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Maternal Obesity, Nutritional Status and Hyperglycemia

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

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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.


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Details

Item Type: University of Pittsburgh ETD
Status: Published
Creators/Authors:
CreatorsEmailPitt UsernameORCID
Tomedi, Lauralet20@pitt.eduLET20
ETD Committee:
TitleMemberEmail AddressPitt UsernameORCID
Committee ChairBodnar, Lisabodnar@edc.pitt.eduLBODNAR
Committee MemberChang, Chung-Chou Ho (Joyce)changj@pitt.eduCHANGJ
Committee MemberMcTigue, Kathleenkmm34@pitt.eduKMM34
Committee MemberEvans, Rhobertrwe2@pitt.eduRWE2
Committee MemberSimhan, Hyagriv hsimhan@mwri.magee.edu
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.
Number of Pages: 133
Institution: University of Pittsburgh
Schools and Programs: Graduate School of Public Health > Epidemiology
Degree: PhD - Doctor of Philosophy
Thesis Type: Doctoral Dissertation
Refereed: Yes
Uncontrolled Keywords: gestational diabetes, obesity, nutrition, maternal hyperglycemia, pregnancy
Date Deposited: 30 Jan 2012 19:27
Last Modified: 15 Nov 2016 13:55
URI: http://d-scholarship.pitt.edu/id/eprint/10588

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