Insight Into Non-Communicable Diseases and Maternal Health Around the Globe

By: Adya Misra, Associate Editor, PLOS ONE

In many parts of the world, the “obstetric transition” is taking place—a shift from mostly direct causes of maternal deaths to more indirect causes, including those related to non-communicable diseases (NCDs). Thus, understanding the root causes of maternal morbidity and mortality is key to optimizing health for women and newborns. Recent research published in PLOS ONE focuses on non-communicable illness such as depression, obesity, cancer and diabetes during pregnancy and its impact on women and their children. The following articles have been selected from the latest collection in partnership with the Maternal Health Task Force, “Non-Communicable Diseases and Maternal Health Around the Globe.”

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 linked to adverse newborn and child health outcomes. For example, poor health behaviors can 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.

What happens when women gain too much—or too little—weight during pregnancy?

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 newborn. Typically referred to as “fetal macrosomia,” this can cause complications during birth for the mother, and the risk of injury to the newborn 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.

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.

The importance of monitoring blood profiles during and after pregnancy

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

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 postpartum depression. Postpartum depression often leads to suicidal thoughts and lack of responsiveness towards the newborn 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.

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 focused 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.

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

This post was slightly edited and originally appeared on PLOS ONE’s EveryONE blog.

Watch the video of a panel discussion marking the launch of the collection.