The effects of cigarette smoking and gestational weight change on birth outcomes in obese and normal-weight women.

Hellerstedt, Wendy L.; Himes, John H.; Story, Mary; Alton, Irene R.; Edwards, Lindsay

doi:10.2105/ajph.87.4.591

Cited by 74 publications

(56 citation statements)

References 21 publications

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“…Being overweight or obese at the start of pregnancy may pose serious complications for mother and child during pregnancy and labor. 21,22 Similar to the results of the present study, 30-40% of women in Sweden and the United States gain weight within the recommendations of IOM, whereas 20% gain too little weight and 40% excessive weight. 7,9,19,40 Of the normal-weight women in our study, women gaining excessive weight were younger than those gaining less weight, and they also tended to be taller and heavier.…”

Section: Discussionsupporting

confidence: 87%

“…[12][13][14][15] Total energy intake (EI) has been related to maternal weight gain, but with regard to the association of the macronutrients with maternal weight gain and birth outcome, data are inconclusive or scarce. 11,[16][17][18] Adequate weight gain is important for optimal perinatal outcome, but high weight gain in pregnancy has been related to gestational complications (i.e., hypertension, diabetes and pre-eclampsia), complications in delivery 1,4,[19][20][21] and macrosomia 22 and low weight gain to retarded fetal growth and preterm birth. 19 With increasing rates of obesity in the world, 23 especially among women, [24][25][26] it is a commonly held notion that excessive pregnancy weight gain contributes to the increased rates of obesity in women.…”

Section: Introductionmentioning

confidence: 99%

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Maternal diet in early and late pregnancy in relation to weight gain

et al. 2005

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Objective: To identify dietary factors related to the risk of gaining weight outside recommendations for pregnancy weight gain and birth outcome. Design: An observational study with free-living conditions. Subjects: Four hundred and ninety five healthy pregnant Icelandic women. Methods: The dietary intake of the women was estimated with a semiquantitative food frequency questionnaire covering food intake together with lifestyle factors for the previous 3 months. Questionnaires were filled out at between 11 and 15 weeks and between 34 and 37 weeks gestation. Comparison of birth outcome between the three weight gain groups was made with ANOVA and Bonferroni post hoc tests. Dietary factors related to at least optimal and excessive weight gain during pregnancy were represented with logistic regression controlling for potential confounding. Results: Of the women, 26% gained suboptimal and 34% excessive weight during pregnancy. Women in late pregnancy with at least optimal, compared with women with suboptimal, weight gain were eating more (OR ¼ 3.32, confidence interval (CI) ¼ 1.81-6.09, Po0.001) and drinking more milk (OR ¼ 3.10, CI ¼ 1.57-6.13, P ¼ 0.001). The same dietary factors were related to excessive, compared with optimal, weight gain. Furthermore, eating more sweets early in pregnancy increased the risk of gaining excessive weight (OR ¼ 2.52, CI ¼ 1.10-5.77, P ¼ 0.029). Women with a body mass index of 25.0-29.9 kg/m 2 before pregnancy were most likely to gain excessive weight (OR ¼ 7.37, CI 4.13-13.14, Po0.001). Women gaining suboptimal weight gave birth to lighter children (Po0.001) and had shorter gestation (P ¼ 0.008) than women gaining optimal or excessive weight. Conclusion: Women who are overweight before pregnancy should get special attention regarding lifestyle modifications affecting consequent weight gain during pregnancy. They are most likely to gain excessive weight and therefore most likely to suffer pregnancy and delivery complications and struggle with increasing overweight and obesity after giving birth.

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Section: Discussionsupporting

confidence: 87%

Section: Introductionmentioning

confidence: 99%

Maternal diet in early and late pregnancy in relation to weight gain

et al. 2005

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“…Oslon & Strawderman 53 found an association between smoking and weight gain in pregnancy, whereby women who smoked 1.5 packs a day gained significantly less weight. Hellerstedt et al 54 found that smokers showed lower mean weight gain as compared to non-smokers (9.3 and 9.7kg, respectively), when the women were obese at the beginning of pregnancy; how- ever, women with normal baseline weight gained less weight when they were non-smokers (13.4 versus 15.0kg).…”

Section: Variablesmentioning

confidence: 99%

Determinants of weight gain in pregnant women attending a public prenatal care facility in Rio de Janeiro, Brazil: a prospective study, 2005-2007

et al. 2008

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The objective of this study was to evaluate the determinants of weight gain during pregnancy. The study adopted a prospective cohort design with four follow-up waves and included a sample of 255 pregnant women that received prenatal care at a public health care facility in Rio de Janeiro, Brazil. A mixed-effects linear longitudinal regression model was used, having as the dependent variable the weight assessed in four follow-up waves, and as independent variables: demographic, socioeconomic, reproductive, behavioral, and nutritional data. Mean weight gain was 0.413kg per gestational week, consistent with recommendations by the Institute of Medicine. Per capita family income and smoking were associated with total weight gain during gestation. According to the longitudinal multiple linear regression model, age (² = 0.6315), menarche (² = -2.3861), triglycerides (² = 0.0437), blood glucose (² = 0.1544), and adequacy of energy consumption (² = -0.0642) were associated with gestational weight gain. Special attention should be given to these sub-groups, due to increased risk of excessive weight gain.

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“…Studies on the effects of maternal smoking on infant growth are consistent in that there is widespread agreement that infants born to mothers who smoke weigh less at birth compared with infants born to mothers who do not smoke. [23][24][25] This fetal growth restriction is followed by an accelerated 'catch up' growth rate in the early months after birth. Some studies showed smoke-affected infants to be more likely to be obese than their nonsmoke-affected counterparts from the age of 6 to 14 months.…”

Section: Discussionmentioning

confidence: 99%

Maternal obesity, associated complications and risk of prematurity

et al. 2009

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Objective: We aimed at (a) examining the rates of obesity over a 12-year period; (b) studying the effect of obesity and morbid obesity on gestational age and birth weight and (c) determining the influence of race on the association between maternal obesity and the gestational age of a newborn. Study Design:We conducted a retrospective analysis using data from the perinatal data set of mothers delivering at the George Washington University between 1992 and 2003. We stratified mother/infant pairs (n ¼ 14 183) into three groups on the basis of maternal prepregnancy body mass index (BMI): not obese (BMI<30), obese (BMI 30 to 39) and morbidly obese (BMIX40). We identified all spontaneous and induced preterm deliveries in each group. Bivariate and multivariate analyses were conducted to control for significant differences between groups.Result: We identified obesity in 1707 (12%) and morbid obesity in 415 (3%) of the mothers. Obesity and morbid obesity increased over time during the study period. In crude analysis, mothers with obesity and morbid obesity were more likely to deliver prematurely (16.7 and 20.3%, respectively) when compared with nonobese women (14.5%), and were also more likely to have other complications including smoking, anemia, hypertension, diabetes and cesarean delivery. When controlling for these complications in a logistic regression model, obesity and morbid obesity were not associated with prematurity. Conclusion:There is no direct link between obesity and prematurity. Prematurity is more likely caused by medical complications that frequently occur in obese women. Further studies are needed on this growing population to test whether providing adequate prenatal care can control the associated medical conditions and subsequently ameliorate the rate of prematurity.

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The effects of cigarette smoking and gestational weight change on birth outcomes in obese and normal-weight women.

Cited by 74 publications

References 21 publications

Maternal diet in early and late pregnancy in relation to weight gain

Maternal diet in early and late pregnancy in relation to weight gain

Determinants of weight gain in pregnant women attending a public prenatal care facility in Rio de Janeiro, Brazil: a prospective study, 2005-2007

Maternal obesity, associated complications and risk of prematurity

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