Gestational weight gain and macrosomia in a cohort of mothers and their children

Kac, Gilberto; Velásquez-Meléndez, Gustavo

doi:10.2223/1282

Cited by 19 publications

(8 citation statements)

References 19 publications

(37 reference statements)

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“…An association between macrosomia and pregestational overweight/obese women was observed in studies from the Northeast and Southeast of Brazil 17 , 29 , 32 . In one of these studies, women with excessive GWG had a greater chance of having a macrosomic newborn 17 .…”

Section: Discussionmentioning

confidence: 83%

“…These recommendations must be followed to facilitate a comparison between studies and improve the methodological quality of observational studies. The least followed criteria were as follows: the study design did not appear in the title 18 ,, the sample size calculation was not specified (19,21,22,25,24,28,30-32) and there was no mention of financial support 17 , 18 , 22 , 24 , 25 , 26 , 29 , 31 , 32 .…”

Section: Resultsmentioning

confidence: 99%

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A systematic review and meta-analysis of gestational weight gain recommendations and related outcomes in Brazil

Godoy¹,

Nascimento²,

Surita³

2015

Clinics

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Worldwide, different guidelines are used to assess the adequacy of gestational weight gain. This study identified the recommendations for gestational weight gain in Brazilian women. We also determined the proportion of women with adequate weight gain in accordance with these recommendations and the associated perinatal outcomes.A systematic review was performed. A computerized search was conducted utilizing the following databases: PubMed, MEDLINE, Web of Science, Embase, SciELO and Google Scholar. Observational studies of healthy, Brazilian, pregnant women were included. Studies were excluded if they did not provide pregestational weight and gestational weight gain or if they studied women with comorbid conditions. A meta-analysis was performed to evaluate the odds ratio of inadequate (insufficient or excessive) gestational weight gain.Seventeen studies were included in the systematic review and four studies were included in the meta-analysis. The most widely used recommendations were from the Institute of Medicine. Excessive gestational weight gain was associated with fetal macrosomia and high rates of cesarean delivery. Overweight women had a higher risk of excessive gestational weight gain than eutrophic women (OR=2.80, 95%CI=2.22-3.53).There are no standardized recommendations concerning gestational weight gain based on Brazilian population-based data. Many Brazilian women are overweight or obese at the beginning of pregnancy. Overweight pregnant women have a higher risk of excessive gestational weight gain. Excessive gestational weight gain was associated with cesarean delivery and fetal macrosomia.

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Section: Discussionmentioning

confidence: 83%

Section: Resultsmentioning

confidence: 99%

A systematic review and meta-analysis of gestational weight gain recommendations and related outcomes in Brazil

Godoy¹,

Nascimento²,

Surita³

2015

Clinics

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“…Most of the studies on birth weight have investigated risk factors of either low or high birth weight [ 1 , 13 , 53 – 56 ] rather than analyzing birth weight as a continuous variable. In Africa and Ghana in particular, there appeared to be no study to the best of the authors’ knowledge analyzing birth weight as a continuous variable.…”

Section: Discussionmentioning

confidence: 99%

Maternal Determinants of Birth Weight in Northern Ghana

2015

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ObjectivesWeight at birth is usually considered as an indicator of the health status of a given society. As a result this study was designed to investigate the association between birth weight and maternal factors such as gestational weight gain, pre—pregnancy BMI and socio—economic status in Northern Ghana.MethodsThe study was a facility-based cross-sectional survey conducted in two districts in the Northern region of Ghana. These districts were purposively sampled to represent a mix of urban, peri—urban and rural population. The current study included 419 mother-infant pairs who delivered at term (37–42 weeks). Mother’s height, pre-pregnancy weight and weight changes were generated from the antenatal records. Questionnaires were administered to establish socio-economic and demographic information of respondents. Maternal factors associated with birth weight were examined using multiple and univariate regressions.ResultsThe mothers were generally well nourished before conception (Underweight 3.82%, Normal 57.76%, Overweight 25.06% and Obesity 13.37%) but approximately half of them could not gain adequate weight according to Institute of Medicine recommendations (Low weight gain 49.64%, Adequate weight gain 42.96% and Excessive weight gain 7.40%). Infants whose mothers had excess weight gain were 431g (95% CI 18–444) heavier compared to those whose mothers gained normal weight, while those whose mothers gained less were 479g (95% CI -682– (-276) lighter. Infants of mothers who were overweight and obese before conception were 246g (95% CI 87–405) and 595g (95% CI 375–815) respectively heavier than those of normal mothers, whereas those whose mothers were underweight were 305g (95% CI -565 –(-44) lighter. The mean birth weight observed was 2.98 ± 0.68 kg.ConclusionOur findings show that pre-pregnancy body mass index and weight gain during pregnancy influence birth weight. Therefore, emphasis should be placed on counseling and assisting pregnant women to stay within the recommended weight gain ranges.

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“…Macrosomia is defined as an absolute birth weight >4000 g regardless of gestational age ( Boulet et al, 2003 ; Costa et al, 2012 ). The incidence of macrosomia ranges from 12.8 to 37.4% worldwide ( Rodrigues et al, 2000 ; Kac and Velasquez-Melendez, 2005 ; de Oliveira et al, 2008 ) . In developed countries, the prevalence of macrosomia ranges from 5 to 20%; and an increase of 15–25% has been reported over the last three decades, mainly driven by an increase in maternal obesity and type 2 diabetes (T2DM).…”

Section: Introductionmentioning

confidence: 99%

Health economic modeling to assess short-term costs of maternal overweight, gestational diabetes, and related macrosomia â€“ a pilot evaluation

et al. 2015

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Background: Despite the interest in the impact of overweight and obesity on public health, little is known about the social and economic impact of being born large for gestational age or macrosomic. Both conditions are related to maternal obesity and/or gestational diabetes mellitus (GDM) and associated with increased morbidity for mother and child in the perinatal period. Poorly controlled diabetes during pregnancy, pre- pregnancy maternal obesity and/or excessive maternal weight gain during pregnancy are associated with intermittent periods of fetal exposure to hyperglycemia and subsequent hyperinsulinemia, leading to increased birth weight (e.g., macrosomia), body adiposity, and glycogen storage in the liver. Macrosomia is associated with an increased risk of developing obesity and type 2 diabetes mellitus later in life.Objective: Provide insight in the short-term health-economic impact of maternal overweight, GDM, and related macrosomia. To this end, a health economic framework was designed. This pilot study also aims to encourage further health technology assessments, based on country- and population-specific data.Results: The estimation of the direct health-economic burden of maternal overweight, GDM and related macrosomia indicates that associated healthcare expenditures are substantial. The calculation of a budget impact of GDM, based on a conservative approach of our model, using USA costing data, indicates an annual cost of more than $1,8 billion without taking into account long-term consequences.Conclusion: Although overweight and obesity are a recognized concern worldwide, less attention has been given to the health economic consequences of these conditions in women of child-bearing age and their offspring. The presented outcomes underline the need for preventive management strategies and public health interventions on life style, diet and physical activity. Also, the predisposition in people of Asian ethnicity to develop diabetes emphasizes the urgent need to collect more country-specific data on the incidence of macrosomic births and health outcomes. In addition, it would be of interest to further explore the long-term health economic consequences of macrosomia and related risk factors.

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Gestational weight gain and macrosomia in a cohort of mothers and their children

Cited by 19 publications

References 19 publications

A systematic review and meta-analysis of gestational weight gain recommendations and related outcomes in Brazil

A systematic review and meta-analysis of gestational weight gain recommendations and related outcomes in Brazil

Maternal Determinants of Birth Weight in Northern Ghana

Health economic modeling to assess short-term costs of maternal overweight, gestational diabetes, and related macrosomia â€“ a pilot evaluation

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