High Gestational Weight Gain and the Risk of Preterm Birth and Low Birth Weight: A Systematic Review and Meta-Analysis

McDonald, Sarah D.; Han, Zhen; Mulla, Sohail; Lutsiv, Olha; Lee, Tiffany; Beyene, Joseph; Shah, Prakesh S.; Ohlsson, Arne; Shah, Vibhuti; Murphy, Kellie; Hutton, Eileen K.; Newburn‐Cook, Christine; Frick, Corine; Scott, Fran; Allen, Victoria M.; Cameron, J. Douglas

doi:10.1016/s1701-2163(16)35107-6

Cited by 60 publications

(53 citation statements)

References 52 publications

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“…Based on studies that assessed the associations of gestational weight gain during specific periods of pregnancy, it appears that higher second and third trimester maternal weight gain are especially associated with an increased risk of delivering larger sizes of gestational age infants [19,20] . Also, both maternal pre-pregnancy BMI and gestational weight gain seem to be associated with common adverse neonatal outcomes, such as preterm birth, low Apgar score, neonatal hypoglycemia and referrals to the neonatal intensive care unit, with stronger and more consistent associations for maternal pre-pregnancy BMI than for gestational weight gain [20][21][22][23][24][25] . Thus, both maternal pre-pregnancy obesity and excessive gestational weight gain lead to increased risks of fetal complications throughout the pregnancy period.…”

Section: Fetal Outcomesmentioning

confidence: 99%

Childhood Health Consequences of Maternal Obesity during Pregnancy: A Narrative Review

Gaillard

Santos²,

Duijts

et al. 2016

Ann Nutr Metab

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Background: Obesity is a major public health problem among women of reproductive age. In a narrative review, we examined the influence of maternal obesity during pregnancy on fetal outcomes and childhood adiposity, cardio-metabolic, respiratory and cognitive-related health outcomes. We discuss results from recent studies, the causality and potential underlying mechanisms of observed associations and challenges for future epidemiological studies. Summary: Evidence from observational studies strongly suggests that maternal pre-pregnancy obesity and excessive gestational weight gain are associated with increased risks of fetal pregnancy complications and adverse childhood cardio-metabolic, respiratory and cognitive-related health outcomes. It remains unclear whether these associations are due to intrauterine mechanisms or explained by confounding family-based sociodemographic, lifestyle and genetic factors. The underlying mechanisms have mainly been assessed in animal studies and small human studies, and are yet to be further explored in large human studies. Key Message: Maternal obesity is an important modifiable factor during pregnancy that is associated with a variety of adverse offspring health outcomes. Further studies are needed to explore the causality and underlying mechanisms of the observed associations. Ultimately, preventive strategies focused on reducing maternal obesity and excessive weight gain during pregnancy may reduce common diseases in future generations.

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Section: Fetal Outcomesmentioning

confidence: 99%

Childhood Health Consequences of Maternal Obesity during Pregnancy: A Narrative Review

Gaillard

Santos²,

Duijts

et al. 2016

Ann Nutr Metab

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“…Children of mothers who are obese before pregnancy, or who gain too much weight during pregnancy, are at high risk of a number of adverse short-term and long-term outcomes, including preterm birth,1 stillbirth, obesity2 and later-life cardiovascular disease 3. Recent data suggest that maternal obesity and/or mothers who gain excessive weight during pregnancy may also have children who are at increased risk of cognitive impairments (eg, deficits in intelligence4 and executive function5) and problem behaviours that are consistent with attention-deficit hyperactivity disorder 6.…”

Section: Introductionmentioning

confidence: 99%

Child academic achievement in association with pre-pregnancy obesity and gestational weight gain

Pugh

Hutcheon

Richardson

et al. 2016

J Epidemiol Community Health

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Background Recent data suggest that children of mothers who are obese before pregnancy, or who gain too much weight during pregnancy, may be at an increased risk of cognitive impairments. Methods Mother–infant dyads enrolled in a birth cohort study in Pittsburgh, Pennsylvania (1983–1986), were followed from early pregnancy to 14 years postpartum (n=574). Math, reading and spelling achievements were assessed at ages 6 and 10 years using the Wide Range Achievement Test-Revised, and at age 14 years using the Wechsler Individual Achievement Test Screener. Self-reported total GWG was converted to gestational age-standardised z-scores. Generalised estimating equations were used to estimate the effects of GWG and pre-pregnancy body mass index (BMI) on academic achievement at 6, 10 and 14 years, while adjusting for maternal race, child sex, parity, employment, family income, maternal intelligence, maternal depression, pre-pregnancy BMI (in GWG models only) and the home environment. Results The mean (SD) BMI was 23.4 (5.7) kg/m2 and the mean (SD) GWG reported at delivery was 14.4 (5.9) kg. There was a significant non-linear association between pre-pregnancy BMI and an offspring’s academic achievement. At 6, 10 and 14 years, an offspring’s academic scores were inversely associated with pre-pregnancy BMI beyond 22 kg/m2. High GWG (>1 SD) was associated with approximately 4-point lower reading (adjusted β (adjβ) −3.75, 95% CI −7.1 to −0.4) and spelling scores (adjβ −3.90, 95% CI −7.8 to −0.2), compared with GWG −1 to +1 SD. Conclusions Future studies in larger and socioeconomically diverse populations are needed to confirm maternal weight and weight gain as causal determinants of a child’s academic skills, and whether this effect persists into adulthood.

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“…Their results are quite mixed. The second body of the literature evaluates the effects of gestational weight gain only, without controlling for preconception body weight (Hediger et al, 1989;Abrams and Selvin, 1995;Hickey et al, 1996;Ludwig and Currie, 2010;McDonald et al, 2011). However, the omitted pre-pregnancy BMI clearly biases the parameter estimate on weight gain, since women in various BMI categories differ systematically in gestational weight gain.…”

Section: Introductionmentioning

confidence: 99%

Maternal pre-pregnancy BMI, gestational weight gain, and infant birth weight: A within-family analysis in the United States

Yan

2015

Economics & Human Biology

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In the United States, the high prevalence of unhealthy preconception body weight and inappropriate gestational weight gain among pregnant women is an important public health concern. However, the relationship among pre-pregnancy BMI, gestational weight gain, and newborn birth weight has not been well established. This study uses a very large dataset of sibling births and a within-family design to thoroughly address this issue. The baseline analysis controlling for mother fixed effects indicates maternal preconception overweight, preconception obesity, and excessive gestational weight gain significantly increase the risk of having a high birth weight baby, respectively, by 1.3, 3 and 3.9 percentage points, while underweight before pregnancy and inadequate gestational weight gain increase the low birth weight incidence by 1.4 and 2 percentage points. The benchmark results are robust in a variety of sensitivity checks. Since poor birth outcomes especially high birth weight and low birth weight have lasting adverse impacts on one's health, education, and socio-economic outcomes later in life, the findings of this research suggest promoting healthy weight among women before pregnancy and preventing inappropriate weight gain during pregnancy can generate significant intergenerational benefits Yan, Ji (2015) "Maternal pre-pregnancy BMI, gestational weight gain, and infant birth weight: A withinfamily analysis in the United States"

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High Gestational Weight Gain and the Risk of Preterm Birth and Low Birth Weight: A Systematic Review and Meta-Analysis

Cited by 60 publications

References 52 publications

Childhood Health Consequences of Maternal Obesity during Pregnancy: A Narrative Review

Childhood Health Consequences of Maternal Obesity during Pregnancy: A Narrative Review

Child academic achievement in association with pre-pregnancy obesity and gestational weight gain

Maternal pre-pregnancy BMI, gestational weight gain, and infant birth weight: A within-family analysis in the United States

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