RESUMEN
BACKGROUND: Gestational weight gain (GWG) can have implications for the health of both mother and child. However, the contributing factors remain unclear. Despite the advantages of using a biopsychosocial approach, this approach has not been applied to study GWG in the UK. This study aimed to investigate the risk factors of excessive GWG in a UK population, employing a biopsychosocial model. METHODS: This study utilised data from the longitudinal Grown in Wales (GiW) cohort, which recruited women in late pregnancy in South Wales. Specifically, data was collected from midwife recorded notes and an extensive questionnaire completed prior to an elective caesarean section (ELCS) delivery. GWG was categorised according to Institute of Medicine (IOM) guidelines. The analysis was undertaken for 275 participants. RESULTS: In this population 56.0% of women had excessive GWG. Increased prenatal depression symptoms (Exp(B)=1.10, p=.019) and an overweight (Exp(B)=4.16, p<.001) or obese (Exp(B)=4.20, p=.010) pre-pregnancy BMI, consuming alcohol in pregnancy (Exp(B)=.37, p=.005) and an income of less than £18,000 (Exp(B)=.24, p=.043) and £25-43,000 (Exp(B)=.25, p=.002) were associated with excessive GWG. CONCLUSION: GWG is complex and influenced by a range of biopsychosocial factors, with the high prevalence of excessive weight gain in this population a cause for concern. Women in the UK may benefit from a revised approach toward GWG within the National Health Service (NHS), such as tracking weight gain throughout pregnancy. Additionally, this research provides evidence for potential targets for future interventions, and potentially at-risk populations to target, to improve GWG outcomes.
Asunto(s)
Ganancia de Peso Gestacional , Modelos Biopsicosociales , Complicaciones del Embarazo/etiología , Adulto , Consumo de Bebidas Alcohólicas/efectos adversos , Índice de Masa Corporal , Cesárea/estadística & datos numéricos , Estudios de Cohortes , Depresión/complicaciones , Procedimientos Quirúrgicos Electivos/estadística & datos numéricos , Femenino , Humanos , Renta , Sobrepeso/complicaciones , Embarazo , Complicaciones del Embarazo/epidemiología , Complicaciones del Embarazo/psicología , Prevalencia , Factores de Riesgo , Encuestas y Cuestionarios , Delgadez/complicaciones , Reino Unido/epidemiología , Gales/epidemiologíaRESUMEN
BACKGROUND: Sex differences in the behaviour of children exposed to prenatal maternal depression and anxiety have been reported. This study compared depression and anxiety symptoms reported by mothers at term with maternal perceptions of one year old male and female infant temperament and with researcher observed infant characteristics, identifying differences for males and females with both approaches. METHODS: Infant behaviour and temperament was assessed via maternally completed questionnaires including Infant Behavioural Questionnaire Revised - Short form and by researcher administered subcomponents of Laboratory Temperament Assessment Battery and Bayley Scales of Infant Development III. RESULTS: For female infants, higher prenatal scores for depression and anxiety were associated with maternal perceptions of lower bonding, higher aggression and negativity, and lower soothability (nâ¯=â¯67 mother-infant dyads). In the laboratory assessment, intensity of escape was the only female infant factor significantly associated with maternal mood (nâ¯=â¯41). For male infants, there was minimal association between prenatal mood scores and maternal perceptions (nâ¯=â¯46) whereas in the laboratory assessment (nâ¯=â¯35) depression scores were associated with expressive language, facial interest and facial fear while anxiety scores were associated with expressive and receptive language, parent behaviour and facial fear. LIMITATIONS: Findings may be restricted to a single ethnicity or mode of delivery. Fewer infants attended the infant assessment. A laboratory setting may mask symptomatology in females. CONCLUSIONS: Atypical maternal perceptions may present a barrier to the early identification of male infants impacted by maternal depression and anxiety.
Asunto(s)
Ansiedad , Depresión , Relaciones Madre-Hijo , Temperamento , Ansiedad/epidemiología , Depresión/epidemiología , Femenino , Humanos , Lactante , Masculino , Madres , Percepción , Embarazo , Caracteres SexualesRESUMEN
In mammals, mothers are the primary caregiver, programmed, in part, by hormones produced during pregnancy. High-quality maternal care is essential for the survival and lifelong health of offspring. We previously showed that the paternally silenced imprinted gene pleckstrin homology-like domain family A member 2 (Phlda2) functions to negatively regulate a single lineage in the mouse placenta called the spongiotrophoblast, a major source of hormones in pregnancy. Consequently, the offspring's Phlda2 gene dosage may influence the quality of care provided by the mother. Here, we show that wild-type (WT) female mice exposed to offspring with three different doses of the maternally expressed Phlda2 gene-two active alleles, one active allele (the extant state), and loss of function-show changes in the maternal hypothalamus and hippocampus during pregnancy, regions important for maternal-care behaviour. After birth, WT dams exposed in utero to offspring with the highest Phlda2 dose exhibit decreased nursing and grooming of pups and increased focus on nest building. Conversely, 'paternalised' dams, exposed to the lowest Phlda2 dose, showed increased nurturing of their pups, increased self-directed behaviour, and a decreased focus on nest building, behaviour that was robustly maintained in the absence of genetically modified pups. This work raises the intriguing possibility that imprinting of Phlda2 contributed to increased maternal care during the evolution of mammals.