Asher Y Rosinger1,2, Hilary J Bethancourt3, Abigail M Pauley4, Celine Latona3, Jason John3, Alysha Kelyman3, Krista S Leonard4, Emily E Hohman5, Katherine McNitt5,6, Alison D Gernand6, Danielle Symons Downs4,7, Jennifer S Savage5,6. 1. Department of Biobehavioral Health, Pennsylvania State University, 219 Biobehavioral Health Building, University Park, PA, 16802, USA. arosinger@psu.edu. 2. Department of Anthropology, Pennsylvania State University, University Park, PA, USA. arosinger@psu.edu. 3. Department of Biobehavioral Health, Pennsylvania State University, 219 Biobehavioral Health Building, University Park, PA, 16802, USA. 4. Exercise Psychology Laboratory, Department of Kinesiology, Pennsylvania State University, University Park, PA, USA. 5. Center for Childhood Obesity Research, Pennsylvania State University, University Park, PA, USA. 6. Department of Nutritional Sciences, Pennsylvania State University, University Park, PA, USA. 7. Department of Obstetrics and Gynecology, Penn State College of Medicine, Hershey, PA, USA.
Abstract
PURPOSE: Water needs increase during pregnancy, and proper hydration is critical for maternal and fetal health. This study characterized weekly hydration status changes throughout pregnancy and examined change in response to a randomized, behavioral intervention. An exploratory analysis tested how underhydration during pregnancy was associated with birth outcomes. METHODS: The Healthy Mom Zone Study is a longitudinal, randomized-control trial intervention aiming to regulate gestational weight gain (GWG) in pregnant women with overweight/obesity (n = 27). Fourteen women received standard of care; 13 women additionally received weekly guidance on nutrition, physical activity, water intake, and health-promoting behaviors. Hydration status was measured weekly via overnight urine osmolality (Uosm) from ~ 8-36 weeks gestation; underhydration was dichotomized (Uosm ≥ 500 mOsm/kg). Gestational age- and sex-standardized birth weight and length z scores and percentiles were calculated. We used mixed-effect and linear regression models to test covariate-adjusted relationships. RESULTS: No differences existed in Uosm or other characteristics between control and intervention women at baseline. Significant interactions (p = 0.01) between intervention and week of pregnancy on Uosm indicated intervention women maintained lower Uosm, whereas control women had a significant quadratic (inverse-U) relationship and greater Uosm in the second and early third trimesters. Results were consistent across robustness and sensitivity checks. Exploratory analyses suggest underhydration was associated with birth weight, but not length, in opposite ways in the second vs. third trimester. CONCLUSION: A multi-component behavioral intervention helped women with overweight/obesity maintain better hydration throughout pregnancy. Future studies should confirm birth outcome results as they have important implications for early life nutrition. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT03945266; registered May 10, 2019 retrospectively.
PURPOSE: Water needs increase during pregnancy, and proper hydration is critical for maternal and fetal health. This study characterized weekly hydration status changes throughout pregnancy and examined change in response to a randomized, behavioral intervention. An exploratory analysis tested how underhydration during pregnancy was associated with birth outcomes. METHODS: The Healthy Mom Zone Study is a longitudinal, randomized-control trial intervention aiming to regulate gestational weight gain (GWG) in pregnant women with overweight/obesity (n = 27). Fourteen women received standard of care; 13 women additionally received weekly guidance on nutrition, physical activity, water intake, and health-promoting behaviors. Hydration status was measured weekly via overnight urine osmolality (Uosm) from ~ 8-36 weeks gestation; underhydration was dichotomized (Uosm ≥ 500 mOsm/kg). Gestational age- and sex-standardized birth weight and length z scores and percentiles were calculated. We used mixed-effect and linear regression models to test covariate-adjusted relationships. RESULTS: No differences existed in Uosm or other characteristics between control and intervention women at baseline. Significant interactions (p = 0.01) between intervention and week of pregnancy on Uosm indicated intervention women maintained lower Uosm, whereas control women had a significant quadratic (inverse-U) relationship and greater Uosm in the second and early third trimesters. Results were consistent across robustness and sensitivity checks. Exploratory analyses suggest underhydration was associated with birth weight, but not length, in opposite ways in the second vs. third trimester. CONCLUSION: A multi-component behavioral intervention helped women with overweight/obesity maintain better hydration throughout pregnancy. Future studies should confirm birth outcome results as they have important implications for early life nutrition. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT03945266; registered May 10, 2019 retrospectively.
Authors: Matthew W Cooper; Molly E Brown; Stefan Hochrainer-Stigler; Georg Pflug; Ian McCallum; Steffen Fritz; Julie Silva; Alexander Zvoleff Journal: Proc Natl Acad Sci U S A Date: 2019-08-12 Impact factor: 11.205
Authors: Kimberly K Vesco; Njeri Karanja; Janet C King; Matthew W Gillman; Nancy Perrin; Cindy McEvoy; Cara Eckhardt; K Sabina Smith; Victor J Stevens Journal: Contemp Clin Trials Date: 2012-03-20 Impact factor: 2.226
Authors: Nancy F Butte; Kenneth J Ellis; William W Wong; Judy M Hopkinson; E O'Brian Smith Journal: Am J Obstet Gynecol Date: 2003-11 Impact factor: 8.661