Stephanie A Leonard1, Jennifer A Hutcheon2, Lisa M Bodnar3,4, Lucia C Petito5, Barbara Abrams1. 1. Division of Epidemiology, School of Public Health, University of California, Berkeley, CA. 2. Department of Obstetrics and Gynaecology, University of British Columbia, Vancouver, British Columbia, Canada. 3. Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA. 4. Department of Obstetrics, Gynecology, and Reproductive Sciences, School of Medicine, University of Pittsburgh, Pittsburgh, PA. 5. Division of Biostatistics, School of Public Health, University of California, Berkeley, CA.
Abstract
BACKGROUND: Gestational weight gain may be a modifiable contributor to infant health outcomes, but the effect of gestational duration on gestational weight gain has limited the identification of optimal weight gain ranges. Recently developed z-score and percentile charts can be used to classify gestational weight gain independent of gestational duration. However, racial/ethnic variation in gestational weight gain and the possibility that optimal weight gain differs among racial/ethnic groups could affect generalizability of the z-score charts. The objectives of this study were (1) to apply the weight gain z-score charts in two different U.S. populations as an assessment of generalisability and (2) to determine whether race/ethnicity modifies the weight gain range associated with minimal risk of preterm birth. METHODS: The study sample included over 4 million live, singleton births in California (2007-2012) and Pennsylvania (2003-2013). We implemented a noninferiority margin approach in stratified subgroups to determine weight gain ranges for which the adjusted predicted marginal risk of preterm birth (gestation <37 weeks) was within 1 or 2 percentage points of the lowest observed risk. RESULTS: There were minimal differences in the optimal ranges of gestational weight gain between California and Pennsylvania births, and among several racial/ethnic groups in California. The optimal ranges decreased as severity of prepregnancy obesity increased in all groups. CONCLUSIONS: The findings support the use of weight gain z-score charts for studying gestational age-dependent outcomes in diverse U.S. populations and do not support weight gain recommendations tailored to race/ethnicity.
BACKGROUND:Gestational weight gain may be a modifiable contributor to infant health outcomes, but the effect of gestational duration on gestational weight gain has limited the identification of optimal weight gain ranges. Recently developed z-score and percentile charts can be used to classify gestational weight gain independent of gestational duration. However, racial/ethnic variation in gestational weight gain and the possibility that optimal weight gain differs among racial/ethnic groups could affect generalizability of the z-score charts. The objectives of this study were (1) to apply the weight gain z-score charts in two different U.S. populations as an assessment of generalisability and (2) to determine whether race/ethnicity modifies the weight gain range associated with minimal risk of preterm birth. METHODS: The study sample included over 4 million live, singleton births in California (2007-2012) and Pennsylvania (2003-2013). We implemented a noninferiority margin approach in stratified subgroups to determine weight gain ranges for which the adjusted predicted marginal risk of preterm birth (gestation <37 weeks) was within 1 or 2 percentage points of the lowest observed risk. RESULTS: There were minimal differences in the optimal ranges of gestational weight gain between California and Pennsylvania births, and among several racial/ethnic groups in California. The optimal ranges decreased as severity of prepregnancy obesity increased in all groups. CONCLUSIONS: The findings support the use of weight gain z-score charts for studying gestational age-dependent outcomes in diverse U.S. populations and do not support weight gain recommendations tailored to race/ethnicity.
Authors: Lisa M Bodnar; Jennifer A Hutcheon; Robert W Platt; Katherine P Himes; Hyagriv N Simhan; Barbara Abrams Journal: Am J Epidemiol Date: 2011-06-01 Impact factor: 4.897
Authors: L A Schieve; M E Cogswell; K S Scanlon; G Perry; C Ferre; C Blackmore-Prince; S M Yu; D Rosenberg Journal: Obstet Gynecol Date: 2000-08 Impact factor: 7.661
Authors: Jennifer A Hutcheon; Lisa M Bodnar; K S Joseph; Barbara Abrams; Hyagriv N Simhan; Robert W Platt Journal: Paediatr Perinat Epidemiol Date: 2012-01-16 Impact factor: 3.980
Authors: Patricia M Dietz; William M Callaghan; Mary E Cogswell; Brian Morrow; Cynthia Ferre; Laura A Schieve Journal: Epidemiology Date: 2006-03 Impact factor: 4.822
Authors: Lisa M Bodnar; Katherine P Himes; Barbara Abrams; Timothy L Lash; Sara M Parisi; Cara L Eckhardt; Betty J Braxter; Sarah Minion; Jennifer A Hutcheon Journal: Obstet Gynecol Date: 2019-11 Impact factor: 7.661
Authors: Stephanie A Leonard; Barbara Abrams; Elliott K Main; Deirdre J Lyell; Suzan L Carmichael Journal: Am J Clin Nutr Date: 2020-04-01 Impact factor: 7.045
Authors: Cassandra M Pickens; Carol J Hogue; Penelope P Howards; Michael R Kramer; Martina L Badell; Donald J Dudley; Robert M Silver; Robert L Goldenberg; Halit Pinar; George R Saade; Michael W Varner; Barbara J Stoll Journal: BMC Pregnancy Childbirth Date: 2019-11-29 Impact factor: 3.007