&lt;p&gt;Do Gestational Obesity and Gestational Diabetes Have an Independent Effect on Neonatal Adiposity? Results of Mediation Analysis from a Cohort Study in South India&lt;/p&gt;

Babu, Giridhara R; Deepa, R; Lewis, Melissa Glenda; Lobo, Eunice; Krishnan, Anjaly; Ana, Yamuna; Katon, Jodie G.; Enquobahrie, Daniel A.; Arah, Onyebuchi A.; Kinra, Sanjay; Murthy, Gvs

doi:10.2147/clep.s222726

Cited by 20 publications

(13 citation statements)

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“…However, most likely due to the discrepancies in race and the condition of GDM and overweight/obesity among woman of childbearing age between countries, the highest mediated proportion (up to 16%) observed by Kondracki et al [ 17 ] was relatively lower than that observed in this study. Babu and colleagues [ 35 ] recruited a cohort of 1120 women of all BMI ranges from Bangalore, India, and revealed a mediator effect of GDM between maternal obesity and neonatal adiposity. Given the generalized increase in body fat of the macrosomic fetuses [ 36 ], the observations of Babu and colleagues also provided evidence for our findings.…”

Section: Discussionmentioning

confidence: 99%

Pre-Pregnancy Body Mass Index and Risk of Macrosomia and Large for Gestational Age Births with Gestational Diabetes Mellitus as a Mediator: A Prospective Cohort Study in Central China

et al. 2022

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This study aimed to examine the risk of macrosomia and large for gestational age (LGA) births in relation to maternal pre-pregnancy body mass index (BMI) status mediated through gestational diabetes mellitus (GDM). This prospective study included 34,104 singleton pregnancies at 8–14 weeks of gestation. The interesting outcomes were macrosomia (≥4000 g) and LGA (≥90th percentile). Mediation analyses were conducted using log-binomial regression adjusted for age, education, parity, fetal sex, and gestational weight gain. The proportion mediated was estimated based on the risk difference scale, and the E-value was utilized to assess potential confounders. Overall, 15.9% of women had GDM, and there were 4.0% macrosomia and 9.9% LGA births. The proportion mediated by GDM on macrosomia was up to 40% among obese women, and the estimate of the total effect was 6.18 (95% CI: 5.26–7.26), of the natural direct effect was 4.10 (95% CI: 3.35–4.99), and of the natural indirect effect was 1.51 (95% CI: 1.31–1.76). Likewise, among overweight women, the proportion mediated by GDM on macrosomia was up to 40%. Furthermore, consistent findings were evident for the outcome of LGA births. Pre-pregnancy overweight/obesity increased the risk of macrosomia and LGA births independently and partly mediated by GDM.

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Section: Discussionmentioning

confidence: 99%

Pre-Pregnancy Body Mass Index and Risk of Macrosomia and Large for Gestational Age Births with Gestational Diabetes Mellitus as a Mediator: A Prospective Cohort Study in Central China

et al. 2022

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“…In India, measuring MUAC in pregnancy and birth weight to assess obesity can help plan and prevent potential adverse outcomes. We recently showed that maternal obesity is an independent risk factor for neonatal adiposity [ 44 ]. Total skinfold measurement, the preferred method for assessing obesity, is often impeded by the dearth of trained staff, time, and costly equipment.…”

Section: Discussionmentioning

confidence: 99%

Mid-upper arm circumference in pregnant women and birth weight in newborns as substitute for skinfold thickness: findings from the MAASTHI cohort study, India

Babu

Das

Lobo

et al. 2021

BMC Pregnancy Childbirth

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Background Estimating total body fat in public hospitals using gold-standard measurements such as air displacement plethysmography (ADP), deuterium oxide dilution, or dual-energy X-ray absorptiometry (DXA) is unaffordable, and it is challenging to use skinfold thickness. We aimed to identify the appropriate substitute marker for skinfold thickness to estimate total body fat in pregnant women and infants. Methods The study is part of a prospective cohort study titled MAASTHI in Bengaluru, from 2016 to 19. Anthropometric measurements such as body weight, head circumference, mid-upper arm circumference (MUAC), and skinfold thickness were measured in pregnant women between 14 and 36 weeks of gestational age; while measurements such as birth weight, head, chest, waist, hip, mid-upper arm circumference, and skinfold thickness were recorded for newborns. We calculated Kappa statistics to assess agreement between these anthropometric markers with skinfold thickness. Results We found the highest amount of agreement between total skinfold thickness and MUAC (Kappa statistic, 0.42; 95 % CI 0.38–0.46) in pregnant women. For newborns, the highest agreement with total skinfold thickness was with birth weight (0.57; 95 % CI 0.52–0.60). Our results indicate that MUAC higher than 29.2 cm can serve as a suitable alternative to total skinfolds-based assessments for obesity screening in pregnancy in public facilities. Similarly, a birth weight cut-off of 3.45 kg can be considered for classifying obesity among newborns. Conclusion Mid-upper arm circumference and birth weight can be used as markers of skinfold thickness, reflecting total body fat in pregnant women and the infant, respectively. These two anthropometric measurements could substitute for skinfold thickness in low- and middle-income urban India settings.

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“…The participating hospital had an obstetric department that caters to the urban population of Bengaluru in the surrounding vicinity. A detailed protocol and related publications can be found elsewhere [17,31].…”

Section: Study Design and Settingmentioning

confidence: 99%

“…Advanced maternal age, high body mass index (BMI), a family history of T2DM are significant independent risk factors for hyperglycemia in pregnancy [14]. Among other modifiable risk factors of GDM, tackling obesity is essential; even moderate changes in pre-pregnancy weight have shown to affect the risk of gestational diabetes among obese women [5,[15][16][17]. Studies have also shown that minor degrees of carbohydrate intolerance are related to obesity [18].…”

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confidence: 99%

Food habits in pregnancy and its association with gestational diabetes mellitus: results from a prospective cohort study in public hospitals of urban India

et al. 2020

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Background Few studies have explored the relationship between food habits and the risk of gestational diabetes mellitus (GDM) in women from India. We aimed to investigate the associations of food habits and the risk of GDM. Methods As part of the MAASTHI prospective cohort study in urban Bengaluru, India, pregnant women between 18 and 45 years, less than 36 weeks of gestation were included. During baseline, the participant’s age, education, physical activity levels, and food habits were recorded. Screening of GDM was done by the World Health Organization diagnostic criteria using a 2-h 75-g oral glucose tolerance test between the 24th–36th weeks of gestation. Results We included 1777 pregnant women in the study. We show that 17.6% of the women had GDM, of which 76.7% consume red meat. Red meat consumption was associated with an increased risk of GDM (aRR = 2.1, 95% CI 1.5, 2.9) after adjusting for age, family history of diabetes and socioeconomic status. Conclusion The high intake of red meat consumption in pregnancy needs further examination. Also, future evaluations should consider evaluating the risk of red meat consumption against the combined effect of inadequate consumption of vegetables, fruits, and dairy products in pregnant women. Interventions to educate women in lower socioeconomic status on inexpensive, seasonal, and healthy food might be helpful.

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<p>Do Gestational Obesity and Gestational Diabetes Have an Independent Effect on Neonatal Adiposity? Results of Mediation Analysis from a Cohort Study in South India</p>

Cited by 20 publications

References 69 publications

Pre-Pregnancy Body Mass Index and Risk of Macrosomia and Large for Gestational Age Births with Gestational Diabetes Mellitus as a Mediator: A Prospective Cohort Study in Central China

Pre-Pregnancy Body Mass Index and Risk of Macrosomia and Large for Gestational Age Births with Gestational Diabetes Mellitus as a Mediator: A Prospective Cohort Study in Central China

Mid-upper arm circumference in pregnant women and birth weight in newborns as substitute for skinfold thickness: findings from the MAASTHI cohort study, India

Food habits in pregnancy and its association with gestational diabetes mellitus: results from a prospective cohort study in public hospitals of urban India

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