Pregnancy-related Weight Research Articles

Intersecting Expectations when Expecting: Pregnancy-Related Weight Stigma in Women of Colour.

Weight stigma is a social justice issue that can lead to weight-based discrimination and mistreatment. In pregnancy, emerging evidence has highlighted that weight stigma predominantly affects individuals who have larger bodies and is associated with postpartum depression and avoidance of healthcare. Racial and ethnic background will influence perceptions of, and responses to, weight stigma and therefore it is necessary to ensure diverse voices are represented in our understanding of weight stigma. Semi-structured interviews were conducted with ten women who were within one year postpartum; nine identified as Black or African American and one as Hawaiian. Thematic analysis led to identification of three themes: (1) sources of weight stigma and their response to it, (2) support systems to overcome weight stigma, and (3) intersectional experiences. Women reported that sources of weight stigma included unsolicited comments made about their weight often coming from strangers or healthcare professionals that resulted in emotional distress. Support systems identified were family members and partners who encouraged them to not focus on negative remarks made about weight. Intersectional accounts included comparing their bodies to White women, suggesting that they may carry their weight differently. Women shared that, although they felt immense pressure to lose weight quickly postpartum, motherhood and childcare was their utmost priority. These findings inform further prospective examination of the implications of weight stigma in pregnancy among diverse populations, as well as inform inclusive public health strategies to mitigate weight stigma.

Validation of Long-term Recall of Pregnancy-related Weight in the Life-course Experiences And Pregnancy Study.

Prepregnancy body mass index (BMI) and gestational weight gain (GWG) are determinants of maternal and child health. However, many studies of these factors rely on error-prone self-reported measures. Using data from Life-course Experiences And Pregnancy (LEAP), a US-based cohort, we assessed the validity of prepregnancy BMI and GWG recalled on average 8 years postpartum against medical record data treated as alloyed gold standard ("true") values. We calculated probabilities of being classified into a self-reported prepregnancy BMI or GWG category conditional on one's true category (analogous to sensitivities and specificities) and probabilities of truly being in each prepregnancy BMI or GWG category conditional on one's self-reported category (analogous to positive and negative predictive values). There was a tendency toward under-reporting prepregnancy BMI. Self-report misclassified 32% (95% confidence interval [CI] = 19%, 48%) of those in LEAP with truly overweight and 13% (5%, 27%) with obesity into a lower BMI category. Self-report correctly predicted the truth for 72% (55%, 84%) with self-reported overweight to 100% (90%, 100%) with self-reported obesity. For GWG, both under- and over-reporting were common; self-report misclassified 32% (15%, 55%) with truly low GWG as having moderate GWG and 50% (28%, 72%) with truly high GWG as moderate or low GWG. Self-report correctly predicted the truth for 45% (25%, 67%) with self-reported high GWG to 85% (76%, 91%) with self-reported moderate GWG. Misclassification of BMI and GWG varied across maternal characteristics. Findings can be used in quantitative bias analyses to estimate bias-adjusted associations with prepregnancy BMI and GWG.

0518 Characteristics of obstructive sleep apnea among pregnant Japanese woman and their birth outcomes

Abstract Introduction Pregnant women are at an increased risk for obstructive sleep apnea (OSA) due to pregnancy-related weight gain. However, a detailed clinical study on OSA and birth outcomes among pregnant women in eastern Asia has not been conducted. This study, therefore, aimed to investigate characteristics of OSA among pregnant Japanese women and their birth outcomes. Methods Subjects were selected from pregnant women who underwent a polysomnography (PSG) during 28–36 weeks gestation at Tokyo Medical and Dental University Hospital. Diagnosis of OSA was based on sleep history and PSG with an apnea-hypopnea index (AHI) ≥ 5 (OSA+ group). Those with AHI < 5 were regarded as the OSA- group. The body height, weight, head circumference, and chest circumference of all offspring were measured at birth and 1 month of age. Data were analyzed statistically using unpaired t test and Pearson correlation and logistic regression analyses. Results Of 102 pregnant Japanese women, 13.7 % were diagnosed with OSA during the third trimester. PSG data showed significant differences in AHI between the OSA- (1.2 ± 1.0) and OSA+ (14.8 ± 16.7) groups. Moreover, there were significant differences in the oxygen desaturation index, mean and minimum SpO2, and mean and maximum heart rate between the OSA+ and OSA- groups. The logistic regression analysis revealed that AHI was associated with body mass index (OR, 1.274; p = 0.001), but not with age, gestational age, and body height, suggesting that high BMI is a risk factor for OSA in Japanese pregnant women. The Epworth sleepiness scale score was comparable between the two groups. A comparison of body weight between the pregnant mothers and their offspring showed that the maternal weight during the third trimester was negatively associated with offspring’s weight at birth and at 1 month of age in the OSA+ group. Conclusion Findings suggest that a high BMI is a major risk factor for OSA among pregnant Japanese women. Support (if any)

Internalized Weight Bias, Weight-Related Experiences, And Peripartum Weight.

The purpose of this study was to investigate internalized weight bias (IWB) and its relationship with pregnancy-related weight changes and postpartum depression. IWB is defined as the internalization of negative attitudes and beliefs about people due to their weight. Although IWB has been linked with weight change and depression in other samples, it has never been investigated in the postpartum period. We used a cross-sectional survey design. Participants were 251 women recruited via social media who were living in the United States and 6 to 12 months postpartum. We calculated percentage of body weight gained during pregnancy and percentage of that weight that was retained postpartum from self-reported weights. Participants completed self-report measures of IWB (modified version of the Weight Bias Internalization Scale) and postpartum depression (Edinburgh Postnatal Depression Scale). Gestational weight gain was not significantly associated with IWB or depression. Postpartum retention of gestational weight was significantly positively associated with both IWB and depressive symptoms. Furthermore, IWB mediated the relationship between postpartum weight retention and depressive symptoms. Postpartum retention of weight gained during pregnancy, but not weight gain itself, was related to both IWB and depressive symptoms. The relationship between pregnancy-related weight changes and psychological distress is complex. Sociocultural pressures to return to a prepregnancy physical state swiftly after giving birth may increase risk for IWB during a time in life when stress is already likely to be high, posing additional psychological risk. IWB existing prepregnancy may also worsen postpartum self-concept, contributing to depression. This is the first study, to our knowledge, to directly assess associations among gestational weight change, IWB, and postpartum depression. In addition to discussing weight in pregnancy, perinatal care providers could improve postpartum health by helping women set realistic, body-positive goals postpartum.

Performance of glycated albumin as a biomarker of hyperglycemia in pregnancy: Results from the National Health and Nutrition Examination Survey 1999–2004

AimWe sought to evaluate the performance of glycated albumin (GA) as a measure of hyperglycemia in pregnant women. MethodsWe used data from 555 pregnant women aged 20–40 years who participated in NHANES 1999–2004 and did not report a pre-pregnancy diagnosis of diabetes. We used Pearson’s correlations and evaluated the area under the curve (AUC) for GA to detect elevated concentrations of random glucose, HbA1c, or fasting glucose (subset). We compared results to 1607 nonpregnant women aged 20–40 without diabetes. ResultsIn pregnant women, 1.9 % had HbA1c ≥ 39 mmol/mol (≥5.7 %), 9.1 % had random glucose ≥ 5.3 mmol/L (≥95 mg/dL), and 10.7 % had fasting glucose ≥ 5.3 mmol/L. In pregnancy, GA was poorly correlated with HbA1c (r = 0.08) and random glucose (r = 0.17). BMI was positively associated with HbA1c (r = 0.33) and random glucose (r = 0.25) but was inversely associated with GA (r = -0.27). GA had poor discrimination for detecting hyperglycemia in pregnant women, defined as HbA1c ≥ 39 mmol/mol (AUC = 0.634) or random glucose ≥ 5.3 mmol/L (AUC = 0.628). Similar patterns were observed among nonpregnant women. ConclusionsGA is not a sensitive test to screen for hyperglycemia in pregnancy. GA was inversely associated with adiposity in pregnant women without diabetes. Pregnancy-related weight gain may complicate interpretation of repeated GA measurements.

Musculoskeletal Disorders in Pakistani Women during Pregnancy: A Population Base Study

Introduction: Changes in posture, blood physiology, weight increase, changes in musculotendinous strength, and joints and ligaments laxity are only some of the physical changes that occur during pregnancy. According to several studies, pregnancy-related back discomfort affects 25% to 75% of women. The primary goal of this research is to provide a comprehensive picture of women's musculoskeletal issues during pregnancy and identify the most prevalent triggers of pregnancy-related musculoskeletal discomfort.
 Methodology: From Jan 2019 to Jan 2020, the Department of Orthopedic Surgery Territory Care Hospital performed this investigation. In this research, 92 women were enrolled after the IRB (Institutional Review Board) of the Territory Care Hospital approved the study's ethical standards. This research monitored patients throughout their pregnancies to see if they had any musculoskeletal issues. Pregnant women between the ages of 18 and 45 who had a term pregnancy (37-42 weeks) were included in the research. The authors didn't include women with any history of rheumatoid arthritis, osteoarthritis, or SLE, a systemic autoimmune disease.
 Findings: Participants in the research were 32.18 years old on average with a standard deviation of 7.82 years. Moreover, half of the participants were college graduates, 71. (76.44%) while pregnant, participants gained an average weight of 14.70 and 7.82 kg. Only four (4 %) of these women engaged in aerobic activity. Most study participants reported musculoskeletal complaints at night with 75 reporting nighttime symptoms (85%). There were 82 (90%) people with low back pain, 10 (10%) participants with arthralgia, 35 (40%) participants with arthritis, and 32 (35%) participants with neck pain in the study. Pregnancy-related musculoskeletal issues substantially drain the health care system's budget. Arthritis and neck discomfort is among the most prevalent musculoskeletal complaints. Pregnancy-related weight gain and inactivity exacerbate these issues. The findings of this research need to be validated in more extensive trials.

Influence of gestational weight gain on baby's birth weight in Addis Ababa, Central Ethiopia: a follow-up study.

BackgroundGestational weight gain (GWG) is an important indicator of fetal well-being during pregnancy. Inadequate or excessive GWG could have undesirable effects on birth weight. However, information regarding the influence of GWG on birth weight is lacking from the Ethiopian setting.ObjectiveThis study aimed to determine the influence of GWG and other maternal-related factors on birth weight in Addis Ababa, Ethiopia.Design and methodsA cohort of pregnant women who received the first antenatal care before or at 16 weeks of gestation in health centres in Addis Ababa were followed from 10 January 2019 to 25 September 2019. Data were collected using a structured questionnaire and medical record reviews. We conducted a multivariable linear regression analysis to determine the independent effect of gestational weight on birth weight.ResultsOf the 395 women enrolled in the study, the participants’ pregnancy outcome was available for 329 (83.3%). The mean birth weight was 3130 (SD, 509) g. The proportion of low birth weight (<2500 g) was 7.5% (95% CI 4.8% to 11.0%). Babies born to underweight women were 150.9 g (95% CI 5.8 to 308.6 g, p=0.049) lighter than babies born to normal-weight women. Similarly, babies whose mothers gained inadequate weight were 248 g (95% CI 112.8 to 383.6 g, p<0.001) lighter than those who gained adequate weight. Moreover, babies whose mothers had a previous history of abortion or miscarriages or developed gestational hypertension in the current pregnancy were 147.2 g (95% CI 3.2 to 291.3 g, p=0.045) and 310.7 g (95% CI 62.7 to 552.8 g, p=0.012) lighter, respectively, compared with those whose mothers had not.ConclusionsPrepregnancy weight, GWG, having had a previous history of abortion or miscarriages, and developing gestational hypertension during a current pregnancy were independently associated with birth weight. Pregnancy-related weight management should be actively promoted through intensive counseling during routine antenatal care contacts.

Close Relationships as Sources of Pregnancy-Related Weight Stigma for Expecting and New Mothers.

Experiencing weight stigma during pregnancy is detrimental to psychosocial health outcomes, including increasing maternal stress and undermining engagement in health behaviors. Guided by a recent socioecological framework, close interpersonal relationships are integral in pregnancy to facilitate healthy behaviors and protect maternal mental health, but they may also be sources that project weight stigma. The purpose of this study was to characterize weight stigma experienced during pregnancy and postpartum from close relationships including partners, immediate family, extended family, and friends. Women who were pregnant or up to 1year postpartum completed a survey that assessed sources of weight stigma since becoming pregnant. A thematic analysis was performed to code open-ended responses to understand the lived experiences of pregnancy-related weight stigma experienced from close relations. Of the 501 women who completed the online survey, 157 indicated experiencing weight stigma from close relations. Average frequency of weight stigma from close relations was 1.83 ("less than once a month" to "a few times a month"). Weight-stigmatizing examples from close relations during pregnancy included negative assumptions about maternal or fetal health and maternal lifestyle behaviors based on weight gain; comparing women to pregnant body ideals; and making comments that resulted in women judging themselves poorly as a pregnant individual or mother. Close relationships can be sources of pregnancy-related weight stigma. This may not only increase risk for adverse stigma-related consequences, but also could cut off the important benefits of maternal social support resulting in poor mental health outcomes and health behaviors.

The WOMBS Framework: A review and new theoretical model for investigating pregnancy-related weight stigma and its intergenerational implications.

As the growing weight stigma literature has developed, one critically relevant and vulnerable population has received little consideration-pregnant and postpartum women. Because weight fluctuations are inherent to this life phase, and rates of prepregnancy overweight and obesity are already high, this gap is problematic. More recently, however, there has been a rising interest in pregnancy-related weight stigma and its consequences. This paper therefore sought to (a) review the emerging research on pregnancy-related weight stigma phenomenology and (b) integrate this existing evidence to present a novel theoretical framework for studying pregnancy-related weight stigma. The Weight gain, Obesity, Maternal-child Biobehavioral pathways, and Stigma (WOMBS) Framework proposes psychophysiological mechanisms linking pregnancy-related weight stigmatization to increased risk of weight gain and, in turn, downstream childhood obesity risk. This WOMBS Framework highlights pregnant and postpartum women as a theoretically unique at-risk population for whom this social stigma engages maternal physiology and transfers obesity risk to the child via social and physiological mechanisms. The WOMBS Framework provides a novel and useful tool to guide the emerging pregnancy-related weight stigma research and, ultimately, support stigma-reduction efforts in this critical context.

Beyond BMI: Pregnancy-related weight stigma increases risk of gestational diabetes

The objective of this research brief was to assess if prenatal weight stigma is a predictive factor for perinatal complications compared to pre-pregnancy body mass index (BMI). Data were assessed from 358 women. Results indicated weight stigma concerns increased the odds of gestational diabetes, with a stronger association than BMI.

CHARACTERISING A NOVEL MODEL OF SUPER-IMPOSED PRE-ECLAMPSIA

Objective: The stroke-prone spontaneously hypertensive (SHRSP) rat is a model of chronic hypertension and defective vascular remodelling during pregnancy that can be stressed by administration of angiotensin II (ANGII) to mimic super-imposed pre-eclampsia. This novel model has been tested with doses of 500 ng/kg/min and 1000 ng/kg/min ANGII. The aim of this study was to characterise the pathology of this model with a dose of 750 ng/kg/min to enhance reproducibility and refine the model. Design and method: SHRSP and normotensive Wistar Kyoto (WKY) females were time mated with males of the relevant strain. On gestational day (GD) 10.5 mini osmotic pumps were implanted administering either 0.9% saline or 750 ng/kg/min of ANGII. SHRSPs were split into either SHAM (saline) or ANGII groups. WKY received saline only. At pre-pregnancy (PP), GD 6.5, 14.5 and 18.5 blood pressure, cardiac function and uteroplacental blood flow were measured by tail cuff plethysmography and ultrasound. Urine was collected by metabolic cage at PP, GD6.5 &amp; 18.5 to assess proteinuria. Results: ANGII showed reduced pregnancy-related weight gain vs WKY and SHAM (168.3 ± 3.7 g vs 231.2 ± 3.0 g vs 183.3 ± 5.9 g, p &lt; 0.001). ANGII showed an increased BP when compared to SHAM and WKY (180.9 ± 9.7mmHg vs 127.5 ± 6.5mmHg vs 139.8 ± 7.1 mmHg p &lt; 0.001 GD18.5). ANGII dams showed signs of left ventricular cardiac dysfunction with an elevated relative wall thickness and reduced stroke volume and cardiac output vs WKY (p &lt; 0.05). ANGII and SHAM exhibited impaired uteroplacental blood flow vs WKY at GD18.5 (0.57 ± 0.03au vs 0.62 ± 0.05au vs 0.38 ± 0.02au, p &lt; 0.01). Infusion of ANGII successfully induced proteinuria, measured as urinary albumin:creatinine compared to SHAM and WKY (12.2 ± 8.28 μg/μmol/L vs 0.16 ± 0.01 μg/μmol/L vs 3.9 ± 0.40 μg/μmol/L, p &lt; 0.001). Conclusions: The results presented here show this model has effectively captured the overall disease picture of pre-eclampsia with consistent disease characteristics such as proteinuria, hypertension, maternal cardiovascular impairment and dysregulated uterine artery remodelling. It may serve as a useful tool in the study of pre-eclampsia.

Pregnancy-related weight among immigrant and US-born mothers: The role of nativity, maternal duration of residence, and age at arrival.

Objectives:The goals of this study were to examine the associations between nativity and pregnancy-related weight and to assess the associations between maternal duration of residence and age at arrival in the United States on pregnancy-related weight among immigrants.Methods:Using logistic regression and data from the Early Childhood Longitudinal Study–Birth Cohort, we assessed differences in preconception weight and gestational weight gain between US-born and immigrant women (N = 7000). We then analyzed differences in both outcomes by duration of residence among immigrants (n = 1850) and examined whether the identified relationships varied by age at arrival in the United States.Results:Compared to US-born mothers, immigrants were less likely to be classified as obese prior to pregnancy (odds ratio 0.435, 95% confidence interval, 0.321–0.590) or experience excessive gestational weight gain (odds ratio 0.757, 95% confidence interval, 0.614–0.978). Among the immigrant sub-sample, living in the United States for 10–15 years (odds ratio 2.737, 95% confidence interval, 1.459–5.134) or 16+ years was positively associated with both preconception obesity (odds ratio 2.918, 95% confidence interval, 1.322–6.439) and excessive gestational weight gain (odds ratio 1.683, 95% confidence interval, 1.012–2.797, 16+ years only). There was some evidence that the duration of residence was positively associated with preconception obesity, but only among women who had moved to the United States at age 18 years and older.Conclusion:In sum, while immigrants are less likely than US-born mothers to experience preconception obesity or excessive gestational weight gain, these outcomes vary among the former group by duration of US residence.

Midwives' and obstetricians' perspectives about pregnancy related weight management in Ethiopia: A qualitative study.

Midwives and obstetricians are key maternity care providers; they are the most trusted source of information regarding nutrition and gestational weight gain. However, their views, practices and perceived barriers to managing pregnancy related weight gain have not been studied in Ethiopia. The aim of this study was to explore midwives' and obstetricians' observations and perspectives about gestational weight gain and postpartum weight management in Ethiopia. We conducted face-to-face interviews with 11 midwives and 10 obstetricians, from January 2019 to March 2019. All interview data were transcribed verbatim. We analysed the data using thematic analysis with an inductive approach. We identified three themes and associated subthemes. Midwives and obstetricians had limited knowledge of the optimal gestational weight gain. Almost all participants were unaware of the presence of the Institute of Medicine recommendations for optimal weight gain in pregnancy. According to the study participants, women in Ethiopia do not want to gain weight during pregnancy, but do want to gain weight after the birth. Counselling about gestational weight gain and postpartum weight management was not routinely provided for pregnant women. This is mostly because gestational weight gain counselling was not considered to be a priority by maternity care providers in Ethiopia. The limited knowledge of and low attention to pregnancy related weight management by midwives and obstetricians in this setting needs appropriate intervention. Adapting a guideline for pregnancy weight management and integrating it into antenatal care is essential.

The Media as a Source of Weight Stigma for Pregnant and Postpartum Women.

The media often contain weight-stigmatizing material. However, little is known about pregnant and postpartum women's experiences with media-based weight stigma. Two studies investigated weight stigma in the media from multiple perspectives. Study 1 analyzed open-response examples of weight-stigmatizing experiences coming from the media, broadly defined, from 123 pregnant and postpartum women (from a larger sample of 501). Study 2 identified online news-media articles about pregnancy and weight published during the study 1 data collection period (August to November 2017). Study 1 revealed that weight stigma was common and frequent in media, manifesting across three themes: (1) ideal appearance of pregnant bodies, (2) pressure to quickly "bounce back" after birth to a prepregnancy appearance, and (3) media praising celebrities for achieving either of the previous themes. Study 2 identified 33 articles. A content analysis revealed that women with overweight or obesity were rarely portrayed in images. Additionally, discussion of weight was often negative, focusing on adverse maternal-child health consequences. Finally, media-communicated ideals for weight and weight loss were often unrealistic and did not reference medical guidelines. This work is the first to document that online news media are a pervasive and potentially distressing source of pregnancy-related weight stigma, suggesting much-needed reform in media guidelines.

Pregnancy-Related Weight and Postpartum Depressive Symptoms: Do the Relationships Differ by Race/Ethnicity?

Background: There are significant racial/ethnic disparities in the prevalence of postpartum depression. Prior research in the general population suggests that weight status is related to depression and that this relationship varies by race/ethnicity. However, few studies have investigated whether race/ethnicity moderates the relationship between pregnancy-related weight and postpartum depressive symptoms (PPDS). The objective of this study is to examine the relationship between pregnancy-related weight and maternal PPDS overall and by race/ethnicity. Materials and Methods: This study used data from the Early Childhood Longitudinal Study-Birth Cohort (n ≈ 6950). Ordinary least-squares and logistic regression was used to examine whether pregnancy-related weight, including preconception weight status and gestational weight gain (GWG), was associated with PPDS measured using the Center for Epidemiologic Studies-Depression Scale (CES-D). Stratified analyses were used to assess whether these relationships varied by race/ethnicity. Results: Preconception obesity (body mass index [BMI] ≥30 kg/m2) was associated with higher levels of PPDS (β = 0.601, 95% confidence interval [CI], 0.149-1.053). GWG adequacy was not associated with PPDS. Among non-Hispanic (NH) whites, preconception obesity was positively associated with PPDS (β = 1.016, 95% CI, 0.448-1.584). In contrast, among Hispanics, preconception overweight (25 kg/m2 ≤ BMI <30 kg/m2) was associated with lower levels of PPDS (β = -0.887, 95% CI, -1.580 to -0.195). There were no statistically significant relationships between pregnancy-related weight and PPDS among NH black or Asian women, but both groups were significantly more likely than NH whites to report PPDS. Conclusion: Whether and how pregnancy-related weight is associated with PPDS varies by race/ethnicity. Addressing preconception weight could help reduce overall levels of PPDS among NH whites but would likely fail to mitigate racial/ethnic disparities in postpartum mental health.

Pregnancy-Related Weight and Postpartum Depressive Symptoms: Do the Relationships Differ by Race/Ethnicity? [31E

INTRODUCTION: There are significant racial/ethnic disparities in the prevalence of postpartum depression. Prior research suggests that the relationships between weight status and depression may vary by race/ethnicity among the general population. However, few studies have investigated whether race/ethnicity moderates the relationships between pregnancy-related weight and postpartum depressive symptoms (PPDS). This study examines the relationships between pregnancy-related weight and maternal PPDS overall and by race/ethnicity. METHODS: This study used data from the Early Childhood Longitudinal Study-Birth Cohort (N≈6950). Ordinary least squares and logistic regression were used to examine whether pregnancy-related weight, including preconception obesity and gestational weight gain, were associated with PPDS. Stratified analyses were used to assess whether these relationships varied by race/ethnicity. RESULTS: Preconception obesity was associated with higher levels of postpartum depressive symptoms (β=1.208, 95% CI 0.995–1.467). In contrast, gestational weight gain adequacy was not associated with PPDS. Among non-Hispanic (NH) whites, preconception obesity was positively associated with PPDS (β=1.016, 95% CI 0.448–1.584). In contrast, among Hispanics, preconception overweight was associated with lower levels of depressive symptoms (β=-0.887, 95% CI -1.580 to -0.195). There were no statistically significant relationships between pregnancy-related weight and PPDS among NH black or Asian women. However, both NH blacks and Asians were significantly more likely to report PPDS compared to NH whites. CONCLUSION: Pregnancy-related weight is associated with higher levels of PPDS, but only among NH white women. Addressing preconception weight could help to reduce overall levels of PPDS but doing so might not mitigate racial/ethnic disparities in postpartum mental health.

Maternal body mass index change as a new optimal gestational weight gain predictor in overweight women

AimTo investigate the relationship between maternal pre-pregnancy body-mass index (BMI) and neonatal birth weight.MethodsThe observational study included 2906 mothers and their neonates born from 2005 to 2011 at the Department of Gynecology and Obstetrics, Split University Hospital Center. Mothers with singleton term pregnancies who were overweight before pregnancy (BMI 25-29.9 kg/m2) were compared with those with normal pre-pregnancy weight (BMI 18.5-24.9 kg/m2). BMI change was assessed as a predictor of birth weight, categorized as small (SGA), appropriate (AGA), or large for gestational age (LGA).ResultsThe rate of SGA infants was significantly lower (n = 199; 6.8% vs n = 1548; 9.2%) and the rate of LGA infants significantly greater among pre-pregnancy overweight mothers compared with normal-weight mothers (n = 371; 12.8% vs n = 1302; 7.8%; P < 0.001 both). Overweight mothers had a significant probability of delivering an SGA neonate when they gained less than 6 kg, as compared with 8 kg among normal-weight mothers. They had a significant probability of delivering an LGA neonate when they gained more than 14 kg, compared with more than 20 kg among normal-weight mothers. BMI change was a more consistent indicator, suggesting that the ranges of 3.0-7.9 kg/m2 in normal-weight and 2-5.9 kg/m2 in overweight women were not associated with a significant increase in the rate of SGA or LGA.ConclusionMaternal height seems to be an important factor in optimal weight gain definition, suggesting that BMI change should be a preferred measure of pregnancy-related weight.

The risk, perceived and actual, of developing type 2 diabetes mellitus for mothers of preschool children in urban China.

BackgroundThe perceived risk of developing type 2 diabetes mellitus (T2DM) can motivate individuals to adopt preventive health behaviors. Compared with fathers, mothers of young children often experience unique risk factors for developing T2DM: pregnancy-related weight gain, lifestyle changes related to child care, and the increased incidence of gestational diabetes mellitus. Understanding how actual risk factors affect the perceived risk of developing T2DM can foster effective diabetes prevention interventions for this population. The aims of this study were to describe the risk, perceived and actual, of developing T2DM and to explore the influencing factors of perceived risk for Chinese mothers of preschool children in China.MethodsA multisite, cross-sectional survey was conducted and included 176 mothers (mean age of 31.19 years old) of preschool children (aged 3–7 years old) from four preschools in Changsha, the capital city of Hunan Province, China. The overall perceived risk of developing T2DM was measured by one item “Your own personal health risk is at almost no risk, slight risk, moderate risk or high risk from diabetes” from the Risk Perception Survey for Developing Diabetes (RPS-DD). PRS-DD and the Chinese version of the Canadian Diabetes Risk Assessment Questionnaire (CHINARISK) were used to assess perceived risk related worry, personal control, optimistic bias, and diabetes risk knowledge and actual risk of T2DM. Mothers also reported their height, weight, and waist circumference followed by the NIH protocol. Pearson correlation and stepwise multivariate linear regression were used to explore how the actual risk factors affected the perceived risk of developing diabetes (RPS-DD)).ResultsNearly 90% of mothers perceived almost no/slight risk for developing diabetes. Nearly half of the mothers had parents or siblings with diabetes. Roughly 70% of the mothers did not eat five servings of fruits and vegetables per day, and more than 50% did not exercise at least 30 minutes a day. In the five stepwise multivariate linear regression models, young mothers (95% CI .400–1.311) and those with a family history of diabetes (95% CI -0.74- .000) were founded a higher overall perceived risk. Mothers who reported more sedentary time (95% CI -0.029- -0.008) and less physical activity had less personal control (95% CI -0.354- -0.046). Mothers with more sedentary time had more worries about developing T2DM(95% CI 0.008–0.035) . Mothers who were older (95% CI -0.440–0.055) or had more physical activities (95% CI 0.003–0.048) had more optimistic bias of not developing T2DM. Mothers who had a higher education level (95% CI .354–1.422) and a family history of diabetes (95% CI .029–2.231) had more diabetes risk knowledge of developing T2DM.ConclusionThis study found that Chinese mothers of preschool children in urban areas reported low perceived risk of developing T2DM, although they have actual risk factors. These women did not associate anthropometric, health history, or health behavior factors with the risk of developing T2DM. Anthropometrics and risk factors associated with behavioral risk factors may be the focus of diabetes prevention programs.

Targeting pregnancy-related weight gain to reduce disparities in obesity: Baseline results from the Healthy Babies trial

BackgroundObesity affects African American women more than any other group in the US. Pregnancy represents a critical life stage of heightened vulnerability for new or persistent obesity, yet few interventions have been effective in reducing excessive gestational weight gain among African American women. We describe the design and baseline findings of Healthy Babies, a two-arm randomized controlled trial testing a mobile health intervention to minimize excessive gestational weight gain versus usual care in this high risk group. MethodsAfrican American women in early pregnancy were recruited from two large obstetric practices as well as Philadelphia Women, Infants, and Children's clinics. Participants randomized to the intervention received behavior change goals, daily text messages with feedback, web-based weight gain graphs, health coaching, and a Facebook support group. Data collection included baseline (<22 weeks' gestation), 36-38 weeks' gestation, and 6-month postpartum anthropometric measures and assessments of demographics, contextual factors and behavioral targets. The primary outcome was prevalence of excessive gestational weight gain. ResultsAmong participants at baseline (n = 262), the majority met criteria for obesity (63%), were multiparous (62%), single (77%), and were on average 25.6 ± 5.4 years old with a gestational age of 13.9 ± 4.1 weeks. While 82% completed high school, 61% met criteria for inadequate health literacy. Nearly 20% were food insecure. Eighty-eight percent reported a gestational weight gain goal discordant with Institute of Medicine guidelines. There were no significant differences in baseline characteristics between study arms. ConclusionsParticipants represent a high-risk group for excessive gestational weight gain with demonstrated need for intervention.

SAT-319 ESTIMATING GFR IN PREGNANCY: COMPARISON BETWEEN 24-HOUR CREATININE CLEARANCE RATE AND NANRA EQUATION

Currently there is no validated serum creatinine based eGFR equation available to accurately measure renal function in pregnancy, partly because pregnancy related weight and body surface area changes are not representative of an increase in serum creatinine production. In order to perform accurate renal function measurements in pregnancy, 24-hour urine collections are required to measure the 24-hour creatinine clearance rate. The purpose of this study is to assess the accuracy of the non-weight based, serum creatinine based NANRA equation for calculating eGFR in the setting of pregnancy, as well as assessing the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equation, and a CKD-EPI adjusted Body Surface Area (BSA) equation.