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Gestational weight gain and adverse pregnancy outcomes in a nulliparous cohort.
Eur J Obstet Gynecol Reprod Biol. 2013 Apr; 167(2):149-53.EJ

Abstract

OBJECTIVE

Excessive gestational weight gain (GWG) is an important contributing factor to the obesity epidemic in women and is associated with pregnancy complications. We investigated the relationship between GWG and caesarean delivery in labour, large for gestational age (LGA), small for gestational age (SGA) infants and pregnancy-induced hypertension by maternal pre-pregnancy body mass index (BMI) in a contemporary nulliparous cohort.

STUDY DESIGN

Using 2009 Institute of Medicine guidelines, participants in the SCOPE study (from Cork, Ireland, Auckland, New Zealand and Adelaide, Australia) were classified into GWG categories (low, normal and high) according to pre-pregnancy BMI. Maternal characteristics and pregnancy outcomes were compared between weight gain categories. SGA and LGA were defined as <10th and >90th customised birthweight centile. Multivariable analysis adjusted for confounding factors that impact on GWG including BMI.

RESULTS

Of 1950 participants, 17.2% (n=335) achieved the recommended GWG, 8.6% (n=167) had low and 74.3% (n=1448) had high GWG. Women with high GWG had increased rates of LGA infants [adjusted OR 4.45 (95% CI 2.49-7.99)] and caesarean delivery in labour [aOR 1.46 (1.03-2.07)]. SGA was increased in women with low GWG [aOR 1.79 (1.06-3.00)].

CONCLUSION

Three quarters of participants had high GWG, which was associated with an independent risk of LGA infants and caesarean in labour. Low GWG was associated with SGA infants. These adverse outcomes are potentially modifiable by achievement of normal GWG, which should be an important focus of antenatal care.

Authors+Show Affiliations

Department of Obstetrics and Gynaecology, Private Bag 92019, University of Auckland, Auckland, New Zealand.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Clinical Trial
Journal Article
Multicenter Study
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

23266206

Citation

Chung, Jenny G Y., et al. "Gestational Weight Gain and Adverse Pregnancy Outcomes in a Nulliparous Cohort." European Journal of Obstetrics, Gynecology, and Reproductive Biology, vol. 167, no. 2, 2013, pp. 149-53.
Chung JG, Taylor RS, Thompson JM, et al. Gestational weight gain and adverse pregnancy outcomes in a nulliparous cohort. Eur J Obstet Gynecol Reprod Biol. 2013;167(2):149-53.
Chung, J. G., Taylor, R. S., Thompson, J. M., Anderson, N. H., Dekker, G. A., Kenny, L. C., & McCowan, L. M. (2013). Gestational weight gain and adverse pregnancy outcomes in a nulliparous cohort. European Journal of Obstetrics, Gynecology, and Reproductive Biology, 167(2), 149-53. https://doi.org/10.1016/j.ejogrb.2012.11.020
Chung JG, et al. Gestational Weight Gain and Adverse Pregnancy Outcomes in a Nulliparous Cohort. Eur J Obstet Gynecol Reprod Biol. 2013;167(2):149-53. PubMed PMID: 23266206.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Gestational weight gain and adverse pregnancy outcomes in a nulliparous cohort. AU - Chung,Jenny G Y, AU - Taylor,Rennae S, AU - Thompson,John M D, AU - Anderson,Ngaire H, AU - Dekker,Gustaaf A, AU - Kenny,Louise C, AU - McCowan,Lesley M E, AU - ,, Y1 - 2012/12/23/ PY - 2012/09/11/received PY - 2012/11/13/revised PY - 2012/11/28/accepted PY - 2012/12/26/entrez PY - 2012/12/26/pubmed PY - 2013/9/10/medline SP - 149 EP - 53 JF - European journal of obstetrics, gynecology, and reproductive biology JO - Eur J Obstet Gynecol Reprod Biol VL - 167 IS - 2 N2 - OBJECTIVE: Excessive gestational weight gain (GWG) is an important contributing factor to the obesity epidemic in women and is associated with pregnancy complications. We investigated the relationship between GWG and caesarean delivery in labour, large for gestational age (LGA), small for gestational age (SGA) infants and pregnancy-induced hypertension by maternal pre-pregnancy body mass index (BMI) in a contemporary nulliparous cohort. STUDY DESIGN: Using 2009 Institute of Medicine guidelines, participants in the SCOPE study (from Cork, Ireland, Auckland, New Zealand and Adelaide, Australia) were classified into GWG categories (low, normal and high) according to pre-pregnancy BMI. Maternal characteristics and pregnancy outcomes were compared between weight gain categories. SGA and LGA were defined as <10th and >90th customised birthweight centile. Multivariable analysis adjusted for confounding factors that impact on GWG including BMI. RESULTS: Of 1950 participants, 17.2% (n=335) achieved the recommended GWG, 8.6% (n=167) had low and 74.3% (n=1448) had high GWG. Women with high GWG had increased rates of LGA infants [adjusted OR 4.45 (95% CI 2.49-7.99)] and caesarean delivery in labour [aOR 1.46 (1.03-2.07)]. SGA was increased in women with low GWG [aOR 1.79 (1.06-3.00)]. CONCLUSION: Three quarters of participants had high GWG, which was associated with an independent risk of LGA infants and caesarean in labour. Low GWG was associated with SGA infants. These adverse outcomes are potentially modifiable by achievement of normal GWG, which should be an important focus of antenatal care. SN - 1872-7654 UR - https://www.unboundmedicine.com/medline/citation/23266206/Gestational_weight_gain_and_adverse_pregnancy_outcomes_in_a_nulliparous_cohort_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0301-2115(12)00541-6 DB - PRIME DP - Unbound Medicine ER -