title: The Pattern of Gestational Weight Gain is Associated with Changes in Maternal Body Composition and Neonatal Size.
abstract: OBJECTIVE
  The pattern of gestational weight gain (GWG) reflects general nutrient availability to support growing fetal and maternal compartments and may contribute to later health, but how it relates to changes in maternal body composition is unknown. We evaluated how the pattern of GWG related to changes in maternal body composition during pregnancy and infant size at birth.
  
  
  METHODS
  A prospective, multi-ethnic cohort of 156 pregnant women and their infants was studied in New York City. Prenatal weights were used to estimate total and rate (kg/week) of GWG by trimester. Linear regression models evaluated the association between trimester-specific GWG group (low, medium, high GWG) [total (low ≤25, high ≥75 percentile) or rate (defined by tertiles)] and infant weight, length and maternal body composition changes from 14 to 37 weeks, adjusting for covariates.
  
  
  RESULTS
  Compared to the low gain group, medium/high rate of GWG in the second trimester and high rate of GWG in the third trimester were associated with larger gains in maternal fat mass (β range for fat Δ = 2.86-5.29 kg, all p < 0.01). For infant outcomes, high rate of GWG in the second trimester was associated with higher birth weight (β = 356 g, p = 0.001) and length (β = 0.85 cm, p = 0.002). First and third trimester GWG were not associated with neonatal size.
  
  
  CONCLUSIONS
  The trimester specific pattern and rate of GWG reflect changes in maternal body fat and body water, and are associated with neonatal size, which supports the importance of monitoring trimester-specific GWG.
authors.affiliation: New York Obesity Nutrition Research Center, Columbia University Medical Center, New York, NY, USA. ew2435@cumc.columbia.edu.|Institute of Human Nutrition, College of Physicians and Surgeons, Columbia University Medical Center, New York, NY, USA. ew2435@cumc.columbia.edu.|Department of Epidemiology, Mailman School of Public Health, Columbia University Medical Center, New York, NY, USA. ew2435@cumc.columbia.edu.|Institute of Human Nutrition, Department of Epidemiology, The New York Obesity Nutrition Research Center, Columbia University Medical Center, 1150 St. Nicholas Ave, Suite 121, New York, NY, 10032, USA. ew2435@cumc.columbia.edu.
authors.forename: Elizabeth M
authors.initials: EM
authors.lastname: Widen
authors.affiliation: Department of Epidemiology, Mailman School of Public Health, Columbia University Medical Center, New York, NY, USA.
authors.forename: Pam R
authors.initials: PR
authors.lastname: Factor-Litvak
authors.affiliation: New York Obesity Nutrition Research Center, Columbia University Medical Center, New York, NY, USA.|Institute of Human Nutrition, College of Physicians and Surgeons, Columbia University Medical Center, New York, NY, USA.
authors.forename: Dympna
authors.initials: D
authors.lastname: Gallagher
authors.affiliation: Department of Epidemiology, Mailman School of Public Health, Columbia University Medical Center, New York, NY, USA.|Department of Population and Family Health, Mailman School of Public Health, Columbia University Medical Center, New York, NY, USA.
authors.forename: Anne
authors.initials: A
authors.lastname: Paxton
authors.affiliation: New York Obesity Nutrition Research Center, Columbia University Medical Center, New York, NY, USA.|Institute of Human Nutrition, College of Physicians and Surgeons, Columbia University Medical Center, New York, NY, USA.
authors.forename: Richard N
authors.initials: RN
authors.lastname: Pierson
authors.affiliation: Pennington Biomedical Research Center, Louisiana State University, Baton Rouge, LA, USA.
authors.forename: Steven B
authors.initials: SB
authors.lastname: Heymsfield
authors.affiliation: Institute of Human Nutrition, College of Physicians and Surgeons, Columbia University Medical Center, New York, NY, USA.
authors.forename: Sally A
authors.initials: SA
authors.lastname: Lederman
mesh_terms: D001724:Birth Weight / Q000502:physiology*; D001823:Body Composition; D015992:Body Mass Index; D015331:Cohort Studies; D005260:Female; D006801:Humans; D000068104:Infant Health / Q000706:statistics & numerical data*; D007231:Infant, Newborn; D000068097:Maternal Health / Q000706:statistics & numerical data*; D009519:New York City; D011247:Pregnancy; D011248:Pregnancy Complications / Q000401:mortality*; D011446:Prospective Studies; D015430:Weight Gain
keywords: Body composition; Gestational weight gain; Infant; Maternal; Pregnancy