scholarly journals Pre-Pregnancy Obesity, Excessive Gestational Weight Gain, and the Risk of Pregnancy-Induced Hypertension and Gestational Diabetes Mellitus

2020 ◽  
Vol 9 (6) ◽  
pp. 1980 ◽  
Author(s):  
Małgorzata Lewandowska ◽  
Barbara Więckowska ◽  
Stefan Sajdak
Keyword(s):  
Weight Gain ◽  
Pregnant Women ◽  
Gestational Weight Gain ◽  
Pregnancy Complications ◽  
Gestational Hypertension ◽  
Institute Of Medicine ◽  
Maternal Weight ◽  
Odds Ratios ◽  
Gestational Weight ◽  
The Relationship

Excessive pre-pregnancy weight is a known risk factor of pregnancy complications. The purpose of this analysis was to assess the relationship between several categories of maternal weight and the risk of developing hypertension and diabetes in pregnancy, and the relationship of these complications with the results of the newborn. It was carried out in a common cohort of pregnant women and taking into account the influence of disturbing factors. Our analysis was conducted in a prospective cohort of 912 Polish pregnant women, recruited during 2015–2016. We evaluated the women who subsequently developed diabetes with dietary modification (GDM-1) (n = 125) and with insulin therapy (GDM-2) (n = 21), as well as the women who developed gestational hypertension (GH) (n = 113) and preeclampsia (PE) (n = 24), compared to the healthy controls. Odds ratios of the complications (and confidence intervals (95%)) were calculated in the multivariate logistic regression. In the cohort, 10.8% of the women had pre-pregnancy obesity (body mass index (BMI) ≥ 30 kg/m2), and 36.8% had gestational weight gain (GWG) above the range of the Institute of Medicine recommendation. After correction for excessive GWG and other confounders, pre-pregnancy obesity (vs. normal BMI) was associated with a higher odds ratio of GH (AOR = 4.94; p < 0.001), PE (AOR = 8.61; p < 0.001), GDM-1 (AOR = 2.99; p < 0.001), and GDM-2 (AOR = 11.88; p <0.001). The threshold risk of development of GDM-2 occurred at lower BMI values (26.9 kg/m2), compared to GDM-1 (29.1 kg/m2). The threshold point for GH was 24.3 kg/m2, and for PE 23.1 kg/m2. For GWG above the range (vs. GWG in the range), the adjusted odds ratios of GH, PE, GDM-1, and GDM-2 were AOR = 1.71 (p = 0.045), AOR = 1.14 (p = 0.803), AOR = 0.74 (p = 0.245), and AOR = 0.76 (p = 0.672), respectively. The effect of maternal edema on all the results was negligible. In our cohort, hypertension and diabetes were associated with incorrect birth weight and gestational age at delivery. Conclusions: This study highlights the importance and influence of excessive pre-pregnancy maternal weight on the risk of pregnancy complications such as diabetes and hypertension which can impact fetal outcomes.

scholarly journals The relationship between gestational weight gain and fetal growth: time to take stock?

2014 ◽  
Vol 42 (4) ◽  
Author(s):  
Amy C. O’Higgins ◽  
Anne Doolan ◽  
Laura Mullaney ◽  
Niamh Daly ◽  
Daniel McCartney ◽  
...  
Keyword(s):  
Weight Gain ◽  
Gestational Weight Gain ◽  
Fetal Growth ◽  
Maternal Obesity ◽  
Current Evidence ◽  
Growth Time ◽  
Institute Of Medicine ◽  
Maternal Weight ◽  
Gestational Weight ◽  
The Relationship

AbstractThe aim of this article is to review the current evidence on gestational weight gain (GWG). Maternal obesity has emerged as one of the great challenges in modern obstetrics as it is becoming increasingly common and is associated with increased maternal and fetal complications. There has been an upsurge of interest in GWG with an emphasis on the relationship between excessive GWG and increased fetal growth. Recent recommendations from the Institute of Medicine in the USA have revised downwards the weight gain recommendations in pregnancy for obese mothers. We believe that it is time to take stock again about the advice that pregnant women are given about GWG and their lifestyle before, during, and after pregnancy. The epidemiological links between excessive GWG and aberrant fetal growth are weak, particularly in obese women. There is little evidence that intervention studies decrease excessive GWG or improve intrauterine fetal growth. Indeed, there is a potential risk that inappropriate interventions during the course of pregnancy may lead to fetal malnutrition that may have adverse clinical consequences, both in the short- and long-term. It may be more appropriate to shift the focus of attention from monitoring maternal weight to increasing physical activity levels and improving nutritional intakes.

scholarly journals Gestational Weight Gain among Healthy Pregnant Women from Asia in Comparison with Institute of Medicine (IOM) Guidelines-2009: A Systematic Review

2019 ◽  
Vol 2019 ◽  
pp. 1-10 ◽  
Author(s):  
Priyanka Arora ◽  
Bani Tamber Aeri
Keyword(s):  
Systematic Review ◽  
Weight Gain ◽  
Birth Weight ◽  
Pregnant Women ◽  
Gestational Weight Gain ◽  
Gestational Age ◽  
The United States ◽  
Asian Women ◽  
Institute Of Medicine ◽  
Gestational Weight

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.

scholarly journals Diet, Physical Activity and Gestational Weight Gain Patterns among Pregnant Women Living with Obesity in the North East of England: The GLOWING Pilot Trial

Nutrients ◽  
2021 ◽  
Vol 13 (6) ◽  
pp. 1981
Author(s):  
Nicola Heslehurst ◽  
Angela C. Flynn ◽  
Lem Ngongalah ◽  
Catherine McParlin ◽  
Kathryn V. Dalrymple ◽  
...  
Keyword(s):  
Physical Activity ◽  
Weight Gain ◽  
Pregnant Women ◽  
Gestational Weight Gain ◽  
Pilot Trial ◽  
Institute Of Medicine ◽  
Obesity Class ◽  
Gestational Weight ◽  
North East ◽  
Class 1

Maternal diet, physical activity (PA) behaviours, and gestational weight gain (GWG) are important for optimum health of women and their babies. This secondary analysis of the GLOWING pilot cluster trial explored these among women living with obesity in high deprivation. Pregnant women completed food frequency, PA and psychosocial questionnaires. Weights were retrieved from medical records and measured during routine appointments with midwives. Descriptive and regression analyses were stratified by obesity class. A total of 163 women were recruited; 54.0% had class 1 obesity, 25.8% class 2, 20.2% class 3, and 76.1% lived in the two most deprived quintiles. Women had suboptimal dietary intake, particularly for oily fish, fruit and vegetables. PA was predominantly light intensity, from household, care and occupational activities. Most women gained weight outside of Institute of Medicine (IOM) guideline recommendations (87.8%); women in class 3 obesity were most likely to have inadequate GWG below IOM recommendations (58.3%, p < 0.01) and reduced odds of excessive GWG compared with class 1 (AOR 0.13, 95% 0.04–0.45). Deprived women with obesity have a double inequality as both increase pregnancy risks. This population requires support to meet guideline recommendations for diet, PA and GWG. Further research exploring obesity classes would inform policies and care to achieve the best pregnancy outcomes.

scholarly journals Weight gain in pregnancy: is less truly more for mother and infant?

2012 ◽  
Vol 5 (2) ◽  
pp. 58-64 ◽  
Author(s):  
Linda A Barbour
Keyword(s):  
Weight Gain ◽  
Gestational Weight Gain ◽  
Gestational Age ◽  
Neonatal Morbidity ◽  
Current Data ◽  
Large For Gestational Age ◽  
Institute Of Medicine ◽  
Gestational Weight ◽  
The Relationship ◽  
In Pregnancy

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.

scholarly journals Maternal anthropometry: trends and inequalities in four population-based birth cohorts in Pelotas, Brazil, 1982–2015

2019 ◽  
Vol 48 (Supplement_1) ◽  
pp. i26-i36 ◽  
Author(s):  
Bernardo L Horta ◽  
Fernando C Barros ◽  
Natália P Lima ◽  
Maria C F Assunção ◽  
Iná S Santos ◽  
...  
Keyword(s):  
Socioeconomic Status ◽  
Weight Gain ◽  
Gestational Weight Gain ◽  
Family Income ◽  
Institute Of Medicine ◽  
Maternal Height ◽  
Maternal Weight ◽  
Gestational Weight ◽  
Maternity Hospitals ◽  
Overweight Or Obesity

Abstract Background Pre-pregnancy nutritional status and weight gain during pregnancy have short- and long-term consequences for the health of women and children. This study was aimed at evaluating maternal height,- and overweight or obesity at the beginning of the pregnancy and gestational weight gain, according to socioeconomic status and maternal skin colour of mothers in Pelotas, a southern Brazilian city, in 1982, 1993, 2004 and 2015. Methods In 1982, 1993, 2004 and 2015, the maternity hospitals in Pelotas were visited daily, all deliveries were identified and mothers who lived in the urban area of the city were interviewed. Maternal weight at the beginning of the pregnancy was self-reported by the mother or obtained from the antenatal card. Maternal height was collected from the maternity records or measured by the research team. Overweight or obesity was defined by a body mass index ≥25 kg/m2. Gestational weight gain was evaluated according to the Institute of Medicine guidelines. Results In the four cohorts, we evaluated 19 931 women. From 1982 to 2015, the prevalence of overweight or obesity at the beginning of the pregnancy increased from 22.1% to 47.0% and height increased by an average of 5.2 cm, whereas gestational weight gain did not change. Socioeconomic status was positively associated with maternal height, and the difference between the poorest and the wealthiest decreased. Overweight or obesity was lower among those mothers in the extreme categories of family income. Conclusions Over the 33-year span, mothers were taller at the beginning of the pregnancy, but the prevalence of overweight or obesity more than doubled.

The association of dietary glycaemic index and glycaemic load with gestational weight gain and newborn birth weight

2019 ◽  
Vol 123 (7) ◽  
pp. 818-825
Author(s):  
Caroline de Barros Gomes ◽  
Maíra Barreto Malta ◽  
José Leopoldo Ferreira Antunes ◽  
Caroline de Oliveira Gallo ◽  
Maria Helena D’Aquino Benício ◽  
...  
Keyword(s):  
Weight Gain ◽  
Birth Weight ◽  
Pregnant Women ◽  
Gestational Weight Gain ◽  
Infant Health ◽  
Multiple Linear Regression Model ◽  
Glycaemic Index ◽  
Gestational Weight ◽  
Glycaemic Load ◽  
The Relationship

AbstractDiet during pregnancy is related to several maternal and infant health outcomes; however, the relationship between maternal dietary glycaemic index (GI) and glycaemic load (GL) and gestational weight gain (GWG) or newborn birth weight is controversial. The purpose of the present study was to investigate the relationship between maternal dietary GI and GL and GWG and birth weight. A cohort of adult pregnant women with usual obstetric risk was followed in Botucatu, SP, Brazil. Two 24-h dietary recalls were collected in each gestational trimester (<14, 24–27, 31–34 weeks), one in person and the other by telephone. GI and GL were determined using the software Nutrition Data System for Research. GWG was obtained from medical records and evaluated as the weekly GWG between the second and third gestational trimesters. Newborn birth weight z-score in relation to gestational age was evaluated according to Intergrowth-21st Project recommendations. A multiple linear regression model, adjusted for potential confounders, showed a one-point increase in the GI resulted in a mean decrease of 12·9 (95 % CI –21·48, –4·24) g in weekly GWG; GL was not associated with this outcome. The birth weight z-score was not associated with GI (P = 0·763) or GL (P = 0·317). In conclusion, in a cohort of pregnant women considered at usual risk for obstetric complications, maternal dietary GI was negatively associated with weekly GWG in the second and third gestational trimesters. No association was observed between GL and GWG, and neither GI nor GL was associated with birth weight z-score.

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