Maternal prepregnancy waist circumference and BMI in relation to gestational weight gain and breastfeeding behavior: the CARDIA study

Kirkegaard, Helene; Nøhr, Ellen A.; Rasmussen, Kathleen M.; Støvring, Henrik; Sørensen, Thorkild I A; Lewis, Cora E.; Gunderson, Erica P.

doi:10.3945/ajcn.114.099184

Cited by 13 publications

(13 citation statements)

References 63 publications

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“…However, there’s not an official GWG recommendation based on Chinese BMI cut-off points for Chinese women. 18.3% of women in our study had central adiposity prior to pregnancy, which is lower than the previously reported percentage (25.7%) in developed countries [24]. In general, the status of pre-pregnancy weight and waist circumference in our cohort was less than ideal.…”

Section: Discussioncontrasting

confidence: 88%

The mutual effect of pre-pregnancy body mass index, waist circumference and gestational weight gain on obesity-related adverse pregnancy outcomes: A birth cohort study

et al. 2017

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ObjectiveThe aim of this study was to examine the mutual effect of pre-pregnancy body mass index (BMI), waist circumference (WC) and gestational weight gain (GWG) on obesity-related adverse pregnancy outcomes.MethodsThis birth cohort study was conducted in three Streets in Changsha, China, including a total of 976 mother-child pairs. All data was collected within 15 days after deliveries from a self-administered questionnaire, maternal health manual and perinatal health care information system. Multivariate logistic regression models were conducted to estimate the effects of maternal pre-pregnancy BMI, WC and GWG on obesity-related adverse pregnancy outcomes including gestational diabetes mellitus (GDM), primary cesarean section (P-CS), large for gestational age (LGA) and composite outcome (one or more adverse pregnancy outcomes)ResultsAfter controlling for all confounders, both maternal pre-pregnancy overweight/obesity and central adiposity contributed to increased risks of GDM [ORs 95% CIs = 2.19 (1.02–4.76) and 2.26 (1.11–4.60), respectively], P-CS [ORs 95% CIs = 1.66 (1.05–2.65) and 1.71 (1.11–2.63), respectively], LGA [ORs 95% CIs = 1.93 (1.07–3.50) and 2.14 (1.21–3.75), respectively] and composite outcome [ORs 95% CIs = 1.82 (1.15–2.87) and 1.98 (1.30–3.01), respectively] compared with mothers with normal pre-pregnancy weight and normal WC. Excessive GWG was found to be associated with an increased risk of LGA [OR 95% CI = 1.74 (1.05–2.89)], but was not significantly related to higher risks of GDM, P-CS and composite outcome [ORs 95% CIs = 0.90 (0.47–1.72), 1.08 (0.77–1.52), and 1.30 (0.94–1.79), respectively]. In terms of the joint effect of maternal pregestational BMI and WC on obesity-related composite outcome, mothers with both pre-pregnancy overweight and central adiposity had the highest risk of composite outcome [OR 95% CI = 3.96 (2.40–6.54)], compared with mothers without pre-pregnancy overweight or central adiposity.ConclusionsThe results of this study suggest that maternal pre-pregnancy overweight/obesity and central adiposity may contribute to multiple obesity-related adverse pregnancy outcomes, excessive weight gain during pregnancy is associated with an increased risk of LGA. Healthcare providers should carry out health education, and guide women to keep an ideal BMI and WC prior to pregnancy and help them gain optimal weight during pregnancy based on their pre-pregnancy BMI and WC.

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Section: Discussioncontrasting

confidence: 88%

The mutual effect of pre-pregnancy body mass index, waist circumference and gestational weight gain on obesity-related adverse pregnancy outcomes: A birth cohort study

et al. 2017

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“…Together with the standard obesity measure of body mass index (BMI), another important measure for maternal obesity is gestational weight gain (GWG) (Ferraro et al 2015). Excessive gestational weight gain is an established predictor of pregnancy and post-pregnancy complications, as well as postpartum weight retention, which is known to influence the future risk of obesity (Gunderson 2009; Kirkegaard et al 2015; Krukowski et al 2016). Several studies have demonstrated that risks associated with excessive GWG are higher in early pregnancy, suggesting that early GWG may be an important and clinically relevant time period with respect to adverse health outcomes (Fontaine et al 2012; Ferraro et al 2015; Hedderson et al 2010; Hedderson et al 2014; Carreno et al 2012).…”

Section: Introductionmentioning

confidence: 99%

Urinary phthalate metabolite concentrations and maternal weight during early pregnancy

Bellavia

Hauser

Seely

et al. 2017

International Journal of Hygiene and Environmental Health

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Background Phthalates are a class of chemicals that may be associated with obesity in non-pregnant populations. Little is known about the association between pregnancy phthalate exposure and maternal obesity. Objective We evaluated the association between early-pregnancy urinary concentrations of specific phthalate metabolites and the distribution of body mass index (BMI, cross-sectional), and early gestational weight gain (GWG, prospective). Methods We measured 1st trimester urinary phthalate metabolite concentrations (median 9.9 weeks gestation) in 347 women from the LIFECODES pregnancy cohort (Boston, MA), who delivered term births. All measures were adjusted for specific-gravity and log-transformed. We used quantile regression to evaluate shifts in the entire outcome distributions, calculating multivariable-adjusted differences in the associations between these phthalate metabolites and BMI and GWG at the 25th, 50th, and 75th percentiles of these anthropometric outcomes. Results Higher concentrations of mono-ethyl phthalate (MEP) were associated with a rightward shift of 2.8 kg/m2 at the 75th percentiles of BMI (lowest vs highest quartile, 95% CI: 0.2–5.4) and 1.3 kg at the 75th percentiles of early GWG (lowest vs second quartiles, 95% CI: 0.3–2.4). A significant right-shift in the upper tail of BMI was also observed at higher concentrations of mono-benzyl (MBzP), mono-3-carboxypropyl (MCPP), and a summary measure of di-(2-ethylhexyl) phthalate metabolites (ΣDEHP). ΣDEHP was also associated with lower GWG. Conclusions Certain phthalates may be associated with shifts in maternal obesity measures, with MEP, MBzP, MCPP, and ΣDEHP being cross-sectionally associated with 1st trimester BMI and MEP and ΣDEHP being positively and inversely associated with early GWG, respectively.

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“…In addition, a considerable body of research has demonstrated that greater pre-pregnancy maternal BMI is associated with reduced initiation rates and shorter breastfeeding duration (Rasmussen, 2007). Kirkegaard et al (2015) found that the pre-pregnancy BMI strongly contributed to breastfeeding cessation within 6 weeks of breastfeeding initiation. Hatsu, McDougald, and Anderson (2008) found, somewhat paradoxically, that women at 12 weeks postpartum who were exclusively breastfeeding consumed more calories but also lost more body weight than mothers who non-exclusively breastfed, although the differences were not statistically significant ( p = .08 and p = .07, respectively).…”

Section: Call Outmentioning

confidence: 95%

The Relationship Among Breastfeeding, Postpartum Depression, and Postpartum Weight in Mexican American Women

Reifsnider¹,

Flowers²,

Todd³

et al. 2016

Journal of Obstetric, Gynecologic & Neonatal Nursing

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Objective To determine if symptoms of postpartum depression and postpartum weight varied according to the level of breastfeeding among women of Mexican origin at 1 month and 6 months postpartum. Design We used data from a parent study in which promotoras interviewed new mothers of Mexican origin to encourage appropriate infant weight gain. We performed a secondary quantitative analysis to study the differences in postpartum weight and depression among the mothers in the study who breastfed and those who did not. Setting and Participants The study occurred in a heavily Hispanic community located in a major southwest city. The sample consisted of 150 women of Mexican origin who enrolled during their third trimesters in a local Special Supplemental Nutrition Program for Women, Infants, and Children clinic and were followed for 6 months. Methods Weight was measured at 1 month and at 6 months postpartum at home visits with validated digital scales. Breastfeeding was measured with monthly phone calls to record the level of breastfeeding according to World Health Organization criteria. Depression was measured at home visits at 1 month and 6 months by the Edinburg Postpartum Depression Scale. Results At 6 months postpartum, women who did not breastfeed had the highest scores on the Edinburgh Depression Scale, while the women who breastfed non-exclusively had the lowest scores (p = .067). Considering both time points, there was a significant difference in weight (p = .017) between women who were doing any breastfeeding and women who were not breastfeeding. Conclusions Breastfeeding, even if not exclusive, contributed to lower depression scores and significantly lower postpartum weight among this sample of Mexican American women.

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Maternal prepregnancy waist circumference and BMI in relation to gestational weight gain and breastfeeding behavior: the CARDIA study

Abstract: Maternal prepregnancy body size was differently associated with GWG and breastfeeding behavior depending on the location of the fat mass. Thus, maternal fat distribution may be a more important determinant of GWG and breastfeeding behavior than BMI alone.

Cited by 13 publications

References 63 publications

The mutual effect of pre-pregnancy body mass index, waist circumference and gestational weight gain on obesity-related adverse pregnancy outcomes: A birth cohort study

The mutual effect of pre-pregnancy body mass index, waist circumference and gestational weight gain on obesity-related adverse pregnancy outcomes: A birth cohort study

Urinary phthalate metabolite concentrations and maternal weight during early pregnancy

The Relationship Among Breastfeeding, Postpartum Depression, and Postpartum Weight in Mexican American Women

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