•     To date, we have approached 5775 pregnant women, of whom 4862 were found eligible.  Nine hundred and thirteen women were excluded. Among the 4862 eligible women, 2962 (60.9%) completed both fasting and postprandial oral glucose tolerance test (OGTT). Among those tested, 424 (14.3%) were diagnosed with GDM based on cut-off values of either fasting glucose ≥92 mg/dl or 2 hr ≥153 mg/dl.

•     The mean age of the participants was 24.3 ± 4.0years. Most pregnant women and their spouses had a middle school education and above (91.2%; n= 2695 of 2956 and 81.9%; n= 2415 of 2950). More than 90% of women (93.2%, n= 2756 of 2956) were homemakers, while most spouses were unskilled workers (49.9%).  We found that most women belonged to the lower and upper-lower class (56.3%, n= 1665 of 2956) and lower-middle-class (32.1%, n= 948 of 2956).

•     We found that maternal obesity (odds ratio (OR)=2.16, 95% CI 1.46, 3.18) and GDM (OR=2.21, 95% CI1.38, 3.52) have an independent effect on neonatal adiposity. GDM significantly mediates 25.2% of the total effect between maternal obesity and neonatal adiposity (natural direct effect OR = 1.16 95% CI 1.04, 1.30) with significant direct effect of maternal obesity (natural direct effect OR = 1.90 95% CI 1.16, 3.10) and significant total effect (OR=2.20 95% CI 1.35, 3.58). (1)

•     We also tried to determine the most appropriate substitute for the anthropometric measurement to approximate the skinfold thickness in mothers, pregnant women, and infants. As per the Kappa statistic, we found the highest agreement with total skinfold thickness (SF) attributed to MUAC cut-off (0.42; 95% CI 0.38-0.46) in pregnant women. While for newborns, the highest amount of agreement with total SF was attributed to birth weight (0.57; 95% CI 0.52-0.60). (2)

•     We examined if C-section (elective or emergency) vs. vaginal delivery was associated with adiposity and linear growth over the first year of life. Among 638 women, 361 (56.58%) were delivered by vaginal delivery, 169 (26.49%) were delivered by emergency C-section and 108 (16.93%) by elective C-section. Out of the total 638 infants, 14.9% of the infants were classified as being overweight.  Compared to vaginal delivery, elective C-section was significantly associated with  β=0.61 (95% CI 0.24, 0.99 ) higher BMI for age Z score, and emergency C-section didn’t show statistically significant association with the length for age Z score (β = 0.12,95% CI -0.53,0.30 ) at one year of age. Compared to vaginally delivered infants, those born by elective C-section had 2.84 (95% CI (1.62, 4.96) times higher risk of being overweight; no such association was found for emergency C-section in both with and without imputation. (3)

•     Prevalence of depressive symptoms (EPDS score >11) was 16.5% in antenatal mothers. These women delivered a higher proportion of SGA babies (21.3 v/s 15.8) compared to women with no symptoms. The odds of women giving birth to a child with SGA were twice as high for women with EPDS scores >11.(4)

•     Male infants had 0.5 times higher odds of being fed supplementary food (OR: 0.546, p-value: 0.029), 1.5 times higher odds of being wasted (OR: 2.487, p-value: 0.002), and 0.9 times higher odds of being underweight, compared to female infants (OR: 1.936, p-value: 0.025). Moreover, infants who received supplementary feeding at age 14 weeks had 1.5 times higher odds of being wasted (OR: 2.449, p-value: 0.002) as compared to exclusively breastfed infants.(5)

•     We found that red meat consumption was associated with increased risk of GDM (RR= 2.40, 95% CI 1.73, 3.34) after adjusting for age, parity, family history of diabetes, sum of skinfold thickness, Metabolic Equivalent of Task (MET) values, polished rice, fruit and vegetable intake.(6)

•     Pregnant women with a low level of physical activity were thrice more likely of developing postpartum depressive symptoms.(7)

  1. Babu GR, Deepa R, Lewis MG, Lobo E, Krishnan A, Ana Y, et al. Do Gestational Obesity and Gestational Diabetes Have an Independent Effect on Neonatal Adiposity? Results of Mediation Analysis from a Cohort Study in South India. Clinical Epidemiology. 2019;Volume 11:1067–80.
  2. Babu GR, Das A, Lobo E, R D, John DA, Thankachan P, et al. Mid-upper arm circumference in pregnant women and birth weight in newborns as substitute for skinfold thickness: findings from the MAASTHI cohort study, India. BMC Pregnancy and Childbirth. 2021;21(1):484.
  3. Giridhara R. Babu* NTM, Anjaly Krishnan, Eunice Lobo, Deepa R, Sara E. Benjamin-Neelon. Cesarean delivery, linear growth, and adiposity in infants during the first year of life: Results from a birth cohort study in India (Under review). In: International Journal of Obesity, editor. 2020
  4. Babu GR, Murthy GVS, Reddy Y et al. Small for gestational age babies and depressive symptoms of mothers during pregnancy: Results from a birth cohort in India. Wellcome Open Res 2018, 3:76 (doi: 10.12688/wellcomeopenres.14618.1)
  5. Koya S, Babu GR, R D, Iyer V, Yamuna A, Lobo E, S P, Kinra S and Murthy GVS (2020) Determinants of Breastfeeding Practices and Its Association with Infant Anthropometry: Results From a Prospective Cohort Study in South India. Front. Public Health 8:492596. doi: 10.3389/fpubh.2020.492596 (IF; 2.483)
  6. Deepa R, Lewis MG, Van Schayck OCP, Babu GR. Food habits in pregnancy and its association with gestational diabetes mellitus: results from a prospective cohort study in public hospitals of urban India. BMC Nutr. 2020 Nov 19;6(1):63. doi: 10.1186/s40795-020-00388-x. PMID: 33292687; PMCID: PMC7677816.
  7. Ana Y, Lewis MG, van Schayck OC, Babu GR. Is physical activity in pregnancy associated with prenatal and postnatal depressive symptoms?: Results from MAASTHI cohort study in South India. Journal of Psychosomatic Research. 2021 May 1;144:110390.
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