scholarly journals Pregnancy After Laparoscopic Sleeve Gastrectomy (LSG): The Effect of Gestational Weight Gain (GWG) On Pregnancy and Perinatal Outcomes

Author(s):  
Seda SANCAK ◽  
Özgen ÇELER ◽  
ELİF ÇIRAK ◽  
ALİ ÖZDEMİR ◽  
NALAN OKUROĞLU ◽  
...  

Abstract Introduction: We aimed to evaluate the effect of gestational weight gain (GWG) according to Institute of Medicine (IOM) recommendation after laparoscopic sleeve gastrectomy (LSG) on maternal and fetal outcomes.Materials and methods: A retrospective, observational study on the medical charts of pregnant women who had previously undergone LSG between 2012 and 2020. According to IOM, GWG was grouped as insufficient, appropriate, and excessive.Results: 82 pregnancies were included in this study. GWG was appropriate in 19 of the pregnancies (23%) and was insufficient in 18 (22%) and excessive in 45 (55%) of the cases. The time from operation till conception of excessive group is significantly longer than insufficient and appropriate group (p1:0.000; p2:0.029; p<0.05). There was no statistically significant difference between the groups regarding birthweight, gestational age, cesarean deliveries (CD), preterm birth, whether their child was small or large for their gestational age. There was no difference between mean hemoglobin, anemia, low ferritin level and ferritin level at early pregnancy and predelivery between groups (p<0.05). There was no significant correlation between the time from operation till conception, birthweight and gestational age. There was no significant correlation between body mass index (BMI) at conception, birthweight and gestational age. There was no significant correlation between early and predelivery ferritin and hemoglobin and birthweight and gestational age. There was no correlation between mean GWG and mean BMI at conception between birthweight in either study group. Conclusion: The gestational weight gain (GWG) did not impact maternal and neonatal outcomes.


Author(s):  
S. M. Tafsir Hasan ◽  
Md Alfazal Khan ◽  
Tahmeed Ahmed

Although validated in other parts of the world, the suitability of the U.S. Institute of Medicine (IOM) 2009 recommendations on gestational weight gain (GWG) for Bangladeshi women remains to be examined. We evaluated the association between the weekly rate of weight gain during the second and third trimester of pregnancy, categorized according to IOM recommendations, and adverse perinatal outcomes among 1569 pregnant women with singleton live births in rural Matlab, Bangladesh. Gaining weight at rates below the IOM recommendations was associated with higher odds of preterm birth (adjusted odds ratio (AOR) = 2.0, 95% CI: 1.1–3.6), low birth weight (AOR = 1.4, 95% CI: 1.03–2.0), small-for-gestational-age newborns (AOR = 1.3, 95% CI: 1.04–1.7), and poor neonatal outcome (severe neonatal morbidity or death, AOR = 2.4, 95% CI: 1.03–5.6). A GWG rate above the recommendations was associated with higher odds of cesarean delivery (AOR = 1.7, 95% CI: 1.1–2.6), preterm birth (AOR = 2.2, 95% CI: 1.1–4.4), large-for-gestational-age newborns (AOR = 5.9, 95% CI: 1.5–23.1), and poor neonatal outcome (AOR = 2.7, 95% CI: 1.04–7.0). Our results suggest that the IOM 2009 recommendations on GWG rate during the second and third trimester may be suitable for guiding rural Bangladeshi women in the prenatal period, although the women should aim for rates near the lower bound of the range.



2021 ◽  
Author(s):  
Ana M Ramos-Levi ◽  
Gemma Rodriguez-Carnero ◽  
Cristina Garcia-Fontao ◽  
Antia Fernandez-Pombo ◽  
Paula Andújar-Plata ◽  
...  

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.



2019 ◽  
Vol 2019 ◽  
pp. 1-10 ◽  
Author(s):  
Priyanka Arora ◽  
Bani Tamber Aeri

In 1990, Institute of Medicine (IOM) recommended gestational weight gain (GWG) ranges for women in the United States primarily to improve infant birth weight. Changes in key aspects of reproductive health of women of child bearing age, a rising prevalence of obesity, and noncommunicable diseases prompted the revision of IOM guidelines in 2009. However, there is no such recommendation available for Asian women. This systematic review assesses the utility of IOM-2009 guidelines among Indian and other Asian pregnant women in terms of maternal and fetal outcomes. 624 citations were identified using PubMed and Google Scholar, out of which 13 were included. Prospective/retrospective studies of healthy Asian women with a singleton pregnancy which specifically examined fetal-maternal outcomes relative to IOM-2009 guidelines were included. Results. Majority of pregnant Indian women achieved less GWG than the recommendations whereas a mixed trend was noticed among the other Asian pregnant women. The most common fetal-maternal complications among the excessive GWG women were found to be macrosomia, large for gestational age and caesarean section followed by gestational diabetes and hypertension, whereas low birth weight, small for gestational age and preterm birth, was found to be associated with low GWG women. The findings highlight the need for appropriate GWG limits across the different body mass index levels specifically for Indians and other Asian population. However, there are not enough publications regarding the utility of IOM-2009 guidelines among the Indian and other Asian women. Thus, higher-quality researches are warranted in future to further validate the findings of the present review.



2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Dongxin Lin ◽  
Dazhi Fan ◽  
Shuzhen Wu ◽  
Gengdong Chen ◽  
Pengsheng Li ◽  
...  


2020 ◽  
Author(s):  
Jing Hu ◽  
Jinsong Gao ◽  
Juntao Liu ◽  
Xietong Wang ◽  
Jing He ◽  
...  

Abstract Abstract The study was conducted to evaluate the clinical feasibility of Institute of Medicine (IOM) recommendations on gestational weight gain (GWG) in mainland China. 88,297 singleton pregnancies from a nationwide birth registry study were included. GWG per week was calculated and grouped into within, below and above IOM (IOM) guidelines based on first trimester Chinese body weight index (BMI) status. Univariable and multivariable analyses were performed to determine the relationship between GWG category and perinatal outcomes. We found that excessive GWG was associated with increased risk in pregnancy induced hypertensive disorders (aOR 2.41, 95%CI 2.16-2.69), cesarean section (aOR 1.55, 95%CI 1.47–1.63 for nulliparas, aOR 1.51, 95%CI 1.38–1.65 for multiparas with no prior cesarean section), severe postpartum hemorrhage (aOR 1.15, 95%CI 1.06-1.26), large for gestational neonates (aOR1.76, 95%CI 1.69-1.85) and macrosomia (aOR 1.83, 95%CI 1.72-1.96), while inadequate GWG was correlated with higher risk in placenta abruption (aOR 1.54, 95%CI 1.29-1.85) , fetal distress (aOR 1.19, 95%CI 1.12-1.26), and small for gestational neonates (aOR 1.50, 95%CI 1.41-1.60). Either GWG above or below was associated with increased risk in preterm birth (aOR 1.48, 95%CI 1.38-1.58 for above, aOR 1.47, 95%CI 1.31–1.64 for below), and neonatal asphyxia (aOR 2.28, 95%CI 2.00-2.61 for above, aOR 1.42, 95%CI 1.25-1.61 for below). GWG within IOM recommendations may help prevent various adverse perinatal outcomes and seemed suitable in Chinese population.



2012 ◽  
Vol 5 (2) ◽  
pp. 58-64 ◽  
Author(s):  
Linda A Barbour

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.



2020 ◽  
Author(s):  
Alexander Waits ◽  
Chao-Yu Guo ◽  
Li-Yin Chien

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.





2021 ◽  
Author(s):  
Nandita Perumal ◽  
Dongqing Wang ◽  
Anne Marie Darling ◽  
Molin Wang ◽  
Enju Liu ◽  
...  

Introduction: Gestational weight gain (GWG) is associated with fetal and newborn health; however, data from sub-Saharan Africa are limited. Methods: We used data from a prenatal micronutrient supplementation trial among a cohort of HIV-negative pregnant women in Dar es Salaam, Tanzania to estimate the relationships between GWG and newborn outcomes. GWG adequacy was defined as the ratio of the total observed weight gain over the recommended weight gain based on the Institute of Medicine body mass index (BMI)-specific guidelines. Newborn outcomes assessed were: stillbirth, perinatal death, preterm birth, low birthweight, macrosomia, small-for-gestational age (SGA), large-for-gestational age (LGA), stunting at birth, and microcephaly. Modified Poisson regressions with robust standard error were used to estimate the relative risk of newborn outcomes as a function of GWG adequacy. Results: Of 7561 women included in this study, 51% had severely inadequate (<70%) or inadequate GWG (70-90%), 31% had adequate GWG (90-125%), and 18% had excessive GWG (≥125%). Compared to adequate GWG, severely inadequate GWG was associated with a higher risk of low birthweight, SGA, stunting at birth, and microcephaly; whereas excessive GWG was associated with a higher risk of LGA and macrosomia. Conclusion: Interventions to support optimal gestational weight gain are needed and are likely to improve newborn outcomes.



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