Maternal nutrition, inadequate gestational weight gain and birth weight: results from a prospective birth cohort

Abstract Background Cesarean section (CS) is a rising public health issue globally, and is particularly serious in China. Numerous studies have suggested that gestational weight gain (GWG) control may be an effective way to reduce the rate of CS. However, rare study has examined the association between GWG and CS among women in Southwest China. We proposed to examine their association based on a prospective birth cohort, and further to explore the optimal GWG range. Methods We retrieved data from a prospective birth cohort from Sichuan Provincial Hospital for Women and Children, Southwest China. Unconditional multivariable logistic regression was used to examine the association between GWG and CS by adjusting for potential confounders. In one analysis, we incorporated the GWG as a categorical variable according to the Institute of Medicine (IOM) recommendation, similar to the method used in the majority of previous studies. In the other analysis, we directly incorporated GWG as a continuous variable and natural cubic splines were used to characterize the potential nonlinear exposure-response relationship, aiming to identify the optimal GWG. We further stratified the above analysis by pre-pregnancy BMI and GDM, and then a heterogeneity test based on a multivariate meta-analysis was conducted to examine whether the stratum specific estimations agreed with each other. Results A total of 1363 participants were included. By adopting the IOM recommendation, the adjusted OR of CS was 0.63 (0.47, 0.84) for insufficient GWG and 1.42 (1.06, 1.88) for excessive GWG. After stratification by pre-pregnancy BMI, we found a higher risk of CS in associated with excessive GWG in the stratum of underweight compared with the other strata, which implied that pre-pregnancy BMI may be an effect modifier. By applying a flexible spline regression, the optimal GWG levels in terms of reducing the CS rate based on our data were more stringent than those of IOM recommendation, which were 9–12 kg for underweight women, < 19 kg for normal weight women and < 10 kg for overweight/obese women. Conclusions These results suggested that a more stringent recommendation should be applied in Southwest China, and that more attention should be given to underweight women.

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Prenatal exposure to chlordecone, gestational weight gain, and birth weight in a Guadeloupean birth cohort

Environmental Research ◽

10.1016/j.envres.2016.08.004 ◽

2016 ◽

Vol 151 ◽

pp. 436-444 ◽

Cited By ~ 4

Author(s):

David Hervé ◽

Nathalie Costet ◽

Philippe Kadhel ◽

Florence Rouget ◽

Christine Monfort ◽

...

Keyword(s):

Weight Gain ◽

Birth Weight ◽

Birth Cohort ◽

Gestational Weight Gain ◽

Prenatal Exposure ◽

Gestational Weight

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Association of Gestational Weight Gain with Cesarean Section: A Prospective Birth Cohort Study in Southwest China

10.21203/rs.3.rs-88567/v1 ◽

2020 ◽

Author(s):

Lujiao Huang ◽

Ju Zhang ◽

Hong Sun ◽

Hongli Dong ◽

Run Li ◽

...

Keyword(s):

Weight Gain ◽

Cesarean Section ◽

Birth Cohort ◽

Gestational Weight Gain ◽

Southwest China ◽

Public Health Issue ◽

Birth Cohort Study ◽

Institute Of Medicine ◽

Gestational Weight ◽

Prospective Birth Cohort

Abstract Background: Cesarean section (CS) is a rising public health issue globally, which is even worse in China. Numerous studies have suggested that gestational weight gain (GWG) control may be an effective way to reduce the rate of CS. However, rare study has examined the association between GWG and CS among women in Southwest China. We proposed to examine their association based on a prospective birth cohort, and further to explore the optimal GWG range.Methods: We retrieved data from a prospective birth cohort conducted in Sichuan Provincial Hospital for Women and Children, Southwest China. Unconditional multivariable logistic regression was used to examine the association between GWG and CS by adjusting for potential confounders. In one analysis, we incorporated the GWG as categorical variable according to the Institute of Medicine (IOM) recommendation, just as the majority of previous studies did. In the other analysis, we directly incorporated the GWG as continuous variable and natural cubic splines was used to characterize the potential nonlinear exposure-response relationship, aiming to identify the optimal GWG. We further stratified the above analysis by pre-pregnancy BMI and GDM, and then a heterogeneity test based on multivariate meta-analysis was conducted to examine whether the stratum specific estimation agreed with each other.Results: A total of 1363 participants were included. By adopting the IOM recommendation, the adjusted OR of CS was 0.63 (0.47, 0.84) for insufficient GWG and 1.42 (1.06, 1.88) for excessive GWG respectively. When stratified by pre-pregnancy BMI, we further found that BMI may be an effect modifier with a higher risk of excessive GWG seen in the underweight women. By applying a flexible spline regression, the optimal GWG in term of reducing CS based on our data were more stringent than that of IOM recommendation, which were 9-12 kg for underweight women, <20 kg for normal weight women and <10 kg for overweight/obese women. Conclusion: These results suggested a more stringent recommendation should be applied in Southwest China, and more attention should be given to those underweight women.

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Maternal nutritional adequacy and gestational weight gain and their associations with birth outcomes among Vietnamese women

BMC Pregnancy and Childbirth ◽

10.1186/s12884-019-2643-6 ◽

2019 ◽

Vol 19 (1) ◽

Cited By ~ 1

Author(s):

Nga Thuy Tran ◽

Lam Thi Nguyen ◽

Yatin Berde ◽

Yen Ling Low ◽

Siew Ling Tey ◽

...

Keyword(s):

Weight Gain ◽

Birth Weight ◽

Pregnant Women ◽

Gestational Weight Gain ◽

Birth Outcomes ◽

Maternal Nutrition ◽

Nutrition Status ◽

Control Group ◽

Gestational Weight ◽

Vietnamese Women

Abstract Background During pregnancy, a mother’s nutritional needs increase to meet the added nutrient demands for fetal growth and development. An enhanced understanding of adequate nutrition and sufficient weight gain during pregnancy can guide development of policies and strategies for maternal nutrition care, actions that will ultimately promote better pregnancy outcomes. In a sample of pregnant women in Vietnam, this study characterized maternal nutrition status and gestational weight gain at a mid-pregnancy baseline, then examined the association of these variables with specific birth outcomes. Methods The study used baseline data from a randomized, controlled trial that compared pregnant Vietnamese women who received a nutritional intervention group with those who received only standard dietary counseling (control group). At baseline (26–29 weeks gestation), mothers’ dietary reports were collected, and intake of 10 macro- and micronutrients was estimated; data for baseline gestational weight gain was collected for all pregnant women enrolled into the study (n = 228). This analysis also used weights, lengths, and head circumferences at birth for infants of mothers in the control group. Results At baseline, 95% of the pregnant women had concurrent inadequacies for more than five nutrients, and nearly half had concurrent inadequacies for more than ten nutrients. Almost two-thirds of the pregnant women did not meet recommendations for gestational weight gain. We found a significant, inverse association between the number of nutrient inadequacies and gestational weight gain (overall p ≤ 0.045). After adjusting for potential confounders, gestational weight gain was positively associated with birth weight, length at birth, birth weight-for-age z-score and length-for-age z-score (all p ≤ 0.006). Conclusions Our findings raise concern over the high proportion of pregnant women in Vietnam who have multiple concurrent nutrient inadequacies and who fall short of meeting recommended gestational weight gain standards. To ensure better birth outcomes in this population, policies and strategies to improve the status of maternal nutrition are greatly needed. Trial registration The trial was retrospectively registered at clinicaltrials.gov on December 20, 2013, registration identifier: NCT02016586.

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Maternal Nutrition and Inadequate Gestational Weight Gain in Relation to Birth Weight: Results from a Prospective Cohort Study in India

Clinical Nutrition Research ◽

10.7762/cnr.2020.9.3.213 ◽

2020 ◽

Vol 9 (3) ◽

pp. 213

Author(s):

Kumar Guru Mishra ◽

Vikas Bhatia ◽

Ranjeeta Nayak

Keyword(s):

Cohort Study ◽

Weight Gain ◽

Birth Weight ◽

Gestational Weight Gain ◽

Prospective Cohort Study ◽

Prospective Cohort ◽

Maternal Nutrition ◽

Gestational Weight

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Abstract #534 Influence of Gestational Weight Gain and Pre-Pregnancy Body Mass Index on Birth Weight

Endocrine Practice ◽

10.1016/s1530-891x(20)46878-8 ◽

2019 ◽

Vol 25 ◽

pp. 268-269

Author(s):

Bolanle Okunowo ◽

Ifedayo Odeniyi ◽

Oluwarotimi Olopade ◽

Olufemi Fasanmade ◽

Omololu Adegbola ◽

...

Keyword(s):

Body Mass Index ◽

Weight Gain ◽

Birth Weight ◽

Gestational Weight Gain ◽

Body Mass ◽

Gestational Weight

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Impact of Maternal Glucose and Gestational Weight Gain on Child Obesity over the First Decade of Life in Normal Birth Weight Infants

Maternal and Child Health Journal ◽

10.1007/s10995-016-1955-7 ◽

2016 ◽

Vol 20 (8) ◽

pp. 1559-1568 ◽

Cited By ~ 23

Author(s):

Teresa A. Hillier ◽

Kathryn L. Pedula ◽

Kimberly K. Vesco ◽

Caryn E.S. Oshiro ◽

Keith K. Ogasawara

Keyword(s):

Weight Gain ◽

Birth Weight ◽

Gestational Weight Gain ◽

Child Obesity ◽

Normal Birth Weight ◽

Normal Birth ◽

Gestational Weight ◽

Maternal Glucose

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Composition of gestational weight gain impacts maternal fat retention and infant birth weight

American Journal of Obstetrics and Gynecology ◽

10.1067/s0002-9378(03)00596-9 ◽

2003 ◽

Vol 189 (5) ◽

pp. 1423-1432 ◽

Cited By ~ 162

Author(s):

Nancy F Butte ◽

Kenneth J Ellis ◽

William W Wong ◽

Judy M Hopkinson ◽

E.O'Brian Smith

Keyword(s):

Weight Gain ◽

Birth Weight ◽

Gestational Weight Gain ◽

Gestational Weight ◽

Infant Birth

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Gestational weight gain and its effect on fetomaternal outcome

International Journal of Reproduction Contraception Obstetrics and Gynecology ◽

10.18203/2320-1770.ijrcog20204796 ◽

2020 ◽

Vol 9 (11) ◽

pp. 4477

Author(s):

Khushboo Singh ◽

Alka Goel ◽

Anupriya Narain

Keyword(s):

Weight Gain ◽

Birth Weight ◽

Gestational Weight Gain ◽

Mode Of Delivery ◽

Normal Pregnancy ◽

Statistical Correlation ◽

Asia Pacific ◽

Hypertensive Disorder ◽

Indian Women ◽

Gestational Weight

Background: In normal pregnancy, variable amount of weight gain is a constant phenomenon. The study aims to find an association between gestational weight gain and fetomaternal outcome. GWG (using institute of medicines guidelines meant for US population) and pregnancy outcomes among Asian Indians across different BMI categories (according to WHO Asia Pacific BMI cut points) were studied.Methods: 300 women were split into the three groups based on their gestational weight gain. Namely, below recommended GWG, recommended GWG and above recommended GWG group. Comparison of various fetomaternal outcomes was done between these groups.Results: In women, who had higher than recommended GWG, 30.5% developed GDM, 23.2% had gestational hypertensive disorder, 36.6% developed hypothyroidism, 12.2% had pre-term birth and 15.9% had low birth weight. In recommended GWG category, these were 5.4%, 4.5%, 30.6%, 7.2% and 17.1% respectively; and in below recommended category, these were 14%, 1.9%, 22.4%,12.1% and 24.3% respectively.Conclusions: GWG generally follows the BMI pattern at the time of entering into pregnancy, higher the BMI more the GWG. More GWG was associated with GDM, Gestational hypertensive disorders and poor APGAR at birth. Below recommended GWG was associated with higher occurrence of GDM. No statistical correlation, between GWG and mode of delivery, NICU stay, preterm birth and birth weight was observed. Larger study is required to establish the applicability of IOM Guidelines for GWG on Indian women.

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