1. Gestational Weight Gain-for-Gestational Age Z-Score Charts Applied across U.S. Populations.
- Author
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Leonard SA, Hutcheon JA, Bodnar LM, Petito LC, and Abrams B
- Subjects
- Adolescent, Adult, California epidemiology, Child, Data Interpretation, Statistical, Female, Humans, Obesity complications, Obesity epidemiology, Pennsylvania epidemiology, Pregnancy Complications epidemiology, Racial Groups statistics & numerical data, Risk Factors, Young Adult, Gestational Age, Pregnancy statistics & numerical data, Weight Gain
- Abstract
Background: Gestational weight gain may be a modifiable contributor to infant health outcomes, but the effect of gestational duration on gestational weight gain has limited the identification of optimal weight gain ranges. Recently developed z-score and percentile charts can be used to classify gestational weight gain independent of gestational duration. However, racial/ethnic variation in gestational weight gain and the possibility that optimal weight gain differs among racial/ethnic groups could affect generalizability of the z-score charts. The objectives of this study were (1) to apply the weight gain z-score charts in two different U.S. populations as an assessment of generalisability and (2) to determine whether race/ethnicity modifies the weight gain range associated with minimal risk of preterm birth., Methods: The study sample included over 4 million live, singleton births in California (2007-2012) and Pennsylvania (2003-2013). We implemented a noninferiority margin approach in stratified subgroups to determine weight gain ranges for which the adjusted predicted marginal risk of preterm birth (gestation <37 weeks) was within 1 or 2 percentage points of the lowest observed risk., Results: There were minimal differences in the optimal ranges of gestational weight gain between California and Pennsylvania births, and among several racial/ethnic groups in California. The optimal ranges decreased as severity of prepregnancy obesity increased in all groups., Conclusions: The findings support the use of weight gain z-score charts for studying gestational age-dependent outcomes in diverse U.S. populations and do not support weight gain recommendations tailored to race/ethnicity., (© 2017 John Wiley & Sons Ltd.)
- Published
- 2018
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