{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T01:34:12Z","timestamp":1791941652491,"version":"4.3.4"},"reference-count":39,"publisher":"MDPI AG","issue":"10","license":[{"start":{"date-parts":[[2015,10,7]],"date-time":"2015-10-07T00:00:00Z","timestamp":1444176000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Nutrients"],"abstract":"<jats:p>The health behaviours of pregnant women with very severe obesity are not known, though these women are at high risk of pregnancy complications. We carried out a prospective case-control study including 148 very severely obese (BMI &gt;40 kg\/m2) and  93 lean (BMI &lt;25 kg\/m2) pregnant women. Diet, physical activity, smoking, alcohol and folic acid consumption were assessed by questionnaire in early and late (16 and 28 weeks gestation) pregnancy. Circulating levels of iron, vitamin B12 and folate and other essential trace elements and minerals were measured in a subset at each time point. The findings biochemically confirmed that very severely obese women consumed diets that were energy-rich but poor in essential micronutrients. A third of all women met physical activity recommendations for pregnancy. A third of very severely obese women and two thirds of lean women took folic acid supplements prior to pregnancy. Very severely obese women were more likely to smoke but less likely to drink alcohol than lean women (all p &lt; 0.05). Women with very severe obesity have low self-reported intakes and circulating levels of essential micronutrients in pregnancy and few follow current recommendations for pregnancy nutrition and lifestyle. These high-risk women represent a group to target for education about health behaviours prior to and during pregnancy.<\/jats:p>","DOI":"10.3390\/nu7105403","type":"journal-article","created":{"date-parts":[[2015,10,7]],"date-time":"2015-10-07T10:39:13Z","timestamp":1444214353000},"page":"8431-8443","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":21,"title":["Health Behaviours during Pregnancy in Women with  Very Severe Obesity"],"prefix":"10.3390","volume":"7","author":[{"given":"Nor","family":"Mohd-Shukri","sequence":"first","affiliation":[{"name":"Endocrinology Unit, University\/BHF Centre for Cardiovascular Science, Queen's Medical Research Institute, University of Edinburgh, Edinburgh EH16 4TJ, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew","family":"Duncan","sequence":"additional","affiliation":[{"name":"Scottish Trace Element and Micronutrient Reference Laboratory, Macewen Building, Royal Infirmary, Glasgow G4 0SF, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fiona","family":"Denison","sequence":"additional","affiliation":[{"name":"Tommy's Centre for Maternal and Fetal Health, MRC Centre for Reproductive Health,  Queen's Medical Research Institute, University of Edinburgh, Edinburgh EH16 4TJ), UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shareen","family":"Forbes","sequence":"additional","affiliation":[{"name":"Endocrinology Unit, University\/BHF Centre for Cardiovascular Science, Queen's Medical Research Institute, University of Edinburgh, Edinburgh EH16 4TJ, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brian","family":"Walker","sequence":"additional","affiliation":[{"name":"Endocrinology Unit, University\/BHF Centre for Cardiovascular Science, Queen's Medical Research Institute, University of Edinburgh, Edinburgh EH16 4TJ, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jane","family":"Norman","sequence":"additional","affiliation":[{"name":"Tommy's Centre for Maternal and Fetal Health, MRC Centre for Reproductive Health,  Queen's Medical Research Institute, University of Edinburgh, Edinburgh EH16 4TJ), UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rebecca","family":"Reynolds","sequence":"additional","affiliation":[{"name":"Endocrinology Unit, University\/BHF Centre for Cardiovascular Science, Queen's Medical Research Institute, University of Edinburgh, Edinburgh EH16 4TJ, UK"},{"name":"Tommy's Centre for Maternal and Fetal Health, MRC Centre for Reproductive Health,  Queen's Medical Research Institute, University of Edinburgh, Edinburgh EH16 4TJ), UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2015,10,7]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"420","DOI":"10.1038\/ijo.2009.250","article-title":"A nationally representative study of maternal obesity in England, UK: trends in incidence and demographic inequalities in 619 323 births, 1989\u20132007","volume":"34","author":"Heslehurst","year":"2010","journal-title":"Int. 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