title: Patterns of gestational weight gain related to fetal growth among women with overweight and obesity.
abstract: OBJECTIVE
  Maternal obesity is associated with increased risk of large-for-gestational-age (LGA) and small-for-gestational-age (SGA) births. Both are related to childhood obesity. This study considers that the patterns of gestational weight gain (GWG) may help to disentangle these competing risks.
  
  
  METHODS
  Patterns of GWG were characterized among a cohort of women with overweight or obesity (n = 651). Polytomous logistic regression models were tested for associations between GWG patterns and birth weight outcomes: SGA (<10th) and LGA (>90th percentile).
  
  
  RESULTS
  Rates of SGA were higher than those for LGA (14.9% vs. 7.8%). Four GWG patterns were identified: consistently high (29%), early adequate/late high (33%), consistently adequate (18%), and consistently low (20%). Risk of LGA was highest in women with consistently high GWG (adjusted odds ratio [OR] 4.62 [1.53, 13.96]), and risk was elevated, but with lower magnitude, among women with early adequate/late high gains (OR 3.07 [1.01, 9.37]). High GWG before 20 weeks, regardless of later gain, was related to LGA. Low gain before 20 weeks accompanied by high gain later may be associated with reduced SGA risk (0.55 [0.29, 1.07]).
  
  
  CONCLUSIONS
  The pattern of weight gain during pregnancy may be an important contributor to or marker of abnormal fetal growth among women with overweight or obesity.
authors: Department of Obstetrics, Gynecology & Reproductive Sciences, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA; Department of Epidemiology, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.
authors: Janet M
authors: JM
authors: Catov
authors: Diane
authors: D
authors: Abatemarco
authors: Andrew
authors: A
authors: Althouse
authors: Esa M
authors: EM
authors: Davis
authors: Carl
authors: C
authors: Hubel
mesh_terms: D000328:Adult; D001724:Birth Weight; D015992:Body Mass Index; D015897:Comorbidity; D005260:Female; D047109:Fetal Development; D005320:Fetal Macrosomia / Q000453:epidemiology*; D006801:Humans; D007231:Infant, Newborn; D007236:Infant, Small for Gestational Age; D009765:Obesity / Q000453:epidemiology*; D011247:Pregnancy; D011248:Pregnancy Complications / Q000453:epidemiology*; D011256:Pregnancy Outcome / Q000453:epidemiology*; D011295:Prenatal Care / Q000379:methods; D055815:Young Adult