) mmol/L], abnormal glucose tolerance ratio [30.0% (9/30) vs 28.8% (17/59)] or insulin resistance index (2.92±1.77 vs 2.86±1.92) was found between the control and exercise group (t or Z=-0.940, 0.312, 3.415, 0.005, 1.743, all P>0.05). However, the fasting blood glucose in 75 g OGTT was higher in the control group [(5.53±0.92) vs (5.28±0.43) mmol/L, t=9.268, P=0.003]. The two groups showed no significant difference (exercise group vs control group) in physical activity level [219 (99-504) vs 195 (99-351)], total score of dietary habits [79.00 (72.50-87.50) vs 76.00 (70.00-82.00)] or PDSS score of depression [55.00 (41.00-77.00) vs 70.00 (46.25-84.75)] at follow-up (Z=-0.808, -1.822, -1.620, all P>0.05). Moreover, there was no significant difference in the level of serum triglyceride [(1.25±1.04) vs (1.42±0.85) mmol/L], total cholesterol [(4.56±0.71) vs (4.40±0.67) mmol/L], high density lipoprotein-cholesterol [(1.32±0.29) vs (1.22±0.21) mmol/L] or low density lipoprotein-cholesterol [(2.67±0.56) vs (2.55±0.52) mmol/L] between the exercise and control group (t=0.001, 0.020, 3.255, 0.303, all P>0.05). Conclusions Regular exercise during pregnancy has no long-term effect on maternal health in the absence of continuing lifestyle intervention after delivery. Therefore, postpartum follow-up and continued education on healthy lifestyle should be emphasized. Key words: High body mass index; Exercise intervention; Postpartum; Long-term outcomes of mothers and offspring

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.

Lipidomics Profiles are Related to Preterm Birth and Depressive Symptoms in Pregnant African American Women

African American women have a higher preterm birth rate (PTB, birth before 37 weeks) compared to non‐Hispanic white women. Exposure to chronic stressors has been related to higher rates of PTB (Latendresse et al. 2009 &amp; Misra et al. 2010). This project is a part of a larger research study to investigate the social and biological mechanisms responsible for higher PTB and other pregnancy complications in African American women. We hypothesized that the lipidomic profiles will be related to gestational age at birth and depressive symptoms among pregnant African American women. Thirty women were recruited at the prenatal clinic site in Metropolitan Detroit. Women completed the questionnaires and plasma samples were collected between 8 to 16 weeks of gestation. The lipidomic profiles were determined by “shotgun” Orbitrap high resolution/accurate mass spectrometry. Plasma triglycerides, glycerolipids, phospholipids, sphingolipids, sterols, fatty acids, and signaling lipids were measured. The data were analyzed by multivariate analysis, Principal Component Analysis (PCA), Orthogonal Projections to Latent Structures (OPLS), and OPLS Discriminant Analysis (OPLS‐DA) using SIMCA P+ software. PCA was used to identify the outliers and patterns in the data. OPLS DA score plot showed good separation and groupings of PTB and full‐term birth. The corresponding S‐plot, loading plot, and Variable Importance for the Projection (VIP) plot/list were used to identify the lipids responsible for the groupings. We identified a panel of lipid markers of PTB. Higher levels of triglycerides species TG (53:5), TG (53:4), TG (54:5), TG (54:6), TG (52:6) and TG (52:4) and lower levels of phospholipid species PC (37:1), PC (41:6) and PC (39:3) were associated with PTB. Plasma lipidomics profiles showed a good correlation with the Center for Epidemiologic Studies Depression Scale (CES‐D) scores in the OPLS model. There was a clear separation in the OPLS DA score plot between women with CES‐D scores ≥ 23 compared to women with CES‐D scores &lt; 23. Phosphatidylcholine PC (37:1) levels were also lower among women with CES‐D scores ≥ 23 compared to women with CES‐D scores &lt; 23 pointing toward a possible connection between depressive symptoms and PTB. We also investigated the differences in lipidomics profiles based on Body Mass Index (BMI). Although the overweight pregnant women group (pre‐pregnancy BMI &gt;25 kg/m2) showed higher levels of triglycerides, there was no clear overlap with the PTB model. Our data suggest the role of specific triglycerides and phosphatidylcholines in PTB. Further investigation of the association of PTB and depressive symptoms with lipidomics profiles and phospholipid metabolism in a larger sample of pregnant African American women may lead to the identification of non‐invasive lipid biomarkers of PTB and intervention strategies for these women.Support or Funding InformationR01 MD011575, Social Stressors and Inflammation: A Mixed Methods Approach to Preterm Birth. National Institute on Minority Health and Health DisparitiesThis abstract is from the Experimental Biology 2019 Meeting. There is no full text article associated with this abstract published in The FASEB Journal.

Serum multiple cytokines for the prediction of spontaneous preterm birth in asymptomatic women: A nested case-control study

BackgroundCurrent biomarkers such as fetal fibronectin and cervical length are accurate predictors of spontaneous preterm birth (sPTB) in women with clinically suspected preterm risk; however, these are not effective for predicting the risk of sPTB in asymptomatic women. Therefore, we performed this study with the objective of determining whether the combinations of specific serum cytokines could accurately predict the sPTB risk in asymptomatic women. MethodsWe conducted a nested case-control study with 129 incident sPTB cases and 258 individually matched controls who participated in an ongoing birth cohort study. The maternal serum levels of the selected 35 cytokines were measured. We evaluated the relationship between the multiple cytokines and sPTB risk using conditional logistic regression and elastic net model. ResultsA panel of cytokines was significantly associated with an increased risk of sPTB. The odds ratio (OR) of sPTB per standard deviation (SD) increase of the predictive model score was 1.57 (95% CI 1.25–1.97) for the cytokines model. The combination of the selected serum cytokines was substantially more effective in predicting the risk for sPTB, as the receiver–operator characteristic curve (AUC) values were 0.546 and 0.559 in the single cytokine model and it improved to 0.642 in the multiple cytokines model (PAUC difference = 0.02 for TNF-α vs. multiple cytokines; PAUC difference = 0.05 for TRAIL vs. multiple cytokines). Moreover, the prediction was more accurate in overweight pregnant women, with an AUC = 0.879. ConclusionsThe current study suggested that the combination of selected serum cytokines can more effectively predict the risk of sPTB in asymptomatic women compared with the use of single cytokine.

Factors influencing the adoption of health promoting behaviors in overweight pregnant women: a qualitative study

BackgroundThe ability to adopt and implement health promotion behaviors is one of the most important determinants of health status. Various factors affect the successful changing of behaviors and choosing a healthy lifestyle. The present study aims at exploring the experiences of overweight pregnant women in terms of the factors influencing selection and adoption of health promoting behaviors during pregnancy.MethodsThis qualitative study reports the findings of individual and group in-depth interviews with 32 overweight pregnant women using semi-structured questions which was conducted in Tabriz-Iran in 2017 and lasted for 6 months. The data collection continued until the saturation of the data. Participants were selected using purposive sampling and study inclusion criteria. Interviews were recorded and transcribed. Thereafter, content analysis was made using MAXQDA v. 10. Strength of data was verified by both participants and external control.ResultsThe reported effective factors led to identification of the two themes of two contextual perceived barriers and facilitators, which were classified into four main categories and nine subcategories: 1. Individual barriers (disabilities-additional needs in pregnancy and mental barriers) 2. Socio- environmental barriers (adverse effects of the environment, adverse effects of the relatives and financial pressures) 3. Individual facilitators (intrinsic incentives, abundance and individual skills) 4. Socio- environmental (social and family support, incentive environments, and raising awareness).ConclusionThe adoption of health behaviors and healthy lifestyle is under the mutual influence of individual characteristics and socio-environmental factors. What should be considered in planning and designing interventions is focused on removing barriers and strengthening facilitators, in particular by moderating social factors and taking into account individual needs and personal expectations.

Particularities of pregnancy follow-up in obese patients

Since obesity has reached epidemic proportions even at very young ages, subsequently we notice an increased number of pregnancies in these categories of patients with higher rates of obstetrics complications such as: gestational diabetes, hypertensive disorders, and augmented rates of preterm birth and caesarean section. Maternal obesity has been proven to be associated with an increased risk of congenital malformations, including a significantly increased risk for neural tube defects, congenital heart defects, and orofacial clefts in the offspring, but despite their increased number, malformation detection rate is lower in obese patients. The screening procedures for detecting Down syndrome offered to pregnant women have changed over the last decades. Unfortunately, classical serum screening for Down syndrome testing performs worse in obese patients, the fetal fraction in maternal plasma cf-DNA being affected by maternal excessive weight. In this article, we aim to review the particularities of the available prenatal test and procedures in obese and overweight pregnant women.

The relationship between body mass index before pregnancy and the amount of weight that should be gained during pregnancy: A cross-sectional study

Objective:To investigate the adaptation of pregnant women to the recommended weight gain range according to body mass index (BMI) and to determine the factors affecting them.Methods:This cross-sectional study was performed in a university hospital’s obstetrics and gynecology unit (tertiary center) in Turkey. This study was conducted between March 2018 and August 2018 (6 months) in pregnant women. Pregnant women with chronic disease and receiving treatment during antenatal follow-up, with twin pregnancy, with a fetus with a congenital abnormality, and nutritional disturbance were excluded from the study. Eight hundred twelve pregnant women with normal antenatal follow-up and who volunteered to participate were included in the study.Results:The mean age of the participants was 27.66 ± 5.05 years. The mean weight and BMI before pregnancy were near standard in all participants. The group with the highest rate of recommended weight gain according to BMI before pregnancy was the group with low weight pregnant women. The ideal weight gain rate in all groups was 32%.Conclusions:The groups with overweight and obese pregnant women according to BMI before pregnancy had the highest rates of weight gain, above the recommended limits. BMI before pregnancy directly affects weight gain during pregnancy and the importance of pre-pregnancy counseling and weight loss is emphasized once again.

Experiences related to health promotion behaviors in overweight pregnant women: a qualitative study

BackgroundThe adoption of health behaviors by pregnant women causes their improved health and achievement of appropriate pregnancy outcomes as well as improving the quality of life of the mother and infant. Limited studies have examined such behaviors in pregnant women, especially in overweight mothers. The purpose of this study was to explore the experiences of overweight pregnant women in relation to lifestyle changes during pregnancy to improve their health.MethodsThis qualitative study was carried out with content analysis approach in Tabriz-Iran in 2017. Using purposive sampling, pregnant women with the Body Mass Index of overweight at the preconception were selected considering other inclusion criteria and the sampling was continued to saturate the findings. The data were collected by the first author through semi-structured face-to-face interviews with 32 overweight pregnant women through 18 deep individual interviews and three group interviews. The MAXQDA software version 10 was used for data analysis. Data strength was confirmed by participants and external control.ResultsMost participants were Primigravida 20 (62.5%) and with high-level education 25 (78.1%). Qualitative data analysis led to the emergence of three main themes: “physical self-care”, “mental self-care”, and “risk perception”. The first two themes present the nature of health promotion behaviors in overweight pregnant women; the third theme expresses their feelings and perception of behaviors related to health promotion.ConclusionHealth promoting behaviors include behavioral and cognitive actions resulting from a perception of the risk caused by overweight pregnant mothers. Therefore, pregnancy is the right time to evaluate behaviors and to use high motivation of women to guide them in choosing healthy behaviors and helping them to adhere to health related behaviors.

Association of serum ghrelin with weight gain during pregnancy in overweight and normal women.

Despite the fact that the ghrelin hormone plays pivotal role in the process of weight gain, its correlation with weighing during pregnancy has not been elucidated. Hence, the present study was conducted to evaluate the correlation between plasma ghrelin levels and gestational weight gain in overweight and normal women. This prospective cohort study was conducted in 27 overweight and 18 normal body mass index (BMI) pregnant women referring to Tehran health care centers. Weight gain during all trimesters of pregnancy was measured and the blood samples were collected at 8-12 (first trimester) and 16-20weeks (second trimester) of pregnancy. The plasma total ghrelin concentration was measured by ELISA method. The overweight pregnant women exhibited significantly lower weight gain at the second (p = 0.002), third trimesters (p = 0.005) as well as total weighing during pregnancy (p = 0.001) compared to the normal BMI pregnant women. There was no significant difference in plasma ghrelin levels between the groups from the first to the second trimesters of pregnancy (p > 0.05). Moreover, no correlation was found between ghrelin levels and gestational weight gain in the overweight and normal groups. Our results indicate that the increased level of serum ghrelin could not be considered as a key mediator for weight gain difference during pregnancy of overweight women.

The pattern of gestational weight gains among Chinese women: a repeated measure analysis

This study aimed to investigate the pattern of gestational weight gain (GWG) among Chinese women. We included pregnant women, who delivered at a referral medical center in China and had no pre-specified adverse pregnancy outcomes. We collected weight data across all pregnancy visits, and used the two-level spline linear model to fit for the pattern of GWG according to pre-pregnancy BMI categories. In total, 4,567 pregnant women with 47,699 repeated measures were eligible. For those who were underweight, normal and overweight before pregnancy, the interquartile ranges (25th to 75th quartiles) of GWG between 14 and 36 gestational weeks were 12.9–17.7 kg, 12.6–17.3 kg and 11.7–16.8 kg, and the corresponding rates of GWG were 2.62 kg/month, 2.56 kg/month and 2.37 kg/month. For underweight and normal women, the rates of GWG were similar before 14 weeks (0.57 and 0.58 kg/month) and after 36 weeks (1.69 and 1.70 kg/month); however, the rates of GWG were higher for overweight women (0.66 kg/month before 14 weeks and 1.89 kg/month after 36 weeks). In summary, the pattern of GWG among Chinese pregnant women is generally consistent with the IOM recommendation, particularly for those who are normal or underweight. Modifications are, however, warranted for overweight pregnant women.

The Relationship between Gestational Weight Gain and Postpartum Depression in Normal and Overweight Pregnant Women.

Objective To investigate the relationship between weight gain in pregnancy and postpartum depression (PPD) in normal and overweight pregnant women. Methods The participants of this prospective cohort study were 223 healthy pregnant women with the first trimester body mass index (BMI) between 18.5 and 30 and the gestational age of 10-14 weeks and depressed women were excluded with Beck questionnaire in the first trimester. The evaluation included weight gain at the end of the second and third trimesters and the screening of PPD in 6-8 weeks after delivery by Edinburgh scale. Results 49 participants were excluded from the study and data from 174 people were analyzed. 32.2% of mothers were scored above 12 in the Edinburgh scale. The only variable associated with depression was the third trimester weight gain (OR 1.17, 95%CI 1.04-1.32). Conclusion In addition to considering other risk factors for postpartum depression, health care providers should consider the higher probability of PPD in prepregnancy normal and overweight women who have excessive weight gain especially in the third trimester of pregnancy.