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      Maternal Postpartum Distress and Childhood Overweight

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          Abstract

          Objective

          We investigated associations between maternal postpartum distress covering anxiety, depression and stress and childhood overweight.

          Methods

          We performed a prospective cohort study, including 21 121 mother-child-dyads from the Danish National Birth Cohort (DNBC). Maternal distress was measured 6 months postpartum by 9 items covering anxiety, depression and stress. Outcome was childhood overweight at 7-years-of age. Multiple logistic regression analyses were performed and information on maternal age, socioeconomic status, pre-pregnancy BMI, gestational weight gain, parity, smoking during pregnancy, paternal BMI, birth weight, gestational age at birth, sex, breastfeeding and finally infant weight at 5 and 12 month were included in the analyses.

          Results

          We found, that postpartum distress was not associated with childhood risk of overweight, OR 1.00, 95%CI [0.98–1.02]. Neither was anxiety, depression, or stress exposure, separately. There were no significant differences between the genders. Adjustment for potential confounders did not alter the results.

          Conclusion

          Maternal postpartum distress is apparently not an independent risk factor for childhood overweight at 7-years-of-age. However, we can confirm previous findings of perinatal determinants as high maternal pre-pregnancy BMI, and smoking during pregnancy being risk factors for childhood overweight.

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          Most cited references23

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          The Danish National Birth Cohort--its background, structure and aim.

          It is well known that the time from conception to early childhood has importance for health conditions that reach into later stages of life. Recent research supports this view, and diseases such as cardiovascular morbidity, cancer, mental illnesses, asthma, and allergy may all have component causes that act early in life. Exposures in this period, which influence fetal growth, cell divisions, and organ functioning, may have long-lasting impact on health and disease susceptibility. To investigate these issues the Danish National Birth Cohort (Better health for mother and child) was established. A large cohort of pregnant women with long-term follow-up of the offspring was the obvious choice because many of the exposures of interest cannot be reconstructed with sufficient validity back in time. The study needs to be large, and it is aimed to recruit 100,000 women early in pregnancy, and to continue follow-up for decades. The Nordic countries are better suited for this kind of research than most other countries because of their population-based registers on diseases, demography and social conditions, linkable at the individual level by means of the unique ID-number given to all citizens. Exposure information is mainly collected by computer-assisted telephone interviews with the women twice during pregnancy and when their children are six and 18 months old. Participants are also asked to fill in a self-administered food frequency questionnaire in mid-pregnancy. Furthermore, a biological bank has been set up with blood taken from the mother twice during pregnancy and blood from the umbilical cord taken shortly after birth. Data collection started in 1996 and the project covered all regions in Denmark in 1999. By August 2000. a total of 60,000 pregnant women had been recruited to the study. It is expected that a large number of gene-environmental hypotheses need to be based on case-control analyses within a cohort like this.
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            Combined associations of prepregnancy body mass index and gestational weight gain with the outcome of pregnancy.

            Although both maternal prepregnancy body mass index (BMI) and gestational weight gain (GWG) may affect birth weight, their separate and joint associations with complications of pregnancy and delivery and with postpartum weight retention are unclear. We aimed to investigate the combined associations of prepregnancy BMI and GWG with pregnancy outcomes and to evaluate the trade-offs between mother and infant for different weight gains. Data for 60892 term pregnancies in the Danish National Birth Cohort were linked to birth and hospital discharge registers. Self-reported total GWG was categorized as low ( or=20 kg). Adjusted associations of prepregnancy BMI and GWG with outcomes of interest were estimated by logistic regression analyses. High and very high GWG added to the associations of high prepregnancy BMI with cesarean delivery and were strongly associated with high postpartum weight retention. Moreover, greater weight gains and high maternal BMI decreased the risk of growth restriction and increased the risk of the infant's being born large-for-gestational-age or with a low Apgar score. Generally, low GWG was advantageous for the mother, but it increased the risk of having a small baby, particularly for underweight women. Heavier women may benefit from avoiding high and very high GWG, which brings only a slight increase in the risk of growth restriction for the infant. High weight gain in underweight women does not appear to have deleterious consequences for them or their infants, but they may want to avoid low GWG to prevent having a small baby.
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              Prevalence of overweight among children in Europe.

              Estimates of the prevalence of childhood overweight and obesity have been made in several European countries during the last decade. The methods used and the assessment criteria differ from survey to survey. The present paper reports the prevalence data from 21 surveys in Europe using a single, internationally accepted definition of overweight in childhood, allowing direct comparisons to be made. A tendency for a higher prevalence of overweight among children in western and especially southern Europe is shown and some possible reasons for this are discussed.
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                Author and article information

                Contributors
                Role: Editor
                Journal
                PLoS One
                plos
                plosone
                PLoS ONE
                Public Library of Science (San Francisco, USA )
                1932-6203
                2010
                30 June 2010
                : 5
                : 6
                : e11136
                Affiliations
                [1 ]Institute of Preventive Medicine, Copenhagen University Hospital, Copenhagen, Denmark
                [2 ]Department of Epidemiology, Institute of Public Health, University of Aarhus, Aarhus, Denmark
                Mayo Clinic, United States of America
                Author notes

                Conceived and designed the experiments: TAA CSA EAN TIAS. Analyzed the data: TAA. Contributed reagents/materials/analysis tools: TIAS. Wrote the paper: TAA CSA KGI EAN TIAS.

                Article
                10-PONE-RA-15999R1
                10.1371/journal.pone.0011136
                2894862
                20614031
                fffedb1a-c9c5-4a40-aea7-1d6f11f87ff6
                Ajslev et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
                History
                : 3 February 2010
                : 13 May 2010
                Page count
                Pages: 8
                Categories
                Research Article
                Pediatrics and Child Health
                Diabetes and Endocrinology/Obesity
                Mental Health/Mood Disorders
                Obstetrics/Breast Feeding
                Obstetrics/Postpartum Care
                Public Health and Epidemiology/Social and Behavioral Determinants of Health

                Uncategorized
                Uncategorized

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