The benefits of prenatal care (PNC) are extensively documented; however, controversy surrounds the extent to which benefits are experienced among different racial groups. Determining whether PNC influences positive birth outcomes and if advantages differ by race is pertinent to attaining positive health outcomes. The purpose of this study was to examine the relationship between gestational weight gain (GWG), low birthweight (LBW), and PNC while weighing racial differences. The theoretical foundation was the motivation-facilitation theory of PNC access. Research questions were designed to (a) determine if there was a significant association between GWG and LBW, (b) determine if PNC had a mediating role if GWG was found to be associated with LBW, and (c) determine if PNC was a mediator and if that role differed between races. A quantitative, deductive correlational analysis was carried out using a retrospective observational approach. Spearman correlation showed that the relationship between GWG and LBW was significant (rs = 0.14, p < .001). Binary logistic regression was used for analysis and showed that the overall model was significant, Ï?2(12) = 50.29, p < .001, and that maternal age, race, marital status, GWG, education, body mass index (BMI), cigarette use, and gestational diabetes significantly affected the chances of LBW. Baron and Kenny's mediation analysis supported partial mediation for American Indian or Alaskan Native and Asian or Pacific Islander races and showed that PNC was significantly associated with birthweight. Based on these findings, providers can aim to implement motivational factors to increase the facilitation and use of PNC to decrease adverse birth outcomes and increase population health.

abstract: Excessive gestational weight gain (EGWG) affects 50% of US pregnant women and may be an important contributor to obesity in both the mother and child. Novel strategies to prevent EGWG are needed to reduce the risk of adverse health outcomes for the mother and child. This dissertation presents three manuscripts that 1) propose a novel model to explain how prenatal yoga may prevent EGWG through behavioral, psychological/emotional, and physical factors, 2) test the feasibility and preliminary efficacy of a prenatal yoga intervention to prevent EGWG compared to a pregnancy education comparison group, and 3) qualitatively investigate pregnant women’s experiences participating in a prenatal yoga intervention to prevent EGWG. In manuscript two, 49 women were recruited and randomized to a 12-week prenatal yoga intervention (n=23) or a time-matched pregnancy education comparison group (n=26). A satisfaction survey was administered at post-intervention to assess feasibility outcomes (e.g., acceptability, demand). Mindfulness, emotion regulation, self-awareness, sleep quality, depression, anxiety, and perceived stress were assessed at baseline and post-intervention (12-weeks) and GWG was assessed weekly. Linear mixed models were used to analyze pre-post changes in primary (i.e., GWG during pregnancy) and secondary (i.e., mindfulness, emotion regulation, self-awareness, sleep quality, depression, anxiety, and stress) outcomes. In manuscript three, interviews were conducted with pregnant women who participated in the prenatal yoga intervention (n=13). Interview responses were summarized using an inductive approach to thematic analysis. Findings in manuscript two suggest that prenatal yoga was a feasible method to prevent EGWG with high enjoyment and satisfaction reported among participants. The average number of prenatal yoga sessions attended was 8.84 (SD = 3.85). There was no significant group differences on the rate of GWG or total GWG throughout the intervention and a significant group x time interaction effect for stress (p=.03). In manuscript three, twelve themes were identified among the data and were organized into the following categories (three themes each): 1) experiences of prenatal yoga, 2) prenatal yoga and weight, 3) barriers to prenatal yoga, and 4) facilitators of prenatal yoga. This initial evidence suggests that prenatal yoga has potential as a strategy to prevent EGWG in pregnant women. / Dissertation/Thesis / Embargo form / Doctoral Dissertation Exercise and Nutritional Sciences 2019

SAMMANFATTNING I Sverige är cirka 40 procent av alla kvinnor i fertil ålder överviktiga eller har fetma. Detta medför ökade risker för kvinnan och fostret under graviditet såsom graviditetsdiabetes, preeklampsi, kejsarsnitt, intrauterin fosterdöd och barn som föds stora för tiden. I Sverige idag finns inga riktlinjer för vad som är lämplig viktuppgång utifrån Body mass index innan graviditet. Att banta under graviditet är inget som rekommenderas, men samtidigt visar studier att en överdriven viktuppgång under graviditet ökar riskerna för viktretention efter graviditeten. Det finns otillräcklig kunskap både hos gravida kvinnor och hos vårdpersonal om vad som är lämplig viktuppgång under graviditet. En kvinna som redan innan graviditet är överviktig eller har fetma utsätter sig själv och sitt ofödda barn för ytterligare risker genom överdriven viktuppgång under graviditet. Syftet med detta arbete var att undersöka interventioners effekt på att begränsa viktuppgång hos gravida kvinnor, med övervikt eller fetma, samt om dessa interventioner påverkar kvinnan eller barnet i övrigt under graviditet och förlossning. En litteraturöversikt utfördes där 15 vetenskapliga artiklar inkluderades. Artikelsökningen genomfördes i databaserna Cinahl och Pubmed. Genom att läsa artiklarna ett flertal gånger och göra understrykningar i texten hittades mönster som svarade på arbetets syfte och frågeställningar. Utifrån detta kategoriserades fakta i artiklarna. Resultatet visade att fysisk aktivitet, kostråd och beteendestrategier kan ha effekt på att begränsa viktuppgången hos gravida kvinnor med övervikt eller fetma. Många av kvinnorna som deltog i studierna förbättrade sina matvanor. I övrigt hade dessa interventioner även till viss del positiv effekt på blodtrycket och förekomsten av graviditetsdiabetes, men resultatet är på många områden inte entydigt. Ingen tydlig effekt på att begränsa födelsevikten kunde påvisas hos barnen, men det fanns en viss begränsning av barn som föddes med en födelsevikt över 4000 gram. Livsstilinterventioner kan vara effektiva för att begränsa viktuppgången under graviditet för kvinnor med övervikt eller fetma. Vidare forskning behövs för att säkerställa att detta sker på ett säkert sätt utifrån BMI klassificering.

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O ganho de peso gestacional inadequado é considerado importante indicador para desfechos adversos na gravidez. O baixo peso pré-gestacional e/ou ganho de peso insuficiente durante a gestação resultam em maior risco de anemia e hemorragias. Por outro lado, o sobrepeso ou obesidade pré-gestacional e ganho de peso excessivo durante a gestação implicam em maior risco para desenvolvimento de diabetes gestacional, doença hipertensiva da gestação e maior retenção de peso pósparto. Objetivos: Avaliar a associação entre ganho de peso inadequado na gestação e ocorrência de anemia, insuficiência de vitamina A (IVA) e níveis pressóricos de gestantes atendidas no pré-natal na Estratégia de Saúde da Família de Cruzeiro do Sul, Acre. Métodos: Análise de dados aninhada a estudo de coorte de gestantes, atendidas no prénatal da atenção básica à saúde, na área urbana do município de Cruzeiro do Sul, Acre. Os dados socioeconômicos, demográficos, obstétricos, de assistência pré-natal, antropométricos e de estilo de vida foram coletados entre fevereiro de 2015 e janeiro de 2016. A exposição de interesse ganho de peso gestacional foi obtida pela diferença de peso avaliada entre o segundo e o terceiro trimestres gestacionais, dividida pelo número de semanas nesse intervalo e classificada em: insuficiente, adequado e excessivo segundo critérios do Institute of Medicine USA (IOM) 2009. O desfecho de interesse foi o estado nutricional no terceiro trimestre gestacional avaliado pela frequência de anemia (hemoglobina sanguínea <110 g/L), IVA (retinol sérico <1,5 mol/L) e valores de pressão arterial em mmHg. Medidas de tendência central, intervalos com 95 por cento de confiança (IC95 por cento ) e teste do qui-quadrado foram calculados com auxílio do pacote estatístico STATA 14.0, ao nível de significância de P < 0,05. Modelos de regressão de Poisson múltiplos com variância robusta foram testados para desfechos dicotômicos (anemia e insuficiência de vitamina A). A seleção inicial de variáveis independentes para ajuste múltiplo considerou critérios estatísticos (P < 0,20) e pressupostos teóricos. Resultados: No total, 458 gestantes completaram duas avaliações durante o seguimento. Destas, 72 por cento tinham menos de 30 anos e 19 por cento eram adolescentes. No início da gestação a prevalência de sobrepeso foi de 24 por cento , obesidade e baixo peso, foram semelhantes, na ordem de 7 por cento . No terceiro trimestre gestacional, 18,7 por cento das gestantes apresentaram ganho de peso insuficiente e 59,1 por cento ganho de peso excessivo. As frequências gerais de anemia, IVA e hipertensão (pressão arterial sistólica 140 mmHg e diastólica 90 mmHg) foram de 17,5 por cento , 13,4 por cento e 0,6 por cento , respectivamente. As gestantes com ganho de peso semanal insuficiente apresentaram menor frequência de anemia (8,2 por cento ) e maior ocorrência de IVA (33 por cento ) quando comparadas às gestantes com ganho de peso adequado (19,6 por cento e 11,8 por cento ) e excessivo (19,6 por cento e 19,0 por cento ), respectivamente (teste do qui-quadrado, P <0.05). As razões de prevalências (IC95 por cento ) para anemia entre gestantes com ganho de peso insuficiente e excessivo foram 0,41 (0,18-0,93) e 1,00 (0,63-1,59), respectivamente, quando comparadas às gestantes com ganho de peso adequado (após ajuste por idade, escolaridade e uso de suplementos de vitaminas e minerais). Já para IVA, a prevalência foi maior entre gestantes com ganho de peso insuficiente (2,85; IC95 por cento : 1,55-5,24) e excessivo (1,53; IC95 por cento : 0,84-2,74) quando comparadas às gestantes com ganho de peso adequado (após ajuste por idade, escolaridade e uso de suplementos de vitaminas e minerais). As gestantes com ganho de peso excessivo apresentaram valores médios de pressão arterial sistólica maiores (111,10; IC95 por cento : 109,9-112,2) quando comparadas às gestantes com ganho de peso insuficiente (107,50; IC95 por cento : 105,4-109,6) e adequado (106,20; IC95 por cento : 104,3-108,20). Conclusões: O ganho de peso semanal insuficiente ou excessivo entre segundo e terceiro trimestres gestacionais foram associados ao estado nutricional no terceiro trimestre de gestação. Estratégias visando monitoramento do ganho de peso gestacional com incentivo à alimentação saudável e prática regular de atividade física são necessárias durante toda a atenção e cuidado pré-natal / The gestational weight gain has been considered important indicator for adverse pregnancy outcomes. Low pre-gestational body weight and/or insufficient weight gain during pregnancy are associated with increased risk of anemia and bleeding. On the other hand, pre-gestational overweight or obesity and excessive weight gain during pregnancy imply a greater risk for the development of gestational diabetes, hypertensive gestational disease and greater postpartum weight retention. Objectives: To evaluate the relation between gestational weight gain and anemia, vitamina A insufficiency (VAI) and blood pressure in the third trimester of pregnancy. Methods: Data analysis nested in a cohort study of pregnant women attending prenatal care in the urban area of the city of Cruzeiro do Sul, Acre. Socioeconomic, demographic, obstetric, prenatal, anthropometric and lifestyle data were collected between February 2015 and January 2016. The main exposure \"weight gain\" was obtained by the body weight difference evaluated between the second and the third gestational trimesters, divided by the number of weeks in this interval and classified in relation to pre-gestational body weight in: insufficient, adequate and excessive according to the Institute of Medicine USA (IOM) 2009 criteria. The outcomes of interest were anemia (hemoglobin concentrations <110 g/L), VAI (serum retinol <1.5 mol/L) and blood pressure levels in mmHg. Descriptive statistical data, 95 per cent confidence intervals (95 per cent CI) and chi-square test were calculated using the software STATA 14.0, at P <0.05. Multiple Poisson regression models with robust variance were tested for dichotomous outcomes (anemia and VAI). The initial selection of independent variables for multiple fit considered statistical criteria (P <0.20) and theoretical assumptions. Results: Overall, 458 pregnant women completed two evaluations during follow-up. Of them, 72 per cent were under 30 years old and 19 per cent were teenagers. At the beginning of gestation, the prevalence of overweight was 24 per cent , obesity and low weight, were similar, around 7 per cent . In the third gestational trimester, 18.7 per cent of pregnant women presented insufficient and 59.1 per cent excessive weight gain. The general frequencies of anemia, VAI and hypertension (systolic blood pressure 140 mmHg and diastolic blood pressure 90 mmHg) were 17.5 per cent , 13.4 per cent and 0.6 per cent , respectively. Pregnant women with insufficient weekly weight gain presented a lower frequency of anemia (8.2 per cent ) and a higher occurrence of VAI (33 per cent ) when compared to pregnant women with adequate (19.6 per cent and 11.8 per cent ) and excessive weight gain (19.6 per cent and 19.0 per cent ), respectively (chi-square test, P <0.05). The prevalence ratios (95 per cent CI) for anemia among pregnant women with insufficient and excessive weight gain were 0.41 (0.18-0.93) and 1.00 (0.63-1.59), respectively, when compared to pregnant women with adequate weight gain (after adjusting for age, schooling and use of vitamin and mineral supplements). The risk for VAI was higher among pregnant women with insufficient (2.85; 95 per cent CI: 1.55-5.24) and excessive weight gain (1.53; 95 per cent CI: 0.84-2.74) when compared to pregnant women with adequate weight gain (after adjusting for age, schooling and use of vitamin and mineral supplements. Pregnant women with excessive weight gain had higher mean systolic blood pressure (111.10; 95 per cent CI: 109.9-112.2) when compared to pregnant women with insufficient (107.50; 95 per cent CI: 105.4-109.6) and appropriate weight gain (106.20; 95 per cent CI: 104.3-108.20). Conclusions: Insufficient or excessive weekly weight gain between the second and third gestational trimesters were associated with the nutritional status at the third trimester of gestation. Strategies aimed at monitoring gestational weight gain with encouragement of healthy eating and regular practice of physical activity are required throughout prenatal care

O ganho de peso gestacional inadequado é considerado importante indicador para desfechos adversos na gravidez. O baixo peso pré-gestacional e/ou ganho de peso insuficiente durante a gestação resultam em maior risco de anemia e hemorragias. Por outro lado, o sobrepeso ou obesidade pré-gestacional e ganho de peso excessivo durante a gestação implicam em maior risco para desenvolvimento de diabetes gestacional, doença hipertensiva da gestação e maior retenção de peso pósparto. Objetivos: Avaliar a associação entre ganho de peso inadequado na gestação e ocorrência de anemia, insuficiência de vitamina A (IVA) e níveis pressóricos de gestantes atendidas no pré-natal na Estratégia de Saúde da Família de Cruzeiro do Sul, Acre. Métodos: Análise de dados aninhada a estudo de coorte de gestantes, atendidas no prénatal da atenção básica à saúde, na área urbana do município de Cruzeiro do Sul, Acre. Os dados socioeconômicos, demográficos, obstétricos, de assistência pré-natal, antropométricos e de estilo de vida foram coletados entre fevereiro de 2015 e janeiro de 2016. A exposição de interesse ganho de peso gestacional foi obtida pela diferença de peso avaliada entre o segundo e o terceiro trimestres gestacionais, dividida pelo número de semanas nesse intervalo e classificada em: insuficiente, adequado e excessivo segundo critérios do Institute of Medicine USA (IOM) 2009. O desfecho de interesse foi o estado nutricional no terceiro trimestre gestacional avaliado pela frequência de anemia (hemoglobina sanguínea <110 g/L), IVA (retinol sérico <1,5 mol/L) e valores de pressão arterial em mmHg. Medidas de tendência central, intervalos com 95 por cento de confiança (IC95 por cento ) e teste do qui-quadrado foram calculados com auxílio do pacote estatístico STATA 14.0, ao nível de significância de P < 0,05. Modelos de regressão de Poisson múltiplos com variância robusta foram testados para desfechos dicotômicos (anemia e insuficiência de vitamina A). A seleção inicial de variáveis independentes para ajuste múltiplo considerou critérios estatísticos (P < 0,20) e pressupostos teóricos. Resultados: No total, 458 gestantes completaram duas avaliações durante o seguimento. Destas, 72 por cento tinham menos de 30 anos e 19 por cento eram adolescentes. No início da gestação a prevalência de sobrepeso foi de 24 por cento , obesidade e baixo peso, foram semelhantes, na ordem de 7 por cento . No terceiro trimestre gestacional, 18,7 por cento das gestantes apresentaram ganho de peso insuficiente e 59,1 por cento ganho de peso excessivo. As frequências gerais de anemia, IVA e hipertensão (pressão arterial sistólica 140 mmHg e diastólica 90 mmHg) foram de 17,5 por cento , 13,4 por cento e 0,6 por cento , respectivamente. As gestantes com ganho de peso semanal insuficiente apresentaram menor frequência de anemia (8,2 por cento ) e maior ocorrência de IVA (33 por cento ) quando comparadas às gestantes com ganho de peso adequado (19,6 por cento e 11,8 por cento ) e excessivo (19,6 por cento e 19,0 por cento ), respectivamente (teste do qui-quadrado, P <0.05). As razões de prevalências (IC95 por cento ) para anemia entre gestantes com ganho de peso insuficiente e excessivo foram 0,41 (0,18-0,93) e 1,00 (0,63-1,59), respectivamente, quando comparadas às gestantes com ganho de peso adequado (após ajuste por idade, escolaridade e uso de suplementos de vitaminas e minerais). Já para IVA, a prevalência foi maior entre gestantes com ganho de peso insuficiente (2,85; IC95 por cento : 1,55-5,24) e excessivo (1,53; IC95 por cento : 0,84-2,74) quando comparadas às gestantes com ganho de peso adequado (após ajuste por idade, escolaridade e uso de suplementos de vitaminas e minerais). As gestantes com ganho de peso excessivo apresentaram valores médios de pressão arterial sistólica maiores (111,10; IC95 por cento : 109,9-112,2) quando comparadas às gestantes com ganho de peso insuficiente (107,50; IC95 por cento : 105,4-109,6) e adequado (106,20; IC95 por cento : 104,3-108,20). Conclusões: O ganho de peso semanal insuficiente ou excessivo entre segundo e terceiro trimestres gestacionais foram associados ao estado nutricional no terceiro trimestre de gestação. Estratégias visando monitoramento do ganho de peso gestacional com incentivo à alimentação saudável e prática regular de atividade física são necessárias durante toda a atenção e cuidado pré-natal / The gestational weight gain has been considered important indicator for adverse pregnancy outcomes. Low pre-gestational body weight and/or insufficient weight gain during pregnancy are associated with increased risk of anemia and bleeding. On the other hand, pre-gestational overweight or obesity and excessive weight gain during pregnancy imply a greater risk for the development of gestational diabetes, hypertensive gestational disease and greater postpartum weight retention. Objectives: To evaluate the relation between gestational weight gain and anemia, vitamina A insufficiency (VAI) and blood pressure in the third trimester of pregnancy. Methods: Data analysis nested in a cohort study of pregnant women attending prenatal care in the urban area of the city of Cruzeiro do Sul, Acre. Socioeconomic, demographic, obstetric, prenatal, anthropometric and lifestyle data were collected between February 2015 and January 2016. The main exposure \"weight gain\" was obtained by the body weight difference evaluated between the second and the third gestational trimesters, divided by the number of weeks in this interval and classified in relation to pre-gestational body weight in: insufficient, adequate and excessive according to the Institute of Medicine USA (IOM) 2009 criteria. The outcomes of interest were anemia (hemoglobin concentrations <110 g/L), VAI (serum retinol <1.5 mol/L) and blood pressure levels in mmHg. Descriptive statistical data, 95 per cent confidence intervals (95 per cent CI) and chi-square test were calculated using the software STATA 14.0, at P <0.05. Multiple Poisson regression models with robust variance were tested for dichotomous outcomes (anemia and VAI). The initial selection of independent variables for multiple fit considered statistical criteria (P <0.20) and theoretical assumptions. Results: Overall, 458 pregnant women completed two evaluations during follow-up. Of them, 72 per cent were under 30 years old and 19 per cent were teenagers. At the beginning of gestation, the prevalence of overweight was 24 per cent , obesity and low weight, were similar, around 7 per cent . In the third gestational trimester, 18.7 per cent of pregnant women presented insufficient and 59.1 per cent excessive weight gain. The general frequencies of anemia, VAI and hypertension (systolic blood pressure 140 mmHg and diastolic blood pressure 90 mmHg) were 17.5 per cent , 13.4 per cent and 0.6 per cent , respectively. Pregnant women with insufficient weekly weight gain presented a lower frequency of anemia (8.2 per cent ) and a higher occurrence of VAI (33 per cent ) when compared to pregnant women with adequate (19.6 per cent and 11.8 per cent ) and excessive weight gain (19.6 per cent and 19.0 per cent ), respectively (chi-square test, P <0.05). The prevalence ratios (95 per cent CI) for anemia among pregnant women with insufficient and excessive weight gain were 0.41 (0.18-0.93) and 1.00 (0.63-1.59), respectively, when compared to pregnant women with adequate weight gain (after adjusting for age, schooling and use of vitamin and mineral supplements). The risk for VAI was higher among pregnant women with insufficient (2.85; 95 per cent CI: 1.55-5.24) and excessive weight gain (1.53; 95 per cent CI: 0.84-2.74) when compared to pregnant women with adequate weight gain (after adjusting for age, schooling and use of vitamin and mineral supplements. Pregnant women with excessive weight gain had higher mean systolic blood pressure (111.10; 95 per cent CI: 109.9-112.2) when compared to pregnant women with insufficient (107.50; 95 per cent CI: 105.4-109.6) and appropriate weight gain (106.20; 95 per cent CI: 104.3-108.20). Conclusions: Insufficient or excessive weekly weight gain between the second and third gestational trimesters were associated with the nutritional status at the third trimester of gestation. Strategies aimed at monitoring gestational weight gain with encouragement of healthy eating and regular practice of physical activity are required throughout prenatal care

abstract: Control engineering offers a systematic and efficient approach to optimizing the effectiveness of individually tailored treatment and prevention policies, also known as adaptive or ``just-in-time'' behavioral interventions. These types of interventions represent promising strategies for addressing many significant public health concerns. This dissertation explores the development of decision algorithms for adaptive sequential behavioral interventions using dynamical systems modeling, control engineering principles and formal optimization methods. A novel gestational weight gain (GWG) intervention involving multiple intervention components and featuring a pre-defined, clinically relevant set of sequence rules serves as an excellent example of a sequential behavioral intervention; it is examined in detail in this research.   A comprehensive dynamical systems model for the GWG behavioral interventions is developed, which demonstrates how to integrate a mechanistic energy balance model with dynamical formulations of behavioral models, such as the Theory of Planned Behavior and self-regulation. Self-regulation is further improved with different advanced controller formulations. These model-based controller approaches enable the user to have significant flexibility in describing a participant's self-regulatory behavior through the tuning of controller adjustable parameters. The dynamic simulation model demonstrates proof of concept for how self-regulation and adaptive interventions influence GWG, how intra-individual and inter-individual variability play a critical role in determining intervention outcomes, and the evaluation of decision rules.   Furthermore, a novel intervention decision paradigm using Hybrid Model Predictive Control framework is developed to generate sequential decision policies in the closed-loop. Clinical considerations are systematically taken into account through a user-specified dosage sequence table corresponding to the sequence rules, constraints enforcing the adjustment of one input at a time, and a switching time strategy accounting for the difference in frequency between intervention decision points and sampling intervals. Simulation studies illustrate the potential usefulness of the intervention framework. The final part of the dissertation presents a model scheduling strategy relying on gain-scheduling to address nonlinearities in the model, and a cascade filter design for dual-rate control system is introduced to address scenarios with variable sampling rates. These extensions are important for addressing real-life scenarios in the GWG intervention. / Dissertation/Thesis / Doctoral Dissertation Chemical Engineering 2014

Objetivo: Determinar la relación entre la ganancia del peso gestacional y el peso del recién nacido en el Hospital San Juan de Lurigancho. Metodología: Estudio descriptivo – correlacional y transversal, con un muestreo no probabilístico por conveniencia. Las puérperas fueron clasificadas según IMC pregestacional y ganancia de peso gestacional total. Mientras que los neonatos se clasificaron según el peso al nacer. Se realizó un análisis univariado para determinar las características generales de la población y un análisis bivariado para obtener la relación entre la ganancia de peso gestacional y el peso al nacer. Resultados: De un total de 117 puérperas, se obtuvo que el 55.6% empezó la gestación con sobrepeso y obesidad, el 36% tuvo una ganancia de peso excesiva y el 85% de los neonatos nacieron con una adecuado peso al nacer y sólo el 6.9% fue macrosómico. Del grupo de madres con una alta ganancia de peso gestacional, el 18.6% de los recién nacidos fueron macrosómicos. Conclusión: No existe relación significativa entre la ganancia de peso total de la gestante y el peso al nacer. / Objective: To determine the relationship between gestational weight gain and newborn weight at San Juan de Lurigancho Hospital. Methodology: Descriptive study – correlational and transversal, with non-probabilistic sampling for convenience. The postpartums were classified according to pregestational BMI and total gestational weight gain. While neonates were classified by birth weight. An univariate analysis was performed to determine the overall characteristics of the population and a bivariate analysis to obtain the relationship between gestational weight gain and birth weight. Results: Out of a total of 117 postpartum women, 55.6% began the pregnancy with overweight and obesity, 36% had excessive weight gain and 85% of neonates were born with an adequate birth weight and only 6.9% was macrosomic. Of the group of women with high gestational weight gain, 18.6% of newborns were macrosomic. Conclusion: There is no significant relationship between the total weight gain of the pregnant woman and the birth weight. / Trabajo de investigación

Childhood obesity is a global health concern that puts children at risk for developing serious health complications. With increasing rates worldwide, it is important to determine how to decrease its prevalence and promote prevention in future generations. Emerging evidence indicating that pre-pregnancy weight status and/or gestational weight gain (GWG) may be linked with overweight/obesity in children. Much of this body of research focused on weight status of offspring at birth and at preschool age. The purpose of this study is to: (1) analyze the research findings regarding obesity in children 5 to 18 years and their mother’s pre-pregnancy weight status and/or GWG, and (2) make recommendations for prevention based on a review of current research. A database search of CINAHL, Medline, ERIC and PsycInfo was conducted. A total of 14 articles were identified based on their relevance to key search terms and meeting criteria. This literature review indicated support for associations between an underweight/overweight/obese pre-pregnancy weight status combined with greater than recommended total GWG and higher overweight/obesity in older children and adolescent offspring. Findings also supported the associations between pre-pregnancy weight status with high GWG during early pregnancy and increased offspring overweight/obesity. Pre-pregnancy overweight/obese weight status of mothers was the single factor consistently found to be strongly associated with risk for overweight and obesity in children 5 to 18 years of age. Results of this review support the need for further education, interventions, and policies aimed at healthy nutrition for women during and prior to pregnancy to prevent childhood obesity.