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(searched for: Influence of Excessive Maternal Weight in Pregnancy on Mother’s and Newborn Health)
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Gueye Modou, Boiro Djibril, Sow Amadou, Ndongo Aliou Abdoulaye, Sofiatou Dieye, Papa Souley Sow, Faye Papa Moctar, Ndiaye Ousmane
Journal of Pediatrics, Perinatology and Child Health, Volume 4, pp 86-92; doi:10.26502/jppch.74050045

Abstract:
Excessive weight gain during pregnancy is associated with higher risks of complications in the mother and in the newborn. We carried out this work, the objective of which was to study the influence of excessive maternal weight gain during pregnancy. This was a prospective study carried out in Dakar over a period of 5 months. We included all women with a normal body mass index in early pregnancy. These parturients were divided into two groups: the first group consisted of women whose weight gain during pregnancy was normal between 11.5 and 16 kg and the second group were those who had an excessive weight gain greater than 16 kg. We analyzed maternal data and neonatal parameters. During the period, 194 women had a normal weight gain (PNP) and 104 an excessive weight gain (PEP), i.e., a prevalence of PEP of 10.5%. There were no differences in the two groups for marital status, geographic origin, level of education, drinking habits, maternal size and pathologies during pregnancy (p>0.05). On the other hand, maternal age, parity and absence of a professional activity were significantly associated with excessive weight gain during pregnancy. Regarding neonatal data, we did not note any significant difference with regard to gender, trophicity, Apgar score, stillbirth, postnatal transfer and neonatal mortality between the 2 groups.
Anastasiya Vanyarkina, Alla Petrova, Lyubov Rychkova
Published: 12 June 2019
by BMJ
Abstracts, Volume 104; doi:10.1136/archdischild-2019-epa.786

Abstract:
Background Rising of gestational diabetes (GD) incidence along with obesity, leads to increasing both pregnancy and neonatal complications. In utero exposure to hyperglycaemia increases the risk of future obesity and type 2 diabetes development. The aim was to evaluate influence of metabolic disorders and body mass index (BMI) in women with GD on the risk of diabetic fetopathy development in their newborns. Materials and methods Monocentric, ambispective, observational study was conducted at Tertiary Perinatal Centre, Irkutsk, Russia, between January 2018 and January 2019. It included 34 newborns from mothers with GD. Inclusion criterion was confirmed GD in the mother. Pregnancy complications, perinatal outcomes in diabetic mothers and their newborns follow-up data were collected and analyzed. Results At birth, mean weight was 2647 grams (IQR 920–4420). Mean gestational age was 38 weeks (IQR 27–41). Among newborns, 52.9% was premature and 5.8% was small for gestational age. Symptomatic diabetic fetopathy (DF) was revealed in 17 infants (DF group), and 17 infants did not have DF (controls). Mothers of newborns with fetopathy were tested on GD at 31 (IQR 30–32) week of pregnancy, and mothers of controls (p=1.0) – at 25 (IQR 20–30) week. It was found that mothers of newborns with DF 6 times oftener had an elevated BMI at first pregnancy consultation than mothers of controls - 12 vs 2, respectively (OR = 3.4; 95% CI: 1.2–5.5), and they had excessive weight gain during pregnancy 3.5 times oftener than those without DF - 14 vs 4 (OR = 4.1; 95% CI: 1.0–6.7), respectively. GD was associated with hypertensive disorders of pregnancy (including pre-eclampsia, pregnancy-induced hypertension) in most mothers of DF group, comparing to controls (82.3% versus 47%; p=0.03). Ultrasonography detected excessive growth of the fetus (11.7%; p=0.2) and polyhydramnios (29.4%; p=0.3) in mothers of DF group. Mothers of DF group had caesarean sections 5 times oftener than mothers of controls: 10 vs 2 (p=0.004), respectively. Macrosomia, neonatal hypoglycaemia and hypocalcaemia were common symptoms among DF newborns compared with controls: 47% vs 11.7% (p=0.02), 100% vs 0 (p
Vipin Gupta, Ruchi Saxena, Gagandeep Kaur Walia, Tripti Agarwal, Harsh Vats, Warwick Dunn, Caroline Relton, Ulla Sovio, Aris Papageorghiou, George Davey Smith, et al.
Published: 1 April 2019
by BMJ
BMJ Open, Volume 9; doi:10.1136/bmjopen-2018-025395

Abstract:
IntroductionPregnancy is characterised by a high rate of metabolic shifts from early to late phases of gestation in order to meet the raised physiological and metabolic needs. This change in levels of metabolites is influenced by gestational weight gain (GWG), which is an important characteristic of healthy pregnancy. Inadequate/excessive GWG has short-term and long-term implications on maternal and child health. Exploration of gestational metabolism is required for understanding the quantitative changes in metabolite levels during the course of pregnancy. Therefore, our aim is to study trimester-specific variation in levels of metabolites in relation to GWG and its influence on fetal growth and newborn anthropometric traits at birth.Methods and analysisA prospective longitudinal study is planned (start date: February 2018; end date: March 2023) on pregnant women that are being recruited in the first trimester and followed in subsequent trimesters and at the time of delivery (total 3 follow-ups). The study is being conducted in a hospital located in Bikaner district (66% rural population), Rajasthan, India. The estimated sample size is of 1000 mother-offspring pairs. Information on gynaecological and obstetric history, socioeconomic position, diet, physical activity, tobacco and alcohol consumption, depression, anthropometric measurements and blood samples is being collected for metabolic assays in each trimester using standardised methods. Mixed effects regression models will be used to assess the role of gestational weight in influencing metabolite levels in each trimester. The association of maternal levels of metabolites with fetal growth, offspring’s weight and body composition at birth will be investigated using regression modelling.Ethics and disseminationThe study has been approved by the ethics committees of the Department of Anthropology, University of Delhi and Sardar Patel Medical College, Rajasthan. We are taking written informed consent after discussing the various aspects of the study with the participants in the local language.
Edmond D. Shenassa, Celena Kinsey, Marian Moser Jones, Jenifer Fahey
Obstetrical & Gynecological Survey, Volume 72, pp 445-453; doi:10.1097/ogx.0000000000000459

The publisher has not yet granted permission to display this abstract.
Carmen Mª López Mas
Efectos del ejercicio físico programado durante el embarazo en las variables intra-parto maternas y del recién nacido/a. Ensayo clínico aleatorizado; doi:10.20868/upm.thesis.44392

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C I Ikaraoha, Nkeiruka Chigaekwu Mbadiwe, John Ibhagbemien Anetor, Constance Nwadike, Isreal Ojareva Oforofuo
Asian Journal of Medical Sciences, Volume 7, pp 49-54; doi:10.3126/ajms.v7i4.14372

Abstract:
Background: New evidence suggests that excessive production of reactive oxygen species give rise to oxidative stress which could impair fetal growth. Antioxidant vitamin C and vitamin E have vital role in physiological process of pregnancy and health of the developing fetus.Aims and Objectives: To determine the concentrations of vitamin C and vitamin E in pair-matched maternal and cord serum of newborns and to determine the relationship between maternal/cord serum vitamin C and vitamin E at delivery and birth outcomes.Materials and Methods: A total of 209 maternal and cord blood samples were collected during delivery for serum vitamin C and E determination. Birth outcomes; birth weight, birth length, head circumference, and Apgar score were determined.Result: Newborns had significantly higher levels of vitamin C as compared to their mothers, but had non-significant lower level of vitamin E. Levels of vitamin C and E in both maternal and cord serum were positively correlated to birth weight, birth length, head circumference and Apgar score.Conclusion: Maternal vitamin C and E had significant effects on birth outcomes. A positive correlation of vitamin C and E indicates that their status in mother does influence newborns status.Asian Journal of Medical Sciences Vol.7(4) 2016 49-54
Ruben Barakat, María Perales, Mariano Bacchi, Javier Coteron, Ignacio Refoyo
American Journal of Health Promotion, Volume 29, pp 2-8; doi:10.4278/ajhp.130131-quan-56

The publisher has not yet granted permission to display this abstract.
R C Huang, V Burke, John P Newnham, F J Stanley, G E Kendall, L I Landau, W H Oddy, K V Blake, Lyle J Palmer, L J Beilin
International Journal of Obesity, Volume 31, pp 236-244; doi:10.1038/sj.ijo.0803394

Abstract:
Background:Features of the metabolic syndrome comprise a major risk for cardiovascular disease and will increase in prevalence with rising childhood obesity. We sought to identify early life influences on development of obesity, hypertension and dyslipidemia in children.Methods and results:Cluster analysis was used on a subset of a longitudinal Australian birth cohort who had blood samples at age 8 (n=406). A quarter of these 8-year-olds fell into a cluster with higher body mass index, blood pressure (BP), more adverse lipid profile and a trend to higher serum glucose resembling adult metabolic syndrome. There was a U-shaped relationship between percentage of expected birth weight (PEBW) and likelihood of being in the high-risk cluster. The high-risk cluster had elevated BP and weight as early as 1 and 3 years old. Increased likelihood of the high-risk cluster group occurred with greatest weight gain from 1 to 8 years old (odds ratio (OR)=1.4, 95% confidence interval (CI)=1.3–1.5/kg) and if mothers smoked during pregnancy (OR=1.82, CI=1.05–3.2). Risk was lower if children were breast fed for ⩾4 months (OR=0.6, 95% CI=0.37–0.97). Newborns in the upper two quintiles for PEBW born to mothers who smoked throughout pregnancy were at greatest risk (OR=14.0, 95% CI=3.8–51.1) compared to the nadir PEBW quintile of non-smokers.Conclusion:A U-shaped relationship between birth weight and several components of the metabolic syndrome was confirmed in a contemporary, well-nourished Western population of full-term newborns, but post-natal weight gain was the dominant factor associated with the high-risk cluster. There was a prominence of higher as well as lowest birth weights in those at risk. Future health programs should focus on both pre- and post-natal factors (reducing excess childhood weight gain and smoking during pregnancy), and possibly the greatest benefits may arise from targeting the heaviest, as well as lightest newborns, especially with a history of maternal smoking during pregnancy.
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