ABSTRACT
Abstract Objectives: to investigate the association between sociodemographic, gestational/puerperal factors and postpartum weight retention (PPWR) after 12 months in Brazilian women at a university hospital. Methods: prospective cohort with puerperal women recruited at the maternity ward of a university hospital in a Brazilian metropolis. At baseline (n=260), sociodemographic and anthropometric information on the mother-child binomial and data related to the gestational period were collected. Maternal dietary patterns were measured using a food frequency questionnaire and subsequently determined by Principal Component Analysis. Results: 75 women, with a mean age of 28.4 years (CI95%= 27.0-29.7), 25.3% with excessive PPPR, with an average of 3.6 kg (CI95%= 1.7) continued in the follow-up. -5.4). Higher gestational weight gain (GWG) (ß= 0.36; CI95%= 0.18-0.70) and lower maternal age (ß= -0.41; CI95%= -0.92--0.22) were PRPP predictors (p=0.001) (adjusted for per capita income, parity, type of delivery, number of prenatal visits, baby's birth weight, breastfeeding and physical activity). Conclusion: there was a high occurrence of excessive PPPR, favored by higher GPG and lower maternal age. This highlights the importance of monitoring women's health during the reproductive period, with guidance on ways of life (diet and physical activity), to favor better outcomes for mother-child.
Resumo Objetivos: investigar a associação entre fatores sociodemográficos, gestacionais/puerperais com a retenção de peso pós-parto (RPPP) após 12 meses em mulheres brasileiras em hospital universitário. Métodos: coorte prospectiva com puérperas recrutadas na maternidade do hospital universitário de uma metrópole brasileira. Na linha de base (n=260) foram coletadas informações sociodemográficas, antropométricas do binômio mãe-filho e dados relativos ao período gestacional. O padrão alimentar materno foi mensurado por meio do questionário de frequência alimentar e posteriormente determinado pela Análise de Componentes Principais. A RPPP foi classificada como risco para obesidade se ≥7,5Kg. Resultados: 75 mulheres continuaram no seguimento, com média de 28,4 anos de idade (IC95%= 27,0−29,7), 25,3% com RPPP excessiva, sendo em média 3,6 Kg (IC95%= 1,7−5,4). Maior ganho de peso gestacional (GPG) (β= 0,36; IC95%= 0,18-0,70) e menor idade materna (β= −0,41; IC95%= −0,92--0,22) foram preditores da RPPP (p≥0,001) (ajustado pela renda per capita, paridade, tipo de parto, número de consultas pré-natal, peso ao nascer do bebê, aleitamento materno e atividade física). Conclusão: evidenciou-se elevada ocorrência de RPPP excessiva, favorecida pelo maior GPG e menor idade materna. Aponta-se assim a importância do monitoramento da saúde da mulher durante o período reprodutivo, com orientações sobre modos de vida (alimentação e atividade física), para favorecer melhores desfechos para mãe-filho.
Subject(s)
Humans , Female , Pregnancy , Risk Factors , Postpartum Period , Maternal Nutrition , Feeding Behavior , Gestational Weight Gain , Brazil , Anthropometry , Sociodemographic FactorsABSTRACT
Objetivo: Identificar cuáles son las características maternas asociadas al diagnóstico de macrosomía fetal en el Hospital Sergio E. Bernales de enero a diciembre del 2018. Métodos: Se realizó un estudio de tipo observacional, analítico, retrospectivo, de casos y controles. La población estudiada fueron las gestantes con el diagnostico de macrosomía fetal atendidas en el servicio de ginecoobstetricia del Hospital Sergio E. Bernales enero a diciembre del 2018. A través de una ficha de recolección de datos, se extrajo la información de las historias clínicas, las cuales después fueron procesadas según el programa de IBM SPSS Statistics v25. Resultados: De 532 pacientes estudiados se obtuvieron 133 casos y 399 controles. La edad materna varía entre 14 y 45 años (edad media de 27,01). Se encontró asociación estadísticamente significativa entre macrosomía fetal y las siguientes variables: embarazo postérmino (OR=13,613 IC95% 2,901-63,891), diabetes gestacional (OR 5,7 IC95%2,5 -12,7), ganancia de peso excesiva (OR 1,833 IC95%1,154-2,911), sexo del recién nacido (OR 1,83 IC95%1,2-2,7) y edad de la madre (OR 1,7 IC95%1,0-2,9). Al realizar el análisis multivariado no se encontró asociación con las variables edad de la madre (P =0,228, OR 1,510 IC95%0,773- 2,950) e IMC (P=0,331, OR 0,740 IC95%0,403-1,358), por lo que se consideraron variables confusoras. Conclusión: Las características maternas asociadas al diagnóstico de macrosomía fetal son parto postérmino, diabetes gestacional, ganancia de peso excesiva y sexo del recién nacido.
Objective: To identify the maternal characteristics associated with the diagnosis of fetal macrosomia at Sergio E. Bernales Hospital from January to December 2018. Methods: An observational, analytical, retrospective, case-control study was carried out. The population studied was pregnant women with a diagnosis of fetal macrosomia treated in the gynecoobstetrics service of Sergio E. Bernales Hospital from January to December 2018. Through a data collection sheet, the information from the medical records was extracted; the data was then processed according to the IBM SPSS Statistics v25 program. Results: Of 532 patients studied, 133 cases and 399 controls were obtained. Maternal age varies between 14 and 45 years (average age of 27.01). A statistically significant association was found between fetal macrosomia and the following variables: post-term pregnancy (OR = 13,613 95% CI 2,901-63,891), gestational diabetes (OR 5.7 IC95% 2.5 -12.7), excessive weight gain (OR 1,833 95% CI 1,154-2,911), sex of the newborn (OR 1.83 95% CI 1.2-2.7) and age of the mother (OR 1.7 95% CI 1.0-2.9). When performing the multivariate analysis, no association was found with the variables age of the mother (P = 0.228, OR 1.510 95% CI 0.773-2.950) and BMI (P = 0.331, OR 0.740 95% CI 0.403-1.358), so they were considered confusing variables. Conclusion: The maternal characteristics associated with the diagnosis of fetal macrosomia are post-term delivery, gestational diabetes, excessive weight gain and sex of the newborn.
ABSTRACT
Introducción: La lactancia materna es recomendada como fuente de alimentación optima para los primeros meses de vida. En nuestro Servicio hemos recibido un grupo particular de niños alimentados con lactancia materna exclusiva, que muestran aumento excesivo de peso desde el primer semestre de vida. Objetivo: describir las características clínicas de un grupo de lactantes menores de un año, con aumento excesivo de peso y alimentación con lactancia materna. Población y métodos: estudio observacional, prospectivo y longitudinal. Incluimos todos los niños menores de un año derivados al servicio de Nutrición entre 2003 y 2015, con lactancia materna exclusiva durante los primeros 6 meses, persistencia de la misma al momento de la evaluación y peso- edad mayor a 2 desvíos estándar (DS). Describimos características clínicas y de laboratorio de los lactantes y sus madres, así como el patrón alimentario que pudiera explicar esta inusual ganancia de peso. Resultados: incluimos 73 lactantes, 63% niñas. El 64% tenía peso-talla mayor a 2DS a los 3 meses de vida y el 100% a los 6 meses. No se pudo establecer patrón hambresaciedad. El 44% de las madres aumentó más de 18 kilogramos durante el embarazo. Las niñas nacidas de las madres que habían aumentado más de 18 Kg fueron significativamente más grandes al nacer. En el 14% de los lactantes se encontró alguna enfermedad de base. De toda la muestra, el 75% presentó anemia y el 14.5% hipotiroidismo. Conclusiones: describimos un grupo de lactantes con aumento excesivo de peso desde los primeros 3 meses de vida que se mantiene durante toda la etapa de lactancia materna. Diferentes factores como relación madre-hijo, patrón alimentario, composición de la leche humana, predisposición genética; podrían haber contribuido con este patrón de crecimiento.(AU)
Introduction: Maternal breastfeeding is recommended as the best source of nutrition in the first months of life. At our Department we have seen a group of exclusively breastfed children who showed excessive weight since the first semester of life. Objective: To describe the clinical features of a group of infants under one year of age with excessive weight gain while being breast-fed. Population and methods: A prospective, longitudinal, observational study was conducted. We included all infants under one year of age who were referred to the Department of Nutrition between 2003 and 2015, who were exclusively breastfed during the first 6 months of life and were still being breastfed at the moment of the evaluation, and who had a weight-for-age of more than 2 standard deviation (SD). We describe the clinical and laboratory features of the infants and their mothers, as well as feeding patterns that may explain this unusual weight gain. Results: We included 73 infants, 63% girls. Overall, 64% had a weight-for-height greater than 2 SD at 3 months of life and 100% at 6 months of life. No hunger-satiety pattern could be established. Of the mothers, 44% gained more than 18 kg during the pregnancy. The girls born from mothers who had increased more than 18 Kg were significantly larger at birth. In 14% of the infants, an underlying disease was found. Of all the infants in the sample, 75% had anemia and 14.5% hypothyroidism. Conclusions: We describe a group of infants with excessive weight gain in the first 3 months of life which was maintained throughout the maternal breastfeeding period. Different factors, such as the motherchild relationship, feeding pattern, human milk composition, and genetic predisposition may have contributed to this particular growth pattern. (AU)
Subject(s)
Humans , Infant, Newborn , Infant , Breast Feeding , Milk, Human , Pediatric Obesity/etiology , Weight Gain , AnthropometryABSTRACT
OBJETIVO: identificar la asociación entre factores prenatales y relacionados con el primer año de vida y su influencia en el sobrepeso corporal de edades ulteriores. MÉTODOS: se realizó un estudio observacional, retrospectivo, analítico, de casos y controles en el municipio Bayamo con 200 escolares con sobrepeso corporal y 200 niños normales de 6-11 años de edad, de la misma zona de residencia, nacidos de madres con similar edad gestacional de 37-42 semanas, homogéneos en edad y sexo y con historia de no afecciones de salud. En el análisis estadístico se estimó el riesgo asociado como Odd Ratio. RESULTADOS: se mostró una fuerte asociación entre el sobrepeso corporal en la edad escolar y la ganancia de peso excesiva en los primeros 4 meses de vida, bajo peso, reducida longitud supina y circunferencia cefálica en el momento del nacimiento y hábito de fumar, insuficiente ganancia de peso corporal, bajo IMC y enfermedades de la madre durante el embarazo. CONCLUSIONES: estos factores deben ser considerados en la prevención de la obesidad infantil. La ganancia de peso acelerada en los primeros meses de vida de niños nacidos con afectación del crecimiento fetal debe ser prevenida.
OBJECTIVE: describe the relationship between prenatal factors and those occurring during the first year of life, and determine their influence on overweight in later stages. METHODS: an analytical observational retrospective case-control study was conducted in the municipality of Bayamo with 200 overweight school-age children and 200 normal children aged 6-11 years from the same area of residence, born to mothers with similar gestational age of 37-42 weeks, homogeneous as to age and sex, and with a history of good health. The statistical analysis included estimation of the associated risk as odd ratio. RESULTS: a strong association was found between overweight at school age and the following factors: excessive weight gain during the first 4 months of life, low weight, reduced supine length and head circumference at birth, smoking, insufficient weight gain, low BMI and maternal diseases during pregnancy. CONCLUSIONS: these factors should be borne in mind in the prevention of child obesity. Rapid weight gain during the first months of life should be prevented among children born with fetal growth disorders.
Subject(s)
Humans , Child , Pediatric Obesity/prevention & control , Pediatric Obesity/epidemiology , Case-Control Studies , Retrospective Studies , Observational Study , Informed ConsentABSTRACT
Introducción: la vigilancia del estado nutricional materno se lleva a cabo en Cuba desde el año 1979, pero nunca se había podido disponer de referencias propias del país para gestantes. Objetivos: comparar el estado nutricional de las embarazadas utilizando las referencia cubanas y las del Instituto de Medicina de los Estados Unidos de Norteamérica (IOM) 1990. Métodos: usando como información base los sitios centinelas para la vigilancia nutricional materna se valoró siguiendo los puntos de corte del IOM 1990 y de las referencias nacionales, el estado nutricional de las embarazadas y se obtuvo la comparación entre el índice de masa corporal (IMC) a la captación, la ganancia de peso durante la gestación según el estado nutricional inicial y la edad de las embarazadas según ambas referencias. Resultados: se pudo comprobar que existe una disminución del porcentaje de embarazadas con bajo peso al inicio de la gestación al utilizar las normas cubanas, la ganancia de peso ideal según el estado nutricional inicial es relativamente baja con el uso de ambas normas, las tablas cubanas diagnostican con más frecuencia el sobrepeso y la obesidad que las del Instituto de Medicina de los Estados Unidos de Norteamérica (IOM), las embarazadas menores de 15 años son las que presentan una mayor proporción de ganancia de peso inferior a la ideal. Se demuestra la importancia del uso de referencias propias. Conclusiones: los datos de la vigilancia del estado nutricional materno son mejor interpretados según las tablas cubanas por ser obtenidas de la misma población
Introduction: the surveillance of the maternal nutritional status is conducted in Cuba from 1979, but never has been possible to have our own references for pregnants. Objectives: to compare the nutritional status of pregnants using the Cuban references and that of the Institute of Medicine of the United States of America (IOM) 1990. Methods: using as basement information the sentinel sites for the maternal nutritional surveillance authors assessed the cut points of the IOM 1990 and of the national references of the pregnant nutritional status obtaining the comparison between the body mass index (BMI) for capture, the weight gain during pregnancy according to the initial nutritional status and the pregnant age according to both references. Results: it was possible to verify the existence of a decrease in the low weight pregnants at onset of pregnancy with the use of Cuban standards, the ideal weight gain according to the initial nutritional status is relatively low using both standards, the Cuban tables diagnose more frequently the excess weight and the obesity than that of the IOM, the pregnant aged under 15 are who have a greater ratio of weight gain lower than the ideal one. The significance of the use of own references is demonstrated. Conclusions: the data on maternal nutritional status surveillance are better interpreted according to the Cuban tables because they are obtained from the same population
Subject(s)
Humans , Female , Pregnancy , Anthropometry/methods , Weight Gain/physiology , Body Weight/physiology , Food and Nutritional Surveillance/methods , Cuba/epidemiologyABSTRACT
OBJECTIVE: The purpose of this study was to determine the independent factors that predict neonatal birthweight and find the relationship between maternal weight gain and neonatal birthweight in women with normal glucose tolerance (NGT) and gestational diabetes mellitus (GDM). METHODS: Forty-six women with GDM and one hundred fifty women with NGT were included in the study. All subjects had singleton pregnancies and no medical diseases that may affect the fetal growth and were certain of gestational age by early ultrasonography. Maternal weight at each prenatal visit was recorded and neonatal anthropometic measurement was done within 2 days of birth. RESULTS: The average rate of weight gain (kg/week) in NGT was lowest during the first trimester (0.09 +/-0.10), peaked during the second trimester (0.52+/-0.14), and slowed after 34 gestational weeks (0.46+/-0.26). In women with GDM, the average rate of weight gain was also lowest during the first trimester (0.18+/-0.23), but it was twofold higher compared with women with NGT. There was a significant decrease of the rate of weight gain after 28 gestational weeks in women with GDM. Total weight gain during pregnancy was 3.4 kg less in women with GDM. Neonatal birthweight was correlated with maternal weight gain and the rate of weight gain during 14-27 and 28-33 weeks in NGT. However, birthweight was correlated with maternal weight gain and the rate of weight gain during the first trimester and 14-27 weeks in GDM. CONCLUSION: This result suggests that the women with GDM who have greater weight gain during the first and the second trimester have a increased risk of excessive fetal growth. Thus strict glycemic control during pregnancy is needed especially in these women.