Measured weight in early pregnancy is a valid method for estimating pre-pregnancy weight

Inskip, Hazel; Crozier, Sarah; Baird, Janis; Hammond, Julia; Robinson, Siân; Cooper, Cyrus; Godfrey, Keith M.

doi:10.1017/s2040174420000926

Cited by 23 publications

(25 citation statements)

References 35 publications

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“…Recent studies confirmed that measured weight in early pregnancy provides a more accurate assessment of pre-pregnancy weight than recalled weight and avoids misclassification, underreporting of pre-pregnancy and delivery weight or over-reporting of GWG. 34,35 No difference in mean GWG was found between BMI classes. Still, because the IOM gives different recommendations for BMI groups and not all pregnant women may be aware of them, more than half of the participants did not meet the current guidelines.…”

Section: Health and Lifestyle Behaviormentioning

confidence: 87%

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The weight of motherhood: Identifying obesity, gestational weight gain and physical activity level of Italian pregnant women

Benvenuti

Bø

Draghi

et al. 2021

Womens Health (Lond Engl)

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Objective: Pre-pregnancy obesity and suboptimal gestational weight gain are on the rise globally and are independently associated with several maternal and neonatal complications. A healthy lifestyle, including regular physical activity, may improve health and reduce these complications, but many women are less active and willing to engage in physical activity with advancing gestation. Therefore, the inclusion of a wider range of physical activity such as domestic chore, occupational activity and active commuting may help pregnant women to meet the physical activity recommendations of 150 min/week. Very little is known about these issues in Italy, a country with strong traditional roles regarding pregnancy and motherhood, including “la famiglia” (the family). Primary objective describes health and lifestyle behavior of pregnant Italian women. Secondary objective reports total physical activity level, recreational exercise and context of these activities from pre-pregnancy and throughout gestation in regard to gestational weight gain management. Study design: Cross-sectional study performed in one public hospital and four antenatal clinics in Italy. Participants (n = 513) completed a validated self-administered questionnaire, the Physical Activity Pregnancy Questionnaire, in gestation week 36.01 (standard deviation 2.0). Pre-pregnancy body weight (kg) was self-reported, whereas maternal weight (kg) was measured at gestation week 36. In line with current American College of Obstetricians and Gynecologists guidelines (2020), participants were categorized into regular physical activity (⩾150 min/week) or non-regular physical activity (<150 min/week). Results: Mean pre-pregnancy body-mass index was 22.8 kg/m2 (standard deviation 3.9), with 14.4% of women entering motherhood overweight and 5.3% obese. Mean gestational weight gain was 11.9 kg (standard deviation 4.1). Among those with a body-mass index ⩾25, 46.5% gained above the Institute of Medicine recommendations. With respect to recreational exercise/sport, 4.7% were active according to guidelines, whereas 82.7% accumulated ⩾150 min/week when combining exercise/sport with daily-life physical activity (commuting and occupational). Exercising ⩾150 min/week and working 100% in third trimester were associated with gestational weight gain within Institute of Medicine recommendations (p = 0.06 and p = 0.03). Conclusion: Italian pregnant women have a low exercise level, still over 80% achieved a total physical activity level ⩾150 min/week when adding occupational and commuting activities. Nearly 50% of overweight and obese women exceeded the recommended gestational weight gain during pregnancy.

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Section: Health and Lifestyle Behaviormentioning

confidence: 87%

Section: Discussionmentioning

confidence: 99%

The weight of motherhood: Identifying obesity, gestational weight gain and physical activity level of Italian pregnant women

Benvenuti

Bø

Draghi

et al. 2021

Womens Health (Lond Engl)

View full text Add to dashboard Cite

show abstract

“…The modest sample size in this in-vitro study limits the ability to study interactions between different clinical factors, and other demographic factors such as ethnicity and sex, and we are therefore unable to definitively determine whether DHA-lipids mediate links between maternal BMI or glycemia with birthweight. Consideration of the potential effects of pre-pregnancy BMI and total gestational weight gain were not possible due to the lack of data while noting that a measured weight in early pregnancy provides a more precise assessment of pre-pregnancy weight than recalled weight (Inskip 2020 ). Since participants were Chinese and Indian, findings may not be generalizable to other ethnicities.…”

Section: Discussionmentioning

confidence: 99%

Placental 13C-DHA metabolism and relationship with maternal BMI, glycemia and birthweight

Watkins

Selvam

Pillai

et al. 2021

Mol Med

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Background Fetal docosahexaenoic acid (DHA) supply relies on preferential transplacental transfer, which is regulated by placental DHA lipid metabolism. Maternal hyperglycemia and obesity associate with higher birthweight and fetal DHA insufficiency but the role of placental DHA metabolism is unclear. Methods Explants from 17 term placenta were incubated with 13C-labeled DHA for 48 h, at 5 or 10 mmol/L glucose treatment, and the production of 17 individual newly synthesized 13C-DHA labeled lipids quantified by liquid chromatography mass spectrometry. Results Maternal BMI positively associated with 13C-DHA-labeled diacylglycerols, triacylglycerols, lysophospholipids, phosphatidylcholine and phosphatidylethanolamine plasmalogens, while maternal fasting glycemia positively associated with five 13C-DHA triacylglycerols. In turn, 13C-DHA-labeled phospholipids and triacylglycerols positively associated with birthweight centile. In-vitro glucose treatment increased most 13C-DHA-lipids, but decreased 13C-DHA phosphatidylethanolamine plasmalogens. However, with increasing maternal BMI, the magnitude of the glucose treatment induced increase in 13C-DHA phosphatidylcholine and 13C-DHA lysophospholipids was curtailed, with further decline in 13C-DHA phosphatidylethanolamine plasmalogens. Conversely, with increasing birthweight centile glucose treatment induced increases in 13C-DHA triacylglycerols were exaggerated, while glucose treatment induced decreases in 13C-DHA phosphatidylethanolamine plasmalogens were diminished. Conclusions Maternal BMI and glycemia increased the production of different placental DHA lipids implying impact on different metabolic pathways. Glucose-induced elevation in placental DHA metabolism is moderated with higher maternal BMI. In turn, findings of associations between many DHA lipids with birthweight suggest that BMI and glycemia promote fetal growth partly through changes in placental DHA metabolism.

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“…Self-reported pre-pregnancy weight could introduce a recall bias but is widely used in research and allows comparison with other studies [ 8 , 48 ]. We consider the difference between the self-reported and measured weights at inclusion in the PGDM population (about 2 kilograms) to be plausible [ 49 , 50 ]. High BMI in our PGDM population hampered the ultrasound examination and reduced the success rate for the fetal flow measurements.…”

Section: Discussionmentioning

confidence: 99%

Pre-gestational diabetes: Maternal body mass index and gestational weight gain are associated with augmented umbilical venous flow, fetal liver perfusion, and thus birthweight

et al. 2021

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Objectives To assess how maternal body mass index and gestational weight gain are related to on fetal venous liver flow and birthweight in pregnancies with pre-gestational diabetes mellitus. Methods In a longitudinal observational study, 49 women with pre-gestational diabetes mellitus were included for monthly assessments (gestational weeks 24–36). According to the Institute Of Medicine criteria, body mass index was categorized to underweight, normal, overweight, and obese, while gestational weight gain was classified as insufficient, appropriate or excessive. Fetal size, portal flow, umbilical venous flow and distribution to the fetal liver or ductus venosus were determined using ultrasound techniques. The impact of fetal venous liver perfusion on birthweight and how body mass index and gestational weight gain modified this effect, was compared with a reference population (n = 160). Results The positive association between umbilical flow to liver and birthweight was more pronounced in pregnancies with pre-gestational diabetes mellitus than in the reference population. Overweight and excessive gestational weight gain were associated with higher birthweights in women with pre-gestational diabetes mellitus, but not in the reference population. Fetuses of overweight women with pre-gestational diabetes mellitus had higher umbilical (p = 0.02) and total venous liver flows (p = 0.02), and a lower portal flow fraction (p = 0.04) than in the reference population. In pre-gestational diabetes mellitus pregnancies with excessive gestational weight gain, the umbilical flow to liver was higher than in those with appropriate weight gain (p = 0.02). Conclusions The results support the hypothesis that umbilical flow to the fetal liver is a key determinant for fetal growth and birthweight modifiable by maternal factors. Maternal pre-gestational diabetes mellitus seems to augment this influence as shown with body mass index and gestational weight gain.

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Measured weight in early pregnancy is a valid method for estimating pre-pregnancy weight

Cited by 23 publications

References 35 publications

The weight of motherhood: Identifying obesity, gestational weight gain and physical activity level of Italian pregnant women

The weight of motherhood: Identifying obesity, gestational weight gain and physical activity level of Italian pregnant women

Placental 13C-DHA metabolism and relationship with maternal BMI, glycemia and birthweight

Pre-gestational diabetes: Maternal body mass index and gestational weight gain are associated with augmented umbilical venous flow, fetal liver perfusion, and thus birthweight

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