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

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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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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Fetal Head Growth during Early to Mid-Gestation Associated with Weight Gain in Mothers with Hyperemesis Gravidarum: A Retrospective Cohort Study

Nutrients ◽

10.3390/nu12061664 ◽

2020 ◽

Vol 12 (6) ◽

pp. 1664 ◽

Cited By ~ 1

Author(s):

Mitsue Muraoka ◽

Koichiro Takagi ◽

Mariko Ueno ◽

Yoshihiro Morita ◽

Hiroaki Nagano

Keyword(s):

Weight Gain ◽

Birth Weight ◽

Gestational Age ◽

Hyperemesis Gravidarum ◽

Abdominal Circumference ◽

Control Group ◽

Maternal Weight Gain ◽

Maternal Weight ◽

Fetal Head ◽

Head Growth

The epigenetic impact of malnutrition in mothers with hyperemesis gravidarum (HG) on their offspring has not been fully elucidated. Recently, several reports have demonstrated that children born to mothers with HG were small for gestational age and had low birth weight, reduced insulin sensitivity, and neurodevelopmental delays during childhood. Therefore, we examined the relationship between fetal growth and changes in the maternal body weight in HG cases. A total of 34 patients with HG were hospitalized and delivered at term between 2009 and 2012. The records of 69 cases of pregnant women without a history of HG were extracted after matching their maternal age, parity, pregestational body mass index (BMI), gestational age, and fetal sex ratio with those of the HG group for comparison. The maternal weight gain at term was less in the HG than in the control group. There was no statistical difference in birth weight, placental weight, and ultrasonic fetometric parameters expressed in standard deviation (SD) scores, including biparietal diameter, abdominal circumference, and femur length, between the HG and the control group. Whereas fetal head growth in the HG group was positively associated with maternal weight gain at 20 weeks of gestation only, this association was not observed in the control group. We herein demonstrate that maternal weight gain from the nadir is associated with fetal head growth at mid-gestation. Thus, maternal undernutrition in the first trimester of pregnancy could affect fetal brain growth and development, leading to an increased risk of neurodevelopmental delays in later life.

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A weight-gain-for-gestational-age z score chart for the assessment of maternal weight gain in pregnancy

American Journal of Clinical Nutrition ◽

10.3945/ajcn.112.051706 ◽

2013 ◽

Vol 97 (5) ◽

pp. 1062-1067 ◽

Cited By ~ 65

Author(s):

Jennifer A Hutcheon ◽

Robert W Platt ◽

Barbara Abrams ◽

Katherine P Himes ◽

Hyagriv N Simhan ◽

...

Keyword(s):

Weight Gain ◽

Gestational Age ◽

Maternal Weight Gain ◽

Z Score ◽

Maternal Weight ◽

In Pregnancy

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The Association between Gestational Weight Gain in Each Trimester and Pregnancy Outcomes in Twin Pregnancies

American Journal of Perinatology ◽

10.1055/s-0039-1700853 ◽

2020 ◽

Author(s):

Lilly Y. Liu ◽

Kelly B. Zafman ◽

Nathan S. Fox

Keyword(s):

Weight Gain ◽

Preterm Birth ◽

Gestational Weight Gain ◽

Gestational Age ◽

Pregnancy Outcomes ◽

Maternal Weight Gain ◽

Maternal Weight ◽

Gestational Weight ◽

Entire Pregnancy ◽

Twin Pregnancies

Abstract Objective Adequate maternal weight gain in twin pregnancies is associated with improved outcomes such as increased fetal growth and decreased incidence of preterm birth. However, it remains unclear when gestational weight gain has the greatest influence on pregnancy outcomes. Our objective was to identify at which time in a twin pregnancy does inadequate maternal weight gain have the greatest association with adverse pregnancy outcomes. Study Design This is a retrospective cohort study of women with twin pregnancies and normal prepregnancy body mass index (BMI, 18.5–24.9 kg/m2) who delivered at ≥24 weeks' gestation by a single maternal–fetal medicine practice between 2005 and 2017. Baseline characteristics and pregnancy outcomes were compared between women with and without adequate average gestational weight gain (weight gain per week based on the 2009 Institute of Medicine recommendations). This analysis was performed for weight gain over the entire pregnancy, as well as from 0 to 16, 16 to 24, and 24 weeks to delivery. Multivariable regression analysis was performed to control for potential confounding variables. Results A total of 609 women with twin pregnancies and normal prepregnancy BMI were included, of whom 386 (63.4%) had adequate average gestational weight gain over the entire pregnancy and 223 (36.6%) did not. Inadequate average gestational weight gain between 0 and 16 weeks' gestation was associated with a higher incidence of birthweight less than the 10th percentile for gestational age (adjusted odds ratio [aOR]: 1.67; 95% confidence interval [CI]: 1.11–2.51) and less than the 5th percentile for gestational age (aOR: 2.10; 95% CI: 1.29–3.40). Inadequate gestational weight gain between 16 and 24 weeks was associated with lower birthweight of the larger twin (β: –0.09; p = 0.04). Inadequate weight gain from 24 weeks to delivery was associated with spontaneous preterm birth <37 weeks' gestation (aOR: 1.67; 95% CI: 1.13–2.47), <34 weeks' gestation (aOR: 4.32; 95% CI: 2.45–7.63), <32 weeks' gestation (aOR: 9.07; 95% CI: 3.66–22.48), and a lower incidence of preeclampsia (aOR: 0.31; 95% CI: 0.16–0.63). Conclusion In twin pregnancies, gestational weight gain between 0 and 16 weeks as well as between 16 and 24 weeks is most associated with fetal growth, whereas gestational weight gain after 24 weeks is most associated with preterm birth. This may help elucidate the mechanism of action of the impact of gestational weight gain in twin pregnancies.

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