Association of Gestational Weight Gain With Maternal and Infant Outcomes

Goldstein, Rebecca F.; Abell, Sally K.; Ranasinha, Sanjeeva; Misso, Marie; Boyle, Jacqueline; Black, M. Jane; Li, Nan; Hu, Gang; Corrado, Francesco; Rode, Line; Kim, Young Ju; Haugen, Margaretha; Song, Won O.; Kim, Min Hyoung; Bogaerts, Annick; Devlieger, Roland; Chung, Judith H.; Teede, Helena

doi:10.1001/jama.2017.3635

Cited by 1,253 publications

(1,138 citation statements)

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“…IGWG in these women may be the result of an imbalance between caloric intake and energy expenditure, or medical management. Given that women who gain below GWG recommendations have increased odds of SGA and preterm birth,2 prenatal care providers should follow weight gain throughout pregnancy to ensure that women who are exercising during pregnancy gain appropriately, within the IOM guidelines. Counselling about adequate nutrition and increasing awareness about the risk of IGWG is important.…”

Section: Discussionmentioning

confidence: 99%

“…Compared with adequate GWG (AGWG), excessive GWG (EGWG) and inadequate GWG (IGWG) have been associated with higher adverse maternal and infant outcomes. EGWG was associated with higher odds of large for gestational age (LGA) babies, macrosomia and caesarean delivery 2. IGWG was associated with increased odds of small for gestational age (SGA) babies and preterm birth; these associations were greatest with lower pre-pregnancy body mass index (BMI) 2.…”

Section: Introductionmentioning

confidence: 99%

“…EGWG was associated with higher odds of large for gestational age (LGA) babies, macrosomia and caesarean delivery 2. IGWG was associated with increased odds of small for gestational age (SGA) babies and preterm birth; these associations were greatest with lower pre-pregnancy body mass index (BMI) 2. Several studies have also highlighted that EGWG may contribute exponentially to the obesity epidemic in women 3 4.…”

Section: Introductionmentioning

confidence: 99%

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Effectiveness of exercise interventions in the prevention of excessive gestational weight gain and postpartum weight retention: a systematic review and meta-analysis

et al. 2018

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ObjectiveGestational weight gain (GWG) has been identified as a critical modifier of maternal and fetal health. This systematic review and meta-analysis aimed to examine the relationship between prenatal exercise, GWG and postpartum weight retention (PPWR).DesignSystematic review with random effects meta-analysis and meta-regression. Online databases were searched up to 6 January 2017.Study eligibility criteriaStudies of all designs in English, Spanish or French were eligible (except case studies and reviews) if they contained information on the population (pregnant women without contraindication to exercise), intervention (frequency, intensity, duration, volume or type of exercise, alone [“exercise-only”] or in combination with other intervention components [eg, dietary; “exercise + co-intervention”]), comparator (no exercise or different frequency, intensity, duration, volume or type of exercise) and outcomes (GWG, excessive GWG (EGWG), inadequate GWG (IGWG) or PPWR).ResultsEighty-four unique studies (n=21 530) were included. ‘Low’ to ‘moderate’ quality evidence from randomised controlled trials (RCTs) showed that exercise-only interventions decreased total GWG (n=5819; −0.9 kg, 95% CI −1.23 to –0.57 kg, I2=52%) and PPWR (n=420; −0.92 kg, 95% CI −1.84 to 0.00 kg, I2=0%) and reduced the odds of EGWG (n=3519; OR 0.68, 95% CI 0.57 to 0.80, I2=12%) compared with no exercise. ‘High’ quality evidence indicated higher odds of IGWG with prenatal exercise-only (n=1628; OR 1.32, 95% CI 1.04 to 1.67, I2=0%) compared with no exercise.ConclusionsPrenatal exercise reduced the odds of EGWG and PPWR but increased the risk of IGWG. However, the latter result should be interpreted with caution because it was based on a limited number of studies (five RCTs).

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Effectiveness of exercise interventions in the prevention of excessive gestational weight gain and postpartum weight retention: a systematic review and meta-analysis

et al. 2018

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“…Maternal weight retention between the first and second pregnancies is also associated with adverse pregnancy outcomes in the following pregnancy, even in normal weight women (20). Inadequate GWG is associated with small for gestational age and preterm birth (21). In 2009, the American Institute of Medicine (IOM) published new guidelines on recommended weight gain during pregnancy according to prepregnancy BMI class (22) ( Table 2).…”

Section: Gestational Weight Gainmentioning

confidence: 99%

Maternal obesity, duration of labor and the role of leptin

Carlhäll¹

2018

Linköping University Medical Dissertations

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Background: The prevalence of obesity substantially increases in pregnant women. Maternal obesity is associated with adverse maternal and neonatal outcomes. The increased risk for cesarean section present in obese women has been related to potential impaired uterine contractility. The mechanism that underlies this theory is not clear. In vitro studies have shown that leptin, produced by adipose tissue and the placenta, exerts an inhibitory effect on myometrial contractility. The aim of this thesis was to evaluate the labor process in relation to maternal body mass index (BMI) and the clinical role of leptin in this process.

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“…In a meta-analysis study carried out with 10 171 obese preterm births in pregnant women with gestational weight gain over the indicated increased risk [32]. In another study it was found that gestational weight gain above the recommendations and moderate weight gain during pregnancy is associated with preterm [33,34]. In a study by Vivatkusol, et al, percentage of cesarean section was increased in the overweight and obese pregnant women; in contrast, the rate of preterm births showed an increase in underweight pregnant womens [35].…”

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confidence: 99%