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

Geplaatst op

 

Background: 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 constructed gestational weight gain reference charts for underweight, normal weight, overweight, and grade 1, 2 and 3 obese women and compared these charts with those obtained in women with uncomplicated term pregnancies.

Methods: We used individual participant data from 218,216 pregnant women participating in 33 cohorts from Europe, North America and Oceania. Of these women, 9,065 (4.2%), 148,697 (68.1%), 42,678 (19.6%), 13,084 (6.0%), 3,597 (1.6%), and 1,095 (0.5%) were underweight, normal weight, overweight, and grade 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 size for gestational age infants. Gestational weight gain charts were derived by the Box-Cox t method using the generalized additive model for location, scale and shape.

Results: 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 grade 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 weight gain patterns were observed between cohorts/countries. Similar weight gain patterns were observed in mothers without pregnancy complications.

Conclusions: Gestational weight gain patterns are strongly related to pre-pregnancy body mass index. The 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.

Doel

We used individual participant data from 218,216 pregnant women from 33 European, North American and Oceania pregnancy cohort studies to assess the pattern of weight gain and to construct gestational weight gain charts for underweight, normal weight, overweight, and grade 1, 2 and 3 obese women. Additionally, we compared these charts to those obtained in 138,517 pregnant women from 26 cohorts who had uncomplicated term pregnancies.

Vraagstelling/hypothese

What is the gestational weight gain pattern for different body mass index groups?

Relevantie

These reference charts can be used to classify weight gain independently of gestational age in etiological research focused on maternal and offspring consequences of weight gain.  These charts may also be useful in clinical practice to identify women at risk for adverse short- and long-term health outcomes.

Conclusies

We developed gestational weight gain reference charts for different pre-pregnancy BMI groups for women in Europe, North America and Oceania. Gestational weight gain strongly differed per maternal pre-pregnancy BMI group and was gradually lower across higher BMI groups. These reference charts can be used to classify weight gain independently of gestational age in etiological research focused on maternal and offspring consequences of weight gain. Future research is needed that relates these charts with a broad range of maternal and child health outcomes. These charts may be useful in clinical practice to identify women at risk for adverse short- and long-term health outcomes.

Begeleider(s)

Projectmanagers:
Dr. Susana Santos and prof. dr. Vincent Jaddoe

Lead authors:
Susana Santos, Iris Eekhout, Stef van Buuren and Vincent WV Jaddoe.

Financiers

The lead authors received funding from the EU’s Horizon 2020 research and innovation programme under grant agreement number 733206 (LifeCycle).
Cohort-specific and individual funding is given in the manuscript.

Contactpersonen

Prof.dr. V. Jaddoe (Erasmus (MC))

Periode

We started working on this project in 2016 and finished in 2018.


Publicaties

Santos S, Eekhout I, Voerman E,  et al. Gestational weight gain charts for different body mass index groups for women in Europe, North America and Oceania. BMC Med. 2018;16(1):201.



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