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Associations Between Maternal Body Mass Index, Gestational Weight Gain, Maternal Complications, and Birth Outcome in Singleton, Term Births in a Largely Non-Hispanic White, Rural Population.
J Womens Health (Larchmt). 2019 11; 28(11):1563-1568.JW

Abstract

Background:

In 2009, the Institute of Medicine (IOM) published guidance on gestational weight gain (GWG) modified by body mass index (BMI). GWG outside of IOM recommendations negatively affects birth outcomes and child health. This study examined the relationship between BMI, GWG, birth complications, and birth outcomes in a rural, non-Hispanic white population over 10 years. Materials and

Methods:

We examined maternal BMI, GWG, birth weight, birth complications, and Apgar score in 18,217 term singleton births from medical records at Geisinger, PA from 2006 to 2015. Primary outcomes were GWG, delivery mode, Apgar score, and infant birth weight.

Results:

A majority of women (74.2%) had GWG outside of recommendations. Prevalence of cesarean delivery was highest for women with GWG above recommendations regardless of BMI. One in five neonates of obese women with GWG above recommendations had Apgar scores below eight. Although most births were normal for gestational age (88%), underweight women who gained below recommendations had the highest percentage of small for gestational age (SGA) births (10.4%) and obese women who gained above recommendations had the highest percentage of large for gestational age (LGA) births (22.2%). Among women with BMIs above 35 kg/m2 and GWG within recommendations, 18.9% of births were LGA.

Conclusions:

Most pregnant women are not gaining weight within recommendations. GWG outside of IOM recommendations resulted in poorer birth outcomes, particularly in underweight and obese women. Underweight women with GWG below recommendations are at increased risk for SGA neonates. We suggest reducing GWG recommendations for women above 35 kg/m2 to decrease LGA births and pregnancy complications.

Authors+Show Affiliations

Research Department, American College of Obstetricians and Gynecologists, Washington, District of Columbia. Smithsonian National Zoo and Conservation Biology Institute, Washington, District of Columbia.Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Geisinger, Danville, Pennsylvania.Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Geisinger, Danville, Pennsylvania.Division of Research, Health Resources and Services Administration, Maternal and Child Health Bureau, Office of Epidemiology and Research, Rockville, Maryland.Research Department, American College of Obstetricians and Gynecologists, Washington, District of Columbia. Department of Obstetrics and Gynecology, University of Washington School of Medicine, Seattle, Washington.

Pub Type(s)

Journal Article
Research Support, U.S. Gov't, P.H.S.

Language

eng

PubMed ID

31038373

Citation

Power, Michael L., et al. "Associations Between Maternal Body Mass Index, Gestational Weight Gain, Maternal Complications, and Birth Outcome in Singleton, Term Births in a Largely Non-Hispanic White, Rural Population." Journal of Women's Health (2002), vol. 28, no. 11, 2019, pp. 1563-1568.
Power ML, Lott ML, Mackeen AD, et al. Associations Between Maternal Body Mass Index, Gestational Weight Gain, Maternal Complications, and Birth Outcome in Singleton, Term Births in a Largely Non-Hispanic White, Rural Population. J Womens Health (Larchmt). 2019;28(11):1563-1568.
Power, M. L., Lott, M. L., Mackeen, A. D., DiBari, J. N., & Schulkin, J. (2019). Associations Between Maternal Body Mass Index, Gestational Weight Gain, Maternal Complications, and Birth Outcome in Singleton, Term Births in a Largely Non-Hispanic White, Rural Population. Journal of Women's Health (2002), 28(11), 1563-1568. https://doi.org/10.1089/jwh.2018.7531
Power ML, et al. Associations Between Maternal Body Mass Index, Gestational Weight Gain, Maternal Complications, and Birth Outcome in Singleton, Term Births in a Largely Non-Hispanic White, Rural Population. J Womens Health (Larchmt). 2019;28(11):1563-1568. PubMed PMID: 31038373.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Associations Between Maternal Body Mass Index, Gestational Weight Gain, Maternal Complications, and Birth Outcome in Singleton, Term Births in a Largely Non-Hispanic White, Rural Population. AU - Power,Michael L, AU - Lott,Melisa L, AU - Mackeen,A Dhanya, AU - DiBari,Jessica N, AU - Schulkin,Jay, Y1 - 2019/04/30/ PY - 2019/5/1/pubmed PY - 2020/7/21/medline PY - 2019/5/1/entrez KW - birth weight KW - obesity KW - obstetrics KW - pregnancy SP - 1563 EP - 1568 JF - Journal of women's health (2002) JO - J Womens Health (Larchmt) VL - 28 IS - 11 N2 - Background: In 2009, the Institute of Medicine (IOM) published guidance on gestational weight gain (GWG) modified by body mass index (BMI). GWG outside of IOM recommendations negatively affects birth outcomes and child health. This study examined the relationship between BMI, GWG, birth complications, and birth outcomes in a rural, non-Hispanic white population over 10 years. Materials and Methods: We examined maternal BMI, GWG, birth weight, birth complications, and Apgar score in 18,217 term singleton births from medical records at Geisinger, PA from 2006 to 2015. Primary outcomes were GWG, delivery mode, Apgar score, and infant birth weight. Results: A majority of women (74.2%) had GWG outside of recommendations. Prevalence of cesarean delivery was highest for women with GWG above recommendations regardless of BMI. One in five neonates of obese women with GWG above recommendations had Apgar scores below eight. Although most births were normal for gestational age (88%), underweight women who gained below recommendations had the highest percentage of small for gestational age (SGA) births (10.4%) and obese women who gained above recommendations had the highest percentage of large for gestational age (LGA) births (22.2%). Among women with BMIs above 35 kg/m2 and GWG within recommendations, 18.9% of births were LGA. Conclusions: Most pregnant women are not gaining weight within recommendations. GWG outside of IOM recommendations resulted in poorer birth outcomes, particularly in underweight and obese women. Underweight women with GWG below recommendations are at increased risk for SGA neonates. We suggest reducing GWG recommendations for women above 35 kg/m2 to decrease LGA births and pregnancy complications. SN - 1931-843X UR - https://www.unboundmedicine.com/medline/citation/31038373/Associations_Between_Maternal_Body_Mass_Index_Gestational_Weight_Gain_Maternal_Complications_and_Birth_Outcome_in_Singleton_Term_Births_in_a_Largely_Non_Hispanic_White_Rural_Population_ L2 - https://www.liebertpub.com/doi/10.1089/jwh.2018.7531?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -