孕晚期孕妇肠道菌群与孕期体重增长的相关性

【背景】孕妇体重过度增长在全球范围内呈现上升趋势,对母亲和子代健康均会造成不良影响。肠道菌群与人体众多疾病相关,其有可能作为重要的调节因素影响母婴健康。【目的】研究孕晚期孕妇肠道菌群的多样性和群落组成,探讨孕期体重增长对肠道菌群的影响。【方法】收集62位孕晚期(36.82±2.19孕周)孕妇粪便样本,利用MiSeq高通量测序技术对样品中16SrRNA基因V3-V4区序列进行测序,分析不同孕期体重增长水平的孕妇肠道菌群的多样性、群落结构和物种丰度,探讨孕期体重增长对孕妇肠道菌群的影响。【结果】与正常孕妇相比,孕期体重增长过度孕妇肠道菌群多样性显著降低,群落结构变化不大;在菌群组成上,筛选出5个与孕期体重增长最为相关的菌群,分别为Alistipes spp.、Eubacterium-nodatum group spp.、Oxalobacter spp.、Raoultella spp.和Odoribacter spp.,其中Alistipesspp.不仅是相关程度最高也是丰度最高的菌群,与孕期体重增长密切相关。【结论】孕期体重增长对孕晚期孕妇肠道菌群群落结构影响显著,在孕期保持肠道菌群稳态能够促进母婴健康。     

Chronic maternal depression is associated with reduced weight gain in latino infants from birth to 2 years of age

Background

Latino children are at increased risk for mirconutrient deficiencies and problems of overweight and obesity. Exposures in pregnancy and early postpartum may impact future growth trajectories.

Objectives

To evaluate the relationship between prenatal and postnatal maternal depressive symptoms experienced in pregnancy and infant growth from birth to 2 years of age in a cohort of Latino infants.

Methods

We recruited pregnant Latina mothers at two San Francisco hospitals and followed their healthy infants to 24 months of age. At 6, 12 and 24 months of age, infants were weighed and measured. Maternal depressive symptoms were assessed prenatally and at 4-6 weeks postpartum. Women who had high depressive symptoms at both time periods were defined as having chronic depression. Logistic mixed models were applied to compare growth curves and risk for overweight and underweight based on exposure to maternal depression.

Results

We followed 181 infants to 24 months. At 12 and 24 months, respectively, 27.4% and 40.5% were overweight, and 5.6% and 2.2% were underweight. Exposure to chronic maternal depression was associated with underweight (OR = 12.12, 95%CI 1.86-78.78) and with reduced weight gain in the first 2 years of life (Coef = -0.48, 95% CI -0.94—0.01) compared with unexposed infants or infants exposed to episodic depression (depression at one time point). Exposure to chronic depression was also associated with reduced risk for overweight in the first 2 years of life (OR 0.28, 95%CI 0.03-0.92).

Conclusions

Exposure to chronic maternal depression in the pre- and postnatal period was associated with reduced weight gain in the first two years of life and greater risk for failure to thrive, in comparison with unexposed infants or those exposed episodically. The infants of mothers with chronic depression may need additional nutritional monitoring and intervention.     

Risks of maternal prepregnancy overweight/obesity,excessive gestational weight gain,and bottle-feeding in infancy rapid weight gain: evidence from a cohort study in China

Rapid weight gain(RWG) in infants is associated with numerous health problems, and its risk factors are still unclear. We assessed 98,097 maternal-infant pairs from a population-based cohort study and followed up with them until the infants were6 months old. We assessed the associations between maternal prepregnancy weight status; gestational weight gain; feeding pattern; and infants' RWG at 0–1, 0–3, 1–3, and 3–6 months using multivariate unconditional logistic regression models, with controlled confounders. We found that maternal prepregnancy weight status, gestational weight gain, and feeding pattern at the1 st, 3 rd, and 6 th months had significant impacts on the infants' RWG at each time period(P0.05). Infants with overweight/obese mothers had a higher risk of RWG after birth, whereas those of mothers who experienced excessive gestational weight gain had higher risks of RWG from birth than the other groups(P0.01). Infants who were formula-fed had a higher risk of RWG than breastfed infants at the same time point(P0.01). In conclusion, maternal prepregnancy obesity, excessive gestational weight gain, and formula-feeding were risk factors for infants' RWG during the first 6 months of life.     

孕期体重增长和母儿远期健康的研究进展

孕期体重增长过多或不足不仅对近期妊娠结局产生不良影响,而且对母儿的远期健康也起着不可忽视的作用.孕期体重增长过多可能引起母亲远期肥胖、糖尿病及高血压等,对子代则会造成其儿童期及成年期超重、肥胖及高血压.孕期体重增长过少亦可能引起子代远期肥胖,且可导致成年期糖代谢紊乱,以至发展为糖尿病.运动及饮食调节可以控制孕期增重,孕期体重合理增长对减少不良妊娠预后有重要意义.现将近年来孕期体重增长和母儿远期健康的研究进展作一综述.     

Predictors of excessive and inadequate gestational weight gain in Hispanic women

Factors influencing gestational weight gain are incompletely understood, particularly among Hispanic women. We assessed medical, sociodemographic, behavioral, and psychosocial predictors of overall gestational weight gain, as well as gains below, within, or above the range recommended by the Institute of Medicine (IOM) within a prospective study of 770 Hispanic (predominantly Puerto Rican) prenatal care patients at a large tertiary care facility in Western Massachusetts. One third of women gained within the recommended range, 22% gained below, and 45% gained above the range. In multivariate analysis, women in the highest category of BMI (P(trend)<0.001) and parity (P(trend)<0.001) gained on average 9 lbs less than those in the lowest category. Increasing time in residence in the continental United States (P(trend)<0.01) as well as a number of prenatal care visits (P(trend)=0.03) were positively associated with weight gain. Overweight women (odds ratio (OR)=2.2, 95% confidence interval (CI) 1.3, 3.8) and those over age 30 years (OR=2.5, 95% CI 1.2, 5.0) were more likely to gain above the IOM range as compared to normal-weight women and those aged 20-24, respectively. Women with <10 years of residence in the United States were 50% less likely to gain above the IOM range as compared to third-generation women (95% CI 0.3, 0.9). Findings identify determinants of gestational weight gain which can form the basis of targeted interventions in this rapidly growing ethnic group.     

Effect of maternal weight gain during pregnancy on exercise performance

We examined the effect of maternal weight gain during pregnancy on exercise performance. Ten women performed submaximal cycle (up to 60 W) and treadmill (4 km/h, up to 10% grade) exercise tests at 34 +/- 1.5 (SD) wk gestation and 7.6 +/- 1.7 wk postpartum. Postpartum subjects wearing weighted belts designed to equal their body weight during the antepartum tests performed two additional treadmill tests. Absolute O2 uptake (VO2) at the same work load was higher during pregnancy than postpartum during cycle (1.04 +/- 0.08 vs. 0.95 +/- 0.09 l/min, P = 0.014), treadmill (1.45 +/- 0.19 vs. 1.27 +/- 0.20 l/min, P = 0.0002), and weighted treadmill (1.45 +/ 0.19 vs. 1.36 +/- 0.20 l/min, P = 0.04) exercise. None of these differences remained, however, when VO2 was expressed per kilogram of body weight. Maximal VO2 (VO2max) estimated from the individual heart rate-VO2 curves was the same during and after pregnancy during cycling (1.96 +/- 0.37 to 1.98 +/- 0.39 l/min), whereas estimated VO2max increased postpartum during treadmill (2.04 +/- 0.38 to 2.21 +/- 0.36 l/min, P = 0.03) and weighted treadmill (2.04 +/- 0.38 to 2.19 +/- 0.38 l/min, P = 0.03) exercise. We conclude that increased body weight during pregnancy compared with the postpartum period accounts for 75% of the increased VO2 during submaximal weight-bearing exertion in pregnancy and contributes to reduced exercise capacity. The postpartum increase in estimated VO2max during weight-bearing exercise is the result of consistently higher antepartum heart rates during all submaximal work loads.     

Tissue-specific responses of lipoprotein lipase to dietary macronutrient composition as a predictor of weight gain over 4 years

This study evaluated if the effect of dietary macronutrient composition on adipose tissue lipoprotein lipase (ATLPL) and skeletal muscle lipoprotein lipase (SMLPL) predicted the long-term (over 4 years) changes in body weight and composition in free-living adults. Using a crossover design, 39 healthy subjects (n = 24 normal weight, n = 7 overweight, n = 8 obese) each followed a 2-week isocaloric high-carbohydrate (HC; 55% CHO:25% fat) and high-fat (HF; 30% CHO:50% fat) diet. On day 15 of each diet, biopsies were performed in the fasted state and 6 h after a meal. Body weight and composition were measured annually over 4 years. The outcomes for body weight, fat mass and % body fat were assessed using a linear two-stage mixed model. The mean (±SEM) increase in body weight and fat mass over 4 years was 0.29 ± 0.15 kg/year (P = 0.063) and 0.31 ± 0.15 kg/year (P = 0.051), respectively. The most consistent predictors of future body weight and fat changes were the ΔATLPL and ΔSMLPL responses (0-6 h) to a HC diet/meal. For the HC diet/meal, the subjects who had an increase in ATLPL activity/cell gained more % body fat over 4 years (P = 0.006) whereas subjects who had a decrease in SMLPL activity/g also had an increase in fat mass (P = 0.021). No significant relationships were observed between fasting ATLPL and SMLPL or enzyme responses to meals and any of the outcomes following the HF diet. In free-living adults the variability in tissue-specific lipoprotein lipase (LPL) responsiveness to a HC diet/meal predicts longitudinal changes in body composition.     

Effects of gestational weight gain and body mass index on obstetric outcome

Abstract It is already known that maternal overweight, obesity, and morbid obesity are associated with adverse obstetric and neonatal outcomes. To assess the prevalence of overweight and obesity, and the impact of body mass index (BMI) on maternal and neonatal outcomes in Turkey. The study population consisted of 698 singleton pregnancies whose height and weight follow up were performed from the first trimester of pregnancy and whose deliveries were monitored in Trabzon, Turkey in July 2014–June 2015. The data obtained during the study were evaluated using SPSS 21 package program. The differences in variables were assessed by Chi-square-test for categorical data or by One-way Anova test for continuous data. The results were evaluated at a confidence interval of 95% and at a significance level of p?<?0.05. According to the BMI of the women in the study, 68.8% were in normal weight, 20.6% were overweight, 3.9% were obese, and the majority was in the 20–29 age group and 8–15.9?kg. The rate of cesarean, instrumental delivery, induction, episiotomy, late breastfeeding, low apgar (<7 at 5?min), neonatal intensive care unit admission requirement, the newborn at 4000?g or more in overweight (BMI 25–29.9) and obese (BMI?≥?30) pregnancies was higher and the first and second phases of labor were longer (p?<?0.05). The study showed that as the pre-pregnancy body mass index and gestational weight gain increased the rates of cesarean section and interventional delivery increased and the neonatal need for neonatal intensive care unit increased.     

Association between maternal and child leptin levels 9 years after pregnancy complicated by gestational diabetes.

Obesity is a state of relative leptin resistance, and obesity in childhood is associated with an increased incidence of type 2 diabetes in later life. Offspring of mothers with gestational diabetes mellitus (GDM) are at increased risk of obesity. A cohort consisting of 64 mothers, 33 GDM and 31 controls screened for diabetes during the index pregnancy together with their 9-year-old offspring were studied. Our hypotheses were: 1) an elevated child leptin is associated with elevated maternal leptin in GDM mothers 9 years post delivery; and 2) child leptin at 9 years serves as a marker for incipient insulin resistance. By univariate analyses, child leptins were only significantly correlated with maternal leptins among the offspring of GDMs (OGDM) (r = 0.59; p = 0.001). By multivariate analyses, child leptin for the total study group was significantly associated with child body mass index (BMI) (R(2) = 0.65; p < 0.0001), child fasting insulin (R(2) = 0.08; p = 0.03), and female gender (R(2) = 0.28; p = 0.001). In addition, among OGDM child leptin was associated with maternal leptin (R(2) = 0.14; p = 0.005). Our results suggest that there is an association between maternal and child leptin levels 9 years after a pregnancy complicated by gestational diabetes.     

Late bedtime after 22.00 hours affects daily weight gain in 4-month-old infants

Sleep and Biological Rhythms - This study examined the relation between the bedtime of 4-month-old infants and their daily weight gain, using health check-up data and a questionnaire. The infants,...     

Trajectories of sleep quality and associations with excessive gestational weight gain during pregnancy

Sleep and Biological Rhythms - Poor sleep and excessive weight gain of pregnant women are associated with maternal outcomes. However, it’s unknown regarding their effects of each other in...