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Association of Maternal Weight and Gestational Weight Gain with Maternal and Neonate Outcomes: A Prospective Cohort Study

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Biochemistry and Molecular Genetic Department, CHU Clermont-Ferrand, Université Clermont-Auvergne, Faculty of Medicine, CNRS 6293, INSERM 1103, GReD, 63000 Clermont-Ferrand, France
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Centre de Recherche du CHU de Québec-Université Laval, Department of Molecular Biology, Medical Biochemistry and Pathology, Faculty of Medicine, Québec City, G1V 0A6, Canada
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Centre de Recherche du CHU de Québec-Université Laval, Québec City, G1L 3L5, Canada
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Department of Obstetrics, Gynecology and Reproduction, Faculty of Medicine, Université Laval, Québec City, G1V 0A6, Canada
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Biostatistics Unit (DRCI), CHU de Clermont-Ferrand, 63000 Clermont-Ferrand, France
*
Author to whom correspondence should be addressed.
J. Clin. Med. 2019, 8(12), 2074; https://doi.org/10.3390/jcm8122074
Received: 30 October 2019 / Revised: 18 November 2019 / Accepted: 25 November 2019 / Published: 27 November 2019
(This article belongs to the Section Obstetrics & Gynecology)
We investigated the association of outcomes with pre-pregnancy body mass index (ppBMI), Institute of Medicine (IOM) recommendations about gestational weight gain, and weight gain trajectories during pregnancy. A prospective cohort of 7866 pregnant women was recruited. ppBMI and weight gain at each follow up visit were collected. The outcomes were gestational diabetes mellitus (GDM), hypertensive disorders of pregnancy (HDP), caesarean delivery, macrosomia, small (SGA) and large (LGA) for gestational age, neonatal hypoglycemia. Group-based multi-trajectory modelling was used for weight kinetics during pregnancy. In the third trimester, 53.8% of women were above IOM recommendations, with an increased relative risk (RR) of HDP (1.91 (1.40–2.61)), caesarean (1.34 (1.15–1.56)), macrosomia (2.17 (1.77–2.67)), LGA (2.26 (1.83–2.80)), and hypoglycemia (1.89 (1.12–3.18)). Women with a weight gain above IOM recommendations in the second trimester who normalized their weight gain in third trimester had, compared to those who remained above IOM recommendations, fewer events of HDP (2.8% versus 5.3%, p = 0.008), caesarean delivery (16.9% versus 22%, p = 0.006), macrosomia (8.3% versus 14.2%, p < 0.001), and LGA (7% versus 13.2%, p < 0.001). Multi-trajectory modelling identified three profiles with continued variation in RR of complications, including GDM. Weight gain above IOM recommendations increased the risk of perinatal complications. A correction of excessive weight gain in the second trimester reduces these risks. View Full-Text
Keywords: gestational weight gain; IOM recommendations; gestational diabetes mellitus; hypertensive disorders of pregnancy; caesarean delivery; macrosomia; small for gestational age; large for gestational age; neonatal hypoglycemia; group-based multi-trajectory modelling gestational weight gain; IOM recommendations; gestational diabetes mellitus; hypertensive disorders of pregnancy; caesarean delivery; macrosomia; small for gestational age; large for gestational age; neonatal hypoglycemia; group-based multi-trajectory modelling
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MDPI and ACS Style

Bouvier, D.; Forest, J.-C.; Dion-Buteau, E.; Bernard, N.; Bujold, E.; Pereira, B.; Giguère, Y. Association of Maternal Weight and Gestational Weight Gain with Maternal and Neonate Outcomes: A Prospective Cohort Study. J. Clin. Med. 2019, 8, 2074.

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