Poor fetal growth in overweight & obese with insufficient weight gain
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1. Overweight and obese women who lost weight or gained ≤5 kg were more likely to have an infant who was small for gestational age (SGA).
2. Overweight and obese women who lost weight or gained ≤5 kg were more likely to have infants with lower birth weight, length, head circumference, fat mass, lean mass, and percent body fat.
Evidence Rating Level: 2 (Good)
Study Rundown: This study found that overweight and obese women who lost weight or gained ≤5 kg during pregnancy were more likely to give birth to an infant who was SGA and had lower fat and lean mass. Prior work has yielded mixed results regarding this relationship. While the Institute of Medicine recommends a weight gain of 5 and 9 kg during pregnancy for overweight and obese women, others recommend less weight gain or even weight maintenance to improve pregnancy outcomes. The results of this study suggest that insufficient weight gain may have a negative impact on fetal growth.
Limitations include retrospective design and failure to evaluate potential confounders of this relationship such as drug use, which might affect both weight gain and fetal growth. Reproducibility of findings in prospective studies would solidify results presented here.
Click to read the study in AJOG
Relevant Reading: Associations of gestational weight loss with birth-related outcome: a retrospective cohort study
In-Depth [retrospective cohort study]: This retrospective cohort study compared fetal growth among overweight and obese women who lost weight or gained ≤5 kg (n=188) and those who gained >5 kg (n=1053). Outcomes evaluated were SGA, birth weight, head circumference, length and calculated fat mass, lean mass and % body fat.
Overweight and obese women who lost weight or gained ≤5 kg were more likely to have an SGA infant (p=0.009) and less likely to have a LGA child (p=0.03) than their peers who gained >5 kg. This group of women was also more likely to have an infant with lower birth weight, length, head circumference, lean mass, fat mass and % body fat (p<0.02 for all).
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