Implications of the Institute of Medicine weight gain recommendations for preventing adverse pregnancy outcomes in black and white women.

Abstract

OBJECTIVES: This study examined the relation between gestational weight gain and risk of delivering a small-for-gestational-age or large-for-gestational-age infant by race, along with the implications of gaining weight according to the Institute of Medicine guidelines. METHODS: Logistic regression methods were used to identify risk factors for small- and large-for-gestational-age births among 2617 Black and 1253 White women delivering at the Johns Hopkins Hospital between 1987 and 1989. RESULTS: Rate of total weight gain was related to risk of small- and large-for-gestational-age births; the relationship differed according to maternal body mass index but not race. No differences in outcome by race were evident for women with low body mass indexes; among those with average or high indexes, however, Black women were at higher risk of small-for-gestational-age births and at lower risk of large-for-gestational-age births. CONCLUSIONS: Having Black women gain at the upper end of the recommended range is unlikely to produce measurable reductions in small-for-gestational-age births. Some beneficial reductions in the risk of large-for-gestational-age births may occur if weight gain recommendations are lowered for average-weight and overweight White women.

Maternal body mass index and gestational weight gain and their association with perinatal outcomes in Viet Nam

“…A previous study showing a similar nonlinear trend in African and Caucasian women belonging to various BMI categories suggested that the recommended weight gains represented acceptably low levels of risk for these outcomes rather than minimal risk. 8 The study also revealed that compared with Caucasian women, African women were at greater risk of having infants too small and at lower risk of having infants too large for gestational age. 8 The probability of delivering an infant too small for gestational age among women with low BMI in Nha Trang was twice as high as the risk among women in the same BMI group in the United States, although BMI categories and gestational weight gain ranges were defined differently in the two studies.…”

“…8 The study also revealed that compared with Caucasian women, African women were at greater risk of having infants too small and at lower risk of having infants too large for gestational age. 8 The probability of delivering an infant too small for gestational age among women with low BMI in Nha Trang was twice as high as the risk among women in the same BMI group in the United States, although BMI categories and gestational weight gain ranges were defined differently in the two studies. 8 Thus, racial differences may have mediated the effect of maternal BMI on fetal growth.…”

“…8 The probability of delivering an infant too small for gestational age among women with low BMI in Nha Trang was twice as high as the risk among women in the same BMI group in the United States, although BMI categories and gestational weight gain ranges were defined differently in the two studies. 8 Thus, racial differences may have mediated the effect of maternal BMI on fetal growth.…”

“…Thus, reducing the delivery of excessively small or large infants translates into fewer surgical risks for women. 8 Appropriate antenatal management of maternal nutrition, as dictated by scientific evidence, is critical in reducing the delivery of these babies for whom both the intrauterine environment and the birth process can be life-threatening. 8,9 Maternal anthropometry differs across populations.…”

“…8 Appropriate antenatal management of maternal nutrition, as dictated by scientific evidence, is critical in reducing the delivery of these babies for whom both the intrauterine environment and the birth process can be life-threatening. 8,9 Maternal anthropometry differs across populations. 10 Women belonging to ethnic groups characterized by a small body size have been reported to gain less weight on average during pregnancy than larger women.…”