scholarly journals Cause-Specific Stillbirth and Neonatal Death According to Prepregnancy Obesity and Early Gestational Weight Gain: A Study in the Danish National Birth Cohort

Nutrients ◽  
2021 ◽  
Vol 13 (5) ◽  
pp. 1676
Author(s):  
Ellen Aagaard Nohr ◽  
Sanne Wolff ◽  
Helene Kirkegaard ◽  
Chunsen Wu ◽  
Anne-Marie Nybo Andersen ◽  
...  
Keyword(s):  
Weight Gain ◽  
Birth Cohort ◽  
Gestational Weight Gain ◽  
Neonatal Death ◽  
Causes Of Death ◽  
Normal Weight ◽  
Neonatal Deaths ◽  
Gestational Weight ◽  
Prepregnancy Bmi ◽  
Danish National Birth Cohort

Maternal obesity is associated with impaired fetal and neonatal survival, but underlying mechanisms are poorly understood. We examined how prepregnancy BMI and early gestational weight gain (GWG) were associated with cause-specific stillbirth and neonatal death. In 85,822 pregnancies in the Danish National Birth Cohort (1996–2002), we identified causes of death from medical records for 272 late stillbirths and 228 neonatal deaths. Prepregnancy BMI and early GWG derived from an early pregnancy interview and Cox regression were used to estimate associations with stillbirth or neonatal death as a combined outcome and nine specific cause-of-death categories. Compared to women with normal weight, risk of stillbirth or neonatal death was increased by 66% with overweight and 78% with obesity. Especially deaths due to placental dysfunction, umbilical cord complications, intrapartum events, and infections were increased in women with obesity. More stillbirths and neonatal deaths were observed in women with BMI < 25 and low GWG. Additionally, unexplained intrauterine death was increased with low GWG, while more early stillbirths were seen with both low and high GWG. In conclusion, causes of death that relate to vascular and metabolic disturbances were increased in women with obesity. Low early GWG in women of normal weight deserves more clinical attention.

Obesity, gestational weight gain and preterm birth: a study within the Danish National Birth Cohort

2007 ◽  
Vol 21 (1) ◽  
pp. 5-14 ◽  
Author(s):  
Ellen Aagaard Nohr ◽  
Bodil Hammer Bech ◽  
Michael Vaeth ◽  
Kathleen M. Rasmussen ◽  
Tine Brink Henriksen ◽  
...  
Keyword(s):  
Weight Gain ◽  
Preterm Birth ◽  
Birth Cohort ◽  
Gestational Weight Gain ◽  
Gestational Weight ◽  
Danish National Birth Cohort

Prepregnancy Body Mass Index as a Significant Predictor of Total Gestational Weight Gain and Birth Weight

2017 ◽  
Vol 78 (2) ◽  
pp. 66-73 ◽  
Author(s):  
Anne-Sophie Morisset ◽  
Lise Dubois ◽  
Cynthia K. Colapinto ◽  
Zong-Chen Luo ◽  
William D. Fraser
Keyword(s):  
Weight Gain ◽  
Birth Weight ◽  
Gestational Weight Gain ◽  
Normal Weight ◽  
Institute Of Medicine ◽  
3D Design ◽  
Gestational Weight ◽  
Prepregnancy Bmi ◽  
Iom Recommendations ◽  
Infant Birth

Purpose: We aimed to describe adherence to gestational weight gain (GWG) recommendations and identify determinants of excessive GWG in a sample of women from Quebec, Canada. Methods: Data were collected from the multi-centre 3D (Design, Develop, Discover) pregnancy cohort study, which included women who delivered between May 2010 and August 2012 at 9 obstetrical hospitals in Quebec, Canada. GWG was calculated for 1145 women and compared to the 2009 Institute of Medicine (IOM) recommendations. Results: Overall, 51% of participants exceeded the recommendations. Approximately 68% of women with obesity gained weight in excess of the IOM recommendations. The corresponding numbers were 75%, 44%, and 27% in overweight, normal weight, and underweight women, respectively. A prepregnancy BMI of 25 kg/m2 or more was the only significant predictor of exceeding GWG recommendations (OR 3.35, 95% CI 2.44–4.64) in a multivariate model. Birth weight was positively associated with GWG. GWG and prepregnancy BMI could explain 3.13% and 2.46% of the variance in birth weight, respectively. Conclusion: About half of women exceeded GWG recommendations, and this was correlated with infant birth weight. This reinforces the need to develop and evaluate strategies, including nutritional interventions, for pregnant women to achieve optimal GWG.

scholarly journals Association of gestational weight gain with cesarean section: a prospective birth cohort study in Southwest China

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Lujiao Huang ◽  
Ju Zhang ◽  
Hong Sun ◽  
Hongli Dong ◽  
Run Li ◽  
...  
Keyword(s):  
Weight Gain ◽  
Cesarean Section ◽  
Birth Cohort ◽  
Gestational Weight Gain ◽  
Southwest China ◽  
The Other ◽  
Public Health Issue ◽  
Birth Cohort Study ◽  
Gestational Weight ◽  
Prospective Birth Cohort

Abstract Background Cesarean section (CS) is a rising public health issue globally, and is particularly serious in China. Numerous studies have suggested that gestational weight gain (GWG) control may be an effective way to reduce the rate of CS. However, rare study has examined the association between GWG and CS among women in Southwest China. We proposed to examine their association based on a prospective birth cohort, and further to explore the optimal GWG range. Methods We retrieved data from a prospective birth cohort from Sichuan Provincial Hospital for Women and Children, Southwest China. Unconditional multivariable logistic regression was used to examine the association between GWG and CS by adjusting for potential confounders. In one analysis, we incorporated the GWG as a categorical variable according to the Institute of Medicine (IOM) recommendation, similar to the method used in the majority of previous studies. In the other analysis, we directly incorporated GWG as a continuous variable and natural cubic splines were used to characterize the potential nonlinear exposure-response relationship, aiming to identify the optimal GWG. We further stratified the above analysis by pre-pregnancy BMI and GDM, and then a heterogeneity test based on a multivariate meta-analysis was conducted to examine whether the stratum specific estimations agreed with each other. Results A total of 1363 participants were included. By adopting the IOM recommendation, the adjusted OR of CS was 0.63 (0.47, 0.84) for insufficient GWG and 1.42 (1.06, 1.88) for excessive GWG. After stratification by pre-pregnancy BMI, we found a higher risk of CS in associated with excessive GWG in the stratum of underweight compared with the other strata, which implied that pre-pregnancy BMI may be an effect modifier. By applying a flexible spline regression, the optimal GWG levels in terms of reducing the CS rate based on our data were more stringent than those of IOM recommendation, which were 9–12 kg for underweight women, < 19 kg for normal weight women and < 10 kg for overweight/obese women. Conclusions These results suggested that a more stringent recommendation should be applied in Southwest China, and that more attention should be given to underweight women.

Obesity as a Predictor of Delayed Lactogenesis II

2017 ◽  
Vol 33 (4) ◽  
pp. 684-691 ◽  
Author(s):  
Irma Preusting ◽  
Jessica Brumley ◽  
Linda Odibo ◽  
Diane L. Spatz ◽  
Judette M. Louis
Keyword(s):  
Weight Gain ◽  
Gestational Weight Gain ◽  
Singleton Pregnancy ◽  
Targeted Interventions ◽  
Gestational Weight ◽  
Prepregnancy Bmi ◽  
Increased Risk ◽  
Prepregnancy Obesity ◽  
Observational Cohort ◽  
Breastfeeding Cessation

Background: Lactogenesis II is the onset of copious milk production. A delay in this has been associated with an increased risk of formula supplementation and early cessation of breastfeeding. Prepregnancy obesity has also been associated with decreased breastfeeding rates and early cessation. Research aim: This study aimed to evaluate the effect of prepregnancy obesity on self-reported delayed lactogenesis II. Methods: We conducted a prospective observational cohort study of 216 women with a singleton pregnancy and who planned to breastfeed. We compared the onset of lactogenesis II between women with a body mass index (BMI) < 30 kg/m2 and women with a BMI ≥ 30 kg/m2. Using multivariate logistic regression analyses, we assessed the relationship between maternal BMI and delay of lactogenesis II. Results: The prevalence of delayed lactogenesis II among women with prepregnancy BMI < 30 kg/m2 and BMI ≥ 30 kg/m2 was 46.4% and 57.9%, respectively. Delayed lactogenesis II occurred more frequently among women who were obese at the time of delivery ( p < .05). After controlling for the covariates, age, prepregnancy BMI, and gestational weight gain were positively associated with delayed lactogenesis II. Conclusion: Prepregnancy obesity and excessive gestational weight gain are associated with an increased risk of delayed lactogenesis II. Women who are at risk for delay in lactogenesis II and early breastfeeding cessation will need targeted interventions and support for them to achieve their personal breastfeeding goals.

scholarly journals The influence of pre-pregnancy body mass index and gestational weight gain on pregnancy outcomes in two-child women

2019 ◽  
Author(s):  
Hanqing Chen ◽  
Suhua Zou ◽  
Zhuyu Li ◽  
Jianbo Yang ◽  
Jian Cai ◽  
...  
Keyword(s):  
Body Mass Index ◽  
Weight Gain ◽  
Gestational Weight Gain ◽  
Body Mass ◽  
Perinatal Outcomes ◽  
Normal Weight ◽  
Excessive Weight Gain ◽  
Gestational Weight ◽  
Excessive Weight ◽  
Weight Gain During Pregnancy

Abstract Background Pre-pregnancy body mass index and gestational weight gain were related to perinatal outcomes. It was not know the changes of pre-pregnancy body mass index, weight gain during pregnancy and its effect on perinatal outcomes in two-child women.Methods This was a retrospective study. Data of single term women delivered in the First Affiliated Hospital of Sun Yat-sen University were collected from July 2017 to June 2018. Gestational weight gain criteria of the American Institute of Medical Research and pre-pregnancy body mass index classes were used to evaluate the effects on pregnancy outcomes.Results A total of 3049 cases were enrolled in the study. Overweight cases was 9.0% and obesity was 2.4%. The weight gain of the two-child women was less than that of primipara(12.4±3.9vs13.3±4.0kg, P<0.001). The proportion of primipara with excessive weight gain was higher compared to two-child women(20.1%versus17.3%, P<0.001). There were 40.0% overweight primipara and 55.2% of two-child women had excessive weight gain. And 40.5% primipara and 54.5% two-child women of obesity had excessive weight gain during pregnancy. Obese primipara increased the risk of pre-eclampsia (aOR2.38, 95%CI 0.76-7.46). And the odds of diabetes mellitus and large for gestational age also increased in this group (aOR3.49, 95%CI 1.46-8.35 and aOR7.65, 95%CI 1.83-31.97, respectively). Two-child women had similar results. Underweight primipara with excessive weight gain increased the pre-eclampsia risk (aOR2.26, 95%CI 0.29-17.46). Normal weight and overweight/obese primipara also had similar results. But in two-child women, only overweight/obesity increased the risk of pre-eclampsia (aOR2.01, 95%CI 0.41-9.98). Underweight two-child women with less weight gain increased the risk of diabetes(aOR2.06, 95%CI 0.43-9.8). Two-child women with overweight/obese increased the odds of LGA even if they had less weight gain(aOR2.58, 95%CI 0.11-63.22). Normal weight primipara and two-child women with overweight and obese with excessive weight gain had similar results. On the other way, underweight primipara with less weight gain increased the risk of SGA(aOR1.74, 95%CI 0.81-3.76).Conclusions Gestational weight gain of two-child women was less than primipara. Overweight/obese women with excessive weight gain of two-child women increased the risk of adverse outcomes.

Examining the Effection of Second-and Third-trimester Rate of Gestational Weight Gain on Perinatal Outcomes Among Chinese Twin Gestations Based on the Provisional Guidelines: A Retrospective Cohort Study

2020 ◽  
Author(s):  
Li-hua Lin ◽  
Yi-lin Weng ◽  
Ying-ying Lin ◽  
Xiu-xian Huang ◽  
Yang Lin ◽  
...  
Keyword(s):  
Regression Analysis ◽  
Weight Gain ◽  
Gestational Weight Gain ◽  
Normal Weight ◽  
Premature Delivery ◽  
Third Trimester ◽  
Gestational Weight ◽  
Gain Rate ◽  
Twin Pregnancies ◽  
Weight Gain Rate

Abstract Background: This paper investigated how second and third trimester gestational weight gain relates toperinatal outcomes among normal weight women with twin pregnancies in Fujian, China. Methods: A retrospective study on the medical records of 931 normal weight twin pregant women was conducted in Fujian Maternity and Child Health Hospital from 2014 to 2018.The 2nd and 3rd trimester weekly weight gain rate were calculated and categorized women as gaining below, within, or above the 2009 Institute of Medicine (IOM) recommended rates . The association between trimester-specific weight gain rate and perinatal outcome was performed by traditional regression analysis among groups.Results:A total of 931 pregnant women and 1862 neonates were included for analysis. 25.9% ,19.8% and 54.3%% of women had less than, greater than and within the recommended rates of gain in the 2nd and 3rd trimester, respectively. Multivariate Logistic regression analysis showed that greater than recommended rates of weight gain in 2nd trimester decreased the risks of preeclampsia (adjusted OR:0.458,95% CI:0.255~0.824). Less than recommended rates of weight gain in 3rd trimester increased the risk of premature delivery（adjusted OR=1.926,95%CI:1.403~2.644）, gestational diabetes mellitus (adjusted OR = 2.052,95%CI:1.417~2.972), intrahepatic cholestasis syndrome (adjusted OR = 3.016,95%CI:1.057~8.606), premature rupture of the membrane (adjusted OR = 1.722,95%CI:1.180~2.512) and neonatal respiratory distress syndrome (adjusted OR = 5.135,95%CI:1.701~15.498) and decreased the risk of cesarean section (adjusted OR = 0.587,95%CI:0.385~0.893) .In addition, greater than recommended rates of weight gain in 3rd trimester was associated with increased risks in premature delivery (adjusted OR=1.818,95%CI:1.307~2.527), and gestational hypertension (adjusted OR=2.098,95%CI:1.018~4.324) as well as preeclampsia(adjusted OR:2.029, 95%CI:1.331~3.093). The stratified analysis of weight gain in 3rd trimester showed that there was no significant difference in the incidence of adverse pregnancy outcomes compared to weight gain rate groups in 2nd trimester.Conclusions: While this study showed gestational weight gain rate less than or greater than in 3rd trimester were associated with some adverse maternal and neonatal outcomes, further studies of prospective and multi-center researches are required to explore alternate ranges of gestational weight gain rate in twin pregnancies.

scholarly journals Association between maternal gestational weight gain and preterm birth according to body mass index and maternal age in Quzhou, China

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Ying Hu ◽  
Qi Wu ◽  
Luyang Han ◽  
Yuqing Zou ◽  
Die Hong ◽  
...  
Keyword(s):  
Body Mass Index ◽  
Weight Gain ◽  
Preterm Birth ◽  
Gestational Weight Gain ◽  
Body Mass ◽  
Maternal Age ◽  
Preterm Births ◽  
Normal Weight ◽  
Live Births ◽  
Gestational Weight

Abstract The aim of this study is to investigate the association between maternal gestational weight gain (GWG) and preterm birth according to pre-pregnancy body mass index (BMI) and maternal age. We did a cohort, hospital-based study in Quzhou, South China, from 1 Jan 2018 to 30 June 2019. We selected 4274 singleton live births in our analysis, 315 (7.4%) of which were preterm births. In the overall population, excess GWG was significantly associated with a decreased risk of preterm birth compared with adequate GWG (adjusted OR 0.81 [95% CI 0.72–0.91]), and the risk varied by increasing maternal age and pre-pregnancy BMI. Interestingly, underweight women who older than 35 years with excess GWG had significantly increased odds of preterm birth compared with adequate GWG in underweight women aged 20–29 years (2.26 [1.06–4.85]) and normal weight women older than 35 years (2.23 [1.13–4.39]). Additionally, low GWG was positively and significantly associated with preterm birth overall (1.92 [1.47–2.50]). Among normal weight women category, compared with adequate GWG women aged 20–29 years did, those older than 20 years with low GWG, had significantly higher odds of preterm birth, which increased with maternal age (1.80 [1.16–2.79] in 20–29 years, 2.19 [1.23–3.91] in 30–34 years, 3.30 [1.68–6.46] in ≫ 35 years). In conclusion, maternal GWG was significantly associated with the risk of preterm birth, but the risk varied by pre-pregnancy BMI and maternal age.

Total gestational weight gain and the risk of preeclampsia by pre-pregnancy body mass index categories: a population-based cohort study from 2013 to 2017

2019 ◽  
Vol 47 (6) ◽  
pp. 585-591 ◽  
Author(s):  
Tanja Premru-Srsen ◽  
Zorana Kocic ◽  
Vesna Fabjan Vodusek ◽  
Ksenija Geršak ◽  
Ivan Verdenik
Keyword(s):  
Body Mass Index ◽  
Weight Gain ◽  
Gestational Weight Gain ◽  
Body Mass ◽  
Odds Ratio ◽  
Protective Factor ◽  
Population Based ◽  
Normal Weight ◽  
Obese Women ◽  
Gestational Weight

Abstract Background Identifying the risk factors for preeclampsia (PE) is essential for the implementation of preventive actions. In the present study, we aimed at exploring the association between total gestational weight gain (GWG) and PE. Methods We performed a population-based cohort survey of 98,820 women with singleton pregnancies who delivered in Slovenia from 2013 to 2017. Aggregated data were obtained from the National Perinatal Information System (NPIS). The main outcome measure was the incidence of PE. The main exposure variable was total GWG standardized for the gestational duration by calculating the z-scores. The associations between total GWG and PE stratified by pre-pregnancy body mass index (BMI) categories adjusted for a variety of covariates were determined using multivariable logistic regression. We calculated the crude odds ratio (OR) and adjusted odds ratio (aOR) with a 95% confidence interval using a two-way test. Results Excessive GWG was associated with increased odds of PE in all pre-pregnancy BMI categories. The increase in the odds of PE by 445% was the highest in underweight women and by 122% was the lowest in obese women. Low GWG was associated with decreased odds of PE in all pre-pregnancy BMI categories except in normal-weight women with a GWG below −2 standard deviation (SD) and underweight women. The decrease in the odds of PE by 67% was the highest in obese women and by 41% was the lowest in normal-weight women. Conclusion Excessive GWG is a significant risk factor for PE, especially in underweight women, while low GWG is an important protective factor against PE, especially in obese women.

Size for gestational age at birth according to offspring sex and gestational weight gain in underweight women

2019 ◽  
Vol 10 (5) ◽  
pp. 536-541 ◽  
Author(s):  
Y. Kasuga ◽  
D. Shigemi ◽  
M. Tamagawa ◽  
T. Suzuki ◽  
S.-H. Kim ◽  
...  
Keyword(s):  
Weight Gain ◽  
Gestational Weight Gain ◽  
Gestational Age ◽  
Normal Weight ◽  
Weight Group ◽  
Normal Weight Group ◽  
Gestational Weight ◽  
Offspring Sex ◽  
Gestational Age At Birth ◽  
Age At Birth

AbstractAlthough maternal pre-pregnancy body mass index (BMI) and gestational weight gain (GWG) are related to fetal growth, there is a paucity of data regarding how offspring sex affects the relationship between maternal BMI in underweight mothers (pre-pregnancy BMI <18.5 kg/m2) and size for gestational age at birth. The aim of this study was to investigate the effect of offspring sex on the relationships among maternal pre-pregnancy BMI, GWG and size for gestational age at birth in Japanese underweight mothers. Records of women with full-term pregnancies who underwent perinatal care at Kawasaki Municipal Hospital (Kawasaki, Japan) between January 2013 and December 2017 were retrospectively reviewed. The study cohort included underweight (n=566) and normal-weight women (18.5 kg/m2⩽pre-pregnancy BMI<25 kg/m2; n=2671). The incidence of small for gestational age (SGA) births in the underweight group was significantly higher than that in the normal-weight group (P<0.01). Additionally, SGA incidence in the underweight group was significantly higher than that in the normal-weight group (P<0.01) in female, but not male (P=0.30) neonates. In the women with female neonates, pre-pregnancy underweight was associated with a significantly increased probability of SGA (odds ratio [OR]: 1.80; P<0.01), but inadequate GWG was not (OR: 1.38; P=0.11). In contrast, in women with male neonates, inadequate GWG was associated with a significantly increased probability of SGA (OR: 1.53; P=0.03), but not with pre-pregnancy underweight (OR: 1.30; P=0.10). In conclusion, the present results suggest that pre-pregnancy underweight is associated with SGA in female offspring but not in male offspring.

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