The Independent Importance of Pre-pregnancy Weight and Gestational Weight Gain for the Prevention of Large-for Gestational Age Brazilian Newborns

Abstract

Objectives To study the independent effect of pre-pregnancy weight, gestational weight gain (GWG), and other important risk factors on newborn birth weight. Methods Baseline data of 435 adult women and their singletons born between January and February 2012 at a public hospital in Brazil were used. Logistic regression was applied to determine the independent importance of pre-pregnancy weight and GWG for large for gestational age (LGA) newborns. Results Among all mothers, 37.9 % were overweight and obese before pregnancy and 45.3 % experienced excessive GWG. Among the newborns, 24.4 % were classified as LGA. Univariate analysis showed an association of family income, GWG, pre-pregnancy BMI and excessive GWG with LGA newborns. Smoking before and during pregnancy was associated with a decreased likelihood of giving birth to an LGA newborn compared to mothers who did not smoke. After adjustment for confounding variables, age at birth of first child, GWG, HbA1c and pre-pregnancy weight-GWG were significant and independent determinants of giving birth to an LGA newborn. Mothers with pre-pregnancy overweight and excessive GWG were more likely to deliver an LGA newborn (OR 2.54, P < 0.05) compared to mothers who were normal weight and experienced adequate GWG. Conclusions for Practice Age at first birth of child, GWG, HbA1c and pre-pregnancy overweight combined with excessive GWG are independent determinants of LGA newborns. The results of this study suggest that both primary prevention of overweight in women of childbearing age and management of GWG may be important strategies to reduce the number of LGA newborns and, consequently, the long-term public health burden of obesity.

Association among pre-pregnancy body mass index, gestational weight gain and neonatal birth weight: a prospective cohort study in China

“…The relationships this study found between prepregnancy BMI, GWG and GWG rate are consistent with the findings of some existing studies [21][22][23], including a cohort study located in three provinces in southwest China [24]. A meta-analysis showed that insufficient GWG contributed to a lower risk for LGA while excessive GWG was associated with lower risk for SGA [11].…”

Gestational weight gain outside the Institute of Medicine recommendations and adverse pregnancy outcomes: analysis using individual participant data from randomised trials

“…As Individual Participant Data (IPD) from those studies was not available, the degree of departure from the recommendations is unknown. Although the meta-analysis reaffirmed the association between GWG outside the IOM recommendations and adverse pregnancy outcomes [4, 10, 17, 24–31], the findings were limited by a lack of adjustment for potential confounders (e.g. gestational age in the analysis for preterm birth), inconsistency in outcome definitions (e.g.…”

“…The number of women entering pregnancy with high BMI is increasing [12]. High weight gain in pregnancy occurs in both high-income [13–15] and low-income countries [16, 17]. The US-based Institute of Medicine (IOM), among others, has attempted to identify an optimal amount of GWG [1, 2, 18–20] and has issued recommendations to support healthcare providers advising women on a healthy amount of weight gain in pregnancy [20].…”

Association between FTO gene polymorphism and excess body weight in women from before to after pregnancy: A cohort study

“…This prospective cohort study is part of the Predictors of Maternal and Infant Excess Body Weight (PREDI) Study initiated in 2012 in Joinville/SC, Brazil, a larger research project examining the determinants and related health outcomes of excess body weight in mothers and their children. An in‐depth description of the overall study has been published previously (Mastroeni et al, ; Santos et al, ). Briefly, all women over 18 years of age who gave birth to a full‐term singleton (between 37 and 42 weeks of gestation) and who did not follow any specific type of diet before or during pregnancy or at the time of delivery were invited to participate.…”