Size for gestational age at birth according to offspring sex and gestational weight gain in underweight women

2019 ◽  
Vol 10 (5) ◽  
pp. 536-541 ◽  
Author(s):  
Y. Kasuga ◽  
D. Shigemi ◽  
M. Tamagawa ◽  
T. Suzuki ◽  
S.-H. Kim ◽  
...  
Keyword(s):  
Weight Gain ◽  
Gestational Weight Gain ◽  
Gestational Age ◽  
Normal Weight ◽  
Weight Group ◽  
Normal Weight Group ◽  
Gestational Weight ◽  
Offspring Sex ◽  
Gestational Age At Birth ◽  
Age At Birth

AbstractAlthough maternal pre-pregnancy body mass index (BMI) and gestational weight gain (GWG) are related to fetal growth, there is a paucity of data regarding how offspring sex affects the relationship between maternal BMI in underweight mothers (pre-pregnancy BMI <18.5 kg/m2) and size for gestational age at birth. The aim of this study was to investigate the effect of offspring sex on the relationships among maternal pre-pregnancy BMI, GWG and size for gestational age at birth in Japanese underweight mothers. Records of women with full-term pregnancies who underwent perinatal care at Kawasaki Municipal Hospital (Kawasaki, Japan) between January 2013 and December 2017 were retrospectively reviewed. The study cohort included underweight (n=566) and normal-weight women (18.5 kg/m2⩽pre-pregnancy BMI<25 kg/m2; n=2671). The incidence of small for gestational age (SGA) births in the underweight group was significantly higher than that in the normal-weight group (P<0.01). Additionally, SGA incidence in the underweight group was significantly higher than that in the normal-weight group (P<0.01) in female, but not male (P=0.30) neonates. In the women with female neonates, pre-pregnancy underweight was associated with a significantly increased probability of SGA (odds ratio [OR]: 1.80; P<0.01), but inadequate GWG was not (OR: 1.38; P=0.11). In contrast, in women with male neonates, inadequate GWG was associated with a significantly increased probability of SGA (OR: 1.53; P=0.03), but not with pre-pregnancy underweight (OR: 1.30; P=0.10). In conclusion, the present results suggest that pre-pregnancy underweight is associated with SGA in female offspring but not in male offspring.

scholarly journals Normal Gestational Weight Gain Protects From Large-for-Gestational-Age Birth Among Women With Obesity and Gestational Diabetes

2021 ◽  
Vol 9 ◽  
Author(s):  
Sanna Mustaniemi ◽  
Hilkka Nikkinen ◽  
Aini Bloigu ◽  
Anneli Pouta ◽  
Risto Kaaja ◽  
...  
Keyword(s):  
Weight Gain ◽  
Birth Weight ◽  
Gestational Diabetes ◽  
Gestational Weight Gain ◽  
Gestational Age ◽  
Reference Group ◽  
Normal Weight ◽  
Large For Gestational Age ◽  
Lower Birth Weight ◽  
Gestational Weight

Background: Pre-pregnancy obesity, excess gestational weight gain (GWG), and gestational diabetes (GDM) increase fetal growth. Our aim was to assess whether normal GWG is associated with lower risk for a large-for-gestational-age (LGA; over the 90th percentile of birth weight for sex and gestational age) infant and lower birth weight standard deviation (SD) score in the presence of GDM and maternal obesity.Methods: This multicenter case-control study is part of the Finnish Gestational Diabetes (FinnGeDi) Study and includes singleton pregnancies of 1,055 women with GDM and 1,032 non-diabetic controls. Women were divided into 12 subgroups according to their GDM status, pre-pregnancy body mass index (BMI; kg/m2), and GWG. Non-diabetic women with normal BMI and normal GWG (according to Institute of Medicine recommendations) served as a reference group.Results: The prevalence of LGA birth was 12.2% among women with GDM and 6.2% among non-diabetic women (p &lt; 0.001). Among all women, normal GWG was associated with lower odds of LGA [odds ratio (OR) 0.57, 95% CI: 0.41–0.78]. Among women with both obesity and GDM, the odds for giving birth to a LGA infant was 2.25-fold (95% CI: 1.04–4.85) among those with normal GWG and 7.63-fold (95% CI: 4.25–13.7) among those with excess GWG compared with the reference group. Compared with excess GWG, normal GWG was associated with 0.71 SD (95% CI: 0.47–0.97) lower birth weight SD score among women with GDM and obesity. Newborns of normal weight women with GDM and normal GWG had 0.28 SD (95% CI: 0.05–0.51) lower birth weight SD scores compared with their counterparts with excess GWG. In addition, in the group of normal weight non-diabetic women, normal GWG was associated with 0.46 SD (95% CI: 0.30–0.61) lower birth weight SD scores compared with excess GWG.Conclusion: GDM, obesity, and excess GWG are associated with higher risk for LGA infants. Interventions aiming at normal GWG have the potential to lower LGA rate and birth weight SD scores even when GDM and obesity are present.

scholarly journals Gestational Weight Gain Particularly Affects the Risk of Large for Gestational Age Infants in Non-obese Mothers

2019 ◽  
Vol 79 (11) ◽  
pp. 1183-1190 ◽  
Author(s):  
Friederike Weschenfelder ◽  
Thomas Lehmann ◽  
Ekkehard Schleussner ◽  
Tanja Groten
Keyword(s):  
Risk Factor ◽  
Weight Gain ◽  
Gestational Weight Gain ◽  
Gestational Age ◽  
Significant Risk ◽  
Normal Weight ◽  
Large For Gestational Age ◽  
Excessive Weight Gain ◽  
Gestational Weight ◽  
Excessive Weight

Abstract Introduction The birth of a large for gestational age (LGA) infant is a significant risk factor for birth complications and maternal morbidity and an even higher risk factor for offspring obesity, metabolic syndrome and cardiovascular disease in later life. Relevant factors affecting the risk of delivering an LGA infant are maternal pre-gravid obesity, excessive gestational weight gain exceeding the recommendations of the Institute of Medicine (IOM) and diabetes in pregnancy. We aimed to determine what matters most in terms of the risk of fetal overgrowth. Materials and Methods We performed a database analysis of 12 701 singleton term deliveries documented in our university hospital birth registry from 2003 to 2014. Multivariate logistic regression analysis was used to determine the adjusted odds ratios. Results Excessive weight gain had the strongest impact on LGA (OR: 1.249 [95% CI: 1.018 – 1.533]) compared to maternal pre-gravid body mass index (BMI) (OR: 1.083 [95% CI: 1.066 – 1.099]) and diabetes (OR: 1.315 [95% CI: 0.997 – 1.734]). Keeping gestational weight gain within the recommendations of the IOM resulted in a risk reduction for LGA of 20% (OR: 0.801 [95% CI: 0.652 – 0.982]). The risk for LGA increases by 6.9% with each kg weight gain. Normal weight women (BMI 18.5 – 24.9 kg/m2) and moderately overweight women (BMI 25 – 29.9 kg/m2) showed the highest increase in LGA rates per kg weight gain during pregnancy (OR: 1.078 [95% CI: 1.052 – 1.104] and OR: 1.058 [95% CI: 1.026 – 1.09], resp.). Only in underweight (< 18.5 kg/m2) and normal weight women the risk of LGA birth is strongly influenced by diabetes (OR 11.818 [95% CI: 1.156–120.782] and 1.564 [95% CI: 1.013–2.415]). Conclusion Excessive weight gain is particularly important for non-obese women. These women are therefore a target cohort for intervention, as each prevented additional kilogram weight gain reduces the risk of LGA by more than 5%.

scholarly journals Development of a New Nordic Diet score and its association with gestational weight gain and fetal growth – a study performed in the Norwegian Mother and Child Cohort Study (MoBa)

2014 ◽  
Vol 17 (9) ◽  
pp. 1909-1918 ◽  
Author(s):  
Elisabet R Hillesund ◽  
Elling Bere ◽  
Margaretha Haugen ◽  
Nina C Øverby
Keyword(s):  
Weight Gain ◽  
Gestational Weight Gain ◽  
Fetal Growth ◽  
Gestational Age ◽  
Normal Weight ◽  
Large For Gestational Age ◽  
Gestational Weight ◽  
Mother And Child ◽  
New Nordic Diet ◽  
Diet Score

AbstractObjectiveTo construct a diet score for assessing degree of adherence to a healthy and environmentally friendly New Nordic Diet (NND) and to investigate its association with adequacy of gestational weight gain and fetal growth in a large prospective birth cohort.DesignMain exposure was NND adherence, categorized as low, medium or high adherence. Main outcomes were adequacy of gestational weight gain, described as inadequate, optimal or excessive according to the 2009 Institute of Medicine guidelines, and fetal growth, categorized as being small, appropriate or large for gestational age. Associations of NND adherence with gestational weight gain and fetal growth were estimated with multinomial logistic regression in crude and adjusted models.SettingNorway.SubjectsWomen (n 66 597) from the Norwegian Mother and Child Cohort Study (MoBa).ResultsHigher NND adherence implied higher energy and nutrient intakes, higher nutrient density and a healthier macronutrient distribution. Normal-weight women with high as compared with low NND adherence had lower adjusted odds of excessive gestational weight gain (OR=0·93; 95 % CI 0·87, 0·99; P=0·024). High as compared with low NND adherence was associated with reduced odds of the infant being born small for gestational age (OR=0·92; 95 % CI 0·86, 0·99; P=0·025) and with higher odds of the baby being born large for gestational age (OR=1·07; 95 % CI 1·00, 1·15; P=0·048).ConclusionsThe NND score captures diet quality. Adherence to a regional diet including a large representation of fruits and vegetables, whole grains, potatoes, fish, game, milk and drinking water during pregnancy may facilitate optimal gestational weight gain in normal-weight women and improve fetal growth in general.

scholarly journals Association between perinatal factors, genetic susceptibility to obesity and age at adiposity rebound in children of the EDEN mother–child cohort

2021 ◽  
Author(s):  
Aminata Hallimat Cissé ◽  
Sandrine Lioret ◽  
Blandine de Lauzon-Guillain ◽  
Anne Forhan ◽  
Ken K. Ong ◽  
...  
Keyword(s):  
Weight Gain ◽  
Genetic Susceptibility ◽  
Gestational Weight Gain ◽  
Gestational Age ◽  
Obesity Risk ◽  
Perinatal Factors ◽  
Gestational Weight ◽  
Adiposity Rebound ◽  
Kinetics Of

Abstract Background Early adiposity rebound (AR) has been associated with increased risk of overweight or obesity in adulthood. However, little is known about early predictors of age at AR. We aimed to study the role of perinatal factors and genetic susceptibility to obesity in the kinetics of AR. Methods Body mass index (BMI) curves were modelled by using mixed-effects cubic models, and age at AR was estimated for 1415 children of the EDEN mother–child cohort study. A combined obesity risk-allele score was calculated from genotypes for 27 variants identified by genome-wide association studies of adult BMI. Perinatal factors of interest were maternal age at delivery, parental education, parental BMI, gestational weight gain, maternal smoking during pregnancy, and newborn characteristics (sex, prematurity, and birth weight). We used a hierarchical level approach with multivariable linear regression model to investigate the association between these factors, obesity risk-allele score, and age at AR. Results A higher genetic susceptibility to obesity score was associated with an earlier age at AR. At the most distal level of the hierarchical model, maternal and paternal educational levels were positively associated with age at AR. Children born to parents with higher BMI were more likely to exhibit earlier age at AR. In addition, higher gestational weight gain was related to earlier age at AR. For children born small for gestational age, the average age at AR was 88 [±39] days lower than for children born appropriate for gestational age and 91 [±56] days lower than for children born large for gestational age. Conclusion The timing of AR seems to be an early childhood manifestation of the genetic susceptibility to adult obesity. We further identified low birth weight and gestational weight gain as novel predictors of early AR, highlighting the role of the intrauterine environment in the kinetics of adiposity.

scholarly journals The influence of pre-pregnancy body mass index and gestational weight gain on pregnancy outcomes in two-child women

2019 ◽  
Author(s):  
Hanqing Chen ◽  
Suhua Zou ◽  
Zhuyu Li ◽  
Jianbo Yang ◽  
Jian Cai ◽  
...  
Keyword(s):  
Body Mass Index ◽  
Weight Gain ◽  
Gestational Weight Gain ◽  
Body Mass ◽  
Perinatal Outcomes ◽  
Normal Weight ◽  
Excessive Weight Gain ◽  
Gestational Weight ◽  
Excessive Weight ◽  
Weight Gain During Pregnancy

Abstract Background Pre-pregnancy body mass index and gestational weight gain were related to perinatal outcomes. It was not know the changes of pre-pregnancy body mass index, weight gain during pregnancy and its effect on perinatal outcomes in two-child women.Methods This was a retrospective study. Data of single term women delivered in the First Affiliated Hospital of Sun Yat-sen University were collected from July 2017 to June 2018. Gestational weight gain criteria of the American Institute of Medical Research and pre-pregnancy body mass index classes were used to evaluate the effects on pregnancy outcomes.Results A total of 3049 cases were enrolled in the study. Overweight cases was 9.0% and obesity was 2.4%. The weight gain of the two-child women was less than that of primipara(12.4±3.9vs13.3±4.0kg, P<0.001). The proportion of primipara with excessive weight gain was higher compared to two-child women(20.1%versus17.3%, P<0.001). There were 40.0% overweight primipara and 55.2% of two-child women had excessive weight gain. And 40.5% primipara and 54.5% two-child women of obesity had excessive weight gain during pregnancy. Obese primipara increased the risk of pre-eclampsia (aOR2.38, 95%CI 0.76-7.46). And the odds of diabetes mellitus and large for gestational age also increased in this group (aOR3.49, 95%CI 1.46-8.35 and aOR7.65, 95%CI 1.83-31.97, respectively). Two-child women had similar results. Underweight primipara with excessive weight gain increased the pre-eclampsia risk (aOR2.26, 95%CI 0.29-17.46). Normal weight and overweight/obese primipara also had similar results. But in two-child women, only overweight/obesity increased the risk of pre-eclampsia (aOR2.01, 95%CI 0.41-9.98). Underweight two-child women with less weight gain increased the risk of diabetes(aOR2.06, 95%CI 0.43-9.8). Two-child women with overweight/obese increased the odds of LGA even if they had less weight gain(aOR2.58, 95%CI 0.11-63.22). Normal weight primipara and two-child women with overweight and obese with excessive weight gain had similar results. On the other way, underweight primipara with less weight gain increased the risk of SGA(aOR1.74, 95%CI 0.81-3.76).Conclusions Gestational weight gain of two-child women was less than primipara. Overweight/obese women with excessive weight gain of two-child women increased the risk of adverse outcomes.

scholarly journals Cardiometabolic and mental health in women with early gestational diabetes mellitus: A prospective cohort study

2021 ◽  
Author(s):  
Dan Yedu Quansah ◽  
Justine Gross ◽  
Leah Gilbert ◽  
Amelie Pauchet ◽  
Antje Horsch ◽  
...  
Keyword(s):  
Mental Health ◽  
Risk Factors ◽  
Weight Gain ◽  
Gestational Diabetes ◽  
Gestational Weight Gain ◽  
Gestational Age ◽  
Prospective Cohort ◽  
Gestational Weight ◽  
Pregnancy And Postpartum ◽  
History Of

Abstract Context Early diagnosis and treatment of gestational diabetes (GDM) may reduce adverse obstetric and neonatal outcomes, especially in high-risk women. However, there is a lack of data for other outcomes. Objective We compared cardiometabolic and mental health outcomes in women with early (eGDM) and classical (cGDM) GDM. Methods This prospective cohort included 1185 women with cGDM and 76 women with eGDM. eGDM had GDM-risk factors (BMI &gt;30kg/m 2, family history of diabetes, history of GDM, ethnicity), were tested at &lt;20 weeks gestational age and diagnosed using ADA prediabetes criteria. Women underwent lifestyle adaptations. Obstetric, neonatal, mental, cardiometabolic outcomes were assessed during pregnancy and postpartum. Results eGDM had lower gestational weight gain than cGDM (10.7±6.2 vs 12.6±6.4, p=0.03), but needed more medical treatment (66% vs 42%, p&lt;0.001). They had similar rates of adverse maternal and neonatal outcomes, except for increased large-for-gestational-age infants (25% vs 15%, p=0.02). Mental health during pregnancy and postpartum did not differ between groups. eGDM had more atherogenic postpartum lipid profile than cGDM (p≤0.001). In eGDM, the postpartum prevalence of metabolic syndrome (MetS) was 1.8-times, prediabetes was 3.1-times and diabetes was 7.4-times higher than cGDM (MetS-waist circumference-based: 62% vs 34%/MetS-BMI-based: 46% vs 24%; prediabetes: 47.5% vs 15.3%; diabetes: 11.9% vs 1.6%, all p&lt;0.001). These differences remained unchanged after adjusting for GDM-risk factors. Conclusion Compared to cGDM, eGDM was not associated with differences in mental health, but with increased adverse cardiometabolic outcomes, independent of GDM-risk factors and gestational weight gain. This hints to a pre-existing risk-profile in eGDM.

Examining the Effection of Second-and Third-trimester Rate of Gestational Weight Gain on Perinatal Outcomes Among Chinese Twin Gestations Based on the Provisional Guidelines: A Retrospective Cohort Study

2020 ◽  
Author(s):  
Li-hua Lin ◽  
Yi-lin Weng ◽  
Ying-ying Lin ◽  
Xiu-xian Huang ◽  
Yang Lin ◽  
...  
Keyword(s):  
Regression Analysis ◽  
Weight Gain ◽  
Gestational Weight Gain ◽  
Normal Weight ◽  
Premature Delivery ◽  
Third Trimester ◽  
Gestational Weight ◽  
Gain Rate ◽  
Twin Pregnancies ◽  
Weight Gain Rate

Abstract Background: This paper investigated how second and third trimester gestational weight gain relates toperinatal outcomes among normal weight women with twin pregnancies in Fujian, China. Methods: A retrospective study on the medical records of 931 normal weight twin pregant women was conducted in Fujian Maternity and Child Health Hospital from 2014 to 2018.The 2nd and 3rd trimester weekly weight gain rate were calculated and categorized women as gaining below, within, or above the 2009 Institute of Medicine (IOM) recommended rates . The association between trimester-specific weight gain rate and perinatal outcome was performed by traditional regression analysis among groups.Results:A total of 931 pregnant women and 1862 neonates were included for analysis. 25.9% ,19.8% and 54.3%% of women had less than, greater than and within the recommended rates of gain in the 2nd and 3rd trimester, respectively. Multivariate Logistic regression analysis showed that greater than recommended rates of weight gain in 2nd trimester decreased the risks of preeclampsia (adjusted OR:0.458,95% CI:0.255~0.824). Less than recommended rates of weight gain in 3rd trimester increased the risk of premature delivery（adjusted OR=1.926,95%CI:1.403~2.644）, gestational diabetes mellitus (adjusted OR = 2.052,95%CI:1.417~2.972), intrahepatic cholestasis syndrome (adjusted OR = 3.016,95%CI:1.057~8.606), premature rupture of the membrane (adjusted OR = 1.722,95%CI:1.180~2.512) and neonatal respiratory distress syndrome (adjusted OR = 5.135,95%CI:1.701~15.498) and decreased the risk of cesarean section (adjusted OR = 0.587,95%CI:0.385~0.893) .In addition, greater than recommended rates of weight gain in 3rd trimester was associated with increased risks in premature delivery (adjusted OR=1.818,95%CI:1.307~2.527), and gestational hypertension (adjusted OR=2.098,95%CI:1.018~4.324) as well as preeclampsia(adjusted OR:2.029, 95%CI:1.331~3.093). The stratified analysis of weight gain in 3rd trimester showed that there was no significant difference in the incidence of adverse pregnancy outcomes compared to weight gain rate groups in 2nd trimester.Conclusions: While this study showed gestational weight gain rate less than or greater than in 3rd trimester were associated with some adverse maternal and neonatal outcomes, further studies of prospective and multi-center researches are required to explore alternate ranges of gestational weight gain rate in twin pregnancies.

scholarly journals Patterns of Gestational Weight Gain in Women with Overweight or Obesity and Risk of Large for Gestational Age

Obesity Facts ◽  
2019 ◽  
Vol 12 (4) ◽  
pp. 407-415 ◽  
Author(s):  
Wei Zheng ◽  
Wenyu Huang ◽  
Zhi Zhang ◽  
Li Zhang ◽  
Zhihong Tian ◽  
...  
Keyword(s):  
Weight Gain ◽  
Gestational Weight Gain ◽  
Gestational Age ◽  
Large For Gestational Age ◽  
Gestational Weight ◽  
Overweight Or Obesity

scholarly journals Association between maternal gestational weight gain and preterm birth according to body mass index and maternal age in Quzhou, China

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Ying Hu ◽  
Qi Wu ◽  
Luyang Han ◽  
Yuqing Zou ◽  
Die Hong ◽  
...  
Keyword(s):  
Body Mass Index ◽  
Weight Gain ◽  
Preterm Birth ◽  
Gestational Weight Gain ◽  
Body Mass ◽  
Maternal Age ◽  
Preterm Births ◽  
Normal Weight ◽  
Live Births ◽  
Gestational Weight

Abstract The aim of this study is to investigate the association between maternal gestational weight gain (GWG) and preterm birth according to pre-pregnancy body mass index (BMI) and maternal age. We did a cohort, hospital-based study in Quzhou, South China, from 1 Jan 2018 to 30 June 2019. We selected 4274 singleton live births in our analysis, 315 (7.4%) of which were preterm births. In the overall population, excess GWG was significantly associated with a decreased risk of preterm birth compared with adequate GWG (adjusted OR 0.81 [95% CI 0.72–0.91]), and the risk varied by increasing maternal age and pre-pregnancy BMI. Interestingly, underweight women who older than 35 years with excess GWG had significantly increased odds of preterm birth compared with adequate GWG in underweight women aged 20–29 years (2.26 [1.06–4.85]) and normal weight women older than 35 years (2.23 [1.13–4.39]). Additionally, low GWG was positively and significantly associated with preterm birth overall (1.92 [1.47–2.50]). Among normal weight women category, compared with adequate GWG women aged 20–29 years did, those older than 20 years with low GWG, had significantly higher odds of preterm birth, which increased with maternal age (1.80 [1.16–2.79] in 20–29 years, 2.19 [1.23–3.91] in 30–34 years, 3.30 [1.68–6.46] in ≫ 35 years). In conclusion, maternal GWG was significantly associated with the risk of preterm birth, but the risk varied by pre-pregnancy BMI and maternal age.

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