TY - JOUR
T1 - Inadequate gestational weight gain increases risk of small-for-gestational-age term birth in girls in Japan
T2 - A population-based cohort study
AU - Melby, Melissa K.
AU - Yamada, Goro
AU - Surkan, Pamela J.
N1 - Funding Information:
The authors thank the women and children who generously shared their maternal child health handbooks and made this research possible. The authors gratefully acknowledge the cooperation and assistance of staff from the National Institute of Health and Nutrition; (Saku Central Hospital) and (Koumimachi); and the Boards of Education and elementary and middle schools of Yachiho, Koumi and Kitamaki. The authors thank M. Kaihoku for research coordination and data entry, K. Maizuru for data entry, M. Griffin for extensive data clean-up and preliminary analyses, Y. Ito for consultation about the use of Japanese anthropometric indicators and S. Noazin for data cleaning.
Publisher Copyright:
© 2016 Wiley Periodicals, Inc.
PY - 2016/9/10
Y1 - 2016/9/10
N2 - OBJECTIVES: Babies born small for gestational age (SGA) have a higher risk of neonatal morbidity and mortality as well as later life chronic disease. The objectives of this study were to examine the extent to which prepregnancy body mass index (BMI) and gestational weight gain (GWG) influenced risk of SGA among Japanese, and to evaluate physician response to, and potential effects on, GWG.METHODS: We examined SGA risk as a function of maternal BMI and GWG using logistic regression with data from maternal child health handbooks obtained from women in Japan (N = 383). Physicians' written comments on weight and dietary restriction were analyzed for responses to and influence on GWG.RESULTS: SGA babies comprised 8.6% of the sample, with 13% and 6% of the mothers being underweight and overweight, respectively, and 21.7% and 19.8% of mothers gaining less and more than the recommended amounts, respectively. In adjusted models, higher prepregnancy BMI and GWG were associated with lower risk of SGA (OR 0.71, 95% CI 0.56, 0.90; 0.75, 95% CI 0.61, 0.92 respectively) in models for girls, but not for boys. Inadequate GWG was associated with higher risk of SGA in girls (OR 6.64, 95% CI 2.18, 20.22). Physician written instructions to restrict dietary intake and weight gain followed an average weight gain of 0.69 kg/week from the previous prenatal exam, and were followed by weight gains that decreased to 0.30 kg/week.CONCLUSIONS: Prepregnancy BMI and GWG significantly influence SGA risk in female babies. GWG may be influenced by physicians' recommendations. Am. J. Hum. Biol. 28:714-720, 2016.
AB - OBJECTIVES: Babies born small for gestational age (SGA) have a higher risk of neonatal morbidity and mortality as well as later life chronic disease. The objectives of this study were to examine the extent to which prepregnancy body mass index (BMI) and gestational weight gain (GWG) influenced risk of SGA among Japanese, and to evaluate physician response to, and potential effects on, GWG.METHODS: We examined SGA risk as a function of maternal BMI and GWG using logistic regression with data from maternal child health handbooks obtained from women in Japan (N = 383). Physicians' written comments on weight and dietary restriction were analyzed for responses to and influence on GWG.RESULTS: SGA babies comprised 8.6% of the sample, with 13% and 6% of the mothers being underweight and overweight, respectively, and 21.7% and 19.8% of mothers gaining less and more than the recommended amounts, respectively. In adjusted models, higher prepregnancy BMI and GWG were associated with lower risk of SGA (OR 0.71, 95% CI 0.56, 0.90; 0.75, 95% CI 0.61, 0.92 respectively) in models for girls, but not for boys. Inadequate GWG was associated with higher risk of SGA in girls (OR 6.64, 95% CI 2.18, 20.22). Physician written instructions to restrict dietary intake and weight gain followed an average weight gain of 0.69 kg/week from the previous prenatal exam, and were followed by weight gains that decreased to 0.30 kg/week.CONCLUSIONS: Prepregnancy BMI and GWG significantly influence SGA risk in female babies. GWG may be influenced by physicians' recommendations. Am. J. Hum. Biol. 28:714-720, 2016.
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U2 - 10.1002/ajhb.22855
DO - 10.1002/ajhb.22855
M3 - Article
C2 - 27153770
AN - SCOPUS:85028265984
SN - 1042-0533
VL - 28
SP - 714
EP - 720
JO - American Journal of Human Biology
JF - American Journal of Human Biology
IS - 5
ER -