Influence of Pregnancy Weight on Maternal and Child Health Workshop Report (2007) / Chapter Skim
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5 Maternal Weight, Gestational Weight Gain, and Children's Health
5 Maternal Weight, Gestational Weight Gain, and Children's Health
Pages 50-64
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The following sections review the available research on short-term infant health outcomes and the long-term child health outcomes of maternal and gestational weight gain. In general, short-term health outcomes refer to infants up to 1 year of age.
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in 1987. Preterm Delivery Maternal prepregnancy weight and gestational weight gain are related to preterm delivery.1 A recent meta-analysis of 13 studies published from 1980 through 1996 concluded that inadequate weight gain is associated with an increased risk of prematurity, with a possible indication specifically on inadequate gain late in pregnancy (Carmichael and Abrams, 1997)
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From page 52... ...
In addition, recent studies indicate that inadequate gestational weight gain and low prepregnancy BMI are associated with an increased risk of premature deliveries; the highest risk was found in underweight women who gained little weight during pregnancy. Although a substantial increase in BMI has occurred in women of reproductive age, the preterm delivery rates in the United States have steadily increased in the past 20 years from about 8 to about 12 percent (Mercer et al., 2006)
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Other factors include such medical problems as maternal hypertension, diabetes, particularly involving vasculopathies, low maternal prepregnancy weight, premature labor, hypoxia, and substance abuse. Catalano stated that poor maternal weight gain in pregnancy has not been found to be directly related to the risk of intrauterine growth restriction.2 For example, in the Dutch winter famine of 1945, women in the latter part of pregnancy were severely restricted in their calories, but the average birth weight decreased by only 240 grams.
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. Gestational age is an important predictor of infant fat mass, but maternal gestational weight gain accounts for only about half of the variance of infant fat mass compared with variance accounted for by maternal prepregnancy BMI.
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However, the women who were overweight or obese before pregnancy had infants who had a greater the amount of fat mass and percentage body fat than the lean normalweight women. Prepregnancy BMI was not predictive of infant lean body mass, but gestational age was the best predictor of infant lean body mass in women who were lean and of average weight before pregnancy.
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In women who were overweight or obese prior to pregnancy, maternal weight gain in pregnancy, the 1-hour glucose screen, and gestational age contributed to the infant's percent body fat. Summary of the Short-Term Infant Health Outcomes The review by Catalano at the workshop indicated that lower rates of maternal prepregnancy weight and gestational weight gain increase the risk of preterm delivery.3 There has been a substantial increase in infant birth weight concomitant with the increase in maternal weight over the past decade.
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. It is important to consider the extent to which maternal weight and weight gain during pregnancy act independent of these pathways, because they may help to clarify the population impact of greater pregnancy obesity and higher gestational weight gains.
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. Maternal Weight In a study of low-income children in the Special Supplemental Food Program for Women, Infants, and Children (WIC)
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There is limited information about child health outcomes other than weight in relation to maternal weight. Gestational Weight Gain Very few published studies examine gestational weight gain and child outcomes.
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, compared with mothers who gained inadequate weight, mothers who gained both adequate and excessive weight had similar elevations in the child's BMI score. Finally, Oken described one study that suggests the relationship between maternal gestational weight gain and child overweight risk seems to vary within different categories of maternal prepregnancy weight; it assumes a J shape among underweight mothers, a U shape among mothers with gestational weight gain less than 45 lbs., and a linear pattern at the highest weight gains (personal communication, A.J.
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A few studies describe the relationship of gestational weight gain and infant body composition. Maternal BMI and gestational weight gain have been shown to predict fat mass and percentage fat in newborns and maternal BMI and gestational weight gain can also predict infant lean body mass.
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In studying complex interactions among maternal weight, gestational weight gain, and infant and child health outcomes, investigations need to use statistical models that build on conceptual theories. There is a compelling need to examine these relationships in a more diverse population.4 Finally, these findings need to be interpreted and referenced through the application of a theoretical model that can lend both coherence and additional research.
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Oken, E 2006 Maternal Weight and Gestational Weight Gain as Predictors of Long-Term Off spring Growth and Health.
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2004 Reasons for increasing trends in large for gestational age births. Obstetrics and Gynecology 104(4)
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