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Optimal gestational weight gain: prepregnancy BMI specific influences on adverse pregnancy and infant health outcomes.

ABSTRACT: 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.

SUBMITTER: Chen A

PROVIDER: S-EPMC5389902 | biostudies-literature | 2017 Apr

REPOSITORIES: biostudies-literature

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Optimal gestational weight gain: prepregnancy BMI specific influences on adverse pregnancy and infant health outcomes.

Chen A A Xie C C Vuong A M AM Wu T T DeFranco E A EA

Journal of perinatology : official journal of the California Perinatal Association 20170119 4

<h4>Objective</h4>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.<h4>Study design</h4>We used data from 836,841 Ohio birth records from 2006 to 2012, and applied generalized additive models to calculate optimal G ...[more]

PMID: 28102854

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Project description:BackgroundMaternal obesity prior to or during pregnancy influences fetal growth, predisposing the offspring to increased risk for obesity across the life course. Placental epigenetic mechanisms may underlie these associations. We conducted an epigenome-wide association study to identify placental DNA methylation changes associated with maternal prepregnancy body mass index (BMI) and rate of gestational weight gain at first (GWG1), second (GWG2), and third trimester (GWG3).MethodParticipants of the NICHD Fetal Growth Studies with genome-wide placental DNA methylation (n = 301) and gene expression (n = 75) data were included. Multivariable-adjusted regression models were used to test the associations of 1 kg/m2 increase in prepregnancy BMI or 1 kg/week increase in GWG with DNA methylation levels. Genes harboring top differentially methylated CpGs (FDR P < 0.05) were evaluated for placental gene expression. We assessed whether DNA methylation sites known to be associated with BMI in child or adult tissues, were also associated with maternal prepregnancy BMI in placenta.ResultsPrepregnancy BMI was associated with DNA methylation at cg14568196[EGFL7], cg15339142[VETZ], and cg02301019[AC092377.1] (FDR P < 0.05, P ranging from 1.4 × 10-10 to 1.7 × 10-9). GWG1 or GWG2 was associated with DNA methylation at cg17918270[MYT1L], cg20735365[DLX5], and cg17451688[SLC35F3] (FDR P < 0.05, P ranging from 6.4 × 10-10 to 1.2 × 10-8). Both prepregnancy BMI and DNA methylation at cg1456819 [EGFL7] were negatively correlated with EGFL7 expression in placenta (P < 0.05). Several CpGs previously implicated in obesity traits in children and adults were associated with prepregnancy BMI in placenta. Functional annotations revealed that EGFL7 is highly expressed in placenta and the differentially methylated CpG sites near EGFL7 and VEZT were cis-meQTL targets in blood.ConclusionsWe identified placental DNA methylation changes at novel loci associated with prepregnancy BMI and GWG. The overlap between CpGs associated with obesity traits in placenta and other tissues in children and adults suggests that epigenetic mechanisms in placenta may give insights to early origins of obesity.

Dataset Information

Optimal gestational weight gain: prepregnancy BMI specific influences on adverse pregnancy and infant health outcomes.

Publications

Optimal gestational weight gain: prepregnancy BMI specific influences on adverse pregnancy and infant health outcomes.

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