Predictors and adverse outcomes of inadequate or excessive gestational weight gain in an Asian population

Koh, Huishan; Ee, Tat Xin; Malhotra, Rahul; Allen, John C.; Tan, Thiam Chye; Østbye, Truls

doi:10.1111/j.1447-0756.2012.02067.x

Cited by 29 publications

(40 citation statements)

References 32 publications

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“…16,25 However, like other studies, 8,20 we failed to find the association between prepregnancy BMI and preterm delivery. Consistent with the previous study that used total GWG as exposure variable, 10 we found women who gained less had a higher risk of preterm delivery. Furthermore, previous studies using the average rate of GWG as exposure variable provided stronger evidence about this association.…”

Section: Discussionsupporting

confidence: 92%

“…2,4 Several previous studies have shown that high prepregnancy body mass index (BMI) or excessive GWG may be associated with increased risks of maternal and neonatal outcomes including gestational diabetes mellitus (GDM), 5,6 hypertensive disorders in pregnancy (HDP), caesarean delivery, large for gestational age infant (LGA), 7,8 and macrosomia. 9,10 Conversely, underweight or inadequate GWG may contribute to the increased risks of low birth weight (LBW) and small for gestational age infant (SGA). 6,10 However, some of the findings are not consistent, especially for the effect of GWG on GDM (since women who are diagnosed as GDM would take lifestyle interventions to control weight gain, it is more reasonable to use weight gain before diagnosis instead of total GWG as exposure variable).…”

Section: Introductionmentioning

confidence: 99%

“…9,10 Conversely, underweight or inadequate GWG may contribute to the increased risks of low birth weight (LBW) and small for gestational age infant (SGA). 6,10 However, some of the findings are not consistent, especially for the effect of GWG on GDM (since women who are diagnosed as GDM would take lifestyle interventions to control weight gain, it is more reasonable to use weight gain before diagnosis instead of total GWG as exposure variable). 2,11,12 Together with few published studies that assessed the joint effects of prepregnancy BMI and GWG on adverse pregnancy outcomes, 2,13 we aimed to gain more insight into the single effects of prepregnancy BMI or GWG on pregnancy outcomes and to evaluate the joint effects of these 2 factors.…”

Section: Introductionmentioning

confidence: 99%

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Effects of Prepregnancy Body Mass Index and Gestational Weight Gain on Pregnancy Outcomes

Zhang

Liu

Zhan

et al. 2015

Asia Pac J Public Health

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To investigate the single and joint effects of prepregnancy body mass index (BMI) and gestational weight gain (GWG) on pregnancy outcomes, electronic medical records of 14,196 women who delivered singleton live infant at a maternal and child health hospital in Beijing, China, in 2012 were reviewed. Logistic regression was used to assess the associations, adjusting for maternal age, height, education, parity, and offspring sex. Women of high prepregnancy BMI or excessive GWG had higher risks of gestational diabetes mellitus, hypertensive disorders in pregnancy, postpartum hemorrhage, caesarean delivery, macrosomia, and large for gestational age infant, while women of inadequate GWG had higher risks of preterm delivery, low birth weight, and small for gestational age infant. Findings suggest that antenatal care providers should help pregnant women control their GWG to normal.

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Section: Discussionsupporting

confidence: 92%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Effects of Prepregnancy Body Mass Index and Gestational Weight Gain on Pregnancy Outcomes

Zhang

Liu

Zhan

et al. 2015

Asia Pac J Public Health

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“…Differences may also relate to ethnic variation. In Singapore, difference in GWG between ethnicities was postulated to be due to difference in diet quality and psychosocial factors [55]. However we postulate that the degree of observed difference primarily related to application of BMI categories.…”

Section: Discussionmentioning

confidence: 86%

“…Asian studies have already suggested the need for specific guidelines [56]. In 2000, Chinese-specific guidelines for GWG [57] were developed, but have not been commonly adopted, with most Asian studies using mainly Caucasian-derived IOM GWG guidelines [55]. A call has been made for multi-centre collaboration to create optimal GWG guidelines for Asian women using modified BMI categories [58].…”

Section: Discussionmentioning

confidence: 99%

Gestational weight gain across continents and ethnicity: systematic review and meta-analysis of maternal and infant outcomes in more than one million women

Goldstein

Abell

Ranasinha

et al. 2018

BMC Med

358

334

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BackgroundThe association between Institute of Medicine (IOM) guidelines and pregnancy outcomes across ethnicities is uncertain. We evaluated the associations of gestational weight gain (GWG) outside 2009 IOM guidelines, with maternal and infant outcomes across the USA, western Europe and east Asia, with subgroup analyses in Asia. The aim was to explore ethnic differences in maternal prepregnancy body mass index (BMI), GWG and health outcomes across these regions.MethodsSystematic review, meta-analysis and meta-regression of observational studies were used for the study. MEDLINE, MEDLINE In-Process, Embase and all Evidence-Based Medicine (EBM) Reviews were searched from 1999 to 2017. Studies were stratified by prepregnancy BMI category and total pregnancy GWG. Odds ratio (ORs) 95% confidence intervals (CI) applied recommended GWG within each BMI category as the reference. Primary outcomes were small for gestational age (SGA), preterm birth and large for gestational age (LGA). Secondary outcomes were macrosomia, caesarean section and gestational diabetes.ResultsOverall, 5874 studies were identified and 23 were included (n = 1,309,136). Prepregnancy overweight/obesity in the USA, Europe and Asia was measured at 42%, 30% and 10% respectively, with underweight 5%, 3% and 17%. GWG below guidelines in the USA, Europe and Asia was 21%, 18% and 31%, and above was 51%, 51% and 37% respectively. Applying regional BMI categories in Asia showed GWG above guidelines (51%) was similar to that in the USA and Europe.GWG below guidelines was associated with a higher risk of SGA (USA/Europe [OR 1.51; CI 1.39, 1.63]; Asia [1.63; 1.45, 1.82]) and preterm birth (USA/Europe [1.35; 1.17, 1.56]; Asia [1.06; 0.78, 1.44]) than GWG within guidelines. GWG above guidelines was associated with a higher risk of LGA (USA/Europe [1.93; 1.81, 2.06]; Asia [1.68; 1.51 , 1.87]), macrosomia (USA/Europe [1.87; 1.70, 2.06]; Asia [2.18; 1.91, 2.49]) and caesarean (USA/Europe [1.26; 1.21, 1.33]; Asia [1.37; 1.30, 1.45]). Risks remained elevated when regional BMI categories were applied for GWG recommendations. More women in Asia were categorised as having GWG below guidelines using World Health Organization (WHO) (60%) compared to regional BMI categories (16%), yet WHO BMI was not accompanied by increased risks of adverse outcomes.ConclusionsWomen in the USA and western Europe have higher prepregnancy BMI and higher rates of GWG above guidelines than women in east Asia. However, when using regional BMI categories in east Asia, rates of GWG above guidelines are similar across the three continents. GWG outside guidelines is associated with adverse outcomes across all regions. If regional BMI categories are used in east Asia, IOM guidelines are applicable in the USA, western Europe and east Asia.Electronic supplementary materialThe online version of this article (10.1186/s12916-018-1128-1) contains supplementary material, which is available to authorized users.

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Early gestational weight gains within current recommendations result in increased risk of gestational diabetes mellitus among Korean women

Park

Kim

2014

Diabetes Metabolism Res

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Predictors and adverse outcomes of inadequate or excessive gestational weight gain in an Asian population

Abstract: Maternal predictors and perinatal outcomes of GWG among Asian women are similar to those identified previously among Caucasian, African-American and Hispanic women.

Cited by 29 publications

References 32 publications

Effects of Prepregnancy Body Mass Index and Gestational Weight Gain on Pregnancy Outcomes

Effects of Prepregnancy Body Mass Index and Gestational Weight Gain on Pregnancy Outcomes

Gestational weight gain across continents and ethnicity: systematic review and meta-analysis of maternal and infant outcomes in more than one million women

Early gestational weight gains within current recommendations result in increased risk of gestational diabetes mellitus among Korean women

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