Effect Of Gestational Weight Gain Research Articles

Mediating effect of gestational weight gain on the preventive effect of exercise during pregnancy on macrosomia: a randomized clinical trial.

We sought to investigate the impact of individualized exercise guidance during pregnancy on the incidence of macrosomia and the mediating effect of gestational weight gain (GWG). A prospective randomized clinical trial. A Hospital in Xingtai District, Hebei Province. Older than 20years of age, mid-pregnancy, and singleton pregnant women without contraindications to exercise during pregnancy. A randomized clinical trial was conducted from December 2021 to September 2022 to compare the effects of standard prenatal care with individualized exercise guidance on the incidence of macrosomia. Incidence of macrosomia. In all, 312 singleton women were randomized into an intervention group (N = 162) or a control group (N = 150). Participants who received individualized exercise guidance had a significantly lower incidence of macrosomia (3.73% vs. 13.61%, P = 0.002) and infants large for gestational age (9.94% vs. 19.73%, P = 0.015). However, no differences were observed in the rate of preterm birth (1.86% vs. 3.40%, P = 0.397) or the average gestational age at birth (39.14 ± 1.51 vs. 38.69 ± 1.85, P = 0.258). Mediation analysis revealed that GWG mediated the effect of exercise on reducing the incidence of macrosomia. Individualized exercise guidance may be a preventive tool for macrosomia, and GWG mediates the effect of exercise on reducing the incidence of macrosomia. However, evidence does not show that exercise increases the rate of preterm birth or affects the average gestational age at birth. The trial is registered at www.clinicaltrails.gov [registration number: NCT05760768; registration date: 08/03/2023 (retrospectively registered)].

Effect of gestational weight gain on growth trajectory in children aged 0 to 3 years

To describe the growth trajectory of body mass index for age Z score(BAZ) in children aged 0 to 3 years and to explore the association between gestational weight gain and BAZ growth trajectory. Based on a prospective cohort study, we recruited pregnant women in their early pregnancy into this study from 2013 to 2017 in Taicang of Jiangsu Province, tracked their weight changes until they gave birth, and calculated and evaluated their gestational weight gain(GWG) as appropriate, inadequate or excessive GWG based on Chinese GWG standard. Children's height/length and weight were measured at birth, 1, 3, 6, 8, 12, 18, 24, 30 and 36 months of age, and their BAZ scores were calculated. Group-based trajectory modeling(GBTM) was used for fitting BAZ trajectories. Multilevel Logistic regression was used to analyze the association between the level of GWG and BAZ growth trajectories. There were 1864 mother-child pairs in the study, and three groups of BAZ trajectories were fitted including slow growth trajectory(34.07%), appropriate growth trajectory(48.23%), and fast growth trajectory(17.70%). In univariate analysis, compared with children whose mothers had appropriate GWG, the children whose mothers had inadequate GWG were more likely in the group of slow growth trajectory(OR = 1.95, 95%CI 1.28-2.96), and the children whose mothers had excessive GWG were more likely in the group of fast growth trajectory(OR = 1.57, 95% CI 1.19-2.07). After adjusting for maternal pre-pregnancy body mass index(BMI) and parity, and the child's gender and birth weight, the children whose mothers gained in adequate GWG were more likely in the group of slow growth trajectory(OR = 1.84, 95%CI 1.19-2.84), while the association between excessive GWG and fast growth trajectory was not statistically significant(OR = 1.26, 95%CI 0.94-1.68). The BAZ trajectories of children aged 0-3 years can be categorized into slow, appropriate, and fast growth groups, and children's slow growth was associated with maternal inadequate GWG.

Gestational weight gain and pregnancy outcomes in Chinese women with type 2 diabetes mellitus: evidence from a tertiary hospital in Beijing.

To examine the effects of gestational weight gain on pregnancy outcomes and determine the optimal range of weight gain during pregnancy for Chinese women with type 2 diabetes mellitus. This retrospective cohort study included 691 Chinese women with type 2 diabetes mellitus from 2012 to 2020. The study utilized a statistical-based approach to determine the optimal range of gestational weight gain. Additionally, multivariate logistic regression analysis was conducted to assess the impact of gestational weight gain on pregnancy outcomes. (1) In the obese subgroup, gestational weight gain below the recommendations was associated with decreased risks of large for gestational age (adjusted odds ratio [aOR] 0.19; 95% confidence interval [CI] 0.06-0.60) and macrosomia (aOR 0.18; 95% CI 0.05-0.69). In the normal weight subgroup, gestational weight gain below the recommendations of the Institute of Medicine was associated with decreased risks of preeclampsia (aOR 0.18; 95% CI 0.04-0.82) and neonatal hypoglycemia (aOR 0.38; 95% CI 0.15-0.97). (2) In the normal weight subgroup, gestational weight gain above the recommendations of the Institute of Medicine was associated with an increased risk of large for gestational age (aOR 4.56; 95% CI 1.54-13.46). In the obese subgroup, gestational weight gain above the recommendations was associated with an increased risk of preeclampsia (aOR 2.74; 95% CI 1.02, 7.38). (3) The optimal ranges of gestational weight gain, based on our study, were 9-16kg for underweight women, 9.5-14kg for normal weight women, 6.5-12kg for overweight women, and 3-10kg for obese women. (4) Using the optimal range of gestational weight gain identified in our study seemed to provide better prediction of adverse pregnancy outcomes. For Chinese women with type 2 diabetes, inappropriate gestational weight gain is associated with adverse pregnancy outcomes, and the optimal range of gestational weight gain may differ from the Institute of Medicine recommendations.

Insulin requirements during pregnancy in women with type 1 diabetes treated with insulin pump.

Insulin requirement in women with Type 1 diabetes (T1DM) changes throughout pregnancy. The aim of this study was to determine the total change in insulin requirements and the effect of gestational weight gain (GWG) and pre-gestational BMI on insulin requirements during pregnancy in women with T1DM treated with continuous subcutaneous insulin infusion and continuous glucose monitoring. This historical cohort study included all consecutive women with T1DM who were monitored during pregnancy at the high-risk pregnancy clinic at a tertiary medical center during April 2011-April 2019. One Way Repeated Measures ANOVA with Bonferroni adjustment was conducted to compare the effects of gestational age on insulin requirements and a Two Way Repeated Measures ANOVA was employed to test for the interaction between gestational age intervals and maternal BMI and GWG. Data regarding insulin requirements of 185 pregnancies were included in the analyses. There was a significant effect of gestational age on total insulin (Wilks' Lambda=0.34, F(6,14)=4.52, p=0.009), basal insulin (Wilks' Lambda=0.41, F(6,14)=3.30, p=0.031) and bolus insulin (Wilks' Lambda=0.43, F(6,14)=3.02, p=0.041). Total insulin/kg requirements increased by 5.5% from 13-20weeks to 20-26weeks, 19% from 20-26weeks to 26-33weeks, and 17.4% from 26 to 33weeks to delivery (p for trend=0.009). Overall, insulin requirements increased by 42.1% from conception to delivery (p<0.01). There was no significant main effect of maternal BMI or GWG on insulin requirements. There is a significant increase in insulin requirements per kg during pregnancy in women with T1DM who were treated with an insulin pump.

EPH219 The Effect of Gestational Weight Gain on Pregnancy Outcome

EPH219 The Effect of Gestational Weight Gain on Pregnancy Outcome

Long-term effects of gestational weight gain on mortality

Long-term effects of gestational weight gain on mortality

Effect of Dietary Diversity on the Nutritional Status in Pregnant Women and in Turn its Effect on Birth Weight of the Baby

Background: Nutrient intake is important to the well-being of pregnant women and the fetus. Most of the previous studies points nutrition status based on energy and protein intake. However there are few studies indicate the use of dietary diversity as a marker of assessing the nutrition status. Healthy diets include the most diverse foods, and balance in eating food provides maternal and fetal health and reduces the prevalence of Low birthweight. Objectives: The objectives of the present study are to find out the association between Dietary diversity score with the nutrition status of the Pregnant Women (Gestational weight gain and nutritional anaemia.) And to find out the effects of gestational weight gain and nutritional anemia on the birth weight of the baby. Methods: An Institutional ethical clearance was obtained and the present Hospital based study was carried out in the OBG department of tertiary care centre of North Karnataka between December 2019 to February 2020. Sample size was estimated to be 120. Results: In the present study, a total of 120 women participated in the study. The Mean age of the study participants was 25.2±3.4, and the study found mean DDS was 7.04±1.58, with the scores ranging from 3 to 12. Association between the Dietary diversity score (DDS) and birthweight of the baby was found to be statistically significant (p=0.03) There is a statistically significant difference in DDS mean score between anaemic and normal pregnant women (p=0.007). There was a statistically significant positive correlation between Gestational weight gain and birth weight of the baby (p=0.03). There were positive correlation between the DDS and the Birthweight and Gestational weight gain, though it was statistically non-significant. Conclusion: Nutrition education for pregnant women should include the facts about the different food groups, it advantages will help to include diverse food items in their diet. Keywords: Dietary diversity score, Gestational weight gain, Birth weight

An Evaluation of the Effects of Gestational Weight Gain on the Early Postpartum Pelvic Floor Using Transperineal Ultrasound.

We herein evaluated the effects of gestational weight gain (GWG) on postpartum pelvic floor function using transperineal ultrasound (TPUS). We analyzed retrospectively the data from 228 primiparous women with singleton pregnancies who were evaluated for postpartum pelvic floor function between February 2022 and October 2022. According to the 2009 Institute of Medicine guidelines regarding GWG, subjects were separated into three groups: inadequate GWG, recommended GWG, and excessive GWG. All underwent TPUS 6-10 weeks postpartum to assess bladder neck descent between rest and Valsalva (BND), retrovesical angle at Valsalva (RVA), urethral rotation angle between rest and Valsalva (URA), the area of levator hiatus at Valsalva (LHA), and abnormal pelvic floor function. Univariate and multivariate regression analyses were applied to explore the association measures between GWG and the pelvic floor. A P-value <.05 was considered statistically significant. Of the 228 primiparous women, 113 (49.6%) showed excessive GWG. Univariate analysis revealed that there were no statistical differences in ultrasonic parameters of the pelvic floor among the three groups (P > .05). After adjusting for potential confounders and using the recommended GWG group as a reference group, inadequate GWG was significantly associated with BND ≥25 mm (OR = 0.36, 95% CI = 0.14-0.93), and excessive GWG was significantly associated with uterine prolapse (OR = 2.79, 95% CI = 1.13-6.92). GWG was associated with the ultrasonic parameters of the female pelvic floor in the early postpartum period.

Effect of Gestational Weight Gain on Length of Induction of Labor [ID: 1377561

INTRODUCTION: Review of institutional data found an association between maternal obesity and increased cesarean delivery (CD) among nulliparous, term, single, vertex (NTSV) pregnancies. To identify modifiable risk factors for CD, we evaluated the relationship of gestational weight gain (GWG) to length of induction of labor. METHODS: From January 2020 to May 2021, NTSV inductions were identified via retrospective chart review (IRB#4954). Gestational weight gain according to prepregnancy body mass index (BMI) was categorized using ACOG standards as appropriate, insufficient, or excessive. Time of initial induction agent to delivery time equated to total induction time. Chi square, t test, and regression analyses were performed where appropriate. RESULTS: Of 1,031 inductions, 244 (24%) patients had appropriate, 160 (15%) had insufficient, and 627 (61%) had excessive GWG. 366 (36%) had prepregnancy BMI greater than 30. Average total induction times for appropriate, insufficient, and excessive GWG were 1,179, 1,072, and 1,286 minutes, respectively. Excessive GWG was a positive predictor of length of induction (P&lt;.001). Additionally, those with excessive GWG labored significantly longer with ruptured membranes (84 minutes) than those with appropriate GWG (P=.006). CONCLUSION: Excessive GWG correlated with 107 additional minutes in the induction process and more time with ruptured membranes. These data emphasize the importance of appropriate GWG particularly in patients beginning pregnancy with obesity. Patients with obesity otherwise have worse pregnancy outcomes; therefore, nutrition and exercise counseling during prenatal care could be advantageous. These data also help inform counseling and preparation on labor units, particularly as inductions become more prevalent.

The effect of gestational weight gain on delivery and neonatal characteristics: exploring sex differences in the "MAMI-MED" cohort

The effect of gestational weight gain on delivery and neonatal characteristics: exploring sex differences in the "MAMI-MED" cohort

Effect of gestational weight gain on postpartum pelvic floor function in twin primiparas: a single-center retrospective study in China

BackgroundThe effect of gestational weight gain (GWG) as a controllable factor during pregnancy pelvic floor function has rarely been investigated, and studies on twin primiparas are even less frequent. The objective of the present study was to explore the effect of GWG on postpartum pelvic floor function in twin primiparas.MethodsWe retrospectively analyzed the clinical data of 184 twin primiparas in the pelvic floor rehabilitation system of the First Affiliated Hospital of Chongqing Medical University from January 2020 to October 2021. Based on the GWG criteria recommended by the Institute of Medicine, the study subjects were classified into two groups: adequate GWG and excessive GWG. Univariate and multivariate logistic regression models were applied to explore the relationship between GWG and pelvic floor function.ResultsAmong the 184 twin primiparas, 20 (10.87%) had excessive GWG. The rates of abnormal vaginal dynamic pressure (95% vs. 74.39%), injured type I muscle fibers (80% vs. 45.73%), anterior vaginal wall prolapse (90% vs. 68.90%), and stress urinary incontinence (50% vs. 20.12%) of twin primiparas with excessive GWG were significantly higher than those with adequate GWG. There was no significant difference between the total score of the Pelvic Floor Distress Inventory-Short Form 20 (PFDI-20) or the scores of the Pelvic Organ Prolapse Distress Inventory 6 (POPDI-6), the Colorectal-Anal Distress Inventory 8 (CRADI-8), and the Urinary Distress Inventory 6 (UDI-6) in the two groups (P > 0.05). After adjusting for potential confounding factors, the results showed that excessive GWG was positively associated with abnormal vaginal dynamic pressure (OR = 8.038, 95% CI: 1.001–64.514), injured type I muscle fibers (OR = 8.654, 95% CI: 2.462–30.416), anterior vaginal wall prolapse (OR = 4.705, 95% CI: 1.004–22.054), and stress urinary incontinence (OR = 4.424, 95% CI: 1.578–12.403).ConclusionExcessive GWG in twin primiparas was positively correlated with the prevalence of pelvic floor dysfunction but did not exacerbate pelvic floor symptoms in twin primiparas. Controlling GWG within a reasonable range is recommended for reducing the risk of PFDs in pregnant women with twins.

Invited Commentary: Aligning Methodological Research on Pregnancy Weight Gain With the Questions That Matter Most for Public Health Guidelines.

The inherent correlation between the total amount of weight gained in pregnancy and the duration of pregnancy creates major methodological challenges in the study of pregnancy weight gain. In this issue (Am J Epidemiol. 2022;191(10):1687-1699), Richards et al. examine the extent to which different measures of pregnancy weight gain (including covariate adjustment for gestational age and standardizing weight gain for gestational duration using a pregnancy weight gain chart) are able to disentangle the effects of low weight gain on perinatal health from the role of younger gestational age at delivery for 3 outcomes: small-for-gestational-age birth, cesarean delivery, and low birth weight. While methodological research to understand how to best disentangle the effects of gestational weight gain from pregnancy duration is valuable, we argue that the practical utility of this type of research would be increased by aligning the specific research questions more closely with health outcomes on which evidence is most needed-those not considered in current weight gain guidelines due to lack of high-quality evidence (such as pre-eclampsia and stillbirth). Further, evaluations of weight gain charts should separate out the potential for bias introduced by the use of a normative chart per se from the use of a chart unsuitable for the study population.

Effect of Gestational Weight Gain during the First Half of Pregnancy on the Incidence of GDM, Results from a Pregnant Cohort in Northern Greece.

The aim of this study was to evaluate the effect of gestational weight gain (GWG) up to 23+6 weeks of gestation on the incidence of Gestational Diabetes Mellitus (GDM). A pregnant cohort of 5948 women in Northern Greece was recruited. Anthropometric features before and during pregnancy were recorded, the GWG by 23+6 weeks was calculated and a Generalized Linear Regression Model (GLM) with subgroup analyses based on weight status were computed. GDM was diagnosed in 5.5% of women. GLM results showed that GDM likelihood increased with maternal age (MA) and pre-pregnancy BMI (aOR: 1.08, 95%CI: [1.06, 1.11] and aOR: 1.09, 95%CI: [1.09, 1.11], respectively). Ιn the normal pre-pregnancy weight group, when the extra weight gain was >8 kgs, the odds of GDM increased (OR: 2.13, 95%CI: [0.98, 4.21], p = 0.03). Women with pre-pregnancy level 2 clinical obesity (OB2 pre) (BMI > 35 and <40 kg/m2) that shifted to OB3 category (BMI ≥ 40 kg/m2) had an increased GDM likelihood (OR: 4.85, 95%CI: [1.50, 15.95]). Women of higher MA may require stricter monitoring for GDM from early pregnancy, while in obese women, recommended GWG may need to be re-evaluated, since refraining from any weight gain may have a preventive effect for GDM.

Optimal Gestational Weight Gain for Women with Gestational Diabetes Mellitus - China, 2011-2021.

Joint effects of gestational weight gain (GWG) and hyperglycemia on adverse pregnancy outcomes suggest that lower optimal GWG is optimal for women with gestational diabetes mellitus (GDM). However, there is still a lack of guidelines. Optimal weekly GWG range after diagnosis of GDM for underweight, normal-weight, overweight, and obese women was 0.37-0.56 kg/week, 0.26-0.48 kg/week, 0.19-0.32 kg/week, and 0.12-0.23 kg/week, respectively. The findings may be used to inform prenatal counseling regarding optimal gestational weight gain for women with gestational diabetes mellitus, and suggest the need for weight gain management.

The Effect of Gestational Weight Gain on Low Birth Weight, Case-Control Study in Northeast Amhara Regional State, Ethiopia, 2019

Background: Intrauterine growth and development are one of the most vulnerable periods in the human life cycle that contribute to appropriate fetal development. Therefore, this study aimed to assess the effect of gestational weight on low birth weight (LBW).&#x0D; Methods: A case-control study was conducted from June 30, 2018, to January 1, 2019, in seven governmental hospitals in the northeast Amhara region on 451 participants(150 cases and 301 controls).&#x0D; Results: Inadequate gestational weight gain increases the risk of LBW by four times (AOR: 4.2, 95% CI: 2.4, 6.4). Anemic mothers were 3 times (AOR: 3.2, 95%CI: 2.5, 5.1) more likely to give birth to LBW newborns than non-anemic women. Mothers with a height of less than 150 cm were 2 times more likely to deliver low birth weight babies than their counterparts (AOR:2.1, 95% CI: 1.5,4.4). The odds of LBW delivery were 3.5 times (AOR: 3.5, 95% CI: 2.3, 5.3) higher for mothers with poor dietary diversity than for mothers with good dietary diversity.&#x0D; Conclusion: Inadequate gestational weight gain during pregnancy was found to be a risk factor for LBW. Additionally, anemia, short stature, and poor dietary diversity were also risk factors for LBW. Therefore, selectively targeted interventions such as improving maternal nutrition, anemia prevention, and proper maternal weight monitoring during pregnancy are needed.

Optimal gestational weight gain to reduce the risk of hypertension disorders of pregnancy among women with obesity: A single tertiary referral center study in Japan.

To examine the effect of weight gain during pregnancy on hypertension disorders of pregnancy among women with a prepregnancy body mass index ≥30.0kg/m2 . This retrospective cohort study included 257 Japanese women (116 primipara; 141 multipara) with singleton pregnancies with a prepregnancy body mass index ≥ 30.0kg/m2 , who gave birth during 2013 to 2020 at Ohta Nishinouchi Hospital. Multiple logistic regression analyses were performed to identify the effect of gestational weight gain on early-onset (<34 weeks), late-onset (≥34 weeks), and overall hypertension disorders of pregnancy. The prevalence of hypertension disorders of pregnancy in primiparas and multiparas was 28.4% and 11.3%, respectively. By multiple logistic regression analysis, gestational weight gain during pregnancy increased the risk of early-onset (adjusted odds ratio: 1.20, 95% confidence interval: 1.03-1.39, p< 0.05) and overall hypertension disorders of pregnancy (adjusted odds ratio: 1.12, 95% confidence interval: 1.03-1.22, p< 0.05) among primiparas. Based on receiver operating characteristic curve analyses for early-onset (area under the curve 0.67, 95% confidence interval: 0.56-0.78; p< 0.05) and overall hypertension disorders of pregnancy (area under the curve 0.76, 95% confidence interval: 0.61-0.91; p< 0.05) among primiparas, we determined the cut-off weight gain during pregnancy for early-onset and overall hypertension disorders of pregnancy as 3.85 kg, with sensitivity/specificity of 0.76/0.59 and 0.91/0.53, respectively. We recommend that the optimal gestational weight gain for reducing HDP be under 3.85 kg. This information may facilitate personalized pre-conception counseling among women with obesity.

Effect of Gestational Weight Gain on Overweight and Obese Pregnant Women

Objective: To examine the adherence of gestational weight gain (GWG) recommendations and pregnancy outcomes among overweight and obese pregnant women.Materials and Methods: The medical records of 405 overweight or obese pregnant women who delivered at Siriraj Hospital between September 2018 and June 2019 were reviewed. The adherence to GWG recommendations according to pre-pregnancy body mass index (BMI) was examined. The characteristics and pregnancy outcomes of the overweight and obese pregnancies as well as between the adherence and non-adherence to the GWG recommendations groups were studied and compared between the groups.Results: Adherence to the GWG recommendations between the overweight and obese pregnancy groups were significantly different at 60.2% and 44% respectively (p-value = 0.002), although the average GWG was significantly lower in the obese than overweight pregnancies (p-value = 0.003). Pre-pregnancy BMI was significantly higher in the non-adherence group compared with the adherence group (p-value = 0.025). Pregnancy outcomes as well as the prevalence of gestational diabetes mellitus between these two groups were comparable. Also, adverse pregnancy outcomes were not statistically significantly different among the adherence and non-adherence groups.Conclusion: The adherence to gestational weight gain recommendations in obese and overweight pregnancies is still a challenge. Obese pregnant women are less likely to control weight gain during pregnancy. Pre-pregnancy BMI is an important factor for overweight and obese pregnant women to achieve the GWG goal. Ensuring a proper GWG alone might not improve most adverse pregnancy outcomes in overweight and obese pregnancies.

Sex-specific mediating effect of gestational weight gain between pre-pregnancy body mass index and gestational diabetes mellitus

BackgroundInappropriate weight gain may increase the risk of gestational diabetes mellitus (GDM). However, the relationship between pre-pregnancy body mass index (BMI), weight gain, and GDM has not been precisely quantified. This study aimed to explore whether gestational weight gain played a mediating role between pre-pregnancy BMI and GDM and whether the mediating effect was sex specific.MethodsThis study established a population-based observational cohort to assess weight gain in pregnant women. Mediation analyses were performed to quantify whether weight gain mediated the association between pre-pregnancy BMI and GDM.ResultsA total of 67,777 pregnant women were included in the final analysis, among whom 6751 (10.0%) were diagnosed with GDM. We verified that both pre-pregnancy BMI and weight gain were associated with GDM, and that BMI negatively contributed to weight gain. We also found that weight gain had a significant mediating effect on the relationship between pre-pregnancy BMI and GDM (Za × Zb confidence intervals [CIs] 0.00234–0.00618). Furthermore, the effect was sex-specific, in that it was only significant in overweight women carrying female fetuses (Za × Zb CIs 0.00422–0.01977), but not male fetuses (Za × Zb CIs −0.00085 to 0.01236).ConclusionsWeight gain during pregnancy had a fetal sex-specific mediating effect between pre-pregnancy BMI and GDM.

Effect of gestational weight gain on preeclampsia among underweight women: A single tertiary referral center study in Japanese women.

To examine the effect of weight gain during pregnancy on preeclampsia among women with a prepregnancy body mass index < 18.5kg/m2 . This retrospective cohort study included 479 Japanese women with singleton pregnancies and a prepregnancy body mass index < 18.5kg/m2 , who gave birth between 2013 and 2019 at Ohta Nishinouchi Hospital. The study included 22 (18 with preeclampsia and four with gestational hypertension) and 457 patients with and without hypertensive disorders of pregnancy, respectively. The prevalence of hypertensive disorders of pregnancy and preeclampsia was 4.6% and 3.8%, respectively. With weight gain during pregnancy (continuous variable) set as a reference, multiple logistic regression revealed that excessive weight gain during pregnancy increased the risk of preeclampsia (adjusted odds ratio: 1.13, 95% confidence interval: 1.00-1.28, p< 0.05) and hypertensive disorders of pregnancy (adjusted odds ratio: 1.15, 95% confidence interval: 1.03-1.29, p< 0.05). Based on receiver operating characteristic curve analyses (area under the curve 0.65, 95% confidence interval: 0.50-0.80; p< 0.05), we determined the cutoff value of weight gain during pregnancy for the occurrence of preeclampsia among women with body mass index < 18.5kg/m2 to be 13.0kg, with sensitivity and specificity of 0.50 and 0.78, respectively. This study indicates that excessive weight gain during pregnancy increases preeclampsia risk among underweight women and provides new recommendations for weight gain during pregnancy for such women. Further research regarding the pathogenesis of preeclampsia for underweight women is warranted.

Gestational weight gain rates in the first and second trimesters are associated with small for gestational age among underweight women: a prospective birth cohort study

BackgroundDespite the well-studied effects of gestational weight gain (GWG) on offspring health, little is known about the association of trimester-specific GWG with offspring birth weight among underweight pregnant women. This study aimed to explore the association of trimester-specific GWG rate with small for gestational age (SGA) in underweight women.MethodsThe GWG rate of underweight pregnant women (pre-pregnancy body mass index [BMI] lower than 18.5 kg/m2) of the Born in Guangzhou Cohort Study was calculated as the weight gain during a specific trimester divided by the corresponding duration of week. Total GWG was calculated as the weight difference between pre-pregnancy and delivery, and was categorized into inadequate, adequate, and excessive weight gain based on the 2009 Institute of Medicine (IOM) weight gain recommendation. The INTERGROWTH-21st standards were used to define SGA. Logistic regression models were used to examine the associations of total GWG and trimester-specific GWG rates with SGA. Associations between trimester-specific GWG rates and SGA were also analyzed separately based on different total GWG categories (i.e. inadequate and adequate/excessive GWG).ResultsOf the 3839 participants, SGA births occurred in 397 (10.3%), and mean GWG was 14.9 kg (SD 3.9). A lower risk of SGA was observed among women with higher GWG rate (per 0.5 kg/week increase) during the first (adjusted OR [aOR] 0.74, 95%CI 0.57, 0.96) and second (adjusted OR [aOR] 0.40, 95%CI 0.30, 0.55) but not third trimester. Similar association between higher GWG rate during the second trimester and a decreased risk of SGA were observed among women with inadequate (< 12.5 kg) and adequate/excessive (≥12.5 kg) total GWG, respectively. Compared to women with adequate GWG rate, women with inadequate GWG rate during the second trimester had a significantly increased risk of SGA (aOR 1.58, 95% CI 1.14, 2.20).ConclusionsSecond-trimester GWG might be the key driver for the association between inadequate GWG and increased risk of SGA births in underweight women.