scholarly journals The relationship between gestational weight gain and fetal growth: time to take stock?

2014 ◽  
Vol 42 (4) ◽  
Author(s):  
Amy C. O’Higgins ◽  
Anne Doolan ◽  
Laura Mullaney ◽  
Niamh Daly ◽  
Daniel McCartney ◽  
...  
Keyword(s):  
Weight Gain ◽  
Gestational Weight Gain ◽  
Fetal Growth ◽  
Maternal Obesity ◽  
Current Evidence ◽  
Growth Time ◽  
Institute Of Medicine ◽  
Maternal Weight ◽  
Gestational Weight ◽  
The Relationship

AbstractThe aim of this article is to review the current evidence on gestational weight gain (GWG). Maternal obesity has emerged as one of the great challenges in modern obstetrics as it is becoming increasingly common and is associated with increased maternal and fetal complications. There has been an upsurge of interest in GWG with an emphasis on the relationship between excessive GWG and increased fetal growth. Recent recommendations from the Institute of Medicine in the USA have revised downwards the weight gain recommendations in pregnancy for obese mothers. We believe that it is time to take stock again about the advice that pregnant women are given about GWG and their lifestyle before, during, and after pregnancy. The epidemiological links between excessive GWG and aberrant fetal growth are weak, particularly in obese women. There is little evidence that intervention studies decrease excessive GWG or improve intrauterine fetal growth. Indeed, there is a potential risk that inappropriate interventions during the course of pregnancy may lead to fetal malnutrition that may have adverse clinical consequences, both in the short- and long-term. It may be more appropriate to shift the focus of attention from monitoring maternal weight to increasing physical activity levels and improving nutritional intakes.

scholarly journals Pre-Pregnancy Obesity, Excessive Gestational Weight Gain, and the Risk of Pregnancy-Induced Hypertension and Gestational Diabetes Mellitus

2020 ◽  
Vol 9 (6) ◽  
pp. 1980 ◽  
Author(s):  
Małgorzata Lewandowska ◽  
Barbara Więckowska ◽  
Stefan Sajdak
Keyword(s):  
Weight Gain ◽  
Pregnant Women ◽  
Gestational Weight Gain ◽  
Pregnancy Complications ◽  
Gestational Hypertension ◽  
Institute Of Medicine ◽  
Maternal Weight ◽  
Odds Ratios ◽  
Gestational Weight ◽  
The Relationship

Excessive pre-pregnancy weight is a known risk factor of pregnancy complications. The purpose of this analysis was to assess the relationship between several categories of maternal weight and the risk of developing hypertension and diabetes in pregnancy, and the relationship of these complications with the results of the newborn. It was carried out in a common cohort of pregnant women and taking into account the influence of disturbing factors. Our analysis was conducted in a prospective cohort of 912 Polish pregnant women, recruited during 2015–2016. We evaluated the women who subsequently developed diabetes with dietary modification (GDM-1) (n = 125) and with insulin therapy (GDM-2) (n = 21), as well as the women who developed gestational hypertension (GH) (n = 113) and preeclampsia (PE) (n = 24), compared to the healthy controls. Odds ratios of the complications (and confidence intervals (95%)) were calculated in the multivariate logistic regression. In the cohort, 10.8% of the women had pre-pregnancy obesity (body mass index (BMI) ≥ 30 kg/m2), and 36.8% had gestational weight gain (GWG) above the range of the Institute of Medicine recommendation. After correction for excessive GWG and other confounders, pre-pregnancy obesity (vs. normal BMI) was associated with a higher odds ratio of GH (AOR = 4.94; p < 0.001), PE (AOR = 8.61; p < 0.001), GDM-1 (AOR = 2.99; p < 0.001), and GDM-2 (AOR = 11.88; p <0.001). The threshold risk of development of GDM-2 occurred at lower BMI values (26.9 kg/m2), compared to GDM-1 (29.1 kg/m2). The threshold point for GH was 24.3 kg/m2, and for PE 23.1 kg/m2. For GWG above the range (vs. GWG in the range), the adjusted odds ratios of GH, PE, GDM-1, and GDM-2 were AOR = 1.71 (p = 0.045), AOR = 1.14 (p = 0.803), AOR = 0.74 (p = 0.245), and AOR = 0.76 (p = 0.672), respectively. The effect of maternal edema on all the results was negligible. In our cohort, hypertension and diabetes were associated with incorrect birth weight and gestational age at delivery. Conclusions: This study highlights the importance and influence of excessive pre-pregnancy maternal weight on the risk of pregnancy complications such as diabetes and hypertension which can impact fetal outcomes.

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

2012 ◽  
Vol 5 (2) ◽  
pp. 58-64 ◽  
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.

scholarly journals Maternal anthropometry: trends and inequalities in four population-based birth cohorts in Pelotas, Brazil, 1982–2015

2019 ◽  
Vol 48 (Supplement_1) ◽  
pp. i26-i36 ◽  
Author(s):  
Bernardo L Horta ◽  
Fernando C Barros ◽  
Natália P Lima ◽  
Maria C F Assunção ◽  
Iná S Santos ◽  
...  
Keyword(s):  
Socioeconomic Status ◽  
Weight Gain ◽  
Gestational Weight Gain ◽  
Family Income ◽  
Institute Of Medicine ◽  
Maternal Height ◽  
Maternal Weight ◽  
Gestational Weight ◽  
Maternity Hospitals ◽  
Overweight Or Obesity

Abstract Background Pre-pregnancy nutritional status and weight gain during pregnancy have short- and long-term consequences for the health of women and children. This study was aimed at evaluating maternal height,- and overweight or obesity at the beginning of the pregnancy and gestational weight gain, according to socioeconomic status and maternal skin colour of mothers in Pelotas, a southern Brazilian city, in 1982, 1993, 2004 and 2015. Methods In 1982, 1993, 2004 and 2015, the maternity hospitals in Pelotas were visited daily, all deliveries were identified and mothers who lived in the urban area of the city were interviewed. Maternal weight at the beginning of the pregnancy was self-reported by the mother or obtained from the antenatal card. Maternal height was collected from the maternity records or measured by the research team. Overweight or obesity was defined by a body mass index ≥25 kg/m2. Gestational weight gain was evaluated according to the Institute of Medicine guidelines. Results In the four cohorts, we evaluated 19 931 women. From 1982 to 2015, the prevalence of overweight or obesity at the beginning of the pregnancy increased from 22.1% to 47.0% and height increased by an average of 5.2 cm, whereas gestational weight gain did not change. Socioeconomic status was positively associated with maternal height, and the difference between the poorest and the wealthiest decreased. Overweight or obesity was lower among those mothers in the extreme categories of family income. Conclusions Over the 33-year span, mothers were taller at the beginning of the pregnancy, but the prevalence of overweight or obesity more than doubled.

scholarly journals Risk Factors for Excessive Gestational Weight Gain in a Healthy, Nulliparous Cohort

2014 ◽  
Vol 2014 ◽  
pp. 1-9 ◽  
Author(s):  
Antonia Restall ◽  
Rennae S. Taylor ◽  
John M. D. Thompson ◽  
Deralie Flower ◽  
Gustaaf A. Dekker ◽  
...  
Keyword(s):  
Risk Factors ◽  
Weight Gain ◽  
Gestational Weight Gain ◽  
Maternal Obesity ◽  
Child Outcomes ◽  
Multivariable Analysis ◽  
Fertility Treatment ◽  
Institute Of Medicine ◽  
Gestational Weight ◽  
Excessive Gestational Weight Gain

Objective. Excessive gestational weight gain (GWG) is associated with adverse maternal and child outcomes and contributes to obesity in women. Our aim was to identify early pregnancy factors associated with excessive GWG, in a contemporary nulliparous cohort.Methods. Participants in the SCOPE study were classified into GWG categories (“not excessive” versus “excessive”) based on pregravid body mass index (BMI) using 2009 Institute of Medicine (IOM) guidelines. Maternal characteristics and pregnancy risk factors at 14–16 weeks were compared between categories and multivariable analysis controlled for confounding factors.Results. Of 1950 women, 17% gained weight within the recommended range, 74% had excessive and 9% inadequate GWG. Women with excessive GWG were more likely to be overweight (adjOR 2.9 (95% CI 2.2–3.8)) or obese (adjOR 2.5 (95% CI 1.8–3.5)) before pregnancy compared to women with a normal BMI. Other factors independently associated with excessive GWG included recruitment in Ireland, younger maternal age, increasing maternal birthweight, cessation of smoking by 14–16 weeks, increased nightly sleep duration, high seafood diet, recent immigrant, limiting behaviour, and decreasing exercise by 14–16 weeks. Fertility treatment was protective.Conclusions. Identification of potentially modifiable risk factors for excessive GWG provides opportunities for intervention studies to improve pregnancy outcome and prevent maternal obesity.

scholarly journals Coping with Stress in Complicated Pregnancy and Gestational Weight Gain

2021 ◽  
Vol 18 (19) ◽  
pp. 10493
Author(s):  
Agnieszka Rolińska ◽  
Anna Aftyka ◽  
Marzena Samardakiewicz
Keyword(s):  
Weight Gain ◽  
Pregnant Women ◽  
Gestational Weight Gain ◽  
Maternal Obesity ◽  
Coping Styles ◽  
High Stress ◽  
Dietary Management ◽  
Institute Of Medicine ◽  
Coping With Stress ◽  
Gestational Weight

Maternal obesity is one of the leading health problems in the world. Excessive gestational weight gain (GWG) can lead to many complications during pregnancy, especially when it is accompanied by diabetes. Moreover, the risk of excessive GWG in pregnant women is significant, irrespective of prenatal counseling. Studies on this subject concerning coping with stress are lacking in the literature. The present work is aimed at evaluating the styles of coping with stress and their relation to GWG in pregnant women with gestational diabetes (GDM) for whom sudden adaptation to dietary management during this period can be challenging. It was indicated that women with GDM reported high stress related to potential maternal-fetal complications and worries about compliance with dietary management. The overall weight gain of participants in pregnancy was determined in connection to their prepregnancy body mass index (BMI) and classified based on the Institute of Medicine guidelines. A standardized psychological scale was used to assess coping styles. The results showed that almost half of the participants did not meet the Institute of Medicine recommendations for weight gain during pregnancy. There were significant correlations between the styles of coping with stress and the GWG. Additionally, low correlations were indicated between emotional, avoidant, task-oriented coping styles and the age of pregnant women with GDM. Regression analysis showed that the stress-coping style that focused on emotions was the most predictive of overall weight gain. There is a need for a better understanding of psychological barriers in achieving the recommended GWG and potential limitations in providers’ interventions, particularly for GDM.

Maternal pre-pregnancy underweight and fetal growth in relation to institute of medicine recommendations for gestational weight gain

2013 ◽  
Vol 89 (5) ◽  
pp. 277-281 ◽  
Author(s):  
Milka Jeric ◽  
Damir Roje ◽  
Nina Medic ◽  
Tomislav Strinic ◽  
Zoran Mestrovic ◽  
...  
Keyword(s):  
Weight Gain ◽  
Gestational Weight Gain ◽  
Fetal Growth ◽  
Institute Of Medicine ◽  
Gestational Weight

scholarly journals 1311Postpartum weight retention and pregnancy weight gain in women with Gestational Diabetes Mellitus (GDM)

2021 ◽  
Vol 50 (Supplement_1) ◽  
Author(s):  
Michele Drehmer ◽  
Leticia Silveira ◽  
Paula Bracco ◽  
Maria Inês Schmidt
Keyword(s):  
Weight Gain ◽  
Gestational Weight Gain ◽  
Maternal Obesity ◽  
National Health System ◽  
Institute Of Medicine ◽  
Weight Retention ◽  
Pregnancy Weight Gain ◽  
Chi Square ◽  
Gestational Weight ◽  
Pregnancy Weight

Abstract Background Since GDM is important risk factor for type 2 diabetes and maternal obesity can potentiate this outcome, the study sought to describe gestational weight gain and one-year postpartum weight retention (PPWR) in women with GDM. Methods Multicentre cohort study of 598 women with GDM enrolled in prenatal clinics of the Brazilian National Health System and followed by telephone up to 1-year postpartum. Socioeconomic and nutritional data were evaluated in recruitment. Gestational weight gain (GWG) and pre-pregnancy BMI were classified according to Institute of Medicine, 2009. PPWR was the difference between weights 1-year postpartum and pre-pregnancy. Chi-square test compared proportions of PPWR, pre-gestational BMI and GWG. Results Women had mean age 31.2 ± 6.1 years. Mean pre-pregnancy BMI was 30.3 ± 6.5 kg/m², GWG was 9.6 ± 7.3 kg and PPWR was 0.8 ± 6.8. Pre-pregnancy BMI over 25 kg/m² was found in 78%, excessive GWG in 37.6% and PPWR 1-year in 47.7%. PPWR ≥ 5kg was found in 27.6% and was higher in excessive GWG (p &lt; 0.001). Women with excessive GWG, 55.2% had PPWR ≥ 5kg. For all categories of pre-pregnancy BMI, there was higher proportion of PPWR ≥ 5kg in those who had excessive GWG. Conclusions Almost half of women who had GDM presented weight retention in 1-year postpartum. We found more PPWR in who had excessive pregnancy weight gain. Key messages PPWR is common in women with GDM and there is higher proportion of PPWR ≥ 5kg in women with excessive GWG in all pre-pregnancy BMI categories.

scholarly journals An Analysis of Behaviour Change Techniques Used in a Sample of Gestational Weight Management Trials

2016 ◽  
Vol 2016 ◽  
pp. 1-15 ◽  
Author(s):  
H. Soltani ◽  
M. A. Arden ◽  
A. M. S. Duxbury ◽  
F. J. Fair
Keyword(s):  
Weight Gain ◽  
Weight Management ◽  
Gestational Weight Gain ◽  
Behaviour Change ◽  
Maternal Obesity ◽  
Adverse Outcomes ◽  
Behaviour Change Techniques ◽  
Lifestyle Interventions ◽  
Maternal Weight ◽  
Gestational Weight

Introduction. Maternal obesity and excessive gestational weight gain are associated with multiple adverse outcomes. There is a lack of clarity on the specific components of effective interventions to support pregnant women with gestational weight management.Method. All 44 studies within a preexisting review of lifestyle interventions, with a potential to impact on maternal weight outcomes, were considered for content analysis. Interventions were classified using Behaviour Change Technique (BCT) taxonomy clusters to explore which categories of BCT were used in interventions and their effectiveness in managing gestational weight gain.Results. The most commonly used BCTs were within the categories of “feedback and monitoring,” “shaping knowledge,” “goals and planning,” “repetition and substitution,” “antecedents,” and “comparison of behaviours.” For diet and mixed interventions “feedback and monitoring,” “shaping knowledge,” and “goals and planning” appeared the most successful BCT categories.Conclusions. Poor reporting within studies in defining the BCTs used, in clarifying the differences in processes between intervention and control groups, and in differentiating between the intervention and research processes made BCT classification difficult. Future studies should elaborate more clearly on the behaviour change techniques used and report them accurately to allow a better understanding of the effective ingredients for lifestyle interventions during pregnancy.

scholarly journals Risk factors for excessive gestational weight gain in a UK population: a biopsychosocial model approach

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
S. M. Garay ◽  
L. A. Sumption ◽  
R. M. Pearson ◽  
R. M. John
Keyword(s):  
Risk Factors ◽  
Weight Gain ◽  
Gestational Weight Gain ◽  
Biopsychosocial Model ◽  
Elective Caesarean Section ◽  
Depression Symptoms ◽  
Institute Of Medicine ◽  
Contributing Factors ◽  
Gestational Weight ◽  
The Uk

Abstract Background Gestational weight gain (GWG) can have implications for the health of both mother and child. However, the contributing factors remain unclear. Despite the advantages of using a biopsychosocial approach, this approach has not been applied to study GWG in the UK. This study aimed to investigate the risk factors of excessive GWG in a UK population, employing a biopsychosocial model. Methods This study utilised data from the longitudinal Grown in Wales (GiW) cohort, which recruited women in late pregnancy in South Wales. Specifically, data was collected from midwife recorded notes and an extensive questionnaire completed prior to an elective caesarean section (ELCS) delivery. GWG was categorised according to Institute of Medicine (IOM) guidelines. The analysis was undertaken for 275 participants. Results In this population 56.0% of women had excessive GWG. Increased prenatal depression symptoms (Exp(B)=1.10, p=.019) and an overweight (Exp(B)=4.16, p<.001) or obese (Exp(B)=4.20, p=.010) pre-pregnancy BMI, consuming alcohol in pregnancy (Exp(B)=.37, p=.005) and an income of less than £18,000 (Exp(B)=.24, p=.043) and £25–43,000 (Exp(B)=.25, p=.002) were associated with excessive GWG. Conclusion GWG is complex and influenced by a range of biopsychosocial factors, with the high prevalence of excessive weight gain in this population a cause for concern. Women in the UK may benefit from a revised approach toward GWG within the National Health Service (NHS), such as tracking weight gain throughout pregnancy. Additionally, this research provides evidence for potential targets for future interventions, and potentially at-risk populations to target, to improve GWG outcomes.

scholarly journals Review of Trimester-Specific Gestational Weight Gain and Childhood Adiposity

2014 ◽  
Vol 34 (1) ◽  
pp. 48-53
Author(s):  
K Thapa
Keyword(s):  
Weight Gain ◽  
Childhood Obesity ◽  
Gestational Weight Gain ◽  
Future Research ◽  
Institute Of Medicine ◽  
Short Term ◽  
Global Epidemic ◽  
Targeted Interventions ◽  
Gestational Weight ◽  
Childhood Adiposity

Childhood obesity is a global epidemic and a major public health challenge. There has been increasing evidence that intrauterine exposures, such as alcohol, smoking, and maternal nutritional status, may affect both the long and short term health consequences of the mother and offspring. Childhood adiposity may be affected by the mother’s pre-pregnancy weight and her weight gain during pregnancy. Consequently, interventions may need to start before conception of the child to prevent childhood obesity. In 2009, the Institute of Medicine updated its gestational weight gain recommendations by incorporating rates of gestational weight gain in the second and third trimesters based on the mother’s pre-pregnancy Body Mass Index. There is extensive research on the association between total gestational weight gain and short-term offspring adiposity. However, this review focuses on the association between trimester-specific gestational weight gain and childhood adiposity for singleton pregnancies with respect to the Institute of Medicine’s newly defined weight gain recommendations as very few studies have examined the association between the gestational weight gain during each trimester and childhood adiposity. Identifying the trimester that is most associated with childhood adiposity may help in the development of targeted interventions, guide physician’s nutritional and weight-gain recommendations for child-bearing mothers, and direct future research. DOI: http://dx.doi.org/10.3126/jnps.v34i1.8429   J Nepal Paediatr Soc 2014;34(1):48-53

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