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Inadequate weight gain in overweight and obese pregnant women: what is the effect on fetal growth?

Abstract：

OBJECTIVE:We sought to evaluate inadequate gestational weight gain and fetal growth among overweight and obese women. STUDY DESIGN:We conducted an analysis of prospective singleton term pregnancies in which 1053 overweight and obese women gained >5 kg (14.4 ± 6.2 kg) or 188 who either lost or gained ≤5 kg (1.1 ± 4.4 kg). Birthweight, fat mass, and lean mass were assessed using anthropometry. Small for gestational age (SGA) was defined as ≤10th percentile of a standard US population. Univariable and multivariable analysis evaluated the association between weight change and neonatal morphometry. RESULTS:There was no significant difference in age, race, smoking, parity, or gestational age between groups. Weight loss or gain ≤5 kg was associated with SGA, 18/188 (9.6%) vs 51/1053 (4.9%); (adjusted odds ratio, 2.6; 95% confidence interval, 1.4-4.7; P = .003). Neonates of women who lost or gained ≤5 kg had lower birthweight (3258 ± 443 vs 3467 ± 492 g, P < .0001), fat mass (403 ± 175 vs 471 ± 193 g, P < .0001), and lean mass (2855 ± 321 vs 2995 ± 347 g, P < .0001), and smaller length, percent fat mass, and head circumference. Adjusting for diabetic status, prepregnancy body mass index, smoking, parity, study site, gestational age, and sex, neonates of women who gained ≤5 kg had significantly lower birthweight, lean body mass, fat mass, percent fat mass, head circumference, and length. There were no significant differences in neonatal outcomes between those who lost weight and those who gained ≤5 kg. CONCLUSION:In overweight and obese women weight loss or gain ≤5 kg is associated with increased risk of SGA and decreased neonatal fat mass, lean mass, and head circumference.

journal_name

Am J Obstet Gynecol

journal_title

American journal of obstetrics and gynecology

authors

Catalano PM,Mele L,Landon MB,Ramin SM,Reddy UM,Casey B,Wapner RJ,Varner MW,Rouse DJ,Thorp JM Jr,Saade G,Sorokin Y,Peaceman AM,Tolosa JE,Eunice Kennedy Shriver National Institute of Child Health and Human Development Maternal-

doi

10.1016/j.ajog.2014.02.004

subject

Has Abstract

pub_date

2014-08-01 00:00:00

pages

137.e1-7

issue

eissn

0002-9378

issn

1097-6868

pii

S0002-9378(14)00121-5

journal_volume

211

pub_type

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Inadequate weight gain in overweight and obese pregnant women: what is the effect on fetal growth?