Gestational Weight Gain‐for‐Gestational Age <i>Z</i>‐Score Charts Applied across U.S. Populations

Leonard, Stephanie A.; Hutcheon, Jennifer A.; Bodnar, Lisa M.; Petito, Lucia; Abrams, Barbara

doi:10.1111/ppe.12435

Cited by 24 publications

(26 citation statements)

References 30 publications

(97 reference statements)

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“…27,28 Nevertheless, both lower and higher GWG were significantly associated with preterm birth in recent analyses relying on pregnancy weight gain z-scores, which are unbiased by gestational age. 4,34 Additional consideration of study design and statistical analyses is important when examining GWG data that may be confounded by gestational age.…”

Section: Discussionmentioning

confidence: 99%

“…21,[30][31][32][33] Importantly, the use of these charts confirms that preterm birth is associated with both lower and higher weight gain among pregnant women. 4,34 These analyses suggest somewhat wider ranges of optimal GWG than the current IOM guidelines. 34 However, inclusion of other important outcomes, such as post-partum weight retention and LGA, would likely narrow down the optimal GWG ranges derived using GWG charts.…”

Section: Pregnancy Weight Gain Chartsmentioning

confidence: 91%

“…4,34 These analyses suggest somewhat wider ranges of optimal GWG than the current IOM guidelines. 34 However, inclusion of other important outcomes, such as post-partum weight retention and LGA, would likely narrow down the optimal GWG ranges derived using GWG charts. More research is required to apply the existing GWG charts to multiple pregnancy and birth-related outcomes to determine optimal GWG.…”

Section: Pregnancy Weight Gain Chartsmentioning

confidence: 91%

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Minimization of bias in measures of gestational weight gain

2020

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Summary Gestational weight gain (GWG) is an important predictor of adverse pregnancy outcomes including gestational diabetes, preterm birth, delivery by caesarean and post‐partum weight retention. The Institute of Medicine guidelines on GWG are widely adopted, and GWG is widely researched as an outcome of interest in lifestyle interventions during pregnancy. However, estimation of prepregnancy weight and measurement of weight prior to delivery introduce bias into measures of GWG. This review discusses the sources of bias in measures of GWG and the potential effect of bias on the relationship between adverse pregnancy outcomes associated with GWG. Bias in measures of GWG can be minimized by using measured weight at the first antenatal appointment in early pregnancy rather than self‐reported prepregnancy weight and by adjusting for gestational age when the last weight is collected earlier than the delivery date. Bias owing to gestational age is an important potential confounder in the relationship between GWG and adverse pregnancy outcomes.

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Section: Discussionmentioning

confidence: 99%

Section: Pregnancy Weight Gain Chartsmentioning

confidence: 91%

Section: Pregnancy Weight Gain Chartsmentioning

confidence: 91%

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Minimization of bias in measures of gestational weight gain

2020

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“…The implications of weight gain across this range of adiposity on different outcomes may be important to examine, especially among women beginning pregnancy with lower prepregnancy BMI values who may need to gain more weight for optimal pregnancy outcomes. While the predominately White study population may not be fully generalisable, recent evidence supports the generalisability of existing gestational age‐specific z‐score charts, developed in singletons at the same hospital in Pittsburgh with a similar racial–ethnic distribution, to diverse US populations . Moreover, the proportion of twin infants born small for gestational age was not discussed, which may impact the generalisability of these charts.…”

mentioning

confidence: 88%

“…While the predominately White study population may not be fully generalisable, recent evidence supports the generalisability of existing gestational age-specific z-score charts, developed in singletons at the same hospital in Pittsburgh with a similar racialethnic distribution, to diverse US populations. 7 Moreover, the proportion of twin infants born small for gestational age was not discussed, which may impact the generalisability of these charts.…”

mentioning

confidence: 99%

Weight Gain for Gestational‐Age Charts in Dichorionic Twins: Tool for Establishing Optimal Weight Gain in Twin Pregnancies

Widen

2018

Paediatric Perinatal Epid

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Neighborhood Food Environment and Birth Weight Outcomes in New York City

et al. 2023

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ImportanceInfants born with unhealthy birth weight are at greater risk for long-term health complications, but little is known about how neighborhood characteristics (eg, walkability, food environment) may affect birth weight outcomes.ObjectiveTo assess whether neighborhood-level characteristics (poverty rate, food environment, and walkability) are associated with risk of unhealthy birth weight outcomes and to evaluate whether gestational weight gain mediated these associations.Design, Setting, and ParticipantsThe population-based cross-sectional study included births in the 2015 vital statistics records from the New York City Department of Health and Mental Hygiene. Only singleton births and observations with complete birth weight and covariate data were included. Analyses were performed from November 2021 to March 2022.ExposuresResidential neighborhood-level characteristics, including poverty, food environment (healthy and unhealthy food retail establishments), and walkability (measured by both walkable destinations and a neighborhood walkability index combining walkability measures like street intersection and transit stop density). Neighborhood-level variables categorized into quartiles.Main Outcomes and MeasuresThe main outcomes were birth certificate birth weight measures including small for gestational age (SGA), large for gestational age (LGA), and sex-specific birth weight for gestational age z-score. Generalized linear mixed-effects models and hierarchical linear models estimated risk ratios for associations between density of neighborhood-level characteristics within a 1-km buffer of residential census block centroid and birth weight outcomes.ResultsThe study included 106 194 births in New York City. The mean (SD) age of pregnant individuals in the sample was 29.9 (6.1) years. Prevalence of SGA and LGA were 12.9% and 8.4%, respectively. Residence in the highest density quartile of healthy food retail establishments compared with the lowest quartile was associated with lower adjusted risk of SGA (with adjustment for individual covariates including gestational weight gain z-score: risk ratio [RR], 0.89; 95% CI 0.83-0.97). Higher neighborhood density of unhealthy food retail establishments was associated with higher adjusted risk of delivering an infant classified as SGA (fourth vs first quartile: RR, 1.12; 95% CI, 1.01-1.24). The RR for the association between density of unhealthy food retail establishments and risk of LGA was higher after adjustment for all covariates in each quartile compared with quartile 1 (second: RR, 1.12 [95% CI, 1.04-1.20]; third: RR, 1.18 [95% CI, 1.08-1.29]; fourth: RR, 1.16; [95% CI, 1.04-1.29]). There were no associations between neighborhood walkability and birth weight outcomes (SGA for fourth vs first quartile: RR, 1.01 [95% CI, 0.94-1.08]; LGA for fourth vs first quartile: RR, 1.06 [95% CI, 0.98-1.14]).Conclusions and RelevanceIn this population-based cross-sectional study, healthfulness of neighborhood food environments was associated with risk of SGA and LGA. The findings support use of urban design and planning guidelines to improve food environments to support healthy pregnancies and birth weight.

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Gestational Weight Gain‐for‐Gestational Age Z‐Score Charts Applied across U.S. Populations

Abstract: The findings support the use of weight gain z-score charts for studying gestational age-dependent outcomes in diverse U.S. populations and do not support weight gain recommendations tailored to race/ethnicity.

Cited by 24 publications

References 30 publications

Minimization of bias in measures of gestational weight gain

Minimization of bias in measures of gestational weight gain

Weight Gain for Gestational‐Age Charts in Dichorionic Twins: Tool for Establishing Optimal Weight Gain in Twin Pregnancies

Neighborhood Food Environment and Birth Weight Outcomes in New York City

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