title: Prediction of excessive gestational weight gain from week-specific cutoff values: a cohort study.
abstract: OBJECTIVE
  To assess the prognostic validity of the Institute of Medicine/National Research Council (IOM/NRC) week-specific cutoff values for inadequate or excessive total gestational weight gain (GWG) by 4-week intervals.
  
  
  METHODS
  We merged data from two German cohorts (LMU cohort (all maternal-weight categories) and PEACHES cohort (obese women)) to provide information on GWG for 749 women (365 normal weight, 199 overweight and 185 obese). We calculated the prognostic values for suboptimal and excessive GWG according to the IOM/NRC cutoff values.
  
  
  RESULTS
  The positive predictive values for excessive total GWG for those who experienced excessive GWG early in pregnancy was 70.1% (95% confidence interval (CI) 60.5; 78.6) as of week 12/1 to 16/0 in normal-weight women, 89.5% (95% CI 75.2; 97.1) and 95.2 (76.2; 99.9) 95.2% (95% CI 76.2; 99.9) as of week 8/1 to 12/0 for overweight and obese women, respectively. In absence of excessive GWG as of week 12/1 to 16/0, normal-weight women had 77.5% (95% CI 77.1; 83.1) probability of not experiencing excessive total GWG (negative predictive value). In overweight and obese women, the negative predictive value was considerably lower up to week 24/1 to 28/0 (60.0% (95% CI 48.8; 70.5) in week 20/1 to 24/0 and 50.6% (95% CI 39.3; 61.9) in week 24/1 to 28/0). Most women with inadequate GWG in the first and second trimester had adequate total final GWG (positive predictive value for total inadequate GWG <50% up to week 16/1 to 20/0 in all groups).
  
  
  CONCLUSIONS
  As women with excessive weight gain can be identified with high confidence if the GWG exceeds the IOM/NRC week-specific cutoff values, interventions may be initiated early in pregnancy.
authors.affiliation: Department of Obstetrics and Gynecology, Ludwig-Maximilians-Universität München, Munich, Germany.
authors.forename: J
authors.initials: J
authors.lastname: Knabl
authors.affiliation: Division of Epidemiology, Institute of Social Paediatrics and Adolescent Medicine, Ludwig-Maximilians-Universität München, Munich, Germany.
authors.forename: C
authors.initials: C
authors.lastname: Riedel
authors.affiliation: 1] Department of Obstetrics and Gynecology, Ludwig-Maximilians-Universität München, Munich, Germany [2] Division of Epidemiology, Institute of Social Paediatrics and Adolescent Medicine, Ludwig-Maximilians-Universität München, Munich, Germany [3] Research Center, Dr von Hauner Children's Hospital, Ludwig-Maximilians-Universität München, Munich, Germany [4] Division of Nutritional Sciences, Cornell University, Ithaca, NY, USA.
authors.forename: J
authors.initials: J
authors.lastname: Gmach
authors.affiliation: Research Center, Dr von Hauner Children's Hospital, Ludwig-Maximilians-Universität München, Munich, Germany.
authors.forename: R
authors.initials: R
authors.lastname: Ensenauer
authors.affiliation: Research Center, Dr von Hauner Children's Hospital, Ludwig-Maximilians-Universität München, Munich, Germany.
authors.forename: L
authors.initials: L
authors.lastname: Brandlhuber
authors.affiliation: Division of Nutritional Sciences, Cornell University, Ithaca, NY, USA.
authors.forename: K M
authors.initials: KM
authors.lastname: Rasmussen
authors.affiliation: Department of Obstetrics and Gynecology, Ludwig-Maximilians-Universität München, Munich, Germany.
authors.forename: B
authors.initials: B
authors.lastname: Schiessl
authors.affiliation: 1] Department of Obstetrics and Gynecology, Ludwig-Maximilians-Universität München, Munich, Germany [2] Division of Epidemiology, Institute of Social Paediatrics and Adolescent Medicine, Ludwig-Maximilians-Universität München, Munich, Germany.
authors.forename: R
authors.initials: R
authors.lastname: von Kries
mesh_terms: D000328:Adult; D001724:Birth Weight; D005260:Female; D006801:Humans; D009765:Obesity / Q000175:diagnosis*; D011237:Predictive Value of Tests; D011247:Pregnancy; D011248:Pregnancy Complications / Q000175:diagnosis*; D011379:Prognosis; D015430:Weight Gain / Q000502:physiology*