Maternal and neonatal outcomes in obese women who lose weight during pregnancy

Bauer, Callie Cox; Bernhard, Kiley A.; Greer, Danielle M.; Merrill, David

doi:10.1038/jp.2015.202

Cited by 23 publications

(16 citation statements)

References 25 publications

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“…The current study supports previous studies that have shown maternal health benefits for obese pregnant women who gain less weight than 5 kg or even lose weight [16–18]. Specifically, odds for gestational hypertension, eclampsia, induction of labor and Caesarian section were reduced by the lower GWG.…”

Section: Discussionsupporting

confidence: 90%

An evaluation of whether a gestational weight gain of 5 to 9 kg for obese women optimizes maternal and neonatal health risks

Thompson

2019

BMC Pregnancy Childbirth

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Background Maternal obesity has a wide range of health effects on both the pregnant woman and developing fetus. The clinical significance of these disorders, combined with a dramatically increasing prevalence of obesity among pregnant women has precipitated a major health crisis in the United States. The most commonly used recommendations for gestational weight gain were established by the Institute of Medicine (IOM) in 2009 and have become well known and often adopted. The authors of the IOM report acknowledged that the recommended gestational weight gain of 5 to 9 kg for obese women whose body mass index was greater than 30 kg/m 2 was based on very little empirical evidence. The objective of this study was to evaluate whether a 5 to 9 kg weight gain, for obese women, optimized a set of maternal and neonatal health outcomes. Methods Data containing approximately 12,000,000 birth records were obtained from the United States Natality database for the years 2014 to 2016. A Bayesian modeling approach was used to estimate the controlled direct effects of pre-pregnancy body mass index and gestational weight gain. Results Obese women gaining less than 5 kg during pregnancy had reduced maternal risks for gestational hypertension, eclampsia, induction of labor and Caesarian section. In contrast, maternal gestational weight gain of less than 5 kg was associated with increased risks for multiple adverse neonatal outcomes with macrosomia the exception. Obese women who gained more than 9 kg during pregnancy had increased risk for multiple maternal and neonatal adverse outcomes. Conclusions Obese women who were observed to gain less than 5 kg during gestation had reduced odds of several peripartum disorders. However, this lower gestational weight gain was associated with an increase in multiple risks for the neonate. Electronic supplementary material The online version of this article (10.1186/s12884-019-2273-z) contains supplementary material, which is available to authorized users.

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Section: Discussionsupporting

confidence: 90%

An evaluation of whether a gestational weight gain of 5 to 9 kg for obese women optimizes maternal and neonatal health risks

Thompson

2019

BMC Pregnancy Childbirth

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“…In addition, excessive GWG is related to postpartum weight retention [23]. For these reasons, several studies have argued that for obese pregnant women inadequate weight gain or even weight loss is more appropriate for their lifelong health as long as there are no complications for pregnancy [24, 25]. This study showed that optimal GWG based on IOM recommendations were not likely to be associated with favorable pregnancy outcomes.…”

Section: Discussionmentioning

confidence: 95%

Is it appropriate for Korean women to adopt the 2009 Institute of Medicine recommendations for gestational weight gain?

et al. 2017

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BackgroundThe 2009 Institute of Medicine (IOM) guidelines for gestational weight gain (GWG) are intended for use among women in the United States. Little data are available on whether the 2009 IOM recommendations can be applied to Asian women. This study aimed to evaluate whether the recommendations are related to adverse pregnancy outcomes in Korean pregnant women.Methods and findingsA retrospective cohort study was conducted for all singleton-pregnant women at a university hospital in Korea. After classifying the enrolled women into four Korean pre-pregnancy body mass index (BMI) categories, the risk of adverse pregnancy outcomes were analyzed for women who gained inadequate or excessive GWG based on 2009 IOM recommendations. Of 7,843 pregnancies, 64.0% of women had normal pre-pregnancy BMI and 42.7% achieved optimal GWG. Across all BMI categories, adverse pregnancies outcomes such as small for gestational age (SGA), large for gestational age (LGA), preterm birth, preeclampsia, and cesarean due to dystocia were significantly associated with GWG (all P ≤ 0.001).Women with normal BMI who gained inadequate weight were more likely to develop SGA and preterm birth and less likely to develop LGA (adjusted odds ratio (aOR) 2.21, 1.33, and 0.54, respectively). Whereas, women with normal BMI who gained excessive weight were more likely to develop LGA, preterm birth, preeclampsia, and cesarean section due to dystocia (aOR 2.10, 1.33, 1.37, and 1.37, respectively) and less likely to develop SGA (aOR 0.60).ConclusionsIt is tolerable for Korean women to follow recommended GWG from the 2009 IOM guidelines to decrease adverse pregnancy outcomes. This will be helpful for antenatal care on GWG not only for Korean pregnant women, but also other Asian women who have lower BMI criteria than Caucasian women.

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“…[ 32 – 34 ] Many studies also showed that targeted efforts and effective interventions during pregnancy can improve weight gain trajectories and overall health. [ 35 – 39 ]…”

Section: Discussionmentioning

confidence: 99%

Avoiding excessive pregnancy weight gain to obtain better pregnancy outcomes in Taiwan

Horng

Huang²,

et al. 2018

Medicine

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Pregnancy weight gain may be associated with adverse pregnancy outcomes. The article aims to explore the relationship between weight change and pregnancy outcome in the Taiwanese pregnant women.The retrospective cohort study enrolled women with vertex singleton pregnancy at University-associated Hospital between 2011 and 2014. Pregnancy weight change was separated into 3 groups, based on the Institute of Medicine (IOM) guidelines: below (n = 221); within (n = 544); and above (n = 382). Analysis of variance, χ2 tests, generalized linear models, and logistic regression models were used for statistical comparisons.Pregnant women with weight change above IOM guidelines had a significant increase in both maternal and perinatal complications compared with normal controls (odds ratio [OR] 1.65, 95% confidence interval [CI] 1.03–1.98; P = .043; OR 1.45, 95% CI 1.01–1.87; P = .049, respectively). This finding was not found in pregnant women with weight gain below IOM guidelines. Moreover, age (OR 1.08, 95% CI 1.02–1.15; P = .0011), pre-pregnancy weight (OR 1.04, 95% CI 1.01–1.09; P = .0008), pre-pregnancy body mass index (BMI; OR 1.15, 95% CI 1.06–1.30; P < .0001), weight at the time of delivery (OR 1.05, 95% CI 1.02–1.13; P < .0001) and BMI at the time of delivery (OR 1.15, 95% CI 1.06–1.39; P < .0001), all contributed to increased maternal complications but not perinatal complications, whereas parity (OR 0.23, 95% CI 0.12–0.41; P < .0001) and gestational age (OR 0.50, 95% CI 0.35–0.62; P < .001) were associated with fewer maternal complications.Our study reconfirmed that for Taiwanese pregnant women, the approximate pregnancy weight gain recommended by IOM in 2009 was associated with the fewest maternal and perinatal complications. If approximate pregnancy weight gain cannot be attained, even less weight gain during pregnancy is still reasonable without significantly and adversely affecting maternal and perinatal outcomes in Taiwan.

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Maternal and neonatal outcomes in obese women who lose weight during pregnancy

Cited by 23 publications

References 25 publications

An evaluation of whether a gestational weight gain of 5 to 9 kg for obese women optimizes maternal and neonatal health risks

An evaluation of whether a gestational weight gain of 5 to 9 kg for obese women optimizes maternal and neonatal health risks

Is it appropriate for Korean women to adopt the 2009 Institute of Medicine recommendations for gestational weight gain?

Avoiding excessive pregnancy weight gain to obtain better pregnancy outcomes in Taiwan

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