The Pattern of Gestational Weight Gain is Associated with Changes in Maternal Body Composition and Neonatal Size
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The Pattern of Gestational Weight Gain is Associated with Changes in Maternal Body Composition and Neonatal Size Elizabeth M. Widen1,2,3,6 • Pam R. Factor-Litvak3 • Dympna Gallagher1,2 Anne Paxton3,4 • Richard N. Pierson Jr.1,2 • Steven B. Heymsfield5 • Sally A. Lederman2
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Springer Science+Business Media New York 2015
Abstract Objectives 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 B25, high C75 percentile) or rate (defined by tertiles)] and infant & Elizabeth M. Widen [email protected] 1
New York Obesity Nutrition Research Center, Columbia University Medical Center, New York, NY, USA
2
Institute of Human Nutrition, College of Physicians and Surgeons, Columbia University Medical Center, New York, NY, USA
3
Department of Epidemiology, Mailman School of Public Health, Columbia University Medical Center, New York, NY, USA
4
Department of Population and Family Health, Mailman School of Public Health, Columbia University Medical Center, New York, NY, USA
5
Pennington Biomedical Research Center, Louisiana State University, Baton Rouge, LA, USA
6
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
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 (b range for fat D = 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 (b = 356 g, p = 0.001) and length (b = 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. Keywords Pregnancy Body composition Gestational weight gain Infant Maternal Abbreviations BMI Body mass index DP Whole-body 153Gd dual-photon absorptiometry DXA Dual energy absorptiometry GWG Gestational weight gain IOM Institute of Medicine TBW Total body water
Significance What is already known on this subject? The pattern of gestational weig
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