title: Gestational weight gain is an important risk factor for excessive fetal growth.
abstract: OBJECTIVE
  To estimate the odds ratio of prepregnant body mass index (BMI), gestational weight gain (GWG), and gestational diabetes mellitus (GDM) for excessive fetal growth, which we define as large for gestational age (LGA).
  
  
  METHODS
  We included 16,297 women who delivered a live-born singleton baby at term. We fit logistic regressions to estimate the odds ratios of variables, including maternal age, parity, prepregnant BMI ≥23, GWG ≥15 kg, and GDM, for LGA. We classified GWG into four categories (<10, 10-14.9, 15-19.9, and ≥20 kg) and BMI into four categories (underweight, normal, overweight, and obese). After adjusting for age and parity, we analyzed the odds ratios of prepregnant BMI according to GWG between non-GDM and GDM women for LGA.
  
  
  RESULTS
  The odds ratios of GWG ≥15 kg and prepregnancy BMI ≥23 for LGA were 2.40 (95% confidence interval [CI], 2.16-2.67) and 2.24 (95% CI, 1.99-2.51), respectively. The odd ratio of GDM was 1.37 (95% CI, 1.09-1.71). The risk of GDM women with normal/-overweight BMI and GWG <15 kg for LGA was not significantly greater than those of the reference group. The odd ratios of GDM women with overweight/obese BMI and GWG 15 to 19.9 kg were 3.95 (95% CI, 1.26-12.38) and 9.70 (95% CI, 3.79-24.87), respectively.
  
  
  CONCLUSIONS
  GWG ≥15 kg might be a more important risk factor for LGA than either prepregnancy BMI ≥23 or GDM. Risk for LGA was highest in obese GDM women with GWG ≥15 kg.
authors.affiliation: Department of Obstetrics and Gynecology, Cheil General Hospital and Women's Healthcare Center, Catholic Kwandong University College of Medicine, Seoul, Korea.
authors.forename: Joung Min
authors.initials: JM
authors.lastname: Lee
authors.affiliation: Department of Obstetrics and Gynecology, Cheil General Hospital and Women's Healthcare Center, Catholic Kwandong University College of Medicine, Seoul, Korea.
authors.forename: Min Jung
authors.initials: MJ
authors.lastname: Kim
authors.affiliation: Department of Obstetrics and Gynecology, Cheil General Hospital and Women's Healthcare Center, Catholic Kwandong University College of Medicine, Seoul, Korea.
authors.forename: Moon Young
authors.initials: MY
authors.lastname: Kim
authors.affiliation: Department of Obstetrics and Gynecology, Cheil General Hospital and Women's Healthcare Center, Catholic Kwandong University College of Medicine, Seoul, Korea.
authors.forename: Jung Yeol
authors.initials: JY
authors.lastname: Han
authors.affiliation: Department of Obstetrics and Gynecology, Cheil General Hospital and Women's Healthcare Center, Catholic Kwandong University College of Medicine, Seoul, Korea.
authors.forename: Hyun Kyeong
authors.initials: HK
authors.lastname: Ahn
authors.affiliation: Department of Obstetrics and Gynecology, Cheil General Hospital and Women's Healthcare Center, Catholic Kwandong University College of Medicine, Seoul, Korea.
authors.forename: June Seek
authors.initials: JS
authors.lastname: Choi
authors.affiliation: Department of Obstetrics and Gynecology, Cheil General Hospital and Women's Healthcare Center, Catholic Kwandong University College of Medicine, Seoul, Korea.
authors.forename: Jin Hoon
authors.initials: JH
authors.lastname: Chung
authors.affiliation: Department of Obstetrics and Gynecology, Cheil General Hospital and Women's Healthcare Center, Catholic Kwandong University College of Medicine, Seoul, Korea.
authors.forename: Si Won
authors.initials: SW
authors.lastname: Lee
authors.affiliation: Department of Obstetrics and Gynecology, Cheil General Hospital and Women's Healthcare Center, Catholic Kwandong University College of Medicine, Seoul, Korea.
authors.forename: You Jung
authors.initials: YJ
authors.lastname: Han
authors.affiliation: Department of Obstetrics and Gynecology, Cheil General Hospital and Women's Healthcare Center, Catholic Kwandong University College of Medicine, Seoul, Korea.
authors.forename: Dong Wook
authors.initials: DW
authors.lastname: Kwak
authors.affiliation: Department of Obstetrics and Gynecology, Cheil General Hospital and Women's Healthcare Center, Catholic Kwandong University College of Medicine, Seoul, Korea.
authors.forename: Hyun Mee
authors.initials: HM
authors.lastname: Ryu
authors.affiliation: Department of Obstetrics and Gynecology, Cheil General Hospital and Women's Healthcare Center, Catholic Kwandong University College of Medicine, Seoul, Korea.
authors.forename: Min Hyoung
authors.initials: MH
authors.lastname: Kim
keywords: Birth weight; Body mass index; Diabetes; Gestational; Weight gain