Dataset Information

Pregnancy weight gain by gestational age and stillbirth: a population-based cohort study.

ABSTRACT: To study the association between total and early pregnancy (<22 completed weeks) weight gain and risk of stillbirth, stratified by early-pregnancy body mass index (BMI).Population-based cohort study.Stockholm-Gotland Region, Sweden.Pregnant women with singleton births (n = 160 560).Pregnancy weight gain was standardised into gestational age-specific z-scores. For analyses of total pregnancy weight gain, a matched design with an incidence density sampling approach was used. Findings were also contrasted with current Institute of Medicine (IOM) weight gain recommendations.Stillbirth defined as fetal death at ?22 completed weeks of gestation.For all BMI categories, there was no statistical association between total or early pregnancy weight gain and stillbirth within the range of a weight gain z-score of -2.0 SD to +2.0 SD. Among normal-weight women, the adjusted odds ratio of stillbirth for lower (-2.0 to -1.0 SD) and higher (+1.0 to +1.9 SD) total weight gain was 0.85 (95% CI; 0.48-1.49) and 1.03 (0.60-1.77), respectively, as compared with the reference category. Further, there were no associations between total or early pregnancy weight gain and stillbirth within the range of weight gain currently recommended by the IOM. For the majority of the BMI categories, the point estimates at the extremes of weight gain values (<-2.0SD and ?2.0 SD) suggested protective effects of low weight gain and increased risks of high weight gain, but estimates were imprecise and not statistically significant.We found no associations between total or early pregnancy weight gain and stillbirth across the range of weight gain experienced by most women.There was no association between weight gain during pregnancy and stillbirth among most women.

SUBMITTER: Johansson K

PROVIDER: S-EPMC6032856 | biostudies-other | 2018 Jul

REPOSITORIES: biostudies-other

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Pregnancy weight gain by gestational age and stillbirth: a population-based cohort study.

Johansson K K Hutcheon J A JA Bodnar L M LM Cnattingius S S Stephansson O O

BJOG : an international journal of obstetrics and gynaecology 20171228 8

<h4>Objective</h4>To study the association between total and early pregnancy (<22 completed weeks) weight gain and risk of stillbirth, stratified by early-pregnancy body mass index (BMI).<h4>Design</h4>Population-based cohort study.<h4>Setting</h4>Stockholm-Gotland Region, Sweden.<h4>Population</h4>Pregnant women with singleton births (n = 160 560).<h4>Methods</h4>Pregnancy weight gain was standardised into gestational age-specific z-scores. For analyses of total pregnancy weight gain, a matched ...[more]

PMID: 29160923

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Project description:BackgroundGestational weight gain (GWG) has important health implications for both the mother and offspring. Maternal diet during pregnancy may play an important role in achieving adequate GWG, although its precise role is unclear.ObjectivesAssociations between maternal dietary components (fruits and vegetables, added sugar, percentage energy from fat, dairy) and GWG were examined in 327 pregnant women from the Archive for Research on Child Health cohort.MethodsSelf-reported usual dietary intake was assessed with validated dietary screening tools at the first prenatal visit. GWG was obtained from the birth certificate and was categorized as inadequate, adequate, or excessive according to the Institute of Medicine recommendations. Associations between dietary components and GWG were assessed using multivariable regression models, stratified by maternal prepregnancy BMI category.ResultsOnly 31.5% of women had adequate GWG, with 24.8% gaining insufficient weight and 43.7% gaining excessively. Women who consumed more fruits and vegetables were suggestively less likely to have excessive GWG (OR: 0.86; 95% CI: 0.75, 1.00) in the minimally adjusted model, but the association became nonsignificant after adjusting for covariates (OR: 0.89; 95% CI: 0.77, 1.03). In stratified models, higher fruit and vegetable intake was linked to lower likelihood of excessive GWG among women with obesity (OR: 0.77; 95% CI: 0.60, 0.97), whereas higher added sugar intake was linked to a slight reduction in likelihood of excessive GWG (OR: 0.91; 95% CI: 0.84, 0.99) among women with a prepregnancy BMI in the normal range. Other dietary components were not significantly associated with GWG.ConclusionsThese results suggest that consuming fruits and vegetables during pregnancy may reduce risk of excessive GWG among women with obesity. With the rising prevalence of obesity among women of reproductive age, interventions to increase fruit and vegetable intake during pregnancy may have broad public health impact by improving maternal and child health outcomes.

Project description:BackgroundStudies suggest maternal weight and weight gain during pregnancy may influence foetal immunological development. However, their role in the aetiology of allergic disease is unclear.ObjectivesWe sought to examine the impact of maternal pre-pregnancy body mass index (BMI) and gestational weight gain (GWG) on the incidence of four common paediatric allergic diseases.MethodsWe conducted a retrospective, population-based cohort study of all singleton live births in Ontario, Canada between 2012 and 2014, using maternal-newborn records from the provincial birth registry linked with health administrative databases. Neonates were followed up to 7 years for anaphylaxis, asthma, dermatitis and rhinitis, identified through validated algorithms based on healthcare encounters. We multiply imputed missing data and employed Cox proportional-hazards models to calculate adjusted hazard ratios (aHR) with 95% confidence intervals (CI). To test the robustness of our findings, we also conducted several sensitivity analyses, including probabilistic bias analyses for exposure and outcome misclassification. All methods were prespecified in a published protocol.ResultsOf the 248,017 infants followed, 52% were born to mothers with a pre-pregnancy BMI in the normal range and only 19% were born to mothers with adequate weight gain during pregnancy. Incidence rates (per 100,000 person-days) for anaphylaxis, asthma, dermatitis and rhinitis were 0.22, 6.80, 12.41 and 1.54, respectively. Compared with normal BMI, maternal obesity was associated with increased hazards of asthma in offspring (aHR 1.08, 95% CI 1.05, 1.11), but decreased hazards of anaphylaxis (aHR 0.83, 95% CI 0.69, 0.99) and dermatitis (aHR 0.97, 95% CI 0.94, 0.99). In contrast, maternal underweight was associated with increased hazards of dermatitis (aHR 1.06, 95% CI 1.02, 1.10). We found no associations between pre-pregnancy BMI and rhinitis or GWG and any allergic outcome, and no evidence of effect measures modification by infant sex.ConclusionsThese findings provide support for the involvement of maternal pre-pregnancy BMI in paediatric allergic disease development.

Dataset Information

Pregnancy weight gain by gestational age and stillbirth: a population-based cohort study.

Publications

Pregnancy weight gain by gestational age and stillbirth: a population-based cohort study.

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