Diet Quality Indices and Physical Activity Levels Associated with Adequacy of Gestational Weight Gain in Pregnant Women with Gestational Diabetes Mellitus

Almeida, Vanessa Averof Honorato de; Costa, Rafaela Alkmin da; Paganoti, Cristiane de Freitas; Mikami, Fernanda Cristina Ferreira; Sousa, Ana Maria da Silva; Peres, Stela Verzinhasse; Lopes, Marco Antônio Borges; Francisco, Rossana Pulcineli Vieira

doi:10.3390/nu13061842

Cited by 8 publications

(7 citation statements)

References 33 publications

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“…Conversely, an association between diet quality and IWG was not observed in our study. Our findings corroborate the effect of dietary assessment tools on EWG from studies conducted in Brazil (Almeida et al, 2021 ), Norway (Hillesund et al, 2014 ) and Sweden (Augustin et al, 2020 ). Regardless of what components the tools consist of, a higher score was always correlated with a better intake of nutrients and good eating habits and food choices (Fransen & Ocké, 2008 ).…”

Section: Discussionsupporting

confidence: 89%

Healthier diet associated with reduced risk of excessive gestational weight gain: A Chinese prospective cohort study

Yang

Feng

Chen

et al. 2022

Maternal & Child Nutrition

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Limited studies have examined the associations between diet quality and gestational weight gain (GWG) among Chinese pregnant women, adopting Chinese GWG guidelines. We prospectively investigate the associations of diet quality, using the Chinese Healthy Diet Index for Pregnancy (CHDI-P), which assessed diet quality from 'Diversity', 'Adequacy' and 'Limitation' dimensions with overall 100 points, with GWG among participants enroled in Southwest China. Food consumption was collected by 24 h dietary recalls for three consecutive days and CHDI-P scores were divided into tertiles. GWG was calculated according to the weight measured before delivery and classified into adequate weight gain (AWG), insufficient weight gain (IWG) and excessive weight gain(EWG) following Chinese GWG guidelines.Multinomial regression analyses and stratified analyses by pre-pregnancy body mass index were performed to estimate the association between CHDI-P and GWG. A total of 1416 participants were recruited in early pregnancy, and 971 and 997 participants were respectively followed up in middle and late pregnancy. The mean CHDI-P score was 56.44 ± 6.74, 57.07 ± 7.44 and 57.38 ± 7.94 points in early, middle and late pregnancy, respectively. Women in the lowest CHDI-P scores group had an increased risk of EWG in middle (OR = 1.53, 95% confidence interval[CI] = 1.08-2.17) and late pregnancy (OR = 1.71, 95% CI = 1.21-2.41) than women in the highest group, while overweight/obese women had a greater risk of EWG in late pregnancy (OR = 4.25, 95% CI = 1.30-13.90). No association was found between the CHDI-P scores and IWG. Poor diet quality in middle and late pregnancy was associated with a higher risk of EWG.

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Section: Discussionsupporting

confidence: 89%

Healthier diet associated with reduced risk of excessive gestational weight gain: A Chinese prospective cohort study

Yang

Feng

Chen

et al. 2022

Maternal & Child Nutrition

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“…We found the weight percentiles by GW could be used to estimate the risk of full-term LBW or macrosomia (OBW) during pregnancy, both LBW and macrosomia were prevalent and associated with increased risks of perinatal morbidity and mortality [24][25][26][27][28].This study showed more frequency of maternal weight under 10th percentile during pregnancy was higher risk of LBW and lower risk of OBW, in contrast more frequency of maternal weight over 90th percentile during pregnancy was lower risk of LBW and higher risk of OBW, but we didn't nd similar report. Many previous reported that inappropriate amount or rate of GWG were associated with adverse pregnancy outcomes including LBW and macrosomia [2,29,30], and low or excess pre-pregnancy BMI, gestational diabetes mellitus, and maternal anemia also increased the risk of LBW or macrosomia [31][32][33][34][35][36][37], this paper also showed these factors were associated with LBW or OBW. Furthermore, maternal age, abnormal reproductive history, assisted reproductive, scarred uterus, parity, delivery mode, and infant sex were considered determinant factors of LBW or OBW, which were consistent with the previous reports [38 -42].…”

Section: Discussionmentioning

confidence: 54%

The weight percentiles of singleton full-term pregnant women by gestational week and risks of low birth weight or macrosomia in those outsides: a real word data analysis of 32 hospitals

Xiao

2022

Preprint

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Background: This study was to create the weight percentiles of pregnant women with singleton full-term birth by gestational week (GW), and to evaluate the risks of low birth weight (LBW) and over birth weight/macrosomia (OBW) in newborns with maternal weight under 10th percentile (P10) or over 90th percentile (P90).Methods: The real medical record data of 94473 singleton full-term pregnancy women and their newborns were extracted from a regional information system. All participants were divided into LBW group, normal birth weight (NBW) group and OBW group, and the weight percentiles of all pregnant women and the weight percentiles curves by three groups and maternal BMI category were created. Then we calculated and compared the frequency of under P10 and over P90 during pregnancy in there groups, and used a adjusted generalized linear mixed model (GLMM) to compare the weight of three groups, and estimated the OR (95% CI) of LBW and OBW in under P10 and over P90 women by GW.Results: In all 94473 participants, 1.78% (1678) were full-term LBW and 2.94% (2780) were OBW. Compared with normal weight women, underweight women had a lower level and sharper percentile curves, overweight and obesity women had higher level and flatter percentile curves. Compared with NBW, women with LBW had a lower level percentile curves and women with OBW had a higher level percentile curves. Compared never under P10 women during pregnancy, OR (95% CI) of LBW was 2.15 (1.83, 2.52) in 1-3 frequencies under P10 women and was 3.37 (3.01, 3.77) in more than 3 frequencies under P10 women. Compared never over P90 women during pregnancy, OR (95% CI) of OBW was 2.54 (2.22, 2.91) in 1-3 frequencies over P90 women and was 4.97 (4.57, 5.41) in more than 3 frequencies over P90 women. At each GW, LBW was negative correlation with maternal weight (P < 0.05) and OBW was positive correlation with maternal weight (P < 0.05). In under P10 weight women at each GW (excepting 10th and 14th GW), there was a high risk of LBW (OR values from 1.64 to 3.77, P < 0.05). In over P90 weight women at each GW, there was a high risk of OBW (OR values from 2.22 to 4.28, P < 0.05).Conclusion: The weight percentiles and their curves by GW are available, economical and convenient measure for pregnancy health-care services and self-monitor of pregnant women, under P10 weight increases the risk of LBW and over P90 weight increases the risk of macrosomia.

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“…In Japan, the Japan Society of Obstetrics and Gynecology guidelines on gestational weight gain (created in 1995) have historically been strict (9–12 kg gain for women with BMI < 18.5 kg/m 2 ), and prevention of PE has been a high priority for obstetricians in Japan 11 . Although this study did not focus on obstetrical outcomes such as cesarean section, complicated deliveries, fetal acidosis, birth of large‐for‐gestational‐age infants, gestational diabetes mellitus, and postpartum depression, 11–13,30 which are affected by excessive gestational weight gain, the present study still provides new evidence that weight gain of 13.0 kg during pregnancy should be the upper limit among underweight women to reduce PE risk.…”

Section: Discussionmentioning

confidence: 97%

Effect of gestational weight gain on preeclampsia among underweight women: A single tertiary referral center study in Japanese women

Kyozuka

Jin

Fujimori

et al. 2022

J of Obstet and Gynaecol

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Aim To examine the effect of weight gain during pregnancy on preeclampsia among women with a prepregnancy body mass index < 18.5 kg/m2. Methods This retrospective cohort study included 479 Japanese women with singleton pregnancies and a prepregnancy body mass index < 18.5 kg/m2, who gave birth between 2013 and 2019 at Ohta Nishinouchi Hospital. The study included 22 (18 with preeclampsia and four with gestational hypertension) and 457 patients with and without hypertensive disorders of pregnancy, respectively. Results The prevalence of hypertensive disorders of pregnancy and preeclampsia was 4.6% and 3.8%, respectively. With weight gain during pregnancy (continuous variable) set as a reference, multiple logistic regression revealed that excessive weight gain during pregnancy increased the risk of preeclampsia (adjusted odds ratio: 1.13, 95% confidence interval: 1.00–1.28, p < 0.05) and hypertensive disorders of pregnancy (adjusted odds ratio: 1.15, 95% confidence interval: 1.03–1.29, p < 0.05). Based on receiver operating characteristic curve analyses (area under the curve 0.65, 95% confidence interval: 0.50–0.80; p < 0.05), we determined the cutoff value of weight gain during pregnancy for the occurrence of preeclampsia among women with body mass index < 18.5 kg/m2 to be 13.0 kg, with sensitivity and specificity of 0.50 and 0.78, respectively. Conclusion This study indicates that excessive weight gain during pregnancy increases preeclampsia risk among underweight women and provides new recommendations for weight gain during pregnancy for such women. Further research regarding the pathogenesis of preeclampsia for underweight women is warranted.

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Diet Quality Indices and Physical Activity Levels Associated with Adequacy of Gestational Weight Gain in Pregnant Women with Gestational Diabetes Mellitus

Cited by 8 publications

References 33 publications

Healthier diet associated with reduced risk of excessive gestational weight gain: A Chinese prospective cohort study

Healthier diet associated with reduced risk of excessive gestational weight gain: A Chinese prospective cohort study

The weight percentiles of singleton full-term pregnant women by gestational week and risks of low birth weight or macrosomia in those outsides: a real word data analysis of 32 hospitals

Effect of gestational weight gain on preeclampsia among underweight women: A single tertiary referral center study in Japanese women

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