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

Abstract Objective To determine the association between total gestational weight gain and perinatal outcomes. Study Design Data from the Nulliparous Pregnancy Outcomes Study: Monitoring Mothers-To-Be (NuMoM2b) study were used. Total gestational weight gain was categorized as inadequate, adequate, or excessive based on the 2009 Institute of Medicine guidelines. Outcomes examined included hypertensive disorders of pregnancy, mode of delivery, shoulder dystocia, large for gestational age or small for-gestational age birth weight, and neonatal intensive care unit admission. Results Among 8,628 women, 1,666 (19.3%) had inadequate, 2,945 (34.1%) had adequate, and 4,017 (46.6%) had excessive gestational weight gain. Excessive gestational weight gain was associated with higher odds of hypertensive disorders (adjusted odds ratio [aOR] = 2.05, 95% confidence interval [CI]: 1.78–2.36) Cesarean delivery (aOR = 1.24, 95% CI: 1.09–1.41), and large for gestational age birth weight (aOR = 1.49, 95% CI: 1.23–1.80), but lower odds of small for gestational age birth weight (aOR = 0.59, 95% CI: 0.50–0.71). Conversely, inadequate gestational weight gain was associated with lower odds of hypertensive disorders (aOR = 0.75, 95% CI: 0.62–0.92), Cesarean delivery (aOR = 0.77, 95% CI: 0.65–0.92), and a large for gestational age birth weight (aOR = 0.72, 95% CI: 0.55–0.94), but higher odds of having a small for gestational age birth weight (aOR = 1.64, 95% CI: 1.37–1.96). Conclusion Both excessive and inadequate gestational weight gain are associated with adverse maternal and neonatal outcomes.

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Gestational Weight Gain Influences Neonatal Outcomes in Women With Obesity and Gestational Diabetes

10.21203/rs.3.rs-607107/v1 ◽

2021 ◽

Author(s):

Ana M Ramos-Levi ◽

Gemma Rodriguez-Carnero ◽

Cristina Garcia-Fontao ◽

Antia Fernandez-Pombo ◽

Paula Andújar-Plata ◽

...

Keyword(s):

Weight Gain ◽

Birth Weight ◽

Gestational Diabetes ◽

Gestational Weight Gain ◽

Gestational Age ◽

Perinatal Outcomes ◽

Large For Gestational Age ◽

Gestational Weight ◽

Increased Risk ◽

The Impact

Abstract Background. Obesity and gestational diabetes mellitus (GDM) are associated to increased risk of perinatal complications and obesity in the offspring. However, the impact of gestational weight gain (GWG) on maternal and fetal outcomes has led to controversial results. Research design and methods. Retrospective study of 220 women with GDM and pre-pregnancy body mass index (BMI) ≥ 30 kg/m2. Pregnant women were classified according to the Institute of Medicine (IOM) recommendations regarding prior BMI and GWG. We evaluated the impact of GWG on birth weight and perinatal outcomes. Results. Mean maternal age was 34.7±5.3 years. Pre-pregnancy obesity was classified as grade I in 55.3% of cases, grade II in 32.0%, and grade III in 12.7%. GWG was adequate (5-9kg) in 24.2%, insufficient (< 5kg) in 41.8% and excessive (> 9kg) in 34.2%. Birthweight was within normal range in 81.9%, 3.6% were small for gestational age (SGA) and 14.4% were large for gestational age (LGA). Insufficient GWG was associated to a higher rate of SGA offspring, excessive GWG was associated to LGA and adequate GWG to normal birth weight. Conclusion. GWG in women with pre-pregnancy obesity and GDM impacts neonatal birthweight. Insufficient GWG is associated to SGA and excessive GWG is associated to LGA. Women with adequate GWG according to IOM guidelines obtained better perinatal outcomes.

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Patterns of Gestational Weight Gain and Infants Born Large-for-Gestational Age Across Consecutive Pregnancies

Women s Health Issues ◽

10.1016/j.whi.2018.10.008 ◽

2019 ◽

Vol 29 (2) ◽

pp. 194-200 ◽

Cited By ~ 1

Author(s):

Elizabeth L. Adams ◽

Michele E. Marini ◽

Krista S. Leonard ◽

Danielle Symons Downs ◽

Ian M. Paul ◽

...

Keyword(s):

Weight Gain ◽

Gestational Weight Gain ◽

Gestational Age ◽

Large For Gestational Age ◽

Gestational Weight

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Weight gain in pregnancy: is less truly more for mother and infant?

Obstetric Medicine ◽

10.1258/om.2012.120004 ◽

2012 ◽

Vol 5 (2) ◽

pp. 58-64 ◽

Cited By ~ 10

Author(s):

Linda A Barbour

Keyword(s):

Weight Gain ◽

Gestational Weight Gain ◽

Gestational Age ◽

Neonatal Morbidity ◽

Current Data ◽

Large For Gestational Age ◽

Institute Of Medicine ◽

Gestational Weight ◽

The Relationship ◽

In Pregnancy

SUMMARY Although more than 50% of women gain weight above the Institute of Medicine (IOM) guidelines for weight gain in pregnancy and excessive weight gain is an independent risk factor for significant maternal and neonatal morbidity and offspring obesity, there is little consensus over the ideal weight gain during pregnancy. Surprisingly, the 2009 IOM guidelines varied minimally from the 1990 IOM guidelines, and many critics advocate lower weight gain recommendations. This review explores the energy costs of pregnancy, the relationship between gestational weight gain and birth weight, and considers what gestational weight gain minimizes both large-for-gestational age as well as small-for-gestational age infants. An extensive examination of the current data leads this author to question whether the current weight gain recommendations are too liberal, especially for obese pregnant women.

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Comparison between American Institute of Medicine Guidelines and Local Recommendation for Gestational Weight Gain in Taiwanese Primiparous Women

10.21203/rs.3.rs-15498/v1 ◽

2020 ◽

Author(s):

Alexander Waits ◽

Chao-Yu Guo ◽

Li-Yin Chien

Keyword(s):

Weight Gain ◽

Gestational Weight Gain ◽

Gestational Age ◽

Large For Gestational Age ◽

Future Research ◽

Institute Of Medicine ◽

Weight Retention ◽

American Institute ◽

Discriminative Performance ◽

Gestational Weight

Abstract Background : American Institute of Medicine (IOM) recommends different ranges of gestational weight gain (GWG) based on pre-pregnancy body mass index (BMI). In Taiwan, IOM guidelines are implemented concurrently with the local recommendation for GWG (10–14 kg). This study compared between the two sets of guidelines in relation to adverse perinatal outcomes.Methods : We analyzed 31653 primiparas with singletons from 2011-2016 annual National Breastfeeding Surveys. Logistic regressions for preterm birth, small for gestational age (SGA), large for gestational age (LGA), cesarean section and excessive postpartum weight retention (PWR) were fitted separately for GWG categorized according to IOM and Taiwan ranges. Areas under the receiver-operator curves (AUC) and the predicted probabilities for each outcome were compared in each BMI group.Results : AUC for both guidelines ranged within 0.51 – 0.73. Compared to Taiwan recommendation, IOM ranges showed lower probabilities of SGA for underweight (0.11–0.15 versus 0.14–0.18), of LGA for obese (0.12–0.15 versus 0.15–0.18), of excessive PWR for overweight (0.19–0.30 versus 0.27–0.39), and obese (0.15–0.22 versus 0.25-0.36); and higher probabilities of excessive PWR for underweight (0.17-0.33 versus 0.14-0.22).Conclusions : Discriminative performance of IOM and Taiwan recommendations was poor for the five adverse birth outcomes, and no preference for either set of recommendations could be inferred from our results. In the absence of specific GWG guidelines, health care workers may provide inconsistent information to their patients. Future research is needed to explore optimal GWG ranges that can reliably predict locally relevant perinatal outcomes for mother and child.

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Interprovincial variation in pre-pregnancy body mass index and gestational weight gain and their impact on neonatal birth weight with respect to small and large for gestational age

Can J Public Health ◽

10.17269/s41997-018-0086-x ◽

2018 ◽

Vol 109 (4) ◽

pp. 527-538 ◽

Cited By ~ 11

Author(s):

Sarah D. McDonald ◽

Christy Woolcott ◽

Núria Chapinal ◽

Yanfang Guo ◽

Phil Murphy ◽

...

Keyword(s):

Body Mass Index ◽

Weight Gain ◽

Birth Weight ◽

Gestational Weight Gain ◽

Body Mass ◽

Gestational Age ◽

Large For Gestational Age ◽

Gestational Weight ◽

Neonatal Birth Weight

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Gestational weight gain and nutritional state of the newborn: a descriptive study

Revista Gaúcha de Enfermagem ◽

10.1590/1983-1447.2014.01.42783 ◽

2014 ◽

Vol 35 (1) ◽

pp. 62-69

Author(s):

Kelen Cristina Ramos dos SANTOS ◽

Luana Oliveira MURARO ◽

Maria Carolina WITKOWSKI ◽

Márcia Koja BREIGEIRON

Keyword(s):

Weight Gain ◽

Secondary School ◽

Gestational Weight Gain ◽

Gestational Age ◽

Family Income ◽

Nutritional State ◽

Large For Gestational Age ◽

Level Of Education ◽

Gestational Weight ◽

Excessive Weight

The objective was to characterize puerperal women in relation to gestational weight gain and their newborns in accordance with the nutritional state at birth. This is a descriptive, quantitative and retrospective study approved by the Ethics Committee at the institution responsible. The collection of data was from December 2012 to May 2013. The sample was composed of 24 puerperal women and their children. The participants presented an average age of 26.5 (DP=5.4) years, 79.2% white; 91.7% married; 58.3% multiparous; 75% with a level of education between secondary school and higher education; 58.3% with a low family income; 54.1% presented an altered pre-gestational nutritional state and 75% obtained an inadequate gestational weight gain. 79.2% of the newborns were classified as Adequate for Gestational Age (AIG). The newborns classified as Large for Gestational Age (GIG) were from pregnant women that had excessive weight gain or were overweight. It was concluded that health professionals should be attentive to nutritional deviations with the intention of avoiding complications for maternal/fetal health.

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