This paper is a systematic review of scientific papers that studied postpartum weight retention. The identification of the studies was conducted in the Medline, Lilacs and Digital Library of Theses and Dissertations databases between 2000 until 2013. The main information evaluated was: author, year of publication, sample size, year of data collection, losses and analysis thereof, age, follow-up time, weight in the baseline and in the postpartum, assessment methods of weight retention and main results. Twenty studies were selected, of which 25% (n = 5) were national. Regarding the mode of analysis, in some works the result was analyzed in different ways as continuous and categorical. Of the selected papers, 45% (n = 9) analyzed the retained weight only continuously, 5% (n = 1) only categorically and 40% (n = 8) both ways. One of the studies used distribution in percentiles and the other evaluated continuously, categorical and by indicators of absolute and relative weight reduction. In conclusion, the results found reveal a lack of well-defined information about the forms of anthropometric measurements of women after delivery, indicating the need for developing national proposals, consistent with the reality of our population.

/pdf/metodos-antropometricos-utilizados-na-avaliacao-da-retencao-33bcg6ykyn.pdf

Métodos antropométricos utilizados na avaliação da retenção do peso no período pós-parto: uma revisão sistemática

OBJETIVO: Identificar associacao entre estado nutricional pre-gestacional, ganho ponderal materno e condicoes do pre-natal com os desfechos prematuridade e baixo peso ao nascer (BPN) em filhos de maes adolescentes METODOS: Estudo transversal com 542 pares de puerperas adolescentes e conceptos atendidos em uma maternidade publica do municipio do Rio de Janeiro (RJ) Os dados foram coletados em prontuarios Para verificar a associacao entre as variaveis independentes e os desfechos estudados, foram estimados a odds ratio (OR) e o intervalo de confianca (IC) de 95% RESULTADOS: Quanto ao estado nutricional pre-gestacional das adolescentes, 87% apresentavam eutrofia, 1% baixo peso, 10% sobrepeso e 2% obesidade A inadequacao do ganho de peso gestacional total (72%) superou a adequacao (28%) O peso ao nascer foi favorecido com maior ganho de peso gestacional e reduzido com inicio tardio do pre-natal (PN) A comparacao entre os grupos de conceptos com baixo peso e com peso adequado ao nascer revelou diferencas significativas entre as medias das variaveis: intervalo entre a ultima gestacao e a atual (p = 0,022); peso pre-gestacional (p = 0,018); indice de massa corporal pre-gestacional (p < 0,001) e ganho de peso gestacional total (p = 0,047) As chances de BPN (OR 2,70; IC 95% 1,45 - 5,06) e de prematuridade (OR 5,82; IC 95% 3,10 - 10,92) reduziram quando a adolescente recebeu 6 ou mais consultas de PN CONCLUSAO: O peso ao nascer foi relacionado ao intervalo intergestacional, ao peso pre-gestacional e ao indice de massa corporal pre-gestacional A frequencia minima de 6 consultas de assistencia pre-natal constituiu-se em fator de protecao contra o BPN e a prematuridade

/pdf/estado-nutricional-pre-gestacional-ganho-de-peso-materno-1ixugq2sz9.pdf

Estado nutricional pré-gestacional, ganho de peso materno, condições da assistência pré-natal e desfechos perinatais adversos entre puérperas adolescentes

Epidemiological studies have shown that the offspring of mothers who experience diabetes mellitus during pregnancy are seven times more likely to develop health complications than the offspring of mothers who do not suffer from diabetes during pregnancy. The present study was designed to investigate whether supplementation of streptozotocin (STZ)-induced diabetic pregnant mice with thymoquinone (TQ) during pregnancy and lactation improves the risk of developing diabetic complications acquired by their offspring. Three groups of pregnant female mice were used: non-diabetic control dams (CD), diabetic dams (DD), and diabetic dams supplemented with TQ (DD + TQ) during pregnancy and lactation (n = 10 female mice in each group). Our data demonstrated a marked decrease in the number of neonates born to DD, and these neonates showed a marked increase in their mean body weight (macrosomic pups) compared to those born to CD and DD + TQ. The induction of diabetes during pregnancy and lactation resulted in macrosomic pups with several postpartum complications, such as a marked increase in their levels of blood glucose, free radicals, plasma pro-inflammatory cytokines (IL-1β, IL-6, and TNF-α), and lipids, and a tendency toward abnormal obesity compared to the offspring of CD. By contrast, macrosomic offspring born to DD exhibited a marked reduction in plasma cytokine levels (IL-2, -4 and -7), an obvious reduction in the number of circulating lymphocytes, decreased proliferation of superantigen (SEB)-stimulated lymphocytes and aberrant AKT phosphorylation. Interestingly, the supplementation of DD with TQ during pregnancy and lactation had an obvious and significant effect on the number and mean body weight of neonates. Furthermore, TQ significantly restored the levels of blood glucose, insulin, free radicals, plasma cytokines, and lipids as well as lymphocyte proliferation in the offspring. Our data suggest that the nutritional supplementation of DD with the natural antioxidant TQ during pregnancy and lactation protects their offspring from developing diabetic complications and preserves an efficient lymphocyte immune response later in life.

/pdf/maternal-supplementation-of-diabetic-mice-with-thymoquinone-5egnbvw4j4.pdf

Maternal supplementation of diabetic mice with thymoquinone protects their offspring from abnormal obesity and diabetes by modulating their lipid profile and free radical production and restoring lymphocyte proliferation via PI3K/AKT signaling.

PURPOSE: to determine the dietary consumption of pregnant women, by assessing the intake of macronutrients and micronutrients, and to verify the maternal weight gain during pregnancy. METhODS: a retrospective study conducted from June 2002 to June 2008 with pregnant women who received nutritional counseling during prenatal care at a university hospital, grouped according to anthropometric nutritional status classified by pregestational body mass index (BMI). The dietary intake was analyzed according to the information obtained in food frequency interviews, performed at the first evaluation of pregnant women in the service of nutrition to obtain data about eating habits, and the intake of macronutrients and micronutrients was calculated. The pregnant women received nutritional counseling, and the maternal weight gain was investigated. RESULTS: a total of 187 pregnant women who received nutritional counseling were analyzed. Twenty-three (12.2%) were underweight, 84 (45.0%) normal weight, 37 (19.8%) overweight, and 43 (23.0%) obese. The underweight pregnant women had lower consumption of lipids when compared to the normal weight group (101.4 versus 137.3 g; p=0.043). The average iron intake was higher in normal weight pregnant women (14.6 mg/d) compared to the overweight (12.2 mg/d) or obese (10.9 mg/d; p<0.001) groups. The average intake of folate was higher in normal weight pregnant women compared to obese ones (336.5 µg/d versus 234.5 µg/d; p=0.002). Excessive maternal

/pdf/consumo-dietetico-de-gestantes-e-ganho-ponderal-materno-apos-3ttsnzzcjb.pdf

Consumo dietético de gestantes e ganho ponderal materno após aconselhamento

OBJETIVO: Descrever o resultado obstetrico de mulheres com sobrepeso/obesidade atendidas no servico de pre-natal de uma maternidade publica no Rio de Janeiro METODOS: Estudo do tipo descritivo transversal, tendo sido incluidas 433 puerperas (³20 anos, sem enfermidades cronicas) e seus respectivos recem-nascidos atendidos em maternidade publica do Rio de Janeiro As informacoes foram coletadas em prontuarios e por meio de entrevistas As caracteristicas maternas e dos recem-nascidos avaliadas foram agrupadas em maternas (habitos sociais, antropometricas, da assistencia pre-natal, clinicas e obstetricas) e dos recem-nascidos (condicoes ao nascer) A avaliacao da razao de chance entre as categorias de estado nutricional os desfechos gestacionais se deu por meio da odds ratio (OR), com intervalos de confianca (IC) de 95% RESULTADOS: A prevalencia de sobrepeso/obesidade nesta casuistica foi de 24,5% (n=106) Observou-se uma associacao entre ganho de peso inadequado e a frequencia de sobrepeso/obesidade (OR 2,7; IC95% 1,5-4,9; p<0,05) As mulheres com sobrepeso/obesidade apresentaram maior risco para pre-eclâmpsia (OR 3,3; IC95% 1,1-9,9; p=0,03) Quanto as condicoes ao nascimento, verificou-se peso medio ao nascer de 3291,3 g (±455,2), sendo as taxas de baixo peso de 4,7% (n=5) e macrossomia de 2,8% (n=3) CONCLUSOES: Observou-se uma prevalencia alarmante de inadequacao do estado nutricional pre e gestacional, que pode associar-se ao maior risco de morbimortalidade perinatal Com isso, sugere-se a necessidade de monitoramento nutricional dessas gestantes

/pdf/sobrepeso-e-obesidade-pre-gestacionais-prevalencia-e-292p1d5ldu.pdf

Sobrepeso e obesidade pré-gestacionais: prevalência e desfechos associados à gestação

PURPOSE: to analyze the association between maternal pre-gestational nutritional status and maternal outcomes - hypertensive disorders of pregnancy, gestational diabetes, vitamin A deficiency, and anemia - and the newborn outcome - low birth weight. METHODS: cross-sectional study, with 433 adult puerperal women (> 20 years old) and their newborns, attending the Maternidade Escola of Universidade Federal do Rio de Janeiro (UFRJ). Data was collected through interviews and access to their medical records. Maternal pre-gestational nutritional status was established through pre-gestational body mass index according to the cut-offs for adult women defined by the World Health Organization (WHO), in 1995. The association between gestational outcomes and pre-gestational nutritional status was estimated through odds ratio (OR) and a 95% confidence interval (95%CI). RESULTS: frequency of pre-gestational weight deviation (low weight, overweight and obesity) was 31.6%. Considering the pre-gestational nutritional status, overweight and obese women presented a lower weight gain than eutrophic and low-weight women (p<0.05). Women with pre-gestational obesity presented a higher risk of developing hypertensive disordens of pregnancy (OR=6.3; 95%CI=1.9-20.5) and those with low pre-gestational weight were more likely to give birth to low birth weigh infants (OR=7.1; 95%CI=1.9-27.5). There was no evidence of the association between pre-gestational nutritional status and the development of anemia, vitamin A deficiency and gestational diabetes. The mean weight gain among overweight and obese pregnant women was significantly lower when compared to eutrophic and low-weight pregnant women (p=0.002, p=0.049, p=0.002, p=0.009). CONCLUSIONS: the high number of women with pre-gestational weight deviation reinforces the importance of a nutritional guidance that favors a good nutritional state and reduces the risks of maternal and newborn adverse outcomes.

/pdf/associacao-entre-o-estado-nutricional-pre-gestacional-e-a-lnw30p3a0j.pdf

Enilce de Oliveira Fonseca Sally

Papers

Associação entre o estado nutricional pré-gestacional e a predição do risco de intercorrências gestacionais