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Background <p>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.</p> Objectives <p>We examined the associations between categorical and continuous total GWG and moderate to late preterm birth (32-&lt;37 weeks), and evaluated differences in these associations by pre-pregnancy BMI.</p> Methods <p>We analyzed cross-sectional data from children participating in TARGet Kids! in Toronto, Canada. Parents of children &lt; 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.</p> Results <p>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 &gt; 200% of the recommendations, which is well above the IOM recommended upper limit.</p> Conclusions <p>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.</p>

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The association between self-reported total gestational weight gain by pre-pregnancy body mass index and moderate to late preterm birth

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  • 发表日期：

    2025年1月11日

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  • Alexandra M. Palumbo,
  • Giulia M. Muraca,
  • Anne Fuller,
  • Charles D.G. Keown-Stoneman,
  • Catherine S. Birken,
  • Jonathon L. Maguire,
  • Laura N. Anderson,
  • Christopher Allen,
  • Danielle D’Annunzio,
  • Mateenah Jaleel,
  • Natricha Levy McFarlane,
  • Jessica A. Omand,
  • Sharon Thadani,
  • Mary Aglipay,
  • Imaan Bayoumi,
  • Cornelia M. Borkhoff,
  • Sarah Carsley,
  • Alice Charach,
  • Katherine Cost,
  • Curtis D’Hollander,
  • Laura Kinlin,
  • Michaela Kucab,
  • Patricia Li,
  • Pat Parkin,
  • Nav Persaud,
  • Sarah Rae,
  • Izabela Socynska,
  • Shelley Vanderhout,
  • Leigh Vanderloo,
  • Peter Wong,
  • Piyumi Konara Mudiyanselage,
  • Xuedi Li,
  • Jenny Liu,
  • Michelle Mitchell,
  • Yulika Yoshida-Montezuma,
  • Nusrat Zaffar,
  • Tiffany Bondoc,
  • Pamela Ruth Flores,
  • Sydney Fraser,
  • Kardelen Kurt,
  • Sangeetha Loganathan,
  • Tarandeep Mali,
  • Laurie Thompson,
  • Jennifer Batten,
  • Jennifer Chan,
  • John Clark,
  • Amy Craig,
  • Kim De Castris-Garcia,
  • Sharon Dharman,
  • Sarah Kelleher,
  • Salimah Nasser,
  • Tammara Pabon,
  • Michelle Rhodes,
  • Rafael Salsa,
  • Julie Skelding,
  • Daniel Stern,
  • Kerry Stewart,
  • Erika Sendra Tavares,
  • Shannon Weir,
  • Maria Zaccaria Cho,
  • Magdalena Janus,
  • Eric Duku,
  • Caroline Reid-Westoby,
  • Patricia Raso,
  • Amanda Offord,
  • Emy Abraham,
  • Sara Ali,
  • Kelly Anderson,
  • Gordon Arbess,
  • Jillian Baker,
  • Tony Barozzino,
  • Sylvie Bergeron,
  • Gary Bloch,
  • Joey Bonifacio,
  • Ashna Bowry,
  • Caroline Calpin,
  • Douglas Campbell,
  • Sohail Cheema,
  • Brian Chisamore,
  • Evelyn Constantin,
  • Karoon Danayan,
  • Paul Das,
  • Viveka De Guerra,
  • Mary Beth Derocher,
  • Anh Do,
  • Kathleen Doukas,
  • Anne Egger,
  • Allison Farber,
  • Amy Freedman,
  • Sloane Freeman,
  • Sharon Gazeley,
  • Karen Grewal,
  • Charlie Guiang,
  • Curtis Handford,
  • Laura Hanson,
  • Leah Harrington,
  • Sheila Jacobson,
  • Lukasz Jagiello,
  • Gwen Jansz,
  • Paul Kadar,
  • Lukas Keiswetter,
  • Tara Kiran,
  • Holly Knowles,
  • Bruce Kwok,
  • Piya Lahiry,
  • Sheila Lakhoo,
  • Margarita Lam-Antoniades,
  • Eddy Lau,
  • Denis Leduc,
  • Fok-Han Leung,
  • Alan Li,
  • Patricia Li,
  • Roy Male,
  • Aleks Meret,
  • Elise Mok,
  • Rosemary Moodie,
  • Katherine Nash,
  • James Owen,
  • Michael Peer,
  • Marty Perlmutar,
  • Navindra Persaud,
  • Andrew Pinto,
  • Michelle Porepa,
  • Vikky Qi,
  • Noor Ramji,
  • Danyaal Raza,
  • Katherine Rouleau,
  • Caroline Ruderman,
  • Janet Saunderson,
  • Vanna Schiralli,
  • Michael Sgro,
  • Hafiz Shuja,
  • Farah Siam,
  • Susan Shepherd,
  • Cinntha Srikanthan,
  • Carolyn Taylor,
  • Stephen Treherne,
  • Suzanne Turner,
  • Fatima Uddin,
  • Meta van den Heuvel,
  • Thea Weisdorf,
  • Peter Wong,
  • John Yaremko,
  • Ethel Ying,
  • Elizabeth Young,
  • Michael Zajdman,
  • Esmot Ara Begum,
  • Peter Juni,
  • Gurpreet Lakhanpal,
  • Gerald Lebovic,
  • Ifeayinchukwu Nnorom,
  • Marc Denzel Nunez,
  • Audra Stitt,
  • Kevin Thorpe,
  • Homa Bondar,
  • George S. Charames,
  • Andrea Djolovic,
  • Chelsea Gorscak-Dunn,
  • Mary Hassan,
  • Rita Kandel

摘要

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.