title: Inadequate weight gain in overweight and obese pregnant women: what is the effect on fetal growth?
abstract: OBJECTIVE
  We sought to evaluate inadequate gestational weight gain and fetal growth among overweight and obese women.
  
  
  METHODS
  We conducted an analysis of prospective singleton term pregnancies in which 1053 overweight and obese women gained >5 kg (14.4 ± 6.2 kg) or 188 who either lost or gained ≤5 kg (1.1 ± 4.4 kg). Birthweight, fat mass, and lean mass were assessed using anthropometry. Small for gestational age (SGA) was defined as ≤10th percentile of a standard US population. Univariable and multivariable analysis evaluated the association between weight change and neonatal morphometry.
  
  
  RESULTS
  There was no significant difference in age, race, smoking, parity, or gestational age between groups. Weight loss or gain ≤5 kg was associated with SGA, 18/188 (9.6%) vs 51/1053 (4.9%); (adjusted odds ratio, 2.6; 95% confidence interval, 1.4-4.7; P = .003). Neonates of women who lost or gained ≤5 kg had lower birthweight (3258 ± 443 vs 3467 ± 492 g, P < .0001), fat mass (403 ± 175 vs 471 ± 193 g, P < .0001), and lean mass (2855 ± 321 vs 2995 ± 347 g, P < .0001), and smaller length, percent fat mass, and head circumference. Adjusting for diabetic status, prepregnancy body mass index, smoking, parity, study site, gestational age, and sex, neonates of women who gained ≤5 kg had significantly lower birthweight, lean body mass, fat mass, percent fat mass, head circumference, and length. There were no significant differences in neonatal outcomes between those who lost weight and those who gained ≤5 kg.
  
  
  CONCLUSIONS
  In overweight and obese women weight loss or gain ≤5 kg is associated with increased risk of SGA and decreased neonatal fat mass, lean mass, and head circumference.
authors: Center for Reproductive Health, Department of Reproductive Biology, Case Western Reserve University, MetroHealth Medical Center, Cleveland, OH.
authors: Patrick M
authors: PM
authors: Catalano
authors: George Washington University Biostatistics Center, Washington, DC.
authors: Lisa
authors: L
authors: Mele
authors: Departments of Obstetrics and Gynecology, the Ohio State University, Columbus, OH.
authors: Mark B
authors: MB
authors: Landon
authors: University of Texas Health Science Center at Houston-Children's Memorial Hermann Hospital, Houston, TX.
authors: Susan M
authors: SM
authors: Ramin
authors: Eunice Kennedy Shriver National Institute of Child Health and Human Development.
authors: Uma M
authors: UM
authors: Reddy
authors: University of Texas Southwestern Medical Center, Dallas, TX.
authors: Brian
authors: B
authors: Casey
authors: College of Physicians and Surgeons, Columbia University, New York, NY.
authors: Ronald J
authors: RJ
authors: Wapner
authors: University of Utah School of Medicine, Salt Lake City, UT.
authors: Michael W
authors: MW
authors: Varner
authors: University of Alabama at Birmingham School of Medicine, Birmingham, AL.
authors: Dwight J
authors: DJ
authors: Rouse
authors: University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, NC.
authors: John M
authors: JM
authors: Thorp
authors: University of Texas Medical Branch, Galveston, TX.
authors: George
authors: G
authors: Saade
authors: Wayne State University School of Medicine, Detroit, MI.
authors: Yoram
authors: Y
authors: Sorokin
authors: Northwestern University School of Medicine, Chicago, IL.
authors: Alan M
authors: AM
authors: Peaceman
authors: Oregon Health and Science University, Portland, OR.
authors: Jorge E
authors: JE
authors: Tolosa
mesh_terms: D000328:Adult; D001724:Birth Weight / Q000502:physiology; D050218:Body Fat Distribution; D001827:Body Height / Q000502:physiology; D015992:Body Mass Index; D002508:Cephalometry; D005260:Female; D047109:Fetal Development / Q000502:physiology*; D005951:Glucose Tolerance Test; D006801:Humans; D007231:Infant, Newborn; D007236:Infant, Small for Gestational Age / Q000502:physiology; D008297:Male; D009765:Obesity / Q000503:physiopathology*; D050177:Overweight / Q000503:physiopathology*; D011247:Pregnancy; D012189:Retrospective Studies; D015430:Weight Gain / Q000502:physiology*
keywords: fetal anthropometry; gestational diabetes; gestational weight loss