Prepregnancy Body Mass Index as a Significant Predictor of Total Gestational Weight Gain and Birth Weight
Publication: Canadian Journal of Dietetic Practice and Research
1 February 2017
Abstract
Purpose: We aimed to describe adherence to gestational weight gain (GWG) recommendations and identify determinants of excessive GWG in a sample of women from Quebec, Canada.
Methods: Data were collected from the multi-centre 3D (Design, Develop, Discover) pregnancy cohort study, which included women who delivered between May 2010 and August 2012 at 9 obstetrical hospitals in Quebec, Canada. GWG was calculated for 1145 women and compared to the 2009 Institute of Medicine (IOM) recommendations.
Results: Overall, 51% of participants exceeded the recommendations. Approximately 68% of women with obesity gained weight in excess of the IOM recommendations. The corresponding numbers were 75%, 44%, and 27% in overweight, normal weight, and underweight women, respectively. A prepregnancy BMI of 25 kg/m2 or more was the only significant predictor of exceeding GWG recommendations (OR 3.35, 95% CI 2.44–4.64) in a multivariate model. Birth weight was positively associated with GWG. GWG and prepregnancy BMI could explain 3.13% and 2.46% of the variance in birth weight, respectively.
Conclusion: About half of women exceeded GWG recommendations, and this was correlated with infant birth weight. This reinforces the need to develop and evaluate strategies, including nutritional interventions, for pregnant women to achieve optimal GWG.
Résumé
Objectif : Notre objectif était de décrire l’adhésion aux recommandations relatives au gain de poids gestationnel (GPG) et d’identifier les déterminants d’un GPG excessif dans un échantillon de femmes du Québec (Canada).
Méthodes : Les données ont été recueillies au sein de l’étude multicentrique 3D (Découvrir, Développer, Devenir), une étude de cohorte de grossesses qui incluait des femmes ayant accouché entre mai 2010 et août 2012 dans neuf hôpitaux obstétriques du Québec. Le GPG a été calculé pour 1 145 femmes et comparé aux recommandations de 2009 de l’Institute of Medicine (IOM).
Résultats : Dans l’ensemble, 51 % des participantes ont dépassé les recommandations. Environ 68 % des femmes obèses ont pris du poids au-delà des recommandations de l’IOM. Les chiffres correspondants étaient de 75 %, 44 % et 27 % pour les femmes en excès de poids, ayant un poids normal et en insuffisance pondérale, respectivement. Un IMC prégrossesse de 25 kg/m2 ou plus était le seul prédicteur significatif du dépassement du GPG recommandé (RC 3,35, IC à 95 %, 2,44–4,64) dans un modèle multivarié. Le poids de naissance était positivement associé au GPG. Le GPG et l’IMC prégrossesse pourraient expliquer 3,13 % et 2,46 % de la variance dans le poids de naissance, respectivement.
Conclusions : Environ la moitié des femmes ont dépassé les recommandations de GPG, ce qui était associé avec le poids de naissance du nouveau-né. Ces résultats renforcent la nécessité d’élaborer et d’évaluer des stratégies, notamment des interventions en nutrition, pour les femmes enceintes afin d’atteindre à un GPG optimal.
Get full access to this article
View all available purchase options and get full access to this article.
Sources of financial support: The 3D cohort study was conducted as part of the research programme of the Integrated Research Network in Perinatology of Quebec and Eastern Ontario (IRNPQEO). This work was supported by the Canadian Institutes of Health Research [CRI 88413]. ASM was the recipient of a postdoctoral fellowship from the FRSQ.
Conflicts of interest: The authors declare they have no actual or potential competing financial interests
References
1
Gunderson EP.Childbearing and obesity in females: weight before, during, and after pregnancy. Obstet Gynecol Clin North Am.2009;36(2):317–32-ix.
2
Kerrigan AM and Kingdon C.Maternal obesity and pregnancy: a retrospective study. Midwifery. 2010;26(1):138–46.
3
Gilmore LA, Klempel-Donchenko M, and Redman LM.Pregnancy as a window to future health: excessive gestational weight gain and obesity. Semin Perinatol.2015;39(4):296–303.
4
Cheng YW, Chung JH, Kurbisch-Block I, Inturrisi M, Shafer S, and Caughey AB.Gestational weight gain and gestational diabetes mellitus: perinatal outcomes. Obstet Gynecol. 2008;112(5):1015–22.
5
Langford A, Joshu C, Chang JJ, Myles T, and Leet T.Does gestational weight gain affect the risk of adverse maternal and infant outcomes in overweight females?Matern Child Health J. 2011;15(7):860–5.
6
Ma D, Szeto IM, Yu K, Ning Y, Li W, and Wang J, et al.Association between gestational weight gain according to prepregnancy body mass index and short postpartum weight retention in postpartum females. Clin Nutr. 2015;34(2):291–5.
7
Groth SW, Holland ML, Kitzman H, and Meng Y.Gestational weight gain of pregnant African American adolescents affects body mass index 18 years later. J Obstet Gynecol Neonatal Nurs. 2013;42(5):541–50.
8
Satpathy HK, Fleming A, Frey D, Barsoom M, Satpathy C, and Khandalavala J.Maternal obesity and pregnancy. Postgrad Med. 2008;120(3):E01–9.
9
Yogev Y and Visser GH.Obesity, gestational diabetes and pregnancy outcome. Semin Fetal Neonatal Med. 2009;14(2):77–84.
10
Stothard KJ, Tennant PW, Bell R, and Rankin J.Maternal overweight and obesity and the risk of congenital anomalies: a systematic review and meta-analysis. JAMA. 2009;301(6):636–50.
11
Institute of Medicine. Weight gain recommendations: reexamining the guidelines. Committee to Reexamine IOM Pregnancy Weight Guidelines. Institute of Medicine, National Research Council. Washington, DC: National Academy Press; 2009.
12
Ferraro ZM, Barrowman N, Prud’homme D, Walker M, Wen SW, and Rodger M, et al.Excessive gestational weight gain predicts large for gestational age neonates independent of maternal body mass index. J Matern Fetal Neonatal Med. 2012;25(5):538–42.
13
Deputy NP, Sharma AJ, and Kim SY.Gestational weight gain — United States, 2012 and 2013. Morb Mortal Wkly Rep. 2015;64(43):1215–20.
14
Kinnunen TI, Luoto R, Gissler M, and Hemminki E.Pregnancy weight gain from 1960s to 2000 in Finland. Int J Obes Relat Metab Disord. 2003;27(12):1572–77.
15
Dzakpasu S, Fahey J, Kirby RS, Tough SC, Chalmers B, and Heaman MI, et al.Contribution of prepregnancy body mass index and gestational weight gain to adverse neonatal outcomes: population attributable fractions for Canada. BMC Pregnancy Childbirth. 2015;15:21.
16
Kowal C, Kuk J, and Tamim H.Characteristics of weight gain in pregnancy among Canadian women. Matern Child Health J. 2012;16(3):668–76.
17
Abbasalizad Farhangi M.Gestational weight gain and its related social and demographic factors in health care settings of rural and urban areas in northwest Iran. Ecol Food Nutr. 2016;55(3):258–65.
18
Huynh M, Borrell LN, and Chambers EC.Maternal education and excessive gestational weight gain in New York city, 1999–2001: the effect of race/ethnicity and neighborhood socioeconomic status. Matern Child Health J. 2014;18(1):138–45.
19
Fraser W, Shapiro G, Audibert F, Dubois L, Pasquier J-C, and Julien P, et al.3D cohort study: the integrated research network in perinatology of Quebec and eastern Ontario (IRNPQEO). Paediatr Perinat Epi. 2016 Nov;30(6):623–632.
20
Douketis JD, Paradis G, Keller H, and Martineau C.Canadian guidelines for body weight classification in adults: application in clinical practice to screen for overweight and obesity and to assess disease risk. CMAJ. 2005;172(8):995–98.
21
Berger H, Crane J, Farine D, Armson A, De La RS, and Keenan-Lindsay L, et al.Screening for gestational diabetes mellitus. J Obstet Gynaecol Can. 2002;24(11):894–903.
22
Canadian Diabetes Association. Canadian Diabetes Association 2008 clinical practice guidelines for the prevention and management of diabetes in Canada. Can J Diabetes. 2008;32(2008):S1–201.
23
Kramer MS, Platt RW, Wen SW, Joseph KS, Allen A, and Abrahamowicz M, et al.A new and improved population-based Canadian reference for birth weight for gestational age. Pediatrics. 2001;108(2):E35.
24
Li C, Liu Y, and Zhang W.Joint and independent associations of gestational weight gain and pre-pregnancy body mass index with outcomes of pregnancy in Chinese females: a retrospective cohort study. PloS ONE. 2015;10(8):e0136850.
25
Godoy AC, Nascimento SL, and Surita FG.A systematic review and meta-analysis of gestational weight gain recommendations and related outcomes in Brazil. Clinics (Sao Paulo).2015;70(11):758–64.
26
Koleilat M and Whaley SE.Trends and predictors of excessive gestational weight gain among hispanic WIC participants in Southern California. Matern Child Health J.2013;17(8):1399–404.
27
Hernandez DC.Gestational weight gain as a predictor of longitudinal body mass index transitions among socioeconomically disadvantaged females. J Females’s Health (Larchmt). 2012;21(10):1082–90.
28
Mehta UJ, Siega-Riz AM, and Herring AH.Effect of body image on pregnancy weight gain. Matern Child Health J. 2011;15(3):324–32.
29
Holowko N, Mishra G, and Koupil I.Social inequality in excessive gestational weight gain. Int J Obes (Lond). 2013;38(1):91–6.
30
Hunt KJ, Alanis MC, Johnson ER, Mayorga ME, and Korte JE.Maternal pre-pregnancy weight and gestational weight gain and their association with birthweight with a focus on racial differences. Matern Child Health J. 2013;17(1):85–94.
31
Starling AP, Brinton JT, Glueck DH, Shapiro AL, Harrod CS, and Lynch AM, et al.Associations of maternal BMI and gestational weight gain with neonatal adiposity in the Healthy Start study. Am J Clin Nutr. 2015;101(2):302–9.
32
Camacho-Buenrostro D, Perez-Molina JJ, Vasquez-Garibay EM, and Panduro-Baron JG.The association between pre-pregnancy obesity and weight gain in pregnancy, with growth deviations in newborns. Nutr Hosp. 2015;32(1):124–9.
33
Fraser A, Tilling K, Macdonald-Wallis C, Hughes R, Sattar N, and Nelson SM, et al.Associations of gestational weight gain with maternal body mass index, waist circumference, and blood pressure measured 16 y after pregnancy: the Avon Longitudinal Study of Parents and Children (ALSPAC). Am J Clin Nutr.2011;93(6):1285–92.
34
Nehring I, Schmoll S, Beyerlein A, Hauner H, and von Kries R.Gestational weight gain and long-term postpartum weight retention: a meta-analysis. Am J Clin Nutr.2011;94(5):1225–31.
35
Chu SY, Callaghan WM, Bish CL, and D’Angelo D.Gestational weight gain by body mass index among U.S. females delivering live births, 2004–2005: fueling future obesity. Am J Obst Gynecol.2009;200(3):271–271.e7.
36
Nutrition Working Group, O’Connor DL, Blake J, Bell R, Bowen A, and Callum J, et al.Canadian consensus on female nutrition: adolescence, reproduction, menopause, and beyond. J Obstet Gynaecol Can.2016;38(6):508–554.e18.
37
Dipietro JA, Millet S, Costigan KA, Gurewitsch E, and Caulfield LE.Psychosocial influences on weight gain attitudes and behaviors during pregnancy. J Am Diet Assoc.2003;103(10):1314–19.
38
Shin D, Chung H, Weatherspoon L, and Song WO.Validity of prepregnancy weight status estimated from self-reported height and weight. Matern Child Health J.2014;18(7):1667–74.
Information & Authors
Information
Published In
Canadian Journal of Dietetic Practice and Research
Volume 78 • Number 2 • June 2017
Pages: 66 - 73
History
Version of record online: 1 February 2017
Copyright
© 2017.
Authors
Metrics & Citations
Metrics
Other Metrics
Citations
Cite As
Anne-SophieMorissetRD, PhD, LiseDuboisRD, PhD, Cynthia K.ColapintoRD, PhD, Zong-ChenLuoPhD, and William D.FraserMD. 2017. Prepregnancy Body Mass Index as a Significant Predictor of Total Gestational Weight Gain and Birth Weight. Canadian Journal of Dietetic Practice and Research.
78(2): 66-73. https://doi.org/10.3148/cjdpr-2016-035
Export Citations
If you have the appropriate software installed, you can download article citation data to the citation manager of your choice. Simply select your manager software from the list below and click Download.
Cited by
1. Evaluation of the Olo Prenatal Nutrition Follow-up Care for Vulnerable Pregnant Women
2. Weight Changes and Body Image in Pregnant Women: A Challenge for Health Care Professionals
View Options
Get Access
Login options
Check if you access through your login credentials or your institution to get full access on this article.
Subscribe
Click on the button below to subscribe to Canadian Journal of Dietetic Practice and Research
