Influence of prepregnant body mass and weight gain for gestation on spontaneous preterm delivery and duration of gestation during adolescent pregnancy

Abstract

We examined the influence of two measures of maternal nutritional status: prepregnant body mass (kilograms/meter ) and Weight gain during pregnancy (adjusted for duration of gestation) on spontaneous preterm delivery (<37 completed Weeks' gestation) and duration of gestation, as well as on low birthweight (<2,500 grams) and small-for-gestational-age (SGA) in pregnant adolescents. Inadequate Weight gain for gestation increased the risk of spontaneous preterm delivery when prematurity was reckoned by the obstetric estimate (Adjusted Odds Ratio, AOR = 1.75 95% CI 1.22-2.50) or from the mother's LMP (AOR = 1.49 95% CI 1.10-2.02). In linear models, gestation duration was significantly reduced, by more than half a week, when reckoned from eiter estimate of gestation. However, the association between preterm birth or gestation duration and prepregnancy body mass was not consistent and depended on the method of estimating gestation. Low birthweight and SGA were each significantly associated with inadequate weight gain during pregnancy as well as with prepregnant body mass. These results suggest that current maternal nutritional status, as measured by weight gain during pregnancy, may influence preterm delivery and gestation duration. The inconsistent results obtained with prepregnancy body mass may reflect a size bias inherent in the obstetric estimate of gestation, rather than effects of prepregnant maternal nutritional status on gestation.

Low gestational weight gain and the risk of preterm birth and low birthweight: a systematic review and meta‐analyses

“…Generally, the findings of two of the three cohort studies, which were not included in the above meta‐analyses as the format of their data did not permit pooling, supported the pooled data, with increased risks of PTB <37 weeks with low GWG by the third trimester (37), and increased risks of spontaneous PTB <37 weeks with low total GWG (46) or low GWG by the third trimester (37) although the third study did not show increased risks of PTB with low GWG (35).…”

“…Fifty‐five studies, 37 cohort (19–55) (of which 30 had data which were pooled) and 18 case‐control (56–73) studies (all of which had pooled data) were included, involving a total of 3 467 683 women (with 1 621 818 women with low GWG and 1 825 912 women with normal GWG) in the cohort studies and at least 4 359 cases and 15 549 controls in the case‐control studies (Supporting Information Tables S3 and S4). The studies originated predominantly from developed countries although developing countries were also represented (Supporting Information Tables S3 and S4).…”

Epidemiological differences among birth weight and gestational age subgroups of newborns

“…However, if the uncounted women delivering preterm were significantly different in ways related to the outcome from those who were counted, then we would not have identified the full spectrum of factors distinguishing between adverse birth outcomes in this analysis. Another source of bias in the data could have arisen if the determination of gestational age was biased by knowledge of a woman's risk factor profile (Scholl et al, 1989); however, this is unlikely given that gestational age assessment was made by nurses who were not involved in prenatal care. Finally, if preterm infants were misclassified as small for gestational age, the ratio of odds for a TERM-SGA vs. a PRETERM-AGA birth for any one risk factor would be reduced.…”

Assessment of Nutritional Status using Anthropometric Measurements in Relation to Pregnancy Outcome among Southern Sudanese Pregnant Mothers in Juba City

“…Current maternal nutritional status, as measured by weight gain during pregnancy, may influence preterm delivery and gestation duration [1]. An analysis of study in 20 countries during and after pregnancy indicated that maternal weight gain and body composition are associated with the newborn birth weight and the influence of the birth weight on infant mortality [2].…”