Comparison of gestational weight gain–related pregnancy outcomes in American primiparous and multiparous women

Lan-Pidhainy, Xiaomiao; Nøhr, Ellen Aagaard; Rasmussen, Kathleen M.

doi:10.3945/ajcn.112.052258

Cited by 37 publications

(60 citation statements)

References 18 publications

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“…5 In a Danish study by LanPidhainy et al, multiparous women were found to be at an increased risk for delivering LGA babies whereas the present study does not show such an association. 6 Postdated pregnancies had an association with LGA babies in the present study (p=0.04).…”

Section: Discussionsupporting

confidence: 55%

“…6,8 Person et al also inferred from their study that disproportionate LGA babies had a higher incidence of Caesarean sections and composite neonatal morbidities like birth trauma, low Apgar score, hypoglycemia and respiratory disorders. 15 In this present study also there was a significant association of primary Caesarean section with LGA babies (p=0.02).…”

Section: Discussionmentioning

confidence: 99%

“…7 Increasing gestational weight gain was shown to be associated with LGA babies and Caesarean section in the Danish study. 6 Chung et al studied the adverse effects of increased gestational weight gain among 1950 pregnant women based on their prepregnancy body mass index and found that LGA infants and Caesarean deliveries were higher in that group. 8 In their study by Mc Innis et al significant reduction of incidence of LGA babies were seen if the women achieved normal body weight pre pregnancy or lose 10 % of their body weight.…”

Section: Discussionmentioning

confidence: 99%

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Maternal factors associated with large for gestational age babies and its outcome when compared with those of appropriate for gestational age

John

Rani

Ghose

2017

Int J Reprod Contracept Obstet Gynecol

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INTRODUCTIONFoetal macrosomia is a common obstetrical problem affecting 20% babies born at term.1 Conventionally babies with birth weight more than 90th percentile is considered to be large for gestational age and those between 5 th and 90 th percentile as appropriate for gestational age. The birth weight cut-off may be based on absolute birth weight or greater than a particular percentile for the babies of that gestational age.2 Large for gestational age babies can lead to complications during delivery like prolonged labour, shoulder dystocia, birth injuries, post-partum haemorrhage, increased need for caesarean sections for cephalopelvic disproportion, anaesthetic complications and thromboembolic events. Also neonatal adverse outcomes of hypoglycemia, hypomagnesemia and hyperbilirubinemia are more common in these babies. 4 Antenatal detection of large for gestational age foetus will be helpful in anticipating these complications. This study is undertaken to determine the maternal factors associated with this condition so that the complications can be anticipated and managed in a better manner if not prevented. METHODSThis study was conducted in a tertiary care center based on collection of retrospective data about large for gestational age (LGA) babies born over a period of one year. The inclusion criteria were singleton pregnancies which resulted in LGA babies over this period of time. All the mothers who delivered babies who were large for ABSTRACT Background: Large for gestational age (LGA) babies are known to have a higher incidence of birth trauma, difficult delivery and Caesarean sections. Knowledge about maternal factors associated with this can help in prediction and prevention of complications. Methods: Maternal factors in 112 cases of LGA babies was studied along with its outcome and compared with an equal number of controls. Results: 0.05% deliveries resulted in LGA babies. Age and parity were not significantly different in the two groups and so were the associated medical disorders of hypothyroidism and gestational hypertension. Significant association was found with post-dated pregnancies (p=0.04) and gestational diabetes mellitus (p=0.05). Also, higher number of primary Caesarean sections resulted in the case group. Conclusions: Post dated pregnancies and gestational diabetes were maternal factors associated with LGA babies and higher number of primary Caesarean sections resulted in these cases.

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Section: Discussionsupporting

confidence: 55%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Maternal factors associated with large for gestational age babies and its outcome when compared with those of appropriate for gestational age

John

Rani

Ghose

2017

Int J Reprod Contracept Obstet Gynecol

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“…Women who have not previously given birth have a higher risk of excessive weight gain during pregnancy than multipara [70, 72-73, 75, 80]. Conversely, multipara are more likely to be overweight or obese but less likely to have excessive weight gain in pregnancy [72,75].…”

Section: Effects Of Malnutrition and Of Excessive Weight Gain Includimentioning

confidence: 99%

Consequences and Possible Predictors of Health-damaging Behaviors and Mental Health Problems in Pregnancy – A Review

Ulrich

Petermann

2016

Geburtshilfe Frauenheilkd

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!In recent decades, the understanding of the short and longer term effects of health-damaging behaviors and mental health problems in pregnant women and the underlying mechanisms of these behaviors and illnesses has significantly increased. In contrast, little is known about the factors affecting individual pregnant women which contribute to health-damaging behaviors and mental illness. The aim of this paper was therefore to summarize the current state of research into the consequences of nicotine and alcohol consumption, malnutrition, excessive weight gain or obesity, and impaired mental health (depression and anxiety) during pregnancy. In addition, the characteristics of pregnant women which increase their risk of developing such behaviors or mental disorders are described. A better knowledge of these risks should make it easier for clinicians to identify cases at risk early on and put measures of support in place. A review of the literature has shown that certain characteristics of pregnant women (e.g. her relationship with her partner, a previous history of mental illness prior to pregnancy) are associated with various healthdamaging behaviors as well as with impaired mental health. Affected women often show an accumulated psychosocial stress which was already present prior to the pregnancy and which may persist even after the birth of the child. Zusammenfassung Consequences and Possible Predictors of Health-damaging Behaviors and Mental Health Problems in Pregnancy -A ReviewAuswirkungen und mögliche Prädiktoren gesundheitsschädigender Verhaltensweisen und psychischer Beeinträchtigungen in der Schwangerschaft -ein Überblick

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“…41,42 In addition, smoking cessation is associated with GWG. 43 Interventions for managing GWG are needed, especially among women attempting to quit smoking, and PA has potential in this regard.…”

mentioning

confidence: 99%

The London Exercise And Pregnant smokers (LEAP) trial: a randomised controlled trial of physical activity for smoking cessation in pregnancy with an economic evaluation

Ussher

Lewis

Aveyard

et al. 2015

Health Technol Assess

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BackgroundSmoking during pregnancy is the main preventable cause of poor birth outcomes. Improved methods are needed to help women to stop smoking during pregnancy. Pregnancy provides a compelling rationale for physical activity (PA) interventions as cessation medication is contraindicated or ineffective, and an effective PA intervention could be highly cost-effective.ObjectiveTo examine the effectiveness and cost-effectiveness of a PA intervention plus standard behavioural support for smoking cessation relative to behavioural support alone for achieving smoking cessation at the end of pregnancy.DesignMulticentre, two-group, pragmatic randomised controlled trial and economic evaluation with follow-up at the end of pregnancy and 6 months postnatally. Randomisation was stratified by centre and a computer-generated sequence was used to allocate participants using a 1 : 1 ratio.Setting13 hospitals offering antenatal care in the UK.ParticipantsWomen between 10 and 24 weeks’ gestation smoking five or more cigarettes a day before pregnancy and one or more during pregnancy.InterventionsParticipants were randomised to behavioural support for smoking cessation (control) or behavioural support plus a PA intervention consisting of supervised treadmill exercise plus PA consultations. Neither participants nor researchers were blinded to treatment allocation.Main outcome measuresThe primary outcome was self-reported, continuous smoking abstinence between a quit date and end of pregnancy, validated by expired carbon monoxide and/or salivary cotinine. Secondary outcomes were maternal weight, depression, birth outcomes, withdrawal symptoms and urges to smoke. The economic evaluation investigated the costs of the PA intervention compared with the control intervention.ResultsIn total, 789 women were randomised (n = 394 PA,n = 395 control). Four were excluded post randomisation (two had been enrolled twice in sequential pregnancies and two were ineligible and randomised erroneously). The intention-to-treat analysis comprised 785 participants (n = 392 PA,n = 393 control). There was no significant difference in the rate of abstinence at the end of pregnancy between the PA group (7.7%) and the control group (6.4%) [odds ratio for PA group abstinence 1.21, 95% confidence interval (CI) 0.70 to 2.10]. For the PA group compared with the control group, there was a 33% (95% CI 14% to 56%), 28% (95% CI 7% to 52%) and 36% (95% CI 12% to 65%) significantly greater increase in self-reported minutes of moderate- and vigorous-intensity PA from baseline to 1 week, 4 weeks and 6 weeks respectively. Accelerometer data showed that there was no significant difference in PA levels between the groups. There were no significant differences between the groups for change in maternal weight, depression, withdrawal symptoms or urges to smoke. Adverse events and birth outcomes were similar between the groups except for there being significantly more caesarean births in the control group than in the PA group (28.7% vs. 21.3%;p < 0.023). The PA intervention was less costly than the control intervention by £35 per participant. This was mainly attributable to increased health-care usage in the control group. However, there was considerable statistical uncertainty around this estimate.ConclusionsDuring pregnancy, offering an intervention combining supervised exercise and PA counselling does not add to the effectiveness of behavioural support for smoking cessation. Only 10% of participants had PA levels accessed by accelerometer and it is, therefore, unclear whether or not the lack of an effect on the primary outcome is the result of insufficient increases in PA. Research is needed to identify the smoking populations most suitable for PA interventions and methods for increasing PA adherence.Trial registrationCurrent Controlled Trials ISRCTN48600346.FundingThis project was funded by the NIHR Health Technology Assessment programme and will be published in full inHealth Technology Assessment; Vol. 19, No. 84. See the NIHR Journals Library website for further project information.

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Comparison of gestational weight gain–related pregnancy outcomes in American primiparous and multiparous women

Abstract: These findings extend the concept of a lower optimal GWG among multiparous than primiparous women to American women.

Cited by 37 publications

References 18 publications

Maternal factors associated with large for gestational age babies and its outcome when compared with those of appropriate for gestational age

Maternal factors associated with large for gestational age babies and its outcome when compared with those of appropriate for gestational age

Consequences and Possible Predictors of Health-damaging Behaviors and Mental Health Problems in Pregnancy – A Review

The London Exercise And Pregnant smokers (LEAP) trial: a randomised controlled trial of physical activity for smoking cessation in pregnancy with an economic evaluation

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