First and second trimester gestational weight gains are most strongly associated with cord blood levels of hormones at delivery important for glycemic control and somatic growth

Rifas‐Shiman, Sheryl L.; Fleisch, Abby F.; Hivert, Marie‐France; Mantzoros, Christos S.; Gillman, Matthew W.; Oken, Emily

doi:10.1016/j.metabol.2017.01.019

Cited by 43 publications

(46 citation statements)

References 40 publications

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“…Neonates born to women with greater first‐trimester weight gain demonstrated higher mean cord blood levels of insulin (0.5 units per mL higher; 95% CI, 0.1‐0.9) and C‐peptide (0.06 ng/mL higher; 95% CI, 0.002‐0.009). Neonates born to women with higher second‐trimester weight gain demonstrated higher mean IGF‐1 (2.3 ng/mL; 95% CI, 0.6‐4.0), IGF‐2 (7.0 ng/mL; 95% CI, 1.2‐14.6), IGF binding protein‐3 (41.6 ng/mL; 95% CI, 19.4‐63.7), and leptin (0.9 ng/mL; 95% CI, 0.4‐1.4) . A Greek cohort studying 977 woman‐child pairs evaluated the association between trimester‐specific GWG and offspring fetal growth, obesity risk, and cardio‐metabolic health outcomes up to 4 years of age.…”

Section: Neonatal Outcomes Associated With Excessive Gestational Weigmentioning

confidence: 76%

“…In utero programming may offer an explanation for these childhood outcomes. Rifas‐Shiman et al evaluated levels of adipokines, hormones that when dysregulated are implicated in obesity and weight gain, in umbilical cord blood samples . These hormones included insulin, C‐peptide (a marker of insulin), insulin‐like growth factor (IGF), and leptin.…”

Section: Neonatal Outcomes Associated With Excessive Gestational Weigmentioning

confidence: 98%

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Excessive Gestational Weight Gain

McDowell¹,

Cain²,

Brumley³

2018

J Midwife Womens Health

102

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Excessive gestational weight gain (GWG) is associated with an increasing incidence of maternal and neonatal complications, including hypertensive disorders of pregnancy, fetal macrosomia, and increased cesarean birth rates. In the United States, it is recommended that health care providers use an individualized approach to counsel a woman about pregnancy weight gain goals that is based on the woman's initial body mass index (BMI) and to track GWG throughout the pregnancy by evaluating maternal weight at each visit. Studies have shown that women entering pregnancy with a higher BMI are at increased risk for excessive GWG and postpartum weight retention. Research also demonstrates an increased risk of childhood obesity in children born to women with excessive GWG. Specific counseling about exercise and diet, as well as technology and motivational interviewing, are some tools prenatal care providers can use that have been shown to be effective in reducing excessive GWG. This article reviews the current research regarding maternal and neonatal risks associated with excessive GWG, as well as the interventions that have demonstrated promise for addressing this problem.

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Section: Neonatal Outcomes Associated With Excessive Gestational Weigmentioning

confidence: 76%

Section: Neonatal Outcomes Associated With Excessive Gestational Weigmentioning

confidence: 98%

Excessive Gestational Weight Gain

McDowell¹,

Cain²,

Brumley³

2018

J Midwife Womens Health

102

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“…Weight gain in early pregnancy is primarily maternal fat gain and is associated with cord blood hormones related to offspring glucose and insulin regulation (during the 1 st trimester), while weight gain in later pregnancy is attributed to fetal, placental, and maternal gains and is associated with cord blood hormones related to offspring growth and adiposity (during the 2 nd trimester). 36 In general, findings from studies examining trimester-specific GWG rates suggest that mid-to-late pregnancy GWG rates are more strongly associated with infant anthropometric outcomes compared to early and later pregnancy. [6][7][8]13,16,17 Sridhar et al found that both 2 nd and 3 rd trimester GWG rates above the IOM recommendations were associated with LGA, while only inadequate 2 nd trimester GWG rates were associated with SGA.…”

Section: Discussionmentioning

confidence: 98%

“…Though GWG throughout pregnancy contributes to fetal growth and development, evidence suggests that timing of gains may differentially influence these outcomes. Weight gain in early pregnancy is primarily maternal fat gain and is associated with cord blood hormones related to offspring glucose and insulin regulation (during the 1 st trimester), while weight gain in later pregnancy is attributed to fetal, placental, and maternal gains and is associated with cord blood hormones related to offspring growth and adiposity (during the 2 nd trimester) . In general, findings from studies examining trimester‐specific GWG rates suggest that mid‐to‐late pregnancy GWG rates are more strongly associated with infant anthropometric outcomes compared to early and later pregnancy .…”

Section: Discussionmentioning

confidence: 99%

Total and trimester‐specific gestational weight gain and infant anthropometric outcomes at birth and 6 months in low‐income Hispanic families

et al. 2019

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Objective To describe total and trimester‐specific gestational weight gain (GWG) among low‐income Hispanic women and determine whether these GWG exposures are associated with infant anthropometric outcomes at birth and 6 months. Study Design Data were from 448 mother‐infant pairs enrolled in the Starting Early child obesity prevention trial. Prenatal weights were used to calculate total GWG and 2nd and 3rd trimester GWG rates (kg/week) and categorized as inadequate, adequate, and excessive according to the 2009 Institute of Medicine recommendations. Multivariable linear and modified Poisson regressions estimated associations of infant anthropometric outcomes (birthweight, small‐for‐gestational age [SGA], large‐for‐gestational age [LGA], rapid weight gain, and weight‐for‐age, length‐for‐age, and weight‐for‐length z‐scores at 6 months) with GWG categories. Results For total GWG, 39% and 27% of women had inadequate and excessive GWG, respectively. 57% and 46% had excessive GWG rates in the 2nd and 3rd trimesters, respectively, with 29% having excessive rates in both trimesters. Inadequate total GWG was associated with lower infant weight and length outcomes (ß range for z‐scores = −0.21 to −0.46, p < 0.05) and lower risk of LGA (adjusted Relative Risk, aRR = 0.38; 95% confidence intervals, CI: 0.16, 0.95) and rapid weight gain (aRR = 0.72; 95%CI: 0.51, 1.00). GWG rates above recommendations in the 2nd trimester or 2nd/3rd trimesters were associated with greater weight outcomes at birth and 6 months (ß range for z‐scores = 0.24 to 0.35, p < 0.05). Conclusions Counseling women about health behaviors and closely monitoring GWG beginning in early pregnancy is necessary, particularly among populations at high‐risk of obesity.

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“…For instance, first and second trimester GWG are directly associated with cord blood hormone levels (e.g., insulin, c-peptide, insulin-like growth factor-I (IGF-I) and IGF-II) at delivery. These growth-promoting hormones are vital for glycemic control and somatic growth and, when in excess, have been implicated in obesity predisposition and metabolic dysregulation [38]. On the other hand, a reduction in growthpromoting peptides has been noted in offspring cord blood of maternal exercisers [39].…”

mentioning

confidence: 99%

Optimizing Pregnancy for Intergenerational Health Benefits

Ferraro

2017

UOJM

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A mong the many factors that contribute to childhood obesity (i.e. maternal smoking, nutrition/sugar intake, air pollution, endocrine disruptors, sleep disturbance, lack of breastfeeding), there are two powerful maternal determinants: high maternal body mass index (BMI) and exceeding the Institute of Medicine (IOM) gestational weight gain (GWG) guidelines [1]. Furthermore, pregnancy weight-related issues increase the likelihood of adverse cardiovascular risk factors in offspring [2,3]. Excessive GWG is directly linked to giving birth to a large-for-gestational-age (LGA) neonate [4], which is predictive of downstream obesity and chronic conditions, including Type 2 diabetes and cardiovascular disease [reviewed in 5,6]. Recently, high birth weight and parental overweight/obesity were associated with lower levels of both physical activity (PA) and cardiorespiratory fitness in adolescence [7], further supporting the need for prenatal strategies that optimize fetal growth for long-term health. To the surprise of many, excessive GWG in normal-weight women is associated with higher neonatal fat mass and less favorable body composition (i.e. greater percentage of body fat, less muscle mass) [8]. This dysregulation in body composition suggests that an energy surplus in utero acts independent of parental genetics with respect to predisposition for excess weight. In fact, according to recent systematic reviews and meta-analyses, excessive GWG increases the risk of childhood overweight/obesity by 30-40% [9,10], thereby propagating the intergenerational cycle of obesity and the proliferation of chronic disease [5]. This may be due to a host of sociopolitical and physiological factors that promote maternal resource storage, decrements in PA, a loss of metabolic control, and a partitioning of excess energy reserves to the fetus [5,11].Physical activity remains one of nature's best medicines for prevention and management of chronic disease [12]. However, it is seldom recommended in pregnancy [13]. Furthermore, population PA levels are at an all-time low [14] and reach a nadir during the prenatal period. The reasons for these observations are not well-established, but likely involve a patient-provider knowledge translation discrepancy [15]. Despite the historical dogma and the ensuing clinical recommendations, a pregnant Keywords: Pregnancy; Physical activity; Pediatrics; Obstetrics; Exercise Pregnancy is a critical period of body weight regulation for both mother and baby. Vital energy-sensing processes are established in utero that aid in nutrient storage and metabolic control later in life. Excessive weight gain during pregnancy and a surplus of maternal resources leads to preferential shuttling of nutrients and growth-promoting peptides across the placenta, resulting in fetal overgrowth -a well-established predictor of childhood obesity. Physical activity during pregnancy offers a safe and accessible way in which one can modify these intricate cellular networks across the maternal-placental-fetal interface to prevent dysregu...

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First and second trimester gestational weight gains are most strongly associated with cord blood levels of hormones at delivery important for glycemic control and somatic growth

Cited by 43 publications

References 40 publications

Excessive Gestational Weight Gain

Excessive Gestational Weight Gain

Total and trimester‐specific gestational weight gain and infant anthropometric outcomes at birth and 6 months in low‐income Hispanic families

Optimizing Pregnancy for Intergenerational Health Benefits

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