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Prenatal docosahexaenoic acid supplementation has long-term effects on childhood behavioral and brain responses during performance on an inhibitory task.
Gustafson, KM, Liao, K, Mathis, NB, Shaddy, DJ, Kerling, EH, Christifano, DN, Colombo, J, Carlson, SE
Nutritional neuroscience. 2022;(1):80-90
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Abstract
Introduction: Offsprings from a prenatal docosahexaenoic acid (DHA) supplementation trial, in which pregnant women were assigned to placebo or 600mg DHA/day, were followed to determine the effect of prenatal DHA supplementation on the behavior and brain function at 5.5 years (n=81 placebo, n=86 supplemented).Methods: Event-related potentials (ERP) were recorded during a visual task requiring a button press (Go) to frequent target stimuli and response inhibition to the rare stimuli (No-Go). Univariate ANOVAs were used to test differences between group and sex for behavioral measures. ERP differences were tested using a three-way mixed-design multivariate analysis of variance (MANOVA).Results: There was a significant sex × group interaction for hit rate and errors of omission; there was no difference between males and females in the placebo group, but DHA males outperformed DHA females. Males overall and the placebo group made more errors requiring response inhibition; DHA females were significantly better than placebo females and DHA males. ERP P2 amplitude was larger in the DHA group. A significant N2 amplitude condition effect was observed in females and DHA group males, but not in placebo group males.Discussion: Prenatal DHA supplementation improved inhibitory performance overall, especially for females in the DHA group, possibly accounting for their conservative behavior during Go trials. Development of brain regions responsible for visual processing may be sensitive to maternal DHA status, evidenced by greater P2 amplitude. Males may benefit more from maternal DHA supplementation, indicated by the N2 condition effect seen only in males in the DHA group.
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Psychosocial status and prenatal care of unintended pregnancies among low-income women.
Cruz-Bendezú, AM, Lovell, GV, Roche, B, Perkins, M, Blake-Lamb, TL, Taveras, EM, Simione, M
BMC pregnancy and childbirth. 2020;(1):615
Abstract
BACKGROUND Nearly half of all pregnancies in the United States are reported as unintended and rates are highest among women of low socioeconomic status. The purpose of this study was to examine the associations between unintended pregnancies and maternal mental health and timing of prenatal care among low-income women. METHODS In this cross-sectional study, 870 women, whom were participating in the First 1000 Days program in three community health centers in the Boston area, were enrolled at their first prenatal visit from August 2016 - September 2017. We assessed pregnancy intention by self-report using the Pregnancy Risk Assessment Monitoring System. We used self-reported survey information and electronic health record data to assess the following outcomes: current stress, current depression, and timing of initial prenatal visit. We used multivariable logistic regression models to examine associations and adjusted for sociodemographic factors. RESULTS Women were a mean (SD) age of 29.3 (6.1), and 39.2% reported that their pregnancy was unintended. 50.6% of women were Hispanic, 28.4% were White, 10.1% were Black, and 10.9% were other races. 78.9% of women reported an annual household income <$50,000. Overall, 26.7% of women reported current stress, 8.2% reported current depression, and 18.3% of women initiated prenatal care after their first trimester. In multivariable analyses, women with unintended pregnancies had higher odds of experiencing current stress (OR: 1.72; 95% CI: 1.22, 2.41), current depression (OR: 1.83; 95% CI: 1.04, 3.20), and initiation of prenatal care post-first trimester (OR: 1.84; 95% CI: 1.23, 2.74). CONCLUSIONS Unintended pregnancies were associated with current stress and depression, and delayed prenatal care in this sample of low-income women suggesting the importance of identifying high-risk women and tailoring interventions to support women's needs. TRIAL REGISTRATION ClinicalTrials.gov (NCT03191591; Retrospectively registered on June 19, 2017).
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Association of the First 1,000 Days Systems-Change Intervention on Maternal Gestational Weight Gain.
Blake-Lamb, T, Boudreau, AA, Matathia, S, Perkins, ME, Roche, B, Cheng, ER, Kotelchuck, M, Shtasel, D, Taveras, EM
Obstetrics and gynecology. 2020;(5):1047-1057
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Abstract
OBJECTIVE To examine the associations of a clinical and public health systems-change intervention on the prevalence of excess gestational weight gain among high-risk, low-income women. METHODS In a quasi-experimental trial, we compared the prevalence of excess gestational weight gain among women before (n=643) and after (n=928) implementation of the First 1,000 Days program in two community health centers in Massachusetts. First 1,000 Days is a systematic program starting in early pregnancy and lasting through the first 24 months of childhood to prevent obesity among mother-child pairs. The program includes enhanced gestational weight gain tracking and counseling, screening for adverse health behaviors and sociocontextual factors, patient navigation and educational materials to support behavior change and social needs, and individualized health coaching for women at high risk for excess gestational weight gain based on their prepregnancy body mass index (BMI) or excess first-trimester weight gain. The primary outcome was gestational weight gain greater than the 2009 Institute of Medicine (now known as the National Academy of Medicine) guidelines according to prepregnancy BMI. RESULTS Among 1,571 women in the analytic sample, mean (SD) age was 30.0 (5.9) years and prepregnancy BMI was 28.1 (6.1); 65.8% of women started pregnancy with BMIs of 25 or higher, and 53.2% were Hispanic. We observed a lower prevalence (55.8-46.4%; unadjusted odds ratio [OR] 0.69, 95% CI 0.49-0.97), similar to results in a multivariable analysis (adjusted OR 0.69, 95% CI 0.49-0.99), of excess gestational weight gain among women with prepregnancy BMIs between 25 and 29.9. Among women who were overweight at the start of pregnancy, the lowest odds of excess gestational weight gain were observed among those with the most interaction with the program's components. Program enrollment was not associated with reduced excess gestational weight gain among women with prepregnancy BMIs of 30 or higher. CONCLUSIONS Implementation of a systems-change intervention was associated with modest reduction in excess gestational weight gain among women who were overweight but not obese at the start of pregnancy. CLINICAL TRIAL REGISTRATION ClinicalTrials.gov, NCT03191591.
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[Effectiveness of mobile technology and weight gain in pregnant women in Callao, Peru].
Tarqui-Mamani, C, Sanabria-Rojas, H, Portugal-Benavides, WJ, García, JC, Castro-Garay, W, Escalante-Lazo, R, Calderón-Bedoya, M
Revista de salud publica (Bogota, Colombia). 2018;(1):67-72
Abstract
OBJECTIVE To evaluate the effectiveness of mobile technology in the appropriate weight gain of pregnant women. MATERIALS AND METHODS A quasi-experimental study. The sample included 117 pregnant women attending health facilities at la Dirección Regional de Salud (Diresa), Callao. Messages were sent to 58 pregnant women who formed the experimental group to improve their lifestyles and assistance to prenatal care (APC), while 59 pregnant women received routine education provided for pregnants. Messages were sent every three days. The nutritional status of the pregnant women was evaluated using the pre gestational BMI at the first visit of the APC. The weight gain was obtained from the difference between pre-gestational weight and weight recorded during the last controls. RESULTS The adequate weight gain was 27.6% of intervened pregnancies and 25.4% in the non-intervened. The 79.3% pregnant had six or more NPC in the group intervened and 54.2% in the non-intervened. The weight gain was excessive in 5.1% in the non-intervened pregnant and 1.7% in the intervened. The highest percentage of pregnant women with adequate weight gain (32.0%) was observed in the intervened pregnancies with pre-gestacional overwhegith. CONCLUSIONS There was no statistic difference in the use of mobile technology for a proper weight gain between both study groups. There were greater fulfillment of APC in intervened pregnancies compared to the non-intervened (p<0.05).
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Effects of nutritional management intervention on gestational weight gain and perinatal outcome.
Luo, XD, Dong, X, Zhou, J
Saudi medical journal. 2014;(10):1267-70
Abstract
OBJECTIVES To evaluate whether nutritional management intervention can prevent excessive weight gain during pregnancy and improve perinatal outcomes. METHODS This cross-sectional study included 276 pregnant women undergoing prenatal care between June 2010 and December 2011 at the Obstetrics and Gynecology Department of the Second Affiliate Hospital of the ChongQing University of Medical Sciences, Chongqing, China. Of them, 131 women received individualized nutritional management in addition to routine prenatal care (intervention group), and 145 women received only routine prenatal care (control group). The primary study outcome was gestational weight gain (GWG). Secondary outcomes included birth weight, Apgar score, and incidence of pregnancy complications. RESULTS Baseline demographic characteristics of the 2 groups were the same. The average GWG was higher in the control group (12.57+/-4.62 kg) compared with the intervention group (7.58+/-1.59 kg; p=0.000). The incidence rate of preeclampsia was 3.1% and gestational diabetes was 3.8% for the intervention group, compared with 11% for preeclampsia and 14.5% gestational diabetes for the control group (p<0.05). The incidence rates of premature rupture of membranes, preterm labor, birth weight, birth of a newborn, and major congenital anomalies did not significantly differ between the 2 groups. CONCLUSION Nutritional management intervention prevented excessive GWG and improved perinatal outcomes. These results support the hypothesis that nutritional management intervention can decrease the rate of complications experienced by expecting mothers.
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Lifestyle counseling during pregnancy and offspring weight development until four years of age: follow-up study of a controlled trial.
Mustila, T, Raitanen, J, Keskinen, P, Saari, A, Luoto, R
Journal of negative results in biomedicine. 2012;:11
Abstract
BACKGROUND Fetal conditions are known to be partly responsible for the child's risk for obesity. Our pilot study aimed to determine the effect of gestational lifestyle counseling on the offspring weight gain until 4 years of age and to estimate power for future studies. DESIGN AND METHODS First-time pregnant mothers participated in a controlled trial conducted in maternity health clinics during 2004 - 2006. The intervention included individual counseling on physical activity and diet, and an option to attend supervised group exercise sessions. The participant mothers (N = 109) received a follow-up questionnaire concerning 13 repeated growth measurements of their offspring. Response rate to the follow-up questionnaire was 66.1% (N = 72/109). RESULTS The increase of BMI z-score between 24-48 months was not significantly slower among the intervention group offspring (95% CI -0.025 to 0.009, p = 0.34) compared to control group. Z-scores for weight-for-length/height did not differ between groups when the period 0-48 months was analyzed (95% CI -0.010 to 0.014, p = 0.75). CONCLUSIONS In this pilot study gestational lifestyle counseling did not significantly slow the weight gain of the offspring. Gestational intervention studies with at least 300 mothers per group are needed to confirm the possible effect on offspring's risk for obesity. TRIAL REGISTRATION Current Controlled Trials ISRCTN21512277.