title: Risk factors for excessive gestational weight gain in a healthy, nulliparous cohort.
abstract: OBJECTIVE
  Excessive gestational weight gain (GWG) is associated with adverse maternal and child outcomes and contributes to obesity in women. Our aim was to identify early pregnancy factors associated with excessive GWG, in a contemporary nulliparous cohort.
  
  
  METHODS
  Participants in the SCOPE study were classified into GWG categories ("not excessive" versus "excessive") based on pregravid body mass index (BMI) using 2009 Institute of Medicine (IOM) guidelines. Maternal characteristics and pregnancy risk factors at 14-16 weeks were compared between categories and multivariable analysis controlled for confounding factors.
  
  
  RESULTS
  Of 1950 women, 17% gained weight within the recommended range, 74% had excessive and 9% inadequate GWG. Women with excessive GWG were more likely to be overweight (adjOR 2.9 (95% CI 2.2-3.8)) or obese (adjOR 2.5 (95% CI 1.8-3.5)) before pregnancy compared to women with a normal BMI. Other factors independently associated with excessive GWG included recruitment in Ireland, younger maternal age, increasing maternal birthweight, cessation of smoking by 14-16 weeks, increased nightly sleep duration, high seafood diet, recent immigrant, limiting behaviour, and decreasing exercise by 14-16 weeks. Fertility treatment was protective.
  
  
  CONCLUSIONS
  Identification of potentially modifiable risk factors for excessive GWG provides opportunities for intervention studies to improve pregnancy outcome and prevent maternal obesity.
authors.affiliation: Department of Obstetrics and Gynaecology, Faculty of Medical and Health Sciences, University of Auckland, Private Bag 92019, Auckland 1142, New Zealand.
authors.forename: Antonia
authors.identifier: 0000-0003-4271-4784
authors.initials: A
authors.lastname: Restall
authors.affiliation: Department of Obstetrics and Gynaecology, Faculty of Medical and Health Sciences, University of Auckland, Private Bag 92019, Auckland 1142, New Zealand.
authors.forename: Rennae S
authors.initials: RS
authors.lastname: Taylor
authors.affiliation: Department of Paediatrics, Faculty of Medical and Health Sciences, University of Auckland, Private Bag 92019, Auckland 1142, New Zealand.
authors.forename: John M D
authors.initials: JM
authors.lastname: Thompson
authors.affiliation: Department of Obstetrics and Gynaecology, Faculty of Medical and Health Sciences, University of Auckland, Private Bag 92019, Auckland 1142, New Zealand.
authors.forename: Deralie
authors.initials: D
authors.lastname: Flower
authors.affiliation: Women and Children's Division, Lyell McEwin Hospital, University of Adelaide, Adelaide, SA 5112, Australia.
authors.forename: Gustaaf A
authors.initials: GA
authors.lastname: Dekker
authors.affiliation: The Irish Centre for Fetal and Neonatal Translational Research (INFANT), Department of Obstetrics and Gynaecology, University College Cork, Ireland.
authors.forename: Louise C
authors.initials: LC
authors.lastname: Kenny
authors.affiliation: Department of Maternal and Fetal Medicine and the Division of Women's Health, Women's Health Academic Centre, King's College London and King's Health Partners, London SE1 7EH, UK.
authors.forename: Lucilla
authors.initials: L
authors.lastname: Poston
authors.affiliation: Department of Obstetrics and Gynaecology, Faculty of Medical and Health Sciences, University of Auckland, Private Bag 92019, Auckland 1142, New Zealand ; South Auckland Clinical School and Auckland City Hospital, Auckland 1142, New Zealand.
authors.forename: Lesley M E
authors.initials: LM
authors.lastname: McCowan
mesh_terms: D000328:Adult; D000367:Age Factors; D001724:Birth Weight; D015992:Body Mass Index; D015331:Cohort Studies; D004032:Diet; D004641:Emigration and Immigration; D015444:Exercise; D005260:Female; D006801:Humans; D007494:Ireland; D009765:Obesity / Q000150:complications*; D050177:Overweight / Q000150:complications; D010298:Parity; D011247:Pregnancy; D011248:Pregnancy Complications; D012016:Reference Values; D012307:Risk Factors; D012890:Sleep; D012907:Smoking; D015430:Weight Gain; D055815:Young Adult