Gestational Weight Gain—Re-Examining the Current Paradigm
Open Access
- 1 August 2020
- Vol. 12 (8), 2314
- https://doi.org/10.3390/nu12082314
Abstract
Our aim was to investigate the underlying assumptions of the current gestational weight gain (GWG) paradigm, specifically that—(1) GWG is modifiable through diet and physical activity; (2) optimal GWG and risk of excess GWG, vary by pre-pregnancy body mass index (BMI) category and (3) the association between GWG and adverse pregnancy outcomes is causal. Using data from three large, harmonized randomized controlled trials (RCTs) of interventions to limit GWG and improve pregnancy outcomes and with appropriate regression models, we investigated the link between diet and physical activity and GWG; the relationships between pre-pregnancy BMI, GWG and birth weight z-score; and the evidence for a causal relationship between GWG and pregnancy outcomes. We found little evidence that diet and physical activity in pregnancy affected GWG and that the observed relationships between GWG and adverse pregnancy outcomes are causal in nature. Further, while there is evidence that optimal GWG may be lower for women with higher BMI, target ranges defined by BMI categories do not accurately reflect risk of adverse outcomes. Our findings cast doubt upon current advice regarding GWG, particularly for overweight and obese women and suggest that a change in focus is warranted.Funding Information
- National Health and Medical Research Council (519240; 1043181; 1078980)
This publication has 26 references indexed in Scilit:
- Gestational weight gain outside the Institute of Medicine recommendations and adverse pregnancy outcomes: analysis using individual participant data from randomised trialsBMC Pregnancy and Childbirth, 2019
- Effect of diet and physical activity based interventions in pregnancy on gestational weight gain and pregnancy outcomes: meta-analysis of individual participant data from randomised trialsBMJ, 2017
- Association of Gestational Weight Gain With Maternal and Infant OutcomesJAMA, 2017
- Pre-pregnancy BMI, gestational weight gain and postpartum weight retention: a meta-analysis of observational studiesPublic Health Nutrition, 2014
- High birth weight and obesity—a vicious circle across generationsInternational Journal of Obesity, 2011
- Maternal and perinatal health outcomes by body mass index categoryAustralian and New Zealand Journal of Obstetrics and Gynaecology, 2011
- Predictors of Obesity in Childhood, Adolescence, and Adulthood in a Birth CohortMaternal and Child Health Journal, 2010
- Gestational weight gain and risk of overweight in the offspring at age 7 y in a multicenter, multiethnic cohort studyThe American Journal of Clinical Nutrition, 2008
- Effects of gestational weight gain and body mass index on obstetric outcome in SwedenInternational Journal of Gynecology & Obstetrics, 2006
- The prevalence and impact of overweight and obesity in an Australian obstetric populationThe Medical Journal of Australia, 2006