Should gestational weight gain recommendations be tailored by maternal characteristics?

Area of Science:

• Obstetrics and Gynecology
• Maternal-Fetal Medicine
• Public Health

Background:

• Gestational weight gain (GWG) is linked to various adverse pregnancy outcomes.
• Existing GWG guidelines may not account for maternal characteristics.
• Investigating subgroup differences is crucial for personalized prenatal care.

Purpose of the Study:

• To determine if the relationship between GWG and adverse pregnancy outcomes varies by maternal factors.
• To evaluate the need for modifying GWG guidelines for specific maternal subgroups.
• To assess the adequacy of current GWG recommendations across diverse populations.

Main Methods:

• Cohort study of 23,362 normal-weight mothers delivering singletons.
• Analysis of 5 adverse outcomes: SGA, LGA, spontaneous/indicated preterm birth, unplanned cesarean.
• Adequacy of GWG calculated as observed/recommended GWG; synergy analysis performed.

Main Results:

• Poor GWG combined with smoking, Black race, primiparity, or short height increased SGA risk.
• High GWG with these factors reduced LGA risk compared to counterparts.
• No significant differences in adverse outcomes between current GWG recommendations and risk-minimizing GWG.

Conclusions:

• Current GWG guidelines are appropriate for normal-weight women across different racial/ethnic groups, smoking statuses, parities, ages, and heights.
• Tailoring GWG guidelines based on these maternal characteristics is not supported by the findings.
• Evidence supports the universal application of existing GWG recommendations for this population.