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Maternal overweight is a risk factor for gestational diabetes (GDM) and for newborn macrosomia. Among women without GDM, it is not well understood why some women with high body mass index (BMI) give birth to macrosomic newborns while... more
Maternal overweight is a risk factor for gestational diabetes (GDM) and for newborn macrosomia. Among women without GDM, it is not well understood why some women with high body mass index (BMI) give birth to macrosomic newborns while others do not. We wanted to explore the effect of BMI and fasting plasma glucose (FPG), fasting plasma insulin (FPI) and insulin resistance (HOMA-IR) on the risk of newborn macrosomia. A cohort of 553 Caucasian women was followed throughout pregnancy. The dependent variable was high birth weight (>or=4200 g). Independent variables included gestational age, intake of macronutrients and energy, maternal BMI, weight gain, FPG, FPI and HOMA-IR. FPG in late pregnancy (30-32 weeks) remained a significant determinant of newborn macrosomia in multiple regression analysis (OR: 1.9, 95% CI: [1.1, 3.4]), whereas FPI and HOMA-IR did not. The women in the highest BMI quartile (>or=27 kg/m(2)) who gave birth to macrosomic newborns had higher increase in FPG and HOMA-IR from early to late pregnancy. Among women in this BMI category, the risk for delivering a macrosomic infant was higher among those with an increase in FPG above 0.60 mmol/l (upper quartile) (OR = 4.5, 95% CI: [1.7, 12.5]). Fasting plasma glucose at week 30-32, but not fasting plasma insulin or insulin resistance, is a determinant of newborn macrosomia. Overweight women with high increase in fasting plasma glucose from early to late pregnancy had a 4.5-fold increase in risk of newborn macrosomia compared to the remaining group with high BMI.
Research Interests: Endocrinology, Obstetrics, Medicine, Birth Weight, Insulin Resistance, and 15 moreGestational diabetes, Pregnancy, Overweight, Humans, Blood Glucose, Insulin, Glucose Metabolism, Fasting, Female, Maternal, Body Mass Index, Gestational Age, Logistic Models, Pregnancy complications, and Paediatrics and reproductive medicine
Background: In 2011 Norway granted undocumented women the right to antenatal care and to give birth at a hospital but did not include them in the general practitioner and reimbursement schemes. As a response to limited access to health... more
Background: In 2011 Norway granted undocumented women the right to antenatal care and to give birth at a hospital but did not include them in the general practitioner and reimbursement schemes. As a response to limited access to health care, Non-Governmental Organizations (NGO) have been running health clinics for undocumented migrants in Norway’s two largest cities. To further facilitate universal health coverage, there is a need to investigate how pregnant undocumented women use NGO clinics and how this affects their maternal health. We therefore investigated the care received, occurrence of pregnancy-related complications and pregnancy outcomes in women receiving antenatal care at these clinics.Methods: In this historic cohort study we included pregnant women aged 18-49 attending urban NGO clinics from 2009-2020 and retrieved their medical records from referral hospitals. We compared women based on region of origin using log-binominal regression to estimate relative risk of adver...
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Kapitlet belyser hva hjemmefødende kvinner og jordmødre forteller om fødselsopplevelsen og om samspillet mellom mor, far og jordmor. Kapitlet bygger på en ny empirisk studie av sju fødekvinners narrativer og sju jordmødres... more
Kapitlet belyser hva hjemmefødende kvinner og jordmødre forteller om fødselsopplevelsen og om samspillet mellom mor, far og jordmor. Kapitlet bygger på en ny empirisk studie av sju fødekvinners narrativer og sju jordmødres hjemmefødselserfaringer. Forfatterne undersøker hvordan de, basert på fødekvinners subjektive erfaringer, kan forstå fenomenet hjemmefødsel i lys av estetikk og et stedsfilosofisk forankret folkehelseperspektiv. Studien viser at hjemmefødselen fremtrer som en stedlig estetisk erfaring preget av kropp, natur og kultur. Informantene formidler at det å leve og å føde handler om å risikere. Forfatterne finner at det å føde hjemme innebærer en bred forståelse av risiko, ansvar og medbestemmelse, men også av feiring, fellesskap og ontologisk trygghet
Background Prolonged labor might contribute to a negative birth experience and influence first-time mothers’ attitudes towards future pregnancies. Previous studies have not adjusted for possible confounding factors, such as operative... more
Background Prolonged labor might contribute to a negative birth experience and influence first-time mothers’ attitudes towards future pregnancies. Previous studies have not adjusted for possible confounding factors, such as operative delivery, induction and postpartum hemorrhage. We aimed to determine the impact of prolonged labor on birth experience and a wish for cesarean section in subsequent pregnancies. Methods A survey including the validated “Childbirth Experience Questionnaire”. First-time mothers giving birth between 2012 and 2014 at a Norwegian university hospital participated. Data from deliveries were collected. Regression analysis and thematic content analysis were performed. Results 459 (71%) women responded. Women with labor duration > 12 h had significantly lower scores on two out of four sub-items of the questionnaire: own capacity (p = 0.040) and perceived safety (p = 0.023). Other factors contributing to a negative experience were: Cesarean section vs vaginal b...
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Caesarean section (CS) on maternal request is increasing. There is a need to understand why, and find measures to help women give birth vaginally. The purpose of this study was to compare the rate of complications in the first birth of... more
Caesarean section (CS) on maternal request is increasing. There is a need to understand why, and find measures to help women give birth vaginally. The purpose of this study was to compare the rate of complications in the first birth of 129 second time mothers wanting caesarean section with the rate of complications in the general population; to determine how many changed their mind and wanted to give birth vaginally when given the opportunity to know their midwife in advance; and to examine whether there were any differences in the prevalence of health problems and labour complications between the known midwife group and those maintaining their wish for a CS . A quantitative study based on data from The Medical Birth Registry and from medical records was carried out. The findings show that 129 women had experienced significantly more complications than the general population during their first birth. Among the 48 women joining the ‘known midwife group’, 81% gave birth vaginally. The...
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Research Interests: Obstetrics and Medicine
OBJECTIVES Undocumented migrant children (UMC) are often affected by policies and practices that do not take their best interests into account. The aim of this study was to describe how public health nurses (PHNs) experienced challenges... more
OBJECTIVES Undocumented migrant children (UMC) are often affected by policies and practices that do not take their best interests into account. The aim of this study was to describe how public health nurses (PHNs) experienced challenges and dilemmas in ensuring the best interests of the undocumented migrant child. DESIGN This study had a qualitative descriptive design. SAMPLE Focus group interviews and semi-structured interviews were conducted with seven PHNs in four different child health centers (CHCs). RESULTS Qualitative content analysis was applied. Three main themes were identified: building trust, ensuring the best interests of the child, and dilemmas and challenges in ensuring the best interests of the child. The study revealed examples of immigration policy being prioritized over the best interests of the child. PHNs experienced frustration when the best interests of the child were not taken into account. Strategies for managing these conflicting demands were identified. CONCLUSION Conflicting demands appeared when national immigration policies collided with fundamental human rights and ethical standards. Rules that exclude certain groups are incompatible with PHNs professional ethics.
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It is established that the level of physical activity in the population generally is too low, and data indicate that pregnant women are no exception. Studies of the effects of aerobic fitness on delivery outcomes are limited. In this... more
It is established that the level of physical activity in the population generally is too low, and data indicate that pregnant women are no exception. Studies of the effects of aerobic fitness on delivery outcomes are limited. In this observational study, we investigated the effect of aerobic fitness on duration of labor in nulliparous women who started labor spontaneously. Maximal oxygen uptake was measured in 40 nulliparous women at 35-37 weeks of gestation. Duration of labor was defined as the time between 3 cm cervical dilation with regular uterine contractions and delivery. The mean (SD) maximal oxygen uptake was 2.1 (0.3) L/min and duration of labor 583 (317) minutes. Duration of labor was inversely associated with maximal oxygen uptake after adjusting for birthweight (p = 0.034). We conclude that measurement of maximal oxygen uptake is safe in pregnancy at 35-37 weeks and that increased aerobic fitness was associated with shorter labor in nulliparous women who started labor spontaneously.
Research Interests: Obstetrics, Fitness, Pregnancy, Humans, Female, and 15 moreDuration, Young Adult, Risk factors, Physical Fitness, Gynecology, Adult, Public health systems and services research, Time Factors, Risk Factors, Parity, Gestation, Oxygen Consumption, Exercise Tolerance, Cohort Studies, and Paediatrics and reproductive medicine
Glucose intolerance in pregnancy predicts an increased risk of future type 2 diabetes. The aim of the study was to evaluate glucose metabolism in women with and without gestational diabetes mellitus (GDM) at 5 years follow-up and identify... more
Glucose intolerance in pregnancy predicts an increased risk of future type 2 diabetes. The aim of the study was to evaluate glucose metabolism in women with and without gestational diabetes mellitus (GDM) at 5 years follow-up and identify risk factors associated with disturbed glucose metabolism post partum. This follow-up study included 300 consecutively enrolled women from a previous population-based cohort study. The participants underwent oral glucose tolerance test under pregnancy and at the follow-up study, in addition to dual-energy x-ray absorptiometry at the follow-up study. Fifty-two women (17.7 %) were found to have GDM in pregnancy with an odds ratio of 4.8 developing prediabetes 5 years later. β-cell function, but not insulin resistance or sensitivity, was reduced in the follow-up study after adjusting for known risk factors. Furthermore, visceral fat content at follow-up was increased in GDM women compared to non-GDM women, and the β-cell function declined with increas...
Research Interests: Insulin Resistance, Gestational diabetes, Prospective studies, Pregnancy, Humans, and 12 moreFemale, Follow-up studies, Risk factors, Clinical Sciences, Middle Aged, Adult, Risk Factors, Glucose Tolerance Test, Glucose Intolerance, Cohort Studies, Paediatrics and reproductive medicine, and prediabetic state
Objectives: (1) To evaluate the proportion who correctly classify- or misclassify maternal weight gain; (2) to investigate weight gain attitudes, and (3) to compare weight gain attitudes with weight gain recommendations by the Institute... more
Objectives: (1) To evaluate the proportion who correctly classify- or misclassify maternal weight gain; (2) to investigate weight gain attitudes, and (3) to compare weight gain attitudes with weight gain recommendations by the Institute of Medicine (IOM), as well as background and lifestyle factors. Methods: This is secondary analysis of cohort data collected as part of a prospective study of determinants of macrosomic infants in Norway (the STORKproject). The participants (n = 467) answered a self-administered questionnaire, including report on maternal weight gain and attitudes towards weight gain, in mean gestation week 36.4 (SD = 1.7). The women were also weighted (kg) at the hospital using a digital beam scale. Results: A significant discrepancy was found between self-reported and measured maternal weight gain. About 76% reported to be satisfied with maternal weight gain while 24% were dissatisfied. Women reporting to be dissatisfied were significantly more likely to be sedenta...
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The transtheoretical model (TTM) has been successful in promoting health behavioral change in the general population. However, there is a scant knowledge about physical activity in relation to the TTM during pregnancy. Hence, the aims of... more
The transtheoretical model (TTM) has been successful in promoting health behavioral change in the general population. However, there is a scant knowledge about physical activity in relation to the TTM during pregnancy. Hence, the aims of the present study were (1) to assess readiness to become or stay physically active according to the TTM and (2) to compare background and health variables across the TTM. Healthy pregnant women (n = 467) were allocated to the study from Oslo University Hospital, Norway. The participants filled in a validated self-administered questionnaire, physical activity pregnancy questionnaire (PAPQ) in gestation, weeks 32-36. The questionnaire contained 53 questions with one particular question addressing the TTM and the five stages: (1) precontemplation stage, (2) contemplation stage, (3) preparation stage, (4) action stage, and (5) maintenance stage. More than half of the participants (53%) were involved in regular exercise (stages 4-5); however, only six sp...
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Maternal overweight is a risk factor for gestational diabetes (GDM) and for newborn macrosomia. Among women without GDM, it is not well understood why some women with high body mass index (BMI) give birth to macrosomic newborns while... more
Maternal overweight is a risk factor for gestational diabetes (GDM) and for newborn macrosomia. Among women without GDM, it is not well understood why some women with high body mass index (BMI) give birth to macrosomic newborns while others do not. We wanted to explore the effect of BMI and fasting plasma glucose (FPG), fasting plasma insulin (FPI) and insulin resistance (HOMA-IR) on the risk of newborn macrosomia. A cohort of 553 Caucasian women was followed throughout pregnancy. The dependent variable was high birth weight (>or=4200 g). Independent variables included gestational age, intake of macronutrients and energy, maternal BMI, weight gain, FPG, FPI and HOMA-IR. FPG in late pregnancy (30-32 weeks) remained a significant determinant of newborn macrosomia in multiple regression analysis (OR: 1.9, 95% CI: [1.1, 3.4]), whereas FPI and HOMA-IR did not. The women in the highest BMI quartile (>or=27 kg/m(2)) who gave birth to macrosomic newborns had higher increase in FPG and HOMA-IR from early to late pregnancy. Among women in this BMI category, the risk for delivering a macrosomic infant was higher among those with an increase in FPG above 0.60 mmol/l (upper quartile) (OR = 4.5, 95% CI: [1.7, 12.5]). Fasting plasma glucose at week 30-32, but not fasting plasma insulin or insulin resistance, is a determinant of newborn macrosomia. Overweight women with high increase in fasting plasma glucose from early to late pregnancy had a 4.5-fold increase in risk of newborn macrosomia compared to the remaining group with high BMI.
Research Interests: Birth Weight, Insulin Resistance, Gestational diabetes, Pregnancy, Overweight, and 15 moreHumans, Blood Glucose, Insulin, Glucose Metabolism, Fasting, Female, Maternal, Body Mass Index, Risk factors, Risk Factors, Gestational Age, Weight Gain, Logistic Models, Pregnancy complications, and Paediatrics and reproductive medicine
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Dual-energy X-ray absorptiometry (DXA) is used to measure body composition in newborns; however, data on DXA accuracy are limited. We investigated the reliability of body composition measurements by DXA. The present study included 207... more
Dual-energy X-ray absorptiometry (DXA) is used to measure body composition in newborns; however, data on DXA accuracy are limited. We investigated the reliability of body composition measurements by DXA. The present study included 207 normal-term newborn babies, recruited from a larger study on the determinants of birth weight in healthy pregnancies (STORK) between 2005 and 2008. Reliability analysis of total fat mass (FM(DxA)), fat-free mass, lean mass (LM(DxA)), bone mineral content (BMC), and bone mineral density (BMD) were based on 2 DXA scans of 50 neonates. We also performed a comparison analysis for DXA (FM(DxA)) measurements and caliper (CLP) or circumference (CF) measurements of trunk and extremities (performed on all neonates, n=207). Reliability: All intraclass correlation coefficients (ICC) were satisfactory to excellent for total body and the extremity-compartment FM(DxA), LM(DxA), BMD, and BMC; ICC ranged from 0.86 to 0.96 but with a lower ICC for trunk FM(DxA). For comparison analysis, the Pearson correlation coefficients for CLP vs DXA and CF vs DXA ranged from 0.48 to 0.79 and 0.41 to 0.77, respectively. Quadriceps CLP and CF measurements correlated best with the most reliable DXA results, whereas more modest correlations were found for the trunk region. DXA measurements of body composition demonstrated good reliability and can be used as a reference method in neonates. CLP and CF measurements are appropriate for larger cohorts or when DXA is unavailable, and they provide fair rough estimations of fat mass.
Research Interests: Birth Weight, Humans, Female, Body Composition, Male, and 15 moreReliability Analysis, Reliability, Bone Density, Clinical Sciences, Newborn Infant, Intraclass Correlation Coefficient, Fat Mass, Bone Mineral Density, Age Factors, Correlation coefficient, Reference Values, Predictive value of tests, Cohort Studies, Lean mass, and Bone mineral content
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ObjectiveThe International Association of Diabetes and Pregnancy Study Groups (IADPSG) recently proposed new criteria for diagnosing gestational diabetes mellitus (GDM). We compared prevalence rates, risk factors, and the effect of... more
ObjectiveThe International Association of Diabetes and Pregnancy Study Groups (IADPSG) recently proposed new criteria for diagnosing gestational diabetes mellitus (GDM). We compared prevalence rates, risk factors, and the effect of ethnicity using the World Health Organization (WHO) and modified IADPSG criteria.MethodsThis was a population-based cohort study of 823 (74% of eligible) healthy pregnant women, of whom 59% were from ethnic minorities. Universal screening was performed at 28±2 weeks of gestation with the 75 g oral glucose tolerance test (OGTT). Venous plasma glucose (PG) was measured on site. GDM was diagnosed as per the definition of WHO criteria as fasting PG (FPG) ≥7.0 or 2-h PG ≥7.8 mmol/l; and as per the modified IADPSG criteria as FPG ≥5.1 or 2-h PG ≥8.5 mmol/l.ResultsOGTT was performed in 759 women. Crude GDM prevalence was 13.0% with WHO (Western Europeans 11%, ethnic minorities 15%, P=0.14) and 31.5% with modified IADPSG criteria (Western Europeans 24%, ethnic mi...
Research Interests: Endocrinology, Research Design, Gestational diabetes, Pregnancy, Population, and 13 moreHumans, Diabetes mellitus, Female, Young Adult, Ethnic Groups, Clinical Sciences, European, Prevalence, Adult, World Health Organization, Glucose Tolerance Test, Cohort Studies, and Paediatrics and reproductive medicine
ObjectiveRecently, experimental and clinical studies suggest that retinol-binding protein-4 (RBP4) may provide a link between obesity and insulin resistance. However, no previous studies have investigated the impact of circulating RBP4 on... more
ObjectiveRecently, experimental and clinical studies suggest that retinol-binding protein-4 (RBP4) may provide a link between obesity and insulin resistance. However, no previous studies have investigated the impact of circulating RBP4 on measures of insulin resistance in normal pregnant women, and the objective of this study is to measure serum RBP4 in early and late pregnancy and relate these to measures of insulin resistance and secretion controlling for changes in fat mass.Design and methodsSamples were obtained during oral glucose tolerance test (OGTT) from 44 normal pregnancies at weeks 14–16 and 30–32. Measures of fat mass were body mass index (BMI) and leptin while insulin sensitivity and secretion were predicted from OGTT. Leptin and RPB4 were measured by immunoassay.ResultsInsulin sensitivity decreased during the course of pregnancy. Insulin sensitivity and secretion were best explained by BMI and circulating leptin, but not RBP4, both in early and late pregnancy. However,...
Research Interests: Insulin Resistance, Pregnancy, Humans, Insulin, Glucose Metabolism, and 15 moreFemale, Male, Leptin, Body Mass Index, Clinical Sciences, Newborn Infant, European, Fat Mass, Body mass index (BMI), Adult, Clinical Study, Oral Glucose Tolerance Test, Glucose Tolerance Test, Radioimmunoassay, and Paediatrics and reproductive medicine
ObjectiveTo monitor β-cell function and insulin sensitivity longitudinally in a large cohort of pregnant women to elucidate mechanisms that influence glycemic control in pregnancy.Design and methodsFive hundred and fifty-three pregnant... more
ObjectiveTo monitor β-cell function and insulin sensitivity longitudinally in a large cohort of pregnant women to elucidate mechanisms that influence glycemic control in pregnancy.Design and methodsFive hundred and fifty-three pregnant Scandinavian women underwent 75 g oral glucose tolerance test (OGTT) at weeks 14–16 and 30–32. Insulin sensitivity (Matsuda index) and β-cell function (ratio of AUCinsulin to AUCglucose, AUCins/glc) were calculated from 520 complete tests, and subsequently β-cell function was adjusted for insulin sensitivity, rendering an oral disposition index (DIo).ResultsEleven women (2.1%) had gestational diabetes mellitus (GDM1) at weeks 14–16, and 49 (9.4%) at weeks 30–32 (GDM2), which is higher than that previously reported in this region. In the subdivision of OGTT, more overweight (body mass index>25) was found in glucose-intolerant groups (glucose-tolerant women (normal glucose tolerance, NGT) 38 versus GDM2 women 58 and GDM1 women 82%, P<0.005). In ea...
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Research Interests: Life Style, Physical Activity, Risk assessment, Prospective studies, Pregnancy, and 13 moreHumans, Female, Body Mass Index, Risk factors, Adult, Public health systems and services research, Risk Factors, Risk Assessment, Parity, Gestational Age, Logistic Models, Socioeconomic Factors, and Paediatrics and reproductive medicine
It is generally recommended that healthy, pregnant women should engage in moderate exercise on most days of the week. However, there is scant knowledge about the overall physical activity and exercise levels among pregnant women. To... more
It is generally recommended that healthy, pregnant women should engage in moderate exercise on most days of the week. However, there is scant knowledge about the overall physical activity and exercise levels among pregnant women. To assess the total physical activity level of pregnant women, and to investigate the association between weight gain, physical activity and exercise during pregnancy. Pregnant women (n=467) answered a questionnaire on total physical activity level in gestation week 36. Some 55% of the participants reported working in a sitting position. Most women drove (52.9%) or used public transport (31.7%) to work. A total of 39% reported sedentary activities of&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;gt;or=4 h (watching television and reading) daily; 19% were defined as non-exercisers before pregnancy, 30% in the first trimester, 36% in the second trimester and 53% in the third trimester. Fifty women (10.6%) continued to exercise&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;gt;or=4 times/week in the third trimester. Mean weight gain was 13.8 kg (SD: 5.2). Of the normal pregestational weight women (pre-BMI: &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;26) and overweight women (pre-BMI: &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;gt;or=26), 32 and 51% had exceeded weight gain above accepted recommendations, respectively. Women who exercised regularly had significantly lower weight gain than inactive women in the third trimester only. Pregnant women have a low total physical activity level, and a high percentage of women exceed the recommended weight gain during pregnancy.
Research Interests: Obstetrics, Norway, Pregnancy, Humans, Female, and 15 moreCohort Study, Exercise, Body Mass Index, Middle Aged, Questionnaires, Gynecology, Adult, Public health systems and services research, Physical Exercise, Gestation, Medicine and Science In Sports and Exercise, Cross Sectional Studies, Weight Gain, Cohort Studies, and Paediatrics and reproductive medicine
It is established that the level of physical activity in the population generally is too low, and data indicate that pregnant women are no exception. Studies of the effects of aerobic fitness on delivery outcomes are limited. In this... more
It is established that the level of physical activity in the population generally is too low, and data indicate that pregnant women are no exception. Studies of the effects of aerobic fitness on delivery outcomes are limited. In this observational study, we investigated the effect of aerobic fitness on duration of labor in nulliparous women who started labor spontaneously. Maximal oxygen uptake was measured in 40 nulliparous women at 35-37 weeks of gestation. Duration of labor was defined as the time between 3 cm cervical dilation with regular uterine contractions and delivery. The mean (SD) maximal oxygen uptake was 2.1 (0.3) L/min and duration of labor 583 (317) minutes. Duration of labor was inversely associated with maximal oxygen uptake after adjusting for birthweight (p = 0.034). We conclude that measurement of maximal oxygen uptake is safe in pregnancy at 35-37 weeks and that increased aerobic fitness was associated with shorter labor in nulliparous women who started labor spontaneously.
Research Interests: Obstetrics, Fitness, Pregnancy, Humans, Female, and 15 moreDuration, Young Adult, Risk factors, Physical Fitness, Gynecology, Adult, Public health systems and services research, Time Factors, Risk Factors, Parity, Gestation, Oxygen Consumption, Exercise Tolerance, Cohort Studies, and Paediatrics and reproductive medicine
Current exercise guidelines recommend pregnant women to exercise throughout pregnancy. However, a high percentage of pregnant women are sedentary, and there is an increasing decline of physical activity and exercise, especially in the... more
Current exercise guidelines recommend pregnant women to exercise throughout pregnancy. However, a high percentage of pregnant women are sedentary, and there is an increasing decline of physical activity and exercise, especially in the third trimester. The aim of the present study was to compare demographic and health-related factors in pregnant women exercising and not exercising in the third trimester. Cross-sectional design comparing exercisers and non-exercisers. Rikshospitalet University Hospital and Norwegian School of Sport Sciences, Oslo, Norway. Healthy pregnant women (n = 467) were successively allocated from the application form for birth at Rikshospitalet University Hospital. A questionnaire, including questions about demographic variables, physical activity level, common pregnancy complaints, social modeling, attitudes and barriers towards exercise participation was answered between gestation-week 32 and 36. Demographic variables, pregnancy related health factors and social modeling, including exercise counseling by health care providers, were tested using binary logistic regression analysis. Less than 11% were defined as regular exercisers in the third trimester. Having high gestational weight gain and no social role models with respect to exercise behavior during childhood were inversely associated with third trimester exercise. Pre-pregnancy exercise was the strongest predictor of regular exercise at late gestation. Not receiving advice about exercise from health professionals was borderline significant. Pelvic girdle pain and sick-leave were not statistically significant factors. Pre-pregnancy exercise was strongly related to exercise at late gestation. This study indicates a need for more information and motivation for moderate exercise before and throughout pregnancy.
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ContextDuring pregnancy, changes occur in the maternal calcium homeostasis to fulfill fetal demand. We hypothesized that the fibroblast growth factor 23 (FGF23) system and Wnt signaling pathway are important for normal skeletal... more
ContextDuring pregnancy, changes occur in the maternal calcium homeostasis to fulfill fetal demand. We hypothesized that the fibroblast growth factor 23 (FGF23) system and Wnt signaling pathway are important for normal skeletal development in the offspring.AimsCirculating α-klotho, FGF23, sclerostin, and 25-hydroxyvitamin D (25(OH)D) at the fetal and maternal sides of the placenta were measured to investigate associations with newborn bone mass independent of maternal BMI, calcium and phosphate levels, placental weight, and birth weight.MethodsIn a prospective cohort of healthy pregnant women, the total body bone mineral content (BMC) in 202 newborns was measured by dual-energy X-ray absorptiometry. Maternal circulating levels of the biomarkers were measured at gestational weeks 30–32 and in umbilical cord plasma (UCP) at birth.ResultsMean α-klotho and sclerostin concentrations in the UCP were significantly higher than maternal levels (3004 vs 1077 pg/ml; P<0.001 and 629 vs 346 p...