Rate Of Gestational Weight Gain Research Articles

Pre-pregnancy BMI, rate of gestational weight gain, and preterm birth among US Pacific Islander individuals.

The objective of this study was to examine the association between rate of gestational weight gain (GWG) and preterm birth (PTB) classified by pre-pregnancy BMI among Pacific Islander individuals in the United States. Pacific Islander mothers (n = 55,975) and singleton infants (22-41 gestational weeks) without congenital anomalies were included using data from the National Center for Health Statistics (2014-2018). PTB was compared by pre-pregnancy BMI among women in each stratum of rate of GWG using Cox proportional hazards models. Compared with mothers with a rate of GWG within the guidelines, mothers with a rate of GWG below the guidelines and either pre-pregnancy underweight (adjusted hazard ratio [aHR] = 1.84, 95% CI: 1.10-3.06), healthy weight (aHR = 1.38, 95% CI: 1.15-1.65), obesity class I (aHR = 1.22, 95% CI: 0.97-1.52), or obesity class II (aHR = 1.43, 95% CI: 1.05-1.96) had an increased risk of PTB; mothers with a rate of GWG above the guidelines and either pre-pregnancy underweight (aHR = 1.57, 95% CI: 0.92-2.69) or obesity class II (aHR = 1.31, 95% CI: 0.98-1.76) had an increased risk of PTB. The association between rate of GWG below or above the guidelines and PTB differs by pre-pregnancy BMI among Pacific Islander individuals.

Association of gestational weight gain rate in pregnant women with children's cognitive and behavioral development: A birth cohort study

BackgroundThe evidences on the relationship between gestational weight gain rate (GWGR) and children's cognitive and behavioral development have been limited. MethodsA total of 3273 singleton live birth mother-child pairs from the Ma'anshan Birth Cohort in China were included in the study. Maternal GWGR was calculated based on the weights measured at multiple antenatal checkups. Children's cognitive and behavioral development were assessed by Chinese version of Wechsler Preschool and Primary Scale of Intelligence-Fourth Edition and Achenbach Child Behavior Checklist 1.5–5. Then generalized linear models were performed for analyses. ResultsIn the field of children's cognitive development, excessive GWGR in the second trimester was associated with increased visual space index (VSI), fluid reasoning index (FRI) and full scale intelligence quotient (FSIQ) scores, while excessive GWGR in the third trimester was associated with decreased VSI, working memory index (WMI) and FSIQ scores. In the field of children's behavioral development, excessive GWGR in the second trimester was associated with decreased aggressive behaviors and externalizing problems scores. LimitationsChildren's behavioral development was assessed by main caregivers and might cause a certain degree of bias. There might be other potential confounders that we did not take into account. ConclusionsA high GWGR in the second trimester might be beneficial for children's cognitive and behavioral development, while a high GWGR in the third trimester might be harmful.

The effectiveness of integrated online health-coaching on physical activity and excessive gestational weight gain: a prospective randomized-controlled trial.

Low levels of physical activity during pregnancy go along with increased risks for numerous health complications. We investigated whether an integrated lifestyle intervention leads to higher levels of physical activity and reduces the rate of excessive gestational weight gain (EGWG). We conducted a randomized-controlled trial on 97 pregnant women, randomly assigned to receive an additional telehealth lifestyle intervention (experimental group, EG; n = 49) or conventional antenatal care (control group, CG; n = 48). The core lifestyle intervention comprised regular video calls, providing integrated personal support and motivation to physical activity. The primary outcome was change in physical activity measured in steps per day. An additional exploratory outcome was the proportion of participants with EGWG. The mean step count during the third trimester was 6483 steps/day (EG) and 5957 steps/day (CG), respectively (p = 0.078). Repeated-measures ANOVA revealed a significant interaction effect (p = 0.045) reflecting an overall increase of 497 steps per day in the EG vs. a decrease of 300 steps per day in the CG. The proportion of participants who met the IOM recommendation for total weight gain during pregnancy was significantly higher in the EG (p = 0.048) and the ratio of women that gained excessively was higher in the CG(p = 0.026). We assume that the personalized online intervention supports women in increasing or at least maintaining their level of physical activity during the course of pregnancy. Additionally, it reduces the rate of excessive weight gain.

The association between gestational weight trajectories in women with gestational diabetes and their offspring's weight from birth to 40 months

AimsTo identify the gestational weight gain (GWG) patterns in women with gestational diabetes mellitus (GDM) and evaluate their association with offspring weight status from birth to 40 months.Materials and methodsThis study included 2,723 GDM-mother–child pairs from the Beijing Birth Cohort Study. The association between GWG trajectories identified by the latent class model and offspring weight outcomes from birth to 40 months were evaluated, after adjustment for maternal age, parity, pre-pregnancy body mass index, maternal height, and blood glucose levels.ResultsThree GWG rate groups, including the non-excessive GWG group (1,994/2,732), excessive GWG group (598 /2,732), and excessive early GWG group (140/2,732), were identified in women with GDM, respectively. Compared to the non-excessive GWG group, the adjusted OR (aOR) and 95% CI were 1.83 (1.35–2.47) and 1.79 (1.06–3.01) for macrosomia, 1.33 (1.07–1.66) and 1.48 (1.01–2.17) for large for gestational age (LGA) in the excessive GWG group and excessive early GWG group. Excessive GWG was also associated with an increased risk of BMI-for-age at 40 months (aOR = 1.66, 95% CI 1.14–2.42).ConclusionsBoth excessive GWG and excessive early GWG increased the risk of macrosomia and LGA in women with GDM, but only the excessive GWG was associated with childhood overweight/obesity. The results suggest the long-term impact of GWG on offspring weight status in women with GDM and the potential benefits of GWG restriction after GDM diagnosis.

Associations of gestational weight gain with birth weight outcomes in early pregnancy weight loss women: Findings from the Beijing Birth Cohort Study.

To explore the relationship between gestational weight gain (GWG) and birth weight outcomes and establish suggested GWG patterns in early pregnancy weight loss women. This retrospective study was conducted based on the Beijing Birth Cohort Study from 2014 to 2021 and included 20 688 women. Weight change in early pregnancy was calculated using weight measurements within 16 weeks of gestation. Multivariable logistic regression was used to analyze the relationships of different GWG categories, based on the Chinese standard, and birth weight outcomes. The statistical-based approach was used to determine the optimal GWG ranges and weekly weight gain. Compared to 3313 women who gained appropriate weight in early pregnancy, 2614 women who lost weight in the same period increased the risk of small for gestational age (SGA) (OR = 1.43, 95% CI: 1.14-1.80, P = 0.002). However, the relationship disappeared after adjusting for total GWG. Among the early pregnancy weight loss women, both excessive GWG and inadequate GWG were associated with adverse birth weight outcomes after adjusting for confounders. The suggested GWG range and rate were 11.0 ~ 16.0 kg and 0.46 to 0.67 kg/week from 16 weeks to delivery for women with normal body mass index (BMI) and weight loss in early pregnancy. Weight loss in early pregnancy was not the independent risk factor of birth weight outcomes. GWG may offset the expected effects. To achieve optimal outcomes, women with normal BMI and weight loss in early pregnancy need to have a higher weight gain rate in mid-late pregnancy but similar total GWG ranges with the Chinese standard for general women.

Prospective Association between Total and Trimester-Specific Gestational Weight Gain Rate and Physical Growth Status in Children within 24 Months after Birth.

In this study, our aim was to investigate the potential correlation between the mother's total gestational weight gain (GWG) rate and the trimester-specific GWG rate (GWGR) with the physical development status of the child within 24 months of age. We utilized linear regression models and linear mixed effects models to explore both time point and longitudinal relationships between GWGR and children's anthropometric outcome z-scores at 0, 1, 2, 4, 6, 9, 12, 18, and 24 months. To examine the critical exposure windows, we employed multiple informant models. We also conducted a stratified analysis considering pre-pregnancy BMI and the gender of the children. Our findings revealed notable positive associations between total GWGR and z-scores for body mass index for age (BMIZ), head circumference for age (HCZ), weight for age (WAZ), length for age (LAZ), and weight for length (WHZ) across different trimesters of pregnancy (pint < 0.05). The GWGR during the first two trimesters mainly influenced the relationship between total GWGR and BMIZ, WAZ, and LAZ, while the GWGR during the first trimester had a significant impact on the correlation with HCZ (0.206, 95% CI 0.090 to 0.322). Notably, the associations of GWGR and children's BMIZ were pronounced in male children and pre-pregnancy normal-weight women. In conclusion, our study findings indicated that a higher GWGR during each trimester was associated with greater physical growth during the first 24 months of life, especially GWGR in the first and second trimesters.

The role of gestational weight gain rate in the development of maternal iron deficiency anaemia

Aims: Our aim is to analyze the effect of weight gain rates on the development of anaemia in a homogeneous group of pregnant women taking similar nutritional supplements in our own society and to emphasize the importance of weight control based on this hypothesis. Methods: The study was conducted retrospectively with 127 pregnant women between 20 and 40 years old. Pregnant women in normal weight and having body mass index (BMI) between 18.5 and 24.9 were included in the study. These women were divided into two groups according to the amount of weight they gained during pregnancy: those who weighed less than 11 kg and those who gained 11 kg or more. Ages of patients, number of pregnancies and births, 1st and 3rd trimester weights, 1st and 3rd trimester weight differences, 1st and 3rd trimester hemoglobin (Hgb), hematocrit (Hct), mean corpuscular volume (MCV) measurements were recorded. The correlation of changes between weight gain and blood parameters was evaluated. Results: No statistically significant change was observed between the 1st and 3rd trimester Hgb and Hct averages of pregnant women who gained less than 11 kg during pregnancy. 3rd Trimester Hgb, Hct averages of the pregnant group who gained 11 kg or more were found to be statistically significantly lower than the outset Hgb, Hct averages (p=0.001, p=0.001). No statistically significant difference was observed between the 1st Trimester and 3rd Trimester MCV averages of the &lt;11 kg difference and &gt;11 kg difference groups (p=0.271, p=0.183). No statistically significant difference was observed between the 1st trimester ferritin averages of the &lt;11 kg difference and &gt;11 kg difference groups (p = 0.055). 3rd trimester ferritin averages of the &gt;11 kg difference group were found to be statistically significantly lower than the &lt;11 kg difference group (p =0.016). Conclusion: As a result of our study, we can say that rapid weight gain during pregnancy deepens anaemia. Randomized studies continue to be the best source of evidence in testing hypotheses mentioning that early use of iron supplements and strengthening weight control may reduce the risk of IDA.

THU321 Indirect Effects Of COVID-19 On The Risk Of Gestational Diabetes And Factors Mediating Increased Risk

Abstract Disclosure: Y.J. Rhou: None. J. Elhindi: None. S.J. Melov: None. N. Cheung: None. D. Pasupathy: None. Aim: COVID-19 has had indirect effects on pregnancy outcomes. This study aimed to assess the risk of gestational diabetes (GDM) in distinct COVID-19 exposure periods and determine the potential factors contributing to increased risk of GDM in a multiethnic population. Methods: Multicentre, retrospective cohort study of singleton pregnancies at three hospitals two years pre-COVID-19 (January 2018 - January 2020), 1st year of COVID-19 with low COVID-19 pandemic burden and limited restrictions (February 2020 - January 2021), and 2nd year of COVID-19 with increased pandemic burden and stringent restrictions (February 2021 - January 2022). Baseline maternal characteristics, gestational weight gain (GWG) and pregnancy outcome data were compared between time periods. The primary outcome of GDM was assessed using univariate and multivariate generalized estimating equations models. Results: Of 28,207 pregnancies, 14,663 occurred in the two years pre-COVID-19, 6,890 in COVID-19 Year 1 and 6,654 in COVID-19 Year 2. The study population was diverse, comprising 82.5% of non-Caucasian ethnicity and 22.7% in the quintile of greatest socioeconomic disadvantage. Maternal age increased across exposure periods (30.7 ± 5.0 years pre-COVID-19 vs 31.0 ± 5.0 years COVID-19 Year 1 vs 31.3 ± 5 years COVID-19 Year 2; p&amp;lt;0.001). There were increases in prepregnancy BMI (25.5 ± 5.7 kg/m2 vs 25.7 ± 5.6 kg/m2 vs 26.1 ± 5.7 kg/m2; p&amp;lt;0.001), proportion who were obese (17.5% vs 18.1% vs 20.7%; p&amp;lt;0.001) and proportion with other traditional risk factors for GDM including South Asian ethnicity and prior history of GDM. Weekly rate of GWG and proportion exceeding recommended GWG increased across pandemic exposure periods (64.3% vs 66.0% vs 66.6%; p=0.009). GDM diagnosis increased across exposure periods (21.2% vs 22.9% vs 24.8%; p&amp;lt;0.001). Both COVID-19 Year 1 and Year 2 were associated with increased risk of GDM on univariate analysis, only COVID-19 Year 2 remaining significantly associated after adjusting for maternal baseline characteristics and GWG (OR 1.17 [1.06, 1.28], p=0.01). Conclusion: Diagnosis of GDM increased with pandemic exposure. Progressive sociodemographic changes and greater GWG may have contributed to increased risk. However, exposure to the 2nd year of COVID-19 remained independently associated with GDM after adjusting for shifts in baseline maternal characteristics and GWG. Presentation: Thursday, June 15, 2023

Pre-pregnancy weight, the rate of gestational weight gain, and the risk of early gestational diabetes mellitus among women registered in a tertiary care hospital in India

BackgroundThe impact of pre-pregnancy weight and the rate of gestational weight gain (GWG) together on the risk of early GDM (< 24 weeks gestation; eGDM) has not been studied in the Indian context. We aimed to study the influence of (1) pre-pregnancy weight on the risk of eGDM diagnosed in two time intervals; and (2) in addition, the rate of GWG by 12 weeks on the risk of eGDM diagnosed in 19–24 weeks.MethodOur study utilized real-world clinical data on pregnant women routinely collected at an antenatal care clinic at a private tertiary hospital, in Pune, India. Women registering before 12 weeks of gestation (v1), with a singleton pregnancy, and having a follow-up visit between 19–24 weeks (v2) were included (n = 600). The oral glucose tolerance test was conducted universally as per Indian guidelines (DIPSI) at v1 and v2 for diagnosing eGDM. The data on the onset time of eGDM were interval censored; hence, we modeled the risk of eGDM using binomial regression to assess the influence of pre-pregnancy weight on the risk of eGDM in the two intervals. The rate of GWG by 12 weeks was added to assess its impact on the risk of eGDM diagnosed in v2.ResultOverall, 89 (14.8%) women (age 32 ± 4 years) were diagnosed with eGDM by 24 weeks, of which 59 (9.8%) were diagnosed before 12 weeks and 30 of 541 (5.5%) women were diagnosed between 19–24 weeks. Two-thirds (66%) of eGDM were diagnosed before 12 weeks of gestation. Women’s pre-pregnancy weight was positively associated with the risk of GDM in both time intervals though the lower confidence limit was below zero in v1. The rate of GWG by 12 weeks was not observed to be associated with the risk of eGDM diagnosed between 19–24 weeks of gestation. These associations were independent of age, height, and parity.ConclusionHealth workers may focus on pre-pregnancy weight, a modifiable risk factor for eGDM. A larger community-based study measuring weight and GDM status more frequently may be warranted to deepen the understanding of the role of GWG as a risk factor for GDM.

P18-046-23 The Association Between Gestational Weight Gain Rate and Birth Outcomes Among Nepalese Women

P18-046-23 The Association Between Gestational Weight Gain Rate and Birth Outcomes Among Nepalese Women

P18-057-23 In Couples With Obesity, Poor Paternal Tendency To Eat in Response to Food Cues and Limit Food Intake Is Associated With Higher Total and Rate of Maternal Gestational Weight Gain

P18-057-23 In Couples With Obesity, Poor Paternal Tendency To Eat in Response to Food Cues and Limit Food Intake Is Associated With Higher Total and Rate of Maternal Gestational Weight Gain

The Effect of Maternal Race, Ethnicity, and Nativity on Macrosomia Among Infants Born in the United States.

This study aims to elucidate the influence of race, ethnicity, and nativity on macrosomia rates, hypothesizing that higher rates are observed among White non-Latina mothers and United States (US)-born mothers. We analyzed data from 1,791,718 US births sourced from the National Center for Health Statistics of the Centers for Disease Control and Prevention. Logistic regression analyses were conducted to examine the associations between macrosomia rates and maternal race, ethnicity, and nativity. After excluding non-singleton, preterm, post-term births, and those with missing data, six maternal cohorts were identified: White non-Latina US-born (1,147,096) and foreign-born (75,542), Black non-Latina US-born (174,540) and foreign-born (32,200), and Latina US-born (223,968) and foreign-born (137,515). White non-Latina US-born mothers had the highest rates of excessive gestational weight gain (58.9%). Black non-Latina US-born mothers exhibited the highest rates of pre-pregnancy diabetes (0.7%) and obesity (29.5%). Macrosomia rates were highest among White non-Latina US-born mothers (10.7%) compared to other cohorts. After adjusting for socioeconomic and health-related factors, this group maintained the highest odds of macrosomia (OR: 1.876; 95%CI 1.832-1.922, P<0.001). Our findings reveal that White non-Latina US-born mothers experience the highest macrosomia rates, which persist after adjusting for known confounders. These results have significant implications for the development of gestational surveillance tools and targeted public health interventions aimed at improving pregnancy outcomes among high-risk cohorts.

Prevalence and related factors of inappropriate gestational weight gain among pregnant women with overweight/ obesity in Thailand

BackgroundAn inappropriate gestational weight gain (GWG) among pregnant women with overweight/obesity is a crucial health problem. Its prevalence remains high worldwide, particularly in urban areas. The prevalence and predicting factors in Thailand are lack of evidence. This study aimed to investigate prevalence rates, antenatal care (ANC) service arrangement, predictive factors, and impacts of inappropriate GWG among pregnant women with overweight/obesity in Bangkok and its surrounding metropolitan area.MethodsThis cross-sectional, retrospective study used four sets of questionnaires investigating 685 pregnant women with overweight/obesity and 51 nurse-midwives (NMs) from July to December 2019 in ten tertiary hospitals. Multinomial logistic regression identified predictive factors with a 95% confidence interval (CI).ResultThe prevalence rates of excessive and inadequate GWG were 62.34% and 12.99%. Weight management for pregnant women with overweight/obesity are unavailable in tertiary cares. Over three-fourths of NMs have never received weight management training for this particular group. ANC service factors, i.e., GWG counseling by ANC providers, quality of general ANC service at an excellent and good level, NMs' positive attitudes toward GWG control, significantly decreased the adjusted odds ratio (AOR) of inadequate GWG by 0.03, 0.01, 0.02, 0.20, times, respectively. While maternal factors, sufficient income, and easy access to low-fat foods reduce AOR of inadequate GWG by 0.49, and 0.31 times. In contrast, adequate maternal GWG knowledge statistically increased the AOR of inadequate GWG 1.81 times. Meanwhile, easy access to low-fat foods and internal weight locus of control (WLOC) decreased the AOR of excessive GWG by 0.29 and 0.57 times. Finally, excessive GWG significantly increased the risk of primary C/S, fetal LGA, and macrosomia 1.65, 1.60, and 5.84 times, respectively, while inadequate GWG was not associated with adverse outcomes.ConclusionPrevalence rates of inappropriate GWG, especially excessive GWG remained high and affected adverse outcomes. The quality of ANC service provision and appropriate GWG counseling from ANC providers are significant health service factors. Thus, NMs should receive gestational weight counseling and management training to improve women's knowledge and practice for gestational weight (GW) control.

Effect of Circadian Distribution of Energy and Macronutrients on Gestational Weight Gain in Chinese Pregnant Women.

Gestational weight gain (GWG) may be affected by the timing of dietary intake. Previous studies have reported contradictory findings, possibly due to inconsistent characterizations of meal timing. We conducted a birth cohort study in Tianjin to determine the effect of daily energy and macronutrient distribution in mid and late pregnancy on GWG. Dietary intake information in the second and third trimesters used three 24-h dietary recalls, and meal timing was defined in relation to sleep/wake timing. The adequacy of GWG was assessed using recommendations from the Institute of Medicine guidelines. Pregnant women who had a relatively high average energy and macronutrient distribution in the late afternoon-early evening time window exhibited a greater GWG rate and a greater total GWG than that in morning time window during the third trimester (β = 0.707; β = 0.316). Carbohydrate intake in the morning of the second and third trimesters (β = 0.005; β = 0.008) was positively associated with GWG rates. Morning carbohydrate intake in the second trimester was also positively associated with total GWG (β = 0.004). Fat intake in the morning of the third trimester (β = 0.051; β = 0.020) was positively associated with the GWG rates and total GWG. Excessive GWG of Chinese pregnant women was related closely to eating behavior focused on the late afternoon-early evening and carbohydrate and fat intake in the morning during the second and third trimesters.

Impact of COVID-19 mandatory lockdown on maternal gestational weight gain and neonatal macrosomia rate at an academic medical center in Israel

Background In an effort to prevent the spread of coronavirus disease 2019 (COVID-19), governments restricted outdoor activities and imposed lockdown quarantine. This change in lifestyle probably affected individuals’ eating habits and physical activity. Objective To examine the effect of lockdown due to the COVID-19 pandemic on maternal antenatal weight gain, neonatal macrosomia, and other maternal and neonatal outcomes of women delivering at an academic medical center in Israel. Method A retrospective, two-period cohort study conducted at a university teaching medical center in Afula, Israel. The study period was between April and September 2020. This period signifies worsening in pandemic situations, during which citizens experienced strict prolonged lockdown measures. The parallel unexposed period (control period) was between April and September 2019. Singleton pregnancies delivered at >24 weeks were eligible. Primary outcome was incidence of macrosomia. Secondary outcomes included gestational weight gain, body mass index (BMI) at delivery, rates of gestational diabetes mellitus (GDM), mode of delivery, postpartum hemorrhage (PPH), and neonatal outcomes reflecting neonatal birth weight and condition at delivery. Results A total of 4,765 women were included, 2,442 in the study group and 2,323 in the control group. The incidence of macrosomia was significantly higher in 2020 (6.2%) than in 2019 (4.9%), (p = .048; OR: 1.29; 95% CI: 1.002– 1.65). Women gained significantly more weight (median 1 kg more), weighed more at delivery (median 1 kg), and had higher BMI at delivery in 2020 compared with those in 2019 (p < .01). The incidence of GDM was 9.5% and 8.5% in the study and control groups respectively (p = .26; OR: 1.12; 95% CI: 0.92–1.37). Greater percentage of women did not perform the glucose challenge test in 2020 (9.9%) compared with those in 2019 (7.5%) (p = .003, OR: 1.36; 95% CI: 1.11–1.67). The incidence of any hypertension related to pregnancy was significantly higher in 2020 compared to 2019 (5.8% vs 4.4% respectively, (p = .042; OR: 1.32; 95% CI: 1.02–1.71). The proportion of women who smoked during pregnancy was also significantly higher in 2020 than in 2019 (5.1% vs 3.7%, respectively, p = .02; OR: 1.40; 95% CI: 1.06–1.86). Delivery mode did not differ, while the incidence of PPH was significantly higher in 2020 than in 2019 (5.6% vs 3.4%, respectively, p = .001; OR: 1.65; 95% CI: 1.25–2.19). Neonatal condition at delivery was comparable. Conclusion COVID-19-related lockdown was associated with the increased rate of macrosomic infants. This indirect effect of the pandemic is probably related to poorer maternal antenatal metabolic health status. Long-term consequences should be further examined.

Maternal exposure to phthalates and total gestational weight gain in the LIFECODES birth cohort.

Excessive gestational weight gain contributes to adverse maternal and neonatal outcomes. Environmental exposures such as phthalates may lead to metabolic dysregulation, and studies suggest possible associations between maternal phthalate exposure and altered gestational weight gain. We assessed the association between nine maternal phthalate metabolites and measures of total gestational weight gain (pre-pregnancy to median 35.1 weeks of gestation) in a case-control study nested within LIFECODES (N=379), a prospective birth cohort from Boston, Massachusetts (2006-2008). Our primary outcome was total gestational weight gain z score, a measure independent of gestational age that can provide a less biased estimate of this association. Our secondary outcomes were total gestational weight gain, rate of gestational weight gain, and adequacy ratio. The results were stratified by pre-pregnancy body mass index category. We found that concentrations of mono-(3-carboxypropyl) phthalate (MCPP) and mono-n-butyl phthalate (MBP) were positively associated with total gestational weight gain z scores among participants with obesity: adjusted mean difference (95% Confidence Interval [CI]) =0.242 (0.030 - 0.455) and 0.105 (-0.002 - 0.212) corresponding to an excess weight gain of 1.81kg and 0.77kg at 35 weeks of gestation per interquartile range-increase in MCPP and MBP, respectively. Also, among participants with obesity, MBP demonstrated a potential non-linear relationship with gestational weight gain in cubic spline models. These findings suggest that phthalates may be related to higher gestational weight gain, specifically, among individuals with pre-pregnancy obesity. Future research should investigate whether pregnant people with obesity represent a subpopulation with sensitivity to phthalate exposures.

Rates of maternal weight gain over the course of pregnancy and offspring risk of neurodevelopmental disorders

BackgroundPrevious studies have suggested that gestational weight gain (GWG) outside an optimal range increases the risks of neurodevelopmental disorders (NDDs) in offspring including autism spectrum disorder (ASD), intellectual disability (ID), and attention deficit/hyperactivity disorder (ADHD). The sequential development of the fetal brain suggests that its vulnerability may vary depending on the timing of exposure. Therefore, we aimed to investigate the associations of not only gestational age-standardized total GWG (GWG z-scores) but also the rate of GWG (RGWG) in the second and third trimesters with risks of NDDs in offspring.MethodsIn this population-based cohort study, we used maternal weight data from antenatal care records collected for 57,822 children born to 53,516 mothers between 2007 and 2010 in the Stockholm Youth Cohort. Children were followed from 2 years of age to December 31, 2016. GWG z-scores and RGWG (kg/week) in the second and third trimesters were considered as continuous variables in cox regression models, clustered on maternal identification numbers. Nonlinear relationships were accommodated using restricted cubic splines with 3 knots. RGWG were also categorized according to the 2009 US Institute of Medicine (IOM) guidelines for optimal GWG. According to the IOM guidelines, the optimal rate of GWG for the second and third trimesters for underweight, normal weight, overweight, and obese categories were 0.44–0.58, 0.35–0.50, 0.23–0.33, and 0.17–0.27 kg/week, respectively.ResultsDuring a mean follow-up of 5.4 years (until children were on average 7.4 years old), 2205 (3.8%) children were diagnosed with NDDs, of which 1119 (1.9%) received a diagnosis of ASD, 1353 (2.3%) ADHD, and 270 (0.5%) ID. We observed a J-shaped association between total GWG z-score and offspring risk of NDDs, with higher total GWG (GWG z-score = 2) associated with 19% increased risk of any NDD (95% CI = 3–37%) and lower total GWG (GWG z-score = − 2) associated with 12% increased risk of any NDDs (95% CI = 2–23%), compared to the reference (GWG z-score = 0). In the second trimester, lower RGWG (0.25 kg/week) was associated with a 9% increased risk of any NDD diagnosis (95% CI = 4–15%) compared to the median of 0.57 kg/week, with no apparent relationship between higher RGWG and risk of NDDs. In the third trimester, there was no apparent association between lower RGWG and risk of NDDs, though higher RGWG (1 kg/week) was associated with a 28% increased risk of NDD diagnosis (95% CI = 16–40%), compared to the median (0.51 kg/week). When considering categorized RGWG, we found that slow weight gain in the second trimester followed by rapid weight gain in the third trimester most significantly increased the risk of ADHD (HRadjusted = 1.55, 1.13–2.13) and ID (HRadjusted = 2.53, 1.15–5.55) in offspring. The main limitations of our study are the relatively few years for which detailed GWG data were available and the relatively short follow-up for the outcomes, limiting power to detect associations and misclassifying children who receive an NDD diagnosis later in childhood.ConclusionsThe relationship between maternal weight gain and children’s risk of NDDs varied according to timing in pregnancy, with the greatest risks associated with slow weight gain in the second trimester and rapid weight gain in the third trimester.

The therapeutic effects of attending a one-day outpatient service on patients with gestational diabetes and different pre-pregnancy body mass indices.

This study investigated the effects of attending a one-day outpatient service on the outcomes of patients with gestational diabetes mellitus (GDM) and different pre-pregnancy body mass indices (BMIs). The study recruited 311 pregnant women with GDM into a one-day outpatient service at The Fourth Hospital of Shijiazhuang from September 2019 to December 2021. They were randomly assigned to three groups, based on their pre-pregnancy BMI as follows: group A, BMI < 18.5 kg/m2; group B, 18.5 ≥ BMI > 25.0 kg/m2; group C, BMI ≥25 kg/m2. The following information was collected from all the participants: fasting blood glucose, hemoglobin A1c (HbA1C), insulin dose, gestational weight gain, weight gain after the one-day outpatient service, and perinatal outcomes. The three groups showed significant differences in fasting blood glucose and HbA1C, insulin treatment rate, and the incidence of pregnancy hypertension/preeclampsia and neonatal jaundice (all P < 0.05). The rate of excessive gestational weight gain in all of the groups also reflected significant differences (P < 0.05). Group A showed the lowest weight gain, while group C gained the most weight. There is no significant difference in the incidences of hypertension/preeclampsia, neonatal jaundice, or premature birth between patients with weight loss/no weight gain and those with positive weight gain. One-day diabetes outpatient integrated management may effectively help to manage weight gain and blood glucose in patients with GDM and different pre-pregnancy BMIs. Dietary control after a GDM diagnosis may have helped to avoid weight gain entirely, as well as negative weight gain, but did not increase the risk of maternal and infant-related complications.

Dietary Quality Indices in Early Pregnancy and Rate of Gestational Weight Gain among a Prospective Multi-Racial and Ethnic Cohort.

Meeting the Institute of Medicine (IOM) gestational weight gain (GWG) guidelines is associated with a reduced risk of adverse perinatal outcomes. Overall diet quality comprehensively assesses dietary components and accounts for interactions between them. While GWG is influenced by maternal diet, its association with overall diet quality-measured by various dietary quality indices-is not well-defined. We prospectively estimated the relationship between four established dietary quality indices and the risk of GWG rate above (excessive) or below (inadequate) IOM guidelines in a multi-racial and ethnic cohort of 2914 pregnant people from the Pregnancy Environment and Lifestyle Study (2014-2019). We assessed diet quality using the Healthy Eating Index 2010 (HEI-2010), alternate Mediterranean Diet (aMED), Dietary Approaches to Stop Hypertension (DASH), and Empirical Dietary Inflammatory Index (EDIP). Following the first trimester, 56% of the cohort had excessive GWG, and 14% had inadequate GWG. Poor diet quality (below the 75th percentile), measured by HEI-2010, was associated with a higher risk of excessive GWG in the second and third trimesters [RR = 1.03 (1.00, 1.06)]. Effect modification of this relationship by race and ethnicity and pre-pregnancy BMI was assessed. We found poor diet quality to be associated with elevated risk of excessive GWG among Black participants [RR = 1.14 (1.02, 1.28)] and White participants [RR 1.07 (1.01, 1.12)]. This was also the case for participants with pre-pregnancy BMI < 25.0 [RR 1.05 (1.00, 1.10)]. These results suggest that diet quality measured by the HEI-2010 is associated with excessive GWG, and the associations appear to be stronger among pregnant people without overweight or obesity and pregnant people who identify as Black or White race and ethnicity.

The Rate of Gestational Weight Gain are Associated with Preterm Birth in Pregnant Women at Low Risk for Preterm Birth: A Single-Center, Observational Study

Background: Preterm birth (PTB) is the main cause of infant disease and death worldwide. Approximately 70% of neonatal deaths and 36% of infant deaths worldwide are caused by premature birth. Gestational weight gain (GWG) is associated with adverse pregnancy outcomes. This study explored the relationship between the rate of GWG and PTB among pregnant women at low risk of preterm birth. Methods: Our study used a cohort of mother-child pairs with a one-and-a-half-year follow-up from January 2020 to June 2021. We excluded pregnant women with undisputed high-risk factors for PTB and the remaining women were considered the low-risk group. The average rate of GWG was utilized in this research as the measure of GWG. Multivariate logistic regression was used to evaluate the relationship between GWG and PTB among pregnant women at low risk for preterm birth. Results: The final cohort study of mother-child pairs included 3480 pregnant women in the low-risk group. Women with low GWG had a higher possibility of PTB than those with adequate GWG. Comparing underweight women with an adequate GWG rate to underweight women with a low GWG rate, PTB risk increased by 2.52-fold with a low GWG rate. Compared to women with adequate GWG, underweight women with excessive GWG had significantly higher odds of PTB. No significant results were observed for pregnant women classified as overweight or obese. Conclusions: A reasonable GWG during pregnancy can effectively reduce the risk of PTB, especially for pregnant women with low pre-pregnancy body mass index. Low or excessive GWG may lead to an increased risk of PTB.