Impact of Maternal Vitamin D Insufficiency on Neonatal Bone and Fat Mass

s / Annals of Epidemiology 24 (2014) 682e702 695 CI, 77.3-79.9) for women 20-59, 28.9% (95% CI, 27.6-30.3) for men from 20-59 and adults older than 59 had a prevalence of 68.6% (95% CI, 67.1-70.2). North and central regions of the country had the highest frequency of central obesity. Conclusions: Central obesity is an important public health problem in Mexico. Our results show that Mexico has higher values of central obesity compared to other countries and the problem is more important in women. Physical activity, nutrition and genetic factor should be taken into account to create health interventions programs according to Mexican population. P54. Impact of Maternal Vitamin D Insufficiency on Neonatal Bone and Fat Mass Nansi Boghossian PhD, MPH, Winston Koo, Aiyi Liu PhD, Sunni Mumford, Kerri Kissell, James Mills, Edwina Yeung PhD. National Institute of Child Health and Human Development Purpose: Conflicting evidence suggests that total maternal 25-hydroxyvitamin D [25(OH)D] is associatedwith fetal bone and fat mass. Associations with the more bioavailable, free 25(OH)D however, have not been investigated. We examined the associations for total and free 25(OH)D with neonatal bone and adiposity by dual-energy x-ray absorptiometry (DXA). Methods: 252 newborns of nulliparous women from theMemphis site of the Calcium for Preeclampsia Prevention trial (1993-1995) underwent DXA within the first week of life. Maternal serum samples, collected 3 times during pregnancy, were measured for 25(OH)D, its binding protein, and albumin fromwhich free 25(OH)D was calculated. Multiple linear regression examined whether maternal total and free 25(OH)D, averaged over pregnancy, were associated with birthweight, neonatal total and lumbar bone mineral content (BMC), bone mineral density (BMD), and fat mass after adjusting for maternal BMI, age, race, smoking status, caloric intake, and serum calcium levels. Results: 63(25%) of the women had Vitamin D insufficiency (<20 ng/ml). Means (SD) of total and free 25(OH)D were 26.5(8.8) ng/ml and 11.7(6.6) pg/ ml, respectively. Total (Blacks: 25.2(8.2), Whites 35.0(8.2) ng/ml, p<0.001) and free (Blacks: 12.2(6.7), Whites 8.5(5.3) pg/ml, p1⁄40.003) 25(OH)D differed significantly by race. Vitamin D insufficiency was associated with lower birthweight (-171.7g; 95% confidence interval (CI): -336.5, -6.97), BMD (-0.0095g/cm2, 95% CI: -0.017, -0.0023), and percent fat mass (-1.10%, 95% CI: -2.18, -0.009). No associations were found between free 25(OH)D and examined neonatal DXA measures. Conclusions: Insufficient maternal total but not free 25(OH)D status was associated with lower neonatal bone and fat mass. P55. Seasonality of Metabolic Syndrome Characteristics in the Old Order Amish Jared A. Fisher MPH, Robin C. Puett PhD, Jeff D. Yanosky PhD, Mary Pavlovich MPH, Robert M. Reed MD, James Hibbert MS, Braxton D. Mitchell PhD. University of Maryland Purpose: Prior studies have found that Metabolic Syndrome (MetS) characteristics can vary by season. In order to test if these findings hold true in a predominantly rural/agricultural population, we examined the seasonality of MetS characteristics in a cross-sectional sample of Old Order Amish from Lancaster County, Pennsylvania. This population is a genetically homogeneous population of European ancestry with high levels of physical activity, limited medication use, and rates of obesity comparable to the national average. Methods: We used criteria from the U.S. National Cholesterol Education Program Adult Treatment Panel III (ATPIII) to define MetS as the presence of at least three of the following factors: abdominal obesity, elevated blood pressure, elevated fasting plasma glucose, high serum triglycerides, and low high-density cholesterol (HDL) levels. We used analysis of covariance (ANCOVA) procedures to determine seasonal differences in means and proportions in MetS characteristics while adjusting for age and gender. Significance-level adjustments were made for post-hoc group comparisons. Results: The overall prevalence of MetS was 12.4% among 2,438 participants recruited from 1995-2007. While there were no differences in the prevalence of MetS by season, both systolic (p1⁄40.004) and diastolic (p1⁄40.008) blood pressure were higher in fall and winter compared to spring and summer. In contrast, mean HDL levels were lowest in summer compared to all other seasons (p<0.001). Conclusions: Though there was a relatively low prevalence of MetS in this population, means and proportions of certain MetS characteristics varied by season. These effects may be mediated by seasonal changes in physical activity. P56. Obesity and Work-Site Injury: The National Health Interview Survey (NHIS), 2004-2012 J.A.K. GU MSPH, Luenda E. Charles PhD, Claudia C. Ma MPH, Tara A. Hartley PhD, Michael E. Andrew PhD, John M. Violanti PhD, Cecil M. Burchfiel PhD. NIOSH/CDC Purpose: To investigate the association between obesity and work-site injury. Methods: Self-reported weight, height, and injuries within the previous threemonths were collected annually for US workers in the NHIS from 20042012. Participants were categorized as normal weight (BMI: 18.5 <25 kg/ m), overweight (BMI: 25 <30), obese I (BMI: 30 <35), and obese II (BMI: 35). Prevalence ratios (PR) and 95% confidence intervals (CI) from the fitted logistic regression model were used to assess relationships between obesity and injury. Results: Compared to normal weight workers, overweight and obese workers were more likely to experience work-site injuries (overweight: PR1⁄41.25, 95% CI1⁄41.04-1.52; obese I: 1.41 (1.14-1.74); obese II: 1.68 (1.32-2.14). These injuries were more likely to affect the lower extremities (overweight: PR1⁄41.48, 95% CI1⁄41.03-2.13; obese I: 1.70 (1.13-2.55); obese II: 2.91 (1.91-4.41) and more likely to be due to sprains/strains/twists (overweight: 1.73 (1.292.31); obese I: 2.24 (1.64-3.06); obese II: 2.95 (2.04-4.26). Conclusion: Among NHIS participants, overweight and obese workers were 25% to 68% more likely to experience injuries than normal weight workers. Weight reduction policies and management programs may be effectively targeted towards overweight and obese groups to prevent or reduce worksite injuries. P57. Association Between Prenatal Exposure to Secondhand Smoke and Risk of Postpartum Depressive Symptoms: Examination of Data from the North Carolina Pregnancy Risk Assessment and Monitoring System (2004-2008) Shama Khan MSPH, Ahmed A. Arif PhD, James N. Laditka PhD, Elizabeth F. Racine DrPH. University at North Carolina at Charlotte Purpose: The purpose of this study was to evaluate the association between residential pre-natal secondhand smoke (SHS)exposure and the risk of postpartum depressive symptoms (PPDS). Methods: This study involved secondary data analysis of 6,884 women who participated in the North Carolina Pregnancy Risk Assessment and Monitoring System (2004-2008). Data on both prenatal secondhand smoke and postpartum depressive symptoms was obtained from self-reported questionnaires. Results: In the unadjusted analysis, women exposed to SHS had nearly twice the odds of PPDS than the unexposed (OR1⁄41.90, 95%CI1⁄41.61-2.26). After adjusting for maternal race, income, Medicaid recipient status, physical activity during pregnancy, pregnancy-induced hypertension and timing of entry into prenatal care, the association between PPDS and SHS was weakened but remained statistically significant (OR1⁄41.49, 95%CI1⁄41.23-1.80). A dose response relationship was not evident in the unadjusted and adjusted analysis, because even though the odds of PPDS for women living with 1smoker (OR1⁄41.83, 95%CI1⁄41.51-2.22 for unadjusted analysis; OR1⁄41.50, 95% CI1⁄41.22-1.85 for adjusted analysis) differed from the odds of PPDS for women living with 2 or more smokers (OR1⁄42.10, 95% CI:1.60,2.73 for unadjusted analysis; OR1⁄41.46,95%CI:1.08,1.96 for adjusted analysis), their 95% confidence intervals overlapped substantially. When stratified by infant birth weight and maternal smoking during pregnancy, the adjusted odds ratio was not altered. Conclusions: The current study identified a strong, positive association between SHS and PPDS; however, future research should include using objective clinical tests or standardized scales to measure the exposure and outcome variables. Future studies should also include measuring SHS exposure at work or other public places in addition to residential exposure.