| Summary: | <p>This thesis assesses how gestational weight gain (GWG) influences newborn body composition (NBC) in an ethnically diverse population and determines the modifiers on that relationship. </p> <p>To answer the research question, it was important to understand what may be classified as optimal GWG. To achieve this, I carried out a systematic review of studies that produced GWG charts; this showed there was considerable heterogeneity in the quality of available GWG charts. </p> <p>GWG was transformed into z-scores; this allowed analyses, which were independent of gestation length. Newborn body composition is considered a more accurate marker of neonatal size in anthropometric research when compared with birthweight. It is usually divided into body fat percentage (BF%) and fat free mass (FFM). NBC was measured using a PEAPOD® device which calculates BF% and FFM in infants up to the age of 6 months. It is considered the gold standard of measuring NBC. </p> <p>My results showed that as GWG increased, both BF% and FFM increased. For each z-score unit increase in GWG, BF% increased by 1.8% and FFM by 292.7grams. The strongest modifiers on this relationship were BMI group, gender and GA at delivery. In addition, endocrine disorders and age at PEAPOD measurement affected only FFM and smoking affected only BF%. </p> <p>The factors driving future morbidities are, of course, complex but GWG represents a modifiable factor that is easily measured and monitored hence its appeal. Public health issues such as childhood obesity, adulthood obesity, stunting and wasting and medical issues such as cardiovascular disease and diabetes appear to be affected by fetal environment and NBC. If it is at all possible to alter these, by influencing GWG through women’s behaviour and clinical care we provide, the benefits in both the developed and developing world in the form of preventative medicine would be invaluable.</p>
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