TABLE 17Gestational Weight Gain and Macrosomia > 4,500 g

Author, Year
Country, Setting
Sample Size
Baseline BMI
Quality
Pregravid Weight (How Measured) Total Weight
Gain (How Measured)
Definition of GroupsResultsConfounders and Effect Modifiers Included in Analysis
Hedderson et al., 2006110

USA, Kaiser Permanente Medical Care Program

45,245

All weights/BMI

Good
Pregravid weight:
Self-report

Total weight gain:
Routine prenatal care or maternity records
ORs and 95% CI, for macrosomia based on rate of weight gain

Rate of gain kg/wk:
G1: −0.26 to 0.21
G2: 0.22 to 0.31 (Reference)
G3: 0.32 to 0.39
G4: 0.40 to 1.03
G1: 0.52 (0.34–0.79)
G2: 1.00
G3: 0.99 (0.67–1.47)
G4: 2.23 (1.54–3.22)
Maternal age, maternal race/ethnicity, parity, pregravid BMI, screening glucose value, gestational age
Clausen et al., 2005113

Norway, university hospital 2050

All weights/BMI

Fair
Pregravid weight:
Routine prenatal care

Total weight gain:
Routine prenatal care of maternity records
ORs and 95% CIs for macrosomia

G1: WG, Quartile 1 (Reference)
G2: WG, Quartile 2
G3: WG, Quartile 3
G4: WG, Quartile 4
G1: 1.0
G2: 2.1 (0.8–5.1)
G3: 3.5 (1.5–8.0)
G4: 4.3 (1.9–9.8)
Maternal age, parity, smoking, placental weight, gestational diabetes, first trimester BMI
Cogswell et al., 19942

USA, Pregnancy Nutrition Surveillance System

53,541

Normal/Overweight/Obese

Fair
Pregravid weight:
Self-report

Total weight gain:
Self-report
ORs and 95% CIs for macrosomia by GWG and prepregnancy BMI

G1: Normal BMI, GWG 25–29 lbs (Reference for normal BMI)
G2: Normal BMI, GWG 35–39 lbs
G3: Normal BMI, GWG ≥ 40 lbs
G4: Overweight BMI, GWG 15–19 lbs (Reference for overweight BMI)
G5: Overweight BMI, GWG ≥ 40 lbs
G6: Obese, GWG 15–19 lbs (Reference for obese GMI)
G7: Obese BMI, GWG 30–34 lbs
G8: Obese BMI, GWG 35–39 lbs
G9: Obese BMI, GWG ≥ 40 lbs
G1: 1.0
G2: 1.5 (1.0–2.3)
G3: 3.3 (2.3–4.7)
G4: 1.0
G5: 4.0 (1.6–10.1)
G6: 1.0
G7: 1.9 (1.3–2.9)
G8: 2.1 (1.3–3.2)
G9: 2.3 (1.6–3.3)
Maternal age, maternal race, height, smoking, infant sex, gestational age
Zhou and Olsen,

1997108

Denmark, two communities

7,122

All weights/BMI

Fair
Pregravid weight:
Self-report

Total weight gain:
Routine prenatal care or maternity records
OR and 95% CI, for macrosomia by GWG categories and BMI

G1: GWG < 11 kg, underweight (Reference)
G2: GWG < 11 kg, normal weight
G3: GWG < 11 kg, overweight
G4: GWG 12–15 kg, underweight,
G5: GWG 12–15 kg, normal weight
G6: GWG 12–15 kg, overweight
G7: GWG ≥ 16 kg, underweight
G8: GWG ≥ 16 kg, normal weight
G9: GWG ≥ 16 kg, overweight
G1: 1.0
G2: 52.8 (0.3–22.9)
G3: 9.7 (1.2–81.8)
G4: 0.0 (0.0–7×105)
G5: 6.8 (0.9–51)
G6: 27.1 (3.3–220)
G7: 6.1 (0.7–52.5)
G8: 15.7 (2.2–114)
G9: 45.6 (6.0–349)
Maternal age, parity, alcohol, no diabetes, term delivery, smoking, infant sex, gestational age
Brennand et al., 200549

Canada, medical records

603

Normal/Overweight/Obese

Poor
Pregravid weight:
Medical records

Total weight gain:
Routine prenatal care or maternity records
% Macrosomia among obese women only

G1: Low WG, < 7 kg
G2: Acceptable WG, 7–11.5 kg
G3: Excessive WG, > 11.5 kg
G1: 16.9%
G2: 15.3%
G3: 18.4% (P = 0.834)
N/A

BMI, body mass index; CI, confidence interval; GWG, gestational weight gain; kg, kilogram; kg/wk, kilogram per week; N/A, not applicable; OR, odds ratio; wk, week.

From: E, Results from the Evidence-Based Report on Outcomes of Maternal Weight Gain

Cover of Weight Gain During Pregnancy
Weight Gain During Pregnancy: Reexamining the Guidelines.
Institute of Medicine (US) and National Research Council (US) Committee to Reexamine IOM Pregnancy Weight Guidelines; Rasmussen KM, Yaktine AL, editors.
Washington (DC): National Academies Press (US); 2009.
Copyright © 2009, National Academy of Sciences.

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