The effect of pre-pregnancy body mass index on breastfeeding initiation, intention and duration: A systematic review and dose-response meta-analysis

Hashemi-Nazari, Seyed Saeed; Hasani, Jalil; Izadi, Neda; Najafi, Farid; Rahmani, Jamal; Naseri, Parisa; Rajabi, Abdolhalim; Clark, Cain C. T.

doi:10.1016/j.heliyon.2020.e05622

Cited by 19 publications

(10 citation statements)

References 54 publications

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“…During pregnancy, women with obesity are 2.5 times more likely to experience excessive gestational weight gain (GWG) [ 11 , 12 ] and have a 3- to 5.5-fold higher chance of developing gestational diabetes (GDM) [ 13 ] than women with normal weight. After delivery, more than one third of mothers with overweight/obesity do not initiate breastfeeding [ 14 ], all representing specific single risk factors for childhood overweight. Circumstantial observations showed that maternal obesity and the presence of additional prenatal and/or postnatal factors, such as excessive GWG, no or short duration of breastfeeding, and unfavorable childhood eating habits, confer a substantially higher risk of overweight in offspring than maternal obesity alone [ 15 – 17 ].…”

Section: Introductionmentioning

confidence: 99%

Predicting the earliest deviation in weight gain in the course towards manifest overweight in offspring exposed to obesity in pregnancy: a longitudinal cohort study

Gomes

Perschbacher

et al. 2022

BMC Med

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Background Obesity in pregnancy and related early-life factors place the offspring at the highest risk of being overweight. Despite convincing evidence on these associations, there is an unmet public health need to identify “high-risk” offspring by predicting very early deviations in weight gain patterns as a subclinical stage towards overweight. However, data and methods for individual risk prediction are lacking. We aimed to identify those infants exposed to obesity in pregnancy at ages 3 months, 1 year, and 2 years who likely will follow a higher-than-normal body mass index (BMI) growth trajectory towards manifest overweight by developing an early-risk quantification system. Methods This study uses data from the prospective mother-child cohort study Programming of Enhanced Adiposity Risk in CHildhood–Early Screening (PEACHES) comprising 1671 mothers with pre-conception obesity and without (controls) and their offspring. Exposures were pre- and postnatal risks documented in patient-held maternal and child health records. The main outcome was a “higher-than-normal BMI growth pattern” preceding overweight, defined as BMI z-score >1 SD (i.e., World Health Organization [WHO] cut-off “at risk of overweight”) at least twice during consecutive offspring growth periods between age 6 months and 5 years. The independent cohort PErinatal Prevention of Obesity (PEPO) comprising 11,730 mother-child pairs recruited close to school entry (around age 6 years) was available for data validation. Cluster analysis and sequential prediction modelling were performed. Results Data of 1557 PEACHES mother-child pairs and the validation cohort were analyzed comprising more than 50,000 offspring BMI measurements. More than 1-in-5 offspring exposed to obesity in pregnancy belonged to an upper BMI z-score cluster as a distinct pattern of BMI development (above the cut-off of 1 SD) from the first months of life onwards resulting in preschool overweight/obesity (age 5 years: odds ratio [OR] 16.13; 95% confidence interval [CI] 9.98–26.05). Contributing early-life factors including excessive weight gain (OR 2.08; 95% CI 1.25–3.45) and smoking (OR 1.94; 95% CI 1.27–2.95) in pregnancy were instrumental in predicting a “higher-than-normal BMI growth pattern” at age 3 months and re-evaluating the risk at ages 1 year and 2 years (area under the receiver operating characteristic [AUROC] 0.69–0.79, sensitivity 70.7–76.0%, specificity 64.7–78.1%). External validation of prediction models demonstrated adequate predictive performances. Conclusions We devised a novel sequential strategy of individual prediction and re-evaluation of a higher-than-normal weight gain in “high-risk” infants well before developing overweight to guide decision-making. The strategy holds promise to elaborate interventions in an early preventive manner for integration in systems of well-child care.

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Section: Introductionmentioning

confidence: 99%

Predicting the earliest deviation in weight gain in the course towards manifest overweight in offspring exposed to obesity in pregnancy: a longitudinal cohort study

Gomes

Perschbacher

et al. 2022

BMC Med

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“…Es wird diskutiert, dass das Stillen einem postnatalen Gewichtsbehalt entgegenwirkt [10]. Ungünstig ist, dass vor allem Frauen mit Übergewicht und Adipositas weniger häufig und kürzer stillen [26,31]. Für den Säugling gilt Muttermilch aufgrund der zahlreichen positiven gesundheitlichen Effekte als die optimale Ernährung in den ersten Lebensmonaten.…”

Section: Risikofaktoren Von Adipositas In Den Ersten 1000 Tagenunclassified

Adipositasprävention in den ersten 1000 Tagen

Raab

Geyer

Hauner

2022

Adipositas - Ursachen, Folgeerkrankungen, Therapie

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ZusammenfassungIn den ersten 1000 Tagen werden die Weichen für die langfristige Gesundheit von Mutter und Kind gestellt. Übergewicht, eine exzessive Gewichtzunahme in der Schwangerschaft sowie ein ungünstiger Lebensstil wirken sich kurz- und langfristig negativ auf die Gesundheit von Mutter und Kind aus. Die hohe Prävalenz von Übergewicht und Adipositas bei Frauen im gebärfähigen Alter sowie die steigende Zahl von Kindern und Jugendlichen mit Übergewicht oder Adipositas stellen ein wachsendes Gesundheitsproblem dar. Die Prädisposition für die spätere Gewichtsentwicklung beginnt bereits im Mutterleib. Primärpräventive Maßnahmen sind daher besonders sinnvoll. Bisherige Studien zu Lebensstilinterventionen in der Schwangerschaft zeigten moderat positive Effekte auf Gewichts- und Gesundheitsparameter der Mutter, wirkten sich jedoch nicht auf die Gewichtsentwicklung der Kinder aus. Es sind daher neue Präventionskonzepte erforderlich, die früher beginnen, risikoadaptiert sind und sich flächendeckend in die Praxis implementieren lassen. Digitale Maßnahmen wie Smartphone-Applikationen (Apps) könnten hierbei eine sinnvolle Unterstützung bieten. Die Zahl an aussagekräftigen Studien zur Erprobung App-gestützter Interventionen ist noch dürftig, erste Ergebnisse deuten jedoch auf positive Effekte hin. Die Herausforderung für die kommenden Jahre wird sein, solche Ansätze zur Unterstützung einer gesunden Lebensweise rund um die Schwangerschaft zu entwickeln, zu evaluieren und zu implementieren, um die langfristige Gesundheit von Mutter und Kind wirksamer zu schützen.

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“…Breast milk is the natural and optimal source of nutrition for the newborn; it is associated with multiple health benefits [ 1 , 2 ], providing nutrients, hormonal immunoactives, and microbiomes necessary for growth and development [ 3 ]. Furthermore, in the mother, it reduces the probability of breast and ovarian cancers, improves birth spacing, prevents type 2 diabetes, obesity, and hypertension, among other benefits [ 4 , 5 ].…”

Section: Backgraundmentioning

confidence: 99%

Lactation counseling for maintaining exclusive breastfeeding in adolescent mothers: a trial protocol

Sabogal

Nariño

Monsalve

2021

Pilot Feasibility Stud

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Background Adolescent mothers have lower rates of initiation, continuation, and exclusivity of breastfeeding, and even more so in the first pregnancy. Current interventions target adult women, and little evidence is available for breastfeeding promotion among adolescents. Methods This is a pilot study protocol with a parallel, single-blind, randomized, and controlled trial design, to evaluate the feasibility of the intervention “Lactation Counseling” in first-time adolescent mothers to maintain exclusive breastfeeding in the first 6 months of life. The control group will receive routine education in prenatal care and prenatal and childbirth classes, the experimental group will receive additionally the intervention “Lactation Counseling”, for 4 weeks, both conducted by trained nurses. Feasibility outcome includes recruitment and dropout rates, and, pilot outcomes will be the exclusive breastfeeding rate and the breastfeeding knowledge. Measurements will be taken at baseline, post-intervention, and 2, 4, and 6 months after childbirth. Discussion Exclusive breastfeeding rates could be increased in adolescent mothers through nursing counseling interventions that are previously structured and evaluated from their feasibility. This study will allow the evaluation of the feasibility of an intervention in low-income, Latin American population adolescents. Trial registration ClinicalTrials.gov NCT04655846, Registered 7 December 2020.

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The effect of pre-pregnancy body mass index on breastfeeding initiation, intention and duration: A systematic review and dose-response meta-analysis

Cited by 19 publications

References 54 publications

Predicting the earliest deviation in weight gain in the course towards manifest overweight in offspring exposed to obesity in pregnancy: a longitudinal cohort study

Predicting the earliest deviation in weight gain in the course towards manifest overweight in offspring exposed to obesity in pregnancy: a longitudinal cohort study

Adipositasprävention in den ersten 1000 Tagen

Lactation counseling for maintaining exclusive breastfeeding in adolescent mothers: a trial protocol

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