Prepregnancy Body Mass Index, Gestational Weight Gain, and Odds of Cesarean Delivery in Hispanic Women

Harvey, Megan; Braun, Barry; Ertel, Karen A.; Pekow, Penelope S.; Markenson, Glenn; Chasan‐Taber, Lisa

doi:10.1002/oby.22048

Cited by 24 publications

(20 citation statements)

References 31 publications

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“…In the current study, 39% of women had inadequate total GWG and 27% had excessive total GWG. These frequencies are somewhat more extreme than those reported among other U.S. Hispanic populations in Massachusetts, California, North Carolina, and Texas, ranging from 19–33% for inadequate and 36–52% for excessive total GWG . The underlying contributors to lower GWG in our population, particularly among women with normal weight, compared to others are not clear.…”

Section: Discussioncontrasting

confidence: 69%

“…Hispanic populations in Massachusetts, California, North Carolina, and Texas, ranging from 19-33% for inadequate and 36-52% for excessive total GWG. [26][27][28][29][30] The underlying contributors to lower GWG in our population, particularly among women with normal weight, compared to others are not clear. Our population was lowincome, which, historically, is a risk factor for inadequate GWG.…”

Section: Discussionmentioning

confidence: 99%

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Total and trimester‐specific gestational weight gain and infant anthropometric outcomes at birth and 6 months in low‐income Hispanic families

et al. 2019

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Objective To describe total and trimester‐specific gestational weight gain (GWG) among low‐income Hispanic women and determine whether these GWG exposures are associated with infant anthropometric outcomes at birth and 6 months. Study Design Data were from 448 mother‐infant pairs enrolled in the Starting Early child obesity prevention trial. Prenatal weights were used to calculate total GWG and 2nd and 3rd trimester GWG rates (kg/week) and categorized as inadequate, adequate, and excessive according to the 2009 Institute of Medicine recommendations. Multivariable linear and modified Poisson regressions estimated associations of infant anthropometric outcomes (birthweight, small‐for‐gestational age [SGA], large‐for‐gestational age [LGA], rapid weight gain, and weight‐for‐age, length‐for‐age, and weight‐for‐length z‐scores at 6 months) with GWG categories. Results For total GWG, 39% and 27% of women had inadequate and excessive GWG, respectively. 57% and 46% had excessive GWG rates in the 2nd and 3rd trimesters, respectively, with 29% having excessive rates in both trimesters. Inadequate total GWG was associated with lower infant weight and length outcomes (ß range for z‐scores = −0.21 to −0.46, p < 0.05) and lower risk of LGA (adjusted Relative Risk, aRR = 0.38; 95% confidence intervals, CI: 0.16, 0.95) and rapid weight gain (aRR = 0.72; 95%CI: 0.51, 1.00). GWG rates above recommendations in the 2nd trimester or 2nd/3rd trimesters were associated with greater weight outcomes at birth and 6 months (ß range for z‐scores = 0.24 to 0.35, p < 0.05). Conclusions Counseling women about health behaviors and closely monitoring GWG beginning in early pregnancy is necessary, particularly among populations at high‐risk of obesity.

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Section: Discussioncontrasting

confidence: 69%

Section: Discussionmentioning

confidence: 99%

Total and trimester‐specific gestational weight gain and infant anthropometric outcomes at birth and 6 months in low‐income Hispanic families

et al. 2019

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“…This is in agreement with information in the general obstetric population [ 44 ] and partially with data in women with GDM where the negative association of iGWG with cesarean delivery did not reach significance [ 13 ]. Since GWG in second [ 45 ] and third trimesters [ 46 ] has been related with cesarean delivery, we consider that the relationships described in this study are partially attributable to GWG taking place after GDM diagnosis and affected by its management.…”

Section: Discussionmentioning

confidence: 99%

Inadequate Weight Gain According to the Institute of Medicine 2009 Guidelines in Women with Gestational Diabetes: Frequency, Clinical Predictors, and the Association with Pregnancy Outcomes

Xie

Liu

Pujol

et al. 2020

JCM

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Background: In the care of women with gestational diabetes mellitus (GDM), more attention is put on glycemic control than in factors such as gestational weight gain (GWG). We aimed to evaluate the rate of inadequate GWG in women with GDM, its clinical predictors and the association with pregnancy outcomes. Methods: Cohort retrospective analysis. Outcome variables: GWG according to Institute of Medicine 2009 and 18 pregnancy outcomes. Clinical characteristics were considered both as GWG predictors and as covariates in outcome prediction. Statistics: descriptive, multinomial and logistic regression. Results: We assessed 2842 women diagnosed with GDM in the 1985–2011 period. GWG was insufficient (iGWG) in 50.3%, adequate in 31.6% and excessive (eGWG) in 18.1%; length of follow-up for GDM was positively associated with iGWG. Overall pregnancy outcomes were satisfactory. GWG was associated with pregnancy-induced hypertension, preeclampsia, cesarean delivery and birthweight-related outcomes. Essentially, the direction of the association was towards a higher risk with eGWG and lower risk with iGWG (i.e., with Cesarean delivery and excessive growth). Conclusions: In this cohort of women with GDM, inadequate GWG was very common at the expense of iGWG. The associations with pregnancy outcomes were mainly towards a higher risk with eGWG and lower risk with iGWG.

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“…7 While there are considerable data available regarding gestational weight gain and obstetric outcomes, most previous studies are limited to a single site, have small sample sizes, or lack diversity among their patient population. 1,4,8,9 Some studies focused only on women who were already obese, prior to pregnancy. 10,11 Furthermore, among multiparous women, personal obstetric history is highly predictive of subsequent pregnancy outcomes, such as cesarean delivery and hypertensive disorders, 12,13 and represents a significant confounder when studying the associations between gestational weight gain and pregnancy outcomes among women of mixed parity.…”

mentioning

confidence: 99%

Gestational Weight Gain and Pregnancy Outcomes among Nulliparous Women

et al. 2019

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Objective To determine the association between total gestational weight gain and perinatal outcomes. Study Design Data from the Nulliparous Pregnancy Outcomes Study: Monitoring Mothers-To-Be (NuMoM2b) study were used. Total gestational weight gain was categorized as inadequate, adequate, or excessive based on the 2009 Institute of Medicine guidelines. Outcomes examined included hypertensive disorders of pregnancy, mode of delivery, shoulder dystocia, large for gestational age or small for-gestational age birth weight, and neonatal intensive care unit admission. Results Among 8,628 women, 1,666 (19.3%) had inadequate, 2,945 (34.1%) had adequate, and 4,017 (46.6%) had excessive gestational weight gain. Excessive gestational weight gain was associated with higher odds of hypertensive disorders (adjusted odds ratio [aOR] = 2.05, 95% confidence interval [CI]: 1.78–2.36) Cesarean delivery (aOR = 1.24, 95% CI: 1.09–1.41), and large for gestational age birth weight (aOR = 1.49, 95% CI: 1.23–1.80), but lower odds of small for gestational age birth weight (aOR = 0.59, 95% CI: 0.50–0.71). Conversely, inadequate gestational weight gain was associated with lower odds of hypertensive disorders (aOR = 0.75, 95% CI: 0.62–0.92), Cesarean delivery (aOR = 0.77, 95% CI: 0.65–0.92), and a large for gestational age birth weight (aOR = 0.72, 95% CI: 0.55–0.94), but higher odds of having a small for gestational age birth weight (aOR = 1.64, 95% CI: 1.37–1.96). Conclusion Both excessive and inadequate gestational weight gain are associated with adverse maternal and neonatal outcomes.

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Prepregnancy Body Mass Index, Gestational Weight Gain, and Odds of Cesarean Delivery in Hispanic Women

Cited by 24 publications

References 31 publications

Total and trimester‐specific gestational weight gain and infant anthropometric outcomes at birth and 6 months in low‐income Hispanic families

Total and trimester‐specific gestational weight gain and infant anthropometric outcomes at birth and 6 months in low‐income Hispanic families

Inadequate Weight Gain According to the Institute of Medicine 2009 Guidelines in Women with Gestational Diabetes: Frequency, Clinical Predictors, and the Association with Pregnancy Outcomes

Gestational Weight Gain and Pregnancy Outcomes among Nulliparous Women

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