Gestational Weight Gain and Body Mass Index in Children: Results from Three German Cohort Studies

Beyerlein, Andreas; Nehring, Ina; Rzehak, Peter; Heinrich, Joachim; Müller, Manfred J.; Plachta-Danielzik, Sandra; Wabitsch, Martin; Weck, Melanie N.; Brenner, Hermann; Rothenbacher, Dietrich; Kries, Rüdiger von

doi:10.1371/journal.pone.0033205

Cited by 31 publications

(43 citation statements)

References 33 publications

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“…Inaccurate or unsafe ideas about ways to contain gestational weight may contribute to the increasing frequency of excess GWG. Avoiding excess GWG is important for women in the long term [20], is associated with better perinatal outcome [4,21-23] and appears to reduce inter-generational transmission of obesity [24] but is not usual. More than half of overweight pregnant women gain in excess of that recommended by the IOM [20,25,26] and this trend is increasing rather than abating [27,28].…”

Section: Discussionmentioning

confidence: 99%

Pregnant women’s knowledge of weight, weight gain, complications of obesity and weight management strategies in pregnancy

et al. 2013

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BackgroundObesity is increasingly common in the obstetric population. Maternal obesity and excess gestational weight gain (GWG) are associated with increased perinatal risk. There is limited published data demonstrating the level of pregnant women’s knowledge regarding these problems, their consequences and management strategies.We aimed to assess the level of knowledge of pregnant women regarding: (i) their own weight and body mass index (BMI) category, (ii) awareness of guidelines for GWG, (iii) concordance of women’s own expectations with guidelines, (iv) knowledge of complications associated with excess GWG, and (v) knowledge of safe weight management strategies in pregnancy.Methods364 pregnant women from a single center university hospital antenatal clinic were interviewed by an obstetric registrar. The women in this convenience sample were asked to identify their weight category, their understanding of the complications of obesity and excessive GWG in pregnancy and safe and/or effective weight management strategies in pregnancy.ResultsNearly half (47.8%) of the study population were overweight or obese. 74% of obese women underestimated their BMI category. 64% of obese women and 40% of overweight women overestimated their recommended GWG. Women’s knowledge of the specific risks associated with excess GWG or maternal obesity was poor. Women also reported many incorrect beliefs about safe weight management in pregnancy.ConclusionsMany pregnant women have poor knowledge about obesity, GWG, their consequences and management strategies. Bridging this knowledge gap is an important step towards improving perinatal outcomes for all pregnant women, especially those who enter pregnancy overweight or obese.

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Section: Discussionmentioning

confidence: 99%

Pregnant women’s knowledge of weight, weight gain, complications of obesity and weight management strategies in pregnancy

et al. 2013

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“…Recent studies have shown a positive association between GWG and an increased risk for childhood obesity [23-26], adolescent obesity [27,28], and obesity persisting into adulthood [29-31] propagating a vicious cycle of obesity [9,32,33]. Breaking this cycle at any stage with adequate intervention and prevention strategies is a big challenge.…”

Section: Introductionmentioning

confidence: 99%

Safety and efficacy of a lifestyle intervention for pregnant women to prevent excessive maternal weight gain: a cluster-randomized controlled trial

Rauh

Gabriel

Kerschbaum

et al. 2013

BMC Pregnancy Childbirth

123

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BackgroundExcessive gestational weight gain (GWG) is associated with short- and long-term health problems among mothers and their offspring. There is a strong need for effective intervention strategies targeting excessive GWG to prevent adverse outcomes.MethodsWe performed a cluster-randomized controlled intervention trial in eight gynecological practices evaluating the feasibility and effectiveness of a lifestyle intervention presented to all pregnant women; 250 healthy, pregnant women were recruited for the study. The intervention program consisted of two individually delivered counseling sessions focusing on diet, physical activity, and weight monitoring. The primary outcome was the proportion of pregnant women exceeding weight gain recommendations of the Institute of Medicine (IOM). Secondary outcome variables were maternal weight retention and short-term obstetric and neonatal outcomes.ResultsThe intervention resulted in a lower proportion of women exceeding IOM guidelines among women in the intervention group (38%) compared with the control group (60%) (odds ratio (OR): 0.5; 95% confidence interval (CI): 0.3 to 0.9) without prompting an increase in the proportion of pregnancies with suboptimal weight gain (19% vs. 21%). Participants in the intervention group gained significantly less weight than those in the control group. Only 17% of the women in the intervention group showed substantial weight retention of more than 5 kg compared with 31% of those in the control group at month four postpartum (pp) (OR: 0.5; 95% CI: 0.2 to 0.9). There were no significant differences in obstetric and neonatal outcomes.ConclusionsLifestyle counseling given to pregnant women reduced the proportion of pregnancies with excessive GWG without increasing suboptimal weight gain, and may exert favorable effects on pp weight retention.Trial registrationGerman Clinical Trials Register DRKS00003801.

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“…The details of quantile regression have been described elsewhere[20,21], as has its application to health problems[22,23]. The use of quantile regression with count data is unusual and its application to health forecasting remains novel [24,25].…”

Section: Methodsmentioning

confidence: 99%

The Use of Quantile Regression to Forecast Higher Than Expected Respiratory Deaths in a Daily Time Series: A Study of New York City Data 1987-2000

Soyiri

Reidpath

2013

PLoS ONE

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Forecasting higher than expected numbers of health events provides potentially valuable insights in its own right, and may contribute to health services management and syndromic surveillance. This study investigates the use of quantile regression to predict higher than expected respiratory deaths.Data taken from 70,830 deaths occurring in New York were used. Temporal, weather and air quality measures were fitted using quantile regression at the 90th-percentile with half the data (in-sample). Four QR models were fitted: an unconditional model predicting the 90th-percentile of deaths (Model 1), a seasonal / temporal (Model 2), a seasonal, temporal plus lags of weather and air quality (Model 3), and a seasonal, temporal model with 7-day moving averages of weather and air quality. Models were cross-validated with the out of sample data. Performance was measured as proportionate reduction in weighted sum of absolute deviations by a conditional, over unconditional models; i.e., the coefficient of determination (R1).The coefficient of determination showed an improvement over the unconditional model between 0.16 and 0.19. The greatest improvement in predictive and forecasting accuracy of daily mortality was associated with the inclusion of seasonal and temporal predictors (Model 2). No gains were made in the predictive models with the addition of weather and air quality predictors (Models 3 and 4). However, forecasting models that included weather and air quality predictors performed slightly better than the seasonal and temporal model alone (i.e., Model 3 > Model 4 > Model 2)This study provided a new approach to predict higher than expected numbers of respiratory related-deaths. The approach, while promising, has limitations and should be treated at this stage as a proof of concept.

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Gestational Weight Gain and Body Mass Index in Children: Results from Three German Cohort Studies

Cited by 31 publications

References 33 publications

Pregnant women’s knowledge of weight, weight gain, complications of obesity and weight management strategies in pregnancy

Pregnant women’s knowledge of weight, weight gain, complications of obesity and weight management strategies in pregnancy

Safety and efficacy of a lifestyle intervention for pregnant women to prevent excessive maternal weight gain: a cluster-randomized controlled trial

The Use of Quantile Regression to Forecast Higher Than Expected Respiratory Deaths in a Daily Time Series: A Study of New York City Data 1987-2000

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