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Gestational Weight Gain (gestational + weight_gain)
Selected AbstractsRetention of Pregnancy-Related Weight in the Early Postpartum Period: Implications for Women's Health ServicesJOURNAL OF OBSTETRIC, GYNECOLOGIC & NEONATAL NURSING, Issue 4 2005Lorraine O. Walker Objective: To examine the proportion of women who reached their prepregnant weight at 6 weeks postpartum and the average amount of weight retained or lost by this time; to determine predictors of early (6 week) postpartum weight retention; and to propose related implications for women's health care and services. Data Sources: The literature review was based on a search of Medline for the years 1986 to 2004 using the keywords postpartum weight with inclusion of additional articles known to the authors that did not appear in the electronic search. Study Selection: The resulting 83 articles were scrutinized to identify those that reported data on weight retention at 6 weeks postpartum (range, delivery to 3 months) and associated anthropometric, social, obstetric, or behavioral predictors. A total of 12 articles met inclusion criteria for the review. Data Extraction: Data were extracted related to the proportion of women achieving their postpartum weight at 6 weeks postpartum, the amount of weight retained or lost up to 6 weeks postpartum, and predictors of amount of weight retained or lost. Data Synthesis: On average, at 6 weeks postpartum, women retain 3 to 7 kg of the weight gained during pregnancy, with at least two thirds exceeding their prepregnant weights. Gestational weight gain is the most significant predictor of weight retention. Conclusions: Women vulnerable to obesity and weight gain need weight-related health care and improved access to such care to promote weight loss after 6 weeks postpartum. [source] Are patients with positive screening but negative diagnostic test for gestational diabetes under risk for adverse pregnancy outcome?JOURNAL OF OBSTETRICS AND GYNAECOLOGY RESEARCH (ELECTRONIC), Issue 3 2008Ilknur I. Gumus Abstract Objective:, Our aim was to determine the obstetrics outcomes of patients with positive 1-h glucose challenge test (GCT), but negative diagnostic test for gestational diabetes. Methods:, Pregnancy records of 409 pregnants were reviewed. Patients were screened for gestational diabetes mellitus (GDM) with one-hour 50 g glucose challenge test (GCT) at 24,28 weeks of gestation. Patients with glucose challenge tests values , 130 mg/dL were refered for the 3 h, 100-g oral glucose tolerance test (OGTT). Positive GCT but negative for OGTT group (Group A) were compared retrospectively with the group of negative GCT (Group B) for obstetrics outcomes. Result:, GDM and impared glucose tolerance (IGT) were diagnosed in 33 (7.6%) and 46 (10.5%) patients, respectively. We identified 141 (34.4%) patients with positive GCT but negative for OGTT (Group A) and 189 (46.2%) patients with negative GCT (Group B). Gestational weight gain, polyhydramnios, family history of diabetes mellitus were significantly higher in group A than group B (P < 0.05). Prevalance of preterm labor, hypertension, cesarean delivery, mean birthweight, proportion of babies admitted to neonatal intensive care unit were similar in both groups. Conclusion:, There are some differences for pregnancy outcomes between pregnants with positive GCT but negative for OGTT and negative GCT. These patients should be followed up carefully during the antepartum and intrapartum period. [source] Attitudes toward weight gain during pregnancy: Results from the Norwegian mother and child cohort study (MoBa)INTERNATIONAL JOURNAL OF EATING DISORDERS, Issue 5 2009MSPH, Rebecca A. Swann BS Abstract Objective To explore attitudes toward weight gain during pregnancy in women with and without eating disorders and across eating disorder subtypes, and to examine associations among weight-gain attitudes and actual gestational weight gain, infant birth weight, and infant size-for-gestational-age. Method Pregnant women (35,929) enrolled in the prospective population-based Norwegian mother and child cohort study (MoBa) provided information at approximately week 18 of gestation regarding eating disorders and weight gain attitudes. We explored these variables in women with anorexia nervosa, bulimia nervosa, eating disorder not otherwise specified, purging type, and binge eating disorder (BED). Results The presence of an eating disorderly was associated with greater worry over gestational weight gain. In women without eating disorders, greater worry was associated with higher gestational weight gain, higher infant weights, greater likelihood of a large-for-gestational-age infant, and reduced likelihood of a small-for-gestational-age infant. Women with BED who reported greater worry also experienced higher weight gains during pregnancy. Discussion Women with eating disorders tend to experience weight-gain-related worry during pregnancy. Early worry about gestational weight-gain may be a harbinger of high gestational gain. © 2008 by Wiley Periodicals, Inc. Int J Eat Disord, 2009 [source] Birth outcomes in women with eating disorders in the Norwegian Mother and Child cohort study (MoBa)INTERNATIONAL JOURNAL OF EATING DISORDERS, Issue 1 2009Cynthia M. Bulik PhD Abstract Objective We explored the impact of eating disorders on birth outcomes in the Norwegian Mother and Child Cohort Study. Method Of 35,929 pregnant women, 35 reported broad anorexia nervosa (AN), 304 bulimia nervosa (BN), 1,812 binge eating disorder (BED), and 36 EDNOS-purging type (EDNOS-P) in the six months before or during pregnancy. The referent comprised 33,742 women with no eating disorder. Results Pre-pregnancy body mass index (BMI) was lower in AN and higher in BED than the referent. AN, BN, and BED mothers reported greater gestational weight gain, and smoking was elevated in all eating disorder groups. BED mothers had higher birth weight babies, lower risk of small for gestational age, and higher risk of large for gestational age and cesarean section than the referent. Pre-pregnancy BMI and gestational weight gain attenuated the effects. Conclusion BED influences birth outcomes either directly or via higher maternal weight and gestational weight gain. The absence of differences in AN and EDNOS-P may reflect small numbers and lesser severity in population samples. Adequate gestational weight gain in AN may mitigate against adverse birth outcomes. Detecting eating disorders in pregnancy could identify modifiable factors (e.g., high gestational weight gain, binge eating, and smoking) that influence birth outcomes. © 2008 by Wiley Periodicals, Inc. Int J Eat Disord 2009 [source] Assessment of weight changes during and after pregnancy: practical approachesMATERNAL & CHILD NUTRITION, Issue 1 2008Amanda R. Amorim Abstract The usefulness of routine prenatal weight measurements in predicting pregnancy outcomes is still a controversial issue. Comparisons among studies and the interpretation of research findings are complicated due to the variety of indicators applied to express maternal weight changes during and after pregnancy. A review of literature was conducted to clarify the definitions and examine the strengths and limitations of methods for measuring gestational weight gain (WG) and postpartum weight changes. The reasons for weak correlations or non-significant associations between gestational WG and maternal and neonatal outcomes were probably owing to poor quality of obstetrics records and selection of wrong indicators to compute gestational WG. The choice of an indicator depends on clinical and research purpose, availability and reliability of data and cost. Considering the health implication of gestational WG, it is necessary to take into account the measurements used as initial and final weight, accuracy of gestational age estimation and the inclusion of fetal weight as part of maternal WG. Regardless of the indicators used to compute the weight changes after delivery, attention is drawn to the approach for designating prepregnancy weight, the time frame of postpartum weight measurements and the use of overlapping variables, which results in bias (part,whole correlation). It is necessary to address criticisms on the accuracy of prenatal weight measurements and the way of expressing the maternal weight changes during and after pregnancy in order to have reliable results from research. [source] Obesity and Pregnancy: Implications and Management Strategies for ProvidersMOUNT SINAI JOURNAL OF MEDICINE: A JOURNAL OF PERSONALIZED AND TRANSLATIONAL MEDICINE, Issue 6 2009Taraneh Shirazian MD Abstract Obesity in pregnancy (pregravid body mass ,30) has been linked to several adverse pregnancy outcomes, including spontaneous abortion, preeclampsia, gestational diabetes, fetal macrosomia, cesarean delivery, and wound complications post,cesarean section. Intrapartum and postpartum management of obese gravidas requires multidisciplinary consultations between obstetricians, anesthesiologists, nurses, and pediatricians in order to improve the pregnancy outcomes of the mother and neonate. The American College of Obstetricians and Gynecologists currently supports risk-reducing strategies for obese pregnant patients, including limiting weight gain to 15 lb (standardized by the Institute of Medicine). Interventions to reduce gestational weight gain may be important modifiable risk factors for maternal and fetal perinatal complications. Interventions have targeted modifications of diet and exercise with educational methods such as radio broadcasts, pamphlets, and counseling. Interventions have also focused on motivational methods, such as individual and group classes, and have been implemented both before conception and immediately after birth. Effective interventions appear to be individualized in approach, but there is a lack of data to support any specific model. Prospective interventional studies are needed to demonstrate the benefits of weight limitation on pregnancy outcomes. Mt Sinai J Med 76:539-545, 2009. © 2009 Mount Sinai School of Medicine [source] The impact of past pregnancy experience on subsequent perinatal outcomesPAEDIATRIC & PERINATAL EPIDEMIOLOGY, Issue 4 2008Jennifer A. Hutcheon Summary In perinatal epidemiology, the basic unit of analysis has traditionally been the individual pregnancy. In this study, we sought to explore the idea of a ,reproductive life'-based approach to modelling the effects of reproductive exposures and outcomes, where the basic unit of analysis is a woman's entire reproductive experience. Our objective was to explore whether a first pregnancy risk factor, excess gestational weight gain, has a direct effect on the birthweight outcomes of a subsequent pregnancy, independent of the weight gain and other risk factors of the second pregnancy. A study population was created by linking the obstetric records of 1220 women who delivered their first and second offspring at a McGill University teaching hospital in Montreal, Canada. Multivariable linear and logistic regression analyses were used to model the effects of gestational weight gain above recommendation on the birthweight Z -score and risk of large-for-gestational age (LGA) subsequent offspring. After adjusting for the risk factors of the second pregnancy, an independent effect from the first pregnancy was seen on the birthweight Z -score, (effect size OR 0.17 [95% CI 0.05, 0.28] but not risk of LGA of the second pregnancy 1.30 [95% CI 0.89, 1.89]). We concluded that a pregnancy-centred approach to research that conceptualises pregnancies as self-contained and interchangeable events may not always be appropriate, and propose that analytical methods for some perinatal research questions may need to consider a given pregnancy in the context of a woman's past reproductive experiences. [source] The long-term impact of adolescent gestational weight gain,RESEARCH IN NURSING & HEALTH, Issue 2 2008Susan W. Groth Abstract This study involved 330 primiparous Black adolescents. The purpose of the study was to examine predictors of body mass index (BMI) change in Black adolescents 6 and 9 years after they gave birth. Predictors were gestational weight gain, pre-pregnant BMI, and age (p,<,.001). For older adolescents (ages 18,19), gestational weight gain was the only predictor of BMI change (p,=,.008). Regardless of pre-pregnant BMI category, adolescents whose gestational weight gain exceeded Institute of Medicine (IOM) recommendations were 4.6 times more likely to be obese than those whose weight gain was within recommendations. Excessive gestational weight gain and pre-pregnant overweight contribute to adolescent obesity. These findings have implications from both a clinical and public health perspective. © 2008 Wiley Periodicals, Inc. Res Nurs Health 31:108,118, 2008 [source] Maternal sleep deprivation is a risk factor for small for gestational age: A cohort studyAUSTRALIAN AND NEW ZEALAND JOURNAL OF OBSTETRICS AND GYNAECOLOGY, Issue 4 2009Chrishantha ABEYSENA Aims: To determine trimester-specific risk factors for small-for-gestational-age (SGA) infants. Methods: A population-based prospective cohort study was conducted in Sri Lanka from May 2001 to April 2002. Pregnant women were recruited on or before 16 weeks of gestation and followed up until delivery. The sample size was 690. Trimester-specific exposure status and potential confounding factors were gathered on average at 12th, 28th and 36th weeks of gestation. SGA was assessed using customised birth centile charts. Multiple logistic regression was applied, and the results were expressed as odds ratios (OR) and 95% confidence intervals (95%CI). Results: The risk factors for SGA less than 5th centile were shift work and exposure to physical and chemical hazards during 2nd and 3rd trimesters (OR 4.20, 95%CI 1.10,16.0), sleeping for less than or equal to 8 h during 2nd or 3rd or both trimesters (OR 2.23, 95%CI 1.08,4.59), walking for less than or equal to 2.5 h per day (OR 2.66, 95%CI 1.12,6.31) and alcohol consumption during the 3rd trimester (OR 14.5, 95%CI 2.23,94.7). Poor weekly gestational weight gain was significantly associated with both SGA < 10th and < 5th centiles. None of the other factors became significant for SGA < 10th centile. Conclusions: Risk factors for SGA less than 5th centile were sleep deprivation and shift work and exposure to physical and chemical hazards during 2nd and 3rd trimesters, less walking hours and alcohol consumption during 3rd trimester. Poor weekly gestational weight gain may be considered as a predictor of delivering an SGA infant. [source] Maternal anthropometric risk factors for caesarean delivery before or after onset of labourBJOG : AN INTERNATIONAL JOURNAL OF OBSTETRICS & GYNAECOLOGY, Issue 9 2007A Sherrard Objective, To quantify the effects of pre-pregnancy body mass and gestational weight gain, above and beyond their known effects on birthweight, on the risk of primary and repeat caesarean delivery performed before or after the onset of labour. Design, Hospital-based historical cohort study. Setting, Canadian university-affiliated hospital. Population, A total of 63 390 singleton term (,37 weeks gestation) infants with cephalic presentation. Methods, We studied prospectively archived deliveries at the Royal Victoria Hospital in Montreal, Canada, from 1 January 1978 to 31 March 2001 using multiple logistic regression models to estimate relative odds of caesarean delivery. Main outcome measure, Caesarean delivery, primary or repeat and before or after the onset of labour. Results, Pregravid obesity (body mass index ,30 kg/m2) increased the likelihood of primary caesarean delivery before (OR = 2.01, 95% CI 1.39,2.90) and after (OR = 2.12, 95% CI 1.86,2.42) the onset of labour. High net rate of gestational weight gain (>0.50 kg/week) increased the risk but only after labour onset (OR = 1.40, 95% CI 1.23,1.60). Among women with a previous caesarean, high weight gain modestly increased risk but only before labour (OR = 1.38, 95% CI 1.04,1.83), whereas obesity increased the risk of caesarean delivery both before (OR = 1.85, 95% CI 1.44,2.37) and after (OR = 1.96, 95% CI 1.11,3.47) labour onset. Increased risks of macrosomia accounted for the association between pregravid adiposity and repeat caesarean delivery performed after but not before the onset of labour. Conclusions, Pregravid obesity increases the risk of caesarean delivery both before and after the onset of labour and both with and without a history of caesarean. [source] | ||||||||||