上海地区妊娠期糖尿病孕妇孕前体重指数及孕期体重增加现状分析

目的:分析上海地区妊娠期糖尿病(GDM)孕妇孕前体重指数(BMI)和孕期增重(GWG)特点。方法:选取2017年7月至2018年7月在上海十家医院规律产检并住院分娩的单胎孕妇共3961例,其中610例GDM孕妇和3351例非GDM孕妇。分析GDM的发病高危因素,比较GDM孕妇和非GDM孕妇孕前BMI、GWG、早中晚孕期增重、妊娠合并症等差异,并将两组GWG与美国科学研究院医学协会(IOM)推荐增重标准进行比较。结果:孕前BMI和年龄是GDM发生的独立高危因素(OR=1.18,95%CI为1.05～1.34;OR=1.09,95%CI为1.06～1.11)。GDM组的孕前BMI值为(22.3±3.4)kg/m~2,高于NGDM组[(21.1±2.7)kg/m~2],两者差异有统计学意义(P0.05)。GDM组的GWG为(11.9±4.8)kg,明显低于NGDM组[(13.3±4.3)kg]。两组早孕期增重无统计学差异。GDM组的中、晚孕期增重[(5.5±2.4)kg、(4.1±2.4)kg]少于NGDM组孕妇[(6.5±2.7)kg、(4.8±2.5)kg],差异均有统计学意义(P均0.001)。与IOM推荐孕期增重标准比较,孕前BMI适中、超重的GDM组孕妇中增重偏少者占比均较NGDM组高;NGDM组增重偏多者占比均较GDM组高。结论:孕前超重或肥胖及高龄可导致GDM发生率增加,应对该群体进行孕前指导,合理控制BMI后再备孕。孕中晚期良好的医疗管理可有效控制GDM孕妇的孕期增重,进而减少不良妊娠结局。     

农村妇女孕期体重对妊娠结局的影响

目的:探讨农村妇女孕期体重与妊娠结局的关系,为农村孕妇的体重管理提供理论依据。方法:收集2014年2月至2015年2月禹城市人民医院产一科住院分娩的单胎妊娠农村初产妇896例,按孕前体重指数(BMI)分为孕前消瘦组(≤18.5kg/m~2)、孕前体重正常组(18.5kg/m~2BMI24kg/m~2)、超重组(24kg/m2≤BMI28kg/m~2)、肥胖组(≥28kg/m~2);按孕期体重增长分为体重增长适宜组及体重增长过度组。分析各组孕妇妊娠结局及并发症的发生情况。结果:孕前超重组与孕前体重正常组比较,孕期体重增长过度组与孕期体重增长适宜组比较,均显著增加妊娠期高血压疾病、妊娠期糖尿病、剖宫产、产后出血、巨大儿的风险,差异有统计学意义(P0.05)。结论:孕前超重与孕期体重增长过度是导致农村孕妇不良妊娠结局的危险因素,应加强孕妇的体重管理,降低妊娠不良结局发生。     

孕前超重及肥胖对孕期体质量控制及妊娠结局的影响

目的:评估孕前超重及肥胖对孕期体质量控制及妊娠结局的影响。方法:回顾性收集2015年1月-2017年12月于我院分娩足月单胎孕妇的孕前体质量指数(BMI)、孕期体质量变化及妊娠结局等资料,比较孕前超重、肥胖孕妇与孕前体质量正常孕妇的孕期体质量控制情况及妊娠结局,多因素分析孕前超重及肥胖对孕期体质量控制及妊娠结局的影响。结果:纳入超重孕妇496例(超重组),肥胖孕妇44例(肥胖组)以及体质量正常孕妇(对照组)540例,超重、肥胖及对照组的孕前BMI分别为26.3(2.0)kg/m^2、31.3(2.9)kg/m^2及20.7(2.5)kg/m^2。超重、肥胖组的孕期体质量超标比例高于对照组(分别为63.9%、72.7%及41.3%),超重及肥胖组孕妇的子痫前期、妊娠期糖尿病及剖宫产风险均高于体质量正常孕妇。超重及肥胖组的新生儿平均出生体质量高于正常组[分别为(3 528.0±397.4)kg、(3 562.6±417.6)kg及(3 387.8±384.5)kg,巨大儿比例也呈升高趋势(分别为12.3%、15.9%及5.0%)。多因素分析结果显示孕前超重(OR=3.071,95%CI:2.345~4.022)及肥胖(OR=5.113,95%CI:2.507~10.431)是孕期体质量超标的影响因素,同时对子痫前期(P<0.001)、妊娠期糖尿病(P<0.001)、剖宫产(P<0.05)及巨大儿(P<0.05)风险均有显著影响。结论:孕前超重及肥胖不仅显著影响孕期体质量控制结局(尤其是孕期体质量超标风险),同时对包括子痫前期、妊娠期糖尿病、剖宫产、巨大儿风险在内的妊娠结局也影响显著;孕前体质量控制对于超重及肥胖的育龄妇女具有重要意义。     

孕前体重指数及孕期体重增加与巨大儿的关系

目的探讨孕前体重指数及孕期体重增加与巨大儿的发生率之间的关系。方法回顾性的分析首都医科大学附属北京妇产医院2014年1月至2014年3月住院分娩的单胎、妊娠满37~41周、无并发症及慢性疾病初产妇的临床资料共1 085例。根据世界卫生组织的体重标准,所有病例按产妇孕前体重指数(BMI)分为低体重组BMI18.5kg/m2、标准体重组BMI 18.5~24.9kg/m2、超重组BMI 25~29.9kg/m2、肥胖组BMI≥30kg/m2四个组;孕期体重增加分为低于IOM标准,符合IOM标准,超出IOM标准三组。采用χ2检验法比较各组、各变量间差异的统计学意义。结果孕前低体重指数孕妇占17.42%,孕前标准体重指数孕妇占72.72%。超重及肥胖孕妇占9.9%,其中1.4%达到肥胖标准。超重及肥胖组巨大儿的发生率随孕期体重增加而升高(P0.01)。孕期体重增加符合IOM标准时,仍有高度统计学意义(P0.01)。随孕前BMI的增加,巨大儿的发生率大幅度的增加(P0.01)。结论随着孕前BMI及孕期体重增加的增加巨大儿的发生率增加。提示加强对高危人群的孕前和孕期体重管理有助于预防巨大儿的发生、改善母婴预后。     

孕前超重及肥胖对孕期体质量控制及妊娠结局的影响

目的:评估孕前超重及肥胖对孕期体质量控制及妊娠结局的影响。方法:回顾性收集2015年1月—2017年12月于我院分娩足月单胎孕妇的孕前体质量指数(BMI)、孕期体质量变化及妊娠结局等资料,比较孕前超重、肥胖孕妇与孕前体质量正常孕妇的孕期体质量控制情况及妊娠结局,多因素分析孕前超重及肥胖对孕期体质量控制及妊娠结局的影响。结果:纳入超重孕妇496例(超重组),肥胖孕妇44例(肥胖组)以及体质量正常孕妇(对照组)540例,超重、肥胖及对照组的孕前BMI分别为26.3(2.0)kg/m~2、31.3(2.9)kg/m~2及20.7(2.5)kg/m~2。超重、肥胖组的孕期体质量超标比例高于对照组(分别为63.9%、72.7%及41.3%),超重及肥胖组孕妇的子痫前期、妊娠期糖尿病及剖宫产风险均高于体质量正常孕妇。超重及肥胖组的新生儿平均出生体质量高于正常组[分别为(3 528.0±397.4)kg、(3 562.6±417.6)kg及(3 387.8±384.5)kg,巨大儿比例也呈升高趋势(分别为12.3%、15.9%及5.0%)。多因素分析结果显示孕前超重(OR=3.071,95%CI:2.345～4.022)及肥胖(OR=5.113,95%CI:2.507～10.431)是孕期体质量超标的影响因素,同时对子痫前期(P0.001)、妊娠期糖尿病(P0.001)、剖宫产(P0.05)及巨大儿(P0.05)风险均有显著影响。结论:孕前超重及肥胖不仅显著影响孕期体质量控制结局(尤其是孕期体质量超标风险),同时对包括子痫前期、妊娠期糖尿病、剖宫产、巨大儿风险在内的妊娠结局也影响显著;孕前体质量控制对于超重及肥胖的育龄妇女具有重要意义。     

年龄对妊娠期体重增长及新生儿出生体重的影响

目的:探讨孕妇分娩年龄对妊娠期体重增长及新生儿出生体重的影响。方法:收集于哈尔滨医科大学附属第四医院产科产检并分娩的1563例孕妇,记录其年龄、身高、孕前体重、妊娠期体重增长、新生儿出生体重。根据2009年美国医学研究所(IOM)公布的妊娠期体重增长推荐值,按孕前BMI分为4组:18.5kg/m~2(293例),18.5~24.9kg/m~2(1060例),25~29.9kg/m~2(177例),≥30kg/m~2(33例);再根据妊娠期体重增长值,将每组细分为体重增长不足、增长适宜、增长过多3个亚组。结果:(1)孕前BMI值越大,妊娠期体重增长超过推荐值的发生率越大(r=0.120,P=0.000)。(2)妊娠期体重增长值随着分娩年龄(B=-0.073,P=0.004)及孕前BMI(B=-0.200,P=0.000)的增加而减少。(3)新生儿出生体重随着分娩年龄(B=0.068,P=0.016)及妊娠期体重增长(B=0.188,P=0.00)的增加而增加。结论:选择适当的年龄妊娠,合理控制孕前体重及妊娠期体重增长,有利于获得良好的母儿结局。     

孕期增重对多囊卵巢综合征妊娠结局影响研究

目的探讨孕期增重对多囊卵巢综合征(PCOS)患者妊娠结局的影响。方法对2014年5月至2017年5月辽阳市第三人民医院收治的184例PCOS患者资料进行回顾性分析,按照孕前BMI和孕期增重分为孕期体重增加值(GWG)适宜组92例、过多组54例和过少组38例,比较各组孕妇妊娠期并发症和新生儿并发症的发生率差异。结果 GWG过多组妊娠期糖尿病(GDM)、产后出血发生率和剖宫产率明显高于GWG早产儿、巨大儿、新生儿窒息的发生率均高于GWGGWG适宜组,差异均有统计学意义(P0.05)。结论 PCOS患者孕期增重过多会增加GDM、产后出血、剖宫产、新生儿窒息、早产和巨大儿的风险,增重过少会增加低出生体重儿和早产的风险。     

育龄妇女适宜孕期体重增长值及其与妊娠结局关系的研究

目的:探讨育龄期妇女合理的孕期体重增长值(GWG)范围,并研究GWG与不良妊娠及结局的关系。方法:整群抽取2010年2月至2011年12月在甘肃省妇幼保健院分娩的孕妇(6640例),选择有良好出生结局的单胎足月无合并症孕妇(4462例),分析其孕期体重增加情况,取增重分布的四分位数为推荐的适宜GWG范围;通过χ2检验和多元Logistic回归,分析GWG在推荐范围外与母婴不良妊娠及结局(5464例)之间的关系,并以此验证本推荐范围是否合理。结果:孕前体重过低(BMI18.5 kg/m2)、正常(18.5 kg/m2≤BMI24.0 kg/m2)、超重(24.0 kg/m2≤BMI28.0 kg/m2)、肥胖(BMI≥28.0 kg/m2)孕妇适宜的GWG范围分别为:14.5~21.0 kg、14.0~20.0 kg、12.0~19.0 kg、10.0~16.0 kg。在GWG过高组,妊娠期高血压疾病、产后出血、产程异常、剖宫产、巨大儿、新生儿窒息发生的危险性高于GWG正常组,采用母亲年龄、孕前BMI、孕周、产次、吸烟史及饮酒史调整后差异均有统计学意义(P0.05);在GWG过低组,孕妇新生儿窒息、出生缺陷、低出生体重的危险性高于GWG正常的孕妇,调整前差异均有统计学意义(P0.05)。结论:孕前体重过低、正常、超重、肥胖孕妇适宜的GWG范围分别为:14.5~21.0 kg、14.0~20.0 kg、12.0~19.0 kg、10.0~16.0 kg,GWG在此推荐的适宜范围内,可以获得较好的出生结局,此推荐范围可作为孕期妇女的体重增重的参考标准。     

经产妇孕期增重及妊娠结局的调查分析

目的:探讨经产妇孕期增重及妊娠结局情况,为孕期保健指导提供依据。方法:回顾分析镇江市妇幼保健院2015年1月至12月分娩的3801例单胎产妇,比较经产妇与初产妇的年龄、孕龄、孕前体重、孕期增重(GWG)、分娩信息等临床资料。结果:经产妇的年龄、孕次、孕前BMI、新生儿体重高于初产妇,孕龄、GWG低于初产妇(P均0.05)。经产妇巨大儿和早产的发生率高于初产妇(P均0.05)。孕前高体重产妇(孕前BMI≥24.0kg/m2)中,经产妇GWG达标率高于初产妇(P0.05)。孕前正常体重的产妇(18.5kg/m2≤BMI24.0kg/m2)中,经产妇低体重儿、早产发生率高于初产妇(P均0.05)。结论:经产妇不良妊娠结局发生率较高,需做好孕期保健指导,应重点关注体重管理。     

妊娠合并糖代谢异常孕妇的体重适宜增长

目的 探讨适合糖代谢异常孕妇妊娠期适宜体重增长范围.方法 对2005年1月至2007年12月在北京大学第一医院分娩的妊娠合并糖代谢异常的足月单胎且病历资料完整的孕产妇661例进行回顾性分析.根据孕前体重指数(BMI)将研究对象分为低体重组(BMI<18.5)40例(Ⅰ组);正常体重组(BMI 18.5～23.9)400例(Ⅱ组);超重组(BMI 24～27.9)162例(Ⅲ组);肥胖组(BMI≥28.0)59例(Ⅳ组).分析孕前不同BMI组正常出生体重儿和巨大儿母亲的孕期增重,并计算出新生儿出生体重在3000～3500 g产妇的孕期平均增重,作为各孕前BMI组孕期适宜的体重增长.结果 孕前不同BMI组分娩巨大儿者孕期增重明显大于分娩正常体重儿者的孕期增重,Ⅱ组孕期平均增重分别为(17.0±5.2)kg和(14.1±4.7)kg,m组孕期平均增重分别为(16.8±7.3)kg和(11.9±5.1)kg,Ⅳ组孕期平均增重分别为(18.3±6.7)kg和(11.2±5.4)kg,差异有统计学意义(P<0.05).各组孕妇孕期平均体重增长和适宜增重范围:Ⅰ组(15.6±3.3)kg,(14.0～18.O)kg,Ⅱ组(13.9±4.6)kg,(11.0～16.5)kg,Ⅲ组(11.5±5.2)kg,(9.0～15.0)ks,Ⅳ组(10.1±2.9)kg,(7.0～12.7)kg.结论 对孕前不同体重的糖代谢异常孕妇进行血糖监测的同时,使其妊娠期体重增长在各自适宜的范围,有助于获得理想出生体重的新生儿.     

Impact of Gestational Weight Gain on Cesarean Delivery Risk,Perinatal Birth Weight and Gestational Age in Women with Normal Pre-pregnancy BMI

Background

Gestational weight gain (GWG) proportional to body mass index before pregnancy is one of the factors on maternal and neonatal outcomes. The aim of the current study was to assess association between GWG, and cesarean section, birth weight and gestational age at birth in women with normal BMI prior to pregnancy.

Methods

This was a cross-sectional study carried out in 103 hospitals in Tehran, the capital of Iran, from July 6 to 21, 2015. The data were extracted by 103 trained midwives. Finally, 2394 pregnant women with normal BMI before pregnancy and singleton birth were examined. GWG was categorized based on Institute of Medicine (IOM) recommendations.

Results

Prevalence of low birth weight (LBW) was 5.41% and prevalence of macrosomia was 2.18%. The prevalence of LBW in women with GWG less than the weight gain recommended by IOM was 2.13 times [95% confidence interval (CI) 1.13–4.02, P = 0.019] more than in women with GWG equal to the weight gain recommended by IOM. There was no statistically significant difference in the prevalence of LBW between women with GWG more than recommended weight gain by IOM and women with GWG equal to the weight gain recommended by IOM (OR = 1.21, 95% CI 0.61–2.38, P = 0.580).

Conclusion

After controlling for confounding variables, the prevalence of cesarean section and preterm birth had no significant difference at various levels of GWG. Accordingly, the prevalence of LBW among women with GWG less than the recommended weight gain by IOM was significantly 2.13 more than that among women with GWG equal to the recommended weight gain by IOM.

     

The Institute of Medicine recommendation for gestational weight gain is probably not optimal among non-American pregnant women: a retrospective study from China

Purpose: To investigate whether the Institute of Medicine (IOM) recommended gestational weight gain (GWG) range is optimal among Chinese singleton pregnant women.

Methods: For the purpose of a retrospective observational study, data on 8209 mature singleton deliveries in Shanghai from January 2014 to December 2016 were extracted from medical records in terms of clinical performance. All cases were categorized as undergainers, appropriate-gainers, and above-gainers according to IOM recommended gestational weight gain range after stratification of maternal BMI and proportions of three categories were calculated. Comparisons of maternal and neonatal outcome were conducted among three categories and the associations of those outcome including risks of low birth weight (LBW) and macrosomia (MAC) with GWG were estimated by logistic regression analysis. To examine the applicability of IOM recommendation for Chinese pregnant women, the accumulated risk of LBW and MAC was displayed by stacked column chart and comparison was made among GWG category. The joint predicted risk (JPR) curve of both LBW and MAC in relation to GWG (continuous measurement) was plotted to demonstrate the relation of lowest JPR corresponding GWG with IOM range.

Results: The IOM recommended weight gain was achieved only by 3502 (42.7%) pregnant women and 41.6% gained excessive weight during pregnancy, especially for the overweight and obese women, the proportions of above-gainers mounting to 65.7 and 75.9%, respectively. By multivariate analysis GWG significantly influenced the risk of MAC and caesarean section. Although the association between the risk of LBW and GWG was not significant, p value reached .051. The risk of delivering macrosomia and caesarean section doubled when GWG exceeded the IOM rang. Appropriate gainers did not always gain the lowest joint risk of low birth weight and macrosomia from stacked column chart and it is obvious that the GWG point according to the lowest JPR was always located left to the IOM recommended range for each BMI category from the JPR curve chart in relation to GWG.

Conclusions: The IOM recommended GWG range is possibly too much for Chinese singleton pregnant population for each BMI category. It is necessary to build different gestational weight gain standards for specific ethnic population.     

Prepregnancy body mass index and gestational weight gain with the outcome of pregnancy: a 13-year study of 292,568 cases in China

Purpose

We aimed to investigate the combined associations of prepregnancy body mass index (BMI) and gestational weight gain (GWG) with pregnancy outcomes in Chinese women.

Methods

Data for 292,568 singleton term pregnancies were selected from 1993 to 2005 based on the Perinatal Health Care Surveillance System, with anthropometric measurements being collected prospectively. Prepregnancy BMI was categorized according to the definitions of the World Health Organization (WHO). Total GWG was categorized into four groups. Adjusted associations of prepregnancy BMI and GWG with outcomes of interest were estimated using logistic regression analyses. GWG was categorized as below, within and above the Institute of Medicine (IOM) (2009) recommendations.

Results

Maternal overweight and high GWG or GWG above the IOM recommendation were associated with hypertensive disorders complicating pregnancy, cesarean delivery, macrosomia and large-for-gestational-age (LGA) infants. Maternal underweight and low GWG or GWG below the IOM recommendation were risk factors for low-birth-weight (LBW) and small-for-gestational-age (SGA) infants. Moreover, being overweight [odds ratio (OR) 1.2, 95?% confidence interval (CI) 1.0–1.3) and having a low weight gain (OR 1.1, 95?% CI 1.0–1.1) increased the risk of newborn asphyxia.

Conclusion

Being overweight/obese and having a high weight gain, as well as being underweight and having a low weight gain, were associated with increased risks for adverse pregnancy outcomes in Chinese women.     

Pregnancy and perinatal outcomes according to surgery to conception interval and gestational weight gain in women with previous gastric bypass

Objective: To compare perinatal and pregnancy outcomes including adherence to the Institute of Medicine’s (IOM) recommendations for gestational weight gain (GWG) in pregnant women with conception?<18 months (early group) compared to?≥18 months following gastric bypass (late group).

Methods: Retrospective cohort study comprising 71 women with gastric bypass and a singleton pregnancy presenting at Odense University Hospital, November 2007–October 2013. Data were extracted from medical records and laboratory systems. The primary outcomes were timing of pregnancy and adherence to the IOM’s recommendations for GWG. Secondary outcomes were birthweight, preterm delivery, cesarean section (CS), iron deficiency and post partum hemorrhage (PPH).

Results: Forty-three (61%) women conceived less than 18 months after gastric bypass surgery. Women in the late group had a significantly higher risk of requiring CS or receiving intravenous iron supplementation compared to the early group (57% versus 30%, p?=?0.03 and 29% versus 7%, p?=?0.02, respectively). Early conception was not significantly associated with insufficient GWG, preterm delivery or birthweight. Among 54 women with information on GWG, only 13 (24%) had an appropriate GWG.

Conclusion: The majority of pregnant women with gastric bypass did not fulfill guidelines for GWG; however, this study could not support the recommendation to postpone pregnancy.     

Patterns of gestational weight gain in healthy,low-risk pregnant women without co-morbidities

Background

little is known of the impact of gestational weight gain (GWG) in relation to Body Mass Index (BMI) classification on perinatal outcomes in healthy pregnant women without co-morbidities. As a first step, the prevalence of obesity and the distribution of GWG in relation to the Institute of Medicine (IOM) 2009 guidelines for GWG were examined.

Methods

data from a prospective cohort study of – a priori – low risk, pregnant women from five midwife-led practices (n=1449) were analysed. Weight was measured at 12, 24 and 36 weeks.

Findings

at 12 weeks, 1.4% of the women were underweight, 53.8% had a normal weight, 29.6% were overweight, and 15.1% were obese according to the WHO classification of BMI. In our study population, 60% of the women did not meet the IOM recommendations: 33.4% had insufficient GWG and 26.7% gained too much weight. Although BMI was negatively correlated to total GWG (p<.001), overweight and obese women class I had a significant higher risk of exceeding the IOM guidelines. Normal weight women had a significantly higher risk of gaining less weight than recommended. Obese women classes II and III were at risk in both over- and undergaining.

Conclusions

our data showed that the majority of women were unable to stay within recommended GWG ranges without additional interventions. The effects on pregnancy and health outcomes of falling out the IOM guidelines remain unclear for – a priori – low risk women. Since interventions to control GWG would have considerable impact on women and caregivers, harms and benefits should be well-considered before implementation.     

Excessive gestational weight gain predicts large for gestational age neonates independent of maternal body mass index

Objective: To determine the effects of maternal pre-pregnancy body mass index (BMI) and gestational weight gain (GWG) on large-for-gestational-age (LGA) birth weight (≥90th % ile). Methods: We examined 4321 mother-infant pairs from the Ottawa and Kingston (OaK) birth cohort. Multivariate logistic regression (controlling for gestational and maternal age, pre-pregnancy weight, parity, smoking) were performed and odds ratios (ORs) calculated. Results: Prior to pregnancy, a total of 23.7% of women were overweight and 16.2% obese. Only 29.3% of women met GWG targets recommended by the Institute of Medicine (IOM), whereas 57.7% exceeded the guidelines. Adjusting for smoking, parity, age, maternal height, and achieving the IOM’s recommended GWG, overweight (OR 1.99; 95%CI 1.17–3.37) or obese (OR 2.64; 95% CI 1.59–4.39) pre-pregnancy was associated with a higher rate of LGA compared to women with normal BMI. In the same model, exceeding GWG guidelines was associated with higher rates of LGA (OR 2.86; 95% CI 2.09–3.92), as was parity (OR 1.49; 95% CI 1.22–1.82). Smoking (OR 0.53; 95%CI 0.35–0.79) was associated with decreased rates of LGA. The adjusted association with LGA was also estimated for women who exceeded the GWG guidelines and were overweight (OR 3.59; 95% CI 2.60–4.95) or obese (OR 6.71; 95% CI 4.83–9.31). Conclusion: Pregravid overweight or obesity and gaining in excess of the IOM 2009 GWG guidelines strongly increase a woman’s chance of having a larger baby. Lifestyle interventions that aim to optimize GWG by incorporating healthy eating and exercise strategies during pregnancy should be investigated to determine their effects on LGA neonates and down-stream child obesity.     

Maternal obesity: can pregnancy weight gain modify risk of selected adverse pregnancy outcomes?

Reports by the Institute of Medicine (IOM) recommend that gestational weight gain goals should be modified according to prepregnancy body mass index (BMI), which could result in better maternal and infant outcomes. The authors assessed whether the risk of the pregnancy outcomes such as rate of cesarean section to primiparous and multiparous women, macrosomia, and breastfeeding at 10 weeks postpartum can be modified by following the IOM guidelines for gestational weight gain irrespective of prepregnancy BMI. Staff from the New Jersey Pregnancy Risk Assessment Monitoring System interviewed a sample of women who delivered live births in New Jersey during 2002 through 2005 (n = 7661). In New Jersey, 18% of mothers were obese, 13% were overweight, and 16% were underweight. In logistic regression analyses, after controlling for maternal characteristics, the effect of prepregnancy obesity and weight gain more than 34 lb independently and significantly increased the risk of all four adverse outcomes. For no outcomes was the 25- to 34-pound weight gain category significantly distinguishable from the 16- to 24-pound reference category. These results strongly support the idea that the IOM weight gain recommendation (education during preconception regarding the importance of optimal BMI at the start of pregnancy) will help to achieve better pregnancy outcomes in obese and overweight women.     

Total gestational weight change and rate of change in pregnant Taiwanese women

Objective: The purpose of this study was to estimate and compare total gestational weight gain (GWG) and the trimester-specific mean rate of GWG based on pre-pregnancy body mass index (BMI) as recommended by the Institute of Medicine (IOM).Materials and methods: The medical records of 470 participants who had received antenatal care at medical teaching hospitals in northern Taiwan and who delivered after 37 weeks of pregnancy were analyzed.