Citation
Catalano, Patrick M.; Mele, Lisa; Landon, Mark B.; Ramin, Susan M.; Reddy, Uma M.; Casey, Brian M.; Wapner, Ronald J.; Varner, Michael W.; Rouse, Dwight J.; & Thorp, John M., Jr., et al. (2014). Inadequate Weight Gain in Overweight and Obese Pregnant Women: What Is the Effect on Fetal Growth?. American Journal of Obstetrics & Gynecology, 211(2), 137.e1–7. PMCID: PMC4117705Abstract
OBJECTIVE: To evaluate inadequate gestational weight gain and fetal growth among overweight and obese women (O/O).STUDY DESIGN: Analysis of prospective singleton term pregnancies in which 1053 O/O gained greater (14.4+/- 6.2 kg) or 188 who either lost or gained <5 kg (1.1+/- 4.4 kg). Birth weight, fat(FM) and lean mass (LM) were assessed using anthropometry. Small for gestational age (SGA) was defined as < 10th percentile of a standard US population. Univariable and multivariable analysis evaluated the association between weight change and neonatal morphometry.
RESULTS: There was no significant difference in age, race, smoking, parity, or gestational age between groups. Weight loss or gain = 5 kg was associated with SGA, 18/188 (9.6%) vs. 51/1053 (4.9%); (adjusted OR 2.6, 95% CI 1.4, 4.7; p=0.003). Neonates of women who lost or gained = 5 kg had lower birth weight (3258 +/- 443 g vs. 3467 +/- 492g, p<0.0001), FM (403+/-175 vs. 471 +/- 193g, p<0.0001), LM (2855+/-321 vs. 2995 +/- 347g, p<0.0001) and smaller length, %FM and head circumference (HC). Adjusting for diabetic status, pre-pregnancy BMI, smoking, parity, study site, gestational age and gender; neonates of women who gained = 5 kg had significantly lower birth weight, LBM, FM, %FM, HC and length. There were no significant differences in neonatal outcomes between those who lost weight and those who gained < 5 kg.
CONCLUSION: In O/O weight loss or gain < 5 kg is associated with increased risk of SGA and decreased neonatal FM, LM and HC.
URL
http://dx.doi.org/10.1016/j.ajog.2014.02.004Reference Type
Journal ArticleYear Published
2014Journal Title
American Journal of Obstetrics & GynecologyAuthor(s)
Catalano, Patrick M.Mele, Lisa
Landon, Mark B.
Ramin, Susan M.
Reddy, Uma M.
Casey, Brian M.
Wapner, Ronald J.
Varner, Michael W.
Rouse, Dwight J.
Thorp, John M., Jr.
Saade, George R.
Sorokin, Yoram
Peaceman, Alan M.
Tolosa, Jorge E., for the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) Maternal-Fetal Medicine Units (MFMU) Network