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BACKGROUND: The association between obesity (body mass index (BMI) ≥ 30 kg/m(2)) and pattern of medication use during pregnancy in the United States is not well-studied. Higher prepregnancy BMI may be associated with increases or decreases in medication use across pregnancy as symptoms (e.g. reflux) or comorbidities (e.g. gestational diabetes) requiring treatment that may be associated with higher BMI could also change with advancing gestation. OBJECTIVES: To determine whether prenatal medication use, by the number and types of medications, varies by pre-pregnancy obesity status. METHODS: In a secondary data analysis of a racially/ethnically diverse prospective cohort of pregnant women with low risk for fetal abnormalities enrolled in the first trimester of pregnancy and followed to delivery (singleton, 12 United States clinical sites), free text medication data were obtained at enrollment and up to five follow-up visits and abstracted from medical records at delivery. RESULTS: In 436 women with obesity and 1750 women without obesity (pre-pregnancy BMI, 19–29.9 kg/m(2)), more than 70% of pregnant women (77% of women with and 73% of women without obesity) reported taking at least one medication during pregnancy, respectively (adjusted risk ratio (aRR)=1.10, 95% confidence interval (CI)=1.01, 1.20), with 81% reporting two and 69% reporting three or more. A total of 17 classes of medications were identified. Among medication classes consumed by at least 5% of all women, the only class that differed between women with and without obesity was hormones and synthetic substitutes (including steroids, progesterone, diabetes, and thyroid medications) in which women with obesity took more medications (11 vs. 5%, aRR = 1.9, 95% CI = 1.38, 2.61) compared to women without obesity. Within this class, a higher percentage of women with obesity took diabetes medications (2.3 vs. 0.7%) and progesterone (3.4 vs. 1.3%) than their non-obese counterparts. Similar percentages of women with and without obesity reported consuming medications in the remaining medication classes including central nervous system agents (50 and 46%), gastrointestinal drugs (43 and 40%), anti-infective agents (23 and 21%), antihistamines (20 and 17%), autonomic drugs (10 and 9%), and respiratory tract agents (7 and 6%), respectively (p > 0.05 for all adjusted comparisons). There were no differences in medication use by obesity status across gestation. Since the study exclusion criteria limited the non-obese group to women without thyroid disease, in a sensitivity analysis we excluded all women who reported thyroid medication intake and still a higher proportion of women with obesity took the hormones and synthetic substitutes class compared to women without obesity. CONCLUSION: Our findings suggest that pre-pregnancy obesity in otherwise healthy women is associated with a higher use of only selected medications (such as diabetes medications and progesterone) during pregnancy, while the intake of other more common medication types such as analgesics, antibiotics, and antacids does not vary by pre-pregnancy obesity status. As medication safety information for prenatal consumption is insufficient for many medications, these findings highlight the need for a more in-depth examination of factors associated with prenatal medication use.

Objective To identify the prevalence of pre-pregnancy overweight/obesity in pregnant women and its relationship with socio-demographic factors and to describe the maternal and perinatal outcomes in a Barcelona hospital (Spain). Method A descriptive cross-association study, with retrospective data collection, was performed Barcelona Hospital. The data of 5447 pregnant women who delivered at >=23 weeks of gestation were included. Body Mass Index (BMI) data were categorised into World Health Organization classifications. p values Results The prevalence of pre-pregnancy obesity was 8.4% and 18.9% for overweight. Gestational diabetes was more frequent in pre-pregnancy overweight/obesity (OR 1.92: 95% CI 1.54–2.40 and OR 3.34: 95% CI 2.57–4.33), as were preeclampsia (OR 2.08: 95% CI 1.55–2.79 and OR 3.35: 95% CI 2.38–4.71), induction of labour (OR 1.19: 95% CI 1.02–1.38 and OR 1.94: 95% CI 1.57–2.10), caesarean section (OR 1.41: 95% CI 1.21–1.65 and OR 2.68: 95% CI 2.18–3.29), prematurity (OR 1.28: 95% CI 1–1.65 and OR 1.79: 95% CI 1.32–2.44) and macrosomia (OR 1.87: 95% CI 1.43–2.46 and OR 2.03: 95% CI 1.40–2.93). Conclusions One in four pregnant women had pre-pregnancy overweight or obesity. This study shows the relationship between pre-pregnancy overweight or obesity with adverse maternal and perinatal outcomes.

Introduction Excessive body mass index may have adverse effects on the health of women in their perinatal period. Regular physical activity contributes to body mass control. Aim To determine the association of pre-pregnancy and pregnancy BMIs with labor duration in primi- and multiparas. Also, to determine the proportions of pre-pregnancy BMI > 25 in women after cesarean sections and vaginal deliveries. Material and methods Data of 54 women on a postpartum day 3 to 5 (29 primiparas: 17 after vaginal and 12 after cesarean deliveries; 25 multiparas: 15 after vaginal and 10 after cesarean deliveries). Demographic data collected from the patient’s history included body height, pre-pregnancy and pre-labor body mass, mode of delivery, duration of labor and its second stage, number of deliveries. Pre-pregnancy and pre-labor BMIs were calculated. Results In primiparas, there was a moderate positive correlation between pre-pregnancy and pre-labor BMIs and the labor duration (r = 0.56, p = 0.02; r = 0.65, p = 0.005, respectively). Multiparas did not exhibit a significant correlation between the BMIs and the labor duration (p > 0.05). Neither of the subgroups showed a significant correlation between pre-pregnancy and prelabor BMIs and the duration of the second stage of labor (p > 0.05). Among women after vaginal deliveries, 15.6% had pre-pregnancy BMI > 25; the respective proportion was 22.7% in women after cesarean sections. Conclusions Primiparas with greater pre-pregnancy and pre-labor BMIs were more likely to have a longer labor. The proportion of pre-pregnancy BMI > 25 was higher for cesarean compared to vaginal deliveries. Physical activity should be promoted in women planning pregnancy to help control BMI. Keywords: mirror foot, resection of foot radius, deformation classification

Estimates of prenatal alcohol use among American Indian and Alaska Native (AI/AN) women are limited. This study sought to characterize pre-pregnancy and prenatal alcohol use among AI/AN women in the Pregnancy Risk Assessment Monitoring System (PRAMS) dataset, evaluate variation in alcohol use by state and rural/urban residence, and evaluate associations between potential risk factors and prenatal alcohol use among AI/AN and non-Hispanic white (NHW) women. We pooled PRAMS data from five states (Alaska, New Mexico, Oklahoma, South Dakota and Washington) from 2015 to 2017. We estimated the prevalence of pre-pregnancy and pregnancy risk factors, and alcohol use by race and examined alcohol use by state and rural/urban residence among AI/AN women. We conducted bivariate and multivariable logistic regression modelling to estimate the association between each risk factor of interest and the odds of prenatal alcohol use for AI/AN and NHW women. AI/AN women were less likely to report pre-pregnancy alcohol use compared to NHW women (56% vs. 76%, p

Objectives Women with diabetes are at increased risk of adverse pregnancy outcomes compared to women with gestational diabetes (GDM) or no diabetes. Pregnancy outcomes are improved by specialist pre-pregnancy care. We aimed to explore pharmacists’ and women with diabetes’ perceptions of the roles and barriers to pharmacist participation in a diabetes contraception and pre-pregnancy program in South-Western Sydney (SWS). Methods The Diabetes Contraception and Pre-pregnancy Program (DCAPP) aims to reduce adverse pregnancy outcomes among women with diabetes. This includes awareness raising among, and through, pharmacists. Surveys to explore pharmacists’ roles in contraception and pre-pregnancy management (CPPM) were completed by SWS pharmacists and women with diabetes from diabetes clinics aged 18–50 years. Survey themes were then discussed in interviews and focus groups with pharmacists across Australia. Thematic analysis of transcripts was undertaken. Key findings Pharmacists were seen to have a role in diabetes health promotion, information distribution and referral to pre-pregnancy clinics. Pharmacists and women recognised the need for increased knowledge and educational materials about CPPM and effective awareness and coordination of CPPM services. Some pharmacists recognised deficits in their knowledge regarding diabetes in pregnancy, including CPPM and differences to GDM. Barriers to pharmacists’ involvement in CPPM included difficulty identifying applicable women and reluctance to initiate pregnancy planning and contraception conversations, often due to language and cultural barriers. Conclusions Pharmacists and women with diabetes see an important role for pharmacists in CPPM. Co-designed diabetes training for pharmacists and increased communication about DCAPP were seen important for ongoing implementation.

Objective: To determine the various pregnancy outcomes in females with high pre pregnancy BMI. Study Design: Descriptive case series. Setting: Sheikh Zayed Hospital, Rahim Yar Khan. Duration: 30-06-2016 to 31-12-2017. Methodology; In the present study, pregnant females with age of gestation less than 12 weeks presenting with their first ante natal visit falling in the age range of 20-40 years having pre pregnancy BMI > 25 kg/m2 were included. Then these cases were followed for their whole pregnancy to look for various outcomes. Results; In the present study there were 150 subjects enrolled with high pre pregnancy BMI. Mean age of the participants was 28.41±4.67 year and mean BMI was 28.31±3.57 kg/m2. Regarding various outcome the most common one was C section which was seen in 42 (28%) of the cases, followed by PIH seen in 35 (23.34%) of the cases, while pregnancy remained uneventful in only 21 (14%) of the cases. Conclusion: High pre pregnancy BMI leads to various complication, which are seen in almost 8 out of 10 cases and the most common one is C section. Key words: BMI, C section, PIH

BACKGROUND Obesity has become a global epidemic. Maternal overweight and obesity is now a major challenge to the treating obstetricians. We intended to find the effect of pre pregnancy body mass index (BMI) and gestational weight gain during pregnancy on maternal and neonatal outcome. METHODS 300 women with singleton pregnancy and spontaneous conception, who attended antenatal outpatient department (OPD) in our tertiary hospital, were included in this study after informed consent. The rate of gestational weight gain was calculated by subtracting the pre pregnancy weight from the final weight of the mother during last antenatal visit or during delivery. They were followed up and their maternal and perinatal outcomes such as anaemia, gestational hypertension, gestational diabetes, preterm labour, past dates, and intrauterine growth restriction, low birth weight, large for gestation, caesarean delivery and neonatal intensive care admission were studied. RESULTS The mean age of the woman in this study was 24 ± 2 years. Of them, 13 % (n = 39) of women were underweight. 40 % (n = 120) of women were of normal BMI. 33 % (n = 99) of women were overweight. 14 % (n = 52) of women were obese. Maternal complications such as anaemia, preterm labour and intrauterine growth restriction were significantly common in underweight woman and inadequate gestational weight gain woman. Gestational diabetes, gestational hypertension, large for gestation baby and Caesarean deliveries were more in pre pregnancy obese woman and excess gestational weight gain woman. CONCLUSIONS An appropriate maternal pre pregnancy body mass index of 18.5 to 22.9 Kg / m2 at conception followed by an appropriate gestational weight gain (10 to 14 Kg) during pregnancy has a better maternal and neonatal outcome. KEY WORDS Body Mass Index, Gestational Weight Gain, Maternal Outcome, and Neonatal Outcome, Obese

Hypothyroidism is a systemic metabolic deficiency syndrome caused by a deficiency in thyroid hormone or a decrease in the action of thyroid hormones. It has a high incidence among women of child-bearing age, and pregnant women with hypothyroidism may have a higher risk of birth defects.To explore the specific biological mechanism affecting the occurrence of hypothyroidism.This study determined key molecules by comparing and analyzing the difference in methylation levels between pre-pregnancy women and normal controls using the Illumina Infinium MethylationEPIC BeadChip.3493 Differential methylation positions (DMPs) related genes and 47 differentially methylated regions (DMRs) related genes were found between the Hypothyroidism group and the control group. Among them, miR-21 has been found to be closely related to thyroid hormone regulation. The results of enrichment analysis showed that the DMPs or DMRs-related genes are both significantly enriched in human T-cell leukemia virus 1 infection, osteoclast differentiation and sphingolipid signaling pathway, which were also closely related to the occurrence and development of hypothyroidism. In addition, the combined analysis of CNVs and DMRs showed that significant differences occurred near the regions of 16 M bp in chromosome 1 between the two groups, and the genes involved in these regions included NDUFS2, FCER1G and SHC1.This work screened molecular markers and key signaling pathways that are involved in the development of hypothyroidism in pre-pregnancy women, which may provide new targets for the research and diagnosis of hypothyroidism in the future.

I.A.Lapina, T.G.Chirvon, Yu.E. Dobrokhotova, V.V.Taranov Pirogov Russian National Research Medical University, Moscow, Russian Federation In recent decades, extensive growth in the number of overweight or obese individuals is reported thus making this issue important for the medical community. According to some authors, 8% of overweight women and 18% of obese women have troubles with realizing reproductive function. Glucose and lipid metabolism disorders and hypertension that are common in women with polycystic ovary syndrome (PCOS) allow for referring this condition to metabolic diseases. Metabolic syndrome is an umbrella term for a set of metabolic abnormalities arising from insulin resistance and hyperinsulinemia. PCOS may also be considered as one of its manifestations being regarded as the most common cause of infertility in overweight and obese women. The treatment should be complex to recover reproductive function and to address metabolic disorders. Adherence to lifestyle changes, diet, and regular physical activity is still poor. Therefore, the use and assessment of the efficacy of pharmaceutical s for pre-pregnancy preparation to lose weight and to improve reproductive outcomes in PCOS. Keywords: polycystic ovary syndrome, PCOS, obesity, metabolic syndrome, infertility, pre-pregnancy preparation, treatment, prevention, ovulation. For citation: Lapina I.A., Chirvon T.G., Dobrokhotova Yu.E., Taranov V.V. Pre-pregnancy preparation in women with polycystic ovary syndrome and obesity: state-of-the-art. Russian Journal of Woman and Child Health. 2021;4(2):137–143. DOI: 10.32364/2618-8430-2021-4-2-137-143.

Pre-pregnancy care is an important approach for maternal and child health. This study aimed to determine the knowledge about pre-pregnancy care and factors associated with good pre-pregnancy care knowledge among women with high risk pregnancy in Kinta, Perak. A cross-sectional study was conducted among women diagnosed as high-risk pregnancy in governmental health clinics in Kinta. Stratified random sampling was applied and interviewer-guided questionnaires were administered. A proforma and the validated Pre-pregnancy Care Knowledge and Practice Questionnaire were used, consisting of 21 items on knowledge. Good pre-pregnancy care knowledge was defined as those with the total score of more than 12. Logistic regression analysis was conducted using SPSS software. Of the 490 women, their mean age was 29.98 (SD 5.51) years. Less than half (48.6%) had good knowledge of pre-pregnancy care. Education level and attended pre-pregnancy care services were significantly associated with good pre-pregnancy care knowledge. Compared to women with secondary and below education, those with tertiary education had two times odds of having good pre-pregnancy care knowledge (Adjusted odds ratio 2.06; 95% CI: 1.41, 3.03; p

OBJECTIVE: Loss of control over eating (LOC) is common among women, particularly those with overweight and obesity (OV/OB), and predicts weight gain. Given the importance of understanding weight and eating behaviors during pregnancy, we sought to characterize LOC across pregnancy and the postpartum period among women with pre-pregnancy OV/OB. METHODS: Pregnant women (N = 257; 28.44 ± 5.48 years old) with self-reported OV/OB prior to pregnancy were interviewed using a pregnancy-adapted version of the Eating Disorder Examination (EDE-PV). Pre-pregnancy LOC was retrospectively assessed during the first trimester and then prospectively assessed monthly throughout pregnancy and postpartum over the course of seven assessments. RESULTS: Rates of LOC were significantly higher during pregnancy compared to prior to ([Formula: see text] , p < .01) and after ([Formula: see text] , p < .01) pregnancy, with 37% (n = 95) of women reporting ≥1 LOC episode during pregnancy. LOC during pregnancy was associated with higher likelihood of LOC postpartum. Higher age (OR = 1.084, p = .04) and identifying as a minority (OR = 0.344, p = .02) was associated with greater likelihood of experiencing LOC during pregnancy only. DISCUSSION: LOC during pregnancy is common among women with pre-pregnancy OV/OB, suggesting that screening and intervention for LOC during pregnancy may be warranted. Future research is necessary to examine the relationship between LOC during pregnancy and maternal and infant health outcomes.

In the United States, the number of pregnant women who are overweight or obese is increasing. While such individuals are at increased risk of pregnancy complications, data regarding costs associated with pre-pregnancy body mass index (BMI) and maternal and infant outcomes are lacking.To estimate maternal and infant costs associated with pre-pregnancy BMI in a large cohort of pregnant women.We conducted a retrospective cohort study of women with singleton, non-anomalous births in California from 2007 to 2011. Women with preexisting diabetes mellitus and chronic hypertension were excluded. Hospitalization costs were estimated separately for women and infants using hospital charges adjusted using a cost-to-charge ratio. These costs included hospitalization costs for admission for delivery only. We estimated the differences in median costs between seven categories of pre-pregnancy BMIs, including underweight (BMI18.5), normal weight (BMI 18.5-24.9), overweight (BMI 25.0-29.9), class I obesity (BMI 30.0-34.9), class II obesity (BMI 35.0-39.9), class III obesity (BMI 40.0-49.9) and obesity with BMI ≥50.0. We also performed stratified analyses by mode of delivery and gestational age at delivery. We examined the length of stay for women and infants and estimated the gestational age at delivery. Analyses were conducted utilizing Kruskal-Wallis equality-of-populations rank tests with a significance cutoff of 0.05.In a California cohort of 1,722,840 women, 787,790 (45.7%) had a pre-pregnancy BMI that was considered overweight or obese. The median maternal and infant costs of each pre-pregnancy BMI strata were significantly different when compared to other strata, with underweight and normal weight women having the lowest median costs ($11,581 and $11,721, respectively) and the most obese category (BMI ≥50) having the highest costs ($15,808). When stratified by mode of delivery and gestational age at delivery, this remained true. Hospitalization costs for women and infants with severe maternal morbidity were also significantly different based on maternal BMI.The hospitalization costs associated with each strata of BMI were significantly different when compared to each other and when stratified by mode of delivery and prematurity. This analysis allows for a greater understanding of the health care costs associated with different maternal pre-pregnancy BMI classes.

Rates of maternal mortality are increasing in the United States with significant rural-urban disparities. Pre-pregnancy hypertension is a well-established risk factor for adverse maternal and offspring outcomes.The purpose of this study was to describe trends in maternal pre-pregnancy hypertension among women in rural and urban areas in 2007 to 2018 in order to inform community-engaged prevention and policy strategies.We performed a nationwide, serial cross-sectional study using maternal data from all live births in women age 15 to 44 years between 2007 and 2018 (CDC Natality Database). Rates of pre-pregnancy hypertension were calculated per 1,000 live births overall and by urbanization status. Subgroup analysis in standard 5-year age categories was performed. We quantified average annual percentage change using Joinpoint Regression and rate ratios (95% confidence intervals [CIs]) to compare yearly rates between rural and urban areas.Among 47,949,381 live births to women between 2007 and 2018, rates of pre-pregnancy hypertension per 1,000 live births increased among both rural (13.7 to 23.7) and urban women (10.5 to 20.0). Two significant inflection points were identified in 2010 and 2016, with highest annual percentage changes between 2016 and 2018 in rural and urban areas. Although absolute rates were lower in younger compared with older women in both rural and urban areas, all age groups experienced similar increases. The rate ratios of pre-pregnancy hypertension in rural compared with urban women ranged from 1.18 (95% CI: 1.04 to 1.35) for ages 15 to 19 years to 1.51 (95% CI: 1.39 to 1.64) for ages 40 to 44 years in 2018.Maternal burden of pre-pregnancy hypertension has nearly doubled in the past decade and the rural-urban gap has persisted.

Background and Objectives: The results of cohort studies could be used in evidence-based medicine in case they have a good quality and robust methodology. Therefore, this study was conducted to assess the quality of cohort studies investigating preconception risk factors of gestational diabetes. Methods: In this cross-sectional study, the cohort studies investigating the preconception risk factors of gestational diabetes during 2008-2018 indexed in PubMed, Scopus and Science Direct were searched. Keywords used for search included cohort study, pre pregnancy, preconception, risk factor and gestational diabetes. Out of 312 retrieved articles, 26 were critically appraised using the STROBE checklist. The maximum and minimum score that each article could obtain was 34 and 0, respectively. Data were analyzed using SPSS version 16. Results: Of 26 articles that were reviewed, the overall agreement rate with STROBE was 78.8%. Of these, 18 articles (69/23%) were rated as moderate and eight articles (30.76%) were graded as good quality. The method and result sections were the weakest parts of the published articles. Conclusion: The quality of the reported cohort studies investigating preconception risk factors of gestational diabetes is not optimal. It is recommended that chief editors, reviewers, and authors as well as obstetricians and midwives use the STROBE criteria to appraise articles critically, before using their findings in clinical practice.

To examine relationships among pre-pregnancy body dissatisfaction (BD) and gestational weight gain (GWG), and related attitudes/behaviors. Pre-pregnancy BD was self-reported in early pregnancy. Weight-related attitudes/behaviors were self-reported and physical activity was objectively measured during pregnancy. Overall, 92% of the women reported BD, with 69% desiring a smaller pre-pregnancy size than their actual pre-pregnancy size. Ideal pre-pregnancy weight was 20.7

South Africa faces dual epidemics of HIV and obesity; however, little research has explored whether HIV status influences associations between pre-pregnancy body mass index (BMI) and adverse birth outcomes.To examine associations between pre-pregnancy body mass index (BMI) and adverse birth outcomes, and if they differ by HIV status.We followed HIV-uninfected and -infected pregnant women initiating antiretroviral therapy (ART) from first antenatal visit through delivery. HIV-infected women initiated ART (tenofovir-emtricitabine/lamivudine-efavirenz) in pregnancy. Estimated pre-pregnancy BMI (kg/mAmong 1116 women (53% HIV-infected), 44% of HIV-uninfected women and 36% of HIV-infected women were classified as obese; 4% of women were underweight. Overall, 12% of infants were delivered preterm (37 weeks), 10% small for gestational age (SGA,10th percentile), and 9% large for gestational age (LGA,90th percentile). Compared to HIV-uninfected women, HIV-infected women on ART had less LGA (5% vs 13%) but more SGA (12% vs 8%), and a similar proportion of preterm (13% vs 11%) infants. Pre-pregnancy BMI was not associated with preterm birth. Among HIV-uninfected women, obesity modestly increased the risk of LGA (RR 1.34, 95% confidence interval [CI] 0.82, 2.19), and underweight modestly elevated the risk of SGA (RR 1.66, 95% CI 0.79, 3.46). These associations were attenuated among HIV-infected women (RR 1.07, 95% CI 0.44, 2.64 for LGA, and RR 1.34, 95% CI 0.49, 3.64 for SGA).In this urban African setting of high HIV prevalence, pre-pregnancy obesity was common and did not vary by HIV status. In HIV-uninfected women, obesity increased the risk of LGA and being underweight the risk of SGA, compared with among HIV-uninfected women.

Short interbirth interval (IBI) has serious adverse health consequences, yet has an estimated prevalence of 35% in the United States. Similarly, intimate partner violence (IPV) around time of pregnancy, experienced by approximately 5% of women, is associated with increased risk of poor pregnancy outcomes. IPV might compromise women’s decision-making, contributing to unintended pregnancy and short IBI. This study examines the relationship between pre-pregnancy IPV and short IBI, and whether insurance status moderates this relationship among multiparous women who responded to the 2009–2011 Pregnancy Risk Assessment Monitoring System survey ( N = 13,675). Pre-pregnancy IPV (yes; no), insurance status (Private insurance; Medicaid/public insurance; no insurance), and short IBI (yes; no) were examined. Insurance status was identified as an effect modifier ( p = .03), and maternal age, maternal and paternal education, marital status, and drinking alcohol were identified as potential confounders. Multiple logistic regression analysis stratified by insurance status provided adjusted odds ratios (aOR) with corresponding 95% confidence intervals (CI). Overall, 4.6% of women reported IPV before pregnancy, and 48% had a short IBI. When stratified by insurance status, the odds of short IBI was about 3 times higher among women with no insurance and women on Medicaid/public insurance who reported IPV compared to women who did not report IPV (aOR = 3.36, 95% CI = [1.02, 8.02], and aOR = 2.50, 95% CI = [1.04, 5.92], respectively). There was no observed significant difference in the likelihood of short IBI by experience of IPV among privately insured women. Findings from this study strengthen the evidence that women who experience IPV before pregnancy are significantly more likely to have short IBI compared to women who do not experience pre-pregnancy IPV. Furthermore, the odds of short IBI is highest among women experiencing pre-pregnancy IPV who are uninsured or on Medicaid/public insurance.

D.M.Ibragimova, Yu.E.Dobrokhotova Pirogov Russian National Research Medical University, Moscow, Russian Federation Pre-pregnancy planning is a complex of preventive measures to minimize the risks associated with the realization of reproductive function. Today, women are characterized by high level of anxiety and depressive disorders which result in the dysfunction of hypothalamus and pituitary gland manifested with physiologically elevated levels of prolactin. Available data demonstrate that even physiologically elevated levels of prolactin (in particular, in prolonged physical and emotional stresses) can lead to infertility. Prolactin is commonly regarded as the “stress hormone” since its production increases in regular chronic stresses. In many women, excessive prolactin secretion occurs in stresses. This paper addresses this issue as well as clinical experience with vitamin mineral complex containing Vitex agnus-castus extract used for pre-pregnancy planning in women with functional hyperprolactinemia as a result of chronic stress. Reducing micronutrient deficien cy (as a part of pre-pregnancy planning) significantly improves somatic health, cognitive functions, and life expectancy of the future child (level of evidence A). Vitex agnus-castus extract normalizes prolactin levels and menstrual cycle thus helping women get pregnant more often and improving the functions of female reproductive system. Keywords: pre-pregnancy planning, vitamin mineral complex containing Vitex agnus-castus extract, pregnancy, infertility, hyperprolactinemia, stress. For citation: Ibragimova D.M., Dobrokhotova Yu.E. Current views on the pre-pregnancy planning. Russian Journal of Woman and Child Health. 2020;3(1):51–54. DOI: 10.32364/2618-8430-2020-3-1-51-54.

Objective Most pregnant women gain weight above recommended levels, and this weight gain affects mothers’ and children's health. Factors influencing gestational weight gain (GWG) are numerous and include eating behaviours. The objective of this study was to evaluate the association between eating behaviours and GWG while considering pre-pregnancy body mass index (BMI). Methods Fifty-three (n = 53) women were recruited at 9.4 ± 0.6 gestational weeks. At each trimester, they completed the Three-Factor Eating Questionnaire, which evaluates disinhibition, dietary restraint, and susceptibility to hunger. Using a weight gain curve, trimester-specific GWG was calculated with interpolated weights. Total GWG was calculated as the difference between maternal weight before delivery and self-reported pre-pregnancy weight (Canadian Task Force Classification II-2). Results Women were aged 31.5 ± 3.5, and 81.1% had a university degree. The proportion of women who gained weight within recommendations was 21%, 28%, and 26%, at each trimester, respectively, and 38% for total pregnancy. Overall, dietary restraint score was lower in the third trimester in comparison with the first (6.1 ± 4.1 vs. 7.2 ± 4.6; P = 0.049), whereas no difference was observed for disinhibition or susceptibility to hunger. Our data suggest that variations in eating behaviours throughout pregnancy were similar among women who exhibited total GWG below, within, or above recommendations (Ptrim × GWG = NS) (NS: not significant; trim: trimester). Similar observations were reported when women were compared according to their pre-pregnancy BMI (Ptrim × BMI = NS). Conclusion Maintaining high levels of restraint may be challenging considering the increase in hunger, which could explain the decrease observed in dietary restraint scores. Changes in eating behaviours were not associated with total GWG or pre-pregnancy BMI.

This study questioned whether raised pre-pregnancy two-hour (2 h) insulin levels, measured in recurrent embryonic miscarriage (RM) patients via a 75 g Oral Glucose Tolerance Test (OGTT), are associated with an increased risk of gestational diabetes mellitus (GDM) in a subsequent pregnancy. Patients had a 75 g OGTT and insulin levels evaluated (

Background. Maternal weight during pregnancy may affect both, the course of pregnancy and the anthropometric parameters of the newborn. The steadily growing problem of excessive weight in reproductive-age women is associated with the risk for gestational obesity and its negative consequences for the infant. Objectives. The aims of the study were to analyze the following: (i) maternal weight gain as compared to the pre-pregnancy BMI, and (ii) the link between maternal weight and other environmental factors versus neonatal size. Material and methods. The study was conducted among 94 women in singleton term pregnancy, who delivered at the Department of Obstetrics, Gynecology and Oncology, Medical University of Warsaw. The American Institute of Medicine criteria for the recommended weight gain were followed. Multivariate logistic regression model and multiple regression analysis were used for statistical analysis. Results. Normal weight gain was observed in only one-third of the subjects, while excess weight gain was detected in as many as 42.5% of the women. Active smokers were at a 4-fold higher risk for excess weight gain as compared to nonsmokers (OR 4.13, 95% CI 1.19 - 14.34, p = 0.026). Infants born to mothers with insufficient weight gain (24.5% of the mothers) were lighter by 302 g (p=0.0405) and shorter by 2.4 cm (p=0.0025) as compared to those born to mothers with normal weight gain. Conclusions. Maternal weight gain in most of our subjects was not compliant with the current recommendations, regardless of the pre-pregnancy BMI. Inadequate pregnancy weight gain negatively affects the anthropometric parameters of the newborn.

Objective:To explore the effect of maternal BMI class pre-pregnancy (overweight/obese v. healthy weight/underweight) on childhood diet quality and on childhood overweight/obesity risk.Design:Dietary data were collected using 3-d parental-completed food records for their children at ages 18 and 43 months. An index of diet quality was derived by classification of food items into core and non-core foods. Adjusted multiple linear regression analyses were used to explore the effect of maternal BMI class on diet quality in their children.Setting:Avon, UK.Participants:A 10% subsample of the Avon Longitudinal Study of Parents and Children. Nine-hundred and eighty children provided complete dietary data at 18 months and 769 at 43 months.Results:Children with overweight/obese mothers consumed greater amounts of energy from non-core foods than children with healthy weight/underweight mothers (0·20 MJ (48 kcal)/d more at 18 months (P < 0·001); 0·19 MJ (45 kcal)/d more at 43 months (P = 0·008)) in adjusted models. Diet quality deteriorated between 18 and 43 months (children reduced their dietary energy intake from core foods (P < 0·001) and increased intake from non-core foods (P < 0·001)). However, this change was not associated with maternal BMI class in adjusted models. Having an overweight/obese mother was associated with an increased odds of the child being overweight/obese at 43 months (OR 1·74 (1·17, 2·58)).Conclusions:Children aged 18 and 43 months with overweight/obese mothers are likely to have a poorer quality diet than those with healthy/underweight mothers. Parents should be supported in discouraging the consumption of non-core foods in children at these ages.

The perinatal mortality rate, which is one of the important adverse pregnancy outcome and includes stillbirths and infant death within first week of life is estimated to be nearly 40 deaths per 1,000 pregnancies in Gujarat. Also the infant mortality rates have been estimated to be 50 deaths before age of one year per 1,000 pregnancies. It is stated that children whose mothers are illiterate or belong to low socio-economic class have two and half times more chances to die within 1 year of their birth compared to those whose mothers have completed atleast 10 years of education or belong to high socio-economic class. There are nearly 13% of women who does not receive proper antenatal care and facility during pregnancy. In India, there are nearly half of the women (52%) who possess normal BMI range: rest are either underweight or overweight. Approximately 55% of the women of total population in India are anaemic. These maternal parameters directly affect the children causing 48% of the children to be malnourished and 43% to be underweight. Therefore, it is imperative to examine the association of pre-pregnancy Body Mass Index (BMI) as well as Gestational Weight Gain (GWG) with diverse pregnancy outcomes such as gestational diabetes, gestational hypertension and also with preterm delivery, caesarean delivery, etc. The present study was designed to investigate the prevalence, GWG, various pregnancy outcomes of underweight, overweight or obese pregnant women, and to explore the relationship between pre-pregnancy BMI as well as gestational weight gain during pregnancy and adverse pregnancy outcomes. This is a prospective, multi-centric study involving pregnant women with gestation week ≤20 weeks in Ahmedabad in Gujarat region. Our study observed that out of 226 women enrolled, 44 women (19.47%) were underweight, 137 women (60.62%) were normal, 30 women (13.27%) were overweight and 15 women (6.64%) were obese. The incidence of caesarean delivery (56.92%) was found more in nuclear family as compared to joint family (46.92%). It was found that in women taking no junk food at all, the chances of LBW were 16.39%, which was less as compared to mothers who had junk food. It was also observed that amongst women taking 1 glass milk daily (42.92%), about 55.67% of had normal type of delivery. Amongst women taking 1 fruit daily (57.52%), 53% women had normal delivery. Present study spotted decrease in risk of caesarean delivery with increase in maternal haemoglobin level from 9.0 gm/dl till 12.0 gm/dl. Average weight gain observed in underweight was 12.93 ± 1.90, in normal 12.32 ± 1.71, in overweight 10.23 ± 1.28 and in obese 9.6 ± 1.50. A negative correlation was found between GWG and pre-pregnancy BMI, i.e. as pre-pregnancy BMI increase, the GWG decrease. The incidence of pre-term delivery (9.49%) was much less in normal BMI range. The average infant birth weight observed in underweight women was 2.63 ± 0.47, in normal was 2.9 ± 0.49, in overweight was 2.92 ± 0.56 and in obese was 2.95 ± 0.86. It is observed that highest birth weight is obtained in obese women, which decreases as the maternal BMI range decreases. The incidence of LBW in normal and overweight women was 15.33 and 16.67%, which was low as compared to obese and underweight women. Our study reveals that parameters such as GWG, type of family, intake of milk, fruits and junk food, haemoglobin concentration directly affects the pregnancy outcomes such as term of delivery, type of delivery and infant birth weight.

ObjectiveAs the high proportion of underweight pregnant women, omission of their weight gain and blood lipids management during gestation might lead to adverse pregnancy outcomes. This study aimed to determine the relationship between lipid profile and risks for adverse pregnancy outcomes in pre-pregnancy underweight women.MethodsThis study was part of an ongoing cohort study including Chinese gravidas delivered from January 2015 to December 2016. Included subjects were grouped into underweight, normal-weight, and overweight by BMI before conception. Logistic regression was used to assess the association between lipid profiles during second trimester and adverse obstetric outcomes in each group. A subgroup analysis according to the gestational weight gain, in which subjects in each group were divided into above and within the Institute of Medicine (IOM) recommendations, was performed.ResultsA total of 6, 223 women were included. The proportion of underweight (19.3%) was similar to that of overweight women (19.4%) in South China. Peripheral total cholesterol (TC) level in underweight women was significantly higher than that in overweight women (P ConclusionUnderweight pregnant women with high TC levels had a higher risk for LGA, especially among women whose gestational weight gain were above the IOM recommendations. Therefore, clinical management of lipids and weight gain during gestation should also be recommended for underweight women.

This study aimed to summarize the evidence regarding the effects of dietary intake before conception on pregnancy outcomes by performing a systematic review and meta-analysis of prospective studies. Electronic databases were searched from inception up to August 2021. Overall, 65 studies involving 831 798 participants were included and 38 studies were quantitatively pooled. With regard to maternal outcomes, pre-pregnancy intake of fried food, fast food, red and processed meat, heme iron and a low-carbohydrate dietary pattern was positively associated with the risk of gestational diabetes mellitus (GDM) (all P 0.05). However, a high dietary fiber intake and folic acid supplementation were negatively associated with GDM risk (both P 0.05). With regard to neonatal outcomes, maternal caffeine intake before pregnancy significantly increased the risk of spontaneous abortion, while folic acid supplementation had protective effects on total adverse neonatal outcomes, preterm birth, and small-for-gestational age (SGA, all P 0.05). However, no significant associations were found between adverse pregnancy outcomes (i.e., GDM and SGA) and the pre-pregnancy dietary intake of sugar-sweetened beverages, potato, fish, and carbohydrates and the Healthy Eating Index. Our study suggests that maintaining a healthy diet before conception has significant beneficial effects on pregnancy outcomes.Supplemental data for this article is available online at https://doi.org/10.1080/10408398.2021.1989658.

The metabolic profile variability of women with diabetes mellitus type 1 (DM1) during breastfeeding, leads to a reassessment in managing glycemia, mainly to prevent hypoglycemia. In this retrospective study we assessed insulin needs, vis-à-vis breastfeeding in DM1. A 10.7% reduction of daily insulin dosage, compared to pre-pregnancy insulin needs, was noted in women who breastfed exclusively versus 10.8% in those who supplemented breastfeeding (p = NS). Women who experienced hypoglycemic episodes, tended (but not significantly) to be younger (

Background The differential effect of pre-pregnancy low BMI on macrosomia has not been fully addressed. Herein, we conducted a city-wide population-based cohort study to illuminate the association between pre-pregnancy low BMI and macrosomia, stratifying by maternal age, parity, and GDM status. Methods All pregnant women who paid their first prenatal visit to the hospital in Qingdao during August 1, 2018, to June 30, 2020, were recruited to this study. The interactive effect of maternal age and pre-pregnancy low BMI on macrosomia was evaluated using logistic regression models, followed by strata-specific analyses. Results A total of 105,768 mother-child pairs were included, and the proportion of fetal macrosomia was 11.66%. The interactive effect of maternal pre-pregnancy BMI and age was statistically significant on macrosomia irrespective of parity (nullipara: Padjusted=0.0265; multipara: Padjusted=0.0356). The protective effect of low BMI on macrosomia was most prominent among nullipara aged 35 years and above (aOR=0.16, 95% CI 0.05–0.49) and multipara aged 25 years and below (aOR=0.17, 95% CI 0.05–0.55). In nullipara without GDM, the risk estimates gradually declined with increasing conception age (20-to-24 years: aOR=0.64, 95% CI 0.51–0.80; 25-to-29 years: aOR=0.43 95% CI 0.36–0.52; 30-to-34 years: aOR=0.40 95% CI 0.29–0.53; and ≥35 years: aOR=0.19, 95% CI 0.06–0.60). A similar pattern could also be observed in nullipara with GDM, where the aOR for low BMI on macrosomia decreased from 0.54 (95% CI 0.32–0.93) in pregnant women aged 25–29 years to 0.30 (95% CI 0.12–0.75) among those aged 30–34 years. However, younger multiparous mothers, especially those aged 25 years and below without GDM (aOR=0.21, 95% CI 0.06–0.68), were more benefited from a lower BMI against the development of macrosomia. Conclusions Maternal low BMI is inversely associated with macrosomia irrespective of maternal age and parity. The impact of pre-pregnancy low BMI on macrosomia varied by maternal age and parity. The protective effect of a lower maternal BMI against fetal macrosomia was more prominent in nulliparous mothers aged 35 years and above, whereas multiparous mothers younger than 25 years of age were more benefited.

David Morris looks at how to advise expectant mothers to manage type 2 diabetes

Background: This study aimed to determine the correlation between maternal weight gain in each trimester and fetal growth according to pre-pregnancy maternal body mass index in twin pregnancies.Methods: We conducted a retrospective review of the medical records of 500 twin pregnancies delivered at 28 weeks’ gestation or greater at a single tertiary center between January 2011 and December 2020. We measured the height, pre-pregnant body weight, and maternal body weight of women with twin pregnancies and evaluated the relationship between the maternal weight gain at each trimester and fetal growth restriction according to pre-pregnancy body mass index.Results: The overweight pregnant women were older than the normal or underweight pregnant women, and the risk of gestational diabetes was high. The underweight pregnant women were younger, and the incidences of preterm labor and short cervical length during pregnancy was high. Especially in normal weight pregnant women, the heavier the weight of the newborn babies as the second trimester of pregnancy weight gain, the less significant the weight gain in the first trimester of pregnancy and fetal growth. The most predictive single factor for the prediction of small neonates was weight gain during 24-28 weeks and 15-18 weeks, and the cutoff value was 6.2 kg. (area under the curve 0.592, p < 0.001).Conclusions: In twin pregnancy, regardless of the pre-pregnant body mass index, maternal weight gain affected fetal growth. Furthermore, weight gain in the second trimester of pregnancy is considered a powerful indicator of fetal growth, especially in normal weight pregnancies.

Study Objective Adolescent pregnancy contributes to accelerated trajectories of adiposity and cardiometabolic diseases. Two potentially low-cost prevention strategies include promoting physical activity (PA) and limiting television (TV) viewing. Few studies have explored these behavior patterns in perinatal adolescents. This study sought to characterize PA and TV viewing in a socioeconomically disadvantaged perinatal adolescent population. Design, Setting, Participants, and Interventions A cross-sectional, retrospective, 10-item survey was used to explore behavior patterns in 79 predominantly Black (86%) postpartum adolescents. Main Outcome Measures: Outcomes included self-reported changes in PA from pre-pregnancy through pregnancy, and 7-day recall of PA and TV viewing in postpartum. Results The majority of adolescents (66%) reported being active on ≥3 days/week in pre-pregnancy; however, many reported low PA (≤2 days/wk) in their first (59%), second (66%), and third (54%) trimesters. Adolescents who reported being active on ≥5 days/wk in pre-pregnancy (19%) experienced first trimester PA decline, which subsequently plateaued. This group remained the most active throughout pregnancy. In postpartum, over half (54%) of all adolescents reported low PA and irrespective of PA, spent considerable time watching TV (median = 1680.0 minutes, inerquartile range = 2940). Conclusion Interventions promoting PA coupled with reducing TV viewing during pregnancy and in postpartum may benefit perinatal adolescents. The findings from this study suggest that PA history is a predictor of gestational PA, and low PA and high TV viewing in postpartum underscore the need for behavioral intervention. Conducting a brief assessment of PA history in early gestation may offer important insight.

Background: The antenatal weight targets of gestational weight gain (GWG) (earlier than 40 weeks) among underweight pregnant women (UPW: pre-pregnancy body mass index≤18.5 kg/m2) that are useful for the management of weight during pregnancy have not been reported. It had been recently pointed out that firm GWG restrictions have led to an increase in the number of low-birth-weight infants in Japan. Thus, this study aimed to evaluate the perinatal outcomes by GWG at 30 weeks of gestation among UPW and to discuss the effects of GWG restrictions.Methods: This retrospective cohort study was conducted at a hospital in Japan from 2003 to 2020. The UPW (n=3,643) were divided into the four quartile groups based on the GWG at 30 weeks of gestation: group A ≤ 5.7 kg, 5.7 kg < group B ≤ 7.2 kg, 7.2 kg < group C ≤ 8.8 kg, and 8.8 kg < group D. Their clinical characteristics and outcomes were compared using t-test, chi-square test, and multivariate logistic regression analysis.Results: The incidence rates of preterm births were 7.5% (n=70), 5.0% (n=45), 5.4% (n=50), and 4.9% (n=44) and the birth rates of small-for-gestational age (SGA) infants were 15.7% (n=147), 9.6% (n=87), 6.9% (n=64), and 5.9% (n=53) in groups A, B, C, and D, respectively. Multivariate logistic regression analysis showed that group A was significantly associated with preterm births [adjusted odds ratio (Adj. OR) = 1.6; 95% confidence interval (CI) = 1.0–2.3; p = 0.018], and groups A and B were significantly associated with SGA [Adj. OR = 3.0; 95% CI = 2.2–4.2; p < 0.001] [Adj. OR = 1.7; 95% CI = 1.2–2.5; p = 0.002] . No significant differences were noted in the ratio of cesarean section (CS) (p = 0.344), hypertensive disorders of pregnancy (HDP) (p = 0.954), and macrosomia (p = 0.147) among the four groups.Conclusions: The GWG at 30 weeks of >5.7 kg for preterm birth and >7.2 kg for SGA is recommended. Firm weight restrictions for UPW may have led to an increase of adverse outcomes without reducing the risk of CS, HDP, and macrosomia.

The gestational weight gain (GWG) range of Chinese women with gestational diabetes mellitus (GDM) still remains unclear. Our objective was to identify the ranges of GWG in Chinese women with GDM, and to investigate the associations between pre-pregnancy body mass index (BMI), GWG and maternal-infant adverse outcomes. GDM Women delivering singleton from 2013 to 2018 in a tertiary public hospital were collected. Logistic regression analysis was used to assess the joint effects of pre-pregnancy BMI and GWG on maternal-infant adverse outcomes. Finally, 14,578 women were collected. The ranges of GWG of Chinese women with GDM in the underweight, normal weight, overweight and obese groups were 5.95-21.95kg, 4.23-21.83kg, 0.88-21.12kg and-1.76-19.95kg, respectively. The risks of large for gestational age (LGA), macrosomia and cesarean delivery were significantly increased with the increase of pre-pregnancy BMI. Furthermore, the risks of LGA, macrosomia and cesarean delivery were significantly higher in normal weight group with GWG higher than the National Academy of Medicine’s (NAM) recommendation. Similarly, in overweight group with GWG higher than NAM recommendation, the risks of LGA were significantly higher, while, the risks of macrosomia were significantly lower. In conclusion, the ranges of GWG in GDM women were different with NAM recommendation.

OBJECTIVES: To evaluate whether pre-pregnancy intakes of omega-3 and omega-6 fatty acids prevent HDP. METHODS: We followed 11,535 women from the Nurses' Health Study-II free of chronic disease that filled out food frequency questionnaires starting in 1991 before their 16,892 singleton pregnancies. Intakes of omega-3 fatty acids (alpha-linolenic acid[ALA] + long-chain omega-3 [LCN-3]) and omega-6 (linoleic acid [LA] + arachidonic acid[ARA]). In 2009, participants reported history of preeclampsia and GHTN. The relative risk (95%CI) of HDP across quintiles of intakes of omega-3 and omega-6 were estimated by log-binomial regression model using generalized estimating equation to account for repeated pregnancies from the same woman and adjusted for age at pregnancy, year of pregnancy, and pre-pregnancy: BMI, physical activity, smoking, infertility diagnosis, marital status, race, parity, multivitamin use, concurrent gestational diabetes, and preeclampsia at baseline. RESULTS: During 18 years of follow-up, there were 495 pregnancies with preeclampsia (2.9%) and 561 pregnancies (3.3%) with GHTN. Mean (SD) age at pregnancy was 34.6 (3.9) years. Intakes of total omega-6 and total omega-3 fatty acids before pregnancy were unrelated with the risk of either HDP. From individual omega subtypes, only ARA had a marginally significant relation to higher risk of GHTN. Women in the highest quintile of ARA had 43% increased risk of GHTN (CI: 1.00–2.04) compared to women in the lowest quintile of intake. Intakes of the remaining subtypes, LA, LCN-3, and ALA were not associated to HDP risk. When we restricted the analysis to a closer window of exposure among 5,208 women with diet assessment one year before pregnancy, only intakes of LCN-3 (RR = 0.55, CI:0.33–0.91) and LA (RR = 0.54, CI: 0.29,0.99) were associated with a lower risk of preeclampsia, comparing women in the highest versus the lowest quintile of intake. CONCLUSIONS: Dietary intake of long-chain omega-3 fatty acid and linoleic acid one year before pregnancy was associated with a reduced risk of preeclampsia. The extent to which long-chain omega-3 prevents preeclampsia may be more relevant in a window of exposure closer to pregnancy. FUNDING SOURCES: National Institutes of Health grants U01-HL145386–01, UM1-CA176726, P30-DK046200, and R00ES026648.

OBJECTIVES: This study analyzed the association between pre-pregnancy body mass index (PPBMI), dietary intake status, and birth size outcomes in the VDPM cohort study in West Sumatra, Indonesia. METHODS: The VDPM study is a prospective longitudinal study including 239 healthy pregnant women of Indonesian women with singleton pregnancies. Data on maternal dietary intake including energy, carbohydrate, protein, and fat intake, and anthropometry were collected during pregnancy. New-born anthropometry for 195 new-born babies was measured immediately after delivery. Bivariate and multivariate regression analyses were constructed to determine the association between PPBMI, dietary intake status, and birth size outcomes. RESULTS: The mean birth weight was 3195 ± 463 g. Dietary intake of pregnant mothers had a significant correlation with newborn birth weight, length of birth, head circumference, and placental weight as pregnancy outcome indicators (p ≤ 0.05). This study showed that no association between pre-pregnancy BMI status and birth size outcomes (p ≥ 0.05). CONCLUSIONS: Our studies have not shown a statistically significant difference between PPBMI and birth size outcomes. However, maternal dietary intake associated with birth size outcomes, more research is warranted to confirm these findings. FUNDING SOURCES: Indonesian Danone Institute Foundation.

During the coronavirus disease 2019 pandemic, the Japanese Society of Diabetes and Pregnancy proposed the use of random plasma glucose and glycated hemoglobin measured 1 month after delivery combined with pre‐pregnancy body mass index to detect postpartum glucose intolerance instead of carrying out the oral glucose tolerance test in women with gestational diabetes. We retrospectively evaluated the clinical utility of this strategy to detect postpartum glucose intolerance evaluated by the oral glucose tolerance test after delivery. A total of 275 Japanese women with gestational diabetes were included in the present study. The specificity of 1‐month postpartum random plasma glucose and glycated hemoglobin combined with pre‐pregnancy body mass index to predict postpartum glucose intolerance was 98.0%, with a negative predictive value of 72.6%. However, sensitivity was 6.4%, with a positive predictive value of 55.6%. In conclusion, this Japanese Society of Diabetes and Pregnancy strategy showed high specificity, but low sensitivity, for detecting glucose intolerance postpartum., During the coronavirus disease 2019 pandemic, the Japanese Society of Diabetes and Pregnancy (JSDP) proposed the use of random plasma glucose and HbA1c measured 1 month after delivery combined with pre‐pregnancy body mass index to detect postpartum glucose intolerance instead of performing oral glucose tolerance test in women with gestational diabetes. This JSDP strategy showed high specificity of 98.0% but low sensitivity of 6.4% for detecting glucose intolerance postpartum.

Background: A healthy pre-pregnancy BMI fosters positive outcomes for both mother and infant both during and after pregnancy. To design interventions to promote a healthy pre-pregnancy BMI in low-income women, it is important to understand correlates. The purpose of this study was to identify the socio-demographic correlates of pre-pregnancy body mass index (BMI) among low-income women.Methods: Participants were low-income pregnant women (n=83) in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) program in Hawai‘i enrolled in a four-month text message-based nutrition intervention program. Participants reported pre-pregnancy weight and height and completed a demographics questionnaire on age, race/ethnicity, education, employment status and number of children. Descriptive statistics (mean, standard deviation for continuous variables, and frequencies and proportions for categorical variables) were used to summarize the sample. Simply linear regression analyses were performed to examine if independent variables were associated with BMI before pregnancy. Results: Among the 83 women, 33 (39.8%) were 18-24 years old, 22 (26.5%) were between 25 and 29, 19 (22.9%) were 30-34 and 9 (10.8%) were 35-41. A total of 18 (21.7%) were Asian. Age and race/ethnicity were marginally associated with BMI before pregnancy. The age group 30-34 had the highest BMI before pregnancy (p=0.06) and Asian had lower BMI before pregnancy than the other races/ethnicities (p=0.01). Conclusions: Being classified as Asian was associated with lower BMI before pregnancy, while those who were 30-34 years old had the highest pre-pregnancy BMI compared to other age groups. These socio-demographic factors should be taken into account when designing interventions to promote healthy weight in women of childbearing age. Trial registration: The trial is registered on clinicaltrials.gov (NCT04330976). Date of registration April 2, 2020 (restrospectively registered). URL: https://clinicaltrials.gov/ct2/show/NCT04330976