Background Gestational diabetes mellitus (GDM) is a common condition, often associated with high maternal and fetal morbidity. The use of new tools for early GDM screening can contribute to metabolic control to reduce maternal and fetal risk. This study aimed to ascertain whether maternal visceral adipose tissue (VAT) measurement by ultrasound during the first half of pregnancy can predict the occurrence of GDM during the third trimester. Methods A prospective cohort study of 133 pregnant women with gestational age �20 weeks in an outpatient setting. VAT depth was measured by ultrasound at the maternal periumbilical region. GDM status was obtained through hospital charts during hospitalization to delivery. A Receiver Operator Characteristic (ROC) curve was used to determine the optimum threshold to predict GDM. Results According to the ROC curve, a 45mm threshold was identified as the best cutoff value, with 66% of accuracy to predict GDM. Crude and adjusted odds ratios (OR) for GDM were 13.4 (95%CI 2.9-61.1) and 8.9 (95%CI 1.9-42.2), respectively. A similar result was obtained among pre-gravid non-obese women, with crude and adjusted OR of 16.6 (95%CI 1.9-PLOS ONE
Background: Determining anthropometric measures that indicate different fat deposits can be useful to predict metabolic risk and set specific treatment goals, reducing negative consequences for maternal and fetal health. In cases where pre-gestational weight measure and subsequent body mass index (BMI) values cannot be determined, other anthropometric measurements may be ideal for measuring the nutritional status of pregnant women, especially in low- and middle-income countries. This study aims to identify which anthropometric measurements correlate better with the maternal fat deposits measured by ultrasound. Methods: A cross-sectional study was conducted with pregnant women from the city of Porto Alegre (city), capital of Rio Grande do Sul (state), southern Brazil, from October 2016 until January 2018. Anthropometrical variables (weight, height, mid-upper arm circumference [MUAC], circumferences of calf and neck and triceps skinfolds [TSF] and subscapular skinfolds [SBSF]), and ultrasound variables (visceral adipose tissue [VAT] and total adipose tissue [TAT]) were collected. To verify the correlation of anthropometric and ultrasound measurements, a non-adjusted and adjusted Spearman correlation was used. The study was approved by the ethics committees.Results: The age median of the 149 pregnant women was 25 years [21 - 31], pre-pregnancy BMI was 26.22kg/m² [22.16 – 31.21] and gestational age was 16.2 weeks [13.05 – 18.10]. The best measurements correlated with VAT and TAT were MUAC and SBSF, both of which showed a higher correlation than pre-pregnancy BMI.Conclusion: It is possible to provide a practical and reliable estimate of VAT and TAT from the anthropometric evaluation (MUAC or SBSF) that is low cost, efficient and replicable in an outpatient clinic environment, especially in low- and middle-income countries.
Aim Higher amounts of maternal visceral adipose tissue were related to abnormal outcomes in pregnancy. Our objective was to evaluate the impact of modifiable and nonmodifiable predictors related to abnormal amounts of maternal visceral fat during three trimesters of pregnancy. Methods Visceral fat thickness was evaluated by ultrasound during three trimesters centered in the maternal epigastrium (preperitoneal m‐VAT) and additionally fat thickness evaluation centered at maternal periumbilical region (periumbilical m‐VAT) among cases with gestational age below 20 weeks. The fourth quartile was considered abnormal m‐VAT and the first three quartiles as normal m‐VAT. Nonmodifiable characteristics included maternal age, past term pregnancies, and ethnicity. Modifiable characteristics included pre‐pregnancy body mass index (BMI), weight gain, usual macronutrients, and sugar consumption during pregnancy. Results Preperitoneal m‐VAT was assessed in 270 pregnant women and m‐VAT periumbilical assessment in 154. The fourth quartile measurement was 15 mm and 53 mm, respectively. Nonmodifiable predictors including maternal age and past term pregnancies significantly impacted the primary study outcome of abnormal periumbilical m‐VAT. Having a non‐Caucasian ethnicity had a significant impact on the amount of normal preperitoneal m‐VAT. Among the modifiable characteristics, both pre‐pregnancy BMI and pre‐pregnancy obesity impacted the amount of abnormal preperitoneal and periumbilical m‐VAT. Conclusion Abnormal amounts of maternal visceral fat during pregnancy are related to nonmodifiable predictors and those present before pregnancy. No impact was found among weight gain during pregnancy or macronutrients and sugar consumption at pregnancy.
Objectives: to evaluate the association between dietary intake during pregnancy and different gestational clinical conditions (hypertensive, diabetics, smokers, having intrauterine growth restriction and a control group) and associated factors. Methods: cross-sectional study nested in a cohort study from 2011 to 2016 that occurred in three hospitals in Porto Alegre (Brazil). Sociodemographic conditions and prenatal were investigated and maternal feeding practices were analyzed by the Food Frequency Questionnaire. To calculate the caloric percentage from food groups, food items were categorized into:unprocessed or minimally processed, processed and ultra-processed foods. The Kruskal-Wallis test with Dunn's post-hoc compared food consumption between the groups and the Poisson regression evaluated the association between the variables. Results: there was no statistical difference in food intake among 303 mothers of different gestational clinical conditions, but diabetic pregnant women had lower caloric contribution value of ultra-processed foods. In addition, pregnant women from all groups showed adequate consumption in relation to the percentage of caloric contribution of macronutrients in the total energy value. Conclusions: there was no difference in energy consumption according to different gestational clinical conditions.In diabetic, smokers and hypertensive pregnant women, associations between total energy intake and different sociodemographic factors were observed between the groups.
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