A B C D E F G H I J K L M N O P Q R S T U V W X Y Z All
Sajid, Asma
- Incidence and Risk Factors of Excess Gestational Weight Gain in Indian Women
Authors
1 Department of Clinical Nutrition and Dietetics, Fernandez Hospital Foundation, Hyderabad, Telangana - 500 001, IN
2 Department of Statistics, Fernandez Hospital Foundation, Hyderabad, Telangana - 500 001, IN
Source
The Indian Journal of Nutrition and Dietetics, Vol 56, No 3 (2019), Pagination: 280-288Abstract
Excess Gestational Weight Gain (EGWG) increases risks of adverse obstetric outcomes, long-term obesity and metabolic disorders in mothers and children. The objective was to identify the incidence and risk factors of EGWG in the Indian context in order to develop effective preventative measures. A prospective cohort study was done to evaluate Gestational Weight Gain (GWG) in pregnant women who have completed a validated knowledge survey on GWG in 4 urban maternity tertiary centres and subsequently delivered at the same centres. Chi square test and Fisher’s exact test were used to identify risk factors associated with EGWG. 245 women completed the study. Gestational weight gain was classified as per the Institute of Medicine BMI-specific recommendations. Of the total women surveyed, 37.5% exceeded the GWG recommendation. The overweight and obese women constituted 50.2% of the entire population. In the overweight-obese category, 52% of women exceeded GWG recommendations. Risk factors for EGWG were high pre-pregnancy BMI (P<0.001), underestimation of pre-pregnancy weight category (P=0.003) and overestimation of GWG recommendations (P<0.001). In overweight-obese women, primiparity also increased risk of EGWG (P=0.04). Maternal age, education and perception of EGWG associated risks did not influence GWG. Ensuring women begin their pregnancies at a normal weight and provision of individualised GWG related counselling, either pre-conception or in the early stages of pregnancy may help foster appropriate weight gain in pregnancy. A modification in the current model of care involving detailed screening and nutritional counselling at the first visit itself could ensure effectiveness.
Keywords
Excess Gestational Weight Gain, Incidence, Risk Factors, Pregnancy, Obesity.
References
- World Health Organization (WHO). Obesity and overweight. (2018). Retrieved from http://www.who.int/en/news-room/fact-sheets/detail/obesity-and-overweight (accessed on 8th September, 2018)
- Meshram, I., Balakrishna, N., Sreeramakrishna, K., Rao, K., Kumar, R., Arlappa, N., et al. Trends in nutritional status and nutrient intakes and correlates of overweight/obesity among rural adult women (>18–60 years) in India: National Nutrition Monitoring Bureau (NNMB) national surveys. Public Health Nutr., 2015, 19, 767-776. doi: 10.1017/s1368980015002268
- Goldstein, R., Abell, S., Ranasinha, S., Misso, M., Boyle, J., Black, M., et al. Association of gestational weight gain with maternal and infant outcomes. JAMA, 2017, 317, 2207. doi: 10.1001/jama.2017.3635
- American College of Obstetricians and Gynecologists. ACOG Committee opinion no. 548: weight gain during pregnancy. Obstet. Gynecol., 2013, 121, 210. doi: 10.1097/01.aog.0000425668.87506.4c
- Samura, T., Steer, J., Michelis, L., Carroll, L., Holland, E. and Perkins, R. Factors associated with excessive gestational weight gain: Review of current literature. Glob. Adv. Health. Med., 2016, 5, 87-93. doi: 10.7453/gahmj.2015.094
- Kapadia, M., Gaston, A., Van Blyderveen, S., Schmidt, L., Beyene, J., McDonald, H. and McDonald, S. Psychological antecedents of excess gestational weight gain: A systematic review. BMC. Preg. Childbirth, 2015, 15. doi: 10.1186/s12884-015-0535-y
- Vanstone, M., Kandasamy, S., Giacomini, M., DeJean, D. and McDonald, S. Pregnant women’s perceptions of gestational weight gain: A systematic review and meta-synthesis of qualitative research. Mat. Child Nutr., 2016, 13, e12374. doi: 10.1111/mcn.12374
- World Health Organisation, Expert Consultation. Appropriate body-mass index for Asian populations and its implications for policy and intervention strategies. The Lancet, 2004, 363, 157-163. doi: 10.1016/s0140-6736(03)15268-3
- Lindberg, S., Anderson, C., Pillai, P., Tandias, A., Arndt, B. and Hanrahan, L. Prevalence and predictors of unhealthy weight gain in pregnancy. WMJ: official publication of the State Medical Society of Wisconsin, 2016, 111, 233-237.
- Popa, A., Popescu, R. and Botnariu, G. Adequate weight gain in pregnancy: An analysis of its determinants in a cross-sectional study. SrpskiArhivZaCelokupnoLekarstvo, 2014, 142, 695-702. doi: 10.2298/sarh1412695p
- Ministry of Health and Family Welfare. National Family Health Survey - 4 Fact Sheet India. (2016). Retrieved from http://rchiips.org/NFHS/pdf/NFHS4/India.pdf (accessed on 8th September, 2018)
- Sui, Z., Turnbull, D. and Dodd, J. Effect of body image on gestational weight gain in overweight and obese women. Women and Birth, 2013, 26, 267-272. doi: 10.1016/j.wombi.2013.07.001
- Herring, S., Oken, E., Haines, J., Rich-Edwards, J., Rifas-Shiman, S., Kleinman ScD, K. and Gillman, M. Misperceived pre-pregnancy body weight status predicts excessive gestational weight gain: findings from a US cohort study. BMC Preg. Childbirth, 2008, 8. doi: 10.1186/1471-2393-8-54
- Shub, A., Huning, E., Campbell, K. and McCarthy, E. Pregnant women’s knowledge of weight, weight gain, complications of obesity and weight management strategies in pregnancy. BMC Research Notes, 2013, 6, 278. doi: 10.1186/1756-0500-6-278
- Gaudet, L., Gruslin, A. and Magee, L. Weight in pregnancy and its implications: what women report. J. Obstet. Gynaecol. Canada, 2011, 33, 227-234. doi:10.1016/s1701-2163(16)34823-x
- Jeffs, E., Haszard, J.J., Sharp, B., Gullam, J. and Paterson, H. Pregnant women lack accurate knowledge of their BMI and recommended gestational weight gain. The New Zealand Med. J. (Online), 2016, 129, 37.
- Stotland, N., Haas, J., Brawarsky, P., Jackson, R., Fuentes-Afflick, E. and Escobar, G. Body mass index, provider advice and target gestational weight gain. Obstet. Gynecol., 2005, 105, 633-638.doi: 10.1097/01.aog.0000152349.84025.35
- Brown, A. and Avery, A. Healthy weight management during pregnancy: what advice and information is being provided. J. Human Nutr. Diet., 2012, 25, 378-387.doi: 10.1111/j.1365-277x.2012.01231.x
- Arinze, N., Karp, S. and Gesell, S. Evaluating provider advice and women’s beliefs on total weight gain during pregnancy. J. Immig. Minority Health, 2015, 18, 282-286. doi: 10.1007/s10903-015-0162-8
- Knowledge of Diet and Lifestyle Measures for Hypertensive Disorders of Pregnancy
Authors
1 Department of Clinical Nutrition and Dietetics, Fernandez Hospital Foundation, Hyderabad, Telangana - 500 001, IN
Source
The Indian Journal of Nutrition and Dietetics, Vol 57, No 1 (2020), Pagination: 52-62Abstract
Hypertensive Disorders of Pregnancy (HDP) pose significant risks to materno-fetal health. Appropriate knowledge of the condition ensures timely intervention. Dietary and lifestyle recommendations in HDP differ from those in the non-pregnant population. Salt restriction is not recommended and physical activity may be contraindicated. The aim of the study is to identify the knowledge of pregnant hypertensive Indian women about normal blood pressure in pregnancy, warning signs and complications of HDP and control measures. A cross sectional study was conducted in maternity centres using purposive convenience sampling and a structured questionnaire. Data was analysed using descriptive statistics. One hundred women completed the study. Sixty three per cent knew what constituted high blood pressure, 56% and 60% had a knowledge score of ≤ 50% for warning signs and complications of high blood pressure respectively. When questioned about control measures, women believed that dietary modifications (88%), physical activity (84%), bed rest (51%) and weight loss (44%) were important. With respect to knowledge of salt intake recommendations, 39% correctly identified the daily recommendation, 93% believed salt reduction is necessary and 21% believed salt elimination is required. Thirty nine per cent of women stated high calcium foods are beneficial for control. Post diagnosis, 80% and 38% reported salt reduction and use of low sodium salt, respectively. Traditional home remedies cited included bananas, spinach, curry leaf, garlic, barley water, flax seeds and beetischolar_main. In adequate awareness of HDP may delay necessary medical interventions. Misconceptions regarding salt restriction need to be addressed to prevent iodine deficiency disorders. Counseling regarding a healthy diet for HDP and risks associated with excess physical activity and strict bed rest need to be communicated more effectively.
Keywords
Hypertension, Pregnancy, Salt Restriction, Physical Activity, Knowledge.References
- ACOG. Hypertension in pregnancy: report of the American College of Obstetricians and Gynecologists' Task Force on Hypertension in Pregnancy. Obstet. Gynecol., 2013, 122, 1122-1131.
- World Health Organization. WHO recommendations for prevention and treatment of preeclampsia and eclampsia. 2011.
- World Health Organization. Iodization of salt for the prevention and control of iodine deficiency disorders. [online] Available at: https://www.who.int/elena/titles/salt_iodization/en/ [Accessed 14 May 2019]. 2019.
- American College of Obstetricians and Gynecologists. ACOG Committee Opinion No. 650: Physical activity and exercise during pregnancy and the postpartum period. Obstet. Gynecol., 2015, 126, 135-142.
- World Health Organization. Guideline: Sodium intake for adults and children. World Health Organization. 2012.
- Wilkinson, J. and Cole, G. Preeclampsia knowledge among women in Utah. Hypertension in pregnan., 2018, 37, 18-24.
- Gingras-Charland, M. E., Côté, A. M., Girard, P., Grenier, A., Pasquier, J. C. and Sauvé, N. Preeclampsia educational tool impact on knowledge, anxiety and satisfaction in pregnant women: Arandomized trial. J. Obstet. Gynaecol. Canada., 2019, 41, 960-970.
- Ouasmani, F., Engeltjes, B., Rahou, B. H., Belayachi, O. and Verhoeven, C. Knowledge of hypertensive disorders in pregnancy of Moroccan women in Morocco and in the Netherlands: a qualitative interview study. BMC pregnancy and childbirth., 2018, 18, 344.
- Tsigas, E. and Magee, L. A. Advocacy organisations as partners in pre-eclampsia progress: patient involvement improves outcomes. Best Pract. Res. Clini. Obstet. Gynaecol., 2011, 25, 523-536.
- Brown, M.C., Bell, R., Collins, C., Waring, G., Robson, S.C., Waugh, J. and Finch, T. Women's perception of future risk following pregnancies complicated by preeclampsia. Hypertension in pregnancy, 2013, 32, 60-73.
- Traylor, J., Chandrasekaran, S., Limaye, M., Srinivas, S. and Durnwald, C.P. Risk perception of future cardiovascular disease in women diagnosed with a hypertensive disorder of pregnancy. The J. Maternal-Fetal. Neonatal Med., 2016, 29, 2067-2072.
- Ravera, A., Carubelli, V., Sciatti, E., Bonadei, I., Gorga, E., Cani, D. et al. Nutrition and cardiovascular disease: finding the perfect recipe for cardiovascular health. Nutr., 2016, 8, 363. doi: 10.3390/nu8060363
- Castro, I., Waclawovsky, G. and Marcadenti, A. Nutrition and physical activity on hypertension: implication of current evidence and guidelines. Current Hypertension Rev., 2015, 11, 91-99.
- World Health Organization. WHO recommendations for prevention and treatment of preeclampsia and eclampsia. 2011.
- Vidler, M., Charantimath, U., Katageri, G., Ramadurg, U., Karadiguddi, C., Sawchuck, D. et al. Community perceptions of pre-eclampsia in rural Karnataka State, India: a qualitative study. Reproductive Health, 2016, 13. doi: 10.1186/s12978-016-0137-9
- de Azevedo, D.V., de Araújo, A.C. and Costa, Í.C.C. An analysis of the meanings of preeclampsia for pregnant and postpartum women and health professionals in Rio Grande do Norte, Brazil. Midwifery, 2011, 27, e182-e187.
- Akeju, D., Vidler, M., Oladapo, O., Sawchuck, D., Qureshi, R., von Dadelszen, P. et al. Community perceptions of pre-eclampsia and eclampsia in Ogun State, Nigeria: a qualitative study. Reproductive Health, 2016, 8, 13. doi: 10.1186/s12978-016-0134-z
- Rah, J.H., Anas, A.M., Chakrabarty, A., Sankar, R., Pandav, C.S. and Aguayo, V.M. Towards universal salt iodisation in India: achievements, challenges and future actions. Maternal. Child Nutr., 2015, 11, 483-496.
- Zimmermann, M.B. The importance of adequate iodine during pregnancy and infancy. In Hidden Hunger, World Rev. Nutr. Diet., 2016, 115, 118-124.
- Sakuyama, H., Katoh, M., Wakabayashi, H., Zulli, A., Kruzliak, P. and Uehara, Y. Influence of gestational salt restriction in fetal growth and in development of diseases in adulthood. J. Biomed. Sci., 2016, 23, 12.
- Ried, K. Garlic lowers blood pressure in hypertensive individuals, regulates serum cholesterol, and stimulates immunity: an updated meta-analysis and review. The J. Nutr., 2016, 146, 389S396S.
- Ashworth, A. and Bescos, R. Dietary nitrate and blood pressure: evolution of a new nutrient? Nutr. Res. Rev., 2017, 30, 208-219.