Weight gain greater, less than recommended during pregnancy linked with increased risk of adverse outcomes
In an analysis that included more than 1.3 million pregnancies, weight gain during pregnancy that was greater or less than guideline recommendations was associated with a higher risk of adverse outcomes for mothers and infants, compared with weight gain within recommended levels, according to a study published by JAMA.
Body mass index (BMI) and gestational (during pregnancy) weight gain are increasing globally. In 2009, the Institute of Medicine (IOM) provided specific recommendations regarding the ideal gestational weight gain. However, the association between gestational weight gain consistent with the IOM guidelines and pregnancy outcomes is unclear. Rebecca F. Goldstein, M.B.B.S., F.R.A.C.P., Helena J. Teede, M.B.B.S., F.R.A.C.P., Ph.D., of Monash University, Victoria, Australia, and colleagues conducted a systematic review and meta-analysis of 23 studies (n = 1,309,136 women) to evaluate associations between gestational weight gain above or below the IOM guidelines (gain of 27.6 - 39.7 lbs. for underweight women [BMI less than 18.5]; 25.4 - 35.3 lbs. for normal-weight women [BMI 18.5-24.9]; 15.4 - 24.3 lbs., for overweight women [BMI 25-29.9]; and 11 - 19.8 lbs. for obese women [BMI 30 or greater]) and maternal and infant outcomes.
The researchers found that 47 percent of pregnancies had gestational weight gain greater than IOM recommendations and 23 percent had weight gain less than the recommendations. Gestational weight gain below the recommendations was associated with higher risk of small for gestational age (SGA) and preterm birth and lower risk of large for gestational age (LGA) and macrosomia (newborn with an excessive birth weight).
Gestational weight gain above the recommendations was associated with lower risk of SGA and preterm birth and higher risk of LGA, macrosomia and cesarean delivery.
Several limitations of the study are noted in the article, including that it lacks studies from developing countries and excluded non-English-language articles.
The World Health Organization has prioritized achievement of ideal BMI prior to conception and prevention of excess gestational weight gain. The authors write that lifestyle interventions in pregnancy can help women attain recommended gestational weight gain.