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Pregnancy and Breastfeeding: Health of Mother, Children through Lifespan

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A special issue of Medicina (ISSN 1648-9144). This special issue belongs to the section "Obstetrics and Gynecology".

Deadline for manuscript submissions: closed (20 August 2023) | Viewed by 34392

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Special Issue Editors

Prof. Dr. Dimitrios Papandreou

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Guest Editor

Department of Clinical Nutrition and Dietetics, College of Health Sciences, University of Sharjah, Sharjah, United Arab Emirates
Interests: pregnancy; breastfeeding; obesity; cardiovascular risk factors; vitamin D deficiency; public health nutrition

Dr. Stefanos Tyrovolas

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Guest Editor

1. Department of Nutrition and Food Studies, George Mason University, Fairfax, VA, USA
2. School of Nursing, The Hong Kong Polytechnic University, Kowloon GH506, Hong Kong
Interests: nutrition; successful and healthy aging; frailty; sarcopenia; chronic diseases
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Special Issue Information

Dear Colleagues,

Childhood obesity is a worldwide epidemic. The number of overweight children is expected to rise by 1.3 million per year, with more than 300,000 of these children becoming obese each year. During pregnancy risk factors such as physical activity, diet, socioeconomic factors, alcohol consumption and smoking may play an important role in the health, development, and BMI status of the offspring in the future. Maternal obesity, GWG, birth weight, pregnancy smoking status, alcohol consumption, gestational diabetes and breast feeding have been found to be connected pediatric obesity. Breastfeeding also has a positive background on the maternal health. The literature has suggested that long-term breastfeeding may reduce the risk of many health issues such as hypertension, hyperlipidemia, type 2 diabetes, sarcopenia and healthy ageing.

In this Special Issue, we are aimed to receive high-quality papers that provide new evidence related to pregnancy and breastfeeding in relation to short- and long-term health consequences. Topics should include, but are not limited to:

Pregnancy;
Breastfeeding;
Pediatric obesity;
Perinatal factors;
Sarcopenia;
Dietary intake;
Cardiovascular risk factors;
Maternal risk factors.

Prof. Dr. Dimitrios Papandreou
Dr. Stefanos Tyrovolas
Guest Editors

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Keywords

pregnancy
breastfeeding
overweight
obesity
maternal risk factors
sarcopenia

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Published Papers (9 papers)

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Research

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19 pages, 674 KiB

Open AccessArticle

Association of Gestational Hypertension with Sociodemographic and Anthropometric Factors, Perinatal Outcomes, Breastfeeding Practices, and Mediterranean Diet Adherence: A Cross-Sectional Study

by Eleni Pavlidou, Sousana K. Papadopoulou, Olga Alexatou, Gerasimos Tsourouflis, Georgios Antasouras, Aikaterini Louka, Ioanna P. Chatziprodromidou, Maria Mentzelou, Anastasia Sampani, Maria Chrysafi, Thomas Apostolou, Antonios Dakanalis, Vasiliki G. Papadopoulou and Constantinos Giaginis

Medicina 2023, 59(12), 2103; https://doi.org/10.3390/medicina59122103 - 30 Nov 2023

Cited by 1 | Viewed by 1705

Abstract

Background and Objectives: Gestational hypertension has been associated with several pregnancy short-term and long-term complications, affecting both the mother and her infant’s health. The present study aims to assess the potential association of gestational hypertension with sociodemographic and anthropometry factors, perinatal outcomes, breastfeeding habits, and Mediterranean diet (MD) compliance. Materials and Methods: This is a cross-sectional study conducted on 5271 mothers that was carried out after delivery. The anthropometry characteristics and perinatal outcomes were retrieved from the mothers’ medical records. Sociodemographic characteristics, MD adherence, and breastfeeding habits were assessed via one-to-one interviews of the assigned women with qualified staff. Results: Maternal older age, being employed, family history of gestational hypertension, overweight/obesity before gestation, and abnormal gestational weight gain (GWG) independently increased the risk of developing gestational hypertension. Moreover, gestational hypertension was independently related with a greater incidence of abnormal childbirth body weight and preterm birth, not exclusively breastfeeding, and lower levels of MD adherence. Conclusions: This study highlights the importance of informing future mothers about the risk factors of gestational hypertension, underlining also that a healthy lifestyle, which simultaneously includes a healthy nutritional pattern such as MD, may decrease the risk of developing gestational hypertension and the subsequent pregnancy complications. Full article

(This article belongs to the Special Issue Pregnancy and Breastfeeding: Health of Mother, Children through Lifespan)

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12 pages, 307 KiB

Open AccessArticle

Assessing Health Care Providers’ Knowledge and Practices of Nutrition during Pregnancy in Lebanon: A Cross-Sectional Study

by Jessy Rizk, Eleni Andreou, Dona Hileti, Ali Ghaddar and Antonis Zampelas

Medicina 2023, 59(8), 1471; https://doi.org/10.3390/medicina59081471 - 16 Aug 2023

Cited by 1 | Viewed by 2237

Abstract

Background and objectives: Health care professionals (HCPs) are well-positioned to discuss healthy behaviors during pregnancy, but the published research of prenatal healthcare providers’ knowledge about the significance of nutrition during pregnancy in Lebanon is scarce. The purpose of this study was to explore the knowledge, attitudes, and practices of Lebanese prenatal healthcare providers towards nutrition during pregnancy. Materials and Methods: A cross-sectional study using an online questionnaire was conducted. Health care providers were contacted by phone and email to participate in the online survey. A list of all clinics providing antenatal health services was obtained from the Order of Physicians and the Order of Midwives. A multistage random sample was selected. In the first stage, it was stratified per region (Beirut center or suburbs, and the southern region). In the second phase, it was stratified per clinic type (private, primary healthcare center, or hospital). Gynecologists and midwives who are members of the Order of Physicians and the Order of Midwives (n = 1333), were included. Results: Two-hundred and six responses (55% males) were obtained. Approximately 44% of the HCP were aged 50 and older, and 68.4% had more than 10 years of work experience. HCPs from Beirut represented 41.3% of the respondents. Eighty-eight percent of the HCPs were physicians, and 11% were midwives. The majority of the participants considered nutrition during pregnancy to be very important. Furthermore, half of these participants considered their position in delivering nutrition information as very significant. Most of the respondents reported that they provide nutrition advice to pregnant women, and they also received nutrition education during their profession. However, they perceived their nutrition knowledge as inadequate. Conclusion: Health care providers’ attitude towards the importance of maternal nutrition and their confidence in talking about nutrition-related topics with pregnant women were positive despite the lack of knowledge in several areas related to nutrition during pregnancy. Therefore, there is a need for continuing nutrition education for health care providers and the implementation of nutrition education programs to achieve better health outcomes. Full article

(This article belongs to the Special Issue Pregnancy and Breastfeeding: Health of Mother, Children through Lifespan)

13 pages, 353 KiB

Open AccessArticle

Caesarean Section Delivery Is Associated with Childhood Overweight and Obesity, Low Childbirth Weight and Postnatal Complications: A Cross-Sectional Study

by Sousana K Papadopoulou, Maria Mentzelou, Eleni Pavlidou, Georgios K Vasios, Maria Spanoudaki, Georgios Antasouras, Anastasia Sampani, Evmorfia Psara, Gavriela Voulgaridou, Gerasimos Tsourouflis, Maria Mantzorou and Constantinos Giaginis

Medicina 2023, 59(4), 664; https://doi.org/10.3390/medicina59040664 - 27 Mar 2023

Cited by 3 | Viewed by 2229

Abstract

Background and Objectives: In the last decades, simultaneously increasing trends have been recorded for both caesarean section delivery and childhood overweight/obesity around the world, which are considered serious public health concerns, negatively affecting child health. Aim: The present study aims to investigate whether caesarean section is associated with the increased rates of childhood overweight/obesity, low childbirth anthropometric indices and postnatal complications in pre-school age. Materials and Methods: This is a cross-sectional study in which 5215 pre-school children aged 2–5 years old were enrolled from nine different Greek regions after applying specific inclusion and exclusion criteria. Non-adjusted and adjusted statistical analysis was performed to assess the impact of caesarean section in comparison to vaginal delivery. Results: Children delivered by caesarean section were significantly more frequently overweight or obese at the age of 2–5 years, also presenting a higher prevalence of low birth weight, length and head circumference. Caesarean section was also associated with higher incidence of asthma and diabetes type I at the age of 2–5 years. In a multivariate analysis, caesarean section increased the risk of childhood overweight/obesity and low childbirth anthropometric indices even if adjusting for several childhood and maternal confounding factors. Conclusions: Increasing trends were recorded for both caesarean section delivery and childhood overweight/obesity, which are considered serious public health concerns. Caesarean section independently increased childhood overweight/obesity in pre-school age, highlighting the emergent need to promote health policies and strategies to inform future mothers about its short and long-term risks and that this mode of delivery should preferably be performed only when there are strong medical recommendations in emergency obstetric conditions. Full article

(This article belongs to the Special Issue Pregnancy and Breastfeeding: Health of Mother, Children through Lifespan)

14 pages, 620 KiB

Open AccessArticle

Maternal Gestational Diabetes Is Associated with High Risk of Childhood Overweight and Obesity: A Cross-Sectional Study in Pre-School Children Aged 2–5 Years

by Maria Mantzorou, Dimitrios Papandreou, Eleni Pavlidou, Sousana K. Papadopoulou, Maria Tolia, Maria Mentzelou, Antigoni Poutsidi, Georgios Antasouras, Georgios K. Vasios and Constantinos Giaginis

Medicina 2023, 59(3), 455; https://doi.org/10.3390/medicina59030455 - 24 Feb 2023

Cited by 8 | Viewed by 6024

Abstract

Background and Objectives: Childhood obesity is a global public health concern with long-term and serious health implications. An important factor for childhood obesity is maternal gestational diabetes mellitus (GDM), which in turn impacts maternal and offspring long-term health. This study aimed to investigate the associations between maternal GDM and childhood weight status and multiple anthropometric and sociodemographic factors and perinatal outcomes. Materials and Methods: A total of 5348 children aged 2–5 years old and their paired mothers took part in the study. Questionnaires were utilized to evaluate the sociodemographic factors and perinatal outcomes as well as smoking habits, educational level, economic status, age, and parity status. Children’s anthropometric parameters were measured, and maternal medical history, preterm birth records, and anthropometric measures during pregnancy were retrieved by their medical records. Results: Overall, 16.4% of the children aged at 2–5 years were overweight, and 8.2% of them were affected by obesity, leading to a total 24.6% of children with overweight/obesity. Further, 5.5% of the enrolled mothers were diagnosed with gestational diabetes mellitus. GDM doubles the probability of childhood overweight/obesity at ages 2–5 years old independently of multiple confounding factors. Pre-pregnancy overweight and obesity, older maternal age, and smoking are risk factors for GDM, while GDM additionally increases the risk of preterm birth. Children of mothers that developed GDM were at greater risk of overweight or obesity, with the association between GDM and offspring’s weight status being independent of confounding factors. Conclusions: GDM is a severe public health issue with prolonged complications for both the mother and their children. Public health approaches and programs need to promote the negative role of pre-pregnancy weight and smoking status as well as the significance of a good glycemic control throughout gestation in women of childbearing age. Full article

(This article belongs to the Special Issue Pregnancy and Breastfeeding: Health of Mother, Children through Lifespan)

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13 pages, 981 KiB

Open AccessArticle

Relation of Maternal Pre-Pregnancy Factors and Childhood Asthma: A Cross-Sectional Survey in Pre-School Children Aged 2–5 Years Old

by Dimitrios Papandreou, Eleni Pavlidou, Stefanos Tyrovolas, Maria Mantzorou, Eleni Andreou, Evmorfia Psara, Georgios Antasouras, Georgios K. Vasios, Efthymios Poulios and Constantinos Giaginis

Medicina 2023, 59(1), 179; https://doi.org/10.3390/medicina59010179 - 16 Jan 2023

Cited by 3 | Viewed by 2814

Abstract

Background and Objectives: Asthma constitutes a constant, prolonged, inflammation-related pulmonary disorder in childhood with serious public health concerns. Several maternal risk factors can enhance the prevalence of its development in this stage of life; however, the currently available data remain contradictory and/or inconsistent. We aim to evaluate the potential impacts of mothers’ sociodemographic, anthropometric and prenatal and perinatal factors on the prevalence of developing asthma in pre-school children. Materials and Methods: This is a retrospective cross-sectional survey, which includes 5133 women and their matched pre-school children. Childhood asthma was diagnosed using validated questionnaires. Statistical analysis was accomplished to evaluate whether maternal sociodemographic, anthropometric and prenatal and perinatal factors can increase the probability of childhood asthma in pre-school age. Results: A prevalence of 4.5% of childhood asthma was recorded in pre-school age. Maternal age and pre-pregnancy overweight and obesity, caesarean section, gestational diabetes and hypertension and not breastfeeding were associated with childhood asthma after adjustment for multiple confounding factors. Conclusion: Our research showed that several maternal factors increase the prevalence of childhood asthma in pre-school age. Suitable and effective health policies and strategies should be taken into account to confront the predominant maternal factors that increase its prevalence in pre-school age. Full article

(This article belongs to the Special Issue Pregnancy and Breastfeeding: Health of Mother, Children through Lifespan)

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12 pages, 1311 KiB

Open AccessArticle

Associations between Vitamin D Deficiency and Carbohydrate Intake and Dietary Factors in Taiwanese Pregnant Women

by Chao-Hsu Lin, Pei-Shun Lin, Meei-Shyuan Lee, Chien-Yu Lin, Yi-Hsiang Sung, Sung-Tse Li, Shun-Long Weng, Shing-Jyh Chang, Hung-Chang Lee, Yann-Jinn Lee, Hung-Yang Chang and Chih-Sheng Lin

Medicina 2023, 59(1), 107; https://doi.org/10.3390/medicina59010107 - 3 Jan 2023

Cited by 1 | Viewed by 2686

Abstract

This cross-sectional observation study investigated the vitamin D (VD) status in Taiwanese pregnant women and the effects of VD supplementation and macronutrient intake on serum 25-hydroxy-vitamin D (25[OH]D) level. Data on VD intake, daily sunlight exposure, and carbohydrate intake were obtained from 125 pregnant women at 30–37 weeks’ gestation. Serum 25[OH]D level was measured before delivery in all enrolled women; and the mean 25(OH)D level was 43 nmol/L or 17.2 ng/mL. The 25(OH)D level was significantly correlated with total VD intake of pregnant women (r = 0.239; p = 0.007). The severe VD deficiency group (n = 16; mean of 25(OH)D level = 8.5 ng/mL) had significantly lower total VD intake and supplementation than the groups with VD deficiency (n = 69), insufficiency (n = 32), and sufficiency (n = 8). Those with ≥400 IU/day total VD intake (including VD from food and supplementation) had significantly higher 25(OH)D concentration than those with <400 IU/day total VD intake. Those with 400 IU/day VD supplementation could significantly increase serum 25(OH)D concentrations for pregnant women. Among 85 pregnant women with carbohydrate intake of ≥300 g/day, serum 25(OH)D levels were negatively correlated with carbohydrate intake (p = 0.031). In conclusion, VD deficiency was highly prevalent in Taiwanese pregnant women. VD supplementation was the most effective method for increasing 25(OH)D concentration in pregnant women. Higher carbohydrate intake might reduce 25(OH)D levels. Full article

(This article belongs to the Special Issue Pregnancy and Breastfeeding: Health of Mother, Children through Lifespan)

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Review

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15 pages, 1367 KiB

Open AccessReview

Potential Protective Role of Pregnancy and Breastfeeding in Delaying Onset Symptoms Related to Multiple Sclerosis

by Alessandra Logoteta, Maria Grazia Piccioni, Riccardo Nistri, Laura De Giglio, Valentina Bruno, Giuseppe La Torre, Stefano Ianni, Luana Fabrizi, Ludovico Muzii, Carlo Pozzilli and Serena Ruggieri

Medicina 2023, 59(3), 619; https://doi.org/10.3390/medicina59030619 - 20 Mar 2023

Cited by 1 | Viewed by 2608

Abstract

The impact of pregnancy and breastfeeding on the development and outcomes of Multiple sclerosis (MS) has been debated for decades. Since several factors can influence the evolution of the disease, the protective role of multiparity and breastfeeding remains uncertain, as well the role of hormone replacement therapy in the perimenopausal period. We report two cases of relatively late-onset MS in two parous women, who developed their first neurological symptoms after six and nine pregnancies, respectively. Both women breastfed each of their children for 3 to 12 months. One of them underwent surgical menopause and received hormone replacement therapy for 7 years before MS onset. We performed a systematic literature review to highlight the characteristics shared by women who develop the disease in similar conditions, after unique hormonal imbalances, and to collect promising evidence on this controversial issue. Several studies suggest that the beneficial effects of pregnancy and breastfeeding on MS onset and disability accumulation may only be realized when several pregnancies occur. However, these data on pregnancy and breastfeeding and their long-term benefits on MS outcomes suffer from the possibility of reverse causality, as women with milder impairment might choose to become pregnant more readily than those with a higher level of disability. Thus, the hypothesis that multiparity might have a protective role on MS outcomes needs to be tested in larger prospective cohort studies of neo-diagnosed women, evaluating both clinical and radiological features at presentation. Full article

(This article belongs to the Special Issue Pregnancy and Breastfeeding: Health of Mother, Children through Lifespan)

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15 pages, 728 KiB

Open AccessReview

The Role of Lifestyle Interventions in the Prevention and Treatment of Gestational Diabetes Mellitus

by Hala Zakaria, Salah Abusanana, Bashair M. Mussa, Ayesha S. Al Dhaheri, Lily Stojanovska, Maysm N. Mohamad, Sheima T. Saleh, Habiba I. Ali and Leila Cheikh Ismail

Medicina 2023, 59(2), 287; https://doi.org/10.3390/medicina59020287 - 1 Feb 2023

Cited by 12 | Viewed by 6406

Abstract

Gestational diabetes mellitus (GDM) is one of the most common pregnancy-related endocrinopathies, affecting up to 25% of pregnancies globally. GDM increases the risk of perinatal and delivery complications, and the chance of developing type 2 diabetes mellitus and its complications, including cardiovascular diseases. This elevated risk is then passed on to the next generation, creating a cycle of metabolic dysfunction across generations. For many years, GDM preventive measures have had inconsistent results, but recent systematic reviews and meta-analyses have identified promising new preventative routes. This review aims to summarize the evidence investigating the efficacy of lifestyle treatments for the prevention of GDM and to summarize the effects of two lifestyle interventions, including physical activity and dietary interventions. Based on the present research, future studies should be conducted to investigate whether initiating lifestyle interventions during the preconception period is more beneficial in preventing GDM. In addition, research targeting pregnancy should be designed with a personalized approach. Therefore, studies should customize intervention approaches depending on the presence of modifiable and non-modifiable risk factors at the individual level. Full article

(This article belongs to the Special Issue Pregnancy and Breastfeeding: Health of Mother, Children through Lifespan)

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Other

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8 pages, 1041 KiB

Open AccessCase Report

Pregnancy and Lactation-Associated Osteoporosis Successfully Treated with Romosozumab: A Case Report

by Yoichi Kaneuchi, Masumi Iwabuchi, Michiyuki Hakozaki, Hitoshi Yamada and Shin-ichi Konno

Medicina 2023, 59(1), 19; https://doi.org/10.3390/medicina59010019 - 22 Dec 2022

Cited by 11 | Viewed by 6703

Abstract

Pregnancy- and lactation-associated osteoporosis (PLO) is a rare type of premenopausal osteoporosis that occurs mainly in the third trimester or immediately after delivery; one of its most common symptoms is back pain caused by a vertebral fracture. The pathogenesis of PLO is unclear, and there is no accepted consensus regarding the treatment of PLO. Although treatments with drugs such as bisphosphonate, strontium ranelate, denosumab, and teriparatide were reported, there is no report of a patient with PLO treated with romosozumab. We present the first case of a patient with PLO treated with romosozumab following 4-month teriparatide treatment. A 34-year-old primiparous and breastfeeding Japanese woman experienced severe low back pain 1 month postdelivery. She was diagnosed with PLO on the basis of low bone marrow density (BMD) and multiple vertebral fractures with no identified cause of secondary osteoporosis. She was treated with teriparatide injection for 4 months, but the treatment was discontinued because of the patient feeling severe nausea after every teriparatide injection and the appearance of new vertebral fractures. Thereafter, we used romosozumab for 12 months. After the romosozumab treatment, her BMD was increased from the baseline by 23.6% at L1–L4, 6.2% at the femoral neck, and 11.2% at the total hip. Treating PLO with 12-month romosozumab after 4 months of teriparatide injection remarkably increased the BMD of the lumbar spine, femoral neck, and total hip without subsequent fracture. Romosozumab has potential as a therapeutic option to improve the BMD and reduce the subsequent fracture risk of patients with PLO. Full article

(This article belongs to the Special Issue Pregnancy and Breastfeeding: Health of Mother, Children through Lifespan)

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