scholarly journals Effect of Gestational Weight Gain on Perinatal Outcomes in Low Risk Pregnancies with Normal Prepregnancy Body Mass Index

2019 ◽  
Vol 2019 ◽  
pp. 1-4
Author(s):  
Mefkure Eraslan Sahin ◽  
Ilknur Col Madendag

Objective. This study aimed to clarify the effect of gestational weight gain (GWG) on perinatal outcomes in low risk pregnancies with normal prepregnancy body mass index (BMI). Study Design. A total of 572 low-risk pregnant women with a normal prepregnancy BMI were included. GWG and inadequate or excessive weight gain were defined according to the United States Institute of Medicine updated guidelines. Adverse perinatal outcomes were compared among inadequate, normal, and excessive weight gain groups. Results. Of the 572 pregnant women enrolled, 62 belonged to inadequate GWG group, 80 to excessive GWG group, and 430 to normal GWG group. Maternal age, prepregnancy BMI, gravity, parity, and previous cesarean delivery rates were similar among groups. Adverse perinatal outcomes were not statistically significant among groups. Fetal weight was significantly lower in inadequate weight gain group compared to normal weight gain group (p<0.001) and fetal weight was significantly lower in normal weight gain group compared to excessive weight gain group (p<0.001). Additionally, low birth weight <2.5kgs, birth weight > 4.0kgs, and SGA and LGA rates were similar among groups (P = 0.765, P = 0. 711, P = 0. 702, and P = 0.414, respectively). Although gestational age at delivery was term in normal percentile it was significantly lower in the inadequate weight gain group compared to others (P=0.010). Conclusions. This study showed that an inadequate or excessive weight gain in low-risk pregnancies with a normal prepregnancy BMI did not increase the risk of adverse perinatal outcomes.

2019 ◽  
Author(s):  
Hanqing Chen ◽  
Suhua Zou ◽  
Zhuyu Li ◽  
Jianbo Yang ◽  
Jian Cai ◽  
...  

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.


2019 ◽  
pp. 01-07
Author(s):  
Magdalena Smyka ◽  
Katarzyna Kosinska- Kaczynska ◽  
Damian Warzecha ◽  
Miroslaw Wielgos

Aim: To evaluate the effects of gestational weight gain on perinatal outcomes in woman with excessive pre-gravid body mass index. Material and Methods: The study group consisted of 197 overweight or obese women who delivered full-term newborns at the 1st Department of Obstetrics and Gynecology, Medical University of Warsaw. Group A included 89 (45.2%) women with inadequate or adequate weight gain. Group B included 108 patients (54.8%) with excessive weight gain during pregnancy. Results: No significant differences in the occurrence of gestational diabetes, hypertension or intrahepatic cholestasis between the analyzed groups were observed. Excessive weight gain was positively correlated with the incidence of cesarean delivery (67.6% vs 32.4%, p=0.009), newborns’ birthweight (3627g±519 vs 3406g±521, p=0.009) and the risk of low for gestational age infants (26.9% vs 12.4%, p=0.01). The highest risk of low for gestational age new born was related to gestational weight gain of about 15 kg. Appropriate preconception counselling for overweight and obese women may reduce the risk of low for gestational age infants.


2020 ◽  
Author(s):  
Nelago Tukondjeni Amagulu ◽  
Bariki Mchome ◽  
Julius Pius Alloyce ◽  
Kingsly Tobi ◽  
Eusebius Maro

Abstract Background: Pre/eclampsia and other hypertensive disorders of pregnancy contributed to 18% of the maternal mortality reported in Northern Tanzanian. There is increasing prevalence of obesity in Tanzania which is related to excessive weight gain in pregnancy. Both high BMI and excessive gestation weight gain are identified to increase risk of PE and subtypes, however this is still inconclusive and little is known about the joint effect of pre-pregnancy BMI and GWG on risk of PE and its subtypes in Africa. We evaluated the independent and joint effects of pre-pregnancy BMI and GWG on the risk of pre-eclampsia and its subtypes among women who delivered at Kilimanjaro Christian Medical Center (KCMC) from October 2018 to May 2019, Northern Tanzania.Methods: We performed a retrospective birth cohort study from October 2018 to May 2019 at KCMC, Tanzania. Pre-pregnancy BMI was categorized using WHO categories into Underweight (˂ 18.5kg/m²), Normal weight (18.5-24.9kg/m²), Overweight (25-29.9kg/m²) and Obese (≥ 30kg/m²). Gestational Weight Gain (GWG) was categorized using the 2009 Institute of Medicine (IOM) guidelines into Inadequate, Adequate and Excessive weight gain in pregnancy. Multinomial logistic regression analysis was used to adjust for confounders using relative risk, 95% confidence interval for the risk ratios (RR) that did not cross 1 and p<0.05 were regarded statistically significant.Results: Among the 1309 women analysed, 5.3% were Underweight, 51.1% Normal weight, 26.9% Overweight and 16.7% were Obese. About 43.5% had excessive GWG. Women with PE were 9.5%. Both obesity and excessive GWG independently increased risk of PE with adjusted RR=2.42, 95%CI: 1.48-3.96 and RR=1.77, 95%CI: 1.16-2.69 when compared to normal BMI and adequate GWG respectively. Jointly, Obesity and Excessive GWG had the highest risk of PE (ARR=4.95, 95%CI: 2.21-11.10). The increased risk was similar for Mild PE (MPE), Severe PE or eclampsia (SP/E) and Late Onset PE (LOPE). No association was found for Early Onset PE (EOPE).Conclusion: Pre-pregnancy Obesity and Excessive GWG independently and jointly increases risk for PE and the risk varies by PE subtype.


2019 ◽  
Vol 79 (11) ◽  
pp. 1183-1190 ◽  
Author(s):  
Friederike Weschenfelder ◽  
Thomas Lehmann ◽  
Ekkehard Schleussner ◽  
Tanja Groten

Abstract Introduction The birth of a large for gestational age (LGA) infant is a significant risk factor for birth complications and maternal morbidity and an even higher risk factor for offspring obesity, metabolic syndrome and cardiovascular disease in later life. Relevant factors affecting the risk of delivering an LGA infant are maternal pre-gravid obesity, excessive gestational weight gain exceeding the recommendations of the Institute of Medicine (IOM) and diabetes in pregnancy. We aimed to determine what matters most in terms of the risk of fetal overgrowth. Materials and Methods We performed a database analysis of 12 701 singleton term deliveries documented in our university hospital birth registry from 2003 to 2014. Multivariate logistic regression analysis was used to determine the adjusted odds ratios. Results Excessive weight gain had the strongest impact on LGA (OR: 1.249 [95% CI: 1.018 – 1.533]) compared to maternal pre-gravid body mass index (BMI) (OR: 1.083 [95% CI: 1.066 – 1.099]) and diabetes (OR: 1.315 [95% CI: 0.997 – 1.734]). Keeping gestational weight gain within the recommendations of the IOM resulted in a risk reduction for LGA of 20% (OR: 0.801 [95% CI: 0.652 – 0.982]). The risk for LGA increases by 6.9% with each kg weight gain. Normal weight women (BMI 18.5 – 24.9 kg/m2) and moderately overweight women (BMI 25 – 29.9 kg/m2) showed the highest increase in LGA rates per kg weight gain during pregnancy (OR: 1.078 [95% CI: 1.052 – 1.104] and OR: 1.058 [95% CI: 1.026 – 1.09], resp.). Only in underweight (< 18.5 kg/m2) and normal weight women the risk of LGA birth is strongly influenced by diabetes (OR 11.818 [95% CI: 1.156–120.782] and 1.564 [95% CI: 1.013–2.415]). Conclusion Excessive weight gain is particularly important for non-obese women. These women are therefore a target cohort for intervention, as each prevented additional kilogram weight gain reduces the risk of LGA by more than 5%.


Author(s):  
Chi-Nien Chen ◽  
Ho-Sheng Chen ◽  
Heng-Cheng Hsu

Epidemiological studies have shown that maternal prepregnancy body mass index (BMI) and gestational weight gain (GWG) are associated with increased risk of perinatal outcomes. However, the evidence of such associations in Asian populations is limited. We conducted a secondary data analysis to investigate the relationships of prepregnancy BMI and GWG with the risks of adverse perinatal outcomes, including gestational diabetes (GDM), gestational hypertension (GHTN), preeclampsia, cesarean delivery, preterm birth, low birth weight (LBW), and macrosomia. We categorized prepregnancy BMI by the WHO classification and GWG by the Institute of Medicine guidelines. We performed adjusted logistic regression models to estimate the odds ratios of adverse perinatal outcomes. A total of 19,052 women were included; prepregnancy overweight and obesity were associated with a greater risk of GDM, GHTN, preeclampsia, cesarean delivery, preterm birth, and macrosomia. Women with excessive GWG had a greater risk of GHTN, preeclampsia, cesarean delivery, and macrosomia. In conclusion, regardless of the range of GWG during pregnancy, maternal prepregnancy BMI is significantly associated with the risk of adverse perinatal outcomes in Taiwan. Public health attention regarding obesity reduction before conception and prenatal counseling for optimal GWG is needed to mitigate the risk of poor perinatal outcomes.


Nutrients ◽  
2018 ◽  
Vol 10 (9) ◽  
pp. 1290 ◽  
Author(s):  
Melanie Larsson ◽  
Mads Lind ◽  
Anni Larnkjær ◽  
Anette Due ◽  
Irina Blom ◽  
...  

Some infants experience excessive weight gain (EWG) during exclusive breastfeeding, but causes and consequences are unknown. The objective was to identify factors associated with early EWG. Infants with EWG (HW-group) were examined at 5, 9 and 18 mo and compared to a breastfed group with normal weight gain (NW-group). Anthropometry, body composition, milk and blood samples, and milk intake were measured. Mean body-mass-index-for-age z-scores (BAZ) increased 1.93 from birth to 5 mo in the HW-group (n = 13) while the NW-group (n = 17) was unchanged (−0.01). The HW-group had 70% more fat mass at 5 mo, and then showed marked catch-down in BAZ from 5 to 18 mo (−0.84). Milk intake at 5–6 mo did not differ between the groups. In the HW-group milk-leptin was lower at 5 mo and serum-leptin was considerably higher at 5 and 9 mo compared to the NW-group. Serum-leptin at 5 mo was positively associated with weight-for-age z-score (WAZ) and fat mass and negatively with WAZ change from 5 to 9 mo. In conclusion, breastfed infants with EWG had catch-down growth when other foods were introduced. Low milk-leptin in the HW-group may have stimulated appetite and milk intake when weight gain was high. High serum-leptin in the HW-group suggests early leptin resistance, which could impact cerebral regulation of energy intake. Larger studies are needed to confirm these results.


2019 ◽  
Vol 53 ◽  
pp. 57 ◽  
Author(s):  
Chiara Alzineth Silva Campos ◽  
Maira Barreto Malta ◽  
Paulo Augusto Ribeiro Neves ◽  
Bárbara Hatzlhoffer Lourenço ◽  
Marcia C Castro ◽  
...  

OBJECTIVE: To evaluate whether weekly gestational weight gain is associated with anemia, vitamin A insufficiency, and blood pressure levels in the third trimester of pregnancy. METHODS: A prospective study with 457 pregnant women attending primary care in Cruzeiro do Sul, Acre. The weekly gestational weight gain rate measured between the second and third trimesters was classified as insufficient, adequate, and excessive according to the recommendations of the Institute of Medicine 2009. The outcomes at the beginning of the third gestational trimester were: anemia (Hb < 110 g/L), vitamin A insufficiency (serum retinol<1.05 μmol/L) and blood pressure levels (continuous values, in mmHg). Age-adjusted prevalence ratios, schooling, and use of vitamin and mineral supplements were calculated in Poisson regression models with robust variance. RESULTS: A total of 18.6% of pregnant women had insufficient weekly weight gain, and 59.1% had excessive weight gain. The frequencies of anemia, vitamin A insufficiency and hypertension (systolic blood pressure ≥ 140 mmHg or diastolic ≥ 90 mmHg) were 17.5%, 13.4%, and 0.6%, respectively. The prevalence ratios for anemia among pregnant women with insufficient and excessive weight gain were 0.41 (95%CI 0.18–0.93) and 1.00 (95%CI 0.63–1.59), respectively, when compared to pregnant women with adequate weight gain. For vitamin A insufficiency, the adjusted prevalence ratio was significantly higher among pregnant women with insufficient weight gain (2.85, 95%CI 1.55–5.24) and no difference for excessive weight gain (1.53, 95%CI 0.84–2.74) when compared to pregnant women with adequate weight gain. Pregnant women with excessive weight gain had higher mean systolic blood pressure (111.10; 95%CI 109.9–112.2) when compared to pregnant women with insufficient weight gain (107.50; 95%CI 105.4–109.6) and adequate (106.20; 95%CI 104.3–108.20). CONCLUSIONS: Insufficient weekly gestational weight gain was associated with the risk of vitamin A insufficiency. Excessive weight gain, in turn, was associated with higher blood pressure values at the beginning of the third gestational trimester.


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