Food insecurity, gestational weight gain and gestational diabetes in the National Children’s Study, 2009–2014

2020 ◽  
Author(s):  
Megan Richards ◽  
Margaret Weigel ◽  
Ming Li ◽  
Molly Rosenberg ◽  
Christina Ludema
Keyword(s):  
Weight Gain ◽  
Gestational Diabetes ◽  
Food Insecurity ◽  
Gestational Weight Gain ◽  
Joint Effect ◽  
Household Food Security ◽  
Logistic Regression Models ◽  
Gestational Weight ◽  
Household Food ◽  
The Usa

Abstract Background Household food insecurity (HFI) and gestational diabetes mellitus (GDM) are both common during pregnancy, yet it is unknown if these two factors are related. We aimed to determine the independent and joint associations between HFI, gestational weight gain (GWG) and GDM among pregnant women in the USA. Methods We used data from 592 women in the National Children’s Study, Initial Vanguard Study from 2009 to 2014. HFI was assessed using the Household Food Security Survey Module at the first study visit; GDM was assessed through questionnaires and medical chart review. Logistic regression models were used to investigate the exposures of HFI, GWG and their joint effect on GDM. Results Among participants, 20.1% were marginally food secure or food insecure and 7.4% were diagnosed with GDM. The elevated unadjusted association between HFI and GDM was attenuated after adjustment (aOR: 1.12; 95%CI: 0.47, 2.66). There was an elevated risk of GDM associated with inadequate GWG, (aOR: 2.42; 95%CI: 0.97, 6.00), but results were imprecise. There were no statistically significant associations in the joint exposure analysis. Conclusion The relationship between HFI and GDM is mostly explained by other covariates, but there is some evidence that inadequate GWG is a possible risk factor for GDM.

Rationale, design, and challenges with implementing a clinical intervention to teach appropriate gestational weight gain (TAGG): Protocol of a Randomized controlled trial (Preprint)

2019 ◽  
Author(s):  
Awathif Mackeen ◽  
Danielle Downs ◽  
Vonda Hetherington ◽  
Shawnee Lutcher ◽  
Jacob Mowery ◽  
...  
Keyword(s):  
Randomized Controlled Trial ◽  
Weight Gain ◽  
Gestational Diabetes ◽  
Usual Care ◽  
Gestational Weight Gain ◽  
Perceived Stress ◽  
Controlled Trial ◽  
Household Food Security ◽  
Gestational Weight ◽  
Randomized Controlled

BACKGROUND Excessive gestational weight gain (GWG) has public health implications including preterm birth, preeclampsia, gestational diabetes, and cesarean delivery. In an effort to mitigate adverse consequences of excessive GWG, this study tests a health intervention that includes enhancements to improve knowledge and awareness of appropriate GWG, and patient-centered nutritional counseling to promote appropriate GWG. OBJECTIVE The primary objective of the study was to increase the proportion of women who are managing their GWG as recommended by the IOM.4,5 METHODS This randomized controlled trial was conducted at Geisinger in Pennsylvania where excessive GWG is common among women with pre-conception obesity. Eligible, consenting participants with pre-pregnancy body mass index >30.0 kg/m2 were randomized (1:1) to: 1) Usual Care: usual written educational materials and counseling by an obstetric care provider or 2) Enhanced Care: Usual Care plus a) a personalized letter from a physician detailing appropriate GWG, b) exposure to individualized GWG chart in the electronic health record via the patient portal, and c) a consult with a Registered Dietitian Nutritionist and follow-up via tele-health counseling (10-20 mins/1-2 weeks) for the duration of the pregnancy. RESULTS The primary outcome was the proportion of women that gain less than 20 pounds over the course of the pregnancy. Secondary outcomes include knowledge, expectations, and attitude about pregnancy weight gain; increased self-efficacy for ability to eat healthy and being physically active to manage weight; and eating behavior. Potential moderators that will be explored include sleep, perceived stress, perceived involvement in care, and household food security. Data collection has been completed as of November 2019. CONCLUSIONS As GWG care was initiated for mothers with pre-pregnancy BMI >30 kg/m2 within the first and second trimesters, the intervention may have the additional benefit of reducing other adverse pregnancy outcomes including the incidence of gestational diabetes due to healthier rates of GWG. In addition to assessing appropriate GWG, this project will assess eating habits, physical activity, GWG attitudes, sleep quality, and psychological measures, all of which are associated with GWG. Exploratory mediators including perceived stress and food insecurity will also be evaluated. CLINICALTRIAL ClinicalTrials.gov NCT02963428

scholarly journals Higher Parity, Pre-Pregnancy BMI and Rate of Gestational Weight Gain Are Associated with Gestational Diabetes Mellitus in Food Insecure Women

2021 ◽  
Vol 18 (5) ◽  
pp. 2694
Author(s):  
Heng Yaw Yong ◽  
Zalilah Mohd Shariff ◽  
Barakatun Nisak Mohd Yusof ◽  
Zulida Rejali ◽  
Yvonne Yee Siang Tee ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Weight Gain ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Food Insecurity ◽  
Pregnant Women ◽  
Household Food Insecurity ◽  
Second Trimester ◽  
Gestational Weight ◽  
Household Food

Food insecurity may exacerbate adverse maternal health outcomes during pregnancy, however, this association has not been well established, particularly in the context of developing countries. This study aimed to identify the associations between household food insecurity and gestational diabetes mellitus (GDM) risk among urban pregnant women. Household food insecurity was assessed using the translated 10-item Radimer/Cornell hunger scale. Logistic regression models were used to estimate the associations between food insecurity status and GDM risk. About 35.6% of women experienced food insecurity, with 25.2% reported household food insecurity, 8.0% individual food insecurity, and 2.4% child hunger. Food insecure women were at significantly higher risk of developing GDM compared to food secure women (AOR = 16.65, 95% CI = 6.17–24.98). The significant association between food insecurity and GDM risk was influenced by pre-pregnancy BMI, parity and rate of GWG at second trimester. Food insecure women with parity ≥ 2 (AOR = 4.21, 95% CI = 1.98–8.92), overweight/obese BMI prior to pregnancy (AOR = 12.11, 95% CI = 6.09–24.10) and excessive rate of GWG in the second trimester (AOR = 9.66, 95% CI = 4.27–21.83) were significantly more likely to develop GDM compared to food secure women. Food insecurity showed strong association with GDM risk in that the association was influenced by maternal biological and physical characteristics. Multipronged interventions may be necessary for food insecure pregnant women who are not only at risk of overweight/obesity prior to pregnancy but also may have excessive gestational weight gain, in order to effectively reduce GDM risk.

scholarly journals Inadequacy of gestational weight gain during high-risk pregnancies is not associated with household food insecurity

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Aléxia Vieira de Abreu Rodrigues ◽  
Ana Lúcia Pires Augusto ◽  
Rosana Salles-Costa
Keyword(s):  
Weight Gain ◽  
High Risk ◽  
Food Insecurity ◽  
Pregnant Women ◽  
Gestational Weight Gain ◽  
Maternal Education ◽  
Household Food Insecurity ◽  
Gestational Weight ◽  
Household Food ◽  
Patient Weight

Abstract Background Inadequate gestational weight gain (GWG) is associated with adverse outcomes in maternal and child health and can be enhanced by social inequalities, such as lower education and household food insecurity (HFI). Women are more vulnerable to HFI, which has been associated with negative health effects for pregnant women during the prenatal and puerperal periods, particularly in regard to the aggravation of pregnancy risks. This study investigated the association between sociodemographic characteristics and HFI with respect to adequacy of total GWG among women with high-risk pregnancies. Methods This was a prospective cohort study that evaluated the total GWG of 169 pregnant women. The women were seen at a public university hospital in the metropolitan region of Rio de Janeiro (Brazil). Their sociodemographic and gestational characteristics and the Brazilian Scale of Domestic Food Insecurity were investigated. To estimate the total GWG, the difference between the patient weight at the last prenatal visit and the initial patient weight was verified, with both collected from the medical records of the pregnant women. The classification of the total GWG considered the recommendations of the Institute of Medicine (IOM) (2009). A multinomial logistic regression model assessed the risk (odds ratio; OR) and confidence intervals (CI 95%)) of insufficient and excessive GWG with exposure to HFI and other covariates (p value <0.05). Results Insufficient and excessive GWG were observed in 27.8% and 47.9% of the pregnant women, respectively. More than half of the women (74.6%) had a high education level. Exposure to mild HFI occurred in 44.2% of the women. After adjustment, the HFI was not associated with insufficient or excessive GWG. The educational level of women was the only variable significantly associated with a lower risk of GWG insufficiency (OR: 0.10; 95% CI: 0.01–0.89). Conclusions In this population, higher maternal education was a protective factor against insufficient GWG. We highlight the importance of additional health support and counseling for women in the most vulnerable social conditions, considering the importance of access to information for reducing health risks.

1100 Impact of gestational weight gain in women with chronic hypertension and pre-gestational diabetes

2021 ◽  
Vol 224 (2) ◽  
pp. S678
Author(s):  
Grace J. Johnson ◽  
Haleh Sangi-Haghpeykar ◽  
Kjersti M. Aagaard ◽  
Alison N. Goulding ◽  
Matthew A. Shanahan ◽  
...  
Keyword(s):  
Weight Gain ◽  
Gestational Diabetes ◽  
Gestational Weight Gain ◽  
Chronic Hypertension ◽  
Gestational Weight

scholarly journals Association between Gestational Weight Gain, Gestational Diabetes Risk, and Obstetric Outcomes: A Randomized Controlled Trial Post Hoc Analysis

Nutrients ◽  
2018 ◽  
Vol 10 (11) ◽  
pp. 1568 ◽  
Author(s):  
David Simmons ◽  
Roland Devlieger ◽  
Andre van Assche ◽  
Sander Galjaard ◽  
Rosa Corcoy ◽  
...  
Keyword(s):  
Insulin Resistance ◽  
Weight Gain ◽  
Gestational Diabetes ◽  
Gestational Weight Gain ◽  
First Trimester ◽  
Obstetric Outcomes ◽  
Lifestyle Interventions ◽  
Gestational Weight ◽  
Randomized Controlled ◽  
Post Hoc

Excess gestational weight gain (GWG) is associated with the development of gestational diabetes mellitus (GDM). Lifestyle trials have not achieved much GWG limitation, and have largely failed to prevent GDM. We compared the effect of substantial GWG limitation on maternal GDM risk. Pregnant women with a body mass index (BMI) ≥29 kg/m2 <20 weeks gestation without GDM (n = 436) were randomized, in a multicenter trial, to usual care (UC), healthy eating (HE), physical activity (PA), or HE and PA lifestyle interventions. GWG over the median was associated with higher homeostasis model assessment insulin resistance (HOMA-IR) and insulin secretion (Stumvoll phases 1 and 2), a higher fasting plasma glucose (FPG) at 24–28 weeks (4.66 ± 0.43 vs. 4.61 ± 0.40 mmol/L, p < 0.01), and a higher rate of caesarean section (38% vs. 27% p < 0.05). The GWG over the median at 35–37 weeks was associated with a higher rate of macrosomia (25% vs. 16%, p < 0.05). A post hoc comparison among women from the five sites with a GWG difference >3 kg showed no significance difference in glycaemia or insulin resistance between HE and PA, and UC. We conclude that preventing even substantial increases in GWG after the first trimester has little effect on maternal glycaemia. We recommend randomized controlled trials of effective lifestyle interventions, starting in or before the first trimester.

445: The relationship between gestational weight gain and gestational diabetes mellitus

2015 ◽  
Vol 212 (1) ◽  
pp. S229
Author(s):  
Amy O'Higgins ◽  
Lisa O'Higgins ◽  
Anne Fennessy ◽  
Thomas McCartan ◽  
Laura Mullaney ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Weight Gain ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Gestational Weight Gain ◽  
Gestational Weight ◽  
The Relationship
Sign in / Sign up

Export Citation Format

Share Document