Implications of the Institute of Medicine weight gain recommendations for preventing adverse pregnancy outcomes in black and white women.

ObjectiveTo assess the associations of gestational weight gain (GWG) in early and late pregnancy with subsequent risks of adverse pregnancy outcomes in Chinese women.DesignProspective cohort study.SettingShanghai, China.ParticipantsWe studied 2630 nulliparous singleton pregnant women with complete data on weight gain in early (≤17 weeks of gestation) and late (>17 weeks) pregnancy in the Shanghai Birth Cohort.MethodsGWG was standardised into z-scores by gestational age and categorised as low (z-score <−1), normal (−1 to +1) and high (>1). The adjusted relative risks (aRRs) and 95%CIs were estimated through log-binomial regression models. Interaction effects between GWG and some other adjustment factors were tested, further stratified analyses were performed separately where interaction terms were significant.Outcome measuresAdverse maternal and neonatal outcomes.ResultsIndependent from GWG in late pregnancy, higher GWG in early pregnancy was associated with higher risks of gestational diabetes mellitus (aRR: 1.66; 95% CI: 1.11 to 2.48), caesarean section (aRR: 1.21; 95% CI: 1.05 to 1.39) and prolonged hospitalisation (aRR: 1.56; 95% CI: 1.03 to 2.38). Higher GWG in late pregnancy was independently associated with higher risks of caesarean section (aRR: 1.24; 95% CI: 1.09 to 1.41), large for gestational age (aRR: 2.01; 95% CI: 1.50 to 2.7) and macrosomia (aRR: 1.90; 95% CI: 1.30 to 2.78). In addition, the risk of gestational hypertension increased significantly with increased total GWG (aRR: 1.78; 95% CI: 1.14 to 2.76). The effects of GWG in late pregnancy on maternal and neonatal outcomes were significantly different between the women bearing a female and the women bearing male fetus.ConclusionThe GWG associations with adverse pregnancy outcomes differ at early and late pregnancy, and there may be effect modification by fetal sex in the association of GWG in late pregnancy with some pregnancy outcomes.

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Inadequate Gestational Weight Gain Predicts Adverse Pregnancy Outcomes in Mothers with Inflammatory Bowel Disease: Results from a Prospective US Pregnancy Cohort

Digestive Diseases and Sciences ◽

10.1007/s10620-017-4547-5 ◽

2017 ◽

Vol 62 (8) ◽

pp. 2063-2069 ◽

Cited By ~ 16

Author(s):

May-Bente Bengtson ◽

Christopher F. Martin ◽

Geir Aamodt ◽

Morten H. Vatn ◽

Uma Mahadevan

Keyword(s):

Inflammatory Bowel Disease ◽

Weight Gain ◽

Gestational Weight Gain ◽

Bowel Disease ◽

Pregnancy Outcomes ◽

Adverse Pregnancy Outcomes ◽

Gestational Weight ◽

Pregnancy Cohort ◽

Inflammatory Bowel ◽

Adverse Pregnancy

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The Impact of Gestational Weight Gain on the Risks of Adverse Maternal and Infant Outcomes among Normal BMI Women with High Triglyceride Levels during Early Pregnancy

Nutrients ◽

10.3390/nu13103454 ◽

2021 ◽

Vol 13 (10) ◽

pp. 3454

Author(s):

Xia-Fei Jiang ◽

Hui Wang ◽

Dan-Dan Wu ◽

Jian-Lin Zhang ◽

Ling Gao ◽

...

Keyword(s):

Weight Gain ◽

Preterm Birth ◽

Gestational Diabetes ◽

Early Pregnancy ◽

Pregnancy Outcomes ◽

Gestational Hypertension ◽

Adverse Pregnancy Outcomes ◽

Gestational Weight ◽

Adverse Pregnancy ◽

The Impact

A high maternal triglyceride (mTG) level during early pregnancy is linked to adverse pregnancy outcomes, but the use of specific interventions has been met with limited success. A retrospective cohort study was designed to investigate the impact of gestational weight gain (GWG) on the relationship between high levels of mTG and adverse pregnancy outcomes in normal early pregnancy body mass index (BMI) women. The patients included 39,665 women with normal BMI who had a singleton pregnancy and underwent serum lipids screening during early pregnancy. The main outcomes were adverse pregnancy outcomes, including gestational hypertension, preeclampsia, gestational diabetes, cesarean delivery, preterm birth, and large or small size for gestational age (LGA or SGA) at birth. As a result, the high mTG (≥2.05mM) group had increased risks for gestational hypertension ((Adjusted odds ratio (AOR), 1.80; 95% CI, 1.46 to 2.24)), preeclampsia (1.70; 1.38 to 2.11), gestational diabetes (2.50; 2.26 to 2.76), cesarean delivery (1.22; 1.13 to 1.32), preterm birth (1.42, 1.21 to 1.66), and LGA (1.49, 1.33 to 1.68) compared to the low mTG group, after adjustment for potential confounding factors. Additionally, the risks of any adverse outcome were higher in each GWG subgroup among women with high mTG than those in the low mTG group. High mTG augmented risks of gestational hypertension, preeclampsia, preterm birth, and LGA among women with 50th or greater percentile of GWG. Interestingly, among women who gained less than the 50th percentile of GWG subgroups, there was no relationship between high mTG level and risks for those pregnancy outcomes when compared to low mTG women. Therefore, weight control and staying below 50th centile of the suggested GWG according to gestational age can diminish the increased risks of adverse pregnancy outcomes caused by high mTG during early pregnancy.

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Rate of gestational weight gain trajectory is associated with adverse pregnancy outcomes

Public Health Nutrition ◽

10.1017/s1368980020002372 ◽

2020 ◽

Vol 23 (18) ◽

pp. 3304-3314

Author(s):

Heng Yaw Yong ◽

Zalilah Mohd Shariff ◽

Geeta Appannah ◽

Zulida Rejali ◽

Barakatun Nisak Mohd Yusof ◽

...

Keyword(s):

Weight Gain ◽

Pregnancy Outcomes ◽

Caesarean Delivery ◽

Adverse Pregnancy Outcomes ◽

Obese Women ◽

Gestational Weight ◽

Group 3 ◽

Group 2 ◽

Adverse Pregnancy ◽

Group 1

AbstractObjective:To examine the gestational weight gain (GWG) trajectory and its possible association with pregnancy outcomes.Design:GWG trajectories were identified using the latent class growth model. Binary logistic regression was performed to examine the associations between adverse pregnancy outcomes and these trajectories.Setting:Negeri Sembilan, Malaysia.Participants:Two thousand one hundred ninety-three pregnant women.Results:Three GWG trajectories were identified: ‘Group 1 – slow initial GWG but followed by drastic GWG’, ‘Group 2 – maintaining rate of GWG at 0·58 kg/week’ and ‘Group 3 – maintaining rate of GWG at 0·38 kg/week’. Group 1 had higher risk of postpartum weight retention (PWR) (adjusted OR (AOR) 1·02, 95 % CI 1·01, 1·04), caesarean delivery (AOR 1·03, 95 % CI 1·01, 1·04) and having low birth weight (AOR 1·04, 95 % CI 1·02, 1·05) compared with group 3. Group 2 was at higher risk of PWR (AOR 1·18, 95 % CI 1·16, 1·21), preterm delivery (AOR 1·03, 95 % CI 1·01, 1·05) and caesarean delivery (AOR 1·02, 95 % CI 1·01, 1·03), but at lower risk of having small-for-gestational-age infants (AOR 0·97, 95 % CI 0·96, 0·99) compared with group 3. The significant associations between group 1 and PWR were observed among non-overweight/obese women; between group 1 and caesarean delivery among overweight/obese women; group 2 with preterm delivery and caesarean delivery were only found among overweight/obese women.Conclusions:Higher GWG as well as increasing GWG trajectories was associated with higher risk of adverse pregnancy outcomes. Promoting GWG within the recommended range should be emphasised in antenatal care to prevent the risk of adverse pregnancy outcomes.

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