Gestational weight gain in women with pre-pregnancy overweight or obesity and anthropometry of infants at birth

Christina Sonne Mogensen; Helle Zingenberg; Jens Svare; Arne Astrup; Faidon Magkos; Nina Rica Wium Geiker

doi:10.3389/fped.2023.1142920

Gestational weight gain in women with pre-pregnancy overweight or obesity and anthropometry of infants at birth

Front Pediatr. 2023 Mar 16:11:1142920. doi: 10.3389/fped.2023.1142920. eCollection 2023.

Authors

Christina Sonne Mogensen¹, Helle Zingenberg², Jens Svare², Arne Astrup¹, Faidon Magkos¹, Nina Rica Wium Geiker^{1

3}

Affiliations

¹ Department of Nutrition, Exercise and Sports, University of Copenhagen, Frederiksberg, Denmark.
² Department of Obstetrics and Gynecology, Copenhagen University Hospital Herlev-Gentofte, Herlev, Denmark.
³ Dietetic and Clinical Nutrition Research Unit, Copenhagen University Hospital Herlev-Gentofte, Herlev, Denmark.

Abstract

Objective: To examine the association of gestational weight gain (GWG) among women with pre-pregnancy overweight or obesity with infant weight and BMI z-score at birth.

Methods: This study is a secondary analysis of a randomized controlled trial including data from 208 infants at birth born by mothers with pre-pregnancy BMI between 28 and 45 kg/m² who completed the APPROACH study (randomized to a high-protein low-glycemic index diet or a moderate-protein moderate-glycemic index diet). This analysis pooled the two diet treatment groups together and data were analyzed using a linear mixed model.

Results: Limiting GWG by 1 kg was associated with lower birthweight (-16 g, P = 0.003), BMI z-score (-0.03SD, P = 0.019), weight z-score (-0.03SD, P = 0.004), and infant abdominal circumference (-0.06 cm, P = 0.039). Infants born by mothers whose GWG was ≤9 kg weighed less (122 g, 95% CI: 6-249, P = 0.040), had similar BMI z-score (0.2SD, 95% CI: -0.06 to 0.55, P = 0.120), and lower incidence of emergency cesarean deliveries (11.5% vs. 23.1%, P = 0.044) compared to infants born by mothers whose GWG was >9 kg. When women were classified into GWG quartiles, women in Q1 (GWG range: -7.0 to 3.2 kg) gave birth to smaller infants (3,420 g, P = 0.015) with lower BMI z-score (-0.5SD, P = 0.041) than women in Q2 (3.3-7.1 kg), Q3 (7.2-10.9 kg) and Q4 (11.1-30.2 kg).

Conclusions: Limiting GWG among women with pre-pregnancy overweight or obesity was associated with lower infant weight, BMI z-score, weight z-score, and abdominal circumference at birth. Moreover, GWG below the Institute of Medicine guideline of a maximum of 9 kg was associated with lower birthweight and fewer emergency cesarean deliveries.

Keywords: BMI z-score (zBMI); body weight (BW); newborn; pre-conception; pregnancy outcomes.

Grants and funding

The Novo Nordisk Foundation funded this study. The APPROACH study was funded by The Nordea Foundation, Danish Pork Levy Foundation, Danish Agriculture & Food Council and Danish Dairy Foundation and has received products from LEGO Charity, PharmaNord and Pharma Vital. The funders had no role in the study design, data collection, data analysis, interpretation, or writing of the manuscript. The corresponding author had full access to all data in the study and had final responsibility for the decision to submit for publication.