Pre-Pregnancy Body Mass Index and Weight Gain During Pregnancy: Relations with Gestational Diabetes and Hypertension, and Birth Outcomes |
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Authors: | B Heude O Thiébaugeorges V Goua A Forhan M Kaminski B Foliguet M Schweitzer G Magnin M A Charles |
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Institution: | (1) INSERM, CESP Centre for Research in Epidemiology and Population Health, UMRS 1018, Epidemiology of Diabetes, Obesity and Chronic Kidney Disease Over the Lifecourse, 94807 Villejuif, France;(2) University Paris-Sud, UMRS 1018, 94807 Villejuif, France;(3) University Hospital of Nancy, Regional Maternity, Nancy, France;(4) Gynaecology and Obstetrics Department, University Hospital of Poitiers, Poitiers, France;(5) INSERM, UMRS 953, Epidemiologic Research on Perinatal and Women’s and Children’s Health, 94807 Villejuif, France;(6) UPMC Univ Paris 06, UMRS 953, 75005 Paris, France;(7) INSERM U1018 Equipe 10, 16 Avenue Paul Vaillant Couturier, 94807 Villejuif cedex, France |
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Abstract: | To study the relationship between pre-pregnancy body mass index (BMI) and weight gain during pregnancy with pregnancy and
birth outcomes, with a focus on gestational diabetes and hypertension and their role in the association with fetal growth.
We studied 1,884 mothers and offspring from the Eden mother–child cohort. Weight before pregnancy (W1) and weight after delivery
(W2) were collected and we calculated BMI and net gestational weight gain (netGWG = (W2 − W1)/(weeks of gestation)). Gestational
diabetes, hypertension gestational age and birth weight were collected. We used multivariate linear or logistic models to
study the association between BMI, netGWG and pregnancy and birth outcomes, adjusting for center, maternal age and height,
parity and average number of cigarettes smoked per day during pregnancy. High BMI was more strongly related to the risk of
giving birth to a large-for-gestational-age (LGA) baby than high netGWG (odds ratio OR 95% CI] of 3.23 1.86–5.60] and 1.61
0.91–2.85], respectively). However, after excluding mothers with gestational diabetes or hypertension the ORs for LGA, respectively
weakened (OR 2.57 1.29–5.13]) for obese women and strengthened for high netGWG (OR 2.08 1.14–3.80]). Low in comparison to
normal netGWG had an OR of 2.18 1.20–3.99] for pre-term birth, which became stronger after accounting for blood pressure
and glucose disorders (OR 2.70 1.37–5.34]). Higher net gestational weight gain was significantly associated with an increased
risk of LGA only after accounting for blood pressure and glucose disorders. High gestational weight gain should not be neglected
in regard to risk of LGA in women without apparent risk factors. |
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