Gestational weight gain

Kominiarek, Michelle A.; Peaceman, Alan M.

doi:10.1016/j.ajog.2017.05.040

Cited by 314 publications

(301 citation statements)

References 71 publications

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“…In our study, maternal body size early in pregnancy was negatively associated with gestational weight gain, which is in line with epidemiological studies . The inverse association between body size and weight gain is postulated to reflect a biological adaptation of women with increased adiposity to minimize the risk for pregnancy complications and infant outcomes . The present study is the first to use gold‐standard methodologies, i.e., air displacement plethysmography combined with stable isotope dilution, and to show that differences in weight gain during pregnancy in women with obesity are largely due to differences in fat accumulation.…”

Section: Discussionsupporting

confidence: 89%

Body Composition During Pregnancy Differs by Obesity Class

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Altazan

Hsia

et al. 2019

Obesity

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Objective: The aim of this study is to characterize changes in body composition during pregnancy in women with obesity. Methods: Fifty-four healthy women with obesity (class 1, 30-34.9 kg/m 2 : n = 25; class 2, 35-39.9 kg/m 2 : n = 21; class 3, ≥ 40.0 kg/m 2 : n = 8) expecting a singleton pregnancy were studied. Body composition was measured in early pregnancy (13-16 weeks), midpregnancy (24-27 weeks), and late pregnancy (35-37 weeks) using air displacement plethysmography, stable isotopes, and skinfold thickness measurements. Fasting glucose, insulin, and leptin were measured. Results: The gain in fat-free mass was lower in the second trimester compared with the third (2.7 ± 0.2 to 5.3 ± 0.2 kg; P < 0.001), whereas fat mass accumulation declined over time (0.6 ± 0.3 to −0.7 ± 0.4 kg; P = 0.005). Women with class 1 and 2 obesity gained 1.1 ± 0.7 kg of fat mass during pregnancy, while women with class 3 obesity lost 4.1 ± 0.6 kg (both P < 0.001). The difference in fat accumulation between obesity classes was observed only in the second trimester (P = 0.02). Gestational weight gain was associated positively with changes in plasma concentrations of insulin, leptin, and insulin resistance (all P < 0.01). Conclusions: Gestational weight gain in pregnancy differs by obesity class and trimester. Women with class 3 obesity gain less body weight and fat mass. Fat mass gain is most likely preventable in the second trimester.Obesity (2020) 28, 268-276. Study ImportanceWhat is already known? ► Healthy gestational weight gain is inversely related to body size. ► Fat mass is the most variable component of gestational weight gain in nonobese pregnancy.What does this study add?► Weight and body composition changes during pregnancy differ by obesity class. ► Fat mass is gained during the second trimester but not the third. ► "Inadequate" weight gain is the result of fat loss.

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Section: Discussionsupporting

confidence: 89%

Body Composition During Pregnancy Differs by Obesity Class

Most

Altazan

Hsia

et al. 2019

Obesity

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“…More women today are entering pregnancy with an elevated body mass index (BMI). As obesity is more prevalent, the incidence of complications associated with obesity during pregnancy, such as increased rates of hypertensive disorders of pregnancy, fetal macrosomia, and cesarean birth rates, is increasing . The 2011 to 2012 National Health and Nutrition Examination Survey found that the prevalence of obesity in women of reproductive age (20‐39 years) in the United States is 31.8% .…”

Section: Introductionmentioning

confidence: 99%

Excessive Gestational Weight Gain

McDowell¹,

Cain²,

Brumley³

2018

J Midwife Womens Health

102

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Excessive gestational weight gain (GWG) is associated with an increasing incidence of maternal and neonatal complications, including hypertensive disorders of pregnancy, fetal macrosomia, and increased cesarean birth rates. In the United States, it is recommended that health care providers use an individualized approach to counsel a woman about pregnancy weight gain goals that is based on the woman's initial body mass index (BMI) and to track GWG throughout the pregnancy by evaluating maternal weight at each visit. Studies have shown that women entering pregnancy with a higher BMI are at increased risk for excessive GWG and postpartum weight retention. Research also demonstrates an increased risk of childhood obesity in children born to women with excessive GWG. Specific counseling about exercise and diet, as well as technology and motivational interviewing, are some tools prenatal care providers can use that have been shown to be effective in reducing excessive GWG. This article reviews the current research regarding maternal and neonatal risks associated with excessive GWG, as well as the interventions that have demonstrated promise for addressing this problem.

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“…The combination of obesity and macrosomia significantly increases the chance of cesarean delivery [6]. Both pre-pregnancy BMI category and gestational weight gain are independent contributors to the development of a large for gestational age or macrosomic infant [7][8]. Obese women tend to have higher gestational weight gain, despite stricter weight gain recommendations, and hence larger birth weight babies [7].…”

Section: Factors Contributing To Cesarean Delivery In Obese Womenmentioning

confidence: 99%

“…Both pre-pregnancy BMI category and gestational weight gain are independent contributors to the development of a large for gestational age or macrosomic infant [7][8]. Obese women tend to have higher gestational weight gain, despite stricter weight gain recommendations, and hence larger birth weight babies [7]. A large fetus, for obvious reasons, predisposes the mother to a protracted labor course and cephalopelvic disproportion leading to an indicated cesarean delivery.…”

Section: Factors Contributing To Cesarean Delivery In Obese Womenmentioning

confidence: 99%

Obesity: Unique Challenges at the Time of Cesarean Delivery

Roloff¹,

Cao²,

Okekpe³

et al. 2020

Recent Advances in Cesarean Delivery

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The obesity epidemic has touched all aspects of obstetric care, including the practice of cesarean delivery. Obesity is an independent risk factor for cesarean delivery, and the increased prevalence of obesity has contributed to the overall rise in primary cesarean delivery seen over the past few decades. Because of the frequent existence of co-morbidities such as hypertension and diabetes, obesity is a plausible contributor to rising maternal mortality. In addition, obese women who undergo both primary and repeat cesarean delivery have a higher chance to develop surgical and post-operative complications, including wound infection and thromboembolic events. Surgical complications increase steadily with increasing maternal weight. In this chapter, we will review the incidence and contributing factors that lead to cesarean delivery in obese patients, peri-operative complications, and strategies to reduce these risks in obese women undergoing cesarean delivery.

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Gestational weight gain

Cited by 314 publications

References 71 publications

Body Composition During Pregnancy Differs by Obesity Class

Body Composition During Pregnancy Differs by Obesity Class

Excessive Gestational Weight Gain

Obesity: Unique Challenges at the Time of Cesarean Delivery

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