scholarly journals Association of Maternal Weight and Gestational Weight Gain with Maternal and Neonate Outcomes: A Prospective Cohort Study

2019 ◽  
Vol 8 (12) ◽  
pp. 2074 ◽  
Author(s):  
Damien Bouvier ◽  
Jean-Claude Forest ◽  
Emilie Dion-Buteau ◽  
Nathalie Bernard ◽  
Emmanuel Bujold ◽  
...  
Keyword(s):  
Weight Gain ◽  
Gestational Weight Gain ◽  
Prospective Cohort ◽  
Caesarean Delivery ◽  
Second Trimester ◽  
Perinatal Complications ◽  
Third Trimester ◽  
Gestational Weight ◽  
Iom Recommendations ◽  
Trajectory Modelling

We investigated the association of outcomes with pre-pregnancy body mass index (ppBMI), Institute of Medicine (IOM) recommendations about gestational weight gain, and weight gain trajectories during pregnancy. A prospective cohort of 7866 pregnant women was recruited. ppBMI and weight gain at each follow up visit were collected. The outcomes were gestational diabetes mellitus (GDM), hypertensive disorders of pregnancy (HDP), caesarean delivery, macrosomia, small (SGA) and large (LGA) for gestational age, neonatal hypoglycemia. Group-based multi-trajectory modelling was used for weight kinetics during pregnancy. In the third trimester, 53.8% of women were above IOM recommendations, with an increased relative risk (RR) of HDP (1.91 (1.40–2.61)), caesarean (1.34 (1.15–1.56)), macrosomia (2.17 (1.77–2.67)), LGA (2.26 (1.83–2.80)), and hypoglycemia (1.89 (1.12–3.18)). Women with a weight gain above IOM recommendations in the second trimester who normalized their weight gain in third trimester had, compared to those who remained above IOM recommendations, fewer events of HDP (2.8% versus 5.3%, p = 0.008), caesarean delivery (16.9% versus 22%, p = 0.006), macrosomia (8.3% versus 14.2%, p < 0.001), and LGA (7% versus 13.2%, p < 0.001). Multi-trajectory modelling identified three profiles with continued variation in RR of complications, including GDM. Weight gain above IOM recommendations increased the risk of perinatal complications. A correction of excessive weight gain in the second trimester reduces these risks.

scholarly journals Excessive gestational weight gain in the first trimester is associated with risk of gestational diabetes mellitus: a prospective study from Southwest China

2019 ◽  
Vol 23 (3) ◽  
pp. 394-401 ◽  
Author(s):  
Xi Lan ◽  
Yi-qi Zhang ◽  
Hong-li Dong ◽  
Ju Zhang ◽  
Feng-ming Zhou ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Weight Gain ◽  
Gestational Weight Gain ◽  
Southwest China ◽  
First Trimester ◽  
Normal Weight ◽  
Second Trimester ◽  
Obese Women ◽  
Gestational Weight ◽  
Iom Recommendations

AbstractObjective:To evaluate the effects of gestational weight gain (GWG) in the first trimester (GWG-F) and the rate of gestational weight gain in the second trimester (RGWG-S) on gestational diabetes mellitus (GDM), exploring the optimal GWG ranges for the avoidance of GDM in Chinese women.Design:A population-based prospective study was conducted. Gestational weight was measured regularly in every antenatal visit and assessed by the Institute of Medicine (IOM) criteria (2009). GDM was assessed with the 75-g, 2-h oral glucose tolerance test at 24–28 weeks of gestation. Multivariable logistic regression was performed to assess the effects of GWG-F and RGWG-S on GDM, stratified by pre-pregnancy BMI. In each BMI category, the GWG values corresponding to the lowest prevalence of GDM were defined as the optimal GWG range.Setting:Southwest China.Participants:Pregnant women (n 1910) in 2017.Results:After adjusting for confounders, GWG-F above IOM recommendations increased the risk of GDM (OR; 95 % CI) among underweight (2·500; 1·106, 5·655), normal-weight (1·396; 1·023, 1·906) and overweight/obese women (3·017; 1·118, 8·138) compared with women within IOM recommendations. No significant difference was observed between RGWG-S and GDM (P > 0·05) after adjusting for GWG-F based on the previous model. The optimal GWG-F ranges for the avoidance of GDM were 0·8–1·2, 0·8–1·2 and 0·35–0·70 kg for underweight, normal-weight and overweight/obese women, respectively.Conclusions:Excessive GWG in the first trimester, rather than the second trimester, is associated with increased risk of GDM regardless of pre-pregnancy BMI. Obstetricians should provide more pre-emptive guidance in achieving adequate GWG-F.

scholarly journals Institute of Medicine Recommendations on the Rate of Gestational Weight Gain and Perinatal Outcomes in Rural Bangladesh

2021 ◽  
Vol 18 (12) ◽  
pp. 6519
Author(s):  
S. M. Tafsir Hasan ◽  
Md Alfazal Khan ◽  
Tahmeed Ahmed
Keyword(s):  
Weight Gain ◽  
Preterm Birth ◽  
Gestational Weight Gain ◽  
Gestational Age ◽  
Neonatal Outcome ◽  
Perinatal Outcomes ◽  
Institute Of Medicine ◽  
Third Trimester ◽  
Gestational Weight ◽  
Iom Recommendations

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.

scholarly journals Relationship of Trimester-Specific Maternal Thyroid Function With Gestational Weight Gain And Birth Weight In Pregnant Women With Normal Thyroid Autoimmunity

2021 ◽  
Author(s):  
Xin He ◽  
Zhengyuan Wang ◽  
Zehuan Shi ◽  
Ping Liao ◽  
Qin Yan ◽  
...  
Keyword(s):  
Weight Gain ◽  
Birth Weight ◽  
Gestational Weight Gain ◽  
Thyroid Function ◽  
Thyroid Autoimmunity ◽  
Second Trimester ◽  
Z Score ◽  
Third Trimester ◽  
Normal Thyroid ◽  
Gestational Weight

Abstract Background: Gestational weight gain (GWG) and birth weight are important indicators of maternal and infant health outcomes. Thyroid function may affect body composition and fetal growth during pregnancy. So far, on the premise of excluding thyroid autoimmunity interference, the correlation of thyroid function in different pregnancy with neonatal birth weight and maternal weight gain is still controversial. Methods: This study used data from a prospective birth cohort in Shanghai, China. Serum concentration of TSH, total thyroxine (TT4), free thyroxine (FT4), total triiodothyronine (TT3), free triiodothyronine (FT3), thyroglobulin antibody (TGAb), thyroid peroxidase antibody (TPOAb) were determined using chemiluminescence assay. Maternal GWG and neonatal sex-specific birth weight-for-gestational age Z-score was calculated.Results: Subjects with a higher BMI before pregnancy turned to have a lower GWG and an infant with a higher birth weight. GWG was negatively associated with maternal FT4 at the first and third trimester (p<0.05), and TT4 at the third trimester (p<0.05). GWG was positively associated with maternal FT3 at the second trimester (p<0.05). Lower birth weight Z-score were associated with higher FT4 at the second and third trimester (p<0.05), and higher TT4 at the second trimester (p<0.05). Conclusions: In the general pregnant population with normal thyroid autoimmunity, higher maternal FT4 and TT4 and lower FT3 are associated with less GWG. Higher maternal FT4 and TT4 have an infant with lower birth weight.

The effects of pre-pregnancy obesity and gestational weight gain on maternal lipid profiles, fatty acids and insulin resistance

2021 ◽  
Vol 0 (0) ◽  
Author(s):  
Muge Gul Gulecoglu Onem ◽  
Canan Coker ◽  
Kemal Baysal ◽  
Sabahattin Altunyurt ◽  
Pembe Keskinoglu
Keyword(s):  
Insulin Resistance ◽  
Fatty Acids ◽  
Lipid Metabolism ◽  
Weight Gain ◽  
Pregnant Women ◽  
Total Cholesterol ◽  
Gestational Weight Gain ◽  
Hdl Cholesterol ◽  
Second Trimester ◽  
Gestational Weight

Abstract Objectives Pregnancy is associated with physiological alterations in insulin sensitivity and lipid metabolism. This study investigates the associations between pregestational body mass index (pBMI) and the rate of gestational weight gain (rGWG) in the second trimester with the biomarkers of lipid, fatty acids metabolism and insulin resistance. Methods Sixty nine pregnant women followed. The body weights of the pregnant women were measured and blood samples were obtained at 11–14th and 24–28th weeks of pregnancy. Glucose, total cholesterol, triglyceride, HDL cholesterol, LDL cholesterol, insulin levels and fatty acids were measured. Rate of GWG (kg/week) and The Homeostasis Model Assessment for Insulin Resistance (HOMA-IR) were calculated. The pregnant women were stratified according to their pBMI and the 2nd trimester rGWG. Results The rate of GWG was significantly higher for the group with pBMI<25, compared to the group with pBMI≥25 (p=0.024). Triglyceride, total cholesterol, LDL and HDL cholesterol were significantly increased in the second trimester compared with the first trimester. Palmitic acid, oleic acid, linoleic acid, myristic acid, docosahexaenoic acid (DHA), arachidonic acid (AA), total omega-6 (n − 6) and omega-3 (n − 3) fatty acid levels and n − 6/n − 3 ratio were significantly higher in the second trimester. Glucose was significantly decreased and insulin was increased in the second trimester. In the overweight/obese group; HOMA-IR, insulin, AA, palmitoleic acid and stearic acid were found to be high in comparison to the group with low/normal pBMI. No parameters were associated with rGWG. Conclusions The changes in lipid parameters, free fatty acids, insulin and HOMA-IR in the second trimester were compatible with the changes in lipid metabolism and the development of insulin resistance. Pregestational BMI was shown to have a stronger influence on lipid profile, insulin resistance, and fatty acids than rGWG.

scholarly journals Cardiometabolic and mental health in women with early gestational diabetes mellitus: A prospective cohort study

2021 ◽  
Author(s):  
Dan Yedu Quansah ◽  
Justine Gross ◽  
Leah Gilbert ◽  
Amelie Pauchet ◽  
Antje Horsch ◽  
...  
Keyword(s):  
Mental Health ◽  
Risk Factors ◽  
Weight Gain ◽  
Gestational Diabetes ◽  
Gestational Weight Gain ◽  
Gestational Age ◽  
Prospective Cohort ◽  
Gestational Weight ◽  
Pregnancy And Postpartum ◽  
History Of

Abstract Context Early diagnosis and treatment of gestational diabetes (GDM) may reduce adverse obstetric and neonatal outcomes, especially in high-risk women. However, there is a lack of data for other outcomes. Objective We compared cardiometabolic and mental health outcomes in women with early (eGDM) and classical (cGDM) GDM. Methods This prospective cohort included 1185 women with cGDM and 76 women with eGDM. eGDM had GDM-risk factors (BMI &gt;30kg/m 2, family history of diabetes, history of GDM, ethnicity), were tested at &lt;20 weeks gestational age and diagnosed using ADA prediabetes criteria. Women underwent lifestyle adaptations. Obstetric, neonatal, mental, cardiometabolic outcomes were assessed during pregnancy and postpartum. Results eGDM had lower gestational weight gain than cGDM (10.7±6.2 vs 12.6±6.4, p=0.03), but needed more medical treatment (66% vs 42%, p&lt;0.001). They had similar rates of adverse maternal and neonatal outcomes, except for increased large-for-gestational-age infants (25% vs 15%, p=0.02). Mental health during pregnancy and postpartum did not differ between groups. eGDM had more atherogenic postpartum lipid profile than cGDM (p≤0.001). In eGDM, the postpartum prevalence of metabolic syndrome (MetS) was 1.8-times, prediabetes was 3.1-times and diabetes was 7.4-times higher than cGDM (MetS-waist circumference-based: 62% vs 34%/MetS-BMI-based: 46% vs 24%; prediabetes: 47.5% vs 15.3%; diabetes: 11.9% vs 1.6%, all p&lt;0.001). These differences remained unchanged after adjusting for GDM-risk factors. Conclusion Compared to cGDM, eGDM was not associated with differences in mental health, but with increased adverse cardiometabolic outcomes, independent of GDM-risk factors and gestational weight gain. This hints to a pre-existing risk-profile in eGDM.

scholarly journals Impact of maternal obesity on pregnancy course and maternal and perinatal complications

2020 ◽  
Vol 71 (3) ◽  
pp. 54-58
Author(s):  
Milan Lacković
Keyword(s):  
Risk Factors ◽  
Weight Gain ◽  
Gestational Weight Gain ◽  
Pregnancy Complications ◽  
Maternal Obesity ◽  
Overweight And Obesity ◽  
Perinatal Complications ◽  
Anthropometric Parameter ◽  
Gestational Weight ◽  
Excessive Gestational Weight Gain

 The prevalence of obesity and obesity-related health problems is increasing worldwide, especially among woman and man of reproductive age and obesity is designated as one of the most important global health threats in 21st century.  Pregnancy in obese woman is considered as a high-risk pregnancy. Pre-pregnancy obesity and excessive gestational weight gain (GWG) are distinct risk factors with differing associated adverse outcomes, but they could also carry a cumulative negative impact on pregnancy course. Pre-pregnancy obesity is the anthropometric parameter most strongly correlated with perinatal complications. Maternal complications following obesity include antepartum, intrapartum and postpartum complications, such as pregnancy related hypertension, preeclampsia, gestational diabetes mellitus, preterm birth, venous thromboembolism, labor dystocia, labor induction, instrumental and cesarean delivery. Fetal complications related to maternal obesity might include increased prevalence of congenital anomalies, growth abnormalities, prematurity and stillbirth. Pre- pregnancy overweight and obesity is a potentially modifiable risk factor compromising pregnancy outcome. Among all complications that might arise during pregnancy and that could not be predicted and therefore prevented, pre- pregnancy overweight and obesity management control can significantly reduce potential pregnancy complications. Pre-conceptual counseling should provide in a timely manner awareness of this arising medical condition and provide risk reduction of complications following pre- pregnancy obesity and excessive GWG  obesity, pre-pregnancy obesity, excessive gestational weight gain, pregnancy risk factors, pregnancy complications  

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