Association between Gestational Weight Gain Adequacy and Adverse Maternal and Neonatal Outcomes

Han-Yang Chen; Suneet P. Chauhan

doi:10.1055/s-0038-1672196

American Journal of Perinatology, Table of Contents

Am J Perinatol 2019; 36(06): 615-623
DOI: 10.1055/s-0038-1672196

Original Article

Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Association between Gestational Weight Gain Adequacy and Adverse Maternal and Neonatal Outcomes

Han-Yang Chen

¹Department of Obstetrics, Gynecology, and Reproductive Sciences, McGovern Medical School, The University of Texas Health Science Center at Houston, Houston, Texas

,

Suneet P. Chauhan

¹Department of Obstetrics, Gynecology, and Reproductive Sciences, McGovern Medical School, The University of Texas Health Science Center at Houston, Houston, Texas

› Author Affiliations

Abstract

Objectives To estimate the prevalence of gestational weight gain (GWG) adequacy according to the 2009 guidelines, and to examine the association between GWG adequacy and the adverse outcomes, stratified by prepregnancy body mass index (BMI).

Study Design A retrospective cohort study, using the 2011 to 2013 U.S. linked birth/infant death datasets, restricted to nonanomalous singleton live births at 37 to 41 weeks. The adverse outcomes included composite maternal morbidity (CMM), composite neonatal morbidity (CNM), and neonatal and infant mortalities. We used multivariable Poisson's regression models with robust error variance to examine the association between GWG adequacy and adverse outcomes.

Results Of 8,656,791 singleton live births, 20, 32, and 48% had inadequate, adequate, and excessive GWG, respectively. After multivariable regression adjustment, compared with adequate GWG, excessive GWG had 1.10 (1.08–1.13) and 1.12 (1.10–1.14) times higher risk of CMM and CNM, respectively; similar findings were observed in BMI subgroups. Compared with adequate GWG, inadequate GWG had 1.14 (1.03–1.26) and 1.12 (1.07–1.18) times higher risk of neonatal and infant mortalities, respectively. Similar results were noted among women with normal weight.

Conclusion Excessive GWG was associated with an increased risk of CMM and CNM, while inadequate GWG was associated with a higher risk of neonatal and infant mortalities.

Keywords

body mass index - gestational weight gain - morbidity - mortality

Full Text

References

References
1 Institute of Medicine. (Subcommittees on Nutritional Status and Weight Gain during Pregnancy and Dietary Intake and Nutrient Supplements during Pregnancy, Committee on Nutritional Status during Pregnancy and Lactation, Food and Nutrition Board). Nutrition during Pregnancy: Part I, Weight Gain; Part II, Nutrient Supplements. Washington, DC: National Academies Press; 1990
2 Ogden CL, Carroll MD, Curtin LR, McDowell MA, Tabak CJ, Flegal KM. Prevalence of overweight and obesity in the United States, 1999-2004. JAMA 2006; 295 (13) 1549-1555
3 Rasmussen KM, Catalano PM, Yaktine AL. New guidelines for weight gain during pregnancy: what obstetrician/gynecologists should know. Curr Opin Obstet Gynecol 2009; 21 (06) 521-526
4 Institute of Medicine/National Research Council. (Committee to Reexamine IOM Pregnancy Weight Guidelines, Food and Nutrition Board and Board on Children, Youth, and Families). Weight Gain during Pregnancy: Reexamining the Guidelines. Washington, DC: National Academies Press; 2009
5 WHO Expert Committee on Physical Status. Physical Status: the Use and Interpretation of Anthropometry. WHO Technical Report Series No. 854. Geneva, Switzerland: WHO; 1995
6 Oken E, Taveras EM, Kleinman KP, Rich-Edwards JW, Gillman MW. Gestational weight gain and child adiposity at age 3 years. Am J Obstet Gynecol 2007; 196 (04) 322.e1-322.e8
7 Kominiarek MA, Peaceman AM. Gestational weight gain. Am J Obstet Gynecol 2017; 217 (06) 642-651
8 Pugh SJ, Albert PS, Kim S. , et al. Patterns of gestational weight gain and birthweight outcomes in the Eunice Kennedy Shriver National Institute of Child Health and Human Development Fetal Growth Studies-Singletons: a prospective study. Am J Obstet Gynecol 2017; 217 (03) 346.e1-346.e11
9 Jebeile H, Mijatovic J, Louie JCY, Prvan T, Brand-Miller JC. A systematic review and metaanalysis of energy intake and weight gain in pregnancy. Am J Obstet Gynecol 2016; 214 (04) 465-483
10 Truong YN, Yee LM, Caughey AB, Cheng YW. Weight gain in pregnancy: does the Institute of Medicine have it right?. Am J Obstet Gynecol 2015; 212 (03) 362.e1-362.e8
11 Margerison Zilko CE, Rehkopf D, Abrams B. Association of maternal gestational weight gain with short- and long-term maternal and child health outcomes. Am J Obstet Gynecol 2010; 202 (06) 574.e1-574.e8
12 Siega-Riz AM, Viswanathan M, Moos MK. , et al. A systematic review of outcomes of maternal weight gain according to the Institute of Medicine recommendations: birthweight, fetal growth, and postpartum weight retention. Am J Obstet Gynecol 2009; 201 (04) 339.e1-339.e14
13 Harper LM, Chang JJ, Macones GA. Adolescent pregnancy and gestational weight gain: do the Institute of Medicine recommendations apply?. Am J Obstet Gynecol 2011; 205 (02) 140.e1-140.e8
14 Han Z, Lutsiv O, Mulla S, Rosen A, Beyene J, McDonald SD. ; Knowledge Synthesis Group. Low gestational weight gain and the risk of preterm birth and low birthweight: a systematic review and meta-analyses. Acta Obstet Gynecol Scand 2011; 90 (09) 935-954
15 Stotland NE, Caughey AB, Lahiff M, Abrams B. Weight gain and spontaneous preterm birth: the role of race or ethnicity and previous preterm birth. Obstet Gynecol 2006; 108 (06) 1448-1455
16 Viswanathan M, Siega-Riz AM, Moos MK. , et al. Outcomes of maternal weight gain. Evid Rep Technol Assess (Full Rep) 2008; May (168) 1-223
17 Goldstein RF, Abell SK, Ranasinha S. , et al. Association of gestational weight gain with maternal and infant outcomes: a systematic review and meta-analysis. JAMA 2017; 317 (21) 2207-2225
18 Cogswell ME, Serdula MK, Hungerford DW, Yip R. Gestational weight gain among average-weight and overweight women--what is excessive?. Am J Obstet Gynecol 1995; 172 (2 Pt 1): 705-712
19 Berggren EK, Stuebe AM, Boggess KA. Excess maternal weight gain and large for gestational age risk among women with gestational diabetes. Am J Perinatol 2015; 32 (03) 251-256
20 Stotland NE, Hopkins LM, Caughey AB. Gestational weight gain, macrosomia, and risk of cesarean birth in nondiabetic nulliparas. Obstet Gynecol 2004; 104 (04) 671-677
21 Dietz PM, Callaghan WM, Sharma AJ. High pregnancy weight gain and risk of excessive fetal growth. Am J Obstet Gynecol 2009; 201 (01) 51.e1-51.e6
22 Blackwell SC, Landon MB, Mele L. , et al; Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) Maternal-Fetal Medicine Units (MFMU) Network. Relationship between excessive gestational weight gain and neonatal adiposity in women with mild gestational diabetes mellitus. Obstet Gynecol 2016; 128 (06) 1325-1332
23 Sridhar SB, Darbinian J, Ehrlich SF. , et al. Maternal gestational weight gain and offspring risk for childhood overweight or obesity. Am J Obstet Gynecol 2014; 211 (03) 259.e1-259.e8
24 Butte NF, Ellis KJ, Wong WW, Hopkinson JM, Smith EO. Composition of gestational weight gain impacts maternal fat retention and infant birth weight. Am J Obstet Gynecol 2003; 189 (05) 1423-1432
25 Vesco KK, Dietz PM, Rizzo J. , et al. Excessive gestational weight gain and postpartum weight retention among obese women. Obstet Gynecol 2009; 114 (05) 1069-1075
26 Phelan S. Pregnancy: a “teachable moment” for weight control and obesity prevention. Am J Obstet Gynecol 2010; 202 (02) 135.e1-135.e8
27 Berggren EK, Groh-Wargo S, Presley L, Hauguel-de Mouzon S, Catalano PM. Maternal fat, but not lean, mass is increased among overweight/obese women with excess gestational weight gain. Am J Obstet Gynecol 2016; 214 (06) 745.e1-745.e5
28 He X, Hu C, Chen L, Wang Q, Qin F. The association between gestational weight gain and substantial weight retention 1-year postpartum. Arch Gynecol Obstet 2014; 290 (03) 493-499
29 Tie HT, Xia YY, Zeng YS. , et al. Risk of childhood overweight or obesity associated with excessive weight gain during pregnancy: a meta-analysis. Arch Gynecol Obstet 2014; 289 (02) 247-257
30 Osterman MJ, Martin JA, Mathews TJ, Hamilton BE. Expanded data from the new birth certificate, 2008. Natl Vital Stat Rep 2011; 59 (07) 1-28
31 Deputy NP, Sharma AJ, Kim SY, Hinkle SN. Prevalence and characteristics associated with gestational weight gain adequacy. Obstet Gynecol 2015; 125 (04) 773-781
32 Hunt KJ, Alanis MC, Johnson ER, Mayorga ME, Korte JE. Maternal pre-pregnancy weight and gestational weight gain and their association with birthweight with a focus on racial differences. Matern Child Health J 2013; 17 (01) 85-94
33 Liu J, Gallagher AE, Carta CM, Torres ME, Moran R, Wilcox S. Racial differences in gestational weight gain and pregnancy-related hypertension. Ann Epidemiol 2014; 24 (06) 441-447
34 Sui Z, Turnbull D, Dodd J. Effect of body image on gestational weight gain in overweight and obese women. Women Birth 2013; 26 (04) 267-272
35 Kapadia MZ, Gaston A, Van Blyderveen S. , et al. Psychological antecedents of excess gestational weight gain: a systematic review. BMC Pregnancy Childbirth 2015; 15: 107-137
36 Stotland NE, Cheng YW, Hopkins LM, Caughey AB. Gestational weight gain and adverse neonatal outcome among term infants. Obstet Gynecol 2006; 108 (3 Pt 1): 635-643
37 Enomoto K, Aoki S, Toma R, Fujiwara K, Sakamaki K, Hirahara F. Pregnancy outcomes based on pre-pregnancy body mass index in Japanese women. PLoS One 2016; 11 (06) e0157081
38 Davis RR, Hofferth SL, Shenassa ED. Gestational weight gain and risk of infant death in the United States. Am J Public Health 2014; 104 (Suppl. 01) S90-S95
39 Friedmann I, Balayla J. Gestational weight gain and the risk of infant mortality amongst women with normal prepregnancy BMI: the Friedmann-Balayla model. J Matern Fetal Neonatal Med 2018; 31 (03) 325-332
40 Curtin SC, Gregory KD, Korst LM, Uddin SF. Maternal morbidity for vaginal and cesarean deliveries, according to previous cesarean history: new data from the birth certificate, 2013. Natl Vital Stat Rep 2015; 64 (04) 1-13
41 Barker DJ. Maternal nutrition, fetal nutrition, and disease in later life. Nutrition 1997; 13 (09) 807-813
42 Chen A, Xie C, Vuong AM, Wu T, DeFranco EA. Optimal gestational weight gain: prepregnancy BMI specific influences on adverse pregnancy and infant health outcomes. J Perinatol 2017; 37 (04) 369-374
43 Flegal KM, Carroll MD, Ogden CL, Curtin LR. Prevalence and trends in obesity among US adults, 1999-2008. JAMA 2010; 303 (03) 235-241
44 Oza-Frank R, Gilson E, Keim SA, Lynch CD, Klebanoff MA. Trends and factors associated with self-reported receipt of preconception care: PRAMS, 2004-2010. Birth 2014; 41 (04) 367-373
45 Wells CS, Schwalberg R, Noonan G, Gabor V. Factors influencing inadequate and excessive weight gain in pregnancy: Colorado, 2000-2002. Matern Child Health J 2006; 10 (01) 55-62
46 Krukowski RA, Bursac Z, McGehee MA, West D. Exploring potential health disparities in excessive gestational weight gain. J Womens Health (Larchmt) 2013; 22 (06) 494-500
47 Krukowski RA, West DS, DiCarlo M, Cleves MA, Saylors ME, Andres A. Association of gestational weight gain expectations and advice on actual weight gain. Obstet Gynecol 2017; 129 (01) 76-82
48 Herring SJ, Cruice JF, Bennett GG, Rose MZ, Davey A, Foster GD. Preventing excessive gestational weight gain among African American women: a randomized clinical trial. Obesity (Silver Spring) 2016; 24 (01) 30-36
49 Wang C, Wei Y, Zhang X. , et al. A randomized clinical trial of exercise during pregnancy to prevent gestational diabetes mellitus and improve pregnancy outcome in overweight and obese pregnant women. Am J Obstet Gynecol 2017; 216 (04) 340-351
50 Caughey AB. Gestational weight gain and outcomes for mothers and infants. JAMA 2017; 317 (21) 2175-2176
51 Mogler BK, Shu SB, Fox CR. , et al. Using insights from behavioral economics and social psychology to help patients manage chronic diseases. J Gen Intern Med 2013; 28 (05) 711-718
52 Schoendorf KC, Branum AM. The use of United States vital statistics in perinatal and obstetric research. Am J Obstet Gynecol 2006; 194 (04) 911-915
53 Martin JA, Wilson EC, Osterman MJK. , et al. Assessing the quality of medical and health data from the 2003 birth certificate revision: results from two states. Natl Vital Stat Rep 2013; 62 (02) 1-19
54 Brunner Huber LR. Validity of self-reported height and weight in women of reproductive age. Matern Child Health J 2007; 11 (02) 137-144
55 Park S, Sappenfield WM, Bish C, Bensyl DM, Goodman D, Menges J. Reliability and validity of birth certificate prepregnancy weight and height among women enrolled in prenatal WIC program: Florida, 2005. Matern Child Health J 2011; 15 (07) 851-859