Affiliation:
1. Department of Epidemiology, School of Public Health Boston University Boston Massachusetts USA
2. Department of Epidemiology, School of Public Health University of Pittsburgh Pittsburgh Pennsylvania USA
3. Department of Obstetrics & Gynaecology University of British Columbia Vancouver British Columbia Canada
4. Department of Obstetrics, Gynecology, and Reproductive Sciences, School of Medicine University of Pittsburgh Medical Center Magee‐Womens Hospital Pittsburgh Pennsylvania USA
5. Muskie School of Public Service University of Southern Maine Portland Maine USA
Abstract
AbstractObjectiveThis case‐cohort study estimated associations between gestational weight gain (GWG) and small‐for‐gestational‐age (SGA) and large‐for‐gestational‐age (LGA) births stratified by obesity class (I: 30–34.9 kg/m2; II: 35–39.9 kg/m2; III: ≥40 kg/m2) (Magee‐Womens Hospital, Pittsburgh, Pennsylvania, 1998–2011).MethodsFirst‐trimester GWG was categorized as being below (<0.2 kg), within (0.2–2.0 kg), or above (>2.0 kg) the Institute of Medicine recommendations. For second‐ and third‐trimester GWG, four linear trajectories were derived: approximating maintenance (slope −0.05 ± 0.03 kg/wk), approximating the recommendations (0.27 ± 0.01 kg/wk; reference), higher than the recommendations (0.54 ± 0.01 kg/wk), and highest among those above the recommendations (0.91 ± 0.02 kg/wk).ResultsFor classes I, II, and III, respectively, there were 1290, 1247, and 1198 pregnancies in the subcohort; 262, 171, and 123 SGA cases; and 353, 286, and 257 LGA cases. First‐trimester GWG was not associated with SGA/LGA births. Second‐ and third‐trimester weight maintenance was associated with potentially lower LGA risk (risk ratio [RR]: 0.80; 95% confidence interval [CI]: 0.55–1.1) but not higher SGA risk (RR: 0.98; 95% CI: 0.64–1.5) for class III. In addition, some sensitivity analyses supported no increased SGA risk with second‐ and third‐trimester weight maintenance for classes I and II.ConclusionsSecond‐ and third‐trimester weight maintenance may be associated with more optimal birth weight for gestational age. However, how this could be achieved (e.g., through diet and exercise interventions) is unclear, given the observational design of our study.
Funder
Eunice Kennedy Shriver National Institute of Child Health and Human Development
National Heart, Lung, and Blood Institute
Subject
Nutrition and Dietetics,Endocrinology,Endocrinology, Diabetes and Metabolism,Medicine (miscellaneous)
Cited by
4 articles.
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