Gestational weight gain across continents and ethnicity:systematic review and meta-analysis of maternal and infant outcomes in more than one million women

Autor: Sanjeeva Ranasinha, Min Hyoung Kim, Young Ju Kim, Nan Li, Rebecca F. Goldstein, Sally K. Abell, Won O. Song, Margaretha Haugen, Hanne Kristine Hegaard, Annick Bogaerts, Mary Helen Black, Judith H. Chung, Cheryce L. Harrison, Helena J. Teede, Marie Misso, Francesco Corrado, Roland Devlieger, Gang Hu, Jacqueline Boyle
Jazyk: angličtina
Rok vydání: 2018
Předmět:
Adult
lcsh:Medicine
Pregnancy Outcome/ethnology
Overweight
Macrosomia
Weight Gain
Weight Gain/ethnology
03 medical and health sciences
0302 clinical medicine
Pregnancy
medicine
Humans
Caesarean section
030212 general & internal medicine
Obesity
Ggestational weight gain
Gestational diabetes
030219 obstetrics & reproductive medicine
business.industry
lcsh:R
Caesarean section
Gestational diabetes
Ggestational weight gain
Large for gestational age
Macrosomia
Maternal and infant outcomes
Obesity
Pregnancy
Preterm birth
Small for gestational age
Medicine (all)
Pregnancy Outcome
Infant
Newborn
Gestational age
Maternal and infant outcomes
Preterm birth
General Medicine
Odds ratio
Small for gestational age
medicine.disease
Pregnancy Complications
Fetal Weight
Large for gestational age
Fetal Weight/ethnology
Female
Human medicine
Underweight
medicine.symptom
business
Body mass index
Demography
Research Article
Zdroj: Goldstein, R F, Abell, S K, Ranasinha, S, Misso, M L, Boyle, J A, Harrison, C L, Black, M H, Li, N, Hu, G, Corrado, F, Hegaard, H, Kim, Y J, Haugen, M, Song, W O, Kim, M H, Bogaerts, A, Devlieger, R, Chung, J H & Teede, H J 2018, ' Gestational weight gain across continents and ethnicity : systematic review and meta-analysis of maternal and infant outcomes in more than one million women ', BMC Medicine, vol. 16, no. 1, 153, pp. 1-14 . https://doi.org/10.1186/s12916-018-1128-1
BMC Medicine
BMC Medicine, Vol 16, Iss 1, Pp 1-14 (2018)
BMC medicine
ISSN: 1741-7015
DOI: 10.1186/s12916-018-1128-1
Popis: Background The association between Institute of Medicine (IOM) guidelines and pregnancy outcomes across ethnicities is uncertain. We evaluated the associations of gestational weight gain (GWG) outside 2009 IOM guidelines, with maternal and infant outcomes across the USA, western Europe and east Asia, with subgroup analyses in Asia. The aim was to explore ethnic differences in maternal prepregnancy body mass index (BMI), GWG and health outcomes across these regions. Methods Systematic review, meta-analysis and meta-regression of observational studies were used for the study. MEDLINE, MEDLINE In-Process, Embase and all Evidence-Based Medicine (EBM) Reviews were searched from 1999 to 2017. Studies were stratified by prepregnancy BMI category and total pregnancy GWG. Odds ratio (ORs) 95% confidence intervals (CI) applied recommended GWG within each BMI category as the reference. Primary outcomes were small for gestational age (SGA), preterm birth and large for gestational age (LGA). Secondary outcomes were macrosomia, caesarean section and gestational diabetes. Results Overall, 5874 studies were identified and 23 were included (n = 1,309,136). Prepregnancy overweight/obesity in the USA, Europe and Asia was measured at 42%, 30% and 10% respectively, with underweight 5%, 3% and 17%. GWG below guidelines in the USA, Europe and Asia was 21%, 18% and 31%, and above was 51%, 51% and 37% respectively. Applying regional BMI categories in Asia showed GWG above guidelines (51%) was similar to that in the USA and Europe. GWG below guidelines was associated with a higher risk of SGA (USA/Europe [OR 1.51; CI 1.39, 1.63]; Asia [1.63; 1.45, 1.82]) and preterm birth (USA/Europe [1.35; 1.17, 1.56]; Asia [1.06; 0.78, 1.44]) than GWG within guidelines. GWG above guidelines was associated with a higher risk of LGA (USA/Europe [1.93; 1.81, 2.06]; Asia [1.68; 1.51 , 1.87]), macrosomia (USA/Europe [1.87; 1.70, 2.06]; Asia [2.18; 1.91, 2.49]) and caesarean (USA/Europe [1.26; 1.21, 1.33]; Asia [1.37; 1.30, 1.45]). Risks remained elevated when regional BMI categories were applied for GWG recommendations. More women in Asia were categorised as having GWG below guidelines using World Health Organization (WHO) (60%) compared to regional BMI categories (16%), yet WHO BMI was not accompanied by increased risks of adverse outcomes. Conclusions Women in the USA and western Europe have higher prepregnancy BMI and higher rates of GWG above guidelines than women in east Asia. However, when using regional BMI categories in east Asia, rates of GWG above guidelines are similar across the three continents. GWG outside guidelines is associated with adverse outcomes across all regions. If regional BMI categories are used in east Asia, IOM guidelines are applicable in the USA, western Europe and east Asia. Electronic supplementary material The online version of this article (10.1186/s12916-018-1128-1) contains supplementary material, which is available to authorized users.
Databáze: OpenAIRE
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