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BMC Med. 2018 Nov 5;16(1):201. doi: 10.1186/s12916-018-1189-1.

Gestational weight gain charts for different body mass index groups for women in Europe, North America, and Oceania.

Author information

1
The Generation R Study Group, Erasmus MC, University Medical Center Rotterdam, PO Box 2040, 3000 CA, Rotterdam, the Netherlands.
2
Department of Pediatrics, Sophia Children's Hospital, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands.
3
TNO Child Health, Leiden, the Netherlands.
4
Department of Epidemiology and Biostatistics, VU University Medical Center, Amsterdam, the Netherlands.
5
EPIUnit-Instituto de Saúde Pública, Universidade do Porto, Rua das Taipas, n° 135, 4050-600, Porto, Portugal.
6
Department of Public Health and Forensic Sciences and Medical Education, Unit of Clinical Epidemiology, Predictive Medicine and Public Health, University of Porto Medical School, Porto, Portugal.
7
INSERM, UMR1153 Epidemiology and Biostatistics Sorbonne Paris Cité Center (CRESS), ORCHAD Team, Villejuif, France.
8
Paris Descartes University, Villejuif, France.
9
Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA.
10
Department of Social Medicine, Faculty of Medicine, University of Crete, Heraklion, Greece.
11
Department of Genetics and Cell Biology, Maastricht University, Maastricht, the Netherlands.
12
Inserm UMR 1085, Irset-Research Institute for Environmental and Occupational Health, F-35000, Rennes, France.
13
First Department of Pediatrics, Athens University Medical School, Aghia Sophia Children's Hospital, National and Kapodistrian University of Athens, Athens, Greece.
14
Department of Epidemiology, University Medical Center Groningen, University of Groningen, P.O. Box 30.001, 9700 RG, Groningen, the Netherlands.
15
MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK.
16
Centre de Recherche du Centre Hospitalier de l'Universite de Sherbrooke, Sherbrooke, QC, Canada.
17
Department of Exposure and Environmental Epidemiology, Norwegian Institute of Public Health, Oslo, Norway.
18
The Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy.
19
Department of Epidemiology, Lazio Regional Health Service, Rome, Italy.
20
Department of Woman and Child Health, Ospedale Versilia, Local Health Authority Toscana Nord Ovest, Viareggio, Italy.
21
NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK.
22
Division of Metabolic and Nutritional Medicine, Dr. von Hauner Children's Hospital, Ludwig-Maximilian-Universität Munich, 80337, Munich, Germany.
23
Department of Environmental Epidemiology, Nofer Institute of Occupational Medicine, Lodz, Poland.
24
Department of Public Health Sciences, School of Medicine, University of California Davis, Davis, CA, 95616, USA.
25
Department of Population Medicine, Harvard Medical School, Harvard Pilgrim Health Care Institute, Boston, MA, USA.
26
Diabetes Unit, Massachusetts General Hospital, Boston, MA, USA.
27
Center for Global Health, University of Illinois College of Medicine, Chicago, IL, USA.
28
Telethon Kids Institute, The University of Western Australia, Perth, WA, Australia.
29
Departments of Public Health Sciences and Environmental Medicine, University of Rochester School of Medicine and Dentistry, Rochester, NY, USA.
30
Department of Health Security, National Institute for Health and Welfare, Kuopio, Finland.
31
MRC Integrative Epidemiology Unit, University of Bristol, Oakfield House, Oakfield Grove, Bristol, BS8 2BN, UK.
32
Population Health Science, Bristol Medical School, University of Bristol, Bristol, BS8 2BN, UK.
33
Department of Public Health, University of Turku, Turku, Finland.
34
Department of Environmental Immunology/Core Facility Studies, Helmholtz Centre for Environmental Research-UFZ, Leipzig, Germany.
35
Epidemiology and Environmental Health Joint Research Unit, FISABIO-Universitat Jaume I-Universitat de València, Valencia, Spain.
36
CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain.
37
Division of Health Data and Digitalization, Norwegian Institute of Public Health, Oslo, Norway.
38
Department of Epidemiology, Chair of Epidemiology and Preventive Medicine, Jagiellonian University Medical College, Krakow, Poland.
39
Turku Centre for Biotechnology, University of Turku and Abo Akademi University, Turku, Finland.
40
Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, Athens, Greece.
41
Department of Pediatrics, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.
42
Department of Epidemiology, Care and Public Health Research Institute, Maastricht University, Maastricht, the Netherlands.
43
National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark.
44
Department of Public Health, Section of Epidemiology, University of Copenhagen, Øster Farimagsgade 5, 1014, Copenhagen, Denmark.
45
Department of Rehabilitation, Nutrition and Sport, La Trobe University, Melbourne, Australia.
46
Department of Environmental Medicine, Faculty of Public Health, Slovak Medical University, Bratislava, Slovak Republic.
47
School of Women's and Infants' Health, University of Western Australia, Crawley, Western Australia, Australia.
48
Research Unit for Gynaecology and Obstetrics, Institute for Clinical Research, University of Southern Denmark, Odense, Denmark.
49
Department of Public Health, Amsterdam Public Health Research Institute, Academic Medical Center, Amsterdam, the Netherlands.
50
Department of Environmental Exposures and Epidemiology, Domain of Infection Control and Environmental Health, Norwegian Institute of Public Health, Lovisenberggata 8, 0477, Oslo, Norway.
51
Department of Public Health, University of Helsinki, Helsinki, Finland.
52
Department of Medical Sciences, University of Turin, Turin, Italy.
53
Department for Health Evidence, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, the Netherlands.
54
Subdirección de Salud Pública Gipuzkoa, San Sebastián, Spain.
55
Instituto de Investigación Sanitaria BIODONOSTIA, San Sebastián, Spain.
56
Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands.
57
The Novo Nordisk Foundation Center for Basic Metabolic Research, Section of Metabolic Genetics, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.
58
Institute of Epidemiology, Helmholtz Zentrum München-German Research Center for Environmental Health, Neuherberg, Germany.
59
School of Public Health, University of Colorado, Aurora, Colorado, USA.
60
Norwegian Institute of Public Health, Oslo, Norway.
61
Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway.
62
Dr. von Hauner Children's Hospital, Ludwig-Maximilians-University Munich, Munich, Germany.
63
Ib-salut, Area de Salut de Menorca, Menorca, Spain.
64
Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.
65
Department of Environmental Medicine, Slovak Medical University, Bratislava, 833 03, Slovak Republic.
66
Radboud REshape Innovation Center, Radboud University Medical Center, Nijmegen, the Netherlands.
67
Department of Pediatrics, Marien-Hospital Wesel, Research Institute, Wesel, Germany.
68
ISGlobal, Institute for Global Health, Barcelona, Spain.
69
Universitat Pompeu Fabra (UPF), Barcelona, Spain.
70
Department of Medical and Social Problems of Family Health, Institute of Pediatrics, Obstetrics and Gynecology, Kyiv, Ukraine.
71
Department of Methodology and Statistics, University of Utrecht, Utrecht, the Netherlands.
72
The Generation R Study Group, Erasmus MC, University Medical Center Rotterdam, PO Box 2040, 3000 CA, Rotterdam, the Netherlands. v.jaddoe@erasmusmc.nl.
73
Department of Pediatrics, Sophia Children's Hospital, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands. v.jaddoe@erasmusmc.nl.
74
Department of Epidemiology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands. v.jaddoe@erasmusmc.nl.

Abstract

BACKGROUND:

Gestational weight gain differs according to pre-pregnancy body mass index and is related to the risks of adverse maternal and child health outcomes. Gestational weight gain charts for women in different pre-pregnancy body mass index groups enable identification of women and offspring at risk for adverse health outcomes. We aimed to construct gestational weight gain reference charts for underweight, normal weight, overweight, and grades 1, 2 and 3 obese women and to compare these charts with those obtained in women with uncomplicated term pregnancies.

METHODS:

We used individual participant data from 218,216 pregnant women participating in 33 cohorts from Europe, North America, and Oceania. Of these women, 9065 (4.2%), 148,697 (68.1%), 42,678 (19.6%), 13,084 (6.0%), 3597 (1.6%), and 1095 (0.5%) were underweight, normal weight, overweight, and grades 1, 2, and 3 obese women, respectively. A total of 138, 517 women from 26 cohorts had pregnancies with no hypertensive or diabetic disorders and with term deliveries of appropriate for gestational age at birth infants. Gestational weight gain charts for underweight, normal weight, overweight, and grade 1, 2, and 3 obese women were derived by the Box-Cox t method using the generalized additive model for location, scale, and shape.

RESULTS:

We observed that gestational weight gain strongly differed per maternal pre-pregnancy body mass index group. The median (interquartile range) gestational weight gain at 40 weeks was 14.2 kg (11.4-17.4) for underweight women, 14.5 kg (11.5-17.7) for normal weight women, 13.9 kg (10.1-17.9) for overweight women, and 11.2 kg (7.0-15.7), 8.7 kg (4.3-13.4) and 6.3 kg (1.9-11.1) for grades 1, 2, and 3 obese women, respectively. The rate of weight gain was lower in the first half than in the second half of pregnancy. No differences in the patterns of weight gain were observed between cohorts or countries. Similar weight gain patterns were observed in mothers without pregnancy complications.

CONCLUSIONS:

Gestational weight gain patterns are strongly related to pre-pregnancy body mass index. The derived charts can be used to assess gestational weight gain in etiological research and as a monitoring tool for weight gain during pregnancy in clinical practice.

KEYWORDS:

Charts; Pregnancy; References; Weight gain

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