Pre-pregnancy Weight Research Articles

Nutrition literacy in Vietnamese pregnant women: a cross-sectional study.

Inadequate nutrition intake during pregnancy elevates the risk of adverse health outcomes during pregnancy, with potential long-term repercussions for both mother and child, extending to subsequent generations. Current initiatives to improve individual dietary habits emphasize promoting nutrition literacy (NL), which encompasses the ability to access, comprehend, and use basic nutrition information and services necessary for making appropriate nutrition decisions. However, there were limited data on the NL of pregnant women in Vietnam. Therefore, this study aims to explore the NL levels of Vietnamese pregnant women and examine the factors related to their NL. A total of 360 Vietnamese pregnant women participated in the study from May to September 2023. A validated questionnaire (Nutrition Literacy Assessment Instrument for Pregnant Women, NLAI-P), assessing the knowledge, behavior and skill, was applied. A general linear model with univariate linear regression analysis was conducted to identify predictor factors of NL. The findings revealed that 70.3% of participants had inadequate NL. Among the three dimensions, nutrition knowledge was particularly low, with no respondents achieving an adequate level and 94.7% scoring at an inadequate level. High household monthly income, age, normal prepregnancy weight and indoor work were statistically associated with higher NL scores. This study highlights the limited NL among Vietnamese pregnant women. Increasing NL is crucial for supporting their optimal healthy diet, enhancing the health of pregnant women and their offspring and future generations.

Association of maternal body mass index with hemodynamic and vascular alterations at 35-37 weeks' gestation.

Globally, one in four pregnant women is classified as overweight or obese, based on their prepregnancy body mass index (BMI). Obese pregnant women are at increased risk of adverse pregnancy outcomes and long-term cardiovascular disease that occurs earlier in life. This study aimed to assess maternal hemodynamic and vascular parameters at 35-37 weeks' gestation, to understand the alterations that may occur in association with increased maternal BMI and gestational weight gain, and to evaluate obesity-related pregnancy outcomes. This was a prospective observational study of 11 731 women with a singleton pregnancy attending for a routine hospital visit at 35 + 0 to 36 + 6 weeks' gestation at King's College Hospital, London, UK, between December 2021 and June 2024. Women were categorized based on their BMI at 11-13 weeks' gestation, as normal weight (BMI, 18.5-24.9 kg/m2), overweight (BMI, 25.0-29.9 kg/m2) or obese (BMI, ≥ 30 kg/m2). We recorded details regarding maternal demographic characteristics and medical history, used Doppler ultrasound to assess the uterine artery pulsatility index (UtA-PI) (as a marker for uteroplacental perfusion) and ophthalmic artery peak systolic velocity (PSV) ratio (as a marker for small vessel peripheral circulation), and measured carotid-to-femoral pulse-wave velocity, augmentation index (as direct and indirect markers of aortic stiffness, respectively), cardiac output, total peripheral resistance (TPR), and central systolic and diastolic blood pressure. Multivariable analysis was performed to examine the relationship of BMI and gestational weight gain with hemodynamic and vascular measures, adjusting for maternal demographics, medical history, pregnancy characteristics and pregnancy outcomes (including pre-eclampsia and gestational diabetes mellitus). Overweight and obese women were more often of black ethnicity, and had higher central systolic and diastolic blood pressure, cardiac output, aortic stiffness and UtA-PI, compared with normal-weight women. There was no significant difference between overweight or obese women and normal-weight women with regard to TPR and ophthalmic artery PSV ratio. On multivariable analysis, increasing BMI at 11-13 weeks and gestational weight gain between 11-13 weeks and 35-37 weeks were independently associated with increases in all cardiovascular indices (including ophthalmic artery PSV ratio), apart from TPR. Women with a high BMI in early pregnancy vs normal-weight women, and those with higher gestational weight gain, had worse maternal hemodynamic and vascular indices at 35-37 weeks' gestation, independent of baseline and pregnancy characteristics. Our findings support the notion that optimization of prepregnancy weight and gestational weight gain may improve maternal hemodynamics and vascular function during pregnancy, and therefore may improve pregnancy outcomes. © 2025 The Author(s). Ultrasound in Obstetrics & Gynecology published by John Wiley & Sons Ltd on behalf of International Society of Ultrasound in Obstetrics and Gynecology.

Pre-pregnancy obesity and weight gain during pregnancy: impact on newborn outcomes

BackgroundOverweight and obesity are global issues, especially among women of childbearing age, linked to adverse maternal and neonatal outcomes. These risks vary by age, race, and ethnicity, with increasing rates among immigrant and minority women. This study compares overweight and obesity rates, pregnancy weight gain, and neonatal outcomes in Turkish and Syrian immigrant/refugee women.MethodsIn this retrospective study, at Buca Seyfi Demirsoy Hospital in Izmir, Turkey a total of 1353 mother-infant pairs were checked for eligibility. Of the entire cohort of 1353 mother-infant pairs, 323 pairs with complete medical records were included. The primary outcome was rate of pregestational obesity or overweight as secondary outcomes were weight gain during pregnancy and adherence to guidelines, neonatal outcomes according to different BMI categories and possible impact of maternal weight gain on neonatal morbidities in two different ethic populations.ResultsOf the 323 mother-infant pairs, overweight/obese mothers had higher birth weights and cesarean-section rates. Syrian mothers were more likely to gain less weight than recommended. Neonatal outcomes, such as hospitalization and SGA/LGA birth rates, were similar across groups, with varying compliance to weight gain guidelines.ConclusionsPre-pregnancy BMI and gestational weight gain significantly affect some of the neonatal outcomes. High obesity rates and ethnic disparities highlight the need for culturally tailored prenatal care to improve maternal and neonatal health, especially in immigrant populations. Further research with larger, diverse cohorts is needed.

The Dose-Dependent Effect of Obesity on Adverse Maternal and Neonatal Outcomes in a Hispanic Population.

To evaluate the frequency of adverse maternal and neonatal outcomes associated with maternal obesity in a Hispanic population. We hypothesized that obesity confers a dose-dependent risk associated with these outcomes. This was a retrospective cohort study of singleton pregnancies delivered between 24 and 42 weeks gestation at an urban county hospital between 2013 and 2021. Body mass index (BMI) at first prenatal visit was used as a proxy for pre-pregnancy weight. Patients were excluded if their first trimester BMI was not available. Trends in adverse outcomes across increasing obesity classes were assessed. During the study period, 58,497 patients delivered a singleton infant, of which 12,365 (21.1%), 5429 (9.3%), and 3482 (6.0%) were in class I, II, and III obesity, respectively. Compared with non-obese patients, more obese patients were more likely to be younger and nulliparous with a higher incidence of hypertension and pregestational diabetes. Higher BMI was associated with a significant dose-dependent increase in cesarean delivery (27% for non-obese, 34% for class I, 39% for class II, and 46% for class III obesity); severe preeclampsia (8% in non-obese and 19% for class III obesity); and gestational diabetes (5% in non-obese and 15% in class III obesity). There were significant trends in increasing morbidity for infants born to patients with correspondingly higher obesity classes. Some of these adverse outcomes included respiratory distress syndrome, neonatal intensive care unit admission, fetal anomalies, and sepsis (all p < 0.001). Increasing body mass index is associated with a significant dose-dependent increase in multiple adverse perinatal outcomes in a Hispanic population. Associated adverse maternal outcomes include severe preeclampsia, gestational diabetes, and cesarean delivery. Infants born to patients with correspondingly higher BMI class have significantly increased associated morbidity. Often, only higher BMI classes are significantly associated with these adverse outcomes.

Development and validation of a prognostic nomogram forsevere postpartum hemorrhage after cesarean delivery: Atwo-center retrospective study.

To develop and validate a nomogram to predict severe postpartum hemorrhage following cesarean delivery. This is a two-center retrospective cohort study. Cesarean delivery patients from the First Affiliate Hospital of Jinan University were divided into a development cohort (n = 11 137) and an internal validation cohort (n = 4739). Cesarean delivery patients from the Dongguan Maternal and Child Health Care Hospital (n = 13 775) were enrolled in the external validation cohort. The nomogram was based on independent risk factors for severe postpartum hemorrhage obtained by multivariate logistic regression. We evaluated the discrimination and calibration of the nomogram in the development and validation cohorts. The nomogram used data including previous cesarean delivery, pre-pregnancy weight, preterm birth, placenta previa, placenta accreta spectrum disorders, placental abruption, and mode of anesthesia. The area under the curves of the nomogram in the internal and external validation cohorts were 0.922 (95% confidence interval [CI] 0.897-0.947) and 0.813 (95% CI 0.785-0.841), respectively. Consistency between the predicted and actual probabilities was observed in both validation cohorts. The nomogram displayed good calibration and discrimination and can be used for screening in clinical practice to enable clinicians to intervene appropriately.

The association between self-reported total gestational weight gain by pre-pregnancy body mass index and moderate to late preterm birth

BackgroundInadequate and excessive gestational weight gain (GWG) defined by the Institute of Medicine (IOM) has been associated with preterm birth. However, studies demonstrate inconsistent associations.ObjectivesWe examined the associations between categorical and continuous total GWG and moderate to late preterm birth (32-<37 weeks), and evaluated differences in these associations by pre-pregnancy BMI.MethodsWe analyzed cross-sectional data from children participating in TARGet Kids! in Toronto, Canada. Parents of children < 6 years of age recalled pre-pregnancy weight, end-of-pregnancy weight, and gestational age. GWG was categorized according to the 2009 IOM guidelines as inadequate, recommended, or excessive for each pre-pregnancy BMI category. GWG was expressed as the percentage of recommendations met to account for gestational duration. Adjusted odds ratios (aORs) for moderate to late preterm birth were estimated using logistic regression models. Restricted cubic splines were used to model the adjusted predicted probability of moderate to late preterm birth against continuous GWG.ResultsOf the 4,529 participants, 8.2% were born moderate to late preterm. 31.1% of parents met the GWG recommendations, 41.0% had excessive GWG, and 27.9% had inadequate GWG. Compared to recommended GWG, excessive GWG had increased odds of moderate to late preterm birth (aOR 1.68, 95% CI 1.29, 2.19). There was insufficient evidence of an association between inadequate GWG and moderate to late preterm birth (aOR 1.10, 95% CI 0.81, 1.50). For parents who were overweight or had obesity, the risk of moderate to late preterm birth did not increase substantially until a GWG > 200% of the recommendations, which is well above the IOM recommended upper limit.ConclusionsExcessive GWG was associated with an increased risk of moderate to late preterm birth, with variation in the association by pre-pregnancy BMI. Current definitions of excessive GWG may not adequately reflect increased risk of preterm birth among those with overweight or obesity.

Maternal Prepregnancy Obesity and Offspring Intelligence Quotient at 5 Years: A Multicohort Analysis.

The relationship between maternal obesity and childhood cognitive development remains unclear. Prior studies did not adjust for important confounders, and preterm infants are a developmentally distinct group that remains scarcely examined. To determine whether maternal prepregnancy body mass index (BMI) is associated with offspring intelligence quotient (IQ) up to 5 years and whether this relationship varies with gestational age. Data from two French birth cohorts, EDEN (all gestational ages) and EPIPAGE-2 (preterm children born between 24 and 34 weeks of gestation), were used for this study. Maternal prepregnancy weight and height were used to calculate prepregnancy BMI. The Wechsler Preschool and Primary Scale of Intelligence was used to assess child IQ around 5 years. Multivariable models were adjusted for confounders, including socioeconomic status and paternal BMI. Analytical cohorts included 1100 children from EDEN and 2629 from EPIPAGE-2. Lower intellectual functioning (full-scale IQ < 85) was observed in 8.1% of children in EDEN and 19.6% in EPIPAGE-2. The prevalence of maternal obesity was 13.6% (EDEN) and 21.3% (EPIPAGE-2) among children with lower intellectual functioning compared to 8.9% (EDEN) and 12.9% (EPIPAGE-2) among children with normal intellectual functioning. Maternal prepregnancy obesity was associated with an approximately 3-point decrease in full-scale IQ scores in fully adjusted models (adjusted β -2.8, 95% confidence interval [CI] -5.6, -0.1 and -2.6, 95% CI -4.7, -0.6 in EDEN and EPIPAGE-2, respectively). In EDEN, maternal obesity was associated with lower scores in the verbal IQ domain. Among infants born preterm (EPIPAGE-2), maternal obesity was associated with lower scores in the processing, reasoning, and verbal IQ domains. Adjustment for paternal BMI did not change the magnitude of the relationship with maternal obesity. High maternal prepregnancy BMI is associated with child cognitive development around 5 years of age.

Racial disparities in gestational weight gain and adverse pregnancy outcomes among Black and White pregnant people with obesity.

This study of pregnant people with obesity examined two aims in testing the hypothesis that the COVID-19 pandemic widened racial disparity in maternal health in high-risk pregnancies; it compared by race both (1) gestational weight gain (GWG) patterns and (2) patterns of preexisting conditions and adverse pregnancy outcomes. This retrospective chart review included birth certificate and delivery records from a large women's specialty hospital in Louisiana between 2018 and 2022. Differences in preexisting conditions, GWG, and adverse pregnancy outcomes were explored across early-, peak-, and late-pandemic periods using log-linear regression and robust Poisson models. Among 7431 deliveries (54% Black), Black pregnant people had higher rates of preexisting type 2 diabetes and chronic hypertension but lower rates of gestational diabetes and preeclampsia compared to White pregnant people across all periods. Black individualshad higher prepregnancy weight and lower GWG compared to White individuals across all periods. GWG differences were not significant in peak- and late-pandemic periods. Black individualswith obesity started pregnancy with higher weight and more preexisting conditions but had lower GWG compared to White individuals. Exacerbated disparities in preexisting conditions demonstrate higher health risks for Black individuals during pregnancy.

Protocol of an adaptive mobile health intervention for the management of gestational weight gain: The LEAP cluster randomized controlled trial.

More than half of pregnant patients with overweight or obesity exceed national gestational weight gain (GWG) guidelines, increasing their risk of adverse outcomes. There is an urgent need to develop effective and scalable interventions to improve GWG. To describe the protocol of Lifestyle, Eating, and Activity in Pregnancy (LEAP), a cluster randomized controlled trial evaluating a mobile health (mHealth) intervention promoting appropriate GWG in an integrated healthcare system. LEAP is a cluster randomized trial with randomization at the clinician level. Patient eligibility includes a pre-pregnancy BMI of 25.0-40.0 kg/m2 and singleton pregnancy. Consented patients receive standard care or standard care plus mHealth intervention per their clinician's randomization. The patient adaptive intervention provides personalized, automated feedback on GWG and physical activity using 1) a smartphone application, 2) a Wi-Fi scale and activity tracker; 3) weekly educational topics; and 4) step-wise support (added when GWG is >75th percentile of the GWG guidelines). Intervention clinicians receive newsletters with motivational interviewing tips to facilitate discussing GWG. Primary outcomes are total GWG (last measured weight - pre-pregnancy weight) and weekly rate of GWG (total GWG/gestational weeks at delivery) as continuous variables and categorized per the IOM GWG guidelines. Secondary outcomes include trimester-specific rate of GWG, GWG trajectory, diet and physical activity, postpartum weight retention, birthweight, infant size for gestational age, and infant growth to 12 months. LEAP addresses gaps in the implementation of GWG interventions in healthcare settings. The adaptive and mHealth nature of the intervention may enhance scalability. ClinicalTrials.govNCT03880461.

Optimizing screening practice for gestational diabetes mellitus in primary healthcare facilities in Tanzania: research protocol

BackgroundTanzania, like most low- and middle-income countries, is facing an increasing prevalence of obesity in the general population, including among women of reproductive age. Excess weight pre-pregnancy is a risk factor for the onset of gestational diabetes mellitus (GDM), which is associated with several poor pregnancy outcomes. Screening for GDM, as a primary preventive measure, is not systematically done in Tanzania. This study aims to explore current practices of screening for GDM during routine antenatal care (ANC), estimate the prevalence of GDM among ANC users and compare the performance of two commonly used GDM screening algorithms. We will then explore the best ways for implementing a functional screening practice for GDM at primary level hospitals using perspectives of health care workers, health managers, and pregnant women.MethodsThis will be an observational cross-sectional study design with sequential mixed-methods approach conducted in ANC clinics of two primary level hospitals: Kisarawe District Hospital in Coast region and Mbagala Rangi Tatu Hospital in Dar es Salaam region, Tanzania. Quantitative data will be collected to determine the current structural capacity and screening practices for GDM, the prevalence of GDM among ANC users, and the sensitivity and specificity of the two recommended screening algorithms. Qualitative data will be collected through key informant interviews with health managers and pregnant women and focus group discussions with healthcare workers to understand the rationale, challenges, possible solutions and benefits of the used screening algorithm. We will also explore the meaning of screening/diagnosis to pregnant women, and propose a functional GDM screening algorithm informed by users (i.e. pregnant women, health managers and care workers).DiscussionANC is an entry point for pregnant women to access preventive services including screening for GDM. When done appropriately, GDM screening would reduce undesired outcomes attributed to GDM also beyond the pregnancy period. Through this study we will understand the bottlenecks and propose evidence to inform feasible ways to overcome them and establish a functional and standardized GDM screening service.

Physical Activity and Weight Gain During Pregnancy: Is This Association Modified by Sleep?

ABSTRACT Objective To evaluate the cross-sectional association of physical activity during pregnancy with gestational weight gain and verify if associations are modified by levels of sleep duration and efficiency. Methods: Mothers who were participants of the 2015 Pelotas (Brazil) Birth Cohort study were analyzed. Physical activity (PA) and sleep were measured using the nondominant wrist accelerometer model wGT3X-BT (ActiGraph, Pensacola, FL). Moderate-to-vigorous activities were measured in bouts of 5 minutes (MVPA 5-min bout). Activities were characterized as sustained and overall physical activity was expressed in mg, and MVPA (non-bouted) activities were characterized as not sustained. Sleep was presented as minute bouts, sleep time window, total sleep time, and sleep efficiency. Gestational weight gain (GWG) was calculated by a woman’s weight at the end of gestation minus the pre-pregnancy weight. Linear regression models were used to evaluate the association between PA and GWG. Stratification by sleep characteristics in tertiles was performed. Results: The analytical sample included 1,938 women with information for PA, sleep, and GWG. The mean GWG was 12,030 g (SD = 6658.8). After adjustments, for every 15 minutes of sustained physical activity (MVPA 5-min bout), the GWG decreased by 591.3 g [β= −591.3 (95%CI: −1,147.1; −35.5). A statistically significant association was observed between 15 minutes of sustained physical activity (MVPA 5-min bout) and GWG in the second and third tertiles of healthier sleep efficiency. Conclusion: MVPA with 5-min bouts is associated with lower GWG. The GWG reduction was greater in the higher sleep efficiency strata.

Association between Clinical Characteristics of Pregnant Women in the Third Trimester and Low Back Pain

Pregnancy is a physiological condition characterized by growth in both the fetus and the mother. Various biomechanical, physiological, and structural changes in pregnant women cause body posture changes, impacting low back pain (LBP). In the third trimester, LBP pain felt by pregnant women is usually accompanied by activity limitations and a decreased quality of life. This study aimed to determine the association between the clinical characteristics of pregnant women in the third trimester and low back pain. This research was conducted at the Department of Obstetrics and Gynecology and Department of Physical Medicine and Rehabilitation, Faculty of Medicine, Universitas Padjadjaran/Dr. Hasan Sadikin General Hospital, Bandung from June to December 2017. The method is observational analysis with a cross-sectional approach with a sample of pregnant women in their third trimester who complained of lower back pain and lived in Bandung. According to the findings, the majority of pregnant women with LBP in the third trimester were under the age of 35 (33 of 38), had multiparous parity (25 of 38), had normal pre-pregnancy weight (21 of 38), gained an average of 11.28 kg during pregnancy, and had a median pain intensity of 5. Age was the only factor significantly correlated with LBP pain intensity; parity and weight gain during pregnancy did not. The study concludes a significant association between age in the third trimester of pregnancy and the intensity of LBP pain. Still, no significant association was found between parity and weight gain during pregnancy with the intensity of LBP pain.

Exploring Beliefs, Concerns, Prenatal Care Advice, and Sources of Information About Gestational Weight Gain Among Immigrant Central American Pregnant Women in the United States.

Gestational weight gain (GWG) is critical for maternal and neonatal health, but excessive GWG can lead to complications such as gestational diabetes, hypertension, and increased obesity risk later in life. Minoritized and immigrant women often face higher risks of excessive GWG. This cross-sectional study assessed Central American women's beliefs and concerns about GWG, the receipt of advice from healthcare providers, and sources of information for healthy weight management during pregnancy. A cross-sectional survey was conducted with 93 pregnant women from El Salvador (31.2%), Guatemala (46.2%), and Honduras (22.6%). Most participants were married (91.4%), and 91.2% had household incomes below $40,000. Self-reported pre-pregnancy weight status varied significantly (p = 0.03), with more Guatemalans self-reporting as overweight (34.9%) compared to Salvadorans (10.3%) and Hondurans (19.1%). Beliefs about GWG varied significantly; 72.1% of Guatemalan women accepted "eating for two", while only 31.0% of Salvadorans did (p = 0.002). More Honduran women (90.5%) received weight gain recommendations from healthcare providers than Salvadorans (62.1%) and Guatemalans (60.5%) (p = 0.04). The Internet and family were common information sources on weight management, highlighting the need for culturally tailored health education. This study underscores critical differences in beliefs and access to prenatal care among pregnant Central American immigrant women, emphasizing the importance of culturally competent health education to support healthy pregnancy outcomes.

Association between the early or late onset of gestational diabetes mellitus with neonatal adverse outcomes: a retrospective cohort study

BackgroundThe literature has been evolving to standardize gestational diabetes mellitus (GDM) diagnosis and terminology. The significance of timing in diagnosing hyperglycemia during pregnancy is underlined by evidence that women diagnosed at 24 weeks of gestation or earlier are at a higher risk of developing postpartum prediabetes, but its association with adverse outcomes for the newborn is controversial. We aimed to investigate the association between early-onset GDM and adverse outcomes in newborns and neonates, comparing it with the late-onset GDM model.MethodsIt was a retrospective cohort study conducted at the Perinatal Diabetes Research Center in Assis/SP, affiliated with the Botucatu Medical School-UNESP in Brazil. The group composition was as follows: early-onset participants had fasting glucose levels ≥ 92 mg/dL and < 126 mg/dL before 20 weeks of gestation, while late-onset participants had a negative first-trimester screening and a positive 75g-OGTT at 24–28 weeks. For early-onset GDM, a fasting glucose level of ≥ 92 mg/dL is a recognized threshold associated with an increased risk of adverse pregnancy outcomes, while < 126 mg/dL ensures the exclusion of overt diabetes. The criteria for late-onset GDM, involving a negative initial screening and a positive OGTT at 24–28 weeks, align with the standard diagnostic timeframe when insulin resistance typically peaks due to placental hormone secretion. The maternal baseline characteristics included pre-pregnancy body mass index (BMI; kg/m2) and pregnancy weight gain (kg), calculated as the difference between the final pregnancy weight (36 gestational weeks or more) and pre-pregnancy maternal weight, classified according to the pre-pregnancy BMI. Additionally, the perinatal outcomes evaluated in this study included gestational age (GA) at birth, birth weight (BW) categorized according to GA as adequate, large, or small and Apgar scores at the first and 5th minutes.ResultsEight hundred eighty pregnant women were selected, of whom 203 (23.07%) presented GDM and were eligible from December 2016 to December 2021. Based on the timing onset of GDM, 89 (43.8%) were in the early-onset group, and 114 (56.2%) were in the late-onset group. The fasting plasma glucose values in the first trimester were higher in the early-onset group. The 75-g OGTT values were higher in the late-onset group. The final BMI was higher in the early-onset group. Univariate linear regression was performed to determine the relationship between late-onset and maternal and neonatal outcomes; however, no significant relation was detected.ConclusionPregnant women with early-onset GDM showed a higher BMI during pregnancy, but there was no difference between early and late-onset GDM concerning neonatal adverse outcomes.

Association Between Obesity and Thrombosis During Pregnancy and the Postpartum Period: A Case-Control Study From a Tertiary Care Center in Kerala, India.

Background Obesity is postulated to be a high-risk factor for thrombosis along with the inherent hypercoagulability of pregnancy. The Confidential Review of Maternal Deaths (CRMD) found that thrombosis was one of the major causes of maternal deaths in Kerala. This study investigates the major risk factor - obesity and its association with thrombosis in our study setting, along with other risk factors. Obesity, being a modifiable risk factor, can thus be targeted to decrease maternal morbidity and mortality for a better pregnancy outcome. This study sought to examine the association between obesity and thrombosis during pregnancy and the postpartum period in a tertiary care center in Kerala, India, while also identifying other risk factors that may contribute to thrombotic events in this population. Methodology A hospital-based case-control study was conducted at Government Medical College, Thiruvananthapuram, Kerala, India, from March 2017 to September 2018. The study population comprised 42 cases diagnosed with thrombotic events during pregnancy and the postpartum period, including deep vein thrombosis (DVT), cortical venous thrombosis (CVT), and pulmonary thromboembolism (PTE). Using consecutive sampling from the hospital's labor register, 84 controls were selected, maintaining a case-to-control ratio of 1:2. Detailed clinical information was collected through direct patient interviews and medical record reviews. Body mass index (BMI) was calculated using pre-pregnancy weight and height measurements. Variables assessed included demographic characteristics, obstetric history, socioeconomic status, blood group, gestational age at thrombosis, type and location of thrombosis, risk factors, comorbidities, clinical manifestations, treatment modalities, and outcomes. Results The study demonstrated a significant association between obesity and thrombotic events in pregnancy and postpartum periods. In the case group, 21 patients (50.0%) presented with Class I obesity, and three patients (7.1%) with Class II obesity. The control group included 14 patients (16.7%) with Class I obesity and no patients (0%) with Class II obesity, revealing a significant difference in BMI class distribution between groups (χ2=25.979, p<0.001). Among the cases, DVTwas the predominant presentation in 29 patients (69.0%), primarily affecting the ileo-femoral region in 26 patients (61.9%). CVT occurred in 12 patients (28.6%). Of the DVT patients, obesity was present in 17 patients (58.6%) compared to 12 non-obese patients (41.4%), showing statistical significance (χ²=14.488, p=0.001).Additional significant risk factors were identified in the study group: period of immobility affected five patients (11.9%), puerperal infection was present in five patients (11.9%), and antiphospholipid antibodies (APLA) positivity was found in five patients (11.9%). All these risk factors showed statistically significant differences compared to controls (p=0.001).Treatment outcomes were favorable, with 40 patients (95.2%) achieving either complete resolution or showing improvement. Conclusion Obesity significantly increases pregnancy-associated thrombosis risk, particularly DVT in the ileo-femoral region. Additional factors like immobility, puerperal infection, and APLA positivity contribute to thrombosis development. While treatment outcomes are favorable, early recognition and management are crucial, especially in women with multiple risk factors.

The Causal Effect of Increasing Area-Level Income on Birth Outcomes and Pregnancy-Related Health: Estimates From the Marcellus Shale Boom Economy

Income is positively correlated with pregnancy health and birth outcomes, but the causal evidence for this association is limited. Leveraging a natural experiment based on the Pennsylvania boom economy created by the extraction of natural gas from the Marcellus Shale geological formation, we test whether area-level income gains impact birth outcomes (birth weight, gestational length, and preterm birth) and pregnancy health (prepregnancy and prenatal smoking, prepregnancy weight status, gestational weight gain, and the timing and adequacy of prenatal care). We append tax data to birth certificate data and compare health outcomes before and after the boom for births occurring in school districts above the Marcellus Shale. We also explore income effects with a subsample of siblings and test for nonlinear income effects by considering preboom district poverty rates. Using instrumented difference-in-differences models, we find that plausibly exogenous income gains increase the likelihood of having adequate prenatal care in the full sample. In the sibling sample, income gains decrease the likelihood of low birth weight but increase the likelihood of prepregnancy underweight among birthing parents. Results are statistically significant in initially high-poverty districts. We thus affirm prior findings of a causal effect of income on birth weight and prenatal care use but find minimal area-level income effects on other pregnancy-related health behaviors and birth outcomes.

Exploring parental factors influencing low birth weight on the 2022 CDC natality dataset

Background and aimsLow birth weight (LBW), known as the condition of a newborn weighing less than 2500 g, is a growing concern in the United States (US). Previous studies have identified several contributing factors, but many have analyzed these variables in isolation, limiting their ability to capture the combined influence of multiple factors. Moreover, past research has predominantly focused on maternal health, demographics, and socioeconomic conditions, often neglecting paternal factors such as age, educational level, and ethnicity. Additionally, most studies have utilized localized datasets, which may not reflect the diversity of the US population. To address these gaps, this study leverages machine learning to analyze the 2022 Centers for Disease Control and Prevention’s National Natality Dataset, identifying the most significant factors contributing to LBW across the US.MethodsWe combined anthropometric, socioeconomic, maternal, and paternal factors to train logistic regression, random forest, XGBoost, conditional inference tree, and attention mechanism models to predict LBW and normal birth weight (NBW) outcomes. These models were interpreted using odds ratio analysis, feature importance, partial dependence plots (PDP), and Shapley Additive Explanations (SHAP) to identify the factors most strongly associated with LBW.ResultsAcross all five models, the most consistently associated factors with birth weight were maternal height, pre-pregnancy weight, weight gain during pregnancy, and parental ethnicity. Other pregnancy-related factors, such as prenatal visits and avoiding smoking, also significantly influenced birth weight.ConclusionThe relevance of maternal anthropometric factors, pregnancy weight gain, and parental ethnicity can help explain the current differences in LBW and NBW rates among various ethnic groups in the US. Ethnicities with shorter average statures, such as Asians and Hispanics, are more likely to have newborns below the World Health Organization’s 2500-gram threshold. Additionally, ethnic groups with historical challenges in accessing nutrition and perinatal care face a higher risk of delivering LBW infants.

Obstetrical Characteristics and Glucose Profile of Singleton Primigravid Women with Gestational Diabetes Mellitus in Meru Mother and Child Health Clinic, Malaysia

This study aims to explore the baseline obstetric characteristics of singleton, primigravid women with Gestational Diabetes Mellitus (GDM) from an experimental study. A total of 58 subjects with GDM, who were solely on diet control, were recruited from Meru Health Clinic in Selangor. The majority of the subjects (97%) were Malay. The mean age of the subjects was 27.59±3.2 years, with a pre-pregnancy weight of 68.86±17.8 kg, a height of 1.56±0.1 m, and Body Mass Index (BMI) of 28.08±6.7 kg/m2. Most subjects in this study (93%) were diagnosed with GDM at their first Oral Glucose Tolerance Test (OGTT), conducted at a mean gestational age of 18.93±2.8 weeks. The OGTT readings at diagnosis were 5.1±0.6 mmol/L for Fasting Blood Glucose (FBG) and 7.9±1.5 mmol/L for 2-Hour Postprandial (2HPP). The Blood Sugar Profile (BSP) levels were recorded as follows: fasting at 4.8±0.4 mmol/L, pre-lunch at 5.1±0.5 mmol/L, post-lunch at 5.3±0.5 mmol/L, and post-dinner at 5.3±1.5 mmol/L. Macronutrient intake was within the recommended guidelines. The subjects delivered at a mean gestational age of 38.8±1.1 weeks, with a mean birth weight of 2.99±0.4 kg. No incidences of macrosomia were recorded in this study. In conclusion, the subjects underwent early GDM screening, had well-controlled antenatal blood glucose levels, and experienced no adverse pregnancy outcomes.

Evaluation of gestational weight gain in women with twin pregnancies and its relationship to neonatal birth weight. A pilot study

BackgroundTo date, there have been no studies in Poland on weight gain in women with twin pregnancies in relation to recommendations.ObjectiveThe aim of this study was to analyze the gestational weight gain of women with twin pregnancies depending on their body weight before pregnancy, and to assess the relationship between the observed weight gain and the neonatal birth weight.Material and MethodsThe study was conducted among 50 women in twin pregnancies and their 100 newborns delivered after 36 weeks of gestation. Gestational weight gain was assessed based on the American Institute of Medicine guidelines for women in twin pregnancies. Data on the pre-pregnancy body weight and gestational weight gain were collected by interviewing the patients. Neonatal data were obtained from the hospital medical records.ResultsNormal gestational weight gain was observed only in 38% of the women. In women with monochorionic pregnancy, too low body weight gain occurred almost 3 times more often than in women with dichorionic pregnancy (74% vs. 26%), (p&lt;0.001). Women with monochorionic pregnancies also gave birth to statistically significantly more newborns with low birth weight (&lt;2500 g), compared to women with dichorionic pregnancies (62.5% vs. 37.5%) (p=0.007). The mean birth weight of newborns born to mothers with excessive weight gain was 151 g higher than children born to mothers with normal weight gain (2727 g vs. 2576 g) (p=0.035).ConclusionsIn the majority of studied women in twin pregnancies, gestational weight gain was not compliant with the current recommendations. The risk of insufficient weight gain is higher in women with monochorionic pregnancies compared to women with dichorionic pregnancies.

Weight gain during pregnancy and the probability of macrosomia in women with gestational diabetes

Objective. To analyze the association between gestational weight gain in women with gestational diabetes and an increased risk of macrosomia. Materials and methods. Cohort study with 139 pregnant women screened by a single-step oral glucose tolerance curve between 24-28 weeks of gestation were confirmed with gestational diabetes and sent to a hospital. Pre-pregnancy body mass index (BMI) was calculated from pre-pregnancy weight. Weight was measured at each prenatal consultation. The reference category was women with normal prenatal BMI who gained appropriate weight during pregnancy. At each visit, medical nutrition therapy (MNT) consisted of nutritional counseling, physical activity plan, and insulin therapy. Compliance with MNT was measured by capillary glucose measurements taken by each participant at home. Results. 74.8% were primiparous, and 28.8% had normal pre-pregnancy BMI. The no linear logistic regression model showed women with normal pre-pregnancy BMI had twice (OR= 2.08, 95%CI: 1.07,4.05) the possibility of macrosomia, compared to mothers with overweight or obesity, adjusting for Capurro index, number of children in the family, and percent of compliance MNT. Macrosomia was the most prevalent childhood complication (12.3%). Conclusion. Women with normal pre-pregnancy BMI who gained more weight during pregnancy were at higher risk of having macrosomic infants.