The INTERGROWTH‐21st gestational weight gain standard and interpregnancy weight increase: A population‐based study of successive pregnancies

Hutcheon, Jennifer A.; Chapinal, N.; Bodnar, Lisa M.; Lee, Lily

doi:10.1002/oby.21858

Cited by 16 publications

(18 citation statements)

References 28 publications

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“…The INTERGROWTH-21st Project developed standards in an international population of normal weight women by only including women with healthy pregnancies with good maternal and perinatal outcomes [ 7 ]. However, a recent study showed that the INTERGROWTH-21st standards do not seem to describe optimal weight gain patterns with respect to maternal postpartum weight retention and thus may still be descriptive [ 31 ]. We developed gestational weight gain reference charts by including all pregnant women that had all necessary information available for these analyses and compared with the charts obtained in a sample with good maternal and perinatal outcomes.…”

Section: Discussionmentioning

confidence: 99%

Gestational weight gain charts for different body mass index groups for women in Europe, North America, and Oceania

Santos

Eekhout

Voerman

et al. 2018

BMC Med

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BackgroundGestational weight gain differs according to pre-pregnancy body mass index and is related to the risks of adverse maternal and child health outcomes. Gestational weight gain charts for women in different pre-pregnancy body mass index groups enable identification of women and offspring at risk for adverse health outcomes. We aimed to construct gestational weight gain reference charts for underweight, normal weight, overweight, and grades 1, 2 and 3 obese women and to compare these charts with those obtained in women with uncomplicated term pregnancies.MethodsWe used individual participant data from 218,216 pregnant women participating in 33 cohorts from Europe, North America, and Oceania. Of these women, 9065 (4.2%), 148,697 (68.1%), 42,678 (19.6%), 13,084 (6.0%), 3597 (1.6%), and 1095 (0.5%) were underweight, normal weight, overweight, and grades 1, 2, and 3 obese women, respectively. A total of 138, 517 women from 26 cohorts had pregnancies with no hypertensive or diabetic disorders and with term deliveries of appropriate for gestational age at birth infants. Gestational weight gain charts for underweight, normal weight, overweight, and grade 1, 2, and 3 obese women were derived by the Box-Cox t method using the generalized additive model for location, scale, and shape.ResultsWe observed that gestational weight gain strongly differed per maternal pre-pregnancy body mass index group. The median (interquartile range) gestational weight gain at 40 weeks was 14.2 kg (11.4–17.4) for underweight women, 14.5 kg (11.5–17.7) for normal weight women, 13.9 kg (10.1–17.9) for overweight women, and 11.2 kg (7.0–15.7), 8.7 kg (4.3–13.4) and 6.3 kg (1.9–11.1) for grades 1, 2, and 3 obese women, respectively. The rate of weight gain was lower in the first half than in the second half of pregnancy. No differences in the patterns of weight gain were observed between cohorts or countries. Similar weight gain patterns were observed in mothers without pregnancy complications.ConclusionsGestational weight gain patterns are strongly related to pre-pregnancy body mass index. The derived charts can be used to assess gestational weight gain in etiological research and as a monitoring tool for weight gain during pregnancy in clinical practice.Electronic supplementary materialThe online version of this article (10.1186/s12916-018-1189-1) contains supplementary material, which is available to authorized users.

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Section: Discussionmentioning

confidence: 99%

Gestational weight gain charts for different body mass index groups for women in Europe, North America, and Oceania

Santos

Eekhout

Voerman

et al. 2018

BMC Med

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“…Notwithstanding, as Intergrowth 9 is a standard, and therefore has a prescriptive character, it is crucial to be cautious when using this reference due to gestational weight gain higher than P70 (excessive) already being associated with LGA. In the cohort study conducted by Hutcheon et al, 26 the authors assessed the risk of excessive maternal weight retention in the postpartum period involving weight change due to successive pregnancies, and found that between P51 and P84, risk of excessive weight retention also increased significantly. Jin et al 27 compared the ability to identify gestational diabetes in women with excessive GWG using three different methods (IOM, 2 Intergrowth 9 and a Chinese reference), and concluded that GWG higher than P84 according to Intergrowth 9 and the local Chinese reference, presented higher risk of gestational diabetes.…”

Section: Discussionmentioning

confidence: 99%

Diferentes métodos para avaliação do ganho de peso gestacional e sua associação com o peso ao nascer

Araújo

Silva

Barros

et al. 2021

Epidemiol. Serv. Saúde

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Resumo Objetivo Analisar a associação de diferentes métodos para avaliação do ganho de peso gestacional com nascidos vivos pequenos para idade gestacional (PIG) ou grandes para idade gestacional (GIG). Métodos Estudo transversal, com mulheres adultas, IMC pré-gestacional de eutrofia, gestação única e idade gestacional no parto ≥28 semanas, da pesquisa ‘Nascer no Brasil’, em 2011-2012. Resultados Participaram do estudo 11 mil mulheres; a prevalência de ganho excessivo foi de 33,1% segundo os métodos Brandão et al., e IOM, e 37,9% segundo Intergrowth. A chance de nascer PIG para ganho de peso insuficiente foi de OR=1,52 (IC95% 1,06;2,19), OR=1,52 (IC95% 1,05;2,20) e OR=1,56 (IC95% 1,06;2,30) para Brandão et al., IOM e Intergrowth, respectivamente, enquanto o ganho de peso excessivo apresentou OR=1,53 (IC95% 1,28;1,82), OR=1,57 (IC95% 1,31;1,87) e OR=1,65 (IC95% 1,40;1,96), para GIG, respectivamente. Conclusão Comparados às recomendações do IOM, Intergrowth e Brandão et al. apresentam-se como alternativas para identificar PIG e GIG.

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“…Among those who had not returned to pre-pregnancy weight by 12 months, the average weight retention remained relatively stable, at 3 ±5.7 kg (Phelan et al 2014). Over the course of several full-term pregnancies, each additional weight gain can thus accumulate to produce a significant metabolic burden (Hutcheon et al 2017) in the mother, with additional potential detrimental consequences for children born from subsequent pregnancies. It is thus important to understand as much as possible about factors that influence post-partum weight loss.…”

Section: Discussionmentioning

confidence: 99%

Early life environment influences the trajectory of post-partum weight loss in adult female rats

Aiken

Tarry-Adkins

Ashmore

et al. 2019

Reproductive BioMedicine Online

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Research question The physiological processes of pregnancy and lactation require profound changes in maternal metabolism and energy balance. The timescale of metabolic reversion after pregnancy, in particular post-partum weight loss, is highly variable between individuals. Currently, mechanisms influencing post-partum metabolic recovery are not well understood. The hypothesis tested here is that, in common with other metabolic and obesity-related outcomes, capacity for post-partum weight loss is influenced by developmental programming. Design Adult female Wistar rats exposed to a maternal low-protein diet in utero then weaned onto a control diet post-natally (recuperated group) were compared with controls. Adult females from both groups underwent pregnancy at 3 months of age. Weight changes and metabolic parameters during pregnancy and lactation were compared between control and recuperated groups, and also with non-pregnant littermates. Results Pregnancy weight gain was not different between the control and recuperated groups, but post-partum recuperated animals remained significantly heavier than both post-partum control animals ( P <0.05) and their non-pregnant recuperated littermates ( P <0.05) at the end of lactation. Post-partum recuperated animals had more intra-abdominal fat mass ( P <0.05) and higher serum triglyceride concentrations ( P <0.01) than controls. Post-partum recuperated animals also had increased expression of IL6, NRF2 and ALOX12 (key regulators of inflammation and lipoxygenase activity) in the intra-abdominal adipose tissue compared with control groups. Conclusions Mothers who themselves have been exposed to adverse early life environments are likely to have slower metabolic recovery from pregnancy than controls. Failure to return to pre-pregnancy weight after delivery predisposes to persisting sequential inter-pregnancy weight gain, which can represent a significant metabolic burden across a life course involving several pregnancies.

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The INTERGROWTH‐21st gestational weight gain standard and interpregnancy weight increase: A population‐based study of successive pregnancies

Cited by 16 publications

References 28 publications

Gestational weight gain charts for different body mass index groups for women in Europe, North America, and Oceania

Gestational weight gain charts for different body mass index groups for women in Europe, North America, and Oceania

Diferentes métodos para avaliação do ganho de peso gestacional e sua associação com o peso ao nascer

Early life environment influences the trajectory of post-partum weight loss in adult female rats

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