AUTHOR=Mogensen Christina Sonne , Zingenberg Helle , Svare Jens , Astrup Arne , Magkos Faidon , Geiker Nina Rica Wium 

TITLE=Gestational weight gain in women with pre-pregnancy overweight or obesity and anthropometry of infants at birth

JOURNAL=Frontiers in Pediatrics

VOLUME=11

YEAR=2023

URL=https://www.frontiersin.org/journals/pediatrics/articles/10.3389/fped.2023.1142920

DOI=10.3389/fped.2023.1142920

ISSN=2296-2360

ABSTRACT=<sec><title>Objective</title><p>To examine the association of gestational weight gain (GWG) among women with pre-pregnancy overweight or obesity with infant weight and BMI z-score at birth.</p></sec><sec><title>Methods</title><p>This study is a secondary analysis of a randomized controlled trial including data from 208 infants at birth born by mothers with pre-pregnancy BMI between 28 and 45 kg/m<sup>2</sup> who completed the APPROACH study (randomized to a high-protein low-glycemic index diet or a moderate-protein moderate-glycemic index diet). This analysis pooled the two diet treatment groups together and data were analyzed using a linear mixed model.</p></sec><sec><title>Results</title><p>Limiting GWG by 1 kg was associated with lower birthweight (−16 g, <italic>P</italic> = 0.003), BMI z-score (−0.03SD, <italic>P</italic> = 0.019), weight z-score (−0.03SD, <italic>P</italic> = 0.004), and infant abdominal circumference (−0.06 cm, <italic>P</italic> = 0.039). Infants born by mothers whose GWG was ≤9 kg weighed less (122 g, 95% CI: 6–249, <italic>P</italic> = 0.040), had similar BMI z-score (0.2SD, 95% CI: −0.06 to 0.55, <italic>P</italic> = 0.120), and lower incidence of emergency cesarean deliveries (11.5% vs. 23.1%, <italic>P</italic> = 0.044) compared to infants born by mothers whose GWG was &gt;9 kg. When women were classified into GWG quartiles, women in Q1 (GWG range: −7.0 to 3.2 kg) gave birth to smaller infants (3,420 g, <italic>P</italic> = 0.015) with lower BMI z-score (−0.5SD, <italic>P</italic> = 0.041) than women in Q2 (3.3–7.1 kg), Q3 (7.2–10.9 kg) and Q4 (11.1–30.2 kg).</p></sec><sec><title>Conclusions</title><p>Limiting GWG among women with pre-pregnancy overweight or obesity was associated with lower infant weight, BMI z-score, weight z-score, and abdominal circumference at birth. Moreover, GWG below the Institute of Medicine guideline of a maximum of 9 kg was associated with lower birthweight and fewer emergency cesarean deliveries.</p></sec>