Patrick M Catalano1, Lisa Mele2, Mark B Landon3, Susan M Ramin4, Uma M Reddy5, Brian Casey6, Ronald J Wapner7, Michael W Varner8, Dwight J Rouse9, John M Thorp10, George Saade11, Yoram Sorokin12, Alan M Peaceman13, Jorge E Tolosa14. 1. Center for Reproductive Health, Department of Reproductive Biology, Case Western Reserve University, MetroHealth Medical Center, Cleveland, OH. 2. George Washington University Biostatistics Center, Washington, DC. 3. Departments of Obstetrics and Gynecology, the Ohio State University, Columbus, OH. 4. University of Texas Health Science Center at Houston-Children's Memorial Hermann Hospital, Houston, TX. 5. Eunice Kennedy Shriver National Institute of Child Health and Human Development. 6. University of Texas Southwestern Medical Center, Dallas, TX. 7. College of Physicians and Surgeons, Columbia University, New York, NY. 8. University of Utah School of Medicine, Salt Lake City, UT. 9. University of Alabama at Birmingham School of Medicine, Birmingham, AL. 10. University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, NC. 11. University of Texas Medical Branch, Galveston, TX. 12. Wayne State University School of Medicine, Detroit, MI. 13. Northwestern University School of Medicine, Chicago, IL. 14. Oregon Health and Science University, Portland, OR.
Abstract
OBJECTIVE: We sought to evaluate inadequate gestational weight gain and fetal growth among overweight and obese women. STUDY DESIGN: We conducted an analysis of prospective singleton term pregnancies in which 1053 overweight and obese women gained >5 kg (14.4 ± 6.2 kg) or 188 who either lost or gained ≤5 kg (1.1 ± 4.4 kg). Birthweight, fat mass, and lean mass were assessed using anthropometry. Small for gestational age (SGA) was defined as ≤10th percentile of a standard US population. Univariable and multivariable analysis evaluated the association between weight change and neonatal morphometry. RESULTS: There was no significant difference in age, race, smoking, parity, or gestational age between groups. Weight loss or gain ≤5 kg was associated with SGA, 18/188 (9.6%) vs 51/1053 (4.9%); (adjusted odds ratio, 2.6; 95% confidence interval, 1.4-4.7; P = .003). Neonates of women who lost or gained ≤5 kg had lower birthweight (3258 ± 443 vs 3467 ± 492 g, P < .0001), fat mass (403 ± 175 vs 471 ± 193 g, P < .0001), and lean mass (2855 ± 321 vs 2995 ± 347 g, P < .0001), and smaller length, percent fat mass, and head circumference. Adjusting for diabetic status, prepregnancy body mass index, smoking, parity, study site, gestational age, and sex, neonates of women who gained ≤5 kg had significantly lower birthweight, lean body mass, fat mass, percent fat mass, head circumference, and length. There were no significant differences in neonatal outcomes between those who lost weight and those who gained ≤5 kg. CONCLUSION: In overweight and obese women weight loss or gain ≤5 kg is associated with increased risk of SGA and decreased neonatal fat mass, lean mass, and head circumference.
OBJECTIVE: We sought to evaluate inadequate gestational weight gain and fetal growth among overweight and obesewomen. STUDY DESIGN: We conducted an analysis of prospective singleton term pregnancies in which 1053 overweight and obesewomen gained >5 kg (14.4 ± 6.2 kg) or 188 who either lost or gained ≤5 kg (1.1 ± 4.4 kg). Birthweight, fat mass, and lean mass were assessed using anthropometry. Small for gestational age (SGA) was defined as ≤10th percentile of a standard US population. Univariable and multivariable analysis evaluated the association between weight change and neonatal morphometry. RESULTS: There was no significant difference in age, race, smoking, parity, or gestational age between groups. Weight loss or gain ≤5 kg was associated with SGA, 18/188 (9.6%) vs 51/1053 (4.9%); (adjusted odds ratio, 2.6; 95% confidence interval, 1.4-4.7; P = .003). Neonates of women who lost or gained ≤5 kg had lower birthweight (3258 ± 443 vs 3467 ± 492 g, P < .0001), fat mass (403 ± 175 vs 471 ± 193 g, P < .0001), and lean mass (2855 ± 321 vs 2995 ± 347 g, P < .0001), and smaller length, percent fat mass, and head circumference. Adjusting for diabetic status, prepregnancy body mass index, smoking, parity, study site, gestational age, and sex, neonates of women who gained ≤5 kg had significantly lower birthweight, lean body mass, fat mass, percent fat mass, head circumference, and length. There were no significant differences in neonatal outcomes between those who lost weight and those who gained ≤5 kg. CONCLUSION: In overweight and obesewomenweight loss or gain ≤5 kg is associated with increased risk of SGA and decreased neonatal fat mass, lean mass, and head circumference.
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