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01-02-2022 | Obesity | Original Contribution

Variation in urine osmolality throughout pregnancy: a longitudinal, randomized-control trial among women with overweight and obesity

Authors: Asher Y. Rosinger, Hilary J. Bethancourt, Abigail M. Pauley, Celine Latona, Jason John, Alysha Kelyman, Krista S. Leonard, Emily E. Hohman, Katherine McNitt, Alison D. Gernand, Danielle Symons Downs, Jennifer S. Savage

Published in: European Journal of Nutrition | Issue 1/2022

Abstract

Purpose

Water needs increase during pregnancy, and proper hydration is critical for maternal and fetal health. This study characterized weekly hydration status changes throughout pregnancy and examined change in response to a randomized, behavioral intervention. An exploratory analysis tested how underhydration during pregnancy was associated with birth outcomes.

Methods

The Healthy Mom Zone Study is a longitudinal, randomized-control trial intervention aiming to regulate gestational weight gain (GWG) in pregnant women with overweight/obesity (n = 27). Fourteen women received standard of care; 13 women additionally received weekly guidance on nutrition, physical activity, water intake, and health-promoting behaviors. Hydration status was measured weekly via overnight urine osmolality (Uosm) from ~ 8–36 weeks gestation; underhydration was dichotomized (Uosm ≥ 500 mOsm/kg). Gestational age- and sex-standardized birth weight and length z scores and percentiles were calculated. We used mixed-effect and linear regression models to test covariate-adjusted relationships.

Results

No differences existed in Uosm or other characteristics between control and intervention women at baseline. Significant interactions (p = 0.01) between intervention and week of pregnancy on Uosm indicated intervention women maintained lower Uosm, whereas control women had a significant quadratic (inverse-U) relationship and greater Uosm in the second and early third trimesters. Results were consistent across robustness and sensitivity checks. Exploratory analyses suggest underhydration was associated with birth weight, but not length, in opposite ways in the second vs. third trimester.

Conclusion

A multi-component behavioral intervention helped women with overweight/obesity maintain better hydration throughout pregnancy. Future studies should confirm birth outcome results as they have important implications for early life nutrition.

Trial registration

ClinicalTrials.gov Identifier: NCT03945266; registered May 10, 2019 retrospectively.

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Title: Variation in urine osmolality throughout pregnancy: a longitudinal, randomized-control trial among women with overweight and obesity
Authors: Asher Y. Rosinger
Hilary J. Bethancourt
Abigail M. Pauley
Celine Latona
Jason John
Alysha Kelyman
Krista S. Leonard
Emily E. Hohman
Katherine McNitt
Alison D. Gernand
Danielle Symons Downs
Jennifer S. Savage
Publication date: 01-02-2022
Publisher: Springer Berlin Heidelberg
Keywords: Obesity
Obesity
Overweight
Published in: European Journal of Nutrition / Issue 1/2022
Print ISSN: 1436-6207
Electronic ISSN: 1436-6215
DOI: https://doi.org/10.1007/s00394-021-02616-x

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