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Gestational weight loss and fetal growth in uncomplicated pregnancies among women with obesity: a population-based retrospective cohort study.
- Source :
-
International journal of obesity (2005) [Int J Obes (Lond)] 2023 Dec; Vol. 47 (12), pp. 1269-1277. Date of Electronic Publication: 2023 Oct 13. - Publication Year :
- 2023
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Abstract
- Objective: The impact of gestational weight loss (GWL) on fetal growth among women with obesity remains unclear. This study aimed to examine the association between weight loss during pregnancy among women with body mass index (BMI) ≥ 30 kg/m <superscript>2</superscript> and the risk of small-for-gestational-age (SGA) and large-for-gestational-age (LGA) neonates.<br />Methods: We conducted a retrospective, population-based cohort study of women with pre-pregnancy obesity that resulted in a singleton live birth in 2012-2017, using birth registry data in Ontario, Canada. Women with pregnancy complications or health conditions which could cause weight loss were excluded. GWL is defined as negative gestational weight change (≤0 kg). The association between GWL and fetal growth was estimated using generalized estimating equation models and restricted cubic spline regression analysis. Stratified analysis was conducted by obesity class (I:30-34.9 kg/m <superscript>2</superscript> , II:35-39.9 kg/m <superscript>2</superscript> , and III + : ≥40 kg/m <superscript>2</superscript> ).<br />Results: Of the 52,153 eligible women who entered pregnancy with a BMI ≥ 30 kg/m <superscript>2</superscript> , 5.3% had GWL. Compared to adequate gestational weight gain, GWL was associated with an increased risk of SGA neonates (aRR:1.45, 95% CI: 1.30-1.60) and a decreased risk of LGA neonates (aRR: 0.81, 95% CI:0.73-0.93). Non-linear L-shaped associations were observed between gestational weight change and SGA neonates, with an increased risk of SGA observed with increased GWL. On the contrary, non-linear S-shaped associations were observed between gestational weight change and LGA neonates, with a decreased risk of LGA observed with increased GWL. Similar findings were observed from the stratified analysis by obesity class.<br />Conclusion: These findings highlight that GWL in women with obesity may increase the risk of SGA neonates but reduce the risk of LGA neonates. Recommendations of GWL for women with obesity should be interpreted with caution.<br /> (© 2023. The Author(s).)
- Subjects :
- Pregnancy
Infant, Newborn
Female
Humans
Retrospective Studies
Cohort Studies
Infant, Small for Gestational Age
Fetal Development
Weight Loss
Fetal Growth Retardation
Ontario epidemiology
Body Mass Index
Birth Weight
Pregnancy Outcome epidemiology
Obesity complications
Obesity epidemiology
Weight Gain
Subjects
Details
- Language :
- English
- ISSN :
- 1476-5497
- Volume :
- 47
- Issue :
- 12
- Database :
- MEDLINE
- Journal :
- International journal of obesity (2005)
- Publication Type :
- Academic Journal
- Accession number :
- 37833559
- Full Text :
- https://doi.org/10.1038/s41366-023-01382-6