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- Title
Variation in urine osmolality throughout pregnancy: a longitudinal, randomized-control trial among women with overweight and obesity.
- Authors
Rosinger, Asher Y.; Bethancourt, Hilary J.; Pauley, Abigail M.; Latona, Celine; John, Jason; Kelyman, Alysha; Leonard, Krista S.; Hohman, Emily E.; McNitt, Katherine; Gernand, Alison D.; Downs, Danielle Symons; Savage, Jennifer S.
- 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.
- Subjects
OBESITY treatment; HYDRATION; RESEARCH; STATURE; WEIGHT gain in pregnancy; REGULATION of body weight; DRINKING (Physiology); THIRD trimester of pregnancy; PREGNANT women; REGRESSION analysis; PREGNANCY outcomes; BIRTH weight; OSMOLAR concentration; URINALYSIS; SECOND trimester of pregnancy; SECONDARY analysis; HEALTH promotion; PREGNANCY
- Publication
European Journal of Nutrition, 2022, Vol 61, Issue 1, p127
- ISSN
1436-6207
- Publication type
Article
- DOI
10.1007/s00394-021-02616-x