Abstract
This study aims to compare the US Institute of Medicine (IOM) and Japanese guidelines proposed by the Ministry and the Japan Society for the Study of Obesity on gestational weight gain (GWG), and to explore the optimal GWG range in Japanese women. We investigated 8,152 Japanese women who had full-term singleton babies between 2010 and 2013 at a single center in Tokyo. Logistic regression models showed that GWG below the recommendation of the IOM and Japanese guidelines was similarly associated with an increased risk of light-for-date (LFD), whereas GWG above these guidelines was similarly associated with an increased risk of heavy-for-date (HFD) in pre-pregnancy body mass index categories of underweight (<18.5 kg/m2, n = 1559), normal-weight (18.5–24.9 kg/m2, n = 4998), overweight (25.0–29.9 kg/m2, n = 270), and obese (30 ≤ kg/m2, n = 60). The receiver-operating characteristic curve demonstrated that the optimal cutoffs for LFD and HFD were 9.7 and 10.4 kg, respectively in normal-weight mothers. The IOM and Japanese guidelines identified the risk of LFD or HFD equally well. The optimal GWG range in normal-weight women observed in this study was more close to Japanese guideline (i.e., 7–12 kg) compared to the IOM guideline (i.e., 11.5–16 kg).
Highlights
Maternal weight prior to and during pregnancy affects the health of mothers and children
This study compared the risk of LFD or HFD associated with below or above the gestational weight gain (GWG) recommendation of the Institute of Medicine (IOM) or JMHLW guideline in underweight and normal-weight mothers, and the GWG recommendation of the IOM and Japanese Society for the Study of Obesity (JSSO) guideline in overweight and obese mothers, and determined the optimal GWG during pregnancy in normal-weight women
The IOM and the two Japanese guidelines discriminated the risks of LFD or HFD in underweight, normal-weight, and overweight mothers, whereas there was no significant findings observed in obese mothers but this may be due to small sample size of this group
Summary
Maternal weight prior to and during pregnancy affects the health of mothers and children. In 2016, the Japanese Society of Obstetrics and Gynecology Successive Pregnancy Birth Registry System[4] performed a large-scale study of 97,157 pregnant Japanese women, which showed that the average weight gain during pregnancy was 10.3 kg in underweight, 10.1 kg in normal-weight, 7.9 kg in overweight, and 5.5 kg in obese women. All such weight gains were much lower than the ranges in the IOM guidelines. The appropriate GWG range to prevent a birth of a low birth weight baby requires immediate clarification
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