Insufficient Gestational Weight Gain and Infant Neurodevelopment at 12 Months of Age: the Japan Environment and Children’s Study

Abstract BackgroundAbnormal gestational weight gain (GWG) increases the risk of obstetric-related complications. This investigation examined the impact of GWG on infant neurodevelopmental abnormalities at 12 months of age using the data of a nationwide Japanese cohort study.MethodsQuestionnaire data were obtained from the ongoing Japan Environment and Children’s Study cohort study. GWG was subdivided as below, within, or above the reference values of the Institution of Medicine pregnancy weight guidelines. The Ages and Stages Questionnaire, third edition (ASQ-3) is a parent-reported developmental screening instrument for children across five domains: communication, gross motor, fine motor, problem solving, and personal-social. Multiple logistic regression analysis was employed to identify correlations between GWG and developmental delay defined as ASQ-3 scores of less than two standard deviations below the mean.ResultsA total of 30,694 mothers with singleton live births and partners who completed the questionnaire were analyzed. The prevalence of mothers below, within, and above the GWG guidelines was 60.4% (18,527), 32.1% (9,850), and 7.5% (2,317), respectively. We recorded 10,943 infants (35.7%) who were outliers in at least one ASQ-3 domain. After controlling for covariates, GWG below established guidelines was associated with a significantly higher risk of developmental delay for the communication (odds ratio [OR] 1.21, 95% confidence interval [CI] 1.09-1.34), gross motor (OR 1.14, 95% CI 1.05-1.24), fine motor (OR 1.13, 95% CI 1.04-1.24), problem solving (OR 1.09, 95% CI 1.01-1.18), and personal-social domains (OR 1.15, 95% CI 1.07-1.24).ConclusionThis large survey revealed a possible deleterious effect of insufficient GWG on infant neurodevelopment.The Japan Environment and Children’s Study (JECS) was registered in the UMIN Clinical Trials Registry on 15 January 2018 (number: UMIN000030786).

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Insufficient maternal gestational weight gain and infant neurodevelopment at 12 months of age: the Japan Environment and Children’s Study

European Journal of Pediatrics ◽

10.1007/s00431-021-04232-7 ◽

2021 ◽

Author(s):

Noriko Motoki ◽

Yuji Inaba ◽

Takumi Shibazaki ◽

Yuka Misawa ◽

Satoshi Ohira ◽

...

Keyword(s):

Cohort Study ◽

Weight Gain ◽

Problem Solving ◽

Developmental Delay ◽

Gestational Weight Gain ◽

Fine Motor ◽

Maternal Weight Gain ◽

Maternal Weight ◽

Gestational Weight ◽

Infant Neurodevelopment

AbstractAbnormal maternal gestational weight gain (GWG) increases the risk of obstetric-related complications. This investigation examined the impact of GWG on infant neurodevelopmental abnormalities at 12 months of age using the data of a nationwide Japanese cohort study. Questionnaire data were obtained from the ongoing Japan Environment and Children’s Study cohort study. Maternal GWG was subdivided as below, within, or above the reference values of the Institution of Medicine pregnancy weight guidelines. The Ages and Stages Questionnaire, third edition (ASQ-3) is a parent-reported developmental screening instrument for children across five domains: communication, gross motor, fine motor, problem-solving, and personal–social. Multiple logistic regression analysis was employed to identify correlations between GWG and developmental delay defined as ASQ-3 scores of less than two standard deviations below the mean. A total of 30,694 mothers with singleton live births and partners who completed the questionnaire were analyzed. The prevalence of mothers below, within, and above the GWG guidelines was 60.4% (18,527), 32.1% (9850), and 7.5% (2317), respectively. We recorded 10,943 infants (35.7%) who were outliers in at least one ASQ-3 domain. After controlling for covariates, GWG below established guidelines was associated with a significantly higher risk of developmental delay for the communication (odds ratio [OR] 1.21, 95% confidence interval [CI] 1.09–1.34), gross motor (OR 1.14, 95% CI 1.05–1.24), fine motor (OR 1.13, 95% CI 1.04–1.24), problem-solving (OR 1.09, 95% CI 1.01–1.18), and personal–social (OR 1.15, 95% CI 1.07–1.24) domains.Conclusion: This large survey revealed a possible deleterious effect of insufficient maternal GWG on infant neurodevelopment.Trial registration: The Japan Environment and Children’s Study (JECS) was registered in the UMIN Clinical Trials Registry on January 15, 2018 (number UMIN000030786). What is Known:• Inappropriate maternal gestational weight gain may cause obstetric complications and adverse birth outcomes.• Excess maternal weight gain may result in gestational diabetes, hypertension, eclampsia, caesarean delivery, and macrosomia, while insufficient maternal weight gain has been associated with pre-term birth and small for gestational age. What is New:• This study provides important information on a possible adverse effect of insufficient maternal gestational weight gain on offspring neurodevelopment at 12 months of age.• Our findings indicate a need to reconsider the optimal body mass index and gestational weight gain for women desiring pregnancy.

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The Relationship Between Pre-Pregnancy Attempts to Lose Weight and Gestational Weight Gain: An Exploratory Primary Care Prospective Cohort Study

Journal of Obstetrics and Gynaecology Canada ◽

10.1016/j.jogc.2020.09.023 ◽

2020 ◽

Author(s):

Helena Piccinini-Vallis ◽

Christy Woolcott ◽

Laura Miller ◽

Erna Snelgrove-Clarke ◽

Susan Cahill

Keyword(s):

Primary Care ◽

Cohort Study ◽

Weight Gain ◽

Gestational Weight Gain ◽

Prospective Cohort Study ◽

Prospective Cohort ◽

Gestational Weight ◽

The Relationship

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The influence of maternal dietary patterns on gestational weight gain: A large prospective cohort study in China

Nutrition ◽

10.1016/j.nut.2018.07.113 ◽

2019 ◽

Vol 59 ◽

pp. 90-95 ◽

Cited By ~ 6

Author(s):

Xueling Wei ◽

Jian-Rong He ◽

Yan Lin ◽

Minshan Lu ◽

Qianling Zhou ◽

...

Keyword(s):

Cohort Study ◽

Weight Gain ◽

Gestational Weight Gain ◽

Prospective Cohort Study ◽

Dietary Patterns ◽

Prospective Cohort ◽

Gestational Weight ◽

Large Prospective Cohort Study ◽

Large Prospective Cohort

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The impact of restricted gestational weight gain by dietary intervention on fetal growth in women with gestational diabetes mellitus

Diabetologia ◽

10.1007/s00125-018-4736-6 ◽

2018 ◽

Vol 61 (12) ◽

pp. 2528-2538 ◽

Cited By ~ 9

Author(s):

Lise L. Kurtzhals ◽

Sidse K. Nørgaard ◽

Anna L. Secher ◽

Vibeke L. Nichum ◽

Helle Ronneby ◽

...

Keyword(s):

Diabetes Mellitus ◽

Weight Gain ◽

Gestational Diabetes ◽

Gestational Diabetes Mellitus ◽

Gestational Weight Gain ◽

Fetal Growth ◽

Dietary Intervention ◽

Gestational Weight ◽

The Impact

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Maternal Body Mass Index and Gestational Weight Gain and Their Association with Pregnancy Complications and Perinatal Conditions

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph16101751 ◽

2019 ◽

Vol 16 (10) ◽

pp. 1751 ◽

Cited By ~ 11

Author(s):

Martin Simko ◽

Adrian Totka ◽

Diana Vondrova ◽

Martin Samohyl ◽

Jana Jurkovicova ◽

...

Keyword(s):

Weight Gain ◽

Cesarean Section ◽

Gestational Weight Gain ◽

Gestational Hypertension ◽

Overweight And Obesity ◽

University Hospital ◽

Maternal Body Mass Index ◽

Gestational Weight ◽

Gynecology And Obstetrics ◽

The Impact

This study aimed to evaluate the impact of selected pregnancy pathologies statistically depending on overweight/obesity and excessive maternal weight gain during pregnancy on women who gave birth in the years 2013–2015 at the Second Department of Gynecology and Obstetrics at the University Hospital in Bratislava, Slovakia. In a retrospective study, we analyzed data gathered from the sample, which consisted of 7122 women. Our results suggest a statistically significant, higher risk for the groups of women with overweight and obesity and gestational hypertension (adjusted odds ratio (AOR) = 15.3; 95% CI 9.0−25.8 for obesity), preeclampsia (AOR = 3.4; 95% CI 1.9−6.0 for overweight and AOR = 13.2; 95% CI 7.7−22.5 for obesity), and gestational diabetes mellitus (AOR = 1.9; 95% CI 1.2−2.9 for overweight and AOR = 2.4; 95% CI 1.4−4.0 for obesity). A higher incidence of pregnancies terminated by cesarean section was observed in the group of obese women. Gestational weight gain above IOM (Institute of Medicine) recommendations was associated with a higher risk of pregnancy terminated by C-section (AOR = 1.2; 95% CI 1.0−1.3), gestational hypertension (AOR = 1.7; 95% CI 1.0−2.7), and infant macrosomia (AOR = 1.7; 95% CI 1.3−2.1). Overweight and obesity during pregnancy significantly contribute to the development of pregnancy pathologies and increased incidence of cesarean section. Systematic efforts to reduce weight before pregnancy through prepregnancy dietary counseling, regular physical activity, and healthy lifestyle should be the primary goal.

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