Pre-pregnancy Women Research Articles

A Comparison Of Healthy Lifestyle Behaviors And Depression In Pre-Eclampsy Pregnancy

Purpose: It is thought that there is a relationship between healthy lifestyle behaviors and depression in preeclampsia, which is frequently encountered during pregnancy. Materials and Methods: This is a descriptive design study. The sample comprised 168 pregnant women, including pregnant women with preeclampsia and healthy pregnant women. The data were collected with the Descriptive Information Form, the Healthy Lifestyle Behavior Scale-II, and the Beck Depression Scale. Appropriate statistical methods were utilized in the evaluation of the study. Results: According to the results, the healthy lifestyle behaviors scale mean scores of pregnant women with preeclampsia were higher than those of healthy pregnant women. No statistically significant difference was seen between preeclampsia and healthy pregnant women in terms of the mean Beck depression scores. A negative, weak, linear relationship was found between Beck scores and healthy lifestyle behaviors scale total scores in pregnant women with. As Beck scale scores increased, healthy lifestyle behaviors scale total scores decreased. Conclusion: The mean scores of health responsibility, spiritual development, and stress management sub-scales of healthy lifestyle behaviors were higher in preeclamptic pregnant women than healthy pregnant women. It is recommended to determine women's pre-pregnancy health behaviors and explore their negative behaviors for maternal and infant health.

Environmental exposure patterns to 94 current-use pesticides in women of reproductive age who are preparing for pregnancy

Current-use pesticides (CUPs), including insecticides, fungicides, and herbicides, are extensively employed in agriculture to manage pests, diseases, and weeds. Nonetheless, their widespread application raises significant concerns regarding potential impacts on human health, particularly with reproductive health. This study focuses on exploring the landscape of CUP exposure among pre-pregnancy women. Based on a cohort study comprising 354 pre-pregnancy women of reproductive age in Beijing, China, we measured the concentrations of 94 CUPs in serum and conducted an in-depth analysis of exposure profiles, health risks, and contributing factors. The results revealed that the serum of pre-pregnancy women was contaminated with CUPs, of which the median concentrations ranged from 0.114 (fenamiphos-sulfone) to 61.2 ng/L (mefenacet). Among the 94 CUPs, 54 exhibited detection rates higher than 50 %, including 26 insecticides, 14 fungicides, and 14 herbicides. The exposure concentration profile highlighted that the insecticides contributed 56 % to the total CUP concentration percentages, with organophosphate insecticides being the primary contributors within this category (63.0 %). The average daily intake (ADI) of CUPs ranged from 2.23 to 16,432.28 ng/kg, while diflubenzuron had the highest ADI. Health risk assessments showed that exposure to a combination of total insecticides or herbicides poses a moderate risk for 15.8 % and 30.2 % of women, with mefenacet being the most significant, which showed moderate hazard in 29.4 % of participants. The overlap analysis showed that methiocarb-sulfone, diflubenzuron, and mefenacet were the dominant pesticides. In addition, maternal age, annual income level, smoking, and vitamin B12 supplementation were associated with serum CUP concentrations. Our study contributes a novel and comprehensive exposure profile of CUPs in pre-pregnancy women in northern China, providing valuable insights for evaluating the potential consequences of pre-pregnancy exposure on reproductive health. SynopsisWe provided a comprehensive exposure landscape, health effects, and influential factors of 94 current-use pesticides among pre-pregnancy women in China.

Pre-pregnancy body mass index and low birthweight: Secondary data analysis using health insurance claims data in Japan.

For women, being underweight increases their susceptibility to osteoporosis, anemia, and other conditions and affects the weight of their infants and the well-being of future generations. This study examined the association between low pre-pregnancy body mass index (BMI) and low birthweight using health insurance claims data and health checkup data, including weight measurements. We used health insurance claims data and health checkup data (JMDC, Tokyo, Japan) of women and their newborns in Japan between 2006 and 2020. We used checkup data, which included more accurate weight measurements and blood test-based diagnoses of anemia and hyperlipidemia compared to self-reported data. Maternal pre-pregnancy BMI was compared across three groups: underweight (BMI <18.5 kg/m2), normal weight (BMI 18.5-24.9 kg/m2), and overweight (BMI ≥25.0 kg/m2). The primary outcome was low birthweight (<2500 g), and secondary outcome was preterm childbirth. Logistic regression analyses were conducted to compare outcomes in the three groups by BMI. The underweight BMI group was considered as the reference group. A subgroup analysis was performed by maternal age. In total, 16 363 mothers (underweight, 3418 [21%], normal weight, 11 493 [70%], and overweight, 1452 [8.9%]) were included. The risk of primary outcome (low birthweight) was significantly lower in the normal weight group than in the underweight group (4.6% vs. 5.7%; adjusted odds ratio 0.78 [95% confidence interval: 0.65-0.96]). In the subgroup analyses, no significant differences were noted in the incidences of low birthweight and preterm childbirth between maternal age groups. Pre-pregnancy BMI was associated with an increased risk of delivering low-birthweight infant. Awareness about the importance of women's pre-pregnancy health and appropriate BMI may reduce the incidence of low birthweight.

Analysis of spinal muscular atrophy carrier screening results in 32,416 pregnant women and 7,231 prepregnant women.

Spinal muscular atrophy (SMA) is an autosomal recessive disease that is one of the most common in childhood neuromuscular disorders. Our screenings are more meaningful programs in preventing birth defects, providing a significant resource for healthcare professionals, genetic counselors, and policymakers involved in designing strategies to prevent and manage SMA. We screened 39,647 participants from 2020 to the present by quantitative real-time PCR, including 7,231 pre-pregnancy participants and 32,416 pregnancy participants, to detect the presence of SMN1 gene EX7 and EX8 deletion in the DNA samples provided by the subjects. To validate the accuracy of our findings, we also utilized the Multiplex Ligation-dependent Probe Amplification (MLPA) to confirm the reliability of screening results obtained by quantitative real-time PCR. Among the 39,647 participants who were screened, 726 participants were the carriers of SMN1. The overall carrier rate was calculated to be 1.83% (95% confidence interval: 0.86-2.8%). After undergoing screening, a total of 592 pregnancy carriers were provided with genetic counseling and only 503 of their spouses (84.97, 95% confidence interval: 82.09-87.85%) voluntarily underwent SMA screening. This study provides crucial insights into the prevalence and distribution of SMA carriers among the female population. The identification of 726 asymptomatic carriers highlights the necessity of comprehensive screening programs to identify at-risk individuals and ensure appropriate interventions are in place to minimize the impact of SMA-related conditions.

Temporal trends and educational inequalities in obesity, overweight and underweight in pre-pregnant women and their male partners: a decade (2010-2019) with no progress in Sweden.

Trends in overweight and obesity among expectant parents can provide useful information about the family environment in which children will grow up and about possible social inequalities that may be passed on to them. Therefore, we aimed to assess whether the prevalence of underweight, overweight and obesity changed over time in pre-pregnant women and their male partners in northern Sweden, and if there were any educational inequalities. This study is based on cross-sectional data from a repeated survey of the population in Västerbotten, Sweden. The study population included 18,568 pregnant women and 18,110 male partners during the period 2010-2019. Multinomial logistic regression models were fitted separately for pregnant women and male partners to assess whether the prevalence of age-adjusted underweight, normal weight, overweight and obesity had evolved between 2010 and 2019, and whether trends differed by educational level. Among women, obesity prevalence increased from 9.4% in 2010 to 11.7% in 2019. Among men, it went from 8.9 to 12.8%. Educational inequalities were sustained across the study period. In 2019, the prevalence of obesity was 7.8 percentage points (pp) (CI = 4.4-11.3) higher among women with low compared to high education. The corresponding figure for men was 6.4 pp (CI = 3.3-9.6). It is not obvious that the prevalence of obesity among parents-to-be will decrease under current dispositions. Public health policies and practice should therefore be strengthened.

Characteristics of Glucose-Lipid Metabolism in Early Pregnancy Among Overweight and Obese Women and Their Predictive Value for Gestational Diabetes Mellitus.

This study explores the link between women's pre-pregnancy overweight and obesity and glucose and lipid metabolism in their early pregnancy. It assesses how early pregnancy glucose and lipid levels predict gestational diabetes mellitus (GDM) risk, aiming to offer foundational weight management strategies for overweight and obese women to prevent GDM. This study analyzed 2172 pregnant women from 2017 to 2021 at Waitan Street Community Health Service Center, Shanghai, monitoring early pregnancy (7-10weeks) glucose and lipid levels (TG, TC, HDL-C, LDL-C, FBG, HbA1c) and 24-week OGTT values. Pre-pregnancy BMI categorized participants into overweight and obese, normal, and underweight groups. We compared early pregnancy glycemic and lipid metrics and GDM incidence across groups, examining the relationship between pre-pregnancy BMI and early pregnancy blood metrics. The overweight and obese cohort was further split into GDM and non-GDM groups, comparing early pregnancy glycolipid indicators and assessing their predictive value for GDM development. In the overweight and obese group, maternal FBG, HbA1c, TG, and LDL-C were higher, while HDL-C was lower than in normal and underweight groups (P<0.05), with a higher GDM incidence (P<0.05). Pre-pregnancy BMI positively correlated with FBG, HbA1c, TG, and LDL-C levels (r=0.556, 0.567, 0.686, 0.214; P<0.05) but not HDL-C. Each 1-unit BMI increase raised GDM risk by 0.204 times (P<0.05). FBG, TG, and LDL-C had high predictive accuracy for GDM in overweight and obese women, with AUCs of 0.991, 0.994, and 0.935, respectively. Pre-pregnancy overweight and obesity can cause early pregnancy glucose and lipid abnormalities, raising GDM risk. Early testing in such women is a strong predictor for GDM.

The Effect of Dental Health Programs in Pre-pregnancy into Low Birth Weight at Brati Public Health Center

Background: The pregnancy period is prone to various dental health conditions that can affect pregnant women’s health and cause growth and development problems for the fetus. Neglecting dental health during pregnancy causes complications at birth, including low birth weight. This study aims to determine the effect of dental health programs for pre-pregnancy women into low birth weight at Brati Public Health Center.&#x0D; Method: This research used secondary data from 80 women who participated in dental health programs for pre-pregnancy women and Antenatal Care (ANC) participants at Brati Health Center who were monitored until birth between January 2020 – June 2023. The data obtained was assessed in a questionnaire regarding the completeness of the dental health programs for pre-pregnancy women, consisting of education, examination, and dental care carried out before and after pregnancy. The data analysis used was the Mann Whitney test.&#x0D; Result: Pre-pregnancy women who completed the dental health programs had a higher average birth weight (3.095 kg) than those who did not complete the program (2.076 kg). Mann Whitney test result revealed an effect between the completeness of dental health programs on pre-pregnancy to birth weight (p=0.000).&#x0D; Conclusion The dental health programs for pre-pregnancy women affect the birth weight. Dental health programs for pre-pregnancy women should be carried out before pregnancy occurs, starting from the examination and education of the prospective bride. Collaboration between antenatal and dental health service providers is needed to increase access to dental prevention and treatment services needed by pre-pregnancy dan pregnant women.

Pre-pregnancy weight, the rate of gestational weight gain, and the risk of early gestational diabetes mellitus among women registered in a tertiary care hospital in India

BackgroundThe impact of pre-pregnancy weight and the rate of gestational weight gain (GWG) together on the risk of early GDM (< 24 weeks gestation; eGDM) has not been studied in the Indian context. We aimed to study the influence of (1) pre-pregnancy weight on the risk of eGDM diagnosed in two time intervals; and (2) in addition, the rate of GWG by 12 weeks on the risk of eGDM diagnosed in 19–24 weeks.MethodOur study utilized real-world clinical data on pregnant women routinely collected at an antenatal care clinic at a private tertiary hospital, in Pune, India. Women registering before 12 weeks of gestation (v1), with a singleton pregnancy, and having a follow-up visit between 19–24 weeks (v2) were included (n = 600). The oral glucose tolerance test was conducted universally as per Indian guidelines (DIPSI) at v1 and v2 for diagnosing eGDM. The data on the onset time of eGDM were interval censored; hence, we modeled the risk of eGDM using binomial regression to assess the influence of pre-pregnancy weight on the risk of eGDM in the two intervals. The rate of GWG by 12 weeks was added to assess its impact on the risk of eGDM diagnosed in v2.ResultOverall, 89 (14.8%) women (age 32 ± 4 years) were diagnosed with eGDM by 24 weeks, of which 59 (9.8%) were diagnosed before 12 weeks and 30 of 541 (5.5%) women were diagnosed between 19–24 weeks. Two-thirds (66%) of eGDM were diagnosed before 12 weeks of gestation. Women’s pre-pregnancy weight was positively associated with the risk of GDM in both time intervals though the lower confidence limit was below zero in v1. The rate of GWG by 12 weeks was not observed to be associated with the risk of eGDM diagnosed between 19–24 weeks of gestation. These associations were independent of age, height, and parity.ConclusionHealth workers may focus on pre-pregnancy weight, a modifiable risk factor for eGDM. A larger community-based study measuring weight and GDM status more frequently may be warranted to deepen the understanding of the role of GWG as a risk factor for GDM.

Preconception education program for non-invasive prenatal testing focused on interest in genetics among female university students in Japan: a quasi-experimental study comparing pre-intervention, post-intervention, and three-month follow-up results

BackgroundNon-invasive prenatal testing (NIPT) is offered as a reproductive choice in many countries. However, pregnant women, particularly those who are primipara or lack knowledge of prenatal testing, experience difficulties understanding adequate information and making decisions on NIPT. This study developed a preconception education program about NIPT, focusing on interest in genetics, and aimed to clarify the effectiveness of the program to help women make decisions on future NIPT.MethodsThis was a one-group, quasi-experimental, pre-post-test study. The study population was female undergraduate students in Japan who participated in the education program. This program included two games and was based on the Attention, Relevance, Confidence, and Satisfaction (ARCS) model, which is an instructional design that stimulates learning interest and motivation. The data of 73 pre-pregnant women who completed all three questionnaires—before, immediately after, and three months after the intervention—were analyzed to clarify the time effects. Moreover, all variables were analyzed using logistic regression analysis to investigate factors related to decisional conflict.ResultsInterest in genetics, knowledge of genetics and prenatal testing, and indecisive attitudes toward NIPT significantly improved immediately after the intervention, and consequently, these changes and reduction of decisional conflict were maintained at three months. Moreover, low decisional conflict at follow-up was significantly associated with a high interest in genetics (adjusted odds ratio, 3.42).ConclusionsThese findings provide preliminary evidence that this preconception education program, which focused on facilitating interest in genetics, assists pre-pregnant women to reduce decisional conflict about future NIPT.Trial registrationThe trial was registered at the UMIN-CTR registry (January 16, 2023), registration number UMIN000050047.

Increasing Knowledge, Self-Efficacy and Hemoglobin Levels in Pre-Conception Women through Nutrition Assistance Program

Anemia, which is associated with various complications during pregnancy and childbirth can be prevented, especially in pre-conception or pre-pregnancy women, by fulfilling nutrition needs. One way to achieve this is by implementing nutrition assistance programs specifically designed for pregnant women or those planning to conceive. Therefore, this study aims to examine the impact of a dietary support program on the knowledge, self-efficacy, and hemoglobin level of pre-conception women. The design used was a non-randomized controlled trial with a pretest-posttest approach, while the sample consisted of married women preparing to get pregnant, with a total of 67 people meeting the inclusion criteria. Data obtained were analyzed using the Wilcoxon Signed Ranks Test and Independent sample T-test. The results demonstrated a significant difference in knowledge levels (p=0.000), self-efficacy (p=0.000), and hemoglobin levels (p=0.000) between the intervention and control groups. Therefore, it is essential to address the readiness of pre-conception women, particularly regarding their nutrition status, to prevent potential complications that may arise during pregnancy and childbirth.&#x0D;

The comparison of effects of iron supplementation since pre-pregnant and during pregnant period on reducing iron deficiency anemia in pregnant women with mild anemia in Bali

Introduction: Iron deficiency anemia (IDA) is still a problem of pregnant women's health related to its high prevalence and its negative effects on health. Prevention efforts have been carried out through administration of oral iron tablets to women during their pregnancy; however, the expected results have not been satisfied yet. This failure is probably due to the assumption that, especially in developing countries, the iron store in pre-pregnant women is very low or may be empty, so that iron supplementation during pregnancy is not enough to prevent IDA. The aim of study is to know the difference of effect of iron supplementation in treated and control groups in terms of hemoglobin concentration, serum ferritin level and prevalence of IDA. Method: A quasi-experimental study was conducted on 99 non-pregnant new couple women. Iron tablets were administered to the treated group from the beginning of pre-pregnant period, continuing until the first 3 months of pregnancy, while in the control group iron tablets were only given during the first 3 months of pregnancy. IDA was measured by serum ferritin and hemoglobin concentration using WHO’s criteria, the benefit of iron tablet was measured by BCR technique. Result: The administration of an oral iron tablet from the prepregnant period (treated group) could decrease prevalence of IDA higher than the administration of oral iron tablet during pregnancy only (control group) (0% vs 38.46%, p&lt;0.05). A significant difference was also observed on mean serum ferritin concentration at the end of observation (the third month of pregnancy) 33.45±14.12 µg/dL in the treated group, and 19.65±8.99 µg/dL in the control group. This difference was statistically significant (p&lt;0.05). Meanwhile, the hemoglobin concentration was 12.25±1.20 g/dL in the treated group and 10.91±0.67 g/dL in the control group. This difference was also statistically significant (p&lt;0.05). Benefit analysis showed that administration of an oral iron tablet starting from pre-pregnancy is more advantageous (BCR &gt;1) compared to oral administration of iron tablet during the pregnancy period only. There were no significant differences in side effects and compliance of the patient to consume iron pills in both treated and control groups. Conclusion: The administration of oral iron tablets (iron supplementation) to pregnant women starting from pre-pregnant period results in a better effect compared to oral iron supplementation during pregnancy only. This program is feasible to be implemented in a community setting because its compliance is good.

Influence of Pre-Pregnancy Obesity on Carbohydrate and Lipid Metabolism with Selected Adipokines in the Maternal and Fetal Compartment

A higher body mass index (BMI) before pregnancy is associated with an increased risk of maternal and perinatal complications. This study aimed to analyze selected parameters of carbohydrate and lipid metabolism, including adipokines, in obese pre-pregnant women, and their influence on the birth weight of newborns. Materials and Methods: The study group (O) consisted of 34 pregnant women with higher BMI (obese) before pregnancy. The control group (C) was 27 pregnant women with target BMI and physiological pregnancy. The BMI index: body weight [kg]/(height [m]2 was assessed on the first obstetrical visit. The research material was the serum of pregnant women collected in the third trimester of pregnancy and umbilical cord blood collected immediately after delivery. Selected parameters of carbohydrate and lipid metabolism and adipokines were determined. Results: There were no statistically significant differences between the study group and the control group concerning the concentrations of insulin, glucose, VLDL, adiponectin, TNF-α, HOMA-IR, as well as LDH and cholesterol in maternal blood serum and umbilical cord blood serum. Total cholesterol and HDL in both maternal blood serum and umbilical cord blood were statistically significantly lower than those in the control group. The concentration of triglycerides (TG) and resistin in the blood serum of obese mothers were higher than those in the control group (p &lt; 0.05). However, no statistically significant differences were found between the two groups regarding the concentrations of TG and resistin in the umbilical cord blood. The concentration of LDL cholesterol in the umbilical blood serum in the obese group was statistically significantly lower than that in the control group. The concentration of leptin in maternal blood serum and umbilical cord blood serum in the study group was statistically significantly higher than that in the control group. Conclusions: Pregestational obesity does not substantially affect the basic parameters of carbohydrate metabolism in pregnant women, but it disturbs the lipid profile, which is manifested by a significant increase in triglycerides and a decrease in the level of HDL cholesterol in the serum. Preexisting obesity increases the concentration of leptin and resistin in the serum of pregnant women, which may be caused by the increased volume of adipose tissue. The concentrations of leptin and resistin in the blood of pregnant women correlate positively, and the concentrations of adiponectin and TNF-α negatively correlate with pre-pregnancy BMI values. There is a positive correlation between the concentration of leptin in the serum of umbilical cord blood and the birth weight of the newborn, which suggests that this parameter contributes to the pathomechanism of macrosomia.

Association between antibiotic exposure and adverse outcomes of children and pregnant women: evidence from an umbrella review.

Antibiotics are widely prescribed among children and pregnant women, but their safety profile is controversial. This study aimed to summarize and appraise current evidence for the potential impact of antibiotic exposure on pregnancy outcomes and children's health. PubMed, Embase, Web of Science and the Cochrane Database of Systematic Reviews were searched from inception to June 2022. Meta-analyses of any study design comparing the impact of antibiotic exposure with nonexposure among children, pregnant women and prepregnant women on adverse health outcomes of children and pregnancy were retrieved. The quality of evidence was assessed by a Measurement Tool to Assess Systematic Reviews 2 (AMSTAR2) and the Grading of Recommendations, Assessment, Development and Evaluation (GRADE). Data were reanalyzed, and the credibility of the evidence was determined. Out of 2956 studies identified, 19 articles with 39 associations were included. Totally 19 of the associations (48.72%) were statistically significant with a P value ≤ 0.05, while only six were supported by highly suggestive evidence. Children with postnatal antibiotic exposure had a higher risk of developing asthma odds ratio (OR): 1.95, 95% confidence interval (CI): 1.76-2.17, wheezing (OR: 1.81, 95% CI 1.65-1.97) and allergic rhinoconjunctivitis (OR: 1.66, 95% CI 1.51-1.83), with prediction intervals excluding the nulls. Quality assessed by both AMSTAR2 and GRADE of included meta-analyses were very low in general. Antibiotic exposure in early life was associated with children's long-term health, especially in cases of allergic diseases. Prenatal exposure might also influence children's health in some aspects but requires more high-quality evidence. Potential adverse effects of antibiotics on pregnancy outcomes were not observed in our study. Studies with higher quality and better quantification of antibiotic exposure are needed in the future.

Association of Body Mass Index for Pre-pregnant Mothers and Weight Gain during Pregnancy with the Outcome of Baby's Birth Weight

Pre-pregnancy mother's body mass index plays a role in increasing or decreasing maternal weight. Maternal body mass index is a prominent indicator for the nutritional status of pregnant women who can be at risk of increasing the occurrence of births with low birth weight babies. This study aims to analyze the relationship between pre-pregnancy body mass index and the occurrence of low birth weight babies at Abdul Moeloek General Hospital Bandar Lampung, Indonesia. This study uses an observational analytic research design with a cross sectional approach. The population in this study were all post-partum mothers who gave birth at the Abdul Moeloek Regional Hospital in Bandar Lampung and involved a sample of 79 respondents who were taken using the consecutive sampling technique. Sampling was carried out based on inclusion and exclusion criteria that met the research criteria until the desired number of samples was met. Analysis of the research data is the chi-square test and logistic regression test. The results showed that the two independent variables, namely the pre-pregnant mother's body mass index and weight gain during pregnancy, had a significant relationship to the baby's birth weight. The significance of body mass index is p-value=0.004 and the significance of weight gain during pregnancy is p-value=0.000. Thus the body mass index of pre-pregnant women and weight gain during pregnancy can affect low birth weight babies at Abdul Moeloek Hospital Bandar Lampung.

Childhood Adversity Predicts Maternal Pre-Pregnancy BMI but not Gestational Weight Gain.

Obesity and excessive weight gain during pregnancy have lasting implications for both women and infant health. Adverse childhood experiences and stressful life events have been associated with pre-pregnancy obesity and excessive gestational weight gain. However, the effect of each has been examined independently and scant work has investigated the effects of both in the same analysis. The current study examined the unique and conjoint effects of adverse childhood experiences and recent stressful life events on women's pre-pregnancy BMI and gestational weight gain. A racially and socioeconomically diverse sample of 176 pregnant women completed questionnaires and anthropometric measurements during the third trimester and two months postpartum. Maternal adverse childhood experiences were uniquely associated with pre-pregnancy BMI (β = 0.21, p = .02), but not gestational weight gain. Recent stressful life events did not uniquely predict pre-pregnancy BMI or gestational weight gain, nor did it explain the association between adverse childhood experiences and pre-pregnancy BMI. Adverse childhood experiences and recent stressful life events did not interact to predict either of the women's weight outcomes. Adverse childhood experiences have lasting unique effects on women's pre-pregnancy BMI. Obesity is related to several perinatal health issues for the mother and child, thus understanding the effects of childhood adversity on women's weight outcomes is critical. Routine screening for ACEs among women of childbearing age and pregnant women, paired with referrals and educational resources, can mitigate the deleterious effects of childhood adversity on women and infant health.

Metabolic profiling of pregnancies complicated by preeclampsia: A longitudinal study.

Preeclampsia is associated with maternal metabolic disturbances, but longitudinal studies with comprehensive metabolic profiling are lacking. We aimed to determine metabolic profiles across gestation in women who developed preeclampsia compared with women with healthy pregnancies. We also explored the respective effects of body mass index (BMI) and preeclampsia on various metabolic measures. We measured 91 metabolites by high-throughput nuclear magnetic resonance spectroscopy at four time points (visits) during pregnancy (weeks 14-16, 22-24, 30-32 and 36-38). Samples were taken from a Norwegian pregnancy cohort. We fitted a linear regression model for each metabolic measure to compare women who developed preeclampsia (n=38) and healthy controls (n=70). Among women who developed preeclampsia, 92% gave birth after 34 weeks of gestation. Compared to women with healthy pregnancies, women who developed preeclampsia had higher levels of several lipid-related metabolites at visit 1, whereas fewer differences were observed at visit 2. At visit 3, the pattern from visit 1 reappeared. At visit 4 the differences were larger in most subgroups of very-low-density lipoprotein particles, the smallest high-density lipoprotein, total lipids and triglycerides. Total fatty acids were also increased, of which monounsaturated fatty acids and saturated fatty acids showed more pronounced differences. Concentration of glycine tended to be lower in pregnancies with preeclampsia until visit 3, although this was not significant after correction for multiple testing. After adjustment for age, BMI, parity and gestational weight gain, all significant differences were attenuated at visits 1 and 2. The estimates were less affected by adjustment at visits 3 and 4. In early pregnancy, the metabolic differences between preeclamptic and healthy pregnancies were primarily driven by maternal BMI, probably representing the women's pre-pregnancy metabolic status. In early third trimester, several weeks before clinical manifestation, the differences were less influenced by BMI, indicating preeclampsia-specific changes. Near term, women with preeclampsia developed an atherogenic metabolic profile, including elevated total lipids, very-low-density lipoprotein, triglycerides, and total fatty acids.

Reducing the risk of gestational diabetes mellitus in chronic hepatitis B virus carriers via more strict control of gestational weight gain.

To explore the association between gestational weight gain (GWG) and gestational diabetes mellitus (GDM) in hepatitis B surface antigen (HBsAg) -positive women using a retrospective cohort study to provide advice on the management of GWG. Our study included 39 539 pregnant women who gave birth at the Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, China. Patients were divided into two groups: the HBsAg-negative and HBsAg-positive groups, comprising 36 500 and 3039 participants, respectively. We used univariate and multivariable logistic regression analyses to explore the association between GWG and GDM in maternal hepatitis B virus (HBV) carrier women. Being HBsAg positive and excessive GWG were independent risk factors for GDM. Excessive GWG was associated with a higher risk of GDM in HBsAg-positive women. Among pre-pregnancy women of normal weight, HBsAg-positive women with adequate GWG had a higher risk of GDM than HBsAg-negative women, whereas HBsAg-positive women with inadequate GWG had a lower risk of GDM. The optimal GWG ranges for pre-pregnancy normal-weight HBsAg-positive pregnancies might be lower than the US Institute of Medicine recommendations. HBsAg-positive women should strictly control GWG to reduce the risk of GDM.

The impact of IOM recommendations on gestational weight gain among US women: An analysis of birth records during 2011-2019.

The prevailing guidelines of the Institute of Medicine (IOM) of United States on gestational weight gain (GWG) are based on women's prepregnancy body mass index (BMI) categories. Previous research has shown that the guidelines issued in 1990 and revised in 2009 had no effect. We investigate the effectiveness of new guidelines issued in 2009 analyzing the records of all singleton births in the U.S. during 2011-2019 (34.0 million observations). We use the discontinuity in recommended guidelines at the threshold values of BMI categories in a regression discontinuity (RD) research design to investigate the effect of IOM guidelines on GWG. We also use an RD analysis in a difference in difference (DID) framework where we compare the effect on women who had any prenatal care to others who did not receive prenatal care. The naïve RD estimator predicts an effect in the expected direction at the threshold BMI values of 18.5 and 25.0 but not at 30.0. After the DID based correction, the RD analyses show that the GWG, measured in kg, drop at the BMI values of 18.5, 25.0 and 30.0 by 0.189 [CI: 0.341, 0.037], 0.085 [CI: 0.179, -0.009] and 0.200 [CI: 0.328, 0.072] respectively when the midpoint of the recommended range in kg drops by 1.5, 4.5 and 2.25. This implies a responsiveness of 12.6%, 1.9% and 8.9% respectively to changes in guidelines at these BMI values. The findings show that the national guidelines have induced some behavioral changes among US women during their pregnancy resulting in a change in GWG in the expected direction. However, the magnitude of the change has not been large compared to the expectations, implying that the existing mechanisms to implement these guidelines have not been sufficiently strong.

The Profiling of Diet and Physical Activity in Reproductive Age Women and Their Association with Body Mass Index.

Pre-pregnancy, pregnancy and postpartum are critical life stages associated with higher weight gain and obesity risk. Among these women, the sociodemographic groups at highest risk for suboptimal lifestyle behaviours and core lifestyle components associated with excess adiposity are unclear. This study sought to identify subgroups of women meeting diet/physical activity (PA) recommendations in relation to sociodemographics and assess diet/PA components associated with body mass index (BMI) across these life stages. Cross-sectional data (Australian National Nutrition and Physical Activity Survey 2011–2012) were analysed for pre-pregnancy, pregnant and postpartum women. The majority (63–95%) of women did not meet dietary or PA recommendations at all life stages. Core and discretionary food intake differed by sociodemographic factors. In pre-pregnant women, BMI was inversely associated with higher whole grain intake (β = −1.58, 95% CI −2.96, −0.21; p = 0.025) and energy from alcohol (β = −0.08, −0.14, −0.005; p = 0.035). In postpartum women, BMI was inversely associated with increased fibre (β = −0.06, 95% CI −0.11, −0.004; p = 0.034) and PA (β = −0.002, 95% CI −0.004, −0.001; p = 0.013). This highlights the need for targeting whole grains, fibre and PA to prevent obesity across life stages, addressing those most socioeconomically disadvantaged.

The associations between low abundance of Mycoplasma hominis and female fecundability: a pregnancy-planning cohort study.

ObjectiveTo explore the impact of pre-pregnancy vaginal Mycoplasma hominis (M. hominis) colonization of low abundance on female fecundability.MethodsIn total, 89 females participating in a pre-pregnancy health examination program were included, and their pregnancy outcomes were followed up for 1 year. Vaginal swabs were collected, 16S rRNA genes were sequenced, and M. hominis colonization was confirmed by qPCR. Cox models were used to estimate the fecundability odds ratio (FOR) for women with M. hominis.ResultsThe prevalence of M. hominis was 22.47% (20/89), and the abundance was relatively low (the cycle thresholds of the qPCR were all more than 25). In terms of the vaginal microbiome, the Simpson index of the positive group was significantly lower than that of the negative group (P = 0.003), which means that the microbiome diversity appeared to increase with M. hominis positivity. The relative abundance of M. hominis was negatively correlated with Lactobacillus crispatus (rho = − 0.24, P = 0.024), but positively correlated with Gardnerella vaginalis, Atopobium vaginae and Prevotella bivia (P all < 0.05). The cumulative one-year pregnancy rate for the M. hominis positive group was lower than that in the negative group (58.96% vs 66.76%, log-rank test: P = 0.029). After controlling for potential confounders, the risk of pregnancy in the M. hominis positive group was reduced by 38% when compared with the positive group (FOR = 0.62, 95% CI: 0.42–0.93).ConclusionThe vaginal colonization of M. hominis at a low level in pre-pregnant women is negatively correlated with female fecundability.Supplementary InformationThe online version contains supplementary material available at 10.1186/s12866-022-02545-7.