Prepregnancy body mass index, gestational weight gain, and birth weight in the BRISA cohort

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ABSTRACT

OBJECTIVE

To analyze the effects of maternal pre-pregnancy body mass index and weight gain during pregnancy on the baby's birth weight.

METHODS

We conducted a cross-sectional study with 5,024 mothers and their newborns using a Brazilian birth cohort study. In the proposed model, estimated by structural equation modeling, we tested socioeconomic status, age, marital status, pre-pregnancy body mass index, smoking habit and alcohol consumption during pregnancy, hypertension and gestational diabetes, gestational weight gain, and type of delivery as determinants of the baby's birth weight.

RESULTS

For a gain of 4 kg/m ² (1 Standard Deviation [SD]) in pre-pregnancy body mass index, there was a 0.126 SD increase in birth weight, corresponding to 68 grams (p < 0.001). A 6 kg increase (1 SD) in gestational weight gain represented a 0.280 SD increase in newborn weight, correponding to 151.2 grams (p < 0.001). The positive effect of pre-pregnancy body mass index on birth weight was direct (standardized coefficient [SC] = 0.202; p < 0.001), but the negative indirect effect was small (SC = -0.076, p < 0.001) and partially mediated by the lower weight gain during pregnancy (SC = -0.070, p < 0.001). The positive effect of weight gain during pregnany on birth weight was predominantly direct (SC = 0.269, p < 0.001), with a small indirect effect of cesarean delivery (SC = 0.011; p < 0.001). Women with a higher pre-pregnancy body mass index gained less weight during pregnancy (p < 0.001).

CONCLUSIONS

The effect of gestational weight gain on the increase in birth weight was greater than that of pre-pregnancy body mass index.

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Effect of Body Mass Index on pregnancy outcomes in nulliparous women delivering singleton babies

Sohinee Bhattacharya, Doris Campbell, William Liston … (2007)

Background The increasing prevalence of obesity in young women is a major public health concern. These trends have a major impact on pregnancy outcomes in these women, which have been documented by several researchers. In a population based cohort study, using routinely collected data, this paper examines the effect of increasing Body Mass Index (BMI) on pregnancy outcomes in nulliparous women delivering singleton babies. Methods This was a retrospective cohort study, based on all nulliparous women delivering singleton babies in Aberdeen between 1976 and 2005. Women were categorized into five groups – underweight (BMI 35 Kg/m2). Obstetric and perinatal outcomes were compared by univariate and multivariate analyses. Results In comparison with women of BMI 20 – 24.9, morbidly obese women faced the highest risk of pre-eclampsia {OR 7.2 (95% CI 4.7, 11.2)} and underweight women the lowest {OR 0.6 (95% CI 0.5, 0.7)}. Induced labour was highest in the morbidly obese {OR 1.8 (95% CI 1.3, 2.5)} and lowest in underweight women {OR 0.8 (95% CI 0.8, 0.9)}. Emergency Caesarean section rates were highest in the morbidly obese {OR 2.8 (95% CI 2.0, 3.9)}, and comparable in women with normal and low BMI. Obese women were more likely to have postpartum haemorrhage {OR 1.5 (95% CI 1.3, 1.7)} and preterm delivery ( 4,000 g was in the morbidly obese {OR 2.1 (95% CI 1.3, 3.2)} and the lowest in underweight women {OR 0.5 (95% CI 0.4, 0.6)}. Conclusion Increasing BMI is associated with increased incidence of pre-eclampsia, gestational hypertension, macrosomia, induction of labour and caesarean delivery; while underweight women had better pregnancy outcomes than women with normal BMI.

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Associations of maternal BMI and gestational weight gain with neonatal adiposity in the Healthy Start study.

Anne Starling, John Brinton, Deborah Glueck … (2015)

Maternal obesity and weight gain during pregnancy are risk factors for child obesity. Associations may be attributable to causal effects of the intrauterine environment or genetic and postnatal environmental factors.

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Position of the Academy of Nutrition and Dietetics: Obesity, Reproduction, and Pregnancy Outcomes.

Laurel G Huffman, Jamie Stang (2016)

It is the position of the Academy of Nutrition and Dietetics that all women of reproductive age receive education about maternal and fetal risks associated with prepregnancy obesity, excessive gestational weight gain, and significant postpartum weight retention, including potential benefits of lifestyle changes. Behavioral counseling to improve dietary intake and physical activity should be provided to overweight and obese women, beginning in the preconception period and continuing throughout pregnancy, for at least 12 to 18 months postpartum. Weight loss before pregnancy may improve fertility and reduce the risk of poor maternal-fetal outcomes, such as preterm birth, gestational diabetes, gestational hypertension, pre-eclampsia, assisted delivery, and select congenital anomalies. Lifestyle interventions that moderate gestational weight gain may reduce the risk of poor pregnancy outcomes, such as gestational diabetes, gestational hypertension, large for gestational age, and macrosomia, as well as lower the risk for significant postpartum retention. Postpartum interventions that promote healthy diet and physical activity behaviors may reduce postpartum weight retention and decrease obesity-related risks in subsequent pregnancies. Analysis of the evidence suggests that there is good evidence to support the role of diet, physical activity, and behavior changes in promoting optimal weight gain during pregnancy; however, there is currently a relative lack of evidence in other areas related to reproductive outcomes.

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Author and article information

Journal

Journal ID (nlm-ta): Rev Saude Publica

Journal ID (iso-abbrev): Rev Saude Publica

Journal ID (publisher-id): rsp

Title: Revista de Saúde Pública

Publisher: Faculdade de Saúde Pública da Universidade de São Paulo

ISSN (Print): 0034-8910

ISSN (Electronic): 1518-8787

Publication date Collection: 2018

Publication date (Electronic): 20 April 2018

Volume: 52

Electronic Location Identifier: 46

Affiliations

[I ]Instituto Federal de Educação, Ciência e Tecnologia do Maranhão - Campus Açailândia. Departamento de Ensino. Açailândia, MA, Brasil

[II ]Universidade Federal do Maranhão. Departamento de Saúde Pública. São Luís, MA, Brasil

[III ]Universidade Federal do Maranhão. Departamento de Medicina III. São Luís, MA, Brasil

[IV ]Universidade Federal do Maranhão. Departamento de Odontologia II. São Luís, MA, Brasil

[V ]Universidade Federal do Maranhão. Centro de Ciências Sociais, Saúde e Tecnologia. Imperatriz, MA, Brasil

[VI ]Universidade de São Paulo. Faculdade de Medicina de Ribeirão Preto. Departamento de Puericultura e Pediatria. Ribeirão Preto, SP, Brasil

Author notes

Correspondence: Raina Jansen Cutrim Propp Lima, Av. Projetada, s/n Vila Progresso II, 65930-000 Açailândia, MA, Brasil, E-mail: raina.propp@ 123456ifma.edu.br

Authors’ Contribution: Conception and planning of the study: RJCPL, RFLB. Data collection, data analysis and interpretation, writing of the study, and critical revision: RJCPL, RFLB, MRCR, CCCR, VMFS, PMLN, AAMS, HB. All authors have approved the final version of the manuscript.

Conflict of Interest: The authors declare no conflict of interest.

Article

Other ID: 00238

DOI: 10.11606/S1518-8787.2018052000125

PMC ID: 5947505

PubMed ID: 29723385

SO-VID: 09931b33-1573-4903-8db8-9c30a0997405

License:

This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

History

Date received : 07 June 2017

Date accepted : 12 October 2017

Page count

Figures: 1, Tables: 4, Equations: 0, References: 27

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Prepregnancy body mass index, gestational weight gain, and birth weight in the BRISA cohort

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ABSTRACT

OBJECTIVE

METHODS

RESULTS

CONCLUSIONS

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Most cited references 19

Effect of Body Mass Index on pregnancy outcomes in nulliparous women delivering singleton babies

Associations of maternal BMI and gestational weight gain with neonatal adiposity in the Healthy Start study.

Position of the Academy of Nutrition and Dietetics: Obesity, Reproduction, and Pregnancy Outcomes.

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Cited by 14

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