Inadequate Gestational Weight Gain Research Articles

BackgroundLow dietary diversity can contribute to undernutrition, impacting gestational weight gain (GWG) and increasing the risk of low birth weight (LBW).ObjectiveThis study investigates the relationships between maternal dietary diversity, dietary quality, GWG, and LBW in a cohort of singleton pregnant mothers in Jordan. It was hypothesized that higher dietary diversity and appropriate GWG would correlate with a reduced likelihood of LBW and that "minimum dietary diversity for women (MDD-W)" and "prime diet quality scores (PDQS) " would have both indirect and direct effects on birth weight, mediated by GWG.MethodsThe prospective study involved 198 singleton pregnant mothers aged 19 to 45, segmented into three groups by trimester (66 women per trimester). Dietary diversity was assessed using the MDD-W and the PDQS. GWG was classified as appropriate, excess, or inadequate based on pre-pregnancy body mass index (BMI). Birth weights, lengths, and head circumferences of neonates were measured.ResultsMothers with MDD-W > 5 and PDQS > 21 had significantly higher average birth weights and lengths compared to those with lower scores (MDD-W: 3.1 ± 0.6 vs. 2.6 ± 0.5 kg; PDQS: 3.0 ± 0.6 vs. 2.6 ± 0.5 kg; MDD-W: 49.8 ± 1.7 vs. 48.1 ± 1.7 cm; PDQS: 49.2 ± 1.8 vs. 48.1 ± 1.8 cm). Significant predictors of LBW included GWG for pre-pregnancy BMI, previous LBW deliveries, PDQS, and family income. Inadequate GWG was significantly associated with LBW. GWG significantly mediated the relationship between MDD-W (B = 0.067, P < 0.001, 95% CI [0.059–0.076]), PDQS (B = 0.069, P < 0.001, 95% CI [0.06–0.077]), and birth weight. Each score increase in MDD-W was associated with a 0.141 kg increase in birth weight (B = 0.141, P < 0.001, 95% CI [0.093–0.189]), compared to a 0.041 kg increase for each PDQS score (B = 0.041, P < 0.001, 95% CI [0.025–0.058]).ConclusionsOur findings indicated that both MDD-W and PDQS are associated with birth weight, with higher scores correlating with increased GWG and birth weight. Notably, dietary diversity and GWG relative to pre-pregnancy BMI emerged as robust predictors of birth weight at delivery.Supplementary InformationThe online version contains supplementary material available at 10.1186/s12937-025-01130-8.

Gestational weight gain and postpartum weight retention: What is the role of perinatal antidepressant use?

Gestational weight gain (GWG) is a critical indicator of the health and nutritional status of pregnant women and their fetuses. However, there is limited evidence on how air pollution affects abnormal GWG in twin pregnancies. In this retrospective analysis of 3,598 twin pregnancies, participants were categorized into three groups based on GWG: optimal, inadequate, and excessive. We collected data on ambient air pollutants, including fine particulate matter (PM2.5), inhalable particulate matter (PM10), sulfur dioxide (SO2), nitrogen dioxide (NO2), carbon monoxide (CO), and ozone (O3). Multivariable linear regression models examined the associations between air pollutant exposure in each trimester and GWG, analyzing pollutants both continuously and by quartiles. Logistic regression and trend analyses assessed the impact of these pollutants on the risks of inadequate and excessive GWG, adjusting for potential confounders. Restricted cubic spline (RCS) models visualized trimester-specific effects, and cumulative effects of extreme air pollution indices on GWG outcomes were evaluated using logistic regression. The results indicated that exposure to PM2.5, PM10, SO2, NO2, and CO during pregnancy was positively associated with GWG in twin pregnancies, while O3 exposure was negatively associated. For inadequate GWG, PM2.5, PM10, and SO2 were identified as risk factors in the first trimester, with aORs of 1.008 (95% CI: 1.001-1.015), 1.006 (95% CI: 1.001-1.010), and 1.033 (95% CI: 1.000-1.067), respectively. In the second and third trimesters, these pollutants exhibited protective effects, alongside NO2 and CO. Conversely, O3 in the third trimester was a risk factor for inadequate GWG, with an aOR of 1.054 (95% CI: 1.008-1.102). Regarding excessive GWG, in the first trimester, PM2.5, PM10, SO2, NO2, and CO acted as protective factors, with aORs of 0.987 (95% CI: 0.980-0.994), 0.992 (95% CI: 0.986-0.997), 0.956 (95% CI: 0.924-0.989), 0.972 (95% CI: 0.948-0.997), and 0.243 (95% CI: 0.075-0.787), respectively. However, their effects reversed in the second and third trimesters, becoming risk factors for excessive GWG, with more pronounced effects observed in the third trimester. O3 remained a protective factor against excessive GWG in both the second and third trimesters, with aORs of 0.951 (95% CI: 0.905-0.999) and 0.876 (95% CI: 0.835-0.920), respectively. Finally, the effects of extreme air pollution exposure on GWG varied across different pregnancy stages. In the first trimester, extreme exposures to PM2.5, PM10, SO2, and CO were associated with an increased risk of inadequate GWG, while NO2 exposure appeared protective. In contrast, extreme air pollution exposure was protective against excessive GWG, with NO2 exposure acting as a risk factor. By the second and third trimesters, extreme exposures to PM2.5, PM10, SO2, and CO became risk factors for excessive GWG. The effects of ambient air pollutants on gestational weight gain in twin pregnancies vary by pregnancy stage, with extreme air pollution exposure exhibiting time-dependent characteristics. These findings highlight the complex, stage-specific relationship between air pollution and maternal weight gain during twin pregnancies.

Black-White disparities in maternal and neonatal morbidity and mortality highlight health inequities in several settings, yet such racial disparities in Canada are not well defined. Our objective was to conduct a scoping review to identify the extent of epidemiologic evidence assessing Black-White disparities in maternal and neonatal health in Canada. We included peer-reviewed epidemiologic studies which measured maternal or neonatal outcomes in Black versus White individuals in Canada. We searched OVID platforms (MEDLINE, Embase, Emcare) from inception to May 9, 2024, using keywords and controlled vocabulary terms related to race and maternal and neonatal morbidity and mortality. Results synthesis was carried out using descriptive analysis. After exclusions, six retrospective cohort studies were included in the scoping review. The majority of the included studies used data obtained from provincial datasets (n = 5), defined maternal race using self-reported race (n = 5), and were set in Ontario (n = 4). All studies reported one or more significant associations between race and adverse maternal or neonatal outcomes, with Black individuals experiencing higher rates of spontaneous fetal loss (n = 1), perinatal mortality (n = 1), preterm birth (n = 3), small for gestational age infants (n = 1), low Apgar scores (n = 2), congenital heart disease (n = 1), neonatal intensive care unit admission (n = 1), preeclampsia (n = 2), gestational diabetes (n = 1), and inadequate gestational weight gain (n = 1). Although literature on the topic is sparse, Black-White disparities in maternal and neonatal health in Canada are apparent. National, population-based data are needed to provide a comprehensive understanding of racial disparities in maternal and neonatal health and the factors driving these differences.

Nausea and vomiting of pregnancy (NVP), including its severe form hyperemesis gravidarum (HG), have been linked to various perinatal outcomes, though findings remain inconsistent. This study aimed to examine the association between NVP severity and adverse pregnancy outcomes and to evaluate whether gestational weight gain (GWG) mediates these relationships. We analyzed data from 8396 nulliparous women enrolled in the U.S. nuMoM2b cohort. NVP severity was measured using the Pregnancy-Unique Quantification of Emesis (PUQE) score across three prenatal visits and categorized as none, one, and ≥2 visits of medium-to-severe NVP. Perinatal outcomes included birth weight, gestational age, preterm delivery, small for gestational age (SGA), and low birth weight (LBW). GWG adequacy was assessed per Institute of Medicine guidelines. Multivariable regression models were used, adjusting for sociodemographic and clinical covariates. Overall, 81.6% of women reported no visit with medium-to-severe NVP, 16.2% with one such visit, and 2.3% with two or three such visits. One visit with medium-to-severe NVP was associated with a modest reduction in birth weight (-41.4g; 95% CI: -72.6, -10.2). Inadequate GWG-regardless of NVP status-was consistently associated with shorter gestation (-0.53weeks), lower birth weight (-261.3g), and increased risks of preterm birth, LBW, and SGA (ORs 1.66-2.75). NVP severity alone showed limited impact on short-term pregnancy outcomes. However, inadequate GWG emerged as a key modifiable risk factor. These findings underscore the importance of nutritional support and symptom management during pregnancy, particularly for women with moderate-to-severe NVP. Long-term outcomes warrant further investigation.

Indonesia has the second-highest prevalence of low birth weight (LBW) babies in ASEAN countries. Various factors contribute to this high incidence. This study examined the association between gestational weight gain (GWG), pre-pregnancy body mass index (BMI), and antenatal care (ANC) visits frequency towards LBW in a region of Indonesia with a high prevalence of LBW. This is an analytical observational study using cross-sectional design with utilizing medical records data, conducted in June-August 2022. We analyzed 78 medical records of pregnant women who gave term-singleton birth. Main independent variables were gestational weight gain, pre-pregnancy BMI, and ANC frequency. Data analysis was performed using statistical package program, including descriptive statistics, bivariate and multivariate analyses to explore associations between those factors and LBW occurrence. The mean of infant birth weight was 3115.4± 465.2 grams. Low birth weight proportion was 11.5%. More than 90% of subjects follow frequency of ANC visits for K1 and K4, but only a third of participants meet K6 ANC visit recommendation. Approximately half of the subjects (48.7%) had inadequate GWG. Bivariate analysis revealed a strong association between insufficient GWG and LBW (OR = 10.4, 95% CI = 1.233–87.74, p=0.013). However, pre-pregnancy BMI and ANC frequency showed no association with LBW. Inadequate gestational weight gain is significantly linked to an elevated risk of LBW. Emphasizing the appropriate quantity of ANC visits and regular monitoring of maternal weight gain throughout pregnancy is crucial to mitigate the risk of LBW.

Infants born to mothers who self-identify as Hispanic account for a substantial and growing share of births in the United States, yet limited research has examined disparities in birth outcomes across Hispanic origin subgroups. This study aims to document trends and identify important factors associated with Cesarean section (C-section), low birthweight, and prematurity within the Hispanic population. We use data from the National Vital Statistics System (2011–2021), covering nearly all U.S. births. We compare outcomes across Hispanic, non-Hispanic White, and non-Hispanic Black mothers and further disaggregate by Hispanic origin (Mexican, Puerto Rican, Cuban, Central/South American, and Other/Unknown). We use logistic regression and classification tree models to assess associations between maternal, infant, and clinical factors and birth outcomes. We find that Hispanic mothers have birth outcomes similar to non-Hispanic Whites and better than non-Hispanic Blacks. However, prematurity rates among Hispanics have slightly increased over time. Mexican mothers exhibit the most favorable outcomes, while Cuban mothers show higher rates of C-section, and Puerto Rican mothers show higher rates of low birthweight and prematurity. Logistic regression results highlight multiple births, breech presentation, and hypertensive conditions as important factors associated with adverse birth outcomes. Our biomedical approach emphasizes physiological and clinical risk factors such as multiple births, breech presentation, hypertensive conditions, and obesity. In parallel, our biosocial analysis incorporates demographic, socioeconomic, and behavioral variables to contextualize how social determinants interact with biology to influence outcomes. Complementing these findings, our classification tree analysis identifies inadequate gestational weight gain (less than 15 pounds) as a prominent risk factor for both low birthweight and prematurity. Additionally, obesity emerges as a significant factor linked to an increased likelihood of C-section. While birth outcomes among Hispanic mothers are generally favorable, subgroup differences and emerging disparities highlight the need for disaggregated research and culturally tailored public health interventions.

Background/Objectives: Suboptimal gestational weight gain (GWG) has been linked to increased risks of adverse maternal outcomes. Evidence linking diet in pregnancy to GWG remains limited. We assessed relationships between adherence to five dietary patterns (Planetary Health Diet [PHD], Dietary Approaches to Stop Hypertension [DASH], Alternate Mediterranean Diet [AMED], Healthy Eating Index [HEI], and Alternate Healthy Eating Index [AHEI]) and 2009 Institute of Medicine GWG categories. Methods: Women expecting singleton pregnancies participated in the NICHD Fetal Growth Studies and completed a food-frequency questionnaire (FFQ) at 8 to 13 weeks of gestation that captured their baseline diet. Adherence to each dietary pattern was calculated, with higher scores indicating greater adherence. Women were categorized into low, moderate or high adherence to each dietary pattern. Using multinomial logistic regression, we estimated adjusted odds ratios and 95% confidence intervals [OR (95% CIs)] of inadequate or excessive GWG (reference category: adequate), for high vs. low adherence to each dietary pattern. Results: In the full cohort, women with high vs. low adherence to DASH, AMED, HEI, or AHEI (but not PHD) had a 13% to 31% lowered odds of inadequate total GWG [ranging from 0.87 (0.58, 1.31) for AMED to 0.69 (0.48, 0.99) for DASH]. High adherence to DASH or HEI was associated with lower odds of inadequate first-trimester GWG, after correcting for multiple testing [DASH: 0.36 (0.22, 0.61), HEI: 0.49 (0.30, 0.79)]. No significant association was observed between any of the dietary patterns and excessive total and trimester-specific GWG. Conclusions: Greater adherence to several dietary patterns was associated with lowered odds of inadequate GWG. Future studies could characterize these diets objectively by identifying metabolite signatures and examining their associations with GWG.

Factors Associated With Gestational Weight Gain Among Nurses in Korea.

The multisystem nature of rheumatic diseases (RDs) as well as their treatments can affect pregnancy and its prognosis. The use of assisted reproductive technologies (ART) can increase the probability of fertility in RDs. The aim of this study was to compare ART outcomes in women with versus without RDs. This retrospective cohort study was carried out between August 2023 and August 2024. Using medical records and documents, the ART outcomes of women with and without RDs were included. The descriptive statistics were provided as mean ± SD, number, and percentage. The distribution status of demographic and clinical variables was done through Mann-Whitney and Chi-squared or Fisher's exact test (for qualitative variables) and the confounder variables were adjusted. Data analysis was performed at a significance level of 5% using SPSS 25 software. A total of 194 women with 334 cycles of ART were included; 62 participants were with RDs while 132 were without RDs. This study demonstrated that women with RDs are at a significantly higher risk of miscarriage (OR = 5.27, CI 1.28 to 21.75, p = 0.021) and inadequate gestational weight gain during pregnancy (OR = 2.25, CI 1.06 to 4.75, p = 0.034) compared to those without RDs. Additionally, fetal/neonatal complications did not show significant differences between the two groups. However, studies with larger sample sizes may yield different results regarding fetal/neonatal outcomes. These results emphasize the importance of personalized and multidisciplinary care for women with RDs, particularly during pregnancy, to manage risks and improve maternal and fetoneonatal outcomes.

Background: Maternal nutrition is one of the main determinants of healthy pregnancy outcomes. The aim of this study is to investigate maternal nutritional risks and their relationship with gestational weight gain (GWG) among Saudi women. Methods: This is a cross-sectional study conducted in the antenatal clinics of a university hospital. The FIGO Nutrition Checklist was used to investigate the nutritional habits of pregnant women attending their regular antenatal visits. The FIGO tool includes a brief food frequency questionnaire (FFQ) and total nutritional risk score (NRS). Data on other variables were collected, including participant demographics and obstetric history. Current weight and height were extracted from nursing notes of the current visit, and the pre-pregnancy weight was self-reported by participants. GWG was reported and participants were classified according to IOM Guidelines. All data were analyzed using SPSS (Version 30, release September 2024) and p < 0.05 was defined as statistically significant. Results: A total of 570 pregnant women participated in the study, of whom 96% had at least one nutritional risk. More than 90% of participants reported sufficient folic acid intake, normal hemoglobin level and adequate meat and poultry intake. Only 23.9% of participants had sufficient fish intake and 24.6% reported proper sun exposure. Additionally, 10% of participants scored poorly on the FFQ, while 30% were classified as high-risk based on NRS scale. Poor nutritional scores were not associated with any clinical or socioeconomical variables. According to IOM guidelines, 26.3% of the participants achieved adequate GWG, while 49.5% had inadequate GWG, and 24.2% exceeded recommended GWG. Inadequate GWG was most common among those with low pre-pregnancy BMI (60%), followed by overweight (43.2%) and obese (37%) women. Neither parity nor nutritional scores significantly influenced GWG. Conclusions: Although poor nutritional quality and high nutritional risk are relatively uncommon among Saudi women, the prevalence rates remain consistent across all sociodemographic groups. This suggests widespread, uniform patterns of suboptimal dietary habits within the community. While GWG was not affected by nutritional status or parity of the participants, nearly half of participants had inadequate GWG, particularly those with a low pre-pregnancy BMI.

BackgroundGestational Weight Gain (GWG) is a crucial factor influencing maternal and neonatal health outcomes. Identifying the determinants of GWG can help develop targeted interventions to improve pregnancy outcomes.ObjectiveThis study aimed to assess the magnitude of gestational weight gain and identify its determinants among pregnant women attending antenatal care (ANC) services at West Shoa Hospital, Ethiopia, in 2024.MethodologyA bidirectional cohort study was conducted among 885 pregnant women attending antenatal care (ANC) services at West Shoa Hospitals, Ethiopia, before 12 weeks of gestation. Data were collected through face-to-face interviews using the CesPro application and document review. The determinants of GWG were analyzed using an ordinal logistic regression model, assuming the proportional odd assumptions. The Brant test was used to determine whether the parallel assumption was held. The STATA “ologit” command was used for ordinal regression, and the “brant” test was applied to verify the validity of the model. Odds ratios (OR) with 95% confidence intervals (CI) were estimated, and statistical significance was declared at p < 0.05.ResultsApproximately 69% of pregnant women experienced insufficient weight gain, 26% had adequate weight gain, and 5% had excessive weight gain during pregnancy. Pre-pregnancy Body Mass Index was a significant determinant of gestational weight gain. Compared to underweight women, overweight women had 10.58 times higher odds (95% CI: 5.24–21.37) of being in a higher weight gain category, while obese women had 10.64 times higher odds (95% CI: 1.87–60.57) of achieving normal or excessive gestational weight gain. Partner education significantly influenced gestational weight gain, with those who could only read and write having 0.22 times lower odds (95% CI: 0.05–0.98) of excessive weight gain compared to those with higher education. Maternal occupation also played a role, as daily laborers had 0.26 times lower odds (95% CI: 0.08–0.87) of adequate weight gain than employed women. The normal hemoglobin category was associated with increased odds of being in a higher weight gain category (adequate or excessive) compared to a lower category, with an odds ratio (OR) of 1.04 (95% CI: 1.01–1.08). Conversely, alcohol consumption was associated with lower odds of being in a higher weight gain category, with an OR of 0.49 (95% CI: 0.25–0.99), suggesting that alcohol drinkers had lower odds of experiencing normal or excessive weight gain compared to non-drinkers.ConclusionA significant proportion of pregnant women experienced inadequate gestational weight gain. Pre-pregnancy BMI, partner’s educational status, maternal occupation, hemoglobin levels, and alcohol consumption were key determinants of gestational weight gain. These findings highlight the need for targeted nutritional counseling and lifestyle interventions to promote optimal weight gain during pregnancy.

Gestational weight gain (GWG) is a critical determinant of pregnancy outcomes; however, studies on factors contributing to suboptimal GWG in developing countries, including Malaysia, remain limited. This study employed an explanatory sequential mixed-methods design, with the quantitative phase conducted between January and March 2020, followed by the qualitative phase from July 2020 to March 2021 in Selangor. The qualitative phase aimed to explain the factors influencing suboptimal (inadequate and excessive) GWG identified in the quantitative phase. Inclusion criteria included Malaysian women aged 18 and above who had suboptimal GWG (either inadequate or excessive) from the quantitative phase. Exclusion criteria included women who refused participation. Of the 475 participants from the quantitative phase, 20 with suboptimal GWG were purposively selected for in-depth telephone interviews using a semi-structured interview protocol. Data were analysed using thematic analysis. Three key themes emerged: (1) the impact of pre-pregnancy overweight and obesity, shaped by unhealthy lifestyles, social influences, and limited access to nutritious food and physical activity; (2) the management of diabetes during pregnancy, contributing to inadequate GWG due to psychological responses, restrictive behaviours, and barriers to dietary guidance; and (3) financial constraints in middle- and low-income households, leading to income vulnerability, financial crises, and food insecurity. This finding highlights the urgent need for targeted interventions to optimize GWG, emphasizing pre-pregnancy health optimization, enhanced diabetes management, and strategies to mitigate financial constraints and food insecurity among pregnant women.

While prior studies have linked maternal pre-pregnancy body mass index (BMI) and gestational weight gain (GWG) to birth weight and early childhood obesity, fewer have examined their joint effect on longitudinal growth trajectories, particularly standardized BMI z-scores through school age. We aimed to examine the relationship between maternal pre-pregnancy BMI, GWG and the trajectory of offspring's early-life weight, BMI z-scores and weight percentiles from birth to age 8. Linear mixed models were employed to assess the association between maternal pre-pregnancy BMI, GWG and children's standardized weight-for-age, BMI and length/height-for-age, adjusting for potential confounders. Data were analysed from 806 mother-child pairs from the Vitamin D Antenatal Asthma Reduction Trial, with children followed longitudinally from birth through 8 years of age. Our study demonstrated a significant association between maternal pre-pregnancy BMI and offspring weight-for-age and BMI z-score trajectories (β = .03, 95% confidence interval [CI]: 0.02-0.04 for both; p < .001, respectively). Specifically, children born to mothers with pre-pregnancy BMI of 25-30 kg/m2 or ≥30 kg/m2 had significantly higher BMI z-scores (β = .15, 95% CI: 0.02-0.29; p = .03; β = .49, 95% CI: 0.33-0.64; p < .001, respectively) compared to those with normal BMI. Maternal BMI was not significantly associated with the child's length/height. GWG was independently and positively associated with weight-for-age and BMI z-scores (β = .01, 95% CI: 0.002-0.015, p = .01 and β = .01, 95% CI: 0.01-0.02, p < .001, respectively). Excessive GWG was linked to higher offspring weight-for-age and BMI z-scores from birth to 8 years (β = .20, 95% CI: 0.08-0.32; β = .19, 95% CI: 0.08-0.31; p = .001, respectively) compared to guideline-congruent or inadequate GWG. Achieving or maintaining a healthy BMI prior to pregnancy and adhering to GWG guidelines may help mitigate the risk of early childhood overweight or obesity.

The influence of residential greenness on maternal gestational weight gain (GWG) and fetal intrauterine growth remains understudied. This study examined the impact of residential greenness on GWG and fetal intrauterine growth and assessed the mediating role of GWG. The research included 29406 births in Shanghai, utilizing the normalized difference vegetation index (NDVI) to measure greenness within a 500 m radius (NDVI-500). The analysis employed a generalized linear model to assess the impacts of residental greenness on GWG, fetal growth and birthweight, and a mediation analysis to explore GWG's role between greenness and fetal development. Results indicated that significant benefits were observed with increased greenness, where each 0.1 unit increase in NDVI-500 was associated with reductions of 9.4% (95% CI: 5.5%-13.2%) in the risk of head circumference undergrowth and 8.5% (95% CI: 4.8%-12.2%) in estimated fetal weight undergrowth. Additionally, each 0.1 unit increase in NDVI-500 was associated with reductions of 9.4% (95% CI: 5.1%-13.5%) and 9.2% (95% CI: 6.2%-12.0%) in the risk of inadequate and excessive GWG, respectively. Notably, total GWG mediated 17.5% of the relationship between NDVI-500 and the birth weight. These findings suggest that enhancing residential greenness could be an effective public health strategy to improve pregnancy outcomes by promoting fetal growth and managing GWG, with the GWG partially mediating these benefits.

Background Both low/high pre-pregnancy body mass index (BMI) and increased bile acid levels during pregnancy (known as gestational hypercholanemia) were risk factors for adverse pregnancy outcomes, with limited information on their joint effects. Methods A total of 63,066 pregnant women were involved in a large retrospective cohort study from May 2014 to December 2018 in Shanghai, China. Data of pregnancy outcomes including hypercholanemia, hypertensive disorders in pregnancy (HDP), preterm delivery, and small for gestation age (SGA), were obtained for multivariable logistic analysis. Results Pre-pregnancy BMI was negatively associated with serum total bile acid (TBA) concentrations during gestation and the risk of hypercholanemia (p < 0.001). Low pre-pregnancy BMI and hypercholanemia coexisting were related to a 2.71-fold risk (95% confidence intervals [CI], 2.10-3.50) of SGA. Whereas, overweight/obese (OWO) with hypercholanemia are associated with 5.34-fold risk (95% CI 3.93-7.25) of HDP when compared with normal weight women without hypercholanemia. Women with excessive gestational weight gain (GWG) and hypercholanemia had a higher risk of HDP (odds ratio [OR] 3.56, 95% CI 2.91-4.36), and macrosomia (OR 2.95, 95% CI 2.42-3.60), compared with non-hypercholanemia women with adequate GWG. Whereas, women with inadequate GWG and hypercholanemia had increased risks of preterm delivery (OR 1.87, 95% CI 1.44-2.43), and SGA (OR 2.32, 95% CI 1.82-2.96). Conclusions Low maternal BMI before pregnancy was an independent risk factor for hypercholanemia. Additionally, pre-pregnancy underweight or OWO may amplify the effect of hypercholanemia on adverse pregnancy outcomes. Thus, pre-pregnancy BMI should be considered in the management of adverse perinatal outcomes related to gestational hypercholanemia.

ImportanceMonitoring and predicting optimal gestational weight gain (GWG) is important for maternal and child health. However, with recommendations based on total pregnancy GWG, available tools for real-time use in pregnancy...

Inadequate gestational weight gain (GWG) is associated with birth weight and premature birth and is a primary problem in Asia, particularly in Japan. This study aimed to identify the risk factors associated with inadequate GWG, focusing on women's target GWG and advised GWG by healthcare professionals. A questionnaire for women in their second trimester inquired about their target GWG and advice regarding GWG by healthcare professionals. Of the 626 participants, 52.6% were classified in the inadequate GWG group. Inadequate GWG was associated with a prepregnancy body mass index (BMI) < 18.5 kg/m2 and weight below the prepregnancy weight in the second trimester. Among the multiparas, inadequate GWG was associated with an individual target GWG below the guideline, with no advice from healthcare professionals, and with an advised GWG below the guideline. Among the primiparas, there were no significant differences in the individual targets or advised GWG. Healthcare professionals must understand the latest guidelines regarding GWG and apply them when advising women. The importance of preconception care in achieving a BMI of at least 18.5 kg/m2 before pregnancy is also suggested.

Understanding the effects of balanced energy and protein (BEP) supplements on gestational weight gain (GWG) and how the effects differ depending on maternal characteristics and the nutritional composition of the supplements will inform the implementation of prenatal BEP interventions. Individual participant data from 11 randomized controlled trials of prenatal BEP supplements (N = 12,549, with 5,693 in the BEP arm and 6,856 in the comparison arm) in low- and middle-income countries were used. The primary outcomes included GWG adequacy (%) and the estimated total GWG at delivery as continuous outcomes, and severely inadequate (<70% adequacy), inadequate GWG (<90% adequacy), and excessive GWG (>125% adequacy) as binary outcomes; all variables were calculated based on the Institute of Medicine recommendations. Linear and log-binomial models were used to estimate study-specific mean differences or risk ratios (RRs), respectively, with 95% confidence intervals (CIs) of the effects of prenatal BEP on the GWG outcomes. The study-specific estimates were pooled using meta-analyses. Subgroup analyses were conducted by individual characteristics. Subgroup analyses and meta-regression were conducted for study-level characteristics. Compared to the comparison group, prenatal BEP led to a 6% greater GWG percent adequacy (95% CI: 2.18, 9.56; p = 0.002), a 0.59 kg greater estimated total GWG at delivery (95% CI, 0.12, 1.05; p = 0.014), a 10% lower risk of severely inadequate GWG (RR: 0.90; 95% CI: 0.83, 0.99; p = 0.025), and a 7% lower risk of inadequate GWG (RR: 0.93; 95% CI: 0.89, 0.97; p = 0.001). The effects of prenatal BEP on GWG outcomes were stronger in studies with a targeted approach, where BEP supplements were provided to participants in the intervention arm under specific criteria such as low body mass index or low GWG, compared to studies with an untargeted approach, where BEP supplements were provided to all participants allocated to the intervention arm. Prenatal BEP supplements are effective in increasing GWG and reducing the risk of inadequate weight gain during pregnancy. BEP supplementation targeted toward pregnant women with undernutrition may be a promising approach to delivering the supplements.

Maternal gestational weight gain and the long-term physical and neurological outcome of small for gestational age children: A 4-year real-world study based on a longitudinal cohort.