Abstract
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.
Highlights
The prevalence of obesity has been increasing significantly in many countries in recent years [1,2]
Overweight and obese women were at increased relative risk of gestational diabetes mellitus (GDM), hypertensive disorders of pregnancy (HDP), caesarean delivery and giving birth to a macrosomic or large for gestational age (LGA) neonate
We showed that compliance with recommendations through both the second and third trimesters reduced the proportion of HDP, caesarean delivery, macrosomia, and LGA
Summary
The prevalence of obesity has been increasing significantly in many countries in recent years [1,2]. In 2009, the Institute of Medicine (IOM) updated its recommendations on gestational weight gain according to ppBMI [9] These guidelines were developed to minimize the negative health consequences for both mother and fetus of inadequate or excessive gain. They incorporated World Health Organization (WHO) categories of ppBMI maternal body mass index (BMI calculated as weight in kilograms divided by height in squared meters; BMI for underweight,
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
