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    Prepregnancy weight, gestational weight gain, and risk of growth affected neonates

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    Authors
    Moore Simas, Tiffany A.
    Waring, Molly E.
    Liao, Xun
    Garrison, Anne
    Sullivan, Gina M. T.
    Howard, Allison E.
    Hardy, Janet R.
    UMass Chan Affiliations
    Department of Quantitative Health Sciences
    Department of Obstetrics and Gynecology
    Document Type
    Journal Article
    Publication Date
    2012-04-13
    Keywords
    Female
    Humans
    Obesity
    Pregnancy
    Prevalence
    Risk Factors
    Severity of Illness Index
    Weight Gain
    Weight Loss
    Maternal and Child Health
    Obstetrics and Gynecology
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    Abstract
    BACKGROUND: In 2009, the Institute of Medicine published revised gestational weight gain (GWG) guidelines with changes notable for altered body mass index (BMI) categorization as per World Health Organization criteria and a stated range of recommended gain (11-20 pounds) for obese women. The goal of this study was to evaluate associations between maternal BMI-specific GWG adherence in the context of these new guidelines and risk of small for gestational age (SGA) and large for gestational age (LGA) neonates. METHODS: Subjects were a retrospective cohort of 11,203 live birth singletons delivered at 22-44 weeks at a Massachusetts tertiary care center between April 2006 and March 2010. Primary exposure was GWG adherence (inadequate, appropriate, or excessive) based on BMI-specific recommendations. SGA and LGA were defined as /=90th percentiles of U.S. population growth curves, respectively. The association between GWG adherence and SGA and LGA was examined in polytomous logistic regression models that estimated adjusted odds ratios (AOR) stratified by prepregnancy weight status, controlling for potential confounders. RESULTS: Before pregnancy, 3.8% of women were underweight, 50.9% were normal weight, 24.6% were overweight, and 20.6% were obese. Seventeen percent had inadequate GWG, and 57.2% had excessive GWG. Neonates were 9.6% SGA and 8.7% LGA. Inadequate GWG was associated with increased odds of SGA (AOR 2.51, 95% confidence interval [CI] 1.31-4.78 for underweight and AOR 1.78, 95% CI 1.42-2.24 for normal weight women) and decreased odds of LGA (AOR 0.5, 95% CI 0.47-0.73 for normal weight and AOR 0.56, 95% CI 0.34-0.90 for obese women). Excessive GWG was associated with decreased odds of SGA (AOR 0.59, 95% CI 0.47-0.73 for normal weight and AOR 0.64, 95% CI 0.47-0.89 for overweight women) and increased odds of LGA (AOR 1.76, 95% CI 1.38-2.24 for normal weight, AOR 2.99, 95% CI 1.92-4.65 for overweight, and AOR 1.55, 95% CI 1.10-2.19 for obese women). CONCLUSIONS: Efforts to optimize GWG are essential to reducing the proportion of SGA and LGA neonates, regardless of prepregnancy BMI.
    Source
    Tiffany A. Moore Simas, Molly E. Waring, Xun Liao, Anne Garrison, Gina M.T. Sullivan, Allison E. Howard, and Janet R. Hardy. Journal of Women's Health. April 2012, 21(4): 410-417. doi:10.1089/jwh.2011.2810. Link to article on publisher's site
    DOI
    10.1089/jwh.2011.2810
    Permanent Link to this Item
    http://hdl.handle.net/20.500.14038/46600
    PubMed ID
    22165953
    Related Resources
    Link to Article in PubMed
    Rights
    Copyright © 2012 Mary Ann Liebert, Inc. publishers. Publisher PDF posted as allowed by the publisher's author rights policy at http://www.liebertpub.com/archpolicy/journal-of-womens-health/42/.
    ae974a485f413a2113503eed53cd6c53
    10.1089/jwh.2011.2810
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