scholarly journals Balancing the Risk of Infant Low Birth Weight and Macrosomia: an Examination of Gestational Weight Gain or Weight Loss among Obese Women

2015 ◽  
Vol 29 (S1) ◽  
Author(s):  
Nicholas Deputy ◽  
Andrea Sharma ◽  
Shin Kim
2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Noriko SATO ◽  
Naoyuki MIYASAKA

Abstract Background Japan has an exceptionally high proportion of low-weight births and underweight women. It has been suggested that an appropriate increase in gestational weight gain (GWG) for underweight women will help to prevent low birth weight. The current strategy aims to raise the desired value of GWG equally for all pregnant women within the underweight category. However, it remains elusive whether or not the relationship between GWG and birth weight for gestational age (BW/GA) are uniformly equivalent for all the women. Methods We performed a retrospective cohort analysis of women who delivered their newborns at Tokyo Medical and Dental University Hospital from 2013 to 2017. First, in order to examine the direct effect of an increase or decrease in GWG on BW/GA, we analyzed the correlation between inter-pregnancy differences in GWG and BW/GA using a sub-cohort of women who experienced two deliveries during the study period (n = 75). Second, we dichotomized the main cohort (n = 1114) according to BW/GA to verify our hypothesis that the correlation between GWG and BW/GA differs depending on the size of the newborn. Results The inter-pregnancy difference in BW/GA was not correlated with that of GWG. However, the correlation between BW/GA of siblings was high (r = 0.63, p = 1.9 × 10− 9). The correlation between GWG and BW/GA in women who delivered larger-sized newborns was higher (r = 0.17, p = 4.1 × 10− 5) than that in women who delivered smaller-sized newborns (r = 0.099, p = 1.9 × 10− 2). This disparity did not change after adjustment for pre-pregnancy BMI. The mean birth weight in the dichotomized groups corresponded to percentile 52.0 and 13.4 of the international newborn size assessed by INTERGROWTH-21st standards. Conclusions In our study, GWG was positively correlated with BW/GA for heavier neonates whose birth weights were similar to the average neonatal weight according to world standards. However, caution might be required for low-birth-weight neonates because increased GWG does not always result in increased birth weight.


2019 ◽  
Vol 6 (6) ◽  
pp. 2374 ◽  
Author(s):  
Naresh P. Motwani ◽  
Ankit Jain ◽  
Sudhakar C.

Background: Maternal undernutrition is a known to be a major factor contributing to adverse pregnancy outcomes. Gestational weight gain and young maternal age at childbearing years is associated with an increased risk low birth weight babies and infant mortality.Methods: Prospective observational study carried out in the post-natal ward of a tertiary care hospital (CM hospital) in a semi-urban area over a period of 1 year in between March 2018 and March 2019. Total 150 mothers who satisfied the inclusion criteria were enrolled. Age of the mothers was noted and were divided into 5 groups. Last known pre-pregnancy weight was recorded on re-call basis, recorded data on first visit during first month of pregnancy and again they were weighed in the third trimester at the time of admission using standard electronic weight machine. Data collected were entered in Microsoft Excel Work sheet 2018 which was imported to SPSS (version16) for data analysis. Quantitative data has been analysed by Mean, Standard deviation, T test and Karl Pearson correlation.Results: Mean birth weight among young age  mother (<20 years) was 2068 g (95%CI,±223.99) which was significantly lower than mean birth weight of 20-30 year old mother (271.19 g±95%CI, 437.02) and >30 year old mother (2932.78, 95%CI±429.99). With increase in gestational weight gain there was a corresponding increase in mean birth weight and this increase was statistically significant (r=0.435, p=<0.001).Conclusions: Maternal age and gestational weight gain had significant impact on new-born anthropometry. Young age (<20yrs) and decreased gestational weight gain is associated with increased number of low birth weight babies.


2014 ◽  
Vol 17 (2) ◽  
pp. 127-133 ◽  
Author(s):  
Jeffrey A. Gavard ◽  
Raul Artal

Limited data is available that estimates the effect of gestational weight gain on maternal and neonatal outcomes in term twin pregnancies in obese women. A historical cohort study of 831 obese (BMI ≥30.0 kg/m2) women in Missouri delivering 1,662 liveborn, term (≥37 weeks gestation) twin infants in 1998–2005 was conducted. Three gestational weight gain categories were examined: <25 pounds, 25–42 pounds, and >42 pounds. Adjusted odds ratios were calculated with multiple logistic regression, using the 2009 Institute of Medicine provisional guideline of 25–42 pounds as the reference group. Significant increasing trends with gestational weight gain were found for preeclampsia (p < .05), larger twin birth weight (p < .01), smaller twin birth weight (p < .001), and infants weighing >2,500 grams (p < .001). Significant increasing trends for preeclampsia and for cesarean delivery were found in concordant twin pairs (smaller twin >80% of birth weight of larger twin). Women who gained >42 pounds had a borderline significantly higher odds of preeclampsia than women who gained 25–42 pounds (adjusted OR 1.72; 95% CI 1.00–2.99, p = .052). No significant differences were found for 1-min Apgar score <4, 5-min Apgar score <7, or infant mortality ≤1 year. Our study suggests that increasing gestational weight gain is associated with larger infants but increased risk of preeclampsia and cesarean delivery in term twin pregnancies in obese women. Limiting gestational weight gain could reduce the risk of preeclampsia and cesarean delivery. Prospective studies of other study populations and maternal/infant outcomes are needed to evaluate the efficacy of the Institute of Medicine guideline.


2018 ◽  
Vol 15 (2) ◽  
pp. 66
Author(s):  
Imelda Fitri ◽  
Rizki Natia Wiji

Background: Based on neonatal nursing installation data at Arifin Achmad Regional Hospital in Riau Province, newborns with low birth weight have always been the highest cases.Objective: This study aimed to examine the effect of macronutrient status (carbohydrate, protein, fat) and gestational weight gain on pregnancy outcomes.Method: The design used in this study was case-control. The study sample was 74 respondents, the case group was 37 mothers with babies born with low birth weight and the control group was 37 mothers with babies born with normal birth weight. Macronutrient intake was collected with a food frequency questionnaire (FFQ). Data were analyzed by using the Chi-Square test (p<0,05).Results: Intake of low carbohydrate has 3 times risk for low birth weight (OR=3.46; 95%CI:1.25-9.47), intake of low fat has 5 times risk for low birth weight (OR=5.11; 95%CI:1.88-13.93), and intake of low protein has a 12 times risk for low birth weight (OR=12.21; 95%CI:3,97-37,94). A gestational weight gain is not following the IOM recommendations increased the risk of giving birth to a low weight baby (OR=3,96; 95%CI:1,49-10,53).Conclusion: Pregnant women with a low intake of carbohydrates, proteins, fats, and weight gain are not following the recommended increased the risk of giving birth to a low weight baby.


Nutrients ◽  
2021 ◽  
Vol 13 (4) ◽  
pp. 1213
Author(s):  
Małgorzata Lewandowska

The associations between maternal pre-pregnancy obesity and low birth weight (LBW, <2500 g) remain inconclusive. Therefore, birth weight in a Polish prospective cohort of 912 mothers was investigated depending on the pre-pregnancy body mass index (BMI). The whole cohort and the subgroup of gestational weight gain (GWG) in the range of the Institute of Medicine (IOM) recommendations, as well as ‘healthy’ women (who did not develop diabetes or hypertension in this pregnancy) were investigated. Adjusted odds ratios (AOR) of the newborn outcomes (with 95% confidence intervals, CI) for obesity (BMI ≥ 30 kg/m2) vs. normal BMI (18.5−24.9 kg/m2) were calculated using multiple logistic regression. Risk profiles (in the Lowess method) were presented for BMI values (kg/m2) and threshold BMI values were calculated. (1) In the cohort, LBW affected 6.6% of pregnancies, fetal growth restriction (FGR) 2.3%, and macrosomia 10.6%. (2) The adjusted risk of macrosomia was more than three-fold higher for obesity compared to normal BMI in the whole cohort (AOR = 3.21 (1.69−6.1), p < 0.001) and the result was maintained in the subgroups. A 17-fold higher adjusted LBW risk for obesity was found (AOR = 17.42 (1.5−202.6), p = 0.022), but only in the normal GWG subgroup. The FGR risk profile was U-shaped: in the entire cohort, the risk was more than three times higher for obesity (AOR = 3.12 (1.02−9.54), p = 0.045) and underweight (AOR = 3.84 (1.13−13.0), p = 0.031). (3) The risk profiles showed that the highest BMI values were found to be associated with a higher risk of these three newborn outcomes and the threshold BMI was 23.7 kg/m2 for macrosomia, 26.2 kg/m2 for LBW, and 31.8 kg/m2 for FGR. These results confirm the multidirectional effects of obesity on fetal growth (low birth weight, fetal growth restriction, and macrosomia). The results for LBW were heavily masked by the effects of abnormal gestational weight gain.


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