Prepregnancy weight change associated with high gestational weight gain

Area of Science:

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

Background:

• Excessive gestational weight gain (GWG) is a significant risk factor for adverse maternal, perinatal, and long-term health outcomes.
• Identifying modifiable risk factors for excessive GWG is crucial for improving pregnancy health.
• Prepregnancy weight changes may influence GWG during pregnancy.

Purpose of the Study:

• To investigate the association between prepregnancy weight gain and the risk of exceeding recommended GWG.
• To determine if prepregnancy weight changes predict excessive GWG in a diverse cohort.

Main Methods:

• Utilized data from 1,126 women in the Coronary Artery Risk Development in Young Adults (CARDIA) study with post-baseline births.
• Estimated prepregnancy annual rate of BMI change (slope) over 5 years preceding pregnancy.
• Employed mixed-effects models to assess the risk of GWG above Institute of Medicine recommendations and GWG z score, adjusting for confounders and stratifying by prepregnancy weight status.

Main Results:

• 56% of women experienced excessive GWG.
• A standard deviation increase in prepregnancy BMI change was associated with an 18% increased risk of excessive GWG.
• This association was significant for women without overweight/obesity but not for those with overweight/obesity; however, prepregnancy weight gain was linked to higher GWG z scores in both groups.

Conclusions:

• Prepregnancy weight gain is significantly associated with higher GWG during pregnancy.
• Assessing prepregnancy weight changes can serve as a valuable tool for identifying individuals at elevated risk for excessive GWG.
• Early identification allows for timely interventions to mitigate risks associated with excessive GWG.