Open Access
Trimester-Specific Gestational Weight Gain and Infant Size for Gestational Age
Author(s) -
Sneha B. Sridhar,
Fei Xu,
Monique M. Hedderson
Publication year - 2016
Publication title -
plos one
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.99
H-Index - 332
ISSN - 1932-6203
DOI - 10.1371/journal.pone.0159500
Subject(s) - gestational age , obstetrics , gestation , weight gain , medicine , small for gestational age , pregnancy , birth weight , biology , body weight , endocrinology , genetics
Gestational weight gain is known to influence fetal growth. However, it is unclear whether the associations between gestational weight gain and fetal growth vary by trimester. In a diverse cohort of 8,977 women who delivered a singleton between 2011 and 2013, we evaluated the associations between trimester-specific gestational weight gain and infant size for gestational age. Gestational weight gain was categorized per the 2009 Institute of Medicine (IOM) recommendations; meeting the recommendations was the referent. Large for gestational age and small for gestational age were defined as birthweight > 90 th percentile or <10 th percentile, respectively, based on a national reference standard birthweight distribution. Logistic regression models estimated the odds of having a large or small for gestational age versus an appropriate for gestational age infant. Only gestational weight gain exceeding the IOM recommendations in the 2 nd and 3 rd trimesters independently increased the odds of delivering a large for gestational age infant (Odds Ratio (95% Confidence Interval): 1 st : 1.17 [0.94, 1.44], 2 nd : 1.47 [1.13, 1.92], 3 rd : 1.70 [1.30, 2.22]). Gestational weight gain below the IOM recommendations increased the likelihood of having a small for gestational age infant in the 2 nd trimester only (1.76 [1.23, 2.52]). There was effect modification, and gestational weight gain below the IOM recommendations increased the likelihood of having a small for gestational age infant in the 2 nd trimester and only among women with a pre-pregnancy body mass index from 18.5–24.9 kg/m 2 (2.06 [1.35, 3.15]). These findings indicate that gestational weight gain during the 2 nd and 3 rd trimesters is more strongly associated with infant growth. Interventions to achieve appropriate gestational weight gain may optimize infant size at birth.