Objective: to examine the effect of gestational weight gain (GWG) on likelihood of referral from midwife-led to obstetrician-led care during pregnancy and childbirth for women in primary care at the outset of their pregnancy.
Design: secondary analysis of data from a prospective cohort study.
Setting: Dutch midwife-led practices.
Participants: a cohort of 1288 women of Northern European descent, with uncomplicated, singleton pregnancy at antenatal booking who consequently were eligible for primary, midwife-led care.
Measurements: because of the absence of an established GWG guideline in the Netherlands, we compared the effect of inadequate and excessive GWG according to two GWG guidelines: the criterion traditionally used, which is based on knowledge of the physiological components of GWG, advising 10-15kg as a normal GWG irrespective of a woman׳s BMI category, and the 2009 Institute of Medicine recommendations (IOMr) on GWG, which provide BMI related advice. Outcome measures were: number of women referred from midwife-led to obstetrician-led care during pregnancy and during childbirth; indications of referral and birth outcomes.
Findings: GWG above traditional criteria (Tc; >15kg between 12 and 36 weeks) was associated with increased odds for referral during childbirth (adjusted odds ratio (aOR) 1.88; 95% confidence interval (CI) 1.22-2.90), but had no effect on referral during pregnancy (aOR .86; 95% CI .57-1.30). No associations were established between GWG below Tc (<10kg) and referral during pregnancy (aOR 1.08; 95% CI .78-1.50) or childbirth (aOR 1.08; 95% CI .74-1.56). No associations were found between GWG below and above the IOMr and referral during pregnancy (below IOMr: aOR 1.01; 95% CI .71-1.45; above IOMr: aOR .89; 95% CI .61-1.28) or childbirth (below IOMr: aOR .85; 95% CI .57-1.25; above IOMr: aOR 1.09; 95% CI .73-1.63). With regard to the effect of GWG according to both recommendations on indications for referral and birth outcomes, GWG above Tc was associated with higher rates of referral for hypertensive disorders (aOR 1.91; 95% CI 1.04-3.50) and for meconium stained liquor (aOR 2.22; CI 1.33-3.71) after adjusting for BMI and parity.
Conclusions: GWG above Tc - irrespective of BMI category - was associated with doubled odds of referral to specialist care during childbirth. GWG below or above IOMR and GWG below TC were not associated with adverse obstetric outcomes in women who were eligible for primary care at the outset of their pregnancy.
Implications For Practice: weight gain <15kg between 12 and 36 weeks is advised for women in all BMI categories in this population. It is important to validate GWG guidelines in a target population before implementing them.
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http://dx.doi.org/10.1016/j.midw.2015.12.006 | DOI Listing |
Obesity (Silver Spring)
January 2025
Department of Nutrition, Exercise and Sports, Faculty of Science, University of Copenhagen, Copenhagen, Denmark.
Objective: The study objective was to evaluate changes in abdominal adipose tissue and ectopic fat during pregnancy and their associations with gestational weight gain (GWG) in women with overweight/obesity.
Methods: This study was a secondary analysis of a randomized controlled trial. Magnetic resonance scans were performed during gestational week (GW) 15, GW 32, and around birth to measure abdominal subcutaneous (SAT) and visceral (VAT) adipose tissues, liver fat, and muscle fat.
AIDS Behav
December 2024
Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA.
Suboptimal gestational weight gain (GWG) is associated with pregnancy complications and postpartum weight retention (PPWR). Little data exists about GWG and PPWR attitudes and beliefs in low-and-middle-income countries (LMICs) to inform interventions. We examined GWG and PPWR attitudes, beliefs, and intentions among pregnant people, with and without HIV, in Cape Town, South Africa.
View Article and Find Full Text PDFFront Cell Infect Microbiol
December 2024
Department of Obstetrics, Women and Children's Hospital, School of Medicine, Xiamen University, Xiamen, China.
Background: Existing literature indicates that Gestational diabetes mellitus (GDM) and maternal obesity disrupt the normal colonization of the neonatal gut microbiota alone. Still, the combined impact of GDM and excessive gestational weight gain (EGWG) on this process remains under explored. The association between gestational weight gain before/after GDM diagnosis and neonatal gut microbiota characteristics is also unclear.
View Article and Find Full Text PDFObesity (Silver Spring)
December 2024
Pennington Biomedical Research Center, Baton Rouge, Louisiana, USA.
Objective: This study of pregnant people with obesity examined two aims in testing the hypothesis that the COVID-19 pandemic widened racial disparity in maternal health in high-risk pregnancies; it compared by race both (1) gestational weight gain (GWG) patterns and (2) patterns of preexisting conditions and adverse pregnancy outcomes.
Methods: This retrospective chart review included birth certificate and delivery records from a large women's specialty hospital in Louisiana between 2018 and 2022. Differences in preexisting conditions, GWG, and adverse pregnancy outcomes were explored across early-, peak-, and late-pandemic periods using log-linear regression and robust Poisson models.
Early Hum Dev
December 2024
Department of Pediatrics, Peking University People's Hospital, Beijing, China. Electronic address:
Background: Globally, small for gestational age (SGA) is increasingly prevalent, paralleling the common high-risk pregnancies with inappropriate gestational weight gain (GWG). However, whether maternal GWG was associated with their SGA offspring's long-term development remained unresolved.
Objective: To examine the associations of maternal GWG with the long-term physical and neurological development of SGA children based on a real-world cohort in our hospital.
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