title: Gestational Weight Gain Trend and Population Attributable Risks of Adverse Fetal Growth Outcomes in Ohio.
abstract: BACKGROUND
  The trend of gestational weight gain (GWG) in relation to the Institute of Medicine (IOM) guidelines and the population attributable risks (PARs) of GWG on fetal growth outcomes remain unclear.
  
  
  METHODS
  We analysed Ohio birth certificates from 2006 to 2012 to examine GWG trend by prepregnancy body mass index, to calculate the risk of small- and large-for-gestational age (SGA and LGA), and macrosomia (birthweight >4000 g or >4500 g) infants, and to estimate the PARs of GWG below or above the guidelines.
  
  
  RESULTS
  Of 869,531 women who delivered singleton live births at 22-44 weeks of gestation, 4.5% were underweight, 48.9% were normal weight, 23.9% were overweight, and 22.7% were obese before pregnancy. About 36.5% of underweight, 52.6% of normal weight, 72.5% of overweight, and 62.4% of obese women gained weight above the guidelines, with only slight changes from 2006 to 2012. Also, 34.9% of underweight, 20.1% of normal weight, 16.3% of overweight, and 27.0% of obese women gained weight below the guidelines. The PAR of GWG below or above the guidelines was -13% for SGA, 32.6% for LGA, 28.1% for macrosomia >4000 g, and 48.3% for macrosomia >4500 g, mostly driven by currently GWG above the guidelines in normal weight, overweight, and obese women.
  
  
  CONCLUSIONS
  A high percentage of pregnant women gained weight outside of the current IOM GWG guidelines; however, changes from 2006 to 2012 were small. GWG above the IOM guidelines significantly contributed to a large proportion of LGA and macrosomic infants in the general population.
authors.affiliation: Division of Epidemiology, Department of Environmental Health, University of Cincinnati College of Medicine, Cincinnati, OH.
authors.forename: Aimin
authors.initials: A
authors.lastname: Chen
authors.affiliation: Division of Epidemiology, Department of Environmental Health, University of Cincinnati College of Medicine, Cincinnati, OH.
authors.forename: Fan
authors.initials: F
authors.lastname: Xu
authors.affiliation: Division of Epidemiology, Department of Environmental Health, University of Cincinnati College of Medicine, Cincinnati, OH.
authors.forename: Changchun
authors.initials: C
authors.lastname: Xie
authors.affiliation: Division of Epidemiology, Department of Environmental Health, University of Cincinnati College of Medicine, Cincinnati, OH.
authors.forename: Tianying
authors.initials: T
authors.lastname: Wu
authors.affiliation: Division of Epidemiology, Department of Environmental Health, University of Cincinnati College of Medicine, Cincinnati, OH.
authors.forename: Ann M
authors.initials: AM
authors.lastname: Vuong
authors.affiliation: Department of Epidemiology and Social Science on Reproductive Health, Shanghai Institute of Planned Parenthood Research, Shanghai, China.
authors.forename: Maohua
authors.initials: M
authors.lastname: Miao
authors.affiliation: Department of Epidemiology and Social Science on Reproductive Health, Shanghai Institute of Planned Parenthood Research, Shanghai, China.
authors.forename: Wei
authors.initials: W
authors.lastname: Yuan
authors.affiliation: Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, University of Cincinnati College of Medicine and Perinatal Institute, Cincinnati Children's Hospital Medical Center, Cincinnati, OH.
authors.forename: Emily A
authors.initials: EA
authors.lastname: DeFranco
mesh_terms: D000328:Adult; D001724:Birth Weight; D015992:Body Mass Index; D005260:Female; D047109:Fetal Development; D005320:Fetal Macrosomia / Q000453:epidemiology* / Q000209:etiology; D017408:Guidelines as Topic; D006801:Humans; D007231:Infant, Newborn; D007236:Infant, Small for Gestational Age; D016017:Odds Ratio; D009820:Ohio; D050177:Overweight; D011247:Pregnancy; D011248:Pregnancy Complications / Q000453:epidemiology*; D011256:Pregnancy Outcome / Q000453:epidemiology*; D012307:Risk Factors; D013851:Thinness; D014481:United States / Q000453:epidemiology; D015430:Weight Gain
keywords: body mass index; gestational weight gain; large-for-gestational age; macrosomia; small-for-gestational age