Gestational weight loss and fetal growth in uncomplicated pregnancies among women with obesity: a population-based retrospective cohort study.

Autor:	Guo Y; Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, ON, Canada. yguo@ohri.ca.; BORN Ontario, Children's Hospital of Eastern Ontario, Ottawa, ON, Canada. yguo@ohri.ca.; School of Epidemiology and Public Health, University of Ottawa, Ottawa, ON, Canada. yguo@ohri.ca., Souza SCS; Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, ON, Canada., Bruce L; BORN Ontario, Children's Hospital of Eastern Ontario, Ottawa, ON, Canada., Luo R; Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, ON, Canada.; School of Epidemiology and Public Health, University of Ottawa, Ottawa, ON, Canada., El-Chaâr D; Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, ON, Canada.; School of Epidemiology and Public Health, University of Ottawa, Ottawa, ON, Canada.; Department of Obstetrics, Gynecology & Newborn Care, The Ottawa Hospital, Ottawa, ON, Canada.; Department of Obstetrics and Gynecology, University of Ottawa, Ottawa, ON, Canada., Gaudet LM; Department of Obstetrics and Gynecology, Kingston Health Sciences Centre, Kingston, ON, Canada.; Department of Obstetrics and Gynecology, Queen's University, Kingston, ON, Canada., Muldoon K; Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, ON, Canada.; Department of Obstetrics and Gynecology, University of Ottawa, Ottawa, ON, Canada., Hawken S; Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, ON, Canada.; School of Epidemiology and Public Health, University of Ottawa, Ottawa, ON, Canada.; Children's Hospital of Eastern Ontario Research Institute, Ottawa, ON, Canada., Dunn SI; Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, ON, Canada.; BORN Ontario, Children's Hospital of Eastern Ontario, Ottawa, ON, Canada.; Children's Hospital of Eastern Ontario Research Institute, Ottawa, ON, Canada.; School of Nursing, University of Ottawa, Ottawa, ON, Canada., Dingwall-Harvey ALJ; Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, ON, Canada., Walker MC; Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, ON, Canada.; BORN Ontario, Children's Hospital of Eastern Ontario, Ottawa, ON, Canada.; School of Epidemiology and Public Health, University of Ottawa, Ottawa, ON, Canada.; Department of Obstetrics, Gynecology & Newborn Care, The Ottawa Hospital, Ottawa, ON, Canada.; Department of Obstetrics and Gynecology, University of Ottawa, Ottawa, ON, Canada.; International and Global Health Office, University of Ottawa, Ottawa, ON, Canada., Wen SW; Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, ON, Canada.; School of Epidemiology and Public Health, University of Ottawa, Ottawa, ON, Canada.; Department of Obstetrics, Gynecology & Newborn Care, The Ottawa Hospital, Ottawa, ON, Canada.; Department of Obstetrics and Gynecology, University of Ottawa, Ottawa, ON, Canada., Corsi DJ; Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, ON, Canada.; BORN Ontario, Children's Hospital of Eastern Ontario, Ottawa, ON, Canada.; School of Epidemiology and Public Health, University of Ottawa, Ottawa, ON, Canada.; Department of Obstetrics and Gynecology, University of Ottawa, Ottawa, ON, Canada.; Children's Hospital of Eastern Ontario Research Institute, Ottawa, ON, Canada.
Jazyk:	angličtina
Zdroj:	International journal of obesity (2005) [Int J Obes (Lond)] 2023 Dec; Vol. 47 (12), pp. 1269-1277. Date of Electronic Publication: 2023 Oct 13.
DOI:	10.1038/s41366-023-01382-6
Abstrakt:	Objective: The impact of gestational weight loss (GWL) on fetal growth among women with obesity remains unclear. This study aimed to examine the association between weight loss during pregnancy among women with body mass index (BMI) ≥ 30 kg/m 2 and the risk of small-for-gestational-age (SGA) and large-for-gestational-age (LGA) neonates. Methods: We conducted a retrospective, population-based cohort study of women with pre-pregnancy obesity that resulted in a singleton live birth in 2012-2017, using birth registry data in Ontario, Canada. Women with pregnancy complications or health conditions which could cause weight loss were excluded. GWL is defined as negative gestational weight change (≤0 kg). The association between GWL and fetal growth was estimated using generalized estimating equation models and restricted cubic spline regression analysis. Stratified analysis was conducted by obesity class (I:30-34.9 kg/m 2 , II:35-39.9 kg/m 2 , and III + : ≥40 kg/m 2 ). Results: Of the 52,153 eligible women who entered pregnancy with a BMI ≥ 30 kg/m 2 , 5.3% had GWL. Compared to adequate gestational weight gain, GWL was associated with an increased risk of SGA neonates (aRR:1.45, 95% CI: 1.30-1.60) and a decreased risk of LGA neonates (aRR: 0.81, 95% CI:0.73-0.93). Non-linear L-shaped associations were observed between gestational weight change and SGA neonates, with an increased risk of SGA observed with increased GWL. On the contrary, non-linear S-shaped associations were observed between gestational weight change and LGA neonates, with a decreased risk of LGA observed with increased GWL. Similar findings were observed from the stratified analysis by obesity class. Conclusion: These findings highlight that GWL in women with obesity may increase the risk of SGA neonates but reduce the risk of LGA neonates. Recommendations of GWL for women with obesity should be interpreted with caution. (© 2023. The Author(s).)
Databáze:	MEDLINE
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