Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 525
Filtrar
1.
Artigo em Inglês | MEDLINE | ID: mdl-33530307

RESUMO

Despite the advancement of the healthcare system, low birth weight (LBW) remains as one of the leading causes of under-five mortality. This cross-sectional study aimed to determine the prevalence of LBW and its associated factors among 483 third trimester pregnant women recruited from six selected public health clinics in the Federal Territory of Kuala Lumpur and the state of Selangor, Malaysia. Pregnant women were interviewed for information on socio-demographic characteristics, smoking behaviour, and second-hand smoke (SHS) exposure at home and in the workplace. Information on the obstetrical history and prenatal care visits history were retrieved from the maternal medical records, while infant's birth outcomes were retrieved from infant medical records. The prevalence of LBW (<2.5 kg) in infants was 10.4%, with a mean birth weight of 3.0 [standard deviation (SD) 0.4] kg. Results from the multivariable logistic regression model showed that inadequate weight gained during pregnancy [odds ratio (OR) = 2.41, 95% confidence interval (CI) = 1.18-4.90] and exposure to SHS at home (OR = 1.92, 95% CI = 1.03-3.55) were significantly associated with LBW. In conclusion, pregnant women should monitor their rate of weight gain throughout pregnancy and avoid SHS exposure at home to reduce the risk of delivering LBW infants.


Assuntos
Ganho de Peso na Gestação , Poluição por Fumaça de Tabaco , Peso ao Nascer , Estudos Transversais , Feminino , Humanos , Lactente , Recém-Nascido de Baixo Peso , Recém-Nascido , Malásia/epidemiologia , Gravidez , Poluição por Fumaça de Tabaco/efeitos adversos , Ganho de Peso
2.
Medicine (Baltimore) ; 100(5): e24511, 2021 Feb 05.
Artigo em Inglês | MEDLINE | ID: mdl-33592904

RESUMO

ABSTRACT: Pregnant women with excessive gestational weight gain express an inflammatory status with multiple negative effects on birth outcomes.The aim of this study was to identify the relationship between gestational weight gain at different gestational ages and inflammatory status in pregnant women and their newborns assessing both interleukin 6 and 8, as well as hepcidin in these couples.Our study included 170 pregnant women and their newborns. Pregnant women were clinically assessed at the end of the 1st trimester and at term, whereas the newborns were assessed over the first 3 days of life. The levels of interleukin 6, 8 and hepcidin were measured in both pregnant women and their newborns.We noticed higher levels of interleukin 6, interleukin 8 and hepcidin in pregnant women at the time of delivery as compared to the end of the 1st trimester. We observed a direct significant correlation between gestational weight gain at the time of delivery and interleukin 8 in both mothers [r = 0.1834, 95% CI: 0.0293-0.3290, (P = .0167)] and newborns [r = 0.1790, 95% CI: 0.0248-0.3249, (P = .0195)]. Our study underlined that a higher gestational weight gain resulted in a significantly higher birth weight [r = 0.2190, 95% CI: 0.0663-0.3617, (P = .0041)].Our findings suggest that interleukin 8 might be an important indicator of inflammatory status in both mothers and newborns. Moreover, excessive gestational weight gain was associated with an increase in birth weight.


Assuntos
Peso ao Nascer/fisiologia , Ganho de Peso na Gestação/fisiologia , Mediadores da Inflamação/sangue , Adulto , Índice de Massa Corporal , Feminino , Idade Gestacional , Hepcidinas/sangue , Humanos , Recém-Nascido , Interleucina-6/sangue , Interleucina-8/sangue , Lipídeos/sangue , Paridade , Gravidez , Resultado da Gravidez , Características de Residência , Fatores Socioeconômicos , Adulto Jovem
3.
Int J Mol Sci ; 22(3)2021 Jan 26.
Artigo em Inglês | MEDLINE | ID: mdl-33530554

RESUMO

The aim of this review is to highlight the influence of the Mediterranean Diet (MedDiet) on Gestational Diabetes Mellitus (GDM) and Gestational Weight Gain (GWG) during the COVID-19 pandemic era and the specific role of interleukin (IL)-6 in diabesity. It is known that diabetes, high body mass index, high glycated hemoglobin and raised serum IL-6 levels are predictive of poor outcomes in coronavirus disease 2019 (COVID-19). The immunopathological mechanisms of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection include rising levels of several cytokines and in particular IL-6. The latter is associated with hyperglycemia and insulin resistance and could be useful for predicting the development of GDM. Rich in omega-3 polyunsaturated fatty acids, vitamins, and minerals, MedDiet improves the immune system and could modulate IL-6, C reactive protein and Nuclear Factor (NF)-κB. Moreover, polyphenols could modulate microbiota composition, inhibit the NF-κB pathway, lower IL-6, and upregulate antioxidant enzymes. Finally, adhering to the MedDiet prior to and during pregnancy could have a protective effect, reducing GWG and the risk of GDM, as well as improving the immune response to viral infections such as COVID-19.


Assuntos
/sangue , Diabetes Gestacional/prevenção & controle , Dieta Mediterrânea , Interleucina-6/sangue , Animais , Diabetes Gestacional/sangue , Diabetes Gestacional/epidemiologia , Feminino , Ganho de Peso na Gestação , Humanos , Estilo de Vida , Obesidade/sangue , Obesidade/epidemiologia , Obesidade/prevenção & controle , Gravidez
4.
São Paulo; s.n; 2021. 291 p.
Tese em Português | LILACS | ID: biblio-1152062

RESUMO

Introdução: O aumento da adiposidade no ambiente intrauterino e alterações na composição corporal neonatal podem estar relacionados com obesidade e doenças crônicas no futuro. O ganho de peso gestacional (GPG) está associado à obesidade infantil, porém, estudos que avaliaram a relação entre o GPG materno e a composição corporal do concepto revelaram resultados inconsistentes, especialmente no que se refere à adiposidade fetal. Objetivo: Avaliar a relação entre o GPG materno e a adiposidade do feto e composição corporal neonatal. Métodos: Estudo epidemiológico prospectivo do tipo coorte, realizado em Araraquara e região, envolvendo gestantes atendidas em 34 Unidades de Saúde do SUS e na Maternidade Municipal "Gota de Leite". As gestantes foram acompanhadas em três períodos gestacionais (≤19, 20-29 e 30-39 semanas), durante o parto, e posteriormente até 72 horas após o parto. Foram avaliadas 1005 gestantes no 1º período gestacional, 1002 pares de gestantes e fetos no 2º período, 991 pares de gestantes e fetos no 3º período e 412 pares de mães e respectivos neonatos. A taxa de ganho de peso (TGP) foi calculada a partir da diferença entre o peso aferido no período gestacional específico menos o peso avaliado no período gestacional anterior, dividido pelo número de semanas correspondente a esse intervalo. O GPG total foi obtido pela diferença entre o peso aferido na data do parto e o peso pré-gestacional e classificado em insuficiente, adequado e excessivo, de acordo com a última diretriz do Institute of Medicine (IOM). A adiposidade fetal e a composição corporal do neonato foram avaliadas, respectivamente, por ultrassonografia e pletismografia por deslocamento de ar. Modelos de regressão linear múltipla foram construídos de acordo com um conjunto de ajustes mínimos suficientes sugeridos por gráficos acíclicos direcionados, considerando os seguintes fatores de confusão: idade, cor da pele/etnia, escolaridade, renda per capita, tabagismo, ingestão de alcool, paridade, diabetes mellitus, hipertensão arterial, altura, IMC pré-gestacional, sexo, idade gestacional ao nascer, horas de vida do neonato. O nível de significância em todos os testes foi α = 5%. Resultados: Durante o 2º período gestacional, verificou-se que para cada 0,1 kg/semana da TGP, houve um aumento de 0,222 mm (p=0,012), 0,462 cm2 (p <0,001), e 0,310 cm2 (p <0,001) no tecido adiposo subcutâneo do abdômen, coxa e braço do feto, respectivamente. Também houve associação entre a TGP materna no 3º período gestacional e deposição de gordura subcutânea no braço (ß=0,484 cm2; p=0,001) e na coxa (ß=0,480 cm2; p=0,049) do feto. Quanto à composição corporal neonatal, observou-se que para cada 1 kg do GPG total houve aumento de 0,004 Kg (p=0,002) na massa gorda, 0,084% (p=0,025) no percentual de massa gorda e 0,009 Kg (p <0,001) na massa livre de gordura do neonato. Crianças de mulheres com GPG total insuficiente apresentaram massa livre de gordura 0,104 kg (p=0,009) menor que os neonatos de mães com GPG total adequado. Conclusão: De acordo com nosso conhecimento, este é o primeiro estudo na literatura internacional que investigou a associação entre ganho de peso materno e adiposidade fetal e composição corporal neonatal. Os resultados mostram um impacto diferente da TGP materno sobre o acúmulo de gordura fetal, de acordo com o período gestacional investigado. Também houve associação positiva entre GPG total e massa gorda, percentual de massa gorda e massa livre de gordura do neonato. Mães com GPG total insuficiente tiveram neonatos com menor massa livre de gordura.


Introduction: The increase in adiposity in the intrauterine environment and changes in neonatal body composition may be related to obesity and chronic diseases in the future. Gestational weight gain (GWG) is associated with childhood obesity, however, studies that evaluated the relationship between the maternal GWG and the body composition of the fetus revealed inconsistent results, especially with regard to fetal adiposity. Objective: To evaluate the relationship between maternal GWG and adiposity of the fetus and body composition of the newborn. Methods: This is an epidemiological prospective cohort study, carried out in Araraquara and region, involving pregnant women attended at 34 Health Units from the Brazilian National Health Service - SUS and at the Municipal Maternity "Gota de Leite". The pregnant women were followed up in the respective gestational periods: ≤ 19, 20-29 and 30-39 weeks, during delivery, and later up to 72 hours after delivery. One thousand and five (1005) pregnant women were evaluated in the 1st period of pregnancy, 1002 pairs of pregnant women and fetuses in the 2nd period, 991 pairs of pregnant women and fetuses in the 3rd period, and 412 pairs of mothers and newborns. The rate of weight gain (RWG) was calculated based on the difference between the weight measured in the gestational period minus the weight assessed in the previous gestational period, divided by the number of weeks corresponding to that interval. GWG was obtained by the difference between the weight measured at the date of delivery and the pre-gestational weight, and classified as insufficient, adequate, and excessive, according to the last guidelines of the Institute of Medicine (IOM). The fetal adiposity and body composition of the newborn were evaluated, respectively, by ultrasound and plethysmography by air displacement. Multiple linear regression models were constructed considering a set of sufficient minimum adjustments suggested by directed acyclic graphs, considering the following confounders: age, skin color/ethnicity, schooling, per capita income, smoking, alcohol intake, parity, diabetes mellitus, arterial hypertension, height, pre-gestational BMI, sex, gestational age at birth, hours of life of the newborn. The level of significance in all tests was α = 5%. Results: During the 2nd gestational period, it was found that for each 0.1 kg/week of RWG, there was an increase of 0.222 mm (p = 0.012), 0.462 cm2 (p<0.001), and 0.310 cm2 (p<0.001) in subcutaneous adipose tissue in the abdomen, thight and arm of the fetus, respectively. There was also an association between the RWG in the 3rd gestational period and deposition of subcutaneous fat in the arm (ß=0.484 cm2; p=0.001) and thigh (ß=0.480 cm2; p=0.049) of the fetus. Concerning the newborn's body composition, it was observed that for each 1 kg of total GWG there was an increase of 0.004 Kg (p=0.002) in the fat mass, 0,084% (p=0.025) in the percentage of fat mass, and 0.009 Kg (p<0.001) in the fat-free mass of the newborn. Considering the guidelines of the IOM, neonates of mothers who had an insufficient total GWG had a fat-free mass of 0.104 kg (p=0.009) less than those born to women with adequate total GWG. Conclusion: As far as we know, this is the first study in the international literature that investigated the association between maternal weight gain in three different periods of gestation and fetal adiposity and newborn adiposity. The results show a different impact of the maternal RWG on the accumulation of fetal fat, according to the gestational period investigated. There was also a positive association between total GWG and mass fat, percentage of fat mass, and fat-free mass of the fetus, regardless of pre-gestational BMI. Women with insufficient total GWG had neonates with lower fat-free mass.


Assuntos
Composição Corporal , Recém-Nascido , Adiposidade , Feto , Ganho de Peso na Gestação , Obesidade Pediátrica
5.
PLoS One ; 15(12): e0244449, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33382776

RESUMO

Dietary changes during pregnancy (DP) and post-partum are essential for women's nutrition status and the health of their offspring. We compared the diet quality DP and at 3-year post-partum (3YPP) and assessed the relationship between maternal diet quality and nutritional status using a prospective cohort design among women in East Jakarta. In total, 107 women were recruited from the study in 2014 and followed up at 3YPP in 2018. The mid-upper arm circumference (MUAC), weight, and height were evaluated. Food consumption data were collected from repeated 24-h recalls. The validated US Diet Quality Index-Pregnancy (DQI-P) scores with eight components were calculated using the food consumption data and compared between DP and 3YPP. Associations of the DQI-P score with the MUAC and weight gain DP and body mass index (BMI) at 3YPP were analyzed using multivariable linear and logistic regression. The median of the DQI-P score DP was significantly higher than at 3YPP [35 (27; 42) versus 27 (19; 30); p-value <0.001, respectively]. The higher DQI-P score was associated with increased weight gain DP of 3.3 kg (adjusted ß = 3.30, 95% confidence interval = 1.06-5.54) after adjusting for the mother's age and household income. The DQI-P score was not associated with an increased risk of chronic energy deficiency DP and overweight-obesity at 3YPP. Thus, the diet adequacy was associated with weight gain DP but did not affect the MUAC DP and BMI at 3YPP. The DQI-P score DP was slightly better than the diet at 3YPP; however, the overall diet quality was inadequate. In conclusion, a higher DQI-P score was associated with increased weight gain DP of 3.3 kg but was not associated with other nutritional status indices in DP and 3YPP. Innovative dietary quality improvement programs are required to reduce malnutrition risk in pregnant and reproductive-age women.


Assuntos
Ganho de Peso na Gestação/fisiologia , Fenômenos Fisiológicos da Nutrição Materna/fisiologia , Obesidade/epidemiologia , Período Pós-Parto/fisiologia , Adulto , Índice de Massa Corporal , Feminino , Seguimentos , Humanos , Indonésia/epidemiologia , Avaliação Nutricional , Estado Nutricional/fisiologia , Obesidade/fisiopatologia , Obesidade/prevenção & controle , Gravidez , Estudos Prospectivos , Adulto Jovem
6.
PLoS One ; 15(12): e0244221, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33332406

RESUMO

BACKGROUND: 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. METHODS: 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. RESULTS: 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. CONCLUSIONS: 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.


Assuntos
Ganho de Peso na Gestação , Conhecimentos, Atitudes e Prática em Saúde , Tocologia/estatística & dados numéricos , Médicos/estatística & dados numéricos , Adulto , Etiópia , Feminino , Humanos , Masculino , Inquéritos e Questionários/estatística & dados numéricos
7.
Wei Sheng Yan Jiu ; 49(5): 705-710, 2020 Sep.
Artigo em Chinês | MEDLINE | ID: mdl-33070809

RESUMO

OBJECTIVE: To explore the effect of pre-pregnancy weight and gestational weight gain in Chongqing City on birth weight of newborns. METHODS: Pregnant women were volunteered for the cohort study in 6 Maternal and Child Centers in Chongqing from January 2016 to June 2017, who were planning to be pregnant in latest 3 months. The basic information included height and weight of prepregnancy, first trimester, mid-trimester and third trimester of pregnancy, and pregnancy outcome were collected. ANOVA, chi square test and multi factor unconditional logistic regression model were used to analyze the data. RESULTS: In pre-pregnancy the major BMI of women were <18. 5(46. 74%, 1119/2394) and 18. 5≤BMI≤29. 99(47. 12%, 1128/2394), in first trimester of pregnancy, the figures were <18. 5(34. 46%, 825/2394) and 18. 5≤BMI≤29. 99(57. 77%, 1383/2394). The distribution BMI in above stages were statistically different(χ~2=74. 95, P<0. 01). The incidence of the low birth weight and macrosomia were 4. 51%(108/2394) and 6. 89%(165/2394). The average of neonatal birth weight, the low birth weight and macrosomia were statistically different(F=24. 18, P<0. 01) and(χ~2=66. 44, P<0. 01) comparisons among all prepregnancy BMI groups. The average birth weight of newborns, the low birth weight of the newborn and macrosomia were statistically different(F=11. 27, P<0. 01), and(χ~2=89. 53, P<0. 01) comparisons among all IOM groups of three stages of pregnancy. Low weight in pregnancy is the risk factor for low birth weight infants(RR=1. 90(95%CI 1. 27-2. 86)), while excessive gestational weight gain is the protective factor(RR=0. 66(95%CI 0. 46-0. 96)). Prepregnancy obesity(RR=3. 06(95%CI 1. 77-5. 31)) and excessive weight gain during pregnancy(RR=3. 60(95%CI 2. 48-5. 22)) were the risk factors for macrosomia. The above two factors, prepregnancy obesity and excessive weight gain during pregnancy interacted multiply. CONCLUSION: The figures of pre-pregnancy BMI are not equal to the BMI in first trimester of pregnancy. Low weight in pre-pregnancy is the risk factor for low birth weight infants, while excessive weight gain during pregnancy is the protective factor. Prepregnancy obesity and excessive weight gain during pregnancy are the risk factors for macrosomia. Prepregnancy obesity and excessive weight gain during pregnancy interacted multiply.


Assuntos
Ganho de Peso na Gestação , Peso ao Nascer , Índice de Massa Corporal , Criança , Estudos de Coortes , Feminino , Humanos , Recém-Nascido , Gravidez , Estudos Prospectivos
8.
Environ Health ; 19(1): 97, 2020 09 11.
Artigo em Inglês | MEDLINE | ID: mdl-32917231

RESUMO

BACKGROUND: Organophosphate esters (OPEs)-used as flame retardants and plasticizers-are associated with adverse pregnancy outcomes such as reduced fecundity and live births and increased preterm delivery. OPEs may interfere with growth and metabolism via endocrine-disruption, but few studies have investigated endocrine-related outcomes. The objective of this pilot study (n = 56 mother-infant pairs) was to evaluate associations of OPEs with gestational weight gain (GWG), gestational age at delivery, infant anthropometry, and infant feeding behaviors. METHODS: We quantified OPE metabolites (bis-2-chloroethyl phosphate [BCEP], bis (1,3-dichloro-2-propyl) phosphate [BDCPP], diphenyl phosphate [DPHP]) in pooled maternal spot urine collected throughout pregnancy (~ 12, 28, and 35 weeks' gestation). We obtained maternal sociodemographic characteristics from questionnaires administered at enrollment and perinatal characteristics from medical record abstraction. Trained research assistants measured infant weight, length, head and abdominal circumferences, and skinfold thicknesses at birth and 6 weeks postpartum. Mothers reported infant feeding behavior via the Baby Eating Behavior Questionnaire (BEBQ). Using multiple linear regression, we assessed associations of log2-transformed maternal urinary OPE metabolites with GWG, gestational age at delivery, infant anthropometry at birth, weekly growth rate, and BEBQ scores at 6 weeks postpartum. We used linear mixed effects (LME) models to analyze overall infant anthropometry during the first 6 weeks of life. Additionally, we considered effect modification by infant sex. RESULTS: We observed weak positive associations between all OPE metabolites and GWG. In LME models, BDCPP was associated with increased infant length (ß = 0.44 cm, 95%CI = 0.01, 0.87) and weight in males (ß = 0.14 kg, 95%CI = 0.03, 0.24). BDCPP was also associated with increased food responsiveness (ß = 0.23, 95%CI = 0.06, 0.40). DPHP was inversely associated with infant abdominal circumference (ß = - 0.50 cm, 95%CI = - 0.86, - 0.14) and female weight (ß = - 0.19 kg, 95%CI = - 0.36, - 0.02), but positively associated with weekly growth in iliac skinfold thickness (ß = 0.10 mm/wk., 95%CI = 0.02, 0.19). Further, DPHP was weakly associated with increased feeding speed. BCEP was associated with greater infant thigh skinfold thickness (ß = 0.34 mm, 95%CI = 0.16, 0.52) and subscapular skinfold thickness in males (ß = 0.14 mm, 95%CI = 0.002, 0.28). CONCLUSIONS: Collectively, these findings suggest that select OPEs may affect infant anthropometry and feeding behavior, with the most compelling evidence for BDCPP and DPHP.


Assuntos
Antropometria , Poluentes Ambientais/urina , Idade Gestacional , Ganho de Peso na Gestação/efeitos dos fármacos , Recém-Nascido/fisiologia , Exposição Materna , Organofosfatos/urina , Adulto , Composição Corporal/efeitos dos fármacos , Tamanho Corporal/efeitos dos fármacos , Ésteres/urina , Comportamento Alimentar/efeitos dos fármacos , Feminino , Humanos , Lactente , Recém-Nascido/crescimento & desenvolvimento , Gravidez , Rhode Island , Adulto Jovem
9.
PLoS One ; 15(8): e0237225, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32817619

RESUMO

Diet is believed to play a major role in maternal recovery, postpartum weight retention (PPWR) is one of the challenges for Chinese women. However, the association between puerperal women's diet and PPWR remained unclear and complicated in China. The study assessed the dietary quality of puerperal women using adjusted Chinese Dietary Balance Index-16 (DBI-16) and explored its associations with PPWR. Participants were enrolled in the Mother-Infant Cohort Study of China. Dietary intake and demographic characteristics were obtained by a semi-quantitative food frequency questionnaire and a self-designed questionnaire at 0-3 months postpartum. PPWR was calculated by the weight difference at 0-3months and 6-8months postpartum minus pre-pregnancy weight. Dietary quality was assessed using adjusted DBI-16. 316 puerperal women were enrolled. According to adjusted DBI-16, 84.8% of participants had an insufficient dietary intake (vegetables 84.8%, fruits 91.8%, dairy 87.3%, soybean 61.4% and aquatic foods 79.4%, respectively), 67.1% had an excessive intake (cereals 60%, meat 57.3% and eggs 64.9%, respectively), 98.4% had an imbalanced diet consumption. PPWR at 0-3, and 6-8 months were 6.0 (±5.1) kg and 5.2 (±7.7) kg, and the percentage of PPWR (≥5kg) were 63.0% and 52.8% respectively. Multivariable linear regression showed the intake of fish and shrimp at 0-3 months postpartum was negatively associated with PPWR at 6-8 months (ß = -0.114, SE = 0.279, p < 0.05). The diet quality of Chinese puerperal women was unreasonable and imbalanced. Fish intake tended to be a favorable factor for postpartum weight loss.


Assuntos
Dieta , Ganho de Peso na Gestação , Adulto , China , Ingestão de Alimentos , Feminino , Humanos , Estudos Longitudinais , Pessoa de Meia-Idade , Período Pós-Parto , Gravidez , Adulto Jovem
10.
Nutrients ; 12(8)2020 Jul 28.
Artigo em Inglês | MEDLINE | ID: mdl-32731389

RESUMO

Reproductive health is a significant public health issue during pandemics; however, the impacts of the novel 2019 coronavirus disease (COVID-19) on noninfected pregnant women are still unknown. This study intends (1) to examine whether emotional eating (EE) occurred during the pandemic triggered by disease concerns and (2) to explore the associations among EE, dietary changes, and gestational weight gain (GWG). Based on an online survey, 640 new mothers who experienced the lockdown in their third trimester were recruited from seven provinces in China. EE was evaluated with the Chinese version of the Dutch Eating Behavior Questionnaire, EE domain. A self-designed e-questionnaire was used to collect the data of participants on the sociodemographic characteristics, concerns about the COVID-19 pandemic, maternity information, physical activities, and dietary changes during lockdown. The results show that the average EE score was 26.5 ± 8.3, and women living in a severely affected area, who are very worried about the pandemic and who had less physical activity had a higher tendency of EE. Although there is a dietary pattern changed during pandemic, the average GWG in the studied group was in the normal range. However, a higher EE score was associated with a significant excess of GWG in women not from Wuhan (EE score 33-65 vs. 13-22: adjusted Odd Ratio (OR), 95% Confidence Interval (CI) = 1.90, 1.08-3.32). The sensitivity analysis that additionally adjusted for the pregestational body mass index and gestational metabolic disease was consistent with this result. The mediation model was also examined and showed that, after adjusting for living area and exercise, EE was associated with significantly increased consumption of cereals (EE score 33-65 vs. 13-22: adjusted OR, 95% CI = 2.22, 1.29-3.82) and oil (EE score 33-65 vs. 13-22: adjusted OR, 95% CI = 3.03, 1.06-8.69) but decreased consumption of fish and seafood (EE score 33-65 vs. 13-22: adjusted OR, 95% CI = 1.88, 1.14-3.11; 23-32 vs. 13-22: adjusted OR, 95% CI = 1.79, 1.20-2.66). In conclusion, this study indicated that EE occurred in a proportional number of pregnant women during the COVID-19 pandemic and is associated with excess GWG mediated by increased intake of certain foods. The findings suggest the need for psychosocial and nutritional education and interventions during pregnancy checkups. Further studies are needed to determine modifiable psychosocial predictors and potential nutritional concerns in pregnant women during disease outbreaks.


Assuntos
Betacoronavirus , Infecções por Coronavirus/epidemiologia , Dieta , Comportamento Alimentar/psicologia , Ganho de Peso na Gestação , Pandemias , Pneumonia Viral/epidemiologia , Adulto , China/epidemiologia , Emoções , Feminino , Humanos , Saúde Materna/estatística & dados numéricos , Fenômenos Fisiológicos da Nutrição Materna/fisiologia , Gravidez , Terceiro Trimestre da Gravidez , Estudos Retrospectivos , Inquéritos e Questionários
11.
BMC Public Health ; 20(1): 1071, 2020 Jul 06.
Artigo em Inglês | MEDLINE | ID: mdl-32631291

RESUMO

BACKGROUND: Parent-child dietary concordance is associated with child diet, but the clinical implications of mother-father dietary concordance during pregnancy are unknown. This study evaluates antenatal mother-father dietary concordance and associations with gestational weight gain (GWG). METHODS: Mother-father (n = 111) dyads with low income reported their fruit/vegetable (FV), fast food (FF), and sugar-sweetened beverage (SSB) consumption frequency during the first trimester of pregnancy. From electronic health records, we collected height and self-reported pre-pregnancy weight and calculated pre-pregnancy body mass index (BMI). The primary outcome was excessive GWG for pre-pregnancy BMI. Dyads were categorized as healthy or unhealthy concordant (consuming similarly high or low amounts of FV, FF, or SSB), or mother-healthy or father-healthy discordant (consuming different amounts of FV, FF, or SSB). Multivariable and logistic regressions analyzed associations between dietary concordance and GWG. RESULTS: Mothers were Hispanic (25%), 43% White, 6% Black, and 23% Asian or Other. Most mothers were employed (62%) making <$50,000/year (64%). Average maternal GWG was 11.6 kg (SD = 6.40), and 36% had excessive GWG. Mothers in the mother-healthy discordant FV group (OR = 4.84; 95% CI = 1.29, 18.22) and the unhealthy concordant FF group (OR = 7.08; 95% CI = 2.08, 24.12) had higher odds for excessive GWG, compared to healthy concordant dyads. SSB concordance was associated with higher GWG in unadjusted, but not adjusted models. CONCLUSIONS: Mothers had higher risk for excessive GWG when both partners had unhealthy FF consumption frequency, and when fathers had unhealthy FV consumption frequency. These findings imply that fathers should be involved in educational opportunities regarding dietary intake during pregnancy.


Assuntos
Dieta/estatística & dados numéricos , Pai/estatística & dados numéricos , Ganho de Peso na Gestação , Mães/estatística & dados numéricos , Complicações na Gravidez/epidemiologia , Adulto , Índice de Massa Corporal , Dieta/efeitos adversos , Inquéritos sobre Dietas , Feminino , Humanos , Modelos Logísticos , Estudos Longitudinais , Masculino , Pobreza , Gravidez , Complicações na Gravidez/etiologia , Trimestres da Gravidez , Cuidado Pré-Natal/estatística & dados numéricos
12.
Am J Clin Nutr ; 112(4): 991-1001, 2020 10 01.
Artigo em Inglês | MEDLINE | ID: mdl-32692805

RESUMO

BACKGROUND: Some nutritional interventions have shown their efficacy in reducing gestational weight gain (GWG); however, their applicability in routine care is limited. OBJECTIVE: We assessed the effectiveness of a low-intensity and high-coverage nutritional intervention on maternal and offspring outcomes; the intervention enhanced existing nutritional health care standards and practices at the primary health care level in Chile. METHODS: This study was a cluster-randomized controlled trial of 12 primary health care centers (PHCCs) from Santiago, Chile. PHCCs were randomly allocated to either nutritional intervention [intervention group (IG), n = 5] or routine care [control group (CG), n = 7]. A total of 4631 pregnant women were recruited (IG, n = 2565; and CG, n = 2066). Primary outcomes were adequate GWG and glycemic control in mothers and birth weight, birth length, macrosomia, and large for gestational age in neonates. The intervention consisted of 4 key actions: training of health care professionals on nutritional recommendations, counseling of pregnant women on diet and physical activity recommendations, offering a physical activity program implemented in the participating PHCCs, and adequate referral to dietitians. Women randomly assigned to the CG received routine antenatal care. RESULTS: At baseline, the mean age was 26.1 y; 45% of women were primipara and 24% were obese. No differences were found in the percentage of women achieving adequate GWG (IG: 30.3%, compared with CG: 31.3%; OR: 0.94; 95% CI: 0.81, 1.09), but women in the IG had lower GWG than those in the CG (11.3 compared with 11.9 kg; mean difference: -0.63 kg; 95% CI: -1.19, -0.08). Effects of the intervention were significantly higher in women with obesity at the begining of pregnancy (mean difference: -1.24 kg; 95% CI: -2.18, -0.30; P for interaction < 0.05). No differences were found between groups regarding maternal glycemic control or neonatal outcomes. CONCLUSIONS: Our findings demonstrate that a low-intensity, high-coverage intervention delivered through the Chilean public health care system under standard operating conditions reduces GWG and has the potential for successful scale-up. This trial was registered at clinicaltrials.gov as NCT01916603.


Assuntos
Peso ao Nascer , Ganho de Peso na Gestação , Fenômenos Fisiológicos da Nutrição Materna , Cuidado Pré-Natal , Adolescente , Adulto , Glicemia/análise , Feminino , Humanos , Recém-Nascido , Estado Nutricional , Gravidez , Adulto Jovem
13.
PLoS One ; 15(6): e0234907, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32569281

RESUMO

BACKGROUND: Low birth weight is a preventable public health problem. It is an important determinant of child survival and development, as well as long-term consequences like the onset of non-communicable disease in the life course. A large number of mortality and morbidity can be prevented by addressing the factors associated with low birth weight. The main objective of this study was to identify associated risk factors of low birth weight. METHODOLOGY: A health facility-based unmatched case-control study was carried out from July 2018 to March 2019 among the mothers who delivered in health facilities of Dang district of Nepal from 17th August to 16th November 2018. The total sample size for the study was 369; 123 cases and 246 controls. Cases and controls were randomly selected independent of the exposure status in the ratio of 1:2. Information regarding exposure status was assessed through interviews and medical records. Mothers who delivered outside Dang districts were excluded from the study. Ethical clearance was obtained from the Institutional Review Committee (IRC) of the Institute of Medicine, Tribhuvan University and written consent was taken from each participant after explaining the objectives of the study. RESULTS: Multivariate logistic regression found that having the kitchen in the same living house (AOR 2.7, CI: 1.5-4.8), iron intake less than 180 tablets (AOR 3.2, CI: 1.7-5.7), maternal weight gain during second and third trimester less than 6.53 kg (AOR 2.6, CI: 1.5-4.7), co-morbidity during pregnancy (AOR 2.4, CI: 1.3-4.5), preterm birth (AOR 2.9, CI: 1.4-6.1) were the risk factors associated with low birth weight. CONCLUSION: Having the kitchen in the same living house, iron intake less than 180 tablets during pregnancy, maternal weight gain less than 6.53 kg during the second and third trimester, co-morbidity during pregnancy and preterm birth were the risk factors associated with low birth weight.


Assuntos
Poluição do Ar em Ambientes Fechados/efeitos adversos , Ganho de Peso na Gestação , Recém-Nascido de Baixo Peso , Ferro/deficiência , Nascimento Prematuro/epidemiologia , Adulto , Estudos de Casos e Controles , Feminino , Instalações de Saúde , Humanos , Recém-Nascido , Mães , Nepal , Estado Nutricional , Gravidez , Complicações na Gravidez , Fatores de Risco , Adulto Jovem
14.
PLoS One ; 15(6): e0232749, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32574162

RESUMO

BACKGROUND: Maternal obesity is increasing worldwide but the consequences for maternal physiology and fetal growth are not fully understood. OBJECTIVE: To study whether changes in glucose and lipid metabolism during pregnancy differ between women with normal weight and overweight/obesity, and investigate which of these metabolic factors are associated with birthweight. DESIGN: Prospective, longitudinal study. SETTING: Department of Obstetrics, Oslo University Hospital, Rikshospitalet. POPULATION: 1031 healthy pregnant women with singleton pregnancies. METHODS: Blood samples from early and late pregnancy were analyzed for fasting glucose, insulin and lipids (total cholesterol, HDL-cholesterol, LDL-cholesterol and triglycerides). Associations between metabolic factors and birthweight (z-scores) were explored by linear regression models. Main Outcome Measures: Group-dependent longitudinal changes in glucose and lipids and their association with birthweight (z-scores). RESULTS: Compared to women with normal weight (BMI < 25), women with overweight (BMI 25-29.9) and obesity (BMI > 30) had significantly higher fasting glucose (4.54, 4.68 and 4.84 mmol/l), insulin (23, 33 and 50 pmol/l), total cholesterol (4.85, 4.99 and 5.14 mmol/l), LDL-C (2.49, 2.66 and 2.88 mmol/l) and triglycerides (1.10, 1.28 and 1.57 mmol/l), but lower HDL-C (1.86, 1.75 and 1.55 mmol/l). BMI (B 0.05, 95% CI 0.03-0.06, p<0.001), gestational weight gain (GWG) (B 0.06, 0.05-0.08, p<0.001) and an increase in fasting glucose (B 0.30, 0.16-0.43, p<0.001) were positively associated with birthweight, whereas a decrease in HDL-C (B -0.72, -0.96- -0.53, p<0.001) had a negative association with birthweight. CONCLUSIONS: Overweight/obesity was associated with an unfavorable metabolic profile in early pregnancy which was associated with increased birthweight. However, modifiable factors like gestational weight gain and an increase in fasting glucose were identified and can be targeted for interventions.


Assuntos
Peso ao Nascer , Glicemia , Índice de Massa Corporal , Lipídeos/sangue , Obesidade/epidemiologia , Complicações na Gravidez/epidemiologia , Adulto , Feminino , Ganho de Peso na Gestação , Humanos , Insulina/sangue , Estudos Longitudinais , Obesidade/sangue , Gravidez , Complicações na Gravidez/sangue , Estudos Prospectivos
15.
PLoS One ; 15(6): e0233671, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32584881

RESUMO

Growth faltering among children during the first five years of life is a common problem among low and middle-income countries. The purpose of this study was to determine the effect of a nutrient-rich, food-based supplement given to Vietnamese rural women prior to and/or during pregnancy on the growth of their infants during first 24 months of life and to identify maternal and newborn factors associated with the infant's growth. This prospective cohort study included 236 infants born to mothers who had received nutritional advice or a food supplement from pre-conception to term or from mid-gestation to term as part of a prior randomized controlled trial. Infant anthropometry and feeding information were monitored monthly and the infant weight for age Z-score (WAZ), length for age Z-score (LAZ), and weight for length Z-score (WLZ) were assessed at 6, 12, 18, and 24 months of age using mixed-effects regression modeling. Compared to the non-supplemented mothers, infants born to mothers receiving food supplementation from mid-gestation to term had significantly higher WLZ only at 18 months (p = 0.03) and did not differ in other outcomes. Supplementation from pre-conception to term did not affect infant growth at any time point during the first 24 months. In the entire study cohort, maternal height and gestational weight gain were positively associated with the infant's WAZ and LAZ from 6 to 24 months of age. Programs designed to improve gestational weight gain among women performing demanding physical work throughout a reproductive cycle may improve postnatal infant growth. Trial registration: Registered Clinical Trials.Gov: NCT01235767.


Assuntos
Desenvolvimento Infantil/fisiologia , Alimentos Fortificados/estatística & dados numéricos , Ganho de Peso na Gestação/fisiologia , Exposição Materna , Cuidado Pré-Natal/estatística & dados numéricos , Adulto , Aleitamento Materno , Pré-Escolar , Feminino , Humanos , Lactente , Recém-Nascido , Masculino , Mães/estatística & dados numéricos , Gravidez , Cuidado Pré-Natal/métodos , Estudos Prospectivos , População Rural/estatística & dados numéricos , Vietnã , Adulto Jovem
16.
Int Dent J ; 70(5): 396-404, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-32501575

RESUMO

OBJECTIVE: The aim of this study was to assess the association between high gestational weight gain and systemic and periodontal status of women between the 32nd and 36th gestational weeks of pregnancy (T1) and after delivery (T2), and the association of these factors with newborns' health. METHODS: The sample was divided into excessive gestational weight gain (GE = 25) and normal gestational weight gain (GN = 25) and was evaluated regarding: (i) socio-economic status; (ii) systemic and periodontal status; and (iii) newborns' health. The results were analysed using the Mann-Whitney U-test, the t-test, the Friedman test, analysis of variance (ANOVA) and Cochran's Q test (P < 0.05). RESULTS: Women with GE had lower household income (P = 0.010) and higher body mass index (BMI) at both T1 and T2. The prevalence of hypertension at T1 was higher in women with GE, but the condition resolved post-delivery (P = 0.001). Worsening in oral hygiene was observed at T2 in both groups (P < 0.001). Sixty-eight percent of women with GE and 16% of women with GN had periodontitis at T1, and 52% and 12%, respectively, had periodontitis at T2. In women with GE, the BMI of newborns was higher (P = 0.031). CONCLUSIONS: Women with high gestational weight gain also showed a high prevalence of hypertension and periodontitis during pregnancy, and persistent periodontitis after delivery. High gestational weight gain was related to high BMI of newborns.


Assuntos
Periodontite/epidemiologia , Complicações na Gravidez/epidemiologia , Índice de Massa Corporal , Feminino , Ganho de Peso na Gestação , Humanos , Recém-Nascido , Gravidez , Fatores de Risco , Ganho de Peso
17.
Diabetes Res Clin Pract ; 165: 108238, 2020 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-32502690

RESUMO

AIMS: To assist preventive strategies, we investigated the predictors and consequences of postpartum weight retention (PPWR) in the early and late postpartum period in women with gestational diabetes (GDM). METHODS: 862 women with GDM between 2011 and 2019 were prospectively included. We investigated PPWR at 6-8 weeks (n = 862) and at 1-year (n = 259) postpartum. Potential predictors included gestational weight gain (GWG), weight, BMI, and glucose control parameters during and after pregnancy. RESULTS: Mean PPWR at 6-8 weeks and 1-year postpartum were 4.6 ± 5.7 kg and 4.0 ± 7.4 kg. The proportion of women with PPWR at 6-8 weeks and at 1-year postpartum were 81% and 66.4% respectively. At 6-8 weeks postpartum, women with PPWR had higher pre-pregnancy weight, 7.5 ± 0.2 kg higher GWG and higher postpartum weight (all p ≤ 0.02), without presenting metabolic differences. At 1-year postpartum, there were no differences in anthropometric parameters before and during pregnancy between women with or without PPWR, except for a 4 ± 0.4 kg higher GWG (p < 0.001). However, women with PPWR had increased postpartum weight and BMI, higher fasting glucose and more pronounced increase in Δfasting glucose and ΔHbA1c at 1-year postpartum (all p ≤ 0.03). GWG predicted higher PPWR at both 6-8 weeks and at 1-year postpartum (all p < 0.001). CONCLUSION: Women with PPWR had increased anthropometric parameters and adverse metabolic consequences at 1-year postpartum. GWG was the most relevant predictor of PPWR.


Assuntos
Índice de Massa Corporal , Diabetes Gestacional/fisiopatologia , Ganho de Peso na Gestação/fisiologia , Adulto , Feminino , Humanos , Período Pós-Parto , Gravidez , Estudos Prospectivos
18.
PLoS One ; 15(6): e0233774, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32484813

RESUMO

OBJECTIVE: To develop and validate a prediction model for excess pregnancy weight gain using early pregnancy factors. DESIGN: Prospective cohort study. SETTING: We recruited from 12 obstetrical, family medicine, and midwifery centers in Ontario, Canada. PARTICIPANTS: We recruited English-speaking women with singleton pregnancies between 8+0-20+6 weeks. Of 1296 women approached, 1050 were recruited (81%). Of those, 970 women had complete data (970/1050, 92%) and were recruited at a mean of 14.8 weeks. PRIMARY OUTCOME MEASURE: We collected data on psychological, physical, and social factors and used stepwise logistic regression analysis to develop a multivariable model predicting our primary outcome of excess pregnancy weight gain, with random selection of 2/3 of women for training data and 1/3 for testing data. RESULTS: Nine variables were included in the final model to predict excess pregnancy weight gain. These included nulliparity, being overweight, planning excessive gain, eating in front of a screen, low self-efficacy regarding pregnancy weight gain, thinking family or friends believe pregnant women should eat twice as much as before pregnancy, being agreeable, and having emotion control difficulties. Training and testing data yielded areas under the receiver operating characteristic curve of 0.76 (95% confidence interval, 0.72 to 0.80) and 0.62 (95% confidence interval 0.56 to 0.68), respectively. CONCLUSIONS: In this first validated prediction model in early pregnancy, we found that nine psychological, physical, and social factors moderately predicted excess pregnancy weight gain in the final model. This research highlights the importance of several predictors, including relatively easily modifiable ones such as appropriate weight gain plans and mindfulness during eating, and lays an important methodological foundation for other future prediction models.


Assuntos
Ganho de Peso na Gestação , Sobrepeso/epidemiologia , Complicações na Gravidez/epidemiologia , Adulto , Emoções , Comportamento Alimentar , Feminino , Humanos , Modelos Estatísticos , Gravidez , Fatores Socioeconômicos
19.
PLoS One ; 15(5): e0233487, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32442181

RESUMO

OBJECTIVE: We identified clinical, dietary, and socioeconomic factors associated with insufficient gestational weight gain among Mexican pregnant women with human immunodeficiency virus (HIV) infection. METHODS: This was a cross-sectional study involving 112 pregnant women with HIV infection receiving antiretroviral therapy (ART). Data including viral load, complete blood analysis, and CD4 counts were extracted from medical records. An inquiry form was used to collect data on socioeconomic status and frequency of food intake. Pre-gestational weight was calculated based on pregnancy weight to obtain the body mass index (BMI) and weight gain for gestational age according the US Institute of Medicine. Of the study population, 68.7% were in consensual union, 31.3% were single, and 33.9% belonged to the two lowest socioeconomic strata. The median age and CD4 count were 27 (interquartile range [IQR]: 23-32) years and 418 (IQR: 267-591), respectively. The adequacy of energy was 91.8% (IQR: 74.1-117.7). The median energy intake from protein was 13.5% (IQR: 12.2-14.9) and from lipids, 35.5% (IQR: 31.1-40.3). Pregnant women with gastrointestinal symptoms and CD4 count <350 were seven times more likely to have folate deficiency (odds ratio [OR] 7.8, 95% confidence interval [CI] 1.6-38.1; p = 0.009) and six times more likely to have poor zinc intake (OR 6.7, 95% CI 1.3-36.8; p = 0.014). In all, 42.9% of the pregnant women consumed iron and folic acid supplements and 54.4% consumed multivitamin supplements. Moreover, 45.5% had a normal pre-gestational BMI, 41.1% were classified overweight, and 13.4% had obesity, whereas 62.5% showed insufficient gestational weight gain, and 18.8% experienced weight loss. The variables associated with insufficient weight gain were consensual union (OR 5.3, 95% CI 1.9-15.0; p = 0.002) and belonging to the lowest socioeconomic stratum (E) (OR 3.1, 95% CI 1.0-9.2; p = 0.046). CONCLUSION: Dietary strategies to improve gestational weight gain for Mexican women with HIV infection receiving ART must consider clinical and socioeconomic factors.


Assuntos
Fármacos Anti-HIV/uso terapêutico , Ganho de Peso na Gestação , Infecções por HIV/complicações , Infecções por HIV/tratamento farmacológico , Complicações Infecciosas na Gravidez/tratamento farmacológico , Complicações Infecciosas na Gravidez/patologia , Adulto , Estudos Transversais , Feminino , Infecções por HIV/patologia , Humanos , México , Estado Nutricional , Gravidez , Fatores de Risco , Classe Social , Carga Viral , Adulto Jovem
20.
Sci Rep ; 10(1): 8486, 2020 05 22.
Artigo em Inglês | MEDLINE | ID: mdl-32444832

RESUMO

This study aimed to identify the independent and combined effects of age, BMI at first prenatal visit and GWG on the risk of GDM. A retrospective cohort study of 1,951 pregnant women in Seremban district, Negeri Sembilan, Malaysia. GDM was defined as fasting plasma glucose (FPG) ≥5.6 mmol/l and/or 2-hour postprandial plasma glucose (2hPPG) ≥7.8 mmol/l. A higher percentage of women with GDM had 2 risk factors (29.0%) or >2 risk factors (8.6%) compared to non-GDM women (2 risk factors: 25.5%; >2 risk factors: 5.0%). In general, women with ≥2 risk factors were respectively 1.36-2.06 times more likely to have GDM compared to those without risk factors. Older maternal age and being overweight/obese were significantly associated with risk of GDM. Overweight/obese women with age ≥35 years had 2.45 times higher risk of GDM and having excessive GWG at second trimester further increased the risk of GDM. Age and BMI are independent risk factors for GDM but not GWG in the first and second trimester. The findings emphasize the need to focus on a healthy BMI before pregnancy and optimal GWG during pregnancy to improve pregnancy outcomes.


Assuntos
Índice de Massa Corporal , Diabetes Gestacional/etiologia , Ganho de Peso na Gestação , Sobrepeso/fisiopatologia , Adulto , Fatores Etários , Diabetes Gestacional/epidemiologia , Diabetes Gestacional/patologia , Feminino , Humanos , Incidência , Malásia/epidemiologia , Gravidez , Estudos Retrospectivos , Fatores de Risco
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA
...