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Balancing the Risk of Infant Low Birth Weight and Macrosomia: an Examination of Gestational Weight Gain or Weight Loss among Obese Women
Author(s) -
Deputy Nicholas,
Sharma Andrea,
Kim Shin
Publication year - 2015
Publication title -
the faseb journal
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.709
H-Index - 277
eISSN - 1530-6860
pISSN - 0892-6638
DOI - 10.1096/fasebj.29.1_supplement.590.3
Subject(s) - medicine , birth certificate , obstetrics , weight gain , birth weight , obesity , fetal macrosomia , low birth weight , gestational age , pregnancy , body mass index , gestational diabetes , pediatrics , gestation , population , body weight , environmental health , biology , genetics
The Institute of Medicine recommends gestational weight gain of 11‐20 pounds for all obese women; however, outcomes associated with gestational weight gain or loss (GWG) may vary by obesity class. Our objective was to examine the association between GWG and infant low birth weight (LBW; <2.5 kg) or macrosomia (蠅4.5 kg) by maternal obesity class using 2012 birth certificate data. Obesity class was defined as class I (BMI 30.0‐34.9 kg/m2), class II (BMI 35.0‐39.9) and class III (BMI 蠅 40.0). We included women who delivered full‐term (蠅37 weeks), singleton infants (n=604,362) and resided in 38 states that used the 2003 revised US Standard Certificate of live birth. We estimated the adjusted risk of LBW or macrosomia using multivariable logistic regression with 8 GWG categories (10 lb increments from ‐30 to 41+) and using predicted probabilities with a continuous GWG variable. The prevalence of LBW was 1.9% for all obesity classes; the prevalence of macrosomia varied by class (class I: 1.8%, II: 2.4%, III: 3.2%; p<0.05). For all obesity classes, compared to GWG of 11‐20 lbs, lower GWG increased risk of LBW (OR range=1.21‐2.64, 95% confidence intervals (CI) range=1.04‐3.81) and decreased risk of macrosomia (OR range=0.40‐0.79, CI range=0.29‐0.97) while higher GWG increased risk of macrosomia (OR range=1.40‐4.41, CI range=1.26‐4.80) and decreased risk of LBW (OR range=0.53‐0.92, CI range=0.49‐1.06). The lowest predicted probability for both outcomes was observed at GWG of 28, 17 and 5 lbs for class I, II and III, respectively. Optimal GWG to balance risk of LBW and macrosomia varies by obesity class, suggesting tailored recommendations are needed.