Gestational weight gain as a predictor of macrosomia and low birth weight: a systematic review

Area of Science:

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

Background:

• Gestational weight gain (GWG) is crucial for maternal and infant health.
• Institute of Medicine (IOM) and Latin American Center of Perinatology (CLAP) provide GWG recommendations.
• Predictive accuracy of these recommendations for adverse birth outcomes requires evaluation.

Purpose of the Study:

• To assess the predictive capacity of IOM and CLAP GWG recommendations.
• To determine their effectiveness in identifying risks for low birth weight (LBW) and neonatal macrosomia.

Main Methods:

• Systematic literature search across multiple databases (PubMed, Embase, Cochrane, etc.).
• Inclusion of 5 studies meeting specific criteria.
• Methodological quality assessed using QUADAS-2 tool.

Main Results:

• No studies evaluated CLAP recommendations; only 5 met inclusion criteria.
• Predictive accuracy (sensitivity, specificity) for LBW and macrosomia varied significantly by country.
• In Latin American cohorts, LBW prediction sensitivity was 62.8-74%, specificity 61.7-68%. Macrosomia prediction sensitivity was 28.8%, specificity 43.8%.
• Positive predictive values were generally low (<25%), while negative predictive values were high (>90%).
• Most included studies exhibited high risk of bias and applicability issues.

Conclusions:

• Limited methodological quality and representativeness of studied cohorts were observed.
• Modest predictive values and potential confounding factors highlight limitations.
• Need for studies developing GWG recommendations tailored to specific epidemiological contexts, such as the Peruvian population.