Good Practices for Observational Studies of Maternal Weight and Weight Gain in Pregnancy

Hutcheon, Jennifer A.; Bodnar, Lisa M.

doi:10.1111/ppe.12439

Cited by 65 publications

(72 citation statements)

References 56 publications

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“…These included maternal age, education, number of pregnancies, number of living children, height, occupation, SES, household food insecurity, reported increase or decrease in the number of meals per day and quantity of food consumed due to pregnancy, reported receipt of food assistance, adequate minimum dietary diversity, micronutrient status (plasma ferritin, zinc, and retinol binding protein adjusted for inflammation; Wessells et al, ; sTfR, vitamin B 12 , and folate), markers of inflammation (AGP and CRP), and malaria antigenemia (HRP2). To explore which predictors were consistently and significantly associated with GWG per week and low GWG, we ran five independent analyses including GWG per week and GWG < 0.35 kg/week adjusting for women's GA, and GWG per week, GWG less than the third centile and GWG < 50th centile INTERGROWTH‐21st standards not adjusting for GA following the methods of the respective standards (Cheikh Ismail et al, ; Hutcheon & Bodnar, ; IOM and NRC, ). If a predictor was associated with at least three GWG (GWG per week and/or different definitions of low GWG) or both of the MUAC outcomes (MUAC in centimeters or low MUAC), it was considered to be a consistent predictor of low GWG or undernutrition.…”

Section: Methodsmentioning

confidence: 99%

Prevalence and determinants of gestational weight gain among pregnant women in Niger

Ouédraogo

Wessells

Young

et al. 2019

Maternal & Child Nutrition

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Low gestational weight gain (GWG) and low mid-upper arm circumference (MUAC) are associated with adverse pregnancy outcomes. We aimed to assess the prevalence and determinants of low GWG and low MUAC among pregnant women in rural Zinder, Niger. A community-based survey was conducted among 1,384 pregnant women in the catchment areas of 18 integrated health centers in the region of Zinder, Niger. Weight and MUAC were measured during an in-home visit and again 1 month later, when haemoglobin concentration and micronutrient status were also assessed. The prevalence of low GWG was defined based on the 2009 United States Institute of Medicine (U.S. IOM) guidelines (<0.35 kg/week) and less than the third centile of the International Fetal and Newborn Growth Consortium for the 21st Century (INTERGROWTH-21st) standards. Factors associated with GWG and MUAC were identified using logistic regression models adjusting for season, village, and gestational age. The median (interquartile range) age was 25.0 (20.7, 30.0) years, and 16.4% were ≤19 years. The prevalence of low GWG were 62.9% and 27.5% according to 2009 IOM and less than the third INTERGROWTH-21st centile, respectively; 24.9% had low MUAC. Higher α-1-acid glycoprotein (OR = 1.7, 95% CI [1.1, 2.8]) and C-reactive protein (OR = 1.2, 95% CI [1.02, 1.50]) increased the odds of low GWG. Adolescents (OR = 2.7, 95% CI [1.8, 4.0]), housewives (OR = 1.97, 95% CI [1.36, 2.86]), and those who reported recent food assistance (OR = 1.80, 95% CI [1.04, 3.11]) had higher odds of low MUAC. Prevalence of low GWG and low MUAC was high among pregnant women. Determinants of GWG and MUAC included socioeconomic, demographic, and biological factors, although only markers of inflammation were consistent predictors across different definitions of low GWG. This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited. 1 of 15 2 of 15 OUÉDRAOGO ET AL. bs_bs_banner The prevalence of low GWG was high among pregnant women in the Zinder region of Niger, and the odds of low GWG were consistently associated with higher concentrations of markers of inflammation (AGP and CRP). A considerable proportion of pregnant women also had low MUAC. Considering the importance of adequate GWG and MUAC for maternal health and pregnancy outcomes, effective and cost-effective interventions (e.g., daily iron folic acid supplementation; Baltussen, Knai, & Sharan, 2004, behaviour change communication about nutrition; Lamstein et al., 2014, and balanced protein energy dietary supplementation; Imdad & Bhutta, 2012) to ensure adequate GWG and nutritional status should be considered. ACKNOWLEDGMENTSWe would like to thank the NiMaNu study team, the participants, the local communities, staff of the Zinder and Mirriah health districts, and the national steering committee. Our sincere appreciation goes to Pro-The authors declare that they have no conflicts of interest. CONTRIBUTIONSThe ...

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Section: Methodsmentioning

confidence: 99%

Prevalence and determinants of gestational weight gain among pregnant women in Niger

Ouédraogo

Wessells

Young

et al. 2019

Maternal & Child Nutrition

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“…To assess the association between GWG or excessive GWG and PPD, analogous Models 1-4 were fitted. All models were additionally adjusted for pre-pregnancy BMI and the interaction term between pre-pregnancy BMI and GWG or excessive GWG, as previously recommended [38]. Models were fitted with GWG as a continuous variable or excessive GWG as a categorical variable.…”

Section: Association Between Gwg or Excessive Gwg And Ppdmentioning

confidence: 99%

Evaluation of antenatal risk factors for postpartum depression: a secondary cohort analysis of the cluster-randomised GeliS trial

Johar

Hoffmann

Günther

et al. 2020

BMC Med

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Background: Maternal weight variables are important predictors of postpartum depression (PPD). While preliminary evidence points to an association between pre-pregnancy obesity and PPD, the role of excessive gestational weight gain (GWG) on PPD is less studied. In this secondary cohort analysis of the German 'healthy living in pregnancy' (GeliS) trial, we aimed to investigate associations between weight-related variables and PPD and to assess the influence of GWG on the risk for PPD. Methods: We included women with normal weight, overweight, and obesity (BMI 18.5-40.0 kg/m 2). Symptoms of PPD were assessed 6-8 weeks postpartum using the Edinburgh Postnatal Depression Scale. Pre-pregnancy BMI was self-reported. During the course of pregnancy, weight was measured at gynaecological practices within regular checkups. GWG was defined as the difference between the last measured weight before delivery and the first measured weight at the time of recruitment (≤ 12 th week of gestation). Excessive GWG was classified according to the Institute of Medicine. Multiple logistic regression analyses were used to estimate the odds of PPD in relation to pre-pregnancy BMI, GWG, and excessive GWG adjusting for important confounders.

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“…Therefore, we utilized a standardized measure of GWG in our analysis which helps alleviate this confounding. This adjustment is necessary in order to account for the fact that women are able to gain more weight the longer they are pregnant [21].…”

Section: Gestational Weight Gainmentioning

confidence: 99%

Associations between gestational weight gain and preterm birth in Puerto Rico

Eick¹,

Welton²,

Claridy³

et al. 2020

BMC Pregnancy Childbirth

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Background Preterm birth (PTB; gestational age < 37 weeks) is the leading cause of infant morbidity and mortality worldwide. Low and excessive gestational weight gain (GWG) have been previously cited as risk factors for PTB, however the magnitude of association varies across populations. No studies have examined low and excessive GWG as modifiable risk factors for PTB in Puerto Rico, an area with inexplicably high PTB rates. Methods To examine the relationship between GWG and PTB, we conducted a retrospective analysis using birth certificate data files from the Puerto Rico Department of Health from 2005 to 2012. GWG was standardized to a 40-week gestational duration and was categorized into low, adequate, or excessive for each category of pre-pregnancy body mass index using American College of Obstetricians and Gynecologists guidelines. Logistic regression was used to determine the crude and adjusted odds ratios (OR) and 95% confidence intervals (CI) for the association between GWG and PTB. Results There were 320,695 births included in this analysis; 40.6% with high GWG and 27.3% with low GWG. A greater percentage of women with low GWG were less than 20 years of age, had less than a high school education, and were underweight compared to women with adequate and excessive GWG. Women with low compared to adequate GWG had increased odds of PTB (OR = 1.34, 95% CI = 1.30–1.37). However, excessive compared to adequate GWG was not associated with PTB (OR = 0.99, 95% CI = 0.97–1.02). Conclusions Among women in Puerto Rico, low GWG was associated with increased odds of PTB. With the exception of obesity, these associations persisted within all strata of pre-pregnancy body mass index, highlighting the importance of maintaining a healthy weight during pregnancy. Future research should examine other factors that may contribute to GWG, such as dietary nutrients, and explore pathways through which GWG may be contributing to PTB.

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Good Practices for Observational Studies of Maternal Weight and Weight Gain in Pregnancy

Cited by 65 publications

References 56 publications

Prevalence and determinants of gestational weight gain among pregnant women in Niger

Prevalence and determinants of gestational weight gain among pregnant women in Niger

Evaluation of antenatal risk factors for postpartum depression: a secondary cohort analysis of the cluster-randomised GeliS trial

Associations between gestational weight gain and preterm birth in Puerto Rico

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