Home The relationship between gestational weight gain and fetal growth: time to take stock?
Article
Licensed
Unlicensed Requires Authentication

The relationship between gestational weight gain and fetal growth: time to take stock?

  • Amy C. O’Higgins EMAIL logo , Anne Doolan , Laura Mullaney , Niamh Daly , Daniel McCartney and Michael J. Turner
Published/Copyright: November 21, 2013

Abstract

The aim of this article is to review the current evidence on gestational weight gain (GWG). Maternal obesity has emerged as one of the great challenges in modern obstetrics as it is becoming increasingly common and is associated with increased maternal and fetal complications. There has been an upsurge of interest in GWG with an emphasis on the relationship between excessive GWG and increased fetal growth. Recent recommendations from the Institute of Medicine in the USA have revised downwards the weight gain recommendations in pregnancy for obese mothers. We believe that it is time to take stock again about the advice that pregnant women are given about GWG and their lifestyle before, during, and after pregnancy. The epidemiological links between excessive GWG and aberrant fetal growth are weak, particularly in obese women. There is little evidence that intervention studies decrease excessive GWG or improve intrauterine fetal growth. Indeed, there is a potential risk that inappropriate interventions during the course of pregnancy may lead to fetal malnutrition that may have adverse clinical consequences, both in the short- and long-term. It may be more appropriate to shift the focus of attention from monitoring maternal weight to increasing physical activity levels and improving nutritional intakes.


Corresponding author: Amy C. O’Higgins, UCD Centre for Human Reproduction, Coombe Women and Infants University Hospital, Dublin 8, Ireland, Tel.: +353-1-4085760, Fax: +353-1-4085786, E-mail:

References

[1] Alavi N, Haley S, Chow K, McDonald SD. Comparison of national gestational weight gain guidelines and energy intake recommendations. Obes Rev. 2013;14:68–85.10.1111/j.1467-789X.2012.01059.xSearch in Google Scholar

[2] Black RE, Allen LH, Bhutta ZA, Caulfield LE, de Onis M, Ezzati M, et al. Maternal and child undernutrition: global and regional exposures and health consequences. Lancet. 2008;371: 243–60.10.1016/S0140-6736(07)61690-0Search in Google Scholar

[3] Brunner Huber LR. Validity of self-reported height and weight in women of reproductive age. Matern Child Health J. 2007:11;137–44.10.1007/s10995-006-0157-0Search in Google Scholar

[4] Butte NF, Ellis KJ, Wong WW, Hopkinson JM, Smith EO. Composition of gestational weight gain impacts maternal fat retention and infant birth weight. Am J Obstet Gynecol. 2003;189:1423–32.10.1067/S0002-9378(03)00596-9Search in Google Scholar

[5] Chu SY, Bachman DJ, Callaghan WM, Whitlock EP, Dietz PM, Berg CJ, et al. Association between obesity during pregnancy and increased use of healthcare. N Engl J Med. 2008;358:1444–53.10.1056/NEJMoa0706786Search in Google Scholar

[6] Engstrom JL, Paterson SA, Doherty A, Trabulsi M, Speer KL. Accuracy of self-reported height and weight in women: an integrative review of the literature. J Midwifery Womens Health. 2003;48:338–45.10.1016/S1526-9523(03)00281-2Search in Google Scholar

[7] Ernst B, Thurnheer M, Schmid SM, Schultes B. Evidence for the necessity to systematically assess micronutrient status prior to bariatric surgery. Obes Surg. 2009;19:66–73.10.1007/s11695-008-9545-4Search in Google Scholar PubMed

[8] Farah N, Kennedy C, Turner C, O’Dwyer V, Kennelly MM, Turner MJ. Maternal obesity and pre-pregnancy folic acid supplementation. Obes Facts. 2013;6:211–5.10.1159/000350393Search in Google Scholar PubMed PubMed Central

[9] Farah N, Maher N, Barry S, Kennelly MM, Turener MJ. Maternal morbid obesity and obstetric outcomes. Obesity Facts. 2009;2:352–4.10.1159/000261951Search in Google Scholar PubMed PubMed Central

[10] Farah N, Stuart B, Donnelly V, Kennelly MM, Turner MJ. The influence of maternal body composition on birth weight. Eur J Obstet Gynaecol Reprod Biol. 2011;157:14–7.10.1016/j.ejogrb.2010.12.047Search in Google Scholar PubMed

[11] Fattah C, Farah N, Barry S, O’Connor N, Stuart B, Turner MJ. The measurement of maternal obesity. J Obstet Gynaecol. 2009;29:686–9.10.3109/01443610903184025Search in Google Scholar PubMed

[12] Fattah C, Farah N, Barry SC, O’Connor N, Stuart B, Turner MJ. Materal weight and body composition in the first trimester of pregnancy. Acta Obstet Gynecol Scand. 2010;89:952–5.10.3109/00016341003801706Search in Google Scholar PubMed

[13] Fattah C, Farah N, O’Toole F, Barry S, Stuart B, Turner MJ. Body mass index (BMI) in women booking for antenatal care: comparison between selfreported and digital measurements. Eur J Obstet Gynecol Reprod Biol. 2009;144:32–4.10.1016/j.ejogrb.2009.01.015Search in Google Scholar PubMed

[14] Finer BF, Henshan SK. Disparities in rates of unintended pregnancy in the United States, 1994 and 2001. Perspect Sex Reprod Health. 2006;38:90–6.10.1363/3809006Search in Google Scholar

[15] Gallagher D, Visser M, Sepulveda D, Pierson RN, Harris T, Heymsfeld SB. How useful is body mass index for comparison of body fatness across age, sex and ethnic groups? Am J Epidemiol. 1996;143:228–39.10.1093/oxfordjournals.aje.a008733Search in Google Scholar PubMed

[16] Gardner B, Wardle J, Poston L, Croker H. Changing diet and physical activity to reduce gestational weight gain: a meta-analysis. Obes Rev. 2011;12:602–20.10.1111/j.1467-789X.2011.00884.xSearch in Google Scholar PubMed

[17] Heslehurst N, Simpson H, Ells LJ, Rankin J, Wilkinson J, Lang R, et al. The impact of maternal BMI status on pregnancy outcomes with immediate short-term obstetric resource implications: a meta-analysis. Obes Rev. 2009;9:635–83.10.1111/j.1467-789X.2008.00511.xSearch in Google Scholar PubMed

[18] Hutcheon JA, Bodnar LM, Joseph KS, Abrams B, Simhan HN, Platt RW. The bias in current measures of gestational weight gain. Paediatr Perinatal Epidemiol. 2012;26:109–16.10.1111/j.1365-3016.2011.01254.xSearch in Google Scholar PubMed PubMed Central

[19] Institute of Medicine and National Research Council of National Academy of Sciences. Weight gain during pregnancy. Reexamining the guidelines. Rasmussen KM, Yaktine AL, editors. Washington: The National Academies Press; 2009.Search in Google Scholar

[20] Institute of Obstetricians and Gynaecologists, Royal College of Physicians of Ireland and Health Services Executive. Obesity and pregnancy. Clinical practice guideline. Dublin: HSE; 2011.Search in Google Scholar

[21] Johnson J, Clifton RG, Roberts JM, Myatt L, Hauth JC, Spong CY, et al. Pregnancy outcomes with weight gain above or below the 2009 Institute of Medicine guidelines. Obstet Gynecol. 2013;121:969–75.10.1097/AOG.0b013e31828aea03Search in Google Scholar PubMed PubMed Central

[22] Kennedy C, Farah N, O’Dwyer V, Hogan J, Kennelly MM, Turner MJ. Maternal obesity and inpatient medication usage. Clin Obes. 2011;1:147–52.10.1111/j.1758-8111.2011.00026.xSearch in Google Scholar PubMed

[23] Kent E, O’Dwyer V, Fattah C, Farah N, O’Connor C, Turner MJ. Correlation between birthweight and maternal body composition. Obstet Gynecol. 2013;121:46–50.10.1097/AOG.0b013e31827a0052Search in Google Scholar

[24] Klienman KP, Oken E, Radesky JS, Rich-Edwards JW, Peterson KE, Gillman MW. How should gestational weight gain be assessed? A comparison of existing methods and a novel method, area under the weight gain curve. Int J Epidiomol. 2007;36:1275–82.10.1093/ije/dym156Search in Google Scholar PubMed PubMed Central

[25] Lawerence M, McKillop FM, Durnin JV. Women who gain more fat during pregnancy may not have bigger babies: implications for recommended weight gain during pregnancy. Br J Obstet Gynaecol. 1991;98:254–9.10.1111/j.1471-0528.1991.tb13389.xSearch in Google Scholar PubMed

[26] National Institute for Health and Clinical Excellence. Weight management before, during and after pregnancy. NICE public health guidance 27. London: National Institute for Health and Clinical Excellence; 2010.Search in Google Scholar

[27] O’Brien T, Ray JG, Chan WS. Maternal body mass index and the risk of pre-eclampsia: a systematic overview. Epidemiology. 2003;14:368–74.10.1097/01.EDE.0000059921.71494.D1Search in Google Scholar

[28] O’Dwyer V, O’Toole F, Darcy S, Farah N, Kennelly MM, Turner MJ. Maternal obesity and gestational weight gain. J Obstet Gynaecol. 2013;33:671–4.10.3109/01443615.2013.821461Search in Google Scholar PubMed

[29] Oken E, Gillman MW. Intervention strategies to improve outcome in obese pregnancies: focus on gestational weight gain. In: Gillman MW, Poston L, editors. Maternal obesity. Cambridge: Cambridge University Press; 2012. p. 151–78.10.1017/CBO9780511782466.015Search in Google Scholar

[30] Plankey MW, Stevens J, Flegal KM, Rust PF. Prediction equations do not eliminate systematic error in self-reported body mass index. Obes Res. 1997;5:308–14.10.1002/j.1550-8528.1997.tb00556.xSearch in Google Scholar PubMed

[31] Rasmussen KM, Abrams B, Bodnar LM, Butte NF, Catalano PM, Maria Siega-Riz A. Recommendations for weight gain during pregnancy in the context of the obesity epidemic. Obstet Gynecol. 2010;116:1191–5.10.1097/AOG.0b013e3181f60da7Search in Google Scholar PubMed PubMed Central

[32] Sewell MF, Huston-Presley L, Super DM, Catalano P. Increased neonatal fat mass, not lean body mass, is associated with maternal obesity. Am J Obstet Gynecol. 2006;195:1100–3.10.1016/j.ajog.2006.06.014Search in Google Scholar PubMed

[33] Sheilds M, Connor Gorber S, Tremblay MS. Effects of measurement on obesity and morbidity. Health Rep. 2008;19:77–84.Search in Google Scholar

[34] Sheilds M, Connor Gorber S, Tremblay MS. Estimates of obesity based on self-report versus direct measures. Health Rep. 2008;19:16–76.Search in Google Scholar

[35] Siega-Riz AM, Viswanathan M, Moos MK, Deierlein A, Mumford S, Knaack J, et al. A systematic review of outcomes of maternal weight gain according to the Institute of Medicine recommendations: birthweight, fetal growth and postpartum weight retention. Am J Obstet Gynecol. 2009;201:339.e1–14.10.1016/j.ajog.2009.07.002Search in Google Scholar PubMed

[36] Suitor CW. Maternal weight gain: a report of an expert work group. Arlington: National Center for Education in Maternal and Child Health; 1997.Search in Google Scholar

[37] Thangaratinam S, Rogozinska E, Jolly K, Glinkowski S, Roseboon T, Tomlinson JW, et al. Effects of interventions in pregnancy on maternal weight and obstetric outcomes: meta-analysis of randomised evidence. BMJ. 2012;344:e2088.10.1136/bmj.e2088Search in Google Scholar PubMed PubMed Central

[38] Turner MJ. The measurement of maternal obesity: can we do better? Clin Obes. 2011;1:127–9.10.1111/j.1758-8111.2011.00024.xSearch in Google Scholar PubMed

[39] Turner MJ, Farah N. Gestational weight gain and birthweight. Ir Med J. 2010;103:293–4.Search in Google Scholar

[40] Turner MJ, Layte R. Obesity levels in a national cohort of women 9 months after delivery. Am J Obstet Gynecol. 2013;209:124.e1–7.10.1016/j.ajog.2013.04.020Search in Google Scholar PubMed

[41] Vesco KK, Sharma AJ, Dietz PM, Rizzo JH, Callaghan WM, England L, et al. Newborn size among obese women with weight gain outside the 2009 Institute of Medicine recommendation. Obstet Gynecol. 2011;117:812–8.10.1097/AOG.0b013e3182113ae4Search in Google Scholar PubMed

The authors stated that there are no conflicts of interest regarding the publication of this article.

Received: 2013-8-8
Accepted: 2013-10-14
Published Online: 2013-11-21
Published in Print: 2014-7-1

©2014 by Walter de Gruyter Berlin/Boston

Articles in the same Issue

  1. Frontmatter
  2. Review articles
  3. The relationship between gestational weight gain and fetal growth: time to take stock?
  4. Risk factors for pregnancy-associated venous thromboembolism: a review
  5. Academy’s Corner
  6. Africa is only 14 km away from my country
  7. Primary prevention of preterm birth
  8. Original articles – Obstetrics
  9. Mother knows best? Comparing primiparous parturients’ expectations and predictions with actual birth outcomes
  10. Silent chorioamnionitis and associated pregnancy outcomes: a review of clinical data gathered over a 16-year period
  11. Clinical factors associated with failed trials of labor in late preterm and term twin pregnancies
  12. Relation of placental diagnosis in stillbirth to fetal maceration and gestational age at delivery
  13. Evaluation of a novel placental alpha microglobulin-1 (PAMG-1) test to predict spontaneous preterm delivery
  14. The relationship of praise/criticism to learning during obstetrical simulation: a randomized clinical trial
  15. Sickle cell disease and pregnancy outcomes: population-based study on 8.8 million births
  16. Differences between external and internal fetal heart rate monitoring during the second stage of labor: a prospective observational study
  17. Perinatal management of preterm premature ruptured membranes affects neonatal prognosis
  18. Impact of the nitric oxide-donor pentaerythrityl-tetranitrate on perinatal outcome in risk pregnancies: a prospective, randomized, double-blinded trial
  19. Umbilical vein volume flow in monochorionic twin pairs at 11–14 weeks
  20. Gestational weight gain according to number of fetuses in Japanese women
  21. Original article – Fetus
  22. Prenatal diagnosis of sex chromosome aneuploidies and disorders of sex development – a retrospective analysis of 11-year data
  23. Short communication
  24. Reference range for amniotic fluid index measurements in a Brazilian population
  25. Congress Calendar
  26. Congress Calendar
Downloaded on 22.10.2025 from https://www.degruyterbrill.com/document/doi/10.1515/jpm-2013-0209/html
Scroll to top button