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Recommendations for total and rate of weight gain during pregnancy, by prepregnancy BMI.

Recommendations for total and rate of weight gain during pregnancy, by prepregnancy BMI.

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Overweight and obesity is a serious health risk in both developed and developing nations. It is a common finding among women in their reproductive age. Half of patients entering their pregnancy in the US have a BMI >25.0 and therefore qualify as overweight or obese. Moreover, there is a tendency towards increased weight gain during pregnancy. Studi...

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Context 1
... is worth noting that the IOM recom- mendations only go as far as 40 gestational weeks. In the event of of 41 or 42 gestational weeks, we added the amount of weight per week that is suggested for the second and third trimester given in Table 1, according to the BMI group. ...
Context 2
... weight gain was found to be very similar in all BMI groups. The median is ranging from 12.0 to 14.0 kg as opposed to the IOM weight gain recommenda- tions ( Tables 1 and 2) that give specific spans of pregnancy weight increase for each BMI group. ...
Context 3
... a representative group of patients (n = 591) we analyzed the development of gestational weight within four BMI are recommended (IOM guidelines from 2009, table 1). It appears difficult to determine which of the contributors to maternal weight are responsible for associated pregnancy and birthing complications. ...
Context 4
... patients in this study across all four BMI groups increased pregnancy weight similarly (12.0 to 14.0 kg, table 2) in contrast to the IOM guidelines that suggest specific weight gain for each BMI group (table 1). In total, more than one third of women (37%) gained ges- tational weight above the IOM recommendations (table 3). ...

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... Numerous publications support the evidence that late maternity is associated with various risks to the mother and hazards to perinatal outcomes [33][34][35][36][37][38]. Over the past two decades, there has been not only a rising proportion of deliveries among mothers with advanced age but also with increased body weight. ...
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Background/objective To investigate the longitudinal development of maternal body weight and analyze the influence of obesity on obstetrics during more than two decades in Germany. Subjects/methods Data collected from the Federal state of Schleswig-Holstein (German Perinatal Survey) were analyzed with regard to the dynamics of maternal anthropometric variables (body weight, BMI) between 1995–7 and 2004–17. In total 335,511 mothers substantiated the presented study-collective. The statistical analysis was performed using IBM SPSS Statistics for Windows, Version 26.0. Armonk, NY. Results Maternal BMI advanced significantly over the study period. Among a rise in mean periconceptional body weight (67.6–72.0 kg), the segment of obese women increased disproportionately (in average 9.4–19.2%). Despite the observed trend to late giving birth (mean maternal age 1995: 29.3 vs. 30.7 years in 2017), it was not advanced maternal age but parity that influenced the continuous increase in maternal weight (mean maternal body weight 1995–7: primi- bi-, multiparae 67.4, 68.3 and 69.0 kg vs. 2004–17: primi- bi-, multiparae 70.0, 71.5 and 73.2 kg respectively). Conclusion Obesity is a major problem on health issues in obstetrics. Advancing maternal BMI, increasing mother’s age and derived prenatal risks considerably complicate pregnancy and delivery. It has to be emphasized that its consequences do not end with delivery or childbed, but represent a livelong burden to the mother and their offspring. Hence, multimodal strategies to reduce/control periconceptional body weight are mandatory.
... p = 0.008). [20] Associations between excessive GWG and gestational diabetes as well as hypertensive disorders have been reported, but the evidence for these associations is limited. [21] A positive correlation between excess gestational weight gain and GDM was reported in a recent prospective cohort study that included 565 pregnant women; [22] the investigators found that pre-pregnancy obesity and excessive GWG during the rst and second trimesters of pregnancy may increase the risk of GDM. ...
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We aim to explore the association between gestational weight gain and adverse events during pregnancy. A retrospective study was conducted to evaluate the perinatal outcomes in singleton women whose weight gain during pregnancy was below, within, or above the 2009 Institute of Medicine's (IOM) guidelines, and delivered between 24 and 42 weeks’ gestation. GWG was derived using weight at delivery minus the pre-pregnancy or first trimester weight. Our results indicated that mothers with low GWG had increased odds of having small-for-gestational-age neonates (adjusted OR 1.202; 95% CI 1.031-1.403), and preterm birth (adjusted OR 2.03; 95% CI 1.769-2.439), but decreased odds of having macrosomia (adjusted OR 0.523; 95% CI 0.24-0.991). Meanwhile, mothers with GWG above the IOM recommendations had higher odds of having hypertensive disease of pregnancy (adjusted OR 2.07; 95% CI 1.314-3.535), gestational diabetes (adjusted OR 1.227; 95% CI 1.038-1.448), cesarean section (adjusted OR 1.34; 95% CI 1.279-1.512), induced labor (adjusted OR 1. 219; 95% CI 1.051-1.409), failure of induced labor (adjusted OR 1.432; 95% CI 1.03-1.992), macrosomia (adjusted OR 1.987; 95% CI 1.384-2.725), and shoulder dystocia (adjusted OR 1.715; 95% CI 1.292-2.18. In conclusion, GWG is an important predictor of adverse maternal and neonatal outcomes during pregnancy.
... p = 0.008). [20] Associations between excessive GWG and gestational diabetes as well as hypertensive disorders have been reported, but the evidence for these associations is limited. [21] A positive correlation between excess gestational weight gain and GDM was reported in a recent prospective cohort study that included 565 pregnant women; [22] the investigators found that prepregnancy obesity and excessive GWG during the rst and second trimesters of pregnancy may increase the risk of GDM. ...
Preprint
Full-text available
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... After screening 8432 articles, 63 studies were included in this systematic review and meta-analysis (Fig. 1). Included studies were published between 2010 and 2018, 21 were from North America , 20 were from Europe [5,[42][43][44][45][46][47][48][49][50][51][52][53][54][55][56][57][58][59][60], 13 were from Asia [29][30][31][32][33][34][35][36][37][38][39][40][41], four were from Oceania [82][83][84][85], four were from South America [86][87][88][89] and one was from Africa [28]. ...
... Studies were published from 2009 to 2017 [5,. The population recruitment periods were 1 year in 12 studies [28,34,35,39,41,50,53,58,59,67,85,86] [37,64,67,73,74,80]. However, regarding the methods of collecting prepregnancy BMI data: only two studies measured it [52,60], twelve used medical records [5,28,29,39,44,49,57,68,77,79,86,89], two used both medical records and self-reported data [43,76], and twenty four used self-reported prepregnancy BMI [29, 32, 34, 37, 45-48, 50, 51, 53, 54, 59, 62-67, 73, 75, 84, 85, 87]. ...
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Background Previous studies have reported a high prevalence of excessive gestational weight gain (GWG) in women with prepregnancy BMI classified as overweight and obese. However, the joint evidence regarding GWG and prepregnancy BMI in the worldwide population has not been synthesized. Thus, this systematic review and meta-analysis aimed to estimate global and regional mean GWG and the prevalence of GWG above, within and below 2009 Institute of Medicine (IOM) guidelines. Second, we aimed to estimate global and regional prepregnancy BMI and the prevalence of BMI categories according to World Health Organization (WHO) classification. Methods We searched Medline, Embase, the Cochrane Library and Web of Science to identify observational studies until 9 May 2018. We included studies published from 2009 that used 2009 IOM guidelines, reporting data from women in general population with singleton pregnancies. The 2009 IOM categories for GWG and the WHO categories for prepregnancy BMI were used. DerSimonian and Laird random effects methods were used to estimate the pooled and their respective 95% confidence intervals (95% CIs) of the mean and by category rates of GWG and prepregnancy BMI, calculated by global and regions. Results Sixty-three published studies from 29 countries with a total sample size of 1,416,915 women were included. The global prevalence of GWG above and below the 2009 IOM guidelines, was 27.8% (95% CI; 26.5, 29.1) and 39.4% (95% CI; 37.1, 41.7), respectively. Furthermore, meta-regression analyses showed that the mean GWG and the prevalence of GWG above guidelines have increased. The global prevalence of overweight and obesity, was 23.0% (95% CI; 22.3, 23.7) and 16.3% (95% CI; 15.4, 17.4), respectively. The highest mean GWG and prepregnancy BMI were in North America and the lowest were in Asia. Conclusions Considering the high prevalence of GWG above the 2009 IOM guidelines and women with overweight/obesity and their continuously increasing trend in most regions, clinicians should recommend lifestyle interventions to improve women’s weight during reproductive age. Due to regional variability, these interventions should be adapted to each cultural context. Trial registration Prospectively registered with PROSPERO (CRD42018093562).
... Maternal obesity is a risk factor for birth trauma and low Apgar scores, and it may contribute to numerous factors associated with neonatal morbidity (26,27). The present study suggested that the probability of an amniotic fluid anomaly in females who are overweight or obese is higher than that in other subjects with severe preeclampsia. ...
Article
The present study aimed to determine the clinical characteristics and perinatal outcomes of females with severe preeclampsia according to their pre-pregnancy body mass index (BMI). Data from 233 patients with severe preeclampsia were reviewed from the Inpatient Obstetrics Department. The data were divided into 3 groups according to the patients' pre-pregnancy BMI: Normal (BMI of 18-25 kg/m2; n=134); underweight (BMI <18 kg/m2; n=15); and overweight and obese (BMI >25 kg/m2; n=84). The incidence of dyslipidemia, amniotic fluid abnormalities and neonatal hospitalizations in the group of females who were overweight or obese before pregnancy were higher than those in the other groups (all P<0.05). In conclusion, the presence of dyslipidemia, excessive weight and obesity prior to pregnancy in patients with severe preeclampsia was associated with maternal and perinatal outcomes.
... Over 50% of women are overweight or of obese preconception [2][3][4], and, once pregnant, 50%-60% of women gain more than the International Institute of Medicine gestational weight gain (GWG) recommendations [5]. Excessive GWG increases the risk of pregnancy and birthing complications [6], infant mortality [7], and maternal cardiovascular risk factors [8]. Furthermore, excess GWG drives postpartum weight retention (PPWR), increasing risk in subsequent pregnancies and fueling maternal obesity development associated with chronic diseases long-term [9,10]. ...
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Reproductive-aged women are at high risk of developing obesity, and diet quality is a potential modifiable risk factor. There is limited research exploring diet quality and its association with time since childbirth. Using data from the Australian Longitudinal Study on Women’s Health (ALSWH) survey 5 (2009) of women born between 1973–1978, who reported having previously given birth, we investigated the association between time since childbirth and diet quality, and differences in energy, macronutrients, micronutrient intake, and diet quality assessed by the dietary guideline index (DGI) in women stratified by time from last childbirth, early (0–6 months; n = 558) and late (7–12 months; n = 547), and all other women with children (>12 months post childbirth n = 3434). From this cohort, 8200 participants were eligible, of which 4539 participants completed a food frequency questionnaire (FFQ) and were included in this analysis. Overall, diet quality was higher in early and late postpartum women (mean DGI score 89.8 (SD 10.5) and mean DGI score 90.0 (SD 10.2), respectively) compared to all other women with children (>12 months post childbirth), mean DGI score 85.2 (SD 11.7), p < 0.001. Factors positively associated with diet quality included higher education, physical activity, health provider support, and vitamin and/or mineral supplement use. Conversely, increasing time from childbirth (>12 months), smoking compared with non-smoking and medium income level compared with no income was negatively associated with diet quality. A lower diet quality in women greater than 12 months post childbirth may be reflective of increased pressures, balancing childrearing and return to work responsibilities. This highlights the need to support women beyond the postpartum period to improve modifiable factors associated with weight gain, including diet quality, to optimize health and reduce chronic disease risk.
... Another risk stratification model showed that in women with a prepregnancy BMI of ≥25 kg/m 2 and a HbA1c ≥ 5.5% (37 mmol/mol) at the 1st GDM booking, the risk for the two most frequent adverse outcomes, i.e. cesarean section and LGA were around nearly twice as high compared to women with a BMI of < 25 kg/m 2 and a HbA1c < 5.5% (37 mmol/mol). Prepregnancy BMI was significantly correlated with the need for cesarean section, which is also consistent with previous studies [40,41]. It showed an inverse association with SGA in univariate and multiple regression analyses, in good agreement with a metanalysis by Goto et al. and a study by Li et al. [42,43]. ...
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Background: Gestational diabetes mellitus (GDM) exposes mothers and their offspring to short and long-term complications. The objective of this study was to identify the importance of potentially modifiable predictors of adverse outcomes in pregnancies with GDM. We also aimed to assess the relationship between maternal predictors and pregnancy outcomes depending on HbA1c values and to provide a risk stratification for adverse pregnancy outcomes according to the prepregnancy BMI (Body mass index) and HbA1c at the 1st booking. Methods: This prospective study included 576 patients with GDM. Predictors were prepregnancy BMI, gestational weight gain (GWG), excessive weight gain, fasting, 1 and 2-h glucose values after the 75 g oral glucose challenge test (oGTT), HbA1c at the 1st GDM booking and at the end of pregnancy and maternal treatment requirement. Maternal and neonatal outcomes such as cesarean section, macrosomia, large and small for gestational age (LGA, SGA), neonatal hypoglycemia, prematurity, hospitalization in the neonatal unit and Apgar score at 5 min < 7 were evaluated. Univariate and multivariate regression analyses and probability analyses were performed. Results: One-hour glucose after oGTT and prepregnancy BMI were correlated with cesarean section. GWG and HbA1c at the end pregnancy were associated with macrosomia and LGA, while prepregnancy BMI was inversely associated with SGA. The requirement for maternal treatment was correlated with neonatal hypoglycemia, and HbA1c at the end of pregnancy with prematurity (all p < 0.05). The correlations between predictors and pregnancy complications were exclusively observed when HbA1c was ≥5.5% (37 mmol/mol). In women with prepregnancy BMI ≥ 25 kg/m2 and HbA1c ≥ 5.5% (37 mmol/mol) at the 1st booking, the risk for cesarean section and LGA was nearly doubled compared to women with BMI with < 25 kg/m2 and HbA1c < 5.5% (37 mmol/mol). Conclusions: Prepregnancy BMI, GWG, maternal treatment requirement and HbA1c at the end of pregnancy can predict adverse pregnancy outcomes in women with GDM, particularly when HbA1c is ≥5.5% (37 mmol/mol). Stratification based on prepregnancy BMI and HbA1c at the 1st booking may allow for future risk-adapted care in these patients.
... It is well known that maternal overweight, obesity and severe obesity increase morbidity in both the mother and the newborn, and are associated with a variety of adverse pregnancy outcomes. The prevalence of maternal obesity and GD is increasing and becoming a major health problem in pregnancy with independent and additive impact on obstetric outcome [11][12][13] . Maternal obesity and GD share common metabolic characteristics such as increased insulin resistance, hyperglycemia and hyperinsulinemia, and GD may elicit distinct effects on clinical outcomes independently of obesity [11][12][13] . ...
... The prevalence of maternal obesity and GD is increasing and becoming a major health problem in pregnancy with independent and additive impact on obstetric outcome [11][12][13] . Maternal obesity and GD share common metabolic characteristics such as increased insulin resistance, hyperglycemia and hyperinsulinemia, and GD may elicit distinct effects on clinical outcomes independently of obesity [11][12][13] . Therefore, examination of the combined association of these common metabolic problems with pregnancy outcome is an important issue. ...
... Half of patients entering their pregnancy in the US have a BMI ≥25.0 and therefore qualify as overweight or obese 11 . Evidence supports association of excessive gestational weight gain with pregnancy complications and pregnancy outcome, as well as short-term and long-term impacts on neonatal outcome [11][12][13] . Controversy exists about the amount of how much weight, if any, obese pregnant women should gain 14,15 . ...
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Gestational diabetes involves disorder of glucose metabolism first diagnosed in pregnancy. Obese women undoubtedly have more often complications in reproductive age, such as fertility difficulties, spontaneous and recurrent miscarriages, premature births, and various obstetric and surgical complications related to the course of pregnancy, delivery and puerperium. Children of obese pregnant women are more likely to develop obesity in childhood and adulthood. We analyzed the outcome of 51 pregnancies in obese pregnant women and 50 pregnant women with normal body mass index. All women in both groups were diagnosed with gestational diabetes by the IADPSG criteria. We analyzed gestational age at delivery and mode of delivery, gestational weight gain, presence of concomitant diagnosis of gestational or chronic hypertension, difference in birth weight, and prevalence of hypertrophic newborns. There was no significant difference in gestational age at pregnancy termination and in the mode of delivery. There was a significant difference in gestational weight gain, number of pregnant women with hypertension, neonatal birth weight and number of hypertrophic children. Based on the data presented, we conclude that obesity is an unfavorable factor for pregnancy outcome. It also influences birth weight and fetal hypertrophy, as well as gestational weight gain.
... [1][2][3][4][5][6][7][8][9][10][11][12][13] Several research studies have proposed optimal gestational weight gains based on different pre-pregnancy BMI classifications. 5,[13][14][15] Pre-pregnancy BMI is considered an important parameter for pre-pregnancy counseling and weight management during pregnancy. ...
Article
Background and objectives: This study explored the appropriate classification of pre-pregnancy body mass index (BMI) in women of childbearing age in Beijing, China. Methods and study design: Women with singleton pregnancies at more than 28 gestational weeks were retrospectively reviewed. Based on the pre-pregnancy BMI (kg/m2), these patients were divided into 7 groups: <18.5, >=18.5-22.9, >=23-23.9, >=24-24.9, >=25-27.9, >=28-29.9, and >=30. Pregnancy adverse outcomes, including gestational hypertension with or without preeclampsia, gestational diabetes mellitus, initial cesarean section, postpartum hemorrhage, macrosomia, large-for-gestational age infant and so on were recorded. Binary logistic regression analysis was used to calculate the uncorrected and corrected odds ratios and 95% confidence intervals, with the >=18.5-22.9 group serving as a reference. Results: A total of 11,136 pregnant women were analyzed. Incidences of above mentioned six adverse outcomes were greater in women with higher pre-pregnancy BMI. The risks of the abovementioned six adverse outcomes were increased significantly among the >=23-23.9, >=24-24.9, >=25-27.9 groups and substantially higher in the >=28-29.9, >=30 groups after correction. <18.5 group showed an increased risk of small-for-gestational age infants. Conclusions: For women of childbearing age in Beijing, China, the optimal pre-pregnancy BMI range was >=18.5-22.9 kg/m2, with the cutoff value for overweight status being >=23.0 kg/m2 and the cutoff value for obesity being >=28.0 kg/m2.
... In the United States, according to the National Center for Health Statistics (1), the birth rate of 40 to 44-year-olds has doubled between 1981 and 2003. Many publications have shown that late maternity is associated with various risks to the mother and various risks to perinatal outcomes, such as preterm delivery (PTD), and chromosomal aberrations (2)(3)(4). Women are generally well informed about age-related decreasing fertility rates and the increasing risk of trisomy 21, but they are Received: 24 April, 2018 Accepted: 26 September, 2018 not as well informed about pregnancy-related risks based on increased maternal age (5). Controlled clinical studies and evidence-based guidelines for advising women who postpone childbearing are necessary (6). ...
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Objective: The aim of the present study was to assess the influence of maternal age and maternal body mass index of early pregnancy on the risk of preterm delivery (PTD). Material and methods: The study included 2.1 million liveborn single newborns with documented data at the perinatal surveys. The statistical analyses were done with SPSS Program. Results: The risk of preterm births was higher in obese women and with advanced age of the mother. Conclusion: The consequences are development of strategies to reduce the Body Mass Index (BMI) preconceptionally and of guidelines for advising women who postponed childbearing.