Ganancia de peso gestacional como predictor de macrosomía y bajo peso al nacer: revisión sistemática

Santos-Antonio, Gabriela; Alvis-Chirinos, Katherine; Aguilar-Esenarro, Luis; Bautista-Olórtegui, William; Velarde-Delgado, Patricia; Aramburu, Adolfo

doi:10.17843/rpmesp.2020.373.4919

Cited by 1 publication

(4 citation statements)

References 47 publications

(80 reference statements)

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“…Findings from this study suggest that the trend in the association between GWG and newborn weight related anthropometric indicators is similar across studies, and the patterns are in line with evidence from high income settings67159798 and previous studies from Latin America,2526 Asia,27 and sub-Saharan Africa 8. Weight gain during pregnancy is a cumulative measure of changing maternal physiology (fat free and fat mass accumulation, blood volume expansion), the placental weight, and the developing fetus (fat and fat free mass and amniotic fluid accretion) 4.…”

Section: Discussionsupporting

confidence: 88%

“…On average, women in sub-Saharan Africa and South Asia are estimated to gain less than 60% of the minimum recommended GWG for women of normal weight based on the IOM guidelines. 29 Recent evidence from systematic reviews and meta-analyses of relatively few studies conducted in sub-Saharan Africa, 8 Brazil, 25 and Asia 27 suggests that the associations between inadequate and excessive GWG and newborn outcomes might be consistent with observations from high income settings. However, most of the studies included in these reviews had cross sectional, case-control, or retrospective cohort study designs, used metrics of GWG that are likely to be confounded by gestational duration, were noted to have poor control of confounding variables, and examined associations primarily with newborn weight.…”

Section: Introductionmentioning

confidence: 83%

“…In contrast, a disproportionate number of the estimated 14.6 million preterm births, 20 million low birthweight births, and 23 million small for gestational age births occur in countries in sub-Saharan Africa and South Asia 222324. Although the epidemiology of maternal nutritional status at conception, GWG, and birth outcomes differs substantially for high income countries compared with low and middle income countries, only a limited number of studies have examined the association between GWG and neonatal outcomes in low and middle income countries 8252627. For example, in one of the largest systematic reviews and meta-analyses examining the role of GWG in perinatal outcomes, which included individual level data from 1.3 million pregnancies in 18 studies, almost all studies were from high income settings in North America, Europe, and Asia (with the exception of four studies from mainland China); most of the participants (76%) were from North America and Europe 67.…”

Section: Introductionmentioning

confidence: 99%

“… 22 23 24 Although the epidemiology of maternal nutritional status at conception, GWG, and birth outcomes differs substantially for high income countries compared with low and middle income countries, only a limited number of studies have examined the association between GWG and neonatal outcomes in low and middle income countries. 8 25 26 27 For example, in one of the largest systematic reviews and meta-analyses examining the role of GWG in perinatal outcomes, which included individual level data from 1.3 million pregnancies in 18 studies, almost all studies were from high income settings in North America, Europe, and Asia (with the exception of four studies from mainland China); most of the participants (76%) were from North America and Europe. 6 7 Approximately 7% of women in that study were underweight, 18% were overweight, and 20% had obesity based on their BMI before pregnancy, with 23% and 47% of women overall gaining weight below and above the IOM recommendations, respectively.…”

Section: Introductionmentioning

confidence: 99%

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Suboptimal gestational weight gain and neonatal outcomes in low and middle income countries: individual participant data meta-analysis

Perumal,

Wang,

Darling

et al. 2023

BMJ

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Objective To estimate the associations between gestational weight gain (GWG) during pregnancy and neonatal outcomes in low and middle income countries. Design Individual participant data meta-analysis. Setting Prospective pregnancy studies from 24 low and middle income countries. Main outcome measures Nine neonatal outcomes related to timing (preterm birth) and anthropometry (weight, length, and head circumference) at birth, stillbirths, and neonatal death. Analysis methods A systematic search was conducted in PubMed, Embase, and Web of Science which identified 53 prospective pregnancy studies published after the year 2000 with data on GWG, timing and anthropometry at birth, and neonatal mortality. GWG adequacy was defined as the ratio of the observed maternal weight gain over the recommended weight gain based on the Institute of Medicine body mass index specific guidelines, which are derived from data in high income settings, and the INTERGROWTH-21st GWG standards. Study specific estimates, adjusted for confounders, were generated and then pooled using random effects meta-analysis models. Maternal age and body mass index before pregnancy were examined as potential modifiers of the associations between GWG adequacy and neonatal outcomes. Results Overall, 55% of participants had severely inadequate (<70%) or moderately inadequate (70% to <90%) GWG, 22% had adequate GWG (90-125%), and 23% had excessive GWG (≥125%). Severely inadequate GWG was associated with a higher risk of low birthweight (adjusted relative risk 1.62, 95% confidence interval 1.51 to 1.72; 48 studies, 93 337 participants; τ 2 =0.006), small for gestational age (1.44, 1.36 to 1.54; 51 studies, 93 191 participants; τ 2 =0.016), short for gestational age (1.47, 1.29 to 1.69; 40 studies, 83 827 participants; τ 2 =0.074), and microcephaly (1.57, 1.31 to 1.88; 31 studies, 80 046 participants; τ 2 =0.145) compared with adequate GWG. Excessive GWG was associated with a higher risk of preterm birth (1.22, 1.13 to 1.31; 48 studies, 103 762 participants; τ 2 =0.008), large for gestational age (1.44, 1.33 to 1.57; 47 studies, 90 044 participants; τ 2 =0.009), and macrosomia (1.52, 1.33 to 1.73; 29 studies, 68 138 participants; τ 2 =0) compared with adequate GWG. The direction and magnitude of the associations between GWG adequacy and several neonatal outcomes were modified by maternal age and body mass index before pregnancy. Conclusions Inadequate and excessive GWG are associated with a higher risk of adverse neonatal outcomes across settings. Interventions to promote optimal GWG during pregnancy are likely to reduce the burden of adverse neonatal outcomes, however further research is needed to assess optimal ranges of GWG based on data from low and middle income countries.

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