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Addressing healthcare needs of women and mothers to ensure a healthy future

The first National Women’s Day was observed in the United States on February 28th 1909 in honour of the garment worker’s strike of 1908, where women had protested against their working conditions. Now recognised and celebrated on 8th March, International Women’s Day is an opportunity to highlight achievements of women in all spheres of life and to remind ourselves of the challenges faced by the modern woman.

In close collaboration with the Maternal Health Task Force based at Harvard T.H. Chan School of Public Health, PLOS have been committed to increasing awareness in women’s health and particularly, in maternal health across the globe. Since 2011, we have published research articles focussing on various aspects of maternal health, including the quality of healthcare, inequality within maternal health, needs of mother-child pairs and non-communicable diseases in pregnancy.

This year on International Women’s Day, we have chosen to highlight some recent research published in PLOS ONE that focuses on non-communicable illness such as depression or obesity during pregnancy and how it impacts women and their children. The following articles have been selected from the latest collection “Non-Communicable Diseases and Maternal Health Around the Globe” in partnership with the Maternal Health Task Force.

 

Impact of mother’s weight gain on the baby

 

Gaining weight is a natural part of pregnancy, but what happens when mothers gain more weight than is recommended during their pregnancy? A recent study published in PLOS ONE studied the weight gained during pregnancy in young mothers (age 15-24) living in large cities in the United States. Authors found that young women who were overweight or obese, were more likely to gain excess weight during their pregnancy. Excessive weight gain during pregnancy has been shown to lead to adversely affect health of the new-born baby in several ways. For instance, poor health behaviours be passed on from mothers to children, obesity during pregnancy can lead to complications during pregnancy or increased risk of obesity to the child in later life.

Image from Scott Sherrill-Mix (Flickr) under CC BY-NC 2.0

Related to this, another study from researchers in Lebanon showed that mothers (age 18-40) who did not gain sufficient weight during pregnancy were at risk of having babies who were also underweight. The authors attributed this to the lack of sufficient nutrients to the developing fetus during pregnancy. They also showed that mothers who gained more weight than recommended during pregnancy gave birth to babies that were larger than the average new-born. Typically referred to as “Fetal macrosomia”, this can cause complications during birth for the mother and the risk of injury to the new-born is also high. Both studies highlight the importance of screening pregnant women who are underweight or overweight so that they may receive tailored interventions to maintain a healthy weight during pregnancy.

 

What happens when women gain excess weight during pregnancy?

Researchers from Mexico investigated markers associated with diabetes and cardiovascular disease in women who were overweight or obese during pregnancy (age 13-44). Authors showed that in the third trimester, women who had gained excessive weight during pregnancy had higher levels of circulating fat (called triglycerides) in the blood and insulin (hormone produced by the pancreas). Although these markers increase the risk of gestational diabetes (high blood sugar during pregnancy) and pre-eclampsia (high blood pressure during pregnancy), these subtle changes did not cause adverse events during pregnancy, however they might be responsible for changes to the developing fetus that predispose to development of metabolic diseases in the future.

 

How do abnormal levels of metabolic markers during pregnancy affect the wellbeing of the mother?

One of the recently published articles focused on the effects of variations in blood profile in women after pregnancy. This work studied women in southern India, who came to the clinic six months after giving birth for a routine check. Authors screened women for symptoms of mental illness and found that 27% of women were experiencing symptoms of post-partum depression. Post-partum depression often leads to suicidal thoughts and lack of responsiveness towards the new-born baby. Upon studying the blood levels of various markers in these women, authors found that there was a correlation between the levels of total cholesterol and the “good” cholesterol High Density Lipoprotein cholesterol (HDL-c) with the severity of depression. This study thus highlights the importance of monitoring blood profiles in women after birth so that they can receive appropriate help and treatment.

 

Image from UNICEF (Flickr) under CC BY-NC-ND 2.0

 

How does mental illness in mothers affect their children?

Developing symptoms of mental illness after giving birth is a neglected topic in women’s health. Studies that have highlighted postpartum depression in women have focussed on screening those at risk and developing policy on how best to provide appropriate therapeutic interventions. However, fewer studies have investigated the effects of maternal mental illness on the mental health of the child.  Researchers in Canada investigated how depression and anxiety in mothers affected the development of their children. The authors found that recurring mental health illness in mothers was likely to affect physical and general cognitive skills in their children.

 

References

 

Chang T, Moniz MH, Plegue MA, Sen A, Davis MM, Villamor E, et al. (2017) Characteristics of women age 15-24 at risk for excess weight gain during pregnancy. PLoS ONE 12(3): e0173790.

Papazian T, Abi Tayeh G, Sibai D, Hout H, Melki I, Rabbaa Khabbaz L (2017) Impact of maternal body mass index and gestational weight gain on neonatal outcomes among healthy Middle-Eastern females. PLoS ONE 12(7): e0181255.

Perichart-Perera O, Muñoz-Manrique C, Reyes-López A, Tolentino-Dolores M, Espino y Sosa S, Ramírez-González MC (2017) Metabolic markers during pregnancy and their association with maternal and newborn weight status. PLoS ONE 12(7): e0180874.

Ramachandran Pillai R, Wilson AB, Premkumar NR, Kattimani S, Sagili H, Rajendiran S (2018) Low serum levels of High-Density Lipoprotein cholesterol (HDL-c) as an indicator for the development of severe postpartum depressive symptoms. PLoS ONE 13(2): e0192811.

Comaskey B, Roos NP, Brownell M, Enns MW, Chateau D, Ruth CA, et al. (2017) Maternal depression and anxiety disorders (MDAD) and child development: A Manitoba population-based study. PLoS ONE 12(5): e0177065.

Featured Image by Jake Guild (Flickr) under CC-BY 2.0

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