TABLE 18Gestational Weight Gain and Macrosomia > 4,000g

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
Bergmann et al., 2003112

Germany, Berlin Perinatal Registry

206,308

All weights/BMI

Fair
Pregravid weight:
Not stated

Total weight gain:
Not stated
ORs and 95% CIs of macrosomia

G1: WG < 10 kg (Reference)
G2: WG 10–16 kg
G3: WG ≥ 16 kg
G1: 1.0
G2: 1.85 (1.77–1.93)
G3: 3.37 (3.22–3.53)
Pregravid BMI, height, parity, smoking, diabetes, postterm delivery
Jain et al., 200777

USA, birth certificate records and Pregnancy

Risk Assessment
Monitoring System

7,661

All weights/BMI

Fair
Pregravid weight:
Not stated

Total weight gain:
Birth certificate
ORs and 95% CIs for macrosomia

G1: WG ≤ 15 lbs
G2: WG 15–24 lbs
G3: WG 25–35 lbs
G4: WG ≥ 35 lbs
G1: 0.49 (0.30–0.82)
G2: 1.0
G3: 1.17 (0.82–1.65)
G4: 2.83 (2.04–3.92)
Maternal age, pregravid BMI, parity, education, race/ethnicity, US/foreign origin
Johnson et al., 199270

USA, prenatal clinics

3,191

All weights/BMI

Fair
Pregravid weight:
Self-report

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

G1: Net WG < 14.9 lbs (Reference)
G2: Net WG 14.9–23.5 lbs
G3: Net WG 24–33 lbs
G4: Net WG > 33 lbs
G1: 1.0
G2: 1.20 (0.83–1.75)
G3: 1.77 (1.24–2.52)
G5: 2.86 (2.02–4.02)
Maternal race, parity, pregravid BMI, height, pregravid weight, marital status, education, tobacco/alcohol/drug use, pregnancy-induced hypertension, gestational age, macrosomia, infant sex
Kiel et al., 20074

USA, birth certificate registry

120,251

Obese

Fair
Pregravid weight:
Medical records

Total weight gain:
Routine prenatal care or maternity records
G1: Odds of macrosomia for WG > 25 lbs
G2: OR of macrosomia for WG < 15 lbs
G3: Reference WG 15–25 lbs
G1: Odds of Macrosomia are higher for women in this group
G2: Odds of Macrosomia are lower for women in this group

Numerical value for ORs not reported in study
Maternal age, maternal race, maternal education, poverty, smoking, parity, chronic hypertension
Kirchengast and Hartmann, 200393

Austria, university hospital

8,011

All weights/BMI

Fair
Pregravid weight:
Estimated from measured weight at first prenatal visit

Total weight gain:
Routine prenatal care or maternity records
G1: OR and 95% CI, for MacrosomiaG1: 1.07 (1.05–1.10)Maternal age, pregravid weight, height, distantia cristarum
Takimoto et al., 2006111

Japan, obstetric units

112,257

All weights/BMI

Fair
Pregravid weight:
Medical records

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

G1: Total GWG < 25th percentile for GA
G2: Total GWG 25–49th percentile for GA
G3: Total GWG 50–74th percentile for GA (Reference)
G4: Total GWG 75–89th percentile for GA
G5: Total GWG ≥ 90th percentile for GA
G1: 0.31 (0.20–0.47)
G2: 0.49 (0.34–0.70)
G3: 1.0
G4: 1.62 (1.24–2.12)
G5: 2.41 (1.83–3.17)
Maternal age, parity, pregravid weight, gestational age, infant sex
Brennand et al., 200549

Canada, medical records

603

Normal/Over-weight/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: 47.0%
G2: 42.9%
G3: 54.4% (P = 0.234)
N/A
Jensen et al., 200559

Denmark, university hospitals

481

Obese

Poor
Pregravid weight
Self-report

Total weight gain:
Routine prenatal care or maternity records
ORs and 95% CIs for Macrosomia

G1: GWG < 5.0 kg (Reference)
G2: GWG 5.0–9.9 kg
G3: GWG 10.0–14.9 kg
G4: GWG ≥ 15.0 kg
G1: 1.0
G2: 1.8 (0.8–3.8)
G3: 2.2 (1.0–4.7)
G4: 4.0 (1.8–9.0)
Maternal age, pregravid BMI, gestational age, 2-hour OGTT, parity, smoking, ethnicity, clinical center

BMI, body mass index; CI, confidence interval; GA, gestational age; GWG, gestational weight gain; lbs, pounds; OGTT, oral glucose tolerance test; OR, odds ratio; WG, weight gain.

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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