Advertisement

Patterns of Gestational Weight Gain and Infants Born Large-for-Gestational Age Across Consecutive Pregnancies

Published:December 07, 2018DOI:https://doi.org/10.1016/j.whi.2018.10.008

      Abstract

      Introduction

      Factors that occur between consecutive pregnancies may influence repeated excessive gestational weight gain (GWG) and infants born large-for-gestational age (LGA). We examined interpregnancy interval, weight retention, and GWG in women's first pregnancy as predictors of excessive GWG and LGA in women's second pregnancy.

      Methods

      We used data from women's first two live births during the First Baby Study, a 3-year prospective observational cohort of first-time mothers (N = 549). GWG was calculated as weight at delivery minus prepregnancy weight for first and second pregnancies and categorized using the Institute of Medicine guidelines. Weight retention at 6 and 12 months and interpregnancy interval (time from first live birth to conception of second infant) were quantified. Infants were considered LGA if birthweight was in the 90th percentile or greater for gestational age.

      Results

      Many women (51.7%) exceeded GWG recommendations in both pregnancies. Women who exceeded guidelines in their first pregnancy had a 5.08 greater odds (p < .01) for exceeding guidelines in their second pregnancy, compared with women who did not exceed guidelines in their first pregnancy. Interpregnancy interval and weight retention had no association with exceeding guidelines in women's second pregnancy. Exceeding guidelines in women's first pregnancy resulted in a 4.48 greater odds (p < .01) of first-born infants being LGA, and exceeding guidelines in women's second pregnancy resulted in a 1.82 greater odds of second-born infants being large-for-gestational age (p = .02), compared with women who met guidelines in their first or second pregnancy, respectively.

      Conclusions

      Exceeding GWG guidelines in women's first pregnancy predicted exceeding guidelines in their second pregnancy, independent of interpregnancy interval and weight retention.
      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribe:

      Subscribe to Women's Health Issues
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      References

        • Austin P.C.
        An introduction to propensity score methods for reducing the effects of confounding in observational studies.
        Multivariate Behavioral Research. 2011; 46: 399-424
        • Boney C.M.
        • Verma A.
        • Tucker R.
        • Vohr B.R.
        Metabolic syndrome in childhood: Associations with birth weight, maternal obesity, and gestational diabetes mellitus.
        Pediatrics. 2005; 115: e290-e296
        • Brown W.J.
        • Heesch K.C.
        • Miller Y.D.
        Life events and changing physical activity patterns in women at different life stages.
        Annals of Behavioral Medicine. 2009; 37: 294-305
        • Carter-Edwards L.
        • Østbye T.
        • Bastian L.A.
        • Yarnall K.S.H.
        • Krause K.M.
        • Simmons T.J.
        Barriers to adopting a healthy lifestyle: Insight from postpartum women.
        BMC Research Notes. 2009; 2: 161
        • Chin J.R.
        • Krause K.M.
        • Ostbye T.
        • Chowdury N.
        • Lovelady C.A.
        • Swamy G.K.
        Gestational weight gain in consecutive pregnancies.
        American Journal of Obstetrics & Gynecology. 2010; 203: 279.e1-279.e6
        • Dalenius K.
        • Brindley P.
        • Smith B.
        • Reinold C.
        • Grummer-Strawn L.
        Pregnancy nutrition surveillance 2010 report.
        U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, Atlanta, GA2012
        • Davis E.M.
        • Babineau D.C.
        • Wang X.
        • Zyzanski S.
        • Abrams B.
        • Bodnar L.
        • Horwitz R.
        Short inter-pregnancy intervals, parity, excessive pregnancy weight gain and risk of maternal obesity.
        Maternal and Child Health. 2014; 18: 554-562
        • Dong Y.
        • Rivera D.E.
        • Thomas D.M.
        • Navarro-Barrientos J.E.
        • Downs D.S.
        • Savage J.S.
        • Collins L.M.
        A dynamical systems model for improving gestational weight gain behavioral interventions.
        Proceedings of the American Control Conference. 2012; : 4059-4064
        • Endres L.K.
        • Straub H.
        • McKinney C.
        • Plunkett B.
        • Minkovitz C.S.
        • Schetter C.D.
        • Shalowitz M.U.
        Postpartum weight retention risk factors and relationship to obesity at one year.
        Obstetrics & Gynecology. 2015; 125: 144-152
        • Goldstein R.F.
        • Abell S.K.
        • Ranasinha S.
        • Misso M.
        • Boyle J.A.
        • Black J.A.
        • Teede H.J.
        Association of gestational weight gain with maternal and infant outcomes: A systematic review and meta-analysis.
        JAMA. 2017; 17: 2207-2225
        • Gorber S.C.
        • Tremblay M.
        • Moher D.
        • Gorber B.
        A comparison of direct vs. self-report measures for assessing height, weight and body mass index: A systematic review.
        Obesity Reviews. 2007; 8: 307-326
        • Hall E.S.
        • Venkatesh M.
        • Greenberg J.M.
        A population study of first and subsequent pregnancy smoking behaviors in Ohio.
        Journal of Perinatology. 2016; 36: 948-953
        • Hill B.
        • McPhie S.
        • Skouteris H.
        The role of parity in gestational weight gain and postpartum weight retention.
        Women’s Health Issues. 2016; 26: 123-129
        • Hill B.
        • Bergmeier H.
        • McPhie S.
        • Fuller-Tyszkiewicz M.
        • Teede H.
        • Forster D.
        • Skouteris H.
        Is parity a risk factor for excessive weight gain during pregnancy and postpartum weight retention? A systematic review and meta-analysis.
        Obesity Reviews. 2017; 18: 755-764
        • Kjerulff K.H.
        • Velott D.L.
        • Zhu J.
        • Chuang C.H.
        • Hillemeier M.M.
        • Paul I.M.
        • Repke J.T.
        Mode of first delivery and women’s intentions for subsequent childbearing: Findings from the First Baby Study.
        Paediatric and Perinatal Epidemiology. 2013; 27: 62-71
        • Linne Y.
        • Dye L.
        • Barkeling B.
        • Rössner S.
        Weight development over time in parous women: The SPAWN study—15 years follow-up.
        International Journal of Obesity and Related Metabolic Disorders. 2003; 27: 1516-1522
        • Oken E.
        • Kleinman K.P.
        • Rich-Edwards J.
        • Gillman M.W.
        A nearly continuous measure of birth weight for gestational age using a United States national reference.
        BMC Pediatrics. 2003; 3: 6
        • Patti M.E.
        Intergenerational programming of metabolic disease: Evidence from human populations and experimental animal models.
        Cellular and Molecular Life Sciences. 2013; 70: 1597-1608
        • Rasmussen K.M.
        • Yaktine A.L.
        Committee to Reexamine IOM Pregnancy Weight Guidelines; Institute of Medicine; National Research Council. Weight gain during pregnancy: Reexamining the guidelines.
        National Academies Press, Washington, DC2009
        • Ronnberg A.
        • Hanson U.
        • Ostlund I.
        • Nilsson K.
        Effects on postpartum weight retention after antenatal lifestyle intervention—A secondary analysis of a randomized controlled trial.
        Acta Obstetricia et Gynecologica Scandinavica. 2016; 95: 999-1007
        • Rooney B.L.
        • Schauberger C.W.
        • Mathiason M.A.
        Impact of perinatal weight change on long-term obesity and obesity-related illnesses.
        Obstetrics & Gynecology. 2005; 106: 1349-1356
        • Salahuddin M.
        • Pérez A.
        • Ranjit N.
        • Hoelscher D.M.
        • Kelder S.H.
        The association of large-for-gestational-age and infant feeding practices with children’s body mass index z-score trajectories: The Early Childhood Longitudinal Study, Birth Cohort.
        Clinical Obesity. 2017; 7: 307-315
        • Savage J.S.
        • Downs D.S.
        • Dong Y.
        • Rivera D.E.
        Control systems engineering for optimizing a prenatal weight gain intervention to regulate infant birth weight.
        American Journal of Public Health. 2014; 104: 1247-1254
        • Shin D.
        • Chung H.
        • Weatherspoon L.
        • Song W.O.
        Validity of Prepregnancy weight status estimated from self-reported height and weight.
        Maternal and Child Health Journal. 2014; 18: 1667-1674
        • Siega-Riz A.M.
        • Viswanathan M.
        • Moos M.K.
        • Deierlein A.
        • Mumford S.
        • Knaack J.
        • Lohr K.N.
        A systematic review of outcomes of maternal weight gain according to the Institute of Medicine recommendations: Birthweight, fetal growth, and postpartum weight retention.
        American Journal of Obstetrics and Gynecology. 2009; 201: e1-e14
        • Viswanathan M.
        • Siega-Riz A.M.
        • Moos M.K.
        • Deierlein A.
        • Mumford S.
        • Knaack J.
        • Lohr K.N.
        Outcomes of maternal weigh gain.
        Evidence Report/Technology Assessment (Full Report). 2008; 168: 1-223
        • Waring M.E.
        • Moore Simas T.A.
        • Liao X.
        Gestational weight gain within recommended ranges in consecutive pregnancies: A retrospective cohort study.
        Midwifery. 2013; 29: 550-556
        • Whitaker K.
        • Young-Hyman D.
        • Vernon M.
        • Wilcox S.
        Maternal stress predicts postpartum weight retention.
        Maternal and Child Health Journal. 2015; 18: 2209-2217
        • Zhao R.
        • Xu L.
        • Wu M.L.
        • Huang S.H.
        • Cao X.J.
        Maternal pre-pregnancy body mass index, gestational weight gain influence birth weight.
        Women and Birth. 2017; 31: e20-e25

      Biography

      Elizabeth L. Adams, MS, is a doctoral student in the Department of Nutrition and the Center for Childhood Obesity Research at Penn State. She studies the development of multidisciplinary, family-based obesity prevention interventions designed to promote healthy behaviors and growth across early childhood.

      Biography

      Michele E. Marini, MS, is a data analyst and statistician for the Center of Childhood Obesity Research at Penn State. Her expertise includes research design, data management, and data analysis.

      Biography

      Krista S. Leonard, MS, is a doctoral student in the Department of Kinesiology at Penn State. She studies behavioral strategies that include physical activity, healthy eating, and psychological components to help manage weight gain among pregnant women with overweight/obesity.

      Biography

      Danielle Symons Downs, PhD, is a Professor of Kinesiology and Obstetrics/Gynecology and Director of the Exercise Psychology Laboratory at Penn State. She is an expert in women's health, motivation, and designing effective health-behavior change interventions (exercise, weight) in women before/during/after pregnancy.

      Biography

      Ian M. Paul, MD, MSc, is Chief of the Division of Academic General Pediatrics and Vice Chair of Faculty Affairs at Penn State College of Medicine in Hershey, Pennsylvania. He is a clinical researcher in preventative interventions, with obesity prevention as the primary interest.

      Biography

      Jennifer L. Kraschnewski, MD, MPH, is Associate Professor of Medicine, Pediatrics, and Public Health Science at the Penn State College of Medicine. She is a community-engaged clinician-investigator with a research focus on behavioral interventions to support healthier lifestyles.

      Biography

      Kristen H. Kjerulff, MA, PhD, is Professor, Departments of Public Health Sciences and Obstetrics and Gynecology, Penn State University, College of Medicine. She studies maternity/reproductive health care and common treatments and procedures. She was Principal Investigator of the First Baby Study.

      Biography

      Jennifer S. Savage, PhD, is the Director of the Center for Childhood Obesity Research at Penn State University. Her research focuses on individual factors affecting the development of behavioral controls and food intake.