Patterns Of Maternal Weight Gain Research Articles

Gestational weight gain in triplet pregnancies in the United States

The Institute of Medicine has published national recommendations for optimal pregnancy weight gain ranges for singletons and twins but not for higher-order multiples. A common clinical resource suggests weight gain targets for triplet pregnancies, but they are based on a single, small study conducted over 20 years ago. We sought to describe contemporary maternal weight gain patterns in triplet gestations in the United States, the weight gain patterns associated with good neonatal outcomes, and how these patterns compare with those of healthy twin pregnancies. We used data from 7705 triplet pregnancies drawn from the United States live birth and fetal death files (2012‒2018). We calculated total pregnancy weight gain as weight at delivery minus the prepregnancy weight. A good neonatal outcome was defined as delivery at ≥32 weeks' gestation of 3 liveborn infants weighing ≥1500 g with 5-minute Apgar scores of ≥3. We described the weight gain patterns of triplet pregnancies with good neonatal outcomes by calculating week-specific percentiles of the total weight gain distribution for deliveries at 32 to 37 weeks' gestation. For comparative purposes, we plotted these values against the percentiles of a previously published weight gain chart for monitoring and evaluating twin pregnancies from a referent cohort. Most participants were over weight (26%) or obese (30%), and 42% were normal weight or underweight. The 50th percentile (25th-75th) of total weight gain in triplet pregnancies was 17 (11-23) kg. As the body mass index category increased, the total weight gain declined: underweight or normal weight, median 19 (14-25) kg; overweight, 17 (12-23) kg; obese, 14 (7.7-20) kg. Approximately 46% of triplet pregnancies had a good neonatal outcome (n=3562). For underweight or normal weight triplet pregnancies with good neonatal outcomes, the 50th percentiles of weight gain at 32 weeks' and 36 weeks' gestation were 12.3 kg and 22.7 kg, respectively. The 10th and 90th percentiles were 12.3 kg and 32.7 kg, respectively, at 32 weeks, and 15.0 kg and 34.1 kg, respectively, at 36 weeks. Triplet pregnancies with prepregnancy overweight or obesity and a good neonatal outcome had lower weight gains. Compared with the reference values for pregnancy weight gain from a twin-specific weight gain chart, the median total weight gain in triplet pregnancies with good neonatal outcomes was approximately 3 to 5 kg more than twins, regardless of body mass index. Our study fills an important gap in understanding how much weight gain can be expected among triplet pregnancies by body mass index category. These descriptive data are a necessary first step to inform science-based triplet gestational weight gain guidelines. Additional research is needed to determine whether monitoring triplet pregnancy weight gain is useful for promoting healthy outcomes for pregnant individuals and children and what targets should be used to optimize maternal and neonatal health.

Pattern of maternal weight gain among primigravidae in tertiary care hospital and urban health centre

Background: The appropriate amount of weight gain during pregnancy has been a topic of interest and debate over a century. A low body mass index (BMI) and suboptimal weight gain during pregnancy are long recognised risk factors for delivery of infants too small for gestational age.Methods: The present study was observational prospective study conducted among primigravidae in two groups with sample size 197 in tertiary care hospital antenatal clinic and 97 in urban health centre antenatal clinic for the period of 1year and 6 months.Results: In tertiary care hospital average weight gain was 10.04 kg with 33 (16.75%) women gained less than or equal to 8 kg weight gain, 148 (75.13%) gained weight in range of 8.1 to 16 kg while 16 (8.12) gained more than 15 kg weight during pregnancy while In urban health centre average weight gain was 8.96 kg with 46 (47.42%) women gained less than or equal to 8 kg weight gain, 45 (46.39%) gained weight in range of 8.1 to 16 kg while 6 (6.19%) gained more than 16 kg weight during pregnancy. Women with lower BMI found to gain lesser weight compared to normal body mass women.Conclusions: Presence of low BMI was an add on social risk factor which may adversely impact the weight gain in the mother and expected child.

Weight gain in gestational diabetes: the effect of treatment modality

Objective: To evaluate treatment effectiveness (diet alone, insulin or glyburide) on maternal weight gain in gestational diabetes (GDM).Methods: GDM patients were treated with diet alone, insulin or glyburide. Weight gain was stratified into: prior to GDM diagnosis, from diagnosis to delivery and total pregnancy weight gain. Good glycemic control was defined as mean blood glucose ≤105 mg/dl and obesity as Body Mass Index (BMI) ≥ 30 kg/m2, overweight BMI 25–29 kg/m2 and normal < 25 kg/m2.Results: Total weight gain was similar in all the treatment groups. Two-thirds of weight gain occurred prior to diagnosis (diet 85%, insulin 67% and glyburide 78%). Post-diagnosis, patients on diet alone gained less weight than those on insulin or glyburide (p < 0.001); insulin-treated patients showed greater weight gain than glyburide-treated patients (p < 0.001). Patients on diet with good glycemic control showed less weight gain after diagnosis than patients on insulin or glyburide (2.8 ± 13, 6.6 ± 10, 5.2 ± 7.9 lbs, respectively, p < 0.02). Poorly-controlled patients, regardless of treatment, had similar patterns of weight gain throughout pregnancy.Conclusion: Patterns of maternal weight gain in GDM pregnancies are associated with treatment modality and level of glycemic control.

Gestational and postpartum weight change patterns in mothers with eating disorders.

Although pregnancy can be associated with adaptive changes in weight and eating behaviour for women with eating disorders, less is known about whether these changes are maintained in the postpartum period. We used a longitudinal design to examine gestational and postpartum weight trajectories in mothers with and without eating disorders in the Norwegian Mother and Child Cohort Study (MoBa) conducted by the Norwegian Institute of Public Health. Fifty-six women reported anorexia nervosa (AN), 636 bulimia nervosa, 3327 binge eating disorder and 69 eating disorder not otherwise specified, purging type. The referent group included 61,233 mothers with no eating disorder. We used a mixed effects model to predict weight change over time by eating disorder subtype. Mothers with AN, bulimia nervosa, binge eating disorder and eating disorder not otherwise specified had greater increases in body mass index (BMI) during pregnancy and greater decreases in BMI over the first 6 months postpartum. Women with AN shifted from the underweight BMI range before pregnancy to the normal weight range at 36 months postpartum Patterns of maternal weight gain and retention during the perinatal period vary across eating disorder subtype and warrant clinical attention.

The association between maternal weight gain and spontaneous preterm birth in twin pregnancies

Objective: To estimate the association between maternal weight gain and SPTB in twin pregnancies.Methods: A case-control study of patients with twin pregnancies and a normal prepregnancy BMI (18.5–24.9 kg/m2) in one maternal-fetal medicine practice from 2005 to 2013. We reviewed maternal weight in six time periods: prepregnancy, 12–15 6/7 weeks, 16–19 6/7 weeks, 20–23 6/7 weeks, 24–27 6/7 weeks and 28–31 6/7 weeks. We compared maternal weight gain patterns across pregnancy between patients who did and did not have SPTB <32 weeks. Student’s t-test and chi-square were used for analysis.Results: In total, 382 patients were included, 29 (7.6%) of whom had SPTB <32 weeks. The baseline height, weight and BMI did not differ between the groups, nor did maternal age, IVF status, race or chorionicity. Patients with SPTB <32 weeks had significantly less weight gain as early as 15 6/7 weeks (2.9 ± 4.6 versus 7.3 ± 6.6 lb, p < 0.001), and this continued until 31 6/7 weeks (25.3 ± 8.7 versus 30.8 ± 10.9 lb, p = 0.037).Conclusions: In twin pregnancies with a normal prepregnancy BMI, there is a significant association between SPTB <32 weeks and lower maternal weight gain, particularly prior to 16 weeks. Future studies are needed to test if prepregnancy or early nutritional interventions in twin pregnancies can reduce the risk of preterm birth and improve neonatal outcomes in this high-risk population.

A weight-gain-for-gestational-age z score chart for the assessment of maternal weight gain in pregnancy

To establish the unbiased relation between maternal weight gain in pregnancy and perinatal health, a classification for maternal weight gain is needed that is uncorrelated with gestational age. The goal of this study was to create a weight-gain-for-gestational-age percentile and z score chart to describe the mean, SD, and selected percentiles of maternal weight gain throughout pregnancy in a contemporary cohort of US women. The study population was drawn from normal-weight women with uncomplicated, singleton pregnancies who delivered at the Magee-Womens Hospital in Pittsburgh, PA, 1998-2008. Analyses were based on a randomly selected subset of 648 women for whom serial prenatal weight measurements were available through medical chart record abstraction (6727 weight measurements). The pattern of maternal weight gain throughout gestation was estimated by using a random-effects regression model. The estimates were used to create a chart with the smoothed means, percentiles, and SDs of gestational weight gain for each week of pregnancy. This chart allows researchers to express total weight gain as an age-standardized z score, which can be used in epidemiologic analyses to study the association between pregnancy weight gain and adverse or physiologic pregnancy outcomes independent of gestational age.

The effects of maternal weight gain patterns on term birth weight in African-American women

Objective. The goals of our study were (1) to estimate the trends in maternal weight gain patterns and (2) to estimate the influence of variation in maternal weight and rate of weight gain over different time periods in gestation on variation in birth weight in African-American and non-African-American gravidas.Study Design and Setting. Data from a prospective cohort study in which pregnant women were monitored at multiple time points during pregnancy were analysed. Maternal weight was measured at three times during pregnancy: preconception (W0); 16–20 weeks gestation (W1); 30–36 weeks gestation (W2), in a cohort of 435 women with full-term singleton pregnancies. The relationship between gestational age-adjusted birth weight (aBW) and measures of maternal weight and rate of weight gain across pregnancy was estimated using a multivariable longitudinal regression analysis stratified on African-American race.Results. The aBW was significantly associated with maternal weight measured at any visit in both strata. For African-American women, variation in aBW was significantly associated with variation in the rate of maternal weight gain in the first half of pregnancy (W01) but not the rate of maternal weight gain in the second half of pregnancy (W12); while for non-African-American women, variation in aBW was significantly associated with W12 but not W01.Conclusion. Factors influencing the relationship between aBW and maternal weight gain patterns depend on the context of the pregnancy defined by race. Clinical decisions and recommendations about maternal weight and weight gain during pregnancy may need to account for such heterogeneity.

The influence of macrosomia on the duration of labor, the mode of delivery and intrapartum complications

This study assessed the perinatal outcome in a series of macrosomic fetuses with mothers from a general obstetric population in whom vaginal delivery was planned. In all, 215 women with macrosomic infants were included from a total of 2,622 deliveries. The pattern of maternal weight gain in pregnancy, the influence of fetal macrosomia on the duration of labor and the delivery outcome were investigated in this group. The main issues studied were the impact of fetal weight on the mode of delivery, the duration of the two stages of delivery and the incidence of intrapartum complications in fetuses larger than 4,000 g in comparison with normal-weight fetuses. Complete data were obtained for 594 patients, including 215 macrosomic infants and 379 randomly assessed normal-weight infants. With regard to the mode of delivery, a direct correlation was observed between maternal weight gain and the incidence of secondary cesarean section (P<0.014) when vaginal delivery was initially planned. There was also a direct correlation between increasing birth weight and a higher incidence of secondary cesarean section and assisted vaginal delivery (P<0.002). In the first stage of labor, there was a statistically significant difference for obstructed labor between the two groups (P<0.03). The rate of perineal injuries and the incidence of postpartum hemorrhage were similar in the two groups. As some of the risk factors identified are known prior to delivery, every woman in whom there is a suspicion that the fetus may weigh up to 4,500 g should receive individual guidance regarding special intrapartum and perinatal conditions.

Excessive maternal weight gain patterns in adolescents

The objective of this study was to examine the correlates of excessive maternal weight gain among adolescent mothers in the United States. Data from the Centers for Disease Control & Prevention 2000 natality file were analyzed to examine weight gain among adolescents (≤19 years) compared with their older counterparts (≥20 years). Using the Institute of Medicine guidelines, we defined excessive weight gain as more than 40 pounds. Our study population was restricted to singleton births, delivered after 36 weeks of gestation, who did not live in California. Maternal weight gain distributions were tabulated by maternal age and other maternal characteristics. Demographic characteristics potentially associated with maternal weight gain were compared for adolescents and older mothers. We further evaluated the role of parity and maternal race on the relationship between excessive weight gain and maternal age. Odds ratios and 95% confidence intervals were estimated using logistic regression. Over 27% of adolescent mothers gained excessive weight during pregnancy, although approximately 18% of their older counterparts gained more than 40 pounds. The association between young maternal age and weight gain was stronger for primiparous women than multiparous women and stronger among non-Hispanic white and non-Hispanic black mothers than Hispanic mothers. Adolescents were more likely to gain excessive weight than their older counterparts in nearly all demographic categories, regardless of parity or race. Adolescents are at high risk of gaining an excessive amount of weight during pregnancy and should be monitored during pregnancy by dietetics professionals.

Psychosocial and Lifestyle Factors Associated with Insufficient and Excessive Maternal Weight gain during Pregnancy

Helping women attain recommended weight gain during pregnancy is an important challenge for clinicians. It is well documented that both insufficient and excessive maternal weight gain are associated with adverse pregnancy outcomes ( (1) Subcommittee on the Nutritional Status and Weight Gain During Pregnancy, Institute of Medicine, National Academy of Sciences. Nutrition During Pregnancy, Weight Gain, Nutrient Supplements. National Academy Press, Washington, DC1990 Google Scholar , (2) Johnson J.W. Yancey M.K. A critical review of the new recommendations for weight gain in pregnancy. Am J Obstet Gynecol. 1996; 174: 254-258 Google Scholar , (3) The Federal-Provincial Subcommittee on Nutrition.Nutrition in Pregnancy. Minister of National Health and Welfare, Ottawa, Ontario, Canada1987 Google Scholar , (4) Bianco A.T. Smilen S.W. Davis Y. Lopez S. Lapinski R. Lockwood C.J. Pregnancy outcome and weight gain recommendations for the morbidly obese woman. Obstet Gynecol. 1998; 91: 97-102 Google Scholar , (5) Edwards L.E. Hellerstedt W.L. Alton I.R. Story M. Himes J.H. Pregnancy complications and birth outcomes in obese and normal-weight women effects of gestational weight change. Obstet Gynecol. 1996; 87: 389-394 Google Scholar , (6) Abrams B. Carmichael S. Selvin A. Factors associated with the pattern of maternal weight gain during pregnancy. Obstet Gynecol. 1995; 86: 170-176 Google Scholar , (7) Abrams B. Selvin S. Maternal weight gain patterns and birth weight. Obstet Gynecol. 1995; 86: 163-169 Google Scholar , (8) Seiga-Riz A.M. Adair L.S. Hobel C.J. Institute of Medicine maternal weight gain recommendations and pregnancy outcome in a predominantly Hispanic population. Obstet Gynecol. 1994; 84: 565-573 Google Scholar , (9) Shepard M.J. Hellenbrand K.G. Bracken M.B. Proportional weight gain and complications of pregnancy, labor, and delivery in healthy women of normal weight prepregnancy stature. Am J Obstet Gynecol. 1986; 155: 947-954 Google Scholar , (10) Garbaciak J.A. Richter M. Miller S. Barton J.J. Maternal weight gain and pregnancy complications. Am J Obstet Gynecol. 1985; 1525: 238-245 Google Scholar , (11) Brown J.E. Jacobson N.H. Askue L.H. Peick M.G. Influences of pregnancy weight gain on the size of infants born to underweight women. Obstet Gynecol. 1981; 57: 13-17 Google Scholar , (12) Abrams B. Laros R.K. Prepregnancy weight, weight gain and birth weight. Am J Obstet Gynecol. 1979; 154: 503-509 Google Scholar , (13) Edwards L.E. Alton I.R. Barrada I.M. Hakanson E.Y. Pregnancy in the underweight woman. Am J Obstet Gynecol. 1979; 135: 297-301 Google Scholar , (14) Naeye R.L. Weight gain and the outcome of pregnancy. Am J Obstet Gynecol. 1979; 135: 39 Google Scholar ). Insufficient gain is linked to low infant birth weight and perinatal mortality, whereas excessive gain is associated with high infant birth weight and mortality, cesarean section, and prolonged second stage of labor. This work was supported by the Fonds de Développement of the University of Montreal, the Interdisciplinary Health Research Group of the University of Montreal, the Fonds de recherche en sauté du Québec, and the Research Center of the Centre Hospitalier de I’Université de Montréal, Notre-Dame Hospital. Part of this work was the topic of C. Chabot's master's degree thesis at the University of Montreal.

Timing of Maternal Weight Gain and Pregnancy Outcome

The purpose of this study was to determine if the timing of weight gain in pregnancy significantly affected pregnancy outcome and if particular weight gain patterns impacted pregnancy outcome.The sample consisted of one hundred pregnant women receiving prenatal care at a county health department. Four subjects were disqualified due to missing data. All subjects started prenatal care during the first trimester and had at least one recorded weight for each trimester. A cluster analysis identified distinct common patterns of weight gain. Chi square and analysis of variance were utilized to identify variables associated with pattern of weight gain.Three distinct patterns of maternal weight gain were identified as Cluster 1, Cluster 2, or Cluster 3. Prepregnancy weight status (p=0.0001), Body Mass Index (p=0.001), race (p=0.015), the mother's health history (p=0.003), prepregnancy substance abuse (p=0.049), and five minute Apgar scores (p=0.036) were found to be associated with the weight gain pattern. Clusters 2 and 3 gained within the recommended guidelines of the Institute of Medicine, whereas Cluster 1 exceeded the recommended total. All three clusters had positive pregnancy outcomes as demonstrated by mean weeks gestations and infant birth weights.This study supports: (a) the importance of early prenatal care, with care originating in the first trimester; (b) the importance of promoting the use of the Institute of Medicine recommendations for the rate of with gain as well as those for total weight gain; (c) the importance of promoting strategies to help women stay within the weight gain range recommended for the prepregnancy BMI; and (d) avoiding substance abuse before and during pregnancy.

Maternal Weight Gain Pattern and Birth Weight

Maternal weight gain during pregnancy has been consistently associated with infant birth weight and pregnancy outcome. Our purpose was to determine the relationship between maternal weight gain pattern and birth weight. Consequently, maternal weight gain is monitored carefully and is encouraged during prenatal care in order to improve pregnancy outcome. Our study group included both 424 uncomplicated women and infant delivered at the Yeungnam University Hospital between 1993-1996. All recorded prenatal weight gain measurements were used to estimate maternal trimester weight gain, pattern of gain (based on low versus not-low gain at each trimester), and total gain at delivery. Multiple linear regression analysis was used to assess the relationship between these weight gain measurements and fetal birth weight. Each kilogram of maternal gain in the first, second, and third trimesters was associated with statistically related to the increase in fetal birth weight by 31.3, 19.0, and 24.5g, respectively. When compaired with the pattern of gain that was not low in any trimester, patterns with low gain in the first trimesters were associated with significant decreases in birth weight, but no important change in birth weight was seen for the group whose gains were not low in the first trimester. The results suggest that specific patterns of maternal weight gain, particularly weight gain during the first trimester, are related to fetal birth weight.

The pattern of maternal weight gain in women with good pregnancy outcomes.

This study describes the pattern of maternal weight gain in women with good pregnancy outcomes and provides data to fill in the provisional weight-gain charts published by the Institute of Medicine (IOM) in 1990. We selected 7002 women with good outcomes (defined by factors related to maternal and infant health) from the University of California, San Francisco, Perinatal Database. For each body mass index category, we compared percentiles of weight gain by trimester in women who achieved the IOM recommendations for total gain and those who did not. Trimester rates of gain varied by body mass index category and exceeded IOM guidelines in all groups. Forty percent of these women with good outcomes had total gains within the guidelines and provided data to complete the IOM weight-gain charts. Most women in this good-outcome sample would have been suspected of being at increased risk for poor outcome on the basis of their weight gain. This confirms the IOM recommendation that evaluation of the underlying causes of excessively high or low weight gain during pregnancy is necessary before appropriate interventions can be applied.

The use of maternal weight measurements during antenatal care. A national survey of midwifery practice throughout the United Kingdom.

The aim of the present study was to examine the use of maternal weight measurements during antenatal care throughout the United Kingdom. A postal questionnaire and follow-up letter were sent to 1500 midwives throughout the United Kingdom, selected at random from the UKCC register. The postal survey achieved a response rate of 44.8% (672/1500 questionnaires), and obtained responses from at least 10 midwives in all but the lowest grade. Respondents were representative of midwives practising throughout the country, in terms of their gender, working hours and grade, although there were fewer midwives in community settings than those in a contemporary representative English sample. The questionnaire obtained information on the background, training and experience of each midwife, together with their attitudes towards antenatal weighing. For those midwives currently involved in antenatal care, additional information was collected on the schedule of antenatal weight measurements, the criteria used to identify 'abnormal' weight gain, and the action taken in response to 'abnormal' weight gain. 61.8% of the midwives thought that the pattern of maternal weight gain was 'not important' in antenatal care, and only 51.5% of those who currently provided antenatal care weighted women at every antenatal visit. However, most midwives (86.1%) cited at least one clinical condition to explain why women are routinely weighed during pregnancy, and over a third of midwives thought that maternal weight gain could detect seven clinical conditions, including obesity, oedema, pre-eclampsia and polyhydramnios. Midwives with more advanced qualifications (degrees and teaching qualifications) and those working in educational or community settings were least likely to believe that weight gain was good at detecting clinical outcomes. Differences in the perceived utility of antenatal weighing influenced whether midwives would act in response to 'abnormal' maternal weight gain, and whether they advised women to gain or lose weight during pregnancy. However, the criteria that midwives used for identifying 'abnormal' weight gain were variable, and often inappropriate, so that different midwives are unlikely to intervene consistently or to give consistent advice on the basis of maternal weight gain. These differences in practice may lead to extensive and inappropriate variation in antenatal care. Clear guidelines are urgently required to ensure that, if maternal weight measurements are collected during antenatal care, they are collected and used consistently.

Maternal weight gain patterns and birth weight outcome in twin gestation

To evaluate the association between maternal weight gain patterns, based on pregravid body mass index (BMI) and birth weight outcome in twins, and to make specific recommendations for maternal weight gain during twin gestation. One hundred eighty-nine twin pregnancies were reviewed retrospectively. Weekly rates of maternal weight gain before 20 weeks, from 20 weeks to delivery, and for total gestation were calculated. Thresholds of weekly maternal weight gain were determined for underweight and normal-weight women. In underweight women, a higher weekly rate of gain before 20 weeks was associated with the birth of both twins weighing at least 2500 g (1.13 versus 0.70 lb/week, P = .017), when compared with mothers of at least one twin weighing less than 2500 g. A higher rate of weight gain from 20 weeks to delivery was associated with the delivery of twins weighing at least 2500 g in both underweight (1.92 versus 1.29 lb/week, P = .031) and normal weight (1.63 versus 1.29 lb/week, P = .046) women. No significant differences in weight gain patterns were found between overweight women delivering twins weighing less than 2500 g or at least 2500 g. A weekly rate of gain from 20 weeks' gestation to delivery of at least 1.75 lb/week in underweight women and at least 1.50 lb/week in normal-weight women was associated with the birth of both twins weighing at least 2500 g. After controlling for other potential determinants of birth weight, the threshold of 1.75 lb/week in underweight women showed a trend toward significance as an independent predictor of both twins weighing at least 2500 g (P = .06). Certain maternal weight gain patterns during twin pregnancy are associated with the birth of each twin weighing at least 2500 g. As with singletons, recommendations for maternal weight gain during twin pregnancy can be based on pregravid BMI.

Factors associated with the pattern of maternal weight gain during pregnancy

To examine the pattern of maternal weight gain using maternal characteristics and pregnancy outcome. We used maternal weight data measured prospectively from all deliveries between 1980-1990 at the University of California, San Francisco. Piecewise linear regression was used to estimate the rate of maternal weight gain in each trimester. Bivariate techniques were used to examine associations between maternal weight gain per trimester and maternal characteristics and pregnancy outcomes. We also used multiple regression analysis to examine the relationship between maternal characteristics and trimester weight gain. Weight data for at least one trimester were available for 10,418 women. The average rate of weight gain (kg/week) was lowest during the first trimester (0.169 +/- 0.268, n = 7587), peaked during the second trimester (0.563 +/- 0.236, n = 8000), and slowed slightly in the third trimester (0.518 +/- 0.234, n = 10,052). Maternal height, hypertension, cesarean delivery, and fetal size correlated positively with the rate of gain in each trimester, but pre-pregnancy body size, age, parity, smoking status, race-ethnicity, and diabetes were associated differently with gain, depending on which trimester was examined. The most important maternal predictors of weight gain per trimester were age and Asian race-ethnicity in the first trimester; pre-pregnancy body mass, parity, and height in the second; and hypertension, age, and parity in the third. Maternal weight gain per trimester is associated with a number of maternal characteristics and pregnancy outcomes, and these relationships vary according to which trimester is being examined.

Maternal weight gain pattern and birth weight

To determine the relationship between maternal weight gain pattern and birth weight. All nonobese, white women delivered at the University of California, San Francisco, between 1980-1990 were eligible for this study. Our study group included 2994 uncomplicated pregnancies with complete data. All recorded prenatal weight gain measurements were used to estimate maternal trimester weight gain, pattern of gain (based on low versus not-low gain at each trimester), and total gain at delivery. Multiple linear regression analysis was used to assess the relationship between these weight gain measurements and fetal birth weight. After adjustment for seven covariates, each kilogram of maternal gain in the first, second, and third trimesters was associated with statistically significant increases in fetal birth weight of 18.0, 32.8, and 17.0 g, respectively. When compared with the pattern of gain that was not low in any trimester, patterns with low gain in the first and second trimesters or in the second and third trimesters were associated with significant decreases in birth weights of 133.0 and 88.5 g, but no important change in birth weight was seen for the group whose gains were low in the first and third trimesters. These findings were not due to differences in total weight gain, which averaged approximately 11 kg in these three pattern groups. The results suggest that specific patterns of maternal weight gain, particularly weight gain during the second trimester, are related to fetal birth weight.

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I. Repeated measurement of maternal weight during pregnancy. Is this a useful practice? II. Patterns of maternal weight gain in pregnancy

I. Repeated measurement of maternal weight during pregnancy. Is this a useful practice? II. Patterns of maternal weight gain in pregnancy