Maternal pre-pregnancy underweight and fetal growth in relation to institute of medicine recommendations for gestational weight gain

Jerić, Milka; Roje, Damir; Medic, Nina; Strinić, Tomislav; Meštrović, Zoran; Vulić, Marko

doi:10.1016/j.earlhumdev.2012.10.004

Cited by 50 publications

(44 citation statements)

References 19 publications

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“…The prevalence of women with a low pre-pregnancy BMI in this study was similar to previous 365 research (Jeric et al, 2012) and our findings highlight an important gap in healthcare guidance 366 for the management of women with a low BMI at pregnancy commencement. Research in this 367 area is limited with the majority of studies to date on health and lifestyle behaviours related to 368 pregnancy focusing on women with high BMIs.…”

supporting

confidence: 84%

Differences in pre-conception and pregnancy healthy lifestyle advice by maternal BMI: Findings from a cross sectional survey

et al. 2016

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HIGHLIGHTS 42 Low maternal BMI is associated with adverse outcomes, however guidance is limited 43  Underweight pregnant women did not receive as much advice as women with high 44 BMIs 45 Alcohol consumption and smoking were relatively common in underweight pregnant 46 women 47  Evidence is needed to inform care recommendations for underweight pregnant women 48 49 ABSTRACT 50Objective 51Being underweight at pregnancy commencement is associated with a range of adverse maternal 52 and infant outcomes, as is being overweight or obese, yet it is an aspect of maternal health 53 which has been relatively neglected by healthcare professionals and researchers. We aimed to 54 investigate differences in pre-pregnancy and pregnancy healthy lifestyle advice routinely 55 offered by relevant healthcare professionals, including midwives and GPs, to women across 56 three different BMI categories -underweight, normal, and overweight or obese. A total of 1173 women completed the survey, with pre-pregnancy BMI data available for 918 77 (78.3%) women, 632 (69%) of whom were of normal weight, 232 (25%) were overweight or 78 obese, and 54 (6%) were underweight. Overall, 253 (28%) of these women reported they had 79 sought pre-conception advice. Women with a low BMI were offered pre-pregnancy and 80 pregnancy healthy lifestyle advice of a similar content to women with a normal BMI, whereas 81 women with a high BMI were more likely to be offered specific pre-conception and pregnancy 82 advice on healthy BMI (respectively OR 2.55; 95% CI 1.64-3.96: OR 1.79; 95% CI 1.26-2.54), 83 pre-conception healthy diet (OR 1.58; 95% CI 1.06-2.37), reducing alcohol consumption (OR 84 1.63; 95% CI 1.06-2.51) and smoking cessation (OR 1.62; 95% CI 1.05-2.50). For all women, 85 reported alcohol consumption during pregnancy was lower than pre-conception, but within 86 each BMI group around half of the women reported consuming alcohol at some time during 87 their pregnancy. 88 89 Key conclusions 90Women with a low BMI are no more likely than women with a normal BMI to be advised by 91 health professionals about a healthy lifestyle or a healthy weight for their height before or 92 during pregnancy. In contrast women with a high BMI are more likely to receive such advice. 93Provision of pre-conception care could provide opportunity to advise women across the weight 94 spectrum of the importance of adopting a healthy lifestyle for optimal pregnancy outcomes, as 95 well as consider management of any pre-existing medical conditions. 96 97 Implications for practice 98 4 Healthy lifestyle advice, including alcohol consumption and smoking cessation, should be 99 offered to women who are underweight before and during pregnancy as well as to women who 100 are overweight or obese, to improve adherence to recommendations to optimise maternal and 101 infant outcomes. Advice should also be tailored to reflect women's ethnic background, which 102 could be an important influence on lifestyle behaviour and weight management. The potential 103 clinical benefit of routi...

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confidence: 84%

Differences in pre-conception and pregnancy healthy lifestyle advice by maternal BMI: Findings from a cross sectional survey

et al. 2016

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“…It is known that underweight women have babies with lower birth weight than normal weight women [21,22], and in a meta- analysis it was confirmed that underweight mothers have increased risk of giving birth to babies with low birth weight and SGA [2]. In a case–control study it was shown that gaining less than IOM rec.…”

Section: Discussionmentioning

confidence: 99%

Associations of pre-pregnancy body mass index and gestational weight gain with pregnancy outcome and postpartum weight retention: a prospective observational cohort study

Haugen

Brantsæter

Winkvist

et al. 2014

BMC Pregnancy Childbirth

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BackgroundExcessive gestational weight gain (GWG) is associated with pregnancy complications, and Norwegian Health Authorities have adopted the GWG recommendations of the US Institute of Medicine and National Research Council (IOM). The aim of this study was to evaluate if a GWG outside the IOM recommendation in a Norwegian population is associated with increased risk of pregnancy complications like hypertension, low and high birth weight, preeclampsia, emergency caesarean delivery, and maternal post-partum weight retention (PPWR) at 6 and 18 months.MethodsThis study was performed in 56 101 pregnant women included in the prospective national Norwegian Mother and Child Cohort Study (MoBa) in the years 1999 to 2008. Women who delivered a singleton live born child during gestational week 37 to 42 were included. Maternal prepregnant and postpartum weight was collected from questionnaires at 17th week of gestation and 6 and 18 months postpartum.ResultsA weight gain less than the IOM recommendations (GWG < IOM rec.) increased the risk for giving birth to a low weight baby among normal weight nulliparous women. A weight gain higher than the IOM recommendations (GWG > IOM rec.) significantly increased the risk of pregnancy hypertension, a high birth weight baby, preeclampsia and emergency cesarean delivery in both nulliparous and parous normal weight women. Similar results were found for overweight women except for no increased risk for gestational hypertension in parous women with GWG > IOM rec. Seventy-four percent of the overweight nulliparous women and 66% of the obese women had a GWG > IOM rec. A GWG > IOM rec. resulted in increased risk of PPWR > 2 kg in all weight classes, but most women attained their prepregnant weight class by 18 months post-partum.ConclusionsFor prepregnant normal weight and overweight women a GWG > IOM rec. increased the risk for unfavorable birth outcomes in both nulliparous and parous women. A GWG > IOM rec. increased the risk of a PPWR > 2 kg at 18 months in all weight classes. This large study supports the Norwegian Health authorities’ recommendations for normal weight and overweight women to comply with the IOM rec.

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“…We hypothesize that since maternal diabetes, obesity, and excess weight gain during pregnancy have been shown to promote fetal growth, these conditions will increase the risk of childhood cancers that have been associated with higher birthweight [27–31]. Whereas pre-pregnancy underweight and insufficient gestational weight gain, which have been linked to restricted fetal growth, will result in an increased risk of childhood cancers that have been associated with lower birthweight [27, 28, 32]. Given the increasing prevalence of obesity and overweight status among women of childbearing age and increasing rates of pre-pregnancy and gestational diabetes deliveries in the US [33–35], we aim to assess the association between pre-pregnancy diabetes, gestational diabetes, pre-pregnancy BMI, and gestational weight gain on the risk of all childhood cancers before age 6 in a very large, diverse and population-based sample of children born in California, in which Hispanics are the dominant ethnicity.…”

Section: Introductionmentioning

confidence: 99%

Maternal pre-pregnancy and gestational diabetes, obesity, gestational weight gain, and risk of cancer in young children: a population-based study in California

Contreras

Ritz

Virk

et al. 2016

Cancer Causes Control

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Purpose We aimed to examine the influence of pre-pregnancy diabetes, pre-pregnancy body mass index (BMI), gestational diabetes, and gestational weight gain on childhood cancer risk in offspring. Methods We identified cancer cases (n=11,149) younger than age 6 years at diagnosis from the California Cancer Registry registered between 1988–2013. Controls (n=270,147) were randomly sampled from California birth records, and frequency-matched by year of birth to all childhood cancers during the study period. Exposure and covariate information was extracted from birth records. Unconditional logistic regression models were generated to assess the importance of pre-pregnancy diabetes, pre-pregnancy BMI, gestational diabetes, and gestational weight gain on childhood cancer risk. Results We observed increased risks of acute lymphoblastic leukemia (ALL) and Wilms’ tumor in children of mothers with pre-pregnancy diabetes [odds ratio (OR) =1.37, 95% confidence interval (CI): (1.11, 1.69), OR=1.45, 95% CI: (0.97, 2.18), respectively]. When born to mothers who were overweight prior to pregnancy (BMI 25–<30), children were at increased risk of leukemia [OR=1.27, 95% CI: (1.01, 1.59)]. Insufficient gestational weight gain increased the risk of acute myeloid leukemia (AML) [OR=1.50 (95% CI: 0.92, 2.42)] while excessive gestational weight gain increased the risk of astrocytomas [OR=1.56, 95% CI: (0.97, 2.50)]. No associations were found between gestational diabetes and childhood cancer risk in offspring. Conclusions We estimated elevated risks of several childhood cancers in the offspring of mothers who had diabetes and were overweight prior to pregnancy, as well as mothers who gained insufficient or excessive weight. Since few studies have focused on these factors in relation to childhood cancer, replication of our findings in future studies is warranted.

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Maternal pre-pregnancy underweight and fetal growth in relation to institute of medicine recommendations for gestational weight gain

Cited by 50 publications

References 19 publications

Differences in pre-conception and pregnancy healthy lifestyle advice by maternal BMI: Findings from a cross sectional survey

Differences in pre-conception and pregnancy healthy lifestyle advice by maternal BMI: Findings from a cross sectional survey

Associations of pre-pregnancy body mass index and gestational weight gain with pregnancy outcome and postpartum weight retention: a prospective observational cohort study

Maternal pre-pregnancy and gestational diabetes, obesity, gestational weight gain, and risk of cancer in young children: a population-based study in California

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