Vitamin D deficiency and visceral adipose tissue in early pregnant women.

BACKGROUND: We aimed to assess the correlation between vitamin D serum level and visceral fat tissue during early pregnancy. METHODS: This cross-sectional study was performed in Pernambuco, Brazil. 190 low risk pregnant women (8-16 gestational weeks) were eligible. Visceral adipose tissue was measured by ultrasonography following the technique described by Armellini. The 25(OH) D in serum was determined through chemiluminescence. The Spearman correlation test was applied to evaluate the correlation between vitamin D serum level and VAT, considering p < 0.05 to be significant. RESULTS: Vitamin D insufficiency was present in 129 (67.8 %) of subjects. Pregnant women with or without vitamin D deficiency did not differ in age, gestational age, nutritional status and visceral adipose tissue. No correlation between visceral adipose tissue and 25(OH) D was observed: - 0.057 (p = 0.435). CONCLUSIONS: Maternal visceral adipose tissue and vitamin D serum level are not correlated during pregnancy.

Longitudinal variance of visceral fat thickness in pregnant adolescents.

This study aims to investigate the longitudinal change in visceral fat thickness (VFT) during normal pregnancy. A prospective cohort study with 75 primiparous adolescents was carried out in Petrolina, Brazil. VFT was evaluated by ultrasound between 12-20 weeks gestation and immediately after delivery. We noted a statistically significant increase in VFT; 1.3 cm ± 1.0. No correlation was found between VFT and maternal anthropometric variables. VFT increases about 30% from the first to the second half of pregnancy in primiparous adolescents.

Visceral adiposity in the first half of pregnancy predicts newborn weight among adolescent mothers.

OBJECTIVE: Maternal obesity is a strong risk factor for gestational diabetes mellitus and fetal macrosomia. We assessed the association between maternal visceral adiposity tissue (VAT) depth in the first half of pregnancy and both glucose tolerance in late pregnancy and newborn weight in pregnant adolescents. METHODS: We completed a prospective cohort study of 73 pregnant adolescents aged 10 to 19 years, without pre-pregnancy diabetes. VAT depth was measured by ultrasound at 12 to 20 weeks' gestation, followed by a two-hour 75-g oral glucose tolerance test at 36 to 39 weeks' gestation, to determine the glucose area under the curve (AUC glucose0-120). The association between VAT depth and newborn weight was evaluated by multiple linear regression analysis, controlling for maternal age, parity, smoking, gestational age at delivery, infant sex, pre-pregnancy BMI, weight gain in pregnancy, and fasting serum glucose at 36 to 39 weeks' gestation. The relation between VAT depth and AUC glucose0-120 was assessed by linear regression analysis, adjusting for maternal age, parity, smoking, pre-pregnancy BMI, and weight gain in pregnancy. RESULTS: A 1 cm increase in VAT depth was associated with a 206 g (95% CI 101 to 311) adjusted increase in mean birth weight. VAT depth and the other model covariates together explained more of the variance in birth weight (r(2) = 0.282; P < 0.001) than pre-pregnancy BMI with the other covariates in the same model (r(2) = 0.081; P = 0.076). All three glucose tolerance test measures were performed at 36 to 39 weeks' gestation in 51 of the 73 participants. The relationship between VAT depth and AUC glucose0-120 was not significant (P = 0.43). CONCLUSION: VAT depth in the first half of pregnancy predicts newborn weight better than BMI, but is not associated with glucose tolerance in late pregnancy.

Objectif : L'obésité maternelle constitue un solide facteur de risque en ce qui concerne le diabète sucré gestationnel et la macrosomie fœtale. Nous avons évalué, chez des adolescentes enceintes, l'association entre, d'une part, la profondeur du tissu adipeux viscéral (TAV) maternel au cours de la première moitié de la grossesse et, d'autre part, la tolérance au glucose aux derniers moments de la grossesse et le poids du nouveau-né. Méthodes : Nous avons mené une étude de cohorte prospective auprès de 73 adolescentes enceintes âgées de 10 à 19 ans qui ne présentaient pas un diabète prégrossesse. La profondeur du TAV a été mesurée par échographie à 12 - 20 semaines de gestation; par la suite, nous avons mené une épreuve d'hyperglycémie provoquée par voie orale (deux heures, 75 g) à 36 - 39 semaines de gestation, en vue de déterminer la surface sous la courbe du glucose (SSC glucose0­120). L'association entre la profondeur du TAV et le poids du nouveau-né a été évaluée au moyen d'une analyse de régression linéaire multiple, en neutralisant l'effet de l'âge maternel, de la parité, du tabagisme, de l'âge gestationnel au moment de l'accouchement, du sexe du nouveau-né, de l'IMC prégrossesse, du gain pondéral pendant la grossesse et de la glycémie à jeun à 36 - 39 semaines de gestation. La relation entre la profondeur du TAV et la SSC glucose0­120 a été évaluée au moyen d'une analyse de régression linéaire, en neutralisant l'effet de l'âge maternel, de la parité, du tabagisme, de l'IMC prégrossesse et du gain pondéral pendant la grossesse. Résultats : L'augmentation de la profondeur du TAV d'un centimètre a été associée à une hausse corrigée du poids moyen de naissance de 206 g (IC à 95 %, 101 - 311). La profondeur du TAV (prise en considération conjointement avec les autres covariables du modèle) a mieux permis d'expliquer la variance du poids de naissance (r2 = 0,282; P < 0,001) que l'IMC prégrossesse (prise en considération conjointement avec les autres covariables du même modèle) (r2 = 0,081; P = 0,076). Les trois épreuves d'hyperglycémie ont été menées à 36 - 39 semaines de gestation chez 51 des 73 participantes. La relation entre la profondeur du TAV et la SSC glucose0­120 ne s'est pas révélée être significative (P = 0,43). Conclusion : Bien que la profondeur du TAV au cours de la première moitié de la grossesse permette de mieux prédire le poids du nouveau-né que l'IMC, elle n'est pas associée à la tolérance au glucose aux derniers moments de la grossesse.

Perinatal characteristics among early (10-14 years old) and late (15-19 years old) pregnant adolescents.

BACKGROUND: Pregnancy in adolescents is a worldwide health problem and has been mostly common in poor populations. It is not clear if socioeconomic or biological factors are the main determinants of perinatal adverse outcomes in pregnant adolescents. Adolescents under 15 years old may present a high growth rate which may contribute to impair fetal growth. Our aim is to compare perinatal characteristics among early (aged 10 to 14 years) and late (aged 15 to 19 years) pregnant adolescents. METHODS: A cross-sectional study was performed using data from Pernambuco State 2009, obtained from DATASUS/SISNAC, a Brazilian Government, open-access public health database. Maternal and neonatal outcomes were compared between early (aged 10-14 years) and late (aged 15-19 years) pregnant adolescents. Family income was compared between early and late pregnant adolescents using a sample of 412 subjects evaluated at Instituto de Medicina Integral Prof. Fernando Figueira (IMIP) during 2011. Statistical comparisons were made using the chi-square test was used with a significant level of 0.05; bivariate and multivariate analysis were performed. This project was approved by the Institutional Ethics Review Board. RESULTS: Data from 31,209 pregnant adolescents were analyzed. 29,733 (95.2%) were aged 15 to 19 years and 1,476 (4.7%) were aged 10 to 14 years. There were significant differences with respect to marital status, education level and number of prenatal visits of mothers aged 10 to 14 years compared to 15 to 19 years. Of importance, early adolescents had a greater rate of neonates born premature and with low birth weight. Prematurity and low birth weight remained statistically significant after multivariate analysis. CONCLUSIONS: Early aged adolescents may have an increased risk of prematurity and low birth weight. These findings highlight the potential role of biological factors in newborn outcomes in pregnant adolescents.