The association between self-reported total gestational weight gain by pre-pregnancy body mass index and moderate to late preterm birth
Abstract Background Inadequate and excessive gestational weight gain (GWG) defined by the Institute of Medicine (IOM) has been associated with preterm birth. However, studies demonstrate inconsistent associations. Objectives We examined the associations between categorical and continuous total GWG a...
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BMC
2025-01-01
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| Series: | BMC Pregnancy and Childbirth |
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| Online Access: | https://doi.org/10.1186/s12884-024-07106-6 |
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| author | Alexandra M. Palumbo Giulia M. Muraca Anne Fuller Charles D.G. Keown-Stoneman Catherine S. Birken Jonathon L. Maguire Laura N. Anderson on behalf of the TARGet Kids! collaboration |
| author_facet | Alexandra M. Palumbo Giulia M. Muraca Anne Fuller Charles D.G. Keown-Stoneman Catherine S. Birken Jonathon L. Maguire Laura N. Anderson on behalf of the TARGet Kids! collaboration |
| author_sort | Alexandra M. Palumbo |
| collection | DOAJ |
| description | Abstract Background Inadequate and excessive gestational weight gain (GWG) defined by the Institute of Medicine (IOM) has been associated with preterm birth. However, studies demonstrate inconsistent associations. Objectives We examined the associations between categorical and continuous total GWG and moderate to late preterm birth (32-<37 weeks), and evaluated differences in these associations by pre-pregnancy BMI. Methods We analyzed cross-sectional data from children participating in TARGet Kids! in Toronto, Canada. Parents of children < 6 years of age recalled pre-pregnancy weight, end-of-pregnancy weight, and gestational age. GWG was categorized according to the 2009 IOM guidelines as inadequate, recommended, or excessive for each pre-pregnancy BMI category. GWG was expressed as the percentage of recommendations met to account for gestational duration. Adjusted odds ratios (aORs) for moderate to late preterm birth were estimated using logistic regression models. Restricted cubic splines were used to model the adjusted predicted probability of moderate to late preterm birth against continuous GWG. Results Of the 4,529 participants, 8.2% were born moderate to late preterm. 31.1% of parents met the GWG recommendations, 41.0% had excessive GWG, and 27.9% had inadequate GWG. Compared to recommended GWG, excessive GWG had increased odds of moderate to late preterm birth (aOR 1.68, 95% CI 1.29, 2.19). There was insufficient evidence of an association between inadequate GWG and moderate to late preterm birth (aOR 1.10, 95% CI 0.81, 1.50). For parents who were overweight or had obesity, the risk of moderate to late preterm birth did not increase substantially until a GWG > 200% of the recommendations, which is well above the IOM recommended upper limit. Conclusions Excessive GWG was associated with an increased risk of moderate to late preterm birth, with variation in the association by pre-pregnancy BMI. Current definitions of excessive GWG may not adequately reflect increased risk of preterm birth among those with overweight or obesity. |
| format | Article |
| id | doaj-art-df2dbc7f41a049a6a8df3f51c392717c |
| institution | Kabale University |
| issn | 1471-2393 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | BMC |
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| series | BMC Pregnancy and Childbirth |
| spelling | doaj-art-df2dbc7f41a049a6a8df3f51c392717c2025-01-12T12:43:52ZengBMCBMC Pregnancy and Childbirth1471-23932025-01-0125111310.1186/s12884-024-07106-6The association between self-reported total gestational weight gain by pre-pregnancy body mass index and moderate to late preterm birthAlexandra M. Palumbo0Giulia M. Muraca1Anne Fuller2Charles D.G. Keown-Stoneman3Catherine S. Birken4Jonathon L. Maguire5Laura N. Anderson6on behalf of the TARGet Kids! collaborationDepartment of Health Research Methods, Evidence, and Impact, McMaster UniversityDepartment of Health Research Methods, Evidence, and Impact, McMaster UniversityDepartment of Health Research Methods, Evidence, and Impact, McMaster UniversityDalla Lana School of Public Health, University of TorontoDalla Lana School of Public Health, University of TorontoDalla Lana School of Public Health, University of TorontoDepartment of Health Research Methods, Evidence, and Impact, McMaster UniversityAbstract Background Inadequate and excessive gestational weight gain (GWG) defined by the Institute of Medicine (IOM) has been associated with preterm birth. However, studies demonstrate inconsistent associations. Objectives We examined the associations between categorical and continuous total GWG and moderate to late preterm birth (32-<37 weeks), and evaluated differences in these associations by pre-pregnancy BMI. Methods We analyzed cross-sectional data from children participating in TARGet Kids! in Toronto, Canada. Parents of children < 6 years of age recalled pre-pregnancy weight, end-of-pregnancy weight, and gestational age. GWG was categorized according to the 2009 IOM guidelines as inadequate, recommended, or excessive for each pre-pregnancy BMI category. GWG was expressed as the percentage of recommendations met to account for gestational duration. Adjusted odds ratios (aORs) for moderate to late preterm birth were estimated using logistic regression models. Restricted cubic splines were used to model the adjusted predicted probability of moderate to late preterm birth against continuous GWG. Results Of the 4,529 participants, 8.2% were born moderate to late preterm. 31.1% of parents met the GWG recommendations, 41.0% had excessive GWG, and 27.9% had inadequate GWG. Compared to recommended GWG, excessive GWG had increased odds of moderate to late preterm birth (aOR 1.68, 95% CI 1.29, 2.19). There was insufficient evidence of an association between inadequate GWG and moderate to late preterm birth (aOR 1.10, 95% CI 0.81, 1.50). For parents who were overweight or had obesity, the risk of moderate to late preterm birth did not increase substantially until a GWG > 200% of the recommendations, which is well above the IOM recommended upper limit. Conclusions Excessive GWG was associated with an increased risk of moderate to late preterm birth, with variation in the association by pre-pregnancy BMI. Current definitions of excessive GWG may not adequately reflect increased risk of preterm birth among those with overweight or obesity.https://doi.org/10.1186/s12884-024-07106-6PregnancyPremature birthGestational weight gainBody mass index |
| spellingShingle | Alexandra M. Palumbo Giulia M. Muraca Anne Fuller Charles D.G. Keown-Stoneman Catherine S. Birken Jonathon L. Maguire Laura N. Anderson on behalf of the TARGet Kids! collaboration The association between self-reported total gestational weight gain by pre-pregnancy body mass index and moderate to late preterm birth BMC Pregnancy and Childbirth Pregnancy Premature birth Gestational weight gain Body mass index |
| title | The association between self-reported total gestational weight gain by pre-pregnancy body mass index and moderate to late preterm birth |
| title_full | The association between self-reported total gestational weight gain by pre-pregnancy body mass index and moderate to late preterm birth |
| title_fullStr | The association between self-reported total gestational weight gain by pre-pregnancy body mass index and moderate to late preterm birth |
| title_full_unstemmed | The association between self-reported total gestational weight gain by pre-pregnancy body mass index and moderate to late preterm birth |
| title_short | The association between self-reported total gestational weight gain by pre-pregnancy body mass index and moderate to late preterm birth |
| title_sort | association between self reported total gestational weight gain by pre pregnancy body mass index and moderate to late preterm birth |
| topic | Pregnancy Premature birth Gestational weight gain Body mass index |
| url | https://doi.org/10.1186/s12884-024-07106-6 |
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