TY - JOUR
T1 - Gestational Weight Gain and Pregnancy Complications in a High-Risk, Racially and Ethnically Diverse Population
AU - Zheng, Zihe
AU - Bennett, Wendy L.
AU - Mueller, Noel T.
AU - Appel, Lawrence J.
AU - Wang, Xiaobin
N1 - Funding Information:
The Boston Birth Cohort (the parent study) was supported in part by March of Dimes PERI grants (20-FY02-56, #21-FY07-605); grants from the Health Resources and Services Administration (HRSA) of the U.S. Department of Health and Human Services (HHS) (R40MC27443 and UJ2MC31074); and the National Institutes of Health (NIH) grants (R21ES011666, R01HD041702, R21HD066471, U01AI090727, R21AI079872, and R01HD086013). Research reported in this publication was also supported in part by the National Heart, Lung, and Blood Institute (NHLBI) of the National Institutes of Health (NIH) under Award Number K01HL141589. This information or content and conclusions are those of the authors and should not be construed as the official position or policy of, nor should any endorsements be inferred by any funding agencies.
Funding Information:
We thank the staff and investigators of the Boston Birth Cohort (BBC) study, particularly Xiumei Hong, MD, PhD, Deanna Caruso, MA, and Guoying Wang, MD, PhD from Johns Hopkins University, Baltimore, MD for their assistance on data management and helpful inputs on this article. We thank the participants of the Boston Birth Cohort study for their time and support. The Boston Birth Cohort (the parent study) was supported in part by March of Dimes PERI grants (20-FY02-56, #21-FY07-605); grants from the Health Resources and Services Administration (HRSA) of the U.S. Department of Health and Human Services (HHS) (R40MC27443 and UJ2MC31074); and the National Institutes of Health (NIH) grants (R21ES011666, R01HD041702, R21HD066471, U01AI090727, R21AI079872, and R01HD086013). Research reported in this publication was also supported in part by the National Heart, Lung, and Blood Institute (NHLBI) of the National Institutes of Health (NIH) under Award Number K01HL141589. This information or content and conclusions are those of the authors and should not be construed as the official position or policy of, nor should any endorsements be inferred by any funding agencies.
Publisher Copyright:
© 2019 Mary Ann Liebert, Inc.
PY - 2019/3
Y1 - 2019/3
N2 - Background: Evidence used to guide the current Institute of Medicine (IOM) gestational weight gain (GWG) recommendations is largely derived from studies of European descent, and as such the guidelines are the same for all races and ethnicities. The guidelines are also the same for prepregnancy obesity classes I through III. Objective: Considering these literature gaps, we aim to (1) determine the association between the IOM GWG guidelines and three common pregnancy complications: preeclampsia, gestational diabetes mellitus, and cesarean delivery in a racially and ethnically diverse population; and (2) assess whether the association between GWG and pregnancy complications differs by race/ethnicity or prepregnancy body mass index (BMI) categories, particularly obesity classes I through III. Methods: To address these aims, we analyzed data from the Boston Birth Cohort. We calculated GWG using data from electronic medical records or, when missing, from a postdelivery questionnaire. We examined GWG continuously and categorically using the IOM formula. Results: Of the 5,568 women included, 54.5% met the IOM criterion for excessive GWG. Compared to women who had adequate GWG, women who gained excessive weight had 1.65 (95% confidence interval [CI] 1.27-2.14) times greater odds of preeclampsia; 1.68 (95% CI 1.15-2.46) times greater odds of gestational diabetes; and no significant change in odds of cesarean delivery (odds ratio [OR] = 1.14, 95% CI 0.99-1.31). Associations did not differ by race, ethnicity, or prepregnancy BMI categories including comparisons of obesity class I versus II or III (all p-values for interaction >0.05). Conclusions: In this racially and ethnically diverse population, excessive GWG was associated with higher odds of preeclampsia, gestational diabetes, and nonsignificantly, with cesarean delivery. Associations did not differ appreciably by race, ethnicity, or prepregnancy BMI categories. Our results support the relevance of the IOM GWG recommendations in racially and ethnically diverse populations, and in women in the higher prepregnancy obesity classes.
AB - Background: Evidence used to guide the current Institute of Medicine (IOM) gestational weight gain (GWG) recommendations is largely derived from studies of European descent, and as such the guidelines are the same for all races and ethnicities. The guidelines are also the same for prepregnancy obesity classes I through III. Objective: Considering these literature gaps, we aim to (1) determine the association between the IOM GWG guidelines and three common pregnancy complications: preeclampsia, gestational diabetes mellitus, and cesarean delivery in a racially and ethnically diverse population; and (2) assess whether the association between GWG and pregnancy complications differs by race/ethnicity or prepregnancy body mass index (BMI) categories, particularly obesity classes I through III. Methods: To address these aims, we analyzed data from the Boston Birth Cohort. We calculated GWG using data from electronic medical records or, when missing, from a postdelivery questionnaire. We examined GWG continuously and categorically using the IOM formula. Results: Of the 5,568 women included, 54.5% met the IOM criterion for excessive GWG. Compared to women who had adequate GWG, women who gained excessive weight had 1.65 (95% confidence interval [CI] 1.27-2.14) times greater odds of preeclampsia; 1.68 (95% CI 1.15-2.46) times greater odds of gestational diabetes; and no significant change in odds of cesarean delivery (odds ratio [OR] = 1.14, 95% CI 0.99-1.31). Associations did not differ by race, ethnicity, or prepregnancy BMI categories including comparisons of obesity class I versus II or III (all p-values for interaction >0.05). Conclusions: In this racially and ethnically diverse population, excessive GWG was associated with higher odds of preeclampsia, gestational diabetes, and nonsignificantly, with cesarean delivery. Associations did not differ appreciably by race, ethnicity, or prepregnancy BMI categories. Our results support the relevance of the IOM GWG recommendations in racially and ethnically diverse populations, and in women in the higher prepregnancy obesity classes.
KW - Body mass index
KW - gestational weight gain
KW - obesity
KW - pregnancy
KW - race and ethnicity
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U2 - 10.1089/jwh.2017.6574
DO - 10.1089/jwh.2017.6574
M3 - Article
C2 - 29920144
AN - SCOPUS:85062964182
SN - 1540-9996
VL - 28
SP - 375
EP - 383
JO - Journal of Women's Health
JF - Journal of Women's Health
IS - 3
ER -