Excess Maternal Weight Gain and Large for Gestational Age Risk among Women with Gestational Diabetes

AbstractDespite many interventions aiming to reduce excessive gestational weight gain (GWG), it is currently unclear the impact on infant anthropometric outcomes. The aim of this review was to evaluate offspring anthropometric outcomes in studies designed to reduce GWG. A systematic search of seven international databases, one clinical trial registry and three Chinese databases was conducted without date limits. Studies were categorised by intervention type: diet, physical activity (PA), lifestyle (diet + PA), other, gestational diabetes mellitus (GDM) (diet, PA, lifestyle, metformin and other). Meta-analyses were reported as weighted mean difference (WMD) for birthweight and birth length, and risk ratio (RR) for small for gestational age (SGA), large for gestational age (LGA), macrosomia and low birth weight (LBW). Collectively, interventions reduced birthweight, risk of macrosomia and LGA by 71 g (WMD: −70.67, 95% CI −101.90 to −39.43,P<0.001), 16% (RR: 0.84, 95% CI 0.73–0.98,P=0.026) and 19% (RR: 0.81, 95% CI 0.69–0.96,P=0.015), respectively. Diet interventions decreased birthweight and LGA by 99 g (WMD −98.80, 95% CI −178.85 to −18.76,P=0.016) and 65% (RR: 0.35, 95% CI 0.17–0.72,P=0.004). PA interventions reduced the risk of macrosomia by 51% (RR: 0.49, 95% CI 0.26–0.92,P=0.036). In women with GDM, diet and lifestyle interventions reduced birthweight by 211 and 296 g, respectively (WMD: −210.93, 95% CI −374.77 to −46.71,P=0.012 and WMD:−295.93, 95% CI −501.76 to −90.10,P=0.005, respectively). Interventions designed to reduce excessive GWG lead to a small reduction in infant birthweight and risk of macrosomia and LGA, without influencing the risk of adverse outcomes including LBW and SGA.

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Gestational diabetes: influence of food intake on birth weight, HBA1, and maternal weight gain

Reproduction Nutrition Development ◽

10.1051/rnd:19970378 ◽

1997 ◽

Vol 37 (3) ◽

pp. 372-373

Author(s):

MC Nuttens ◽

O. Verier-Mine ◽

S. Biausque ◽

A. Wambergue ◽

M. Romon

Keyword(s):

Weight Gain ◽

Birth Weight ◽

Food Intake ◽

Gestational Diabetes ◽

Maternal Weight Gain ◽

Maternal Weight ◽

Influence Of Food

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277: Maternal weight gain and neonatal complications in obese women with gestational diabetes

American Journal of Obstetrics and Gynecology ◽

10.1016/j.ajog.2009.10.292 ◽

2009 ◽

Vol 201 (6) ◽

pp. S113

Author(s):

Dimitrios Mastrogiannis ◽

Emily Fischer ◽

Tasmia Henry ◽

Wadia Mulla ◽

Stamatios Mastrogiannis ◽

...

Keyword(s):

Weight Gain ◽

Gestational Diabetes ◽

Maternal Weight Gain ◽

Obese Women ◽

Maternal Weight ◽

Neonatal Complications

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Maternal weight gain in women with gestational diabetes mellitus

Journal of Perinatal Medicine ◽

10.1515/jpm-2012-0254 ◽

2013 ◽

Vol 0 (0) ◽

pp. 1-6 ◽

Cited By ~ 3

Author(s):

Edyta Horosz ◽

Dorota A. Bomba-Opon ◽

Monika Szymanska ◽

Miroslaw Wielgos

Keyword(s):

Diabetes Mellitus ◽

Weight Gain ◽

Gestational Diabetes ◽

Gestational Diabetes Mellitus ◽

Maternal Weight Gain ◽

Maternal Weight

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Maternal Weight Gain and Infant Birth Weight in Women with Class III Obesity

American Journal of Perinatology ◽

10.1055/s-0039-3402721 ◽

2019 ◽

Author(s):

Ann R. Tucker ◽

Haywood L. Brown ◽

Sarah K. Dotters-Katz

Keyword(s):

Weight Gain ◽

Birth Weight ◽

Gestational Age ◽

Morbidly Obese ◽

Maternal Weight Gain ◽

Class Iii ◽

Maternal Weight ◽

Class Iii Obesity ◽

Iom Recommendations ◽

Infant Birth

Abstract Objective The aim of this study is to describe the impact of maternal weight gain on infant birth weight among women with Class III obesity. Study Design Retrospective cohort of women with body mass index (BMI) ≥40 kg/m2 at initial prenatal visit, delivered from July 2013 to December 2017. Women presenting 14/0 weeks of gestational age (GA), delivering preterm, or had multiples or major fetal anomalies excluded. Maternal demographics and complications, intrapartum events, and neonatal outcomes abstracted. Primary outcomes were delivery of large for gestational age or small for gestational age (SGA) infant. Bivariate statistics used to compare women gaining less than Institute of Medicine (IOM) recommendations (LTR) and women gaining within recommendations (11–20 pounds/5–9.1 kg) (at recommended [AR]). Regression models used to estimate odds of primary outcomes. Results Of included women (n = 230), 129 (56%) gained LTR and 101 (44%) gained AR. In sum, 71 (31%) infants were LGA and 2 (0.8%) were SGA. Women gaining LTR had higher median entry BMI (46 vs. 43, p < 0.01); other demographics did not differ. LTR women were equally likely to deliver an LGA infant (29 vs. 34%, p = 0.5) but not more likely to deliver an SGA infant (0.8 vs. 1%, p > 0.99). After controlling for confounders, the AOR of an LGA baby for LTR women was 0.79 (95% CI: 0.4–1.4). Conclusion In this cohort of morbidly obese women, gaining less than IOM recommendations did not impact risk of having an LGA infant, without increasing risk of an SGA infant.

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Is maternal weight gain between pregnancies associated with risk of large-for-gestational age birth? Analysis of a UK population-based cohort

BMJ Open ◽

10.1136/bmjopen-2018-026220 ◽

2019 ◽

Vol 9 (7) ◽

pp. e026220 ◽

Cited By ~ 7

Author(s):

Nida Ziauddeen ◽

Sam Wilding ◽

Paul J Roderick ◽

Nicholas S Macklon ◽

Nisreen A Alwan

Keyword(s):

Weight Gain ◽

Gestational Age ◽

Population Based ◽

Overweight And Obesity ◽

Large For Gestational Age ◽

Adjusted Relative Risk ◽

Maternal Weight ◽

Overweight Women ◽

Increased Risk ◽

Maternal Overweight

ObjectiveMaternal overweight and obesity during pregnancy increases the risk of large-for-gestational age (LGA) birth and childhood obesity. We aimed to investigate the association between maternal weight change between subsequent pregnancies and risk of having a LGA birth.DesignPopulation-based cohort.SettingRoutinely collected antenatal healthcare data between January 2003 and September 2017 at University Hospital Southampton, England.ParticipantsHealth records of women with their first two consecutive singleton live-birth pregnancies were analysed (n=15 940).Primary outcome measureRisk of LGA, recurrent LGA and new LGA births in the second pregnancy.ResultsOf the 15 940 women, 16.0% lost and 47.7% gained weight (≥1 kg/m2) between pregnancies. A lower proportion of babies born to women who lost ≥1 kg/m2(12.4%) and remained weight stable between −1 and 1 kg/m2(11.9%) between pregnancies were LGA compared with 13.5% and 15.9% in women who gained 1–3 and ≥3 kg/m2, respectively. The highest proportion was in obese women who gained ≥3 kg/m2(21.2%). Overweight women had a reduced risk of recurrent LGA in the second pregnancy if they lost ≥1 kg/m2(adjusted relative risk (aRR) 0.69, 95% CI 0.48 to 0.97) whereas overweight women who gained ≥3 kg/m2were at increased risk of new LGA after having a non-LGA birth in their first pregnancy (aRR 1.35, 95% CI 1.05 to 1.75). Normal-weight women who gained weight were also at increased risk of new LGA in the second pregnancy (aRR 1.26, 95% CI 1.06 to 1.50 with gain of 1–3 kg/m2and aRR 1.34, 95% CI 1.09 to 1.65 with gain of ≥3 kg/m2).ConclusionsLosing weight after an LGA birth was associated with a reduced LGA risk in the next pregnancy in overweight women, while interpregnancy weight gain was associated with an increased new LGA risk. Preventing weight gain between pregnancies is an important measure to achieve better maternal and offspring outcomes.

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Multiple Gestation: Side Effects of Antepartum Bed Rest

Biological Research For Nursing ◽

10.1177/1099800406291455 ◽

2006 ◽

Vol 8 (2) ◽

pp. 115-128 ◽

Cited By ~ 24

Author(s):

Judith A. Maloni ◽

Seunghee Park Margevicius ◽

Elizabeth G. Damato

Keyword(s):

Depressive Symptoms ◽

Weight Gain ◽

Side Effects ◽

Gestational Age ◽

Repeated Measures ◽

Bed Rest ◽

Multiple Gestation ◽

Maternal Weight Gain ◽

Maternal Weight ◽

Infant Birth

The birth rate for higher order multiples has dramatically increased in recent decades. Multiple gestation pregnancies are considered to be at high obstetric risk. Antepartum bed rest is often prescribed to offset complications despite the lack of evidence for its effectiveness in preventing complications. This longitudinal repeated-measures study identified side effects of antepartum bed rest treatment for 31 hospitalized women with twin or triplet gestation. Maternal weight gain and infant birth weight were recorded. Antepartum stressors were measured by the Antepartum Stressors Hospital Inventory, and depressive symptoms were measured by the Center for Epidemiologic Studies Depression Scale (CES-D). Antepartum and post-partum side effects of bed rest were also assessed by the Antepartum and Postpartum Symptom Checklists. The weekly rate of maternal weight gain during hospitalization was significantly less than recent recommendations for multiple gestation weight gain (t =– 2.14,p = .04). Infant birth weights were appropriate for gestational age. There were fewer than expected small-for-gestational-age infants. Concerns regarding family status and separation from family were the major antepartum stressors. Women reported a high number of symptoms during bed rest (M= 22), which did not significantly change across 2 weeks. CES-D scores for depressive symptoms were high on antepartum hospital admission. Postpartum symptoms were initially high but had significantly declined by 6 weeks: F(1, 27)= 15.68, p = .00. These findings suggest that interventions are needed to reduce antepartum maternal weight loss, stress, physiologic and psychosocial symptoms, and depressive symptoms, as well as reduce postpartum symptoms of maternal morbidity.

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Poor maternal weight gain between 28 and 32 weeks gestation may predict small-for-gestational-age infants

BJOG An International Journal of Obstetrics & Gynaecology ◽

10.1111/j.1471-0528.1988.tb06574.x ◽

1988 ◽

Vol 95 (9) ◽

pp. 884-887 ◽

Cited By ~ 16

Author(s):

FRANK G. LAWTON ◽

GERALD C. MASON ◽

KRYSTYNA KELLY ◽

IAN N. RAMSAY ◽

GEOFFREY A. MOREWOOD

Keyword(s):

Weight Gain ◽

Gestational Age ◽

Small For Gestational Age ◽

Maternal Weight Gain ◽

Maternal Weight

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Maternal Weight Gain and its Relationship with Birth Weight of Baby at Term

Bangladesh Journal of Obstetrics & Gynaecology ◽

10.3329/bjog.v32i2.48277 ◽

2020 ◽

Vol 32 (2) ◽

pp. 79-83

Author(s):

Shiffin Rijvi ◽

Sharmin Abbasi ◽

Farhana Dewan ◽

Sehereen Farhad Siddiqua ◽

Anuradha Karmakar

Keyword(s):

Weight Gain ◽

Birth Weight ◽

Pregnant Women ◽

Cross Sectional Study ◽

Large For Gestational Age ◽

Maternal Weight Gain ◽

Maternal Weight ◽

College Hospital ◽

Cross Sectional ◽

Medical College

Background: Perinatal health is influenced by maternal weight gain. Increase in obesity in population and excess weight during pregnancy may be different complications including large for gestational age fetus. As a result cesarean delivery has increased in prevalence. Maternal weight gain during the 2nd and 3rd trimesters is an important determinant of fetal growth Objective: To determine the relationship between maternal weight gain and birth weight of baby at term. Methodology : A cross sectional study was carried among 50 pregnant women at term in the Department of Obstetrics and Gynaecology, Shaheed Suhrawardy Medical College and Hospital and Anwer Khan Modern Medical College Hospital during the period of January 2013 to July 2013. Data were collected in pre-designed data collection sheet. Results: This study found maximum (36%) were age group 21-25 years followed by 28% were ≤20 years, 24% were between 26-30 years, 8% were between 31-35 years and only 4% were of 36-40 years. The average age was 25 years. Among these 50 pregnant women, 2 cases (4%) had BMI < 18.5, 15 cases (30%) had a BMI 18.5-24.9, 19 cases (38%) had a BMI 25-29.9 and 14 cases (28%) had a BMI ≥30. The mean birth weight was 2.77±0.33. kg. Mean weight gain was 10.72±3.72 Kg. Conclusion: This study showed that reasonable maternal weight gain significantly increased birth weight of the baby at term. Bangladesh J Obstet Gynaecol, 2017; Vol. 32(2) : 79-83

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