title: Maternal nutrition, inadequate gestational weight gain and birth weight: results from a prospective birth cohort.
abstract: The aim of our study was to examine maternal weight gain as well as nutrient intake in pregnancy throughout each trimester compared to current recommendations in a low-risk population and its correlation to birth weight. Additionally, we have investigated the association of maternal nutrition with gestational weight gain and birth weight in an economically unrestricted population.
  
  
  
  Our analysis was carried out in a population-based prospective birth cohort in Hamburg, Germany. 200 pregnant women and 197 infants born at term were included in the analysis. Maternal body weight, weight gain throughout gestation, and birth weight, macro- and micronutrients were assessed based on a 24 h dietary recall in each trimester. Our main outcome measures were weight gain, birth weight, and self-reported dietary intake in each trimester in comparison to current recommendations.
  
  
  
  One third of the women were characterized by an elevated pre-pregnancy BMI, 60 % did not comply with current weight gain recommendations. Particularly overweight and obese women gained more weight than recommended. In a multivariate analysis birth weight correlated significantly with maternal BMI (p = 0.020), total weight gain (p = 0.020) and gestational week (p < 0.001). Compared to guidelines mean percentage of energy derived from fat (p = 0.002) and protein (p < 0.001) was significantly higher, whereas carbohydrate (p = 0.033) intake was lower. Mean fiber intake was significantly lower (p < 0.001). Saturated fat and sugar contributed largely to energy consumption. Gestational weight gain correlated significantly with energy (p = 0.027), carbohydrates (p = 0.008), monosaccharides and saccharose (p = 0.006) intake. 98 % of the pregnant women were below the iodine recommendation, while none of the women reached the required folate, vitamin D, and iron intake.
  
  
  
  During gestation appropriate individual advice as to nutrient intake and weight gain seems to be of high priority. Pregnancy should be used as a 'window of opportunity' for behavioral changes.
authors.affiliation: Department of Obstetrics and Fetal Medicine, University Medical Center Hamburg-Eppendorf, Martinistrasse 52, Hamburg, 20246, Germany. a.diemert@uke.de.
authors.forename: Anke
authors.initials: A
authors.lastname: Diemert
authors.affiliation: Institute for Medical Biometry and Epidemiology, University Medical Center Hamburg-Eppendorf, Hamburg, 20246, Germany.
authors.forename: Susanne
authors.initials: S
authors.lastname: Lezius
authors.affiliation: Department of Obstetrics and Fetal Medicine, University Medical Center Hamburg-Eppendorf, Martinistrasse 52, Hamburg, 20246, Germany.
authors.forename: Mirja
authors.initials: M
authors.lastname: Pagenkemper
authors.affiliation: Department of Obstetrics and Fetal Medicine, University Medical Center Hamburg-Eppendorf, Martinistrasse 52, Hamburg, 20246, Germany.
authors.forename: Gudula
authors.initials: G
authors.lastname: Hansen
authors.affiliation: Department of Obstetrics and Fetal Medicine, University Medical Center Hamburg-Eppendorf, Martinistrasse 52, Hamburg, 20246, Germany.
authors.forename: Alina
authors.initials: A
authors.lastname: Drozdowska
authors.affiliation: Department of Obstetrics and Fetal Medicine, University Medical Center Hamburg-Eppendorf, Martinistrasse 52, Hamburg, 20246, Germany.
authors.forename: Kurt
authors.initials: K
authors.lastname: Hecher
authors.affiliation: Department of Obstetrics and Fetal Medicine, University Medical Center Hamburg-Eppendorf, Martinistrasse 52, Hamburg, 20246, Germany.
authors.forename: Petra
authors.initials: P
authors.lastname: Arck
authors.affiliation: Preventive Medicine, University Heart Center, University Medical Center Hamburg-Eppendorf, Hamburg, Hamburg.
authors.forename: Birgit C
authors.initials: BC
authors.lastname: Zyriax
mesh_terms: D000328:Adult; D001724:Birth Weight; D015992:Body Mass Index; D001835:Body Weight; D004034:Diet Surveys; D004435:Eating; D002149:Energy Intake; D005260:Female; D005858:Germany; D005865:Gestational Age; D006801:Humans; D007231:Infant, Newborn; D039382:Maternal Nutritional Physiological Phenomena; D015999:Multivariate Analysis; D050177:Overweight / Q000503:physiopathology; D011247:Pregnancy; D011248:Pregnancy Complications / Q000503:physiopathology; D011264:Pregnancy Trimesters / Q000502:physiology*; D011446:Prospective Studies; D015430:Weight Gain
keywords: Birth cohort; Diet; Gestational weight gain; Nutrient intake; Obesity; Overweight; Pregnancy