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Associations of gestational weight loss with birth-related outcome: a retrospective cohort study.
BJOG 2011; 118(1):55-61BJOG

Abstract

OBJECTIVE

Although the prevention of gestational weight loss (GWL) has become a priority for clinicians in the past few decades, recent work has suggested that GWL may be beneficial for obese mothers. We aimed to identify the potential beneficial or adverse associations of GWL with pregnancy outcome stratified by maternal body mass index (BMI) category.

DESIGN

Retrospective cohort study.

SETTING AND POPULATION

Data on 709 575 singleton deliveries in Bavarian obstetric units from 2000-2007 were extracted from a standard dataset for which data are regularly collected for the national benchmarking of obstetric units.

METHODS

We calculated the odds ratios (ORs) for adverse pregnancy outcome by GWL (explanatory variable) compared with nonexcessive weight gain with adjustment for confounders and stratification by BMI category (underweight, BMI < 18.5 kg/m²; normal weight, BMI = 18.5-24.9 kg/m²; overweight, BMI = 25-29.9 kg/m²; obese class I, BMI = 30-34.9 kg/m²; obese class II, BMI = 35-39.9 kg/m²; obese class III, BMI ≥ 40 kg/m²).

MAIN OUTCOME MEASURES

Pre-eclampsia, nonelective caesarean section, preterm delivery, small or large for gestational age (SGA/LGA) birth and perinatal mortality.

RESULTS

GWL was associated with a decreased risk of pregnancy complications, such as pre-eclampsia and nonelective caesarean section, in overweight and obese women [e.g. OR = 0.65 (95% confidence interval: 0.51, 0.83) for nonelective caesarean section in obese class I women]. The risks of preterm delivery and SGA births, by contrast, were significantly higher in overweight and obese class I/II mothers [e.g. OR = 1.68 (95% confidence interval: 1.37, 2.06) for SGA in obese class I women]. In obese class III women, no significantly increased risks of poor outcomes for infants were observed.

CONCLUSIONS

The association of GWL with a decreased risk of pregnancy complications appears to be outweighed by increased risks of prematurity and SGA in all but obese class III mothers.

Authors+Show Affiliations

Institute of Social Paediatrics and Adolescent Medicine, Division of Epidemiology, Ludwig-Maximilians University of Munich, Munich, Germany. andreas.beyerlein@med.uni-muenchen.deNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

21054761

Citation

Beyerlein, A, et al. "Associations of Gestational Weight Loss With Birth-related Outcome: a Retrospective Cohort Study." BJOG : an International Journal of Obstetrics and Gynaecology, vol. 118, no. 1, 2011, pp. 55-61.
Beyerlein A, Schiessl B, Lack N, et al. Associations of gestational weight loss with birth-related outcome: a retrospective cohort study. BJOG. 2011;118(1):55-61.
Beyerlein, A., Schiessl, B., Lack, N., & von Kries, R. (2011). Associations of gestational weight loss with birth-related outcome: a retrospective cohort study. BJOG : an International Journal of Obstetrics and Gynaecology, 118(1), pp. 55-61. doi:10.1111/j.1471-0528.2010.02761.x.
Beyerlein A, et al. Associations of Gestational Weight Loss With Birth-related Outcome: a Retrospective Cohort Study. BJOG. 2011;118(1):55-61. PubMed PMID: 21054761.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Associations of gestational weight loss with birth-related outcome: a retrospective cohort study. AU - Beyerlein,A, AU - Schiessl,B, AU - Lack,N, AU - von Kries,R, Y1 - 2010/11/04/ PY - 2010/11/9/entrez PY - 2010/11/9/pubmed PY - 2011/2/3/medline SP - 55 EP - 61 JF - BJOG : an international journal of obstetrics and gynaecology JO - BJOG VL - 118 IS - 1 N2 - OBJECTIVE: Although the prevention of gestational weight loss (GWL) has become a priority for clinicians in the past few decades, recent work has suggested that GWL may be beneficial for obese mothers. We aimed to identify the potential beneficial or adverse associations of GWL with pregnancy outcome stratified by maternal body mass index (BMI) category. DESIGN: Retrospective cohort study. SETTING AND POPULATION: Data on 709 575 singleton deliveries in Bavarian obstetric units from 2000-2007 were extracted from a standard dataset for which data are regularly collected for the national benchmarking of obstetric units. METHODS: We calculated the odds ratios (ORs) for adverse pregnancy outcome by GWL (explanatory variable) compared with nonexcessive weight gain with adjustment for confounders and stratification by BMI category (underweight, BMI < 18.5 kg/m²; normal weight, BMI = 18.5-24.9 kg/m²; overweight, BMI = 25-29.9 kg/m²; obese class I, BMI = 30-34.9 kg/m²; obese class II, BMI = 35-39.9 kg/m²; obese class III, BMI ≥ 40 kg/m²). MAIN OUTCOME MEASURES: Pre-eclampsia, nonelective caesarean section, preterm delivery, small or large for gestational age (SGA/LGA) birth and perinatal mortality. RESULTS: GWL was associated with a decreased risk of pregnancy complications, such as pre-eclampsia and nonelective caesarean section, in overweight and obese women [e.g. OR = 0.65 (95% confidence interval: 0.51, 0.83) for nonelective caesarean section in obese class I women]. The risks of preterm delivery and SGA births, by contrast, were significantly higher in overweight and obese class I/II mothers [e.g. OR = 1.68 (95% confidence interval: 1.37, 2.06) for SGA in obese class I women]. In obese class III women, no significantly increased risks of poor outcomes for infants were observed. CONCLUSIONS: The association of GWL with a decreased risk of pregnancy complications appears to be outweighed by increased risks of prematurity and SGA in all but obese class III mothers. SN - 1471-0528 UR - https://www.unboundmedicine.com/medline/citation/21054761/Associations_of_gestational_weight_loss_with_birth_related_outcome:_a_retrospective_cohort_study_ L2 - https://doi.org/10.1111/j.1471-0528.2010.02761.x DB - PRIME DP - Unbound Medicine ER -