Associations of Prepregnancy Morbid Obesity and Prenatal Depression with Gestational Weight Gain.

OBJECTIVES: Pregnancy outcomes and infant growth and development are influenced by various prenatal and postnatal factors. Gestational weight gain (GWG) is an important indicator of pregnancy management and outcomes. Information about the interaction between prenatal obesity and depression on GWG among low-income women is limited. There also is a lack of information about morbid obesity and GWG. The purpose of this study was to examine the associations of prepregnancy weight status, including morbid obesity as a separate group, and prenatal depression with GWG using electronic medical records in an academic prenatal clinic serving a largely low-income population. METHODS: Retrospective data were obtained from existing electronic medical records for pregnant women receiving care from an academic outpatient obstetrics/gynecology clinic, largely serving the low-income population of eastern North Carolina between January 2012 and May 2013 (N = 410). RESULTS: Approximately 74% of the study sample was low-income women (either Medicaid insured or uninsured). There was a high prevalence of obesity (28.3%), morbid obesity (14.1%), and prenatal depression (17.8%). A majority of women exceeded Institute of Medicine GWG recommendations (45%), whereas 30% fell below recommendations and 25% met the recommendations. Morbidly obese women had a lower than recommended average weight gain and were less likely to exceed recommendations than to meet them (odds ratio 0.32, 95% confidence interval 0.15-0.70, P = 0.004). Consistent with other findings, obese and overweight women had a higher than recommended average weight gain. CONCLUSIONS: GWG recommendations should continue to incorporate prepregnancy weight status. Separate recommendations should be considered for morbidly obese women, who tend to fall below current recommendations. Further studies are needed to understand the difference in weight gain or loss among overweight, obese, and morbidly obese women and to help inform prenatal care interventions aimed at promoting healthy weight gain.

Bone health in facioscapulohumeral muscular dystrophy: A cross-sectional study.

INTRODUCTION: Herein we provide a comprehensive overview of bone health in facioscapulohumeral muscular dystrophy (FSHD). METHODS: Ninety-four adult individuals with FSHD type 1 from 2 sites were included in this cross-sectional study. Clinical characteristics and determinants of bone health were examined. Relationships between bone mineral density (BMD), strength, and function were explored. RESULTS: Nearly a third of subjects were deficient in vitamin D3 . Mean whole-body BMD z-score was -0.7; 11% of subjects had greater than age-related reductions in whole-body BMD (z-score < -2.0). Whole-body and regional BMDs were associated with strength and function. Thirty-six percent had a history of fractures. Likelihood of fractures was reduced for those with normal whole-body BMD (odds ratio = 0.25, 95% confidence interval 0.04-0.78). DISCUSSION: A diagnosis of FSHD is not necessarily predictive of reduced BMD or increased fracture rate. Given the considerable variability of bone health in the FSHD population, strength and function can serve as predictors of BMD. Muscle Nerve 56: 1108-1113, 2017.