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Abstract
Gestational age and infant birth weight are influenced by gestational weight gain. This study was aimed to examine the effects of gestational weight gain on pregnancy outcomes. Pregnant women were recruited at two hospitals in Seoul area. Characteristics and dietary intakes of pregnant women were obtained using 24-hour recall questionnaires. Gestational weight gain was categorized as less (Under-gain) than, within (Recommended gain), or greater (Over-gain) than the Institute of Medicine guidelines. Maternal height and pre-pregnancy weight in the over-gain group significantly higher than under-gain and recommended gain group. Mini dietary assessment score of eating bean has significantly higher in under-gain group than recommended gain group and eating kimchi has significantly higher in under-gain group than over-gain group. Score of eating fruit was significantly higher in over-gain group than other groups. The mean intake of carbohydrate in the recommended gain group were significantly higher than under-gain group, and mean intake of potassium in the over-gain group were significantly higher than under-gain group. Under-gain group showed the high rate of the preterm delivery and low birth weight infant delivery. However recommended gain group showed 46% reduced risk of preterm delivery (OR = 0.54 CI = 0.30-0.98). Risk of macrosomia increased with increasing gestational weight gain (p for trend < 0.05). In conclusion, pregnancy outcomes were influenced by gestational weight gain. Therefore, these finding suggested adequate gestational weight gain according to BMI for reducing the risk of preterm delivery, low birth weight and macrosomia.
Figures and Tables
Table 1
Gestational weight gain guidelines by Institute of medicine
Gestational weight gain was categorized as less (Under-gain) than, within (Recommended gain), or greater (Over-gain) than the Institute of Medicine guidelines according to pre-pregnancy BMI (IOM, 2009)14
Table 2
General and obstetrical characteristics of maternals by gestational weight gain category N (%)
Gestational weight gain categories according to the IOM guidelines: see table 1
1) Mean ± SD, 2) p-value by ANOVA, 3) p-value by chi-square test
Table 3
Anthropometric characteristics of the maternals by gestational weight gain category
Gestational weight gain categories according to the IOM guidelines: see table 1
1) Mean ± SD
2) Values with different superscripts within the same row are significantly different at p < 0.05 by Tukey test
3) p-value by ANOVA
Table 4
Smoking status, alcohol and coffee drinking, stress status of the maternals by gestational weight gain category N (%)
Gestational weight gain categories according to the IOM guidelines: see table 1
1) p-value by chi-square test, 2) low < 12, high ≥ 12
Table 5
Weight reduction attempt, physical activity and exercise status of the maternals by gestational weight gain category N (%)
Gestational weight gain categories according to the IOM guidelines: see table 1
1) p-value by chi-square test
Table 6
Mini dietary assessment scores of the maternals by gestational weight gain category
Gestational weight gain categories according to the IOM guidelines: see table 1
1) Mean ± SD, 2) p-value by ANOVA
3) Values with different superscripts within the same row are significantly different at p < 0.05 by Tukey test
Table 7
Nutrient intake of the maternals by gestational weight gain category
Gestational weight gain categories according to the IOM guidelines: see table 1
1) Mean ± SD, 2) p-value by ANOVA
3) Values with different superscripts within the same row are significantly different at p < 0.05 by Tukey test
Table 8
Assessment of nutrient intake of the maternals by pre-pregnancy BMI category using dietary reference intakes for Koreans (KDRIs)
Gestational weight gain categories according to the IOM guidelines: see table 1
1) EER: Estimated Energy Requirements, 2) AMDR: Acceptable Macronutrient Distribution Ranges
3) EAR: Estimated Average Requirement, 4) UL: Upper Intake Level, 5) AI: Adequate Intake
Table 9
Pregnancy outcomes of the maternals and neonates by gestational weight gain category N (%)
Gestational weight gain categories according to the IOM guidelines: see table 1
1) Mean ± SD, 2) Values with different superscripts within the same row are significantly different at p < 0.05 by Tukey test
3) p-value by ANOVA, 4) p-value by chi-square test
Table 10
Odds ratio (OR) and 95% confidence interval (CI) of preterm delivery, low birth weight (LBW) and macrosomia according to gestational weight gain category
Gestational weight gain cutoff was categorized as less (Under-gain) than, within (Recommended gain), or greater (Over-gain) than the Institute of Medicine guidelines according to pre-pregnancy BMI (Table 1)
1) p-value test for trend
2) Odds ratio and 95% confidence intervals were analyzed by logistic regression. Odds ratio (OR) was adjusted for maternal height, income
3) Models adjusted for maternal height, income, education
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