Risk Factors for Excessive Gestational Weight Gain in a Healthy, Nulliparous Cohort

Restall, Antonia; Taylor, Rennae S.; Thompson, John M. D.; Flower, Deralie; Dekker, Gustaaf A.; Kenny, Louise C.; Poston, Lucilla; McCowan, Lesley

doi:10.1155/2014/148391

Cited by 122 publications

(144 citation statements)

References 44 publications

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“…Women are expected to gain adequate weight to support the growing fetus. 71 However, too little or too much weight gain can pose serious health threats, including gestational diabetes, hypertension, and metabolic irregularities, all of which can contribute to obesity. 70,72,73 Each of these specific morbidities are important as they are independent risk factors for adverse pregnancy and infant outcomes, such as preterm birth, small-and large-for gestational-age infants, and future disease.…”

Section: Discussionmentioning

confidence: 99%

Identifying Insomnia in Early Pregnancy: Validation of the Insomnia Symptoms Questionnaire (ISQ) in Pregnant Women

Okun

Buysse

Hall

2015

Journal of Clinical Sleep Medicine

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Study Objectives: Although a substantial number of pregnant women report symptoms of insomnia, few studies have used a validated instrument to determine the prevalence in early gestation. Identifi cation of insomnia in pregnancy is vital given the strong connection between insomnia and the incidence of depression, cardiovascular disease, or immune dysregulation. The goal of this paper is to provide additional psychometric evaluation and validation of the Insomnia Symptom Questionnaire (ISQ) and to establish prevalence rates of insomnia among a cohort of pregnant women during early gestation. Methods: The ISQ was evaluated in 143 pregnant women at 12 weeks gestation. The internal consistency and criterion validity of the dichotomized ISQ were compared to traditional measures of sleep from sleep diaries, actigraphy, and the Pittsburgh Sleep Quality Index using indices of sensitivity, specifi city, positive and negative predictive value (PPV, NPV), and likelihood ratio (LR) tests. Results: The ISQ identifi ed 12.6% of the sample as meeting a case defi nition of insomnia, consistent with established diagnostic criteria. Good reliability was established with Cronbach α = 0.86. The ISQ had high specifi city (most > 85%), but sensitivity, PPV, NPV, and LRs varied according to which sleep measure was used as the validating criterion. Conclusions: Insomnia is a health problem for many pregnant women at all stages in pregnancy. These data support the validity and reliability of the ISQ to identify insomnia in pregnant women. The ISQ is a short and cost-effective tool that can be quickly employed in large observational studies or in clinical practice where perinatal women are seen. 1 Among the many sleep complaints associated with pregnancy, diffi culty initiating or maintaining sleep or unrefreshing sleep, are the most frequently reported issues .1,2 Collectively these sleep symptoms comprise only one aspect of clinical insomnia. According to diagnostic criteria for insomnia, one must have: (1) a diffi culty initiating or maintaining sleep, and/or unrefreshing sleep despite adequate opportunity for sleep; (2) the duration of the sleep complaint is at least 1 mo; and (3) complaints of significant impairment in social, occupational, or daily functioning. 3,4 Insomnia is associated with activation of the stress system resulting in autonomic hyperarousa l. 5,6 It is also linked to various morbidities including depressi on.7-12 Emerging evidence implicates autonomic hyperarousal as a pathway through which the risk of depression is augmen ted. 13 This association is particularly relevant for pregnant women because there is evidence that depression is associated with an increased risk for preterm birth ( PTB), 14 and prenatal depression negatively impairs maternal-child bonding and neurocognitive develo pment.14-17 Having a simple diagnostic tool to identify clinical insomnia in pregnant women could be a fi rst step in reducing the incidence of depression, autonomic hyperarousal, as well as adverse pregnancy outcomes, such as PT...

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Section: Discussionmentioning

confidence: 99%

Identifying Insomnia in Early Pregnancy: Validation of the Insomnia Symptoms Questionnaire (ISQ) in Pregnant Women

Okun

Buysse

Hall

2015

Journal of Clinical Sleep Medicine

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“…Overweight and obese women are particularly at risk of gaining too much weight during pregnancy [69-71, 73-74, 83]. But an expectant mother who herself had a high birth weight [83] and the body mass index of the expectant father were also found to be associated with excessive weight gain during pregnancy [72]. In addition, continued nicotine consumption [72,74], quitting smoking, and lack of physical activities [69,80,83] can also lead to excessive weight gain [83].…”

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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“…Women with a BMI > 30 kg/m 2 (defined as clinically obese) are more likely to gain excessive weight in pregnancy compared to women with a BMI in the normal range (Restall et al, 2014), leading to increased risks of high birthweight, and maternal postpartum weight retention with associated risks (Siega-Riz et al, 2009). In women with a BMI > 40 kg/m 2 (very severely obese), for whom pregnancy risks are incrementally greater (CMACE/RCOG, 2010), limiting gestational weight gain may reduce the risk of adverse pregnancy outcomes (Crane et al, 2009).…”

Section: Introductionmentioning

confidence: 99%

“If she wants to eat…and eat and eat…fine! It's gonna feed the baby”: Pregnant women and partners' perceptions and experiences of pregnancy with a BMI >40 kg/m 2

et al. 2017

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A B S T R A C TIntroduction: women with a raised BMI are more likely to gain excessive weight in pregnancy compared to women with a BMI in the normal range. Recent behaviour change interventions have had moderate to no influence on GWG, and no effect on other perinatal outcomes. Evidence is required regarding the social and cultural contexts of weight and pregnancy. No studies to date have included the views of partners. Aims: to explore the experiences, attitudes and health-related behaviours of pregnant women with a BMI > 40 kg/m 2 ; and to identify the factors and considerations which shape their beliefs, experiences and behaviours, and how these may change during and after pregnancy. 2. To determine the impact, if any, of the beliefs and attitudes of significant members of the women's families and social networks upon the women's experiences, attitudes and health-related behaviours in relation to weight and pregnancy Methods: this was a prospective serial interview study. Semi-structured interviews were conducted with 11 pregnant women with a BMI > 40 kg/m 2 , during pregnancy and after birth, and once with 7 partners (all male) of women. Interview questions were designed to be appropriately but flexibly framed, in order to explore and gather data on participants' everyday life, lifestyles, views, experiences, relationships and behaviours, focussing more specifically on beliefs about health, pregnancy, weight and diet. Thematic content analysis was used to formally analyse and unearth patterns in the data. Findings: the findings can be grouped into six interrelated themes: the complexities of weight histories and relationships with food; resisting risk together; resisting stigma together; pregnancy as a 'pause';receiving dietary advice; postnatal intentions. These themes are interrelated due to the 'spoiled identity' (Goffman, 1963) that the large body represents in western culture and related stigma. Conclusion and implications: this study provides evidence that there exist deeply ingrained social and cultural beliefs among women and in particular their partners, regarding pregnancy diet and weight gain. Further, this study provides evidence that male partners may resist stigmatised risk on behalf of a pregnant partner. All women (and several men) expressed an intention to adopt healthy behaviours and lose weight once their baby was born. Further evidence is required regarding the means by which women who experience stigmatised risk during pregnancy, and their partners, might be engaged and receptive to health advice. Models which draw on ideals of relationship-centred care, and selfefficacy via open discussion with women and families, engaging women and partners by providing them with an opportunity to talk about their beliefs and concerns, could be explored to inform future research and practice.

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Risk Factors for Excessive Gestational Weight Gain in a Healthy, Nulliparous Cohort

Cited by 122 publications

References 44 publications

Identifying Insomnia in Early Pregnancy: Validation of the Insomnia Symptoms Questionnaire (ISQ) in Pregnant Women

Identifying Insomnia in Early Pregnancy: Validation of the Insomnia Symptoms Questionnaire (ISQ) in Pregnant Women

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

“If she wants to eat…and eat and eat…fine! It's gonna feed the baby”: Pregnant women and partners' perceptions and experiences of pregnancy with a BMI >40 kg/m 2

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