The accuracy of self-reported pregnancy-related weight: a systematic review.

Self-reported maternal weight is error-prone, and the context of pregnancy may impact error distributions. This systematic review summarizes error in self-reported weight across pregnancy and assesses implications for bias in associations between pregnancy-related weight and birth outcomes. We searched PubMed and Google Scholar through November 2015 for peer-reviewed articles reporting accuracy of self-reported, pregnancy-related weight at four time points: prepregnancy, delivery, over gestation and postpartum. Included studies compared maternal self-report to anthropometric measurement or medical report of weights. Sixty-two studies met inclusion criteria. We extracted data on magnitude of error and misclassification. We assessed impact of reporting error on bias in associations between pregnancy-related weight and birth outcomes. Women underreported prepregnancy (PPW: -2.94 to -0.29 kg) and delivery weight (DW: -1.28 to 0.07 kg), and over-reported gestational weight gain (GWG: 0.33 to 3 kg). Magnitude of error was small, ranged widely, and varied by prepregnancy weight class and race/ethnicity. Misclassification was moderate (PPW: 0-48.3%; DW: 39.0-49.0%; GWG: 16.7-59.1%), and overestimated some estimates of population prevalence. However, reporting error did not largely bias associations between pregnancy-related weight and birth outcomes. Although measured weight is preferable, self-report is a cost-effective and practical measurement approach. Future researchers should develop bias correction techniques for self-reported pregnancy-related weight.

Changing national guidelines is not enough: the impact of 1990 IOM recommendations on gestational weight gain among US women.

BACKGROUND AND OBJECTIVES: Gestational weight gain (GWG) is associated with both long- and short-term maternal and child health outcomes, particularly obesity. Targeting maternal nutrition through policies is a potentially powerful pathway to influence these outcomes. Yet prior research has often failed to evaluate national policies and guidelines that address maternal and child health. In 1990, the U.S. Institute of Medicine (IOM) released guidelines recommending different GWG thresholds based on women's pre-pregnancy body mass index (BMI), with the goal of improving infant birth weight. In this study, we employ quasi-experimental methods to examine whether the release of the IOM guidelines led to changes in GWG among a diverse and nationally representative sample of women. METHODS: Our sample included female participants of the National Longitudinal Survey of Youth who self-reported GWG for pregnancies during 1979-2000 (n=7442 pregnancies to 4173 women). We compared GWG before and after the guidelines were released using difference-in-differences (DID) and regression discontinuity (RD) analyses. RESULTS: In DID analyses we found no reduction in GWG among overweight/obese women relative to normal/underweight women. Meanwhile, RD analyses demonstrated no changes in GWG by pre-pregnancy BMI for either overweight/obese or normal/underweight women. Results were similar for women regardless of educational attainment, race or parity. CONCLUSIONS: These findings suggest that national guidelines had no effect on weight gain among pregnant women. These results have implications for the implementation of policies targeting maternal and child health via dietary behaviors.

Excessive gestational weight gain over multiple pregnancies and the prevalence of obesity at age 40.

OBJECTIVE: Although several studies have found an association between excessive gestational weight gain (GWG) and obesity later in life, to the best of our knowledge, no studies have explored the role of GWG events across the life course. DESIGN AND METHODS: We describe how the prevalence of midlife obesity (BMI⩾30 at age 40 or 41) among women varies by life course patterns of GWG (using 2009 IOM guidelines) in the USA's National Longitudinal Survey of Youth 1979 cohort. RESULTS: Among women who reported 1-3 births before age 40, the prevalence of midlife obesity increased with a rising number of excessive GWG events: from none (23.4%, n=875) to one (37.6%, n=707), from none (23.4%, n=875) to two (46.8%, n=427) and from none (23.4%, n=875) to three (54.6%, n=108), P<0.00005 for trend. Obesity prevalence was similar for the same number of excessive GWG events, regardless of parity. No clear pattern emerged for the sequencing of excessive GWG event(s) and later obesity. CONCLUSIONS: In our descriptive exploratory study, excessive GWG events appear to be associated with increased prevalence of obesity for parous women, suggesting the importance of preventive interventions regardless of timing of pregnancy-related weight changes over the life course.

Educational attainment and obesity: a systematic review.

Although previous systematic reviews considered the relationship between socioeconomic status and obesity, almost 200 peer-reviewed articles have been published since the last review on that topic, and this paper focuses specifically on education, which has different implications. The authors systematically review the peer-reviewed literature from around the world considering the association between educational attainment and obesity. Databases from public health and medicine, education, psychology, economics, and other social sciences were searched, and articles published in English, French, Portuguese and Spanish were included. This paper includes 289 articles that report on 410 populations in 91 countries. The relationship between educational attainment and obesity was modified by both gender and the country's economic development level: an inverse association was more common in studies of higher-income countries and a positive association was more common in lower-income countries, with stronger social patterning among women. Relatively few studies reported on lower-income countries, controlled for a comprehensive set of potential confounding variables and/or attempted to assess causality through the use of quasi-experimental designs. Future research should address these gaps to understand if the relationship between educational attainment and obesity may be causal, thus supporting education policy as a tool for obesity prevention.

Primary cerebral lymphoma: an association with craniopharyngioma or cadaveric growth hormone therapy?

OBJECTIVES: To present the first case of primary cerebral lymphoma associated with craniopharyngioma or previous cadaveric growth hormone therapy. CLINICAL FEATURES: A 22-year-old male shop assistant of European descent presented with unilateral uveitis and was found to have a high grade primary cerebral lymphoma. This occurred nine years after successful surgical resection of a craniopharyngioma without the administration of adjuvant radiotherapy. INTERVENTION AND OUTCOME: There was initial radiological resolution of cerebral lymphoma after cranial irradiation. Recurrence was noted 10 weeks later, resulting in the patient's death. CONCLUSION: The development of primary cerebral lymphoma following a craniopharyngioma is considered most likely a chance occurrence. Cadaveric growth hormone therapy may play a role in the genesis of lymphoma.

The complex of myxomas, spotty pigmentation and endocrine overactivity.

We describe a 40-year-old male with acromegaly, multiple and recurrent cutaneous myxomas, spotty cutaneous pigmentation, a mammary myxoma, a large-cell calcifying Sertoli cell tumour of the testis, and an unusual calcifying pigmented neuroectodermal tumour. He presented a combination of clinical and histological features not previously documented within the complex of myxomas, spotty pigmentation and endocrine overactivity, and therefore the findings broaden the spectrum of the syndrome.