Insufficient Gestational Weight Gain related to increased poor Infant outcomes: JAMA

A recent study finds that insufficient gestational weight growth (GWG) is linked to an increased risk of bad baby outcomes, even in obese women. The links between GWG and newborn morbidity and death are unknown, and existing GWG guidelines have not been differentiated by the degree of obesity.

This study was conducted by Lijun Wang and team with the objective to determine optimum GWG levels linked with lower risks of newborn morbidity and death across maternal BMI groups.

The findings of this study were published in the Journal of American Medical Association on 30th December, 2021.

This retrospective cohort study used linked birth and infant death data from the United States between 2011 and 2015 to assess the associations of GWG in 2.0-kg groups with infant morbidity and mortality, and to identify optimal GWG ranges associated with lower risks of both outcomes using multivariable logistic regression models. From February 11 through October 14, 2021, statistical analysis was carried out. The gestational weight growth was assumed to be 40 weeks.

The two main outcomes were (1) significant morbidity of the newborn infant, defined as any presence of assisted ventilation, admission to the neonatal intensive care unit, surfactant therapy, antibiotic therapy, or seizures; and (2) infant mortality younger than 1 year of age (one hour, one-and-a-half hours, one-and-a-half days, seven-and-a-half days, seven-and-a-half days, seven-and-a-half days, seven-and-a-half days, seven

The results stated as follows:

1. The mean (SD) age of the women in this sample of 15 759 945 mother-infant dyads was 28.1 (5.9) years. During pregnancy, women acquired a mean (SD) of 14.1 (7.3) kg, while the mean (SD) GWG decreased with BMI category.

2. A total of 8.8 percent of newborns experienced significant morbidity, with the lowest prevalence among infants delivered by women with normal BMI (8.0%) and the highest among infants delivered by women with class 3 obesity (12.4%); 0.34% of infants died within 1 year of birth, with the lowest prevalence among infants delivered by women with normal BMI (0.28%) and the highest among infants delivered by women with class 3 obesity (0.58% ).

3. The optimal GWG ranges for underweight and normal weight women were 12.0 to less than 24.0 kg, 10.0 to less than 20.0 kg for overweight women, 8.0 to less than 16.0 kg for women with class 1 obesity, 6.0 to less than 16.0 kg for class 2 obesity, and 6.0 to less than 10.0 kg for class 3 obesity.

4. The bottom bounds of the ideal GWG ranges seemed to be higher than the present guidelines for overweight women (10.0 vs 7.0 kg) and those with obesity class 1 (8.0 vs 5.0 kg), class 2 (6.0 vs 5.0 kg), and class 3 (6.0 vs 5.0 kg).

In conclusion, the extremes of GWG were linked with elevated risks of unfavorable infant outcomes across BMI categories in this cohort analysis of more than 15.8 million mother-infant dyads, indicating that weight maintenance and weight reduction should not be utilized as normal recommendations, even for obese mothers.

Reference:

Wang L, Zhang X, Chen T, et al. Association of Gestational Weight Gain With Infant Morbidity and Mortality in the United States. JAMA Netw Open. 2021;4(12):e2141498. doi:10.1001/jamanetworkopen.2021.41498