Avoiding excessive pregnancy weight gain to obtain better pregnancy outcomes in Taiwan

Horng, Huann Cheng; Huang, Ben; Lu, Yen Feng; Chang, Wen Yin; Chiou, Jyh Shin; Chang, Po Lun; Lee, Wen Ling; Wang, Peng Hui

doi:10.1097/md.0000000000009711

Cited by 17 publications

(13 citation statements)

References 53 publications

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“…The Institute of Medicine recommends that mothers only gain a certain amount of weight depending on their prepregnancy BMI, for example, normal‐weight women (BMI: 18.5‐24.9 kg/m 2 ) should gain 11.5‐16 kg 5 . Mothers who have exceeded these recommendations for maternal pregnancy weight gain have given birth to heavier children and more often had overweight adult daughters 6,7 …”

Section: Introductionmentioning

confidence: 99%

“…5 Mothers who have exceeded these recommendations for maternal pregnancy weight gain have given birth to heavier children and more often had overweight adult daughters. 6,7 Furthermore, the mere order in which siblings are born was associated with health-related issues such as psychopathology, physical characteristics or tumours. [8][9][10] Also, birth weight has been related to increasing parity and thus to increasing birth order.…”

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confidence: 99%

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Birth weight increases with birth order despite decreasing maternal pregnancy weight gain

et al. 2020

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Aim We investigated whether birth order is an influencing factor for birth weight independent from maternal factors. Methods Data were obtained from the longitudinal cohort study LIFE Child and included 1864 children, of which 526 were only children. The 1338 siblings were ranked into first‐borns (n = 570), second‐borns (n = 606) and third‐or‐later‐borns (n = 162). Children born prematurely, suffering from chronic or syndromic diseases, were excluded. We performed intra‐family comparisons to reduce bias and assessed the impact of perinatal parameters, such as birth order on birth weight, using mixed models. Results Birth weight increased with birth order. In univariate analyses, birth order had a significant effect on birth weight‐SDS with second‐borns having 0.29 SDS (app. 130 g) and third‐borns 0.40 SDS (app. 180 g) higher values than first‐borns (P < .001). Maternal pregnancy weight gain was associated with higher birth weight‐SDS (P < .01) in univariate analysis, though maternal pregnancy weight gain was lower for higher birth orders. Multivariate analyses revealed that being a second or third‐or‐later‐born child had a stronger impact on birth weight than all maternal factors. Conclusion Birth order must be considered a potential risk factor for higher birth weight. Maternal pregnancy weight gain is not the driving factor for higher birth weight in siblings.

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Birth weight increases with birth order despite decreasing maternal pregnancy weight gain

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“…In Western countries, the reported prevalence of overweight or obesity in pregnant women is 11–40% [ [2] , [3] , [4] ], and in Asian countries, it is 8–24% [ [5] , [6] , [7] ]. Previous studies have shown that obesity during pregnancy and a high body mass index (BMI) before pregnancy can cause adverse outcomes for pregnant women and fetuses, such as gestational diabetes mellitus (DM), preeclampsia, cesarean section (CS), postpartum hemorrhage, preterm delivery, a large fetus for gestational age, and even fetal death [ 4 , 6 , 8 , 9 ]. The WHO recommends that weight gain during pregnancy should be based on Institute of Medicine (IOM) guidelines [ 10 ], but less than half of pregnant women experience weight gain that is within the recommended range [ 5 , 11 , 12 ].…”

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confidence: 99%

Impact of prepregnancy body mass index on pregnancy outcomes, incidence of urinary incontinence and quality of life during pregnancy - An observational cohort study

et al. 2020

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Background To evaluate the effects of prepregnancy body mass index (BMI) on pregnancy outcomes, prevalence of urinary incontinence, and quality of life. Methods The observational cohort included 2210 pregnant women who were divided into 4 groups according to their prepregnancy BMI: underweight (<18.5), normal weight (18.5–24.9), overweight (25–29.9), and obese (≥30). Data were analyzed for pregnancy outcomes, prevalence of urinary incontinence during pregnancy, scores of the Short Form 12 health survey (SF-12) and changes in sexual function. Results Compared with normal weight, overweight and obesity were associated with advanced maternal age, low education level, multiparity, preterm delivery, cesarean section, gestational weight gain above the Institute of Medicine (IOM) guidelines, preeclampsia, gestational diabetes, macrosomia and large fetal head circumference. After adjusting for confounding factors, women with overweight and obesity were more likely to have adverse maternal outcomes (gestational weight gain above the IOM guidelines, preeclampsia and gestational diabetes) and fetal outcomes (large fetal head circumference and macrosomia) compared to normal weight women. Overweight and obese women (BMI ≥ 25) were more likely to have urinary incontinence than normal weight and underweight women. There were no significant differences in SF-12 scores among the 4 BMI groups, but more than 90% of pregnant women had reduced or no sexual activities regardless of BMI. Conclusions Maternal prepregnancy overweight and obesity are associated with greater risks of preeclampsia, gestational diabetes, macrosomia and urinary incontinence. Health care providers should inform women to start their pregnancy at a BMI in the normal weight category.

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“…In a cohort of 1147 women from Taipei, maternal (gestational diabetes mellitus, dysfunctional labor, and cesarean delivery) and neonatal complications (macrosomia and meconium aspiration) were significantly associated with excessive GWG, but not with inadequate GWG, based on the IOM classification 9 . In addition, GWG below the values stipulated in the IOM guidelines was an independent risk factor for placental abruption, while preeclampsia was related to pre-pregnancy obesity, but not to excessive GWG 10 .…”

Section: Discussionmentioning

confidence: 99%

Comparison between American Institute of Medicine Guidelines and Local Recommendation for Gestational Weight Gain in Taiwanese Primiparous Women

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Guo

Chien

2020

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Background : American Institute of Medicine (IOM) recommends different ranges of gestational weight gain (GWG) based on pre-pregnancy body mass index (BMI). In Taiwan, IOM guidelines are implemented concurrently with the local recommendation for GWG (10–14 kg). This study compared between the two sets of guidelines in relation to adverse perinatal outcomes.Methods : We analyzed 31653 primiparas with singletons from 2011-2016 annual National Breastfeeding Surveys. Logistic regressions for preterm birth, small for gestational age (SGA), large for gestational age (LGA), cesarean section and excessive postpartum weight retention (PWR) were fitted separately for GWG categorized according to IOM and Taiwan ranges. Areas under the receiver-operator curves (AUC) and the predicted probabilities for each outcome were compared in each BMI group.Results : AUC for both guidelines ranged within 0.51 – 0.73. Compared to Taiwan recommendation, IOM ranges showed lower probabilities of SGA for underweight (0.11–0.15 versus 0.14–0.18), of LGA for obese (0.12–0.15 versus 0.15–0.18), of excessive PWR for overweight (0.19–0.30 versus 0.27–0.39), and obese (0.15–0.22 versus 0.25-0.36); and higher probabilities of excessive PWR for underweight (0.17-0.33 versus 0.14-0.22).Conclusions : Discriminative performance of IOM and Taiwan recommendations was poor for the five adverse birth outcomes, and no preference for either set of recommendations could be inferred from our results. In the absence of specific GWG guidelines, health care workers may provide inconsistent information to their patients. Future research is needed to explore optimal GWG ranges that can reliably predict locally relevant perinatal outcomes for mother and child.

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Avoiding excessive pregnancy weight gain to obtain better pregnancy outcomes in Taiwan

Cited by 17 publications

References 53 publications

Birth weight increases with birth order despite decreasing maternal pregnancy weight gain

Birth weight increases with birth order despite decreasing maternal pregnancy weight gain

Impact of prepregnancy body mass index on pregnancy outcomes, incidence of urinary incontinence and quality of life during pregnancy - An observational cohort study

Comparison between American Institute of Medicine Guidelines and Local Recommendation for Gestational Weight Gain in Taiwanese Primiparous Women

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