Optimal gestational weight gain: prepregnancy BMI specific influences on adverse pregnancy and infant health outcomes
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1Division of Epidemiology, Department of Environmental Health, University of Cincinnati College of Medicine, Cincinnati, OH, USA.
Insights
New gestational weight gain (GWG) guidelines may be needed. This study refines optimal GWG recommendations based on individual prepregnancy BMI units to reduce risks of adverse birth outcomes.
Area of Science:
- Obstetrics and Gynecology
- Maternal-Fetal Medicine
- Public Health
Background:
- The 2009 Institute of Medicine (IOM) guidelines for gestational weight gain (GWG) are based on broad prepregnancy body mass index (BMI) categories.
- Refining GWG recommendations for individual BMI units may optimize pregnancy outcomes and reduce risks.
Purpose of the Study:
- To refine optimal GWG recommendations for each prepregnancy BMI unit.
- To assess the relationship between GWG and risks of small-for-gestational-age (SGA) and large-for-gestational-age (LGA) births, cesarean section (C-section), and infant death.
Main Methods:
- Utilized a large dataset of 836,841 Ohio birth records from 2006 to 2012.
- Applied generalized additive models to determine optimal GWG based on individual prepregnancy BMI units.
Main Results:
- Optimal GWG recommendations aligned with IOM 2009 guidelines for BMIs below 25 kg/m².
- Higher GWG was suggested for BMIs between 25-32 kg/m², while lower GWG was recommended for BMIs 38-50 kg/m².
- Specific GWG ranges were provided for prepregnancy BMIs from 15 to 50 kg/m².
Conclusions:
- Current GWG recommendations may benefit from refinement at the individual prepregnancy BMI level.
- Personalized GWG targets could potentially improve maternal and infant health outcomes.
Objective:
The Institute of Medicine (IOM) 2009 gestational weight gain (GWG) guidelines are based on prepregnancy body mass index (BMI) categories. We intended to refine optimal GWG for each prepregnancy BMI unit in relation to the risk of small- and large-for-gestational-age (SGA and LGA) births, cesarean section (C-section) and infant death.
Study Design:
We used data from 836,841 Ohio birth records from 2006 to 2012, and applied generalized additive models to calculate optimal GWG by prepregnancy BMI unit.
Results:
The suggested optimal GWG was generally similar to IOM 2009 GWG guidelines for prepregnancy BMIs <25 kg m-2, but higher for prepregnancy BMIs 25 to 32 kg m-2 and lower for BMIs 38 to 50 kg m-2. The suggested optimal GWG was 14 to 18.5, 13 to 17, 11.5 to 16, 8.5 to 12.5, 4 to 10, 3 to 7, 1.5 to 6 and 1.5 to 4.5 kg for prepregnancy BMIs 15, 20, 25, 30, 35, 40, 45 and 50 kg m-2, respectively.
Conclusion:
This research suggests that GWG recommendations may be refined at individual prepregnancy BMI levels.
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