title: Health Behaviours during Pregnancy in Women with Very Severe Obesity.
abstract: The health behaviours of pregnant women with very severe obesity are not known, though these women are at high risk of pregnancy complications. We carried out a prospective case-control study including 148 very severely obese (BMI >40 kg/m²) and 93 lean (BMI <25 kg/m²) pregnant women. Diet, physical activity, smoking, alcohol and folic acid consumption were assessed by questionnaire in early and late (16 and 28 weeks gestation) pregnancy. Circulating levels of iron, vitamin B12 and folate and other essential trace elements and minerals were measured in a subset at each time point. The findings biochemically confirmed that very severely obese women consumed diets that were energy-rich but poor in essential micronutrients. A third of all women met physical activity recommendations for pregnancy. A third of very severely obese women and two thirds of lean women took folic acid supplements prior to pregnancy. Very severely obese women were more likely to smoke but less likely to drink alcohol than lean women (all p < 0.05). Women with very severe obesity have low self-reported intakes and circulating levels of essential micronutrients in pregnancy and few follow current recommendations for pregnancy nutrition and lifestyle. These high-risk women represent a group to target for education about health behaviours prior to and during pregnancy.
authors.affiliation: Endocrinology Unit, University/BHF Centre for Cardiovascular Science, Queen's Medical Research Institute, University of Edinburgh, Edinburgh EH16 4TJ, UK.
authors.forename: Nor A
authors.initials: NA
authors.lastname: Mohd-Shukri
authors.affiliation: Scottish Trace Element and Micronutrient Reference Laboratory, Macewen Building, Royal Infirmary, Glasgow G4 0SF, UK. andrew.duncan@ggc.scot.nhs.uk.
authors.forename: Andrew
authors.initials: A
authors.lastname: Duncan
authors.affiliation: Tommy's Centre for Maternal and Fetal Health, MRC Centre for Reproductive Health, Queen's Medical Research Institute, University of Edinburgh, Edinburgh EH16 4TJ), UK. Fiona.denison@ed.ac.uk.
authors.forename: Fiona C
authors.initials: FC
authors.lastname: Denison
authors.affiliation: Endocrinology Unit, University/BHF Centre for Cardiovascular Science, Queen's Medical Research Institute, University of Edinburgh, Edinburgh EH16 4TJ, UK. shareen.forbes@ed.ac.uk.
authors.forename: Shareen
authors.initials: S
authors.lastname: Forbes
authors.affiliation: Endocrinology Unit, University/BHF Centre for Cardiovascular Science, Queen's Medical Research Institute, University of Edinburgh, Edinburgh EH16 4TJ, UK. b.walker@ed.ac.uk.
authors.forename: Brian R
authors.initials: BR
authors.lastname: Walker
authors.affiliation: Tommy's Centre for Maternal and Fetal Health, MRC Centre for Reproductive Health, Queen's Medical Research Institute, University of Edinburgh, Edinburgh EH16 4TJ), UK. jane.norman@ed.ac.uk.
authors.forename: Jane E
authors.initials: JE
authors.lastname: Norman
authors.affiliation: Endocrinology Unit, University/BHF Centre for Cardiovascular Science, Queen's Medical Research Institute, University of Edinburgh, Edinburgh EH16 4TJ, UK. r.reynolds@ed.ac.uk.|Tommy's Centre for Maternal and Fetal Health, MRC Centre for Reproductive Health, Queen's Medical Research Institute, University of Edinburgh, Edinburgh EH16 4TJ), UK. r.reynolds@ed.ac.uk.
authors.forename: Rebecca M
authors.initials: RM
authors.lastname: Reynolds
mesh_terms: D000328:Adult; D000428:Alcohol Drinking; D015992:Body Mass Index; D016022:Case-Control Studies; D004032:Diet; D019587:Dietary Supplements; D005260:Female; D005492:Folic Acid / Q000008:administration & dosage / Q000097:blood; D015438:Health Behavior; D006266:Health Education; D006801:Humans; D007501:Iron / Q000097:blood; D009043:Motor Activity; D009767:Obesity, Morbid / Q000150:complications* / Q000503:physiopathology* / Q000523:psychology; D011247:Pregnancy; D011248:Pregnancy Complications / Q000503:physiopathology*; D018566:Pregnancy, High-Risk; D011446:Prospective Studies; D012907:Smoking; D011795:Surveys and Questionnaires; D006113:United Kingdom; D014805:Vitamin B 12 / Q000097:blood
chemical_list: D005492:Folic Acid; D007501:Iron; D014805:Vitamin B 12
keywords: diet; exercise; lifestyle; micronutrients; obesity; pregnancy