Optimal gestational weight gain ranges for the avoidance of adverse birth weight outcomes: a novel approach

Abstract

Considerably wider optimal GWG ranges than recommended by the Institute of Medicine might be tolerated with respect to avoidance of adverse birth weight outcome. Stratification by maternal body mass index category alone might not be sufficient.

Optimal weight gain in obese and overweight pregnant Japanese women

“…Initially, we used the method of analysis introduced in a study by Beyerlein et al [11], to calculate the predicted probability of pregnancy outcomes according to weight gain in primiparous non-smoking women with an average maternal age (overweight, 32.4 years; obese, 32.0 years) and average gestational delivery week (overweight, 38.9 weeks; obese, 38.9 weeks) .…”

“…They reported that the lowest prevalence of poor maternal and neonatal outcomes was observed in women with a weight loss of 0.03 kg/week; therefore, the preferable weight gain is lower than what is currently recommended by the IOM. In a retrospective study on pregnant women in Bavaria, Germany, Beyerlein et al [11] reported that the range of weight gain that does not increase the risk of poor maternal and neonatal outcomes is considerably wide, and that overweight women might benefit from a lower weight gain than that recommended by the IOM, or weight loss in order to deliver infants with a normal birth weight. Although the results of these studies on pregnant women in Western countries were not directly applicable to our study on Japanese pregnant women, the results were consistent with ours.…”

“…We considered ten main outcomes of interest, which are already known to be influenced by GWG [5][6][7][8][9][10][11][12][13][14][15][16][20][21][22][23][24][25][26][27]: small for gestational age (SGA), large for gestational age (LGA), low birth weight (LBW) (<2,500 g), macrosomia (≥4,000 g), gestational hypertension, preeclampsia, caesarean delivery, operative virginal delivery, umbilical artery pH <7.0, and an Apgar Score at 5 min <7. SGA and LGA neonates were defined as birth weights below the 10th percentile and above 90th percentile, respectively, after matching for gestational age and sex.…”

“…should gain between 5 and 9 kg to obtain the best maternal and perinatal outcomes [4]. However, a few studies from Europe and North America have suggested that a GWG below the IOM guidelines is associated with more favourable pregnancy outcomes in obese women [3,[7][8][9][10][11][12][13].Japanese women are more likely to be underweight than those in Europe and North America; therefore, the Submitted Jan. 22, 2018; Accepted Feb. 3, 2018 as EJ18-0027 Released online in J-STAGE as advance publication Mar. 20, 2018 Correspondence to: Shigeru Aoki, Perinatal Center for Maternity and Neonate, Yokohama City University Medical Center, 4-57 Urafunecyou, Minami-ku, Yokohama City, Kanagawa 232-0024, Japan.…”

“…should gain between 5 and 9 kg to obtain the best maternal and perinatal outcomes [4]. However, a few studies from Europe and North America have suggested that a GWG below the IOM guidelines is associated with more favourable pregnancy outcomes in obese women [3,[7][8][9][10][11][12][13].…”