Pitt Logo LinkContact Us

Maternal Obesity, Nutritional Status and Hyperglycemia

Tomedi, Laura (2012) Maternal Obesity, Nutritional Status and Hyperglycemia. Doctoral Dissertation, University of Pittsburgh.

[img] PDF - Primary Text
Restricted to University of Pittsburgh users only until 30 January 2017.

Download (605Kb) | Request a copy

    Abstract

    Maternal hyperglycemia is a common condition with a profound effect on prenatal and maternal health. We used two complementing cohorts to estimate the associations between: 1) gestational weight gain (GWG), adiposity distribution, and maternal hyperglycemia; 2) pre-pregnancy body mass index (BMI) and an array of maternal nutritional biomarkers; and 3) maternal vitamin D status and maternal hyperglycemia. In the Study of Nutrition and Pregnancy (SNAP), biceps and triceps skinfolds and waist circumference were measured at <13 weeks gestation and 25-hydroxyvitamin D [25(OH)D] concentrations were measured at <16 weeks gestation. Serial weight measurements and post-load glucose concentrations were abstracted from medical records. Because a full array of nutritional biomarkers was not available in SNAP, we also used the Antidepressant Use During Pregnancy (ADUP) study. In ADUP, height and nutritional biomarkers were measured and pre-pregnancy weight was self-reported at ≤ 20 weeks gestation. In the SNAP study, each 0.3-kg/week increase in first trimester GWG rate was associated with a 2.2 (95% CI: 0.1, 4.3)-mg/dl increase in glucose concentration and each 8.6-mm increase in biceps skinfold thickness and 11.7-mm increase in triceps skinfold thickness was associated with a 4.3 (95% CI: 0.2, 8.5)-mg/dl increases in glucose. In the ADUP study, principal component analysis of the biomarkers resulted in an EFA component, a Micronutrient component, and a Carotenoid component. Obese pregnant women were 3.0 (95% CI: 1.1, 7.7) times as likely of being in the lowest tertile of the EFA component and 4.5 (95% CI: 1.7, 12.3) times as likely of being in the lowest tertile of the Carotenoid component as their lean counterparts. Among non-smokers in SNAP, each 21-nmol/L increase in serum 25(OH)D was associated with a 4.1 (95% CI: 0.9, 7.2)-mg/dl increase in maternal post-load glucose concentration. Among smokers, each 21-nmol/L increase in serum 25(OH)D was associated with a 7.3-(95% CI: 11.4, 3.1) mg/dl decrease in maternal post-load glucose concentration after confounder adjustment. This dissertation is important to public health because hyperglycemia has a major impact on the health of mothers and infants and these data may lead to nutritional interventions that are safe, inexpensive, and acceptable to women.


    Share

    Citation/Export:
    Social Networking:

    Details

    Item Type: University of Pittsburgh ETD
    ETD Committee:
    ETD Committee TypeCommittee MemberEmailORCID
    Committee ChairBodnar, Lisabodnar@edc.pitt.edu
    Committee MemberChang, Chung-Chou Ho (Joyce)changj@pitt.edu
    Committee MemberMcTigue, Kathleenkmm34@pitt.edu
    Committee MemberEvans, Rhobertrwe2@pitt.edu
    Committee MemberSimhan, Hyagrivhsimhan@mwri.magee.edu
    Title: Maternal Obesity, Nutritional Status and Hyperglycemia
    Status: Published
    Abstract: Maternal hyperglycemia is a common condition with a profound effect on prenatal and maternal health. We used two complementing cohorts to estimate the associations between: 1) gestational weight gain (GWG), adiposity distribution, and maternal hyperglycemia; 2) pre-pregnancy body mass index (BMI) and an array of maternal nutritional biomarkers; and 3) maternal vitamin D status and maternal hyperglycemia. In the Study of Nutrition and Pregnancy (SNAP), biceps and triceps skinfolds and waist circumference were measured at <13 weeks gestation and 25-hydroxyvitamin D [25(OH)D] concentrations were measured at <16 weeks gestation. Serial weight measurements and post-load glucose concentrations were abstracted from medical records. Because a full array of nutritional biomarkers was not available in SNAP, we also used the Antidepressant Use During Pregnancy (ADUP) study. In ADUP, height and nutritional biomarkers were measured and pre-pregnancy weight was self-reported at ≤ 20 weeks gestation. In the SNAP study, each 0.3-kg/week increase in first trimester GWG rate was associated with a 2.2 (95% CI: 0.1, 4.3)-mg/dl increase in glucose concentration and each 8.6-mm increase in biceps skinfold thickness and 11.7-mm increase in triceps skinfold thickness was associated with a 4.3 (95% CI: 0.2, 8.5)-mg/dl increases in glucose. In the ADUP study, principal component analysis of the biomarkers resulted in an EFA component, a Micronutrient component, and a Carotenoid component. Obese pregnant women were 3.0 (95% CI: 1.1, 7.7) times as likely of being in the lowest tertile of the EFA component and 4.5 (95% CI: 1.7, 12.3) times as likely of being in the lowest tertile of the Carotenoid component as their lean counterparts. Among non-smokers in SNAP, each 21-nmol/L increase in serum 25(OH)D was associated with a 4.1 (95% CI: 0.9, 7.2)-mg/dl increase in maternal post-load glucose concentration. Among smokers, each 21-nmol/L increase in serum 25(OH)D was associated with a 7.3-(95% CI: 11.4, 3.1) mg/dl decrease in maternal post-load glucose concentration after confounder adjustment. This dissertation is important to public health because hyperglycemia has a major impact on the health of mothers and infants and these data may lead to nutritional interventions that are safe, inexpensive, and acceptable to women.
    Date: 30 January 2012
    Date Type: Completion
    Defense Date: 27 September 2011
    Approval Date: 30 January 2012
    Submission Date: 29 November 2011
    Release Date: 30 January 2012
    Access Restriction: 5 year -- Restrict access to University of Pittsburgh for a period of 5 years.
    Patent pending: No
    Number of Pages: 133
    Institution: University of Pittsburgh
    Thesis Type: Doctoral Dissertation
    Refereed: Yes
    Degree: PhD - Doctor of Philosophy
    Uncontrolled Keywords: gestational diabetes, obesity, nutrition, maternal hyperglycemia, pregnancy
    Schools and Programs: Graduate School of Public Health > Epidemiology
    Date Deposited: 30 Jan 2012 14:27
    Last Modified: 04 Jun 2013 13:11

    Actions (login required)

    View Item

    Document Downloads