Abstract
BackgroundGestational weight gain has been associated with some adverse perinatal outcomes, but few studies have examined the association between gestational weight gain and offspring’s cognition and their conclusions are inconsistent. Our systematic review and meta-analysis aimed to synthesize the evidence regarding the association between gestational weight gain and offspring’s cognitive skills.MethodsIn this systematic review and meta-analysis (PROSPERO number, CRD42017073266), we systematically searched MEDLINE, EMBASE, Web of Science and the Cochrane Library for studies examining association between gestational weight gain and offspring’s cognitive skills, without restriction in study design or language. Two reviewers extracted in an independent way the data. The Quality of Reporting of Observational Longitudinal Research scale was used to assess the quality of included studies. Effect size (ES) for adjusted models and their corresponding 95% confidence intervals were calculated for (i) intelligence quotient, (ii) language related skills and (iii) mathematic related skills comparing offspring’s cognitive skills when gestational weight gain was within recommendations (as reference) with those from mothers whose gestational weight gain was above or below the recommendations.ResultsThirteen studies were included. There was a positive trend that associated gestational weight gain above recommendations with better offspring’s intelligence quotient, although not statistically significant (ES 0.02, 95% CI -0.00, 0.05; I2 = 0.00%).ConclusionsThere is a not significant positive association between gestational weight gain above recommendations and intelligence quotient and some studies reported associations between gestational weight gain and offspring’s cognitive skills. Our analyses confirm a wide variability in the results of studies published so far and highlights the need for conducting studies including specific samples of pregnant women by pre-pregnancy body mass index and trimester of pregnancy.
Highlights
Gestational weight gain has been associated with some adverse perinatal outcomes, but few studies have examined the association between gestational weight gain and offspring’s cognition and their conclusions are inconsistent
Studies were excluded when they were focused exclusively on: (i) mothers with intellectual disabilities; (ii) mothers with diabetes, preeclampsia or cardiovascular problems; (iii) offspring with developmental disorders/ diagnoses like symptoms of autism spectrum disorder, because studies in which all children are affected with any detected delay in communication, adaptation, cognition or socio-emotional domains could modify the effect of the main exposure, gestational weight gain (GWG), on offspring’s cognition and might bias the estimates of meta-analysis.; and (iv) new-borns not born at full term
We considered three cognitive domains: intelligence quotient (IQ), language-related skills and mathematics-related skills
Summary
Gestational weight gain has been associated with some adverse perinatal outcomes, but few studies have examined the association between gestational weight gain and offspring’s cognition and their conclusions are inconsistent. Recommendations for gestational weight gain (GWG) have been a debatable issue during the last three decades. In 2009, the Institute of Medicine (IOM) updated GWG recommendations published in 1990 by The National Academy of Science [1], changing pre-gestational body mass index (BMI) classification and suggesting less GWG for obese women to improve perinatal outcomes [2]. Excessive GWG increases the risk of some adverse perinatal outcomes, such as caesarean delivery, hypertensive disorders of pregnancy, macrosomia, neonatal hypoglycaemia or shoulder dystocia [6]. Excessive GWG has been associated with long-term effects, such as mother’s postpartum weight retention [7]; and higher risk of childhood obesity [8] or neurodevelopmental impairment in children [9]. Insufficient GWG has been related with preterm birth [6]
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