Background: Gestational weight gain (GWG) is known to be a potential risk factor for short-term postpartum weight retention (PPWR) and thus for overweight in women. Does GWG also determine the long-term risk of overweight in women? Objective: We aimed to study the short-and long-term effects of GWG in accordance with the Institute of Medicine (IOM) recommendations on postpartum weight retention. Design: We systematically reviewed 5 databases and bibliographies of various publications supplemented by hand search for relevant articles published in English or German and performed meta-analyses to quantify the effect estimate of PPWR by using a random-effects model. We split the data into 4 categories of follow-up: ,0.5, 0.5-1, ;3, and 15 y. Results: Of 1770 search hits, 9 observational studies remained suitable for the analysis. PPWR increased after longer time spans after delivery irrespective of whether GWG had been below, within, or above the guidelines. Compared with women with GWG within the recommendations, those with a GWG above the recommendations retained an additional 3.06 kg (95% CI: 1.50, 4.63 kg) after 3 y and 4.72 kg (95% CI: 2.94, 6.50 kg) on average after 15 y postpartum. Inadequate GWG was associated with less PPWR (22.99 kg; 95% CI: 23.72, 22.27 kg) ,6 mo after pregnancy. This association faded over time and became nonsignificant (21.41 kg; 95% CI: 23.03, 0.21 kg) after 15 y. The results remained stable in sensitivity analyses that accounted for changes in IOM criteria over time and potential effect modification by low social class. A funnel plot did not suggest publication bias. Conclusion: GWG in accordance with the IOM recommendations is associated with long-term effects on PPWR.Am J Clin Nutr 2011;94:1225-31.
The postulated increased risk of overweight and abdominal adiposity in offspring of mothers with gestational diabetes cannot be explained by maternal BMI alone and may be stronger for childhood obesity than for overweight.
Aims/hypothesis Excessive gestational weight gain (GWG) may be a risk factor for gestational diabetes mellitus (GDM). We aimed to study the association between excessive GWG (defined according to Institute of Medicine recommendations) prior to GDM screening, and GDM. Methods We systematically searched four electronic databases from 1990 until September 2014 for observational studies published in English or German that reported an association between excessive GWG and GDM as the outcome. Random effects meta-analyses were performed to provide a pooled estimate of the OR comparing the risk of GDM in women with and without excessive GWG. Results A total of eight studies involving 13,748 participants were included. The pooled analysis of unadjusted OR yielded a summary OR of 1.40 (95% CI 1.21, 1.61; p<0.001) with low between-study heterogeneity (I 2 =16.7%). A sensitivity analysis based on four studies reporting adjusted effect estimates revealed similar results (OR 1.42; 95% CI 1.20, 1.68; p<0.001; I 2 =0%). No evidence was found that the effect of GWG on GDM differs depending on maternal pre-pregnancy BMI category. A funnel plot did not indicate substantial publication bias. Conclusions/interpretation Avoiding excessive weight gain in pregnancy prior to the GDM screening test may be a potential strategy to reduce GDM risk. Meta-analysis registration www.crd.york.ac.uk/PROSPERO CRD42014008802
These data provide evidence for at least a 21% risk for childhood overweight related to excessive GWG. Therefore, further efforts to design appropriate interventions against excessive GWG may appear warranted.
Our data suggest EF to be neither a risk factor nor beneficial for growth, recovery or persistence of AN and the occurrence of psychiatric comorbidities.
IntroductionPrevious studies suggested potential priming effects of gestational weight gain (GWG) on offspring’s body composition in later life. However, consistency of these effects in normal weight, overweight and obese mothers is less clear.MethodsWe combined the individual data of three German cohorts and assessed associations of total and excessive GWG (as defined by criteria of the Institute of Medicine) with offspring’s mean body mass index (BMI) standard deviation scores (SDS) and overweight at the age of 5–6 years (total: n = 6,254). Quantile regression was used to examine potentially different effects on different parts of the BMI SDS distribution. All models were adjusted for birth weight, maternal age and maternal smoking during pregnancy and stratified by maternal pre-pregnancy weight status.ResultsIn adjusted models, positive associations of total and excessive GWG with mean BMI SDS and overweight were observed only in children of non- overweight mothers. For example, excessive GWG was associated with a mean increase of 0.08 (95% CI: 0.01, 0.15) units of BMI SDS (0.13 (0.02, 0.24) kg/m2 of ‘real’ BMI) in children of normal-weight mothers. The effects of total and excessive GWG on BMI SDS increased for higher- BMI children of normal-weight mothers.DiscussionIncreased GWG is likely to be associated with overweight in offspring of non-overweight mothers.
On the basis of second-trimester-specific guidelines, inadequate GWG can be predicted in underweight and normal-weight mothers, whereas excessive GWG can be predicted in overweight and obese mothers. Therefore, it appears possible to identify women at risk of gaining outside of the guideline as early as the second trimester.
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