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Gestational weight gain charts for different body mass index groups for women in Europe, North America, and Oceania

  • Susana Santos
  • , Iris Eekhout
  • , Ellis Voerman
  • , Romy Gaillard
  • , Henrique Barros
  • , Marie-Aline Charles
  • , Leda Chatzi
  • , Cécile Chevrier
  • , George P Chrousos
  • , Eva Corpeleijn
  • , Nathalie Costet
  • , Sarah Crozier
  • , Myriam Doyon
  • , Merete Eggesbø
  • , Maria Pia Fantini
  • , Sara Farchi
  • , Francesco Forastiere
  • , Luigi Gagliardi
  • , Vagelis Georgiu
  • , Keith M Godfrey
    • Davide Gori, Veit Grote, Wojciech Hanke, Irva Hertz-Picciotto, Barbara Heude, Marie-France Hivert, Daniel Hryhorczuk, Rae-Chi Huang, Hazel Inskip, Todd A Jusko, Anne M Karvonen, Berthold Koletzko, Leanne K Küpers, Hanna Lagström, Debbie A Lawlor, Irina Lehmann, Maria-Jose Lopez-Espinosa, Per Magnus, Renata Majewska, Johanna Mäkelä, Yannis Manios, Sheila W McDonald, Monique Mommers, Camilla S Morgen, George Moschonis, Ľubica Murínová, John Newnham, Ellen A Nohr, Anne-Marie Nybo Andersen, Emily Oken, Adriëtte J J M Oostvogels, Agnieszka Pac, Eleni Papadopoulou, Juha Pekkanen, Costanza Pizzi, Kinga Polanska, Daniela Porta, Lorenzo Richiardi, Sheryl L Rifas-Shiman, Nel Roeleveld, Loreto Santa-Marina, Ana C Santos, Henriette A Smit, Thorkild I A Sørensen, Marie Standl, Maggie Stanislawski, Camilla Stoltenberg, Elisabeth Thiering, Carel Thijs, Maties Torrent, Suzanne C Tough, Tomas Trnovec, Marleen M H J van Gelder, Lenie van Rossem, Andrea von Berg, Martine Vrijheid, Tanja G M Vrijkotte, Oleksandr Zvinchuk, Stef van Buuren, Vincent W V Jaddoe
  • Department of Pediatrics, Division of Respiratory Medicine, Erasmus University Medical Center/Sophia Children's Hospital, Rotterdam, The Netherlands. Electronic address: [email protected].
  • Amsterdam University Medical Center
  • Department of Public Health and Forensic Sciences and Medical Education, Unit of Clinical Epidemiology, Predictive Medicine and Public Health, University of Porto Medical School, Porto, Portugal.
  • Paris Descartes University, Villejuif, France.
  • Department of Genetics and Cell Biology, Maastricht University, Maastricht, the Netherlands.
  • Inserm UMR 1085, Irset-Research Institute for Environmental and Occupational Health, F-35000, Rennes, France.
  • First Department of Pediatrics, Athens University Medical School, Aghia Sophia Children's Hospital, National and Kapodistrian University of Athens, Athens, Greece.
  • Department of Epidemiology, University of Groningen, University Medical Center Groningen, HPC FA 40, P.O. Box 30.001, 9700 RB, Groningen, the Netherlands.
  • The Netherlands MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK.
  • Centre de Recherche du Centre Hospitalier de l'Universite de Sherbrooke, Sherbrooke, QC, Canada.
  • Norwegian Institute of Public Health
  • The Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy.
  • Department of Epidemiology, Regional Health Service, Lazio Region, Rome, Italy.
  • Department of Woman and Child Health, Ospedale Versilia, Local Health Authority Toscana Nord Ovest, Viareggio, Italy.
  • Department of Social Medicine, Faculty of Medicine, University of Crete, Heraklion, Greece.
  • NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK.
  • Division of Metabolic and Nutritional Medicine, Dr. von Hauner Children's Hospital, Ludwig-Maximilian-Universität Munich, 80337, Munich, Germany.
  • Department of Environmental Epidemiology, Nofer Institute of Occupational Medicine, Lodz, Poland.
  • Department of Public Health Sciences, School of Medicine, University of California Davis, Davis, CA, 95616, USA.
  • Diabetes Unit, Massachusetts General Hospital, Boston, MA, USA.
  • Center for Global Health, University of Illinois College of Medicine, Chicago, IL, USA.
  • Occupational Respiratory Epidemiology, School of Population and Global Health, The University of Western Australia, 35 Stirling Hwy., Perth, WA 6009, Australia; Biostatistics, Telethon Kids Institute, University of Western Australia, 100 Roberts Rd., Perth, WA 6008, Australia.
  • Departments of Public Health Sciences and Environmental Medicine, University of Rochester School of Medicine and Dentistry, Rochester, NY, USA.
  • Department of Health Security, National Institute for Health and Welfare, Kuopio, Finland.
  • Population Health Science, Bristol Medical School, University of Bristol, Bristol, BS8 2BN, UK.
  • Department of Public Health, University of Turku, Turku, Finland.
  • Department of Environmental Immunology/Core Facility Studies, Helmholtz Centre for Environmental Research-UFZ, Leipzig, Germany.
  • CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain.
  • Division of Health Data and Digitalization, Norwegian Institute of Public Health, Oslo, Norway.
  • Department of Epidemiology, Chair of Epidemiology and Preventive Medicine, Jagiellonian University Medical College, Krakow, Poland.
  • Turku Centre for Biotechnology, University of Turku and Abo Akademi University, Turku, Finland.
  • Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, Athens, Greece.
  • Department of Pediatrics, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.
  • Maastricht University Medical Centre
  • Department of Public Health, Section of Epidemiology, University of Copenhagen, Øster Farimagsgade 5, 1014, Copenhagen, Denmark.
  • Department of Rehabilitation, Nutrition and Sport, La Trobe University, Melbourne, Australia.
  • Department of Environmental Medicine, Faculty of Public Health, Slovak Medical University, Bratislava, Slovak Republic.
  • School of Women's and Infants' Health, University of Western Australia, Crawley, Western Australia, Australia.
  • Research Unit for Gynaecology and Obstetrics, Institute for Clinical Research, University of Southern Denmark, Odense, Denmark.
  • Department of Population Medicine, Harvard Medical School, Harvard Pilgrim Health Care Institute, Boston, MA, USA.
  • Department of Medical Informatics, Academic Medical Center, University of Amsterdam, Amsterdam Public Health Research Institute, Amsterdam, the Netherlands.
  • Department of Environmental Exposures and Epidemiology, Domain of Infection Control and Environmental Health, Norwegian Institute of Public Health, Lovisenberggata 8, 0477, Oslo, Norway.
  • University of Helsinki
  • Department of Medical Sciences, University of Turin, Turin, Italy.
  • Department for Health Evidence, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, the Netherlands.
  • Instituto de Investigación Sanitaria BIODONOSTIA, San Sebastián, Spain.
  • Institute for Risk Assessment Sciences (IRAS), Utrecht University, Utrecht, The Netherlands; Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands.
  • The Novo Nordisk Foundation Center for Basic Metabolic Research, Section of Metabolic Genetics, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.
  • Institute of Epidemiology II, HMGU - Helmholtz Zentrum München, German Research Center for Environmental Health, Institute of Epidemiology II, Ingolstädter Landstr. 1, D-85764 Neuherberg, Germany.
  • Department of Biostatistics and Informatics, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, USA.
  • University of Bergen
  • Dr. von Hauner Children's Hospital, Ludwig-Maximilians-University Munich, Munich, Germany.
  • Ib-salut, Area de Salut de Menorca, Menorca, Spain.
  • Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.
  • Department of Environmental Medicine, Slovak Medical University, Bratislava, 833 03, Slovak Republic.
  • Radboud REshape Innovation Center, Radboud University Medical Center, Nijmegen, the Netherlands.
  • Department of Pediatrics, Marien-Hospital Wesel, Research Institute, Wesel, Germany.
  • ISGlobal, Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain; IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain.
  • Department of Medical and Social Problems of Family Health, Institute of Pediatrics, Obstetrics and Gynecology, Kyiv, Ukraine.
  • Department of Epidemiology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands. [email protected].

Research output: Contribution to journal › Article › Academic › peer-review

Abstract

BACKGROUND: Gestational weight gain differs according to pre-pregnancy body mass index and is related to the risks of adverse maternal and child health outcomes. Gestational weight gain charts for women in different pre-pregnancy body mass index groups enable identification of women and offspring at risk for adverse health outcomes. We aimed to construct gestational weight gain reference charts for underweight, normal weight, overweight, and grades 1, 2 and 3 obese women and to compare these charts with those obtained in women with uncomplicated term pregnancies.

METHODS: We used individual participant data from 218,216 pregnant women participating in 33 cohorts from Europe, North America, and Oceania. Of these women, 9065 (4.2%), 148,697 (68.1%), 42,678 (19.6%), 13,084 (6.0%), 3597 (1.6%), and 1095 (0.5%) were underweight, normal weight, overweight, and grades 1, 2, and 3 obese women, respectively. A total of 138, 517 women from 26 cohorts had pregnancies with no hypertensive or diabetic disorders and with term deliveries of appropriate for gestational age at birth infants. Gestational weight gain charts for underweight, normal weight, overweight, and grade 1, 2, and 3 obese women were derived by the Box-Cox t method using the generalized additive model for location, scale, and shape.

RESULTS: We observed that gestational weight gain strongly differed per maternal pre-pregnancy body mass index group. The median (interquartile range) gestational weight gain at 40 weeks was 14.2 kg (11.4-17.4) for underweight women, 14.5 kg (11.5-17.7) for normal weight women, 13.9 kg (10.1-17.9) for overweight women, and 11.2 kg (7.0-15.7), 8.7 kg (4.3-13.4) and 6.3 kg (1.9-11.1) for grades 1, 2, and 3 obese women, respectively. The rate of weight gain was lower in the first half than in the second half of pregnancy. No differences in the patterns of weight gain were observed between cohorts or countries. Similar weight gain patterns were observed in mothers without pregnancy complications.

CONCLUSIONS: Gestational weight gain patterns are strongly related to pre-pregnancy body mass index. The derived charts can be used to assess gestational weight gain in etiological research and as a monitoring tool for weight gain during pregnancy in clinical practice.

Original languageEnglish
Article number201
JournalBMC Medicine
Volume16
Issue number1
DOIs
Publication statusPublished - 5 Nov 2018

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

  1. SDG 3 - Good Health and Well-being
    SDG 3 Good Health and Well-being

Keywords

  • Weight gain
  • Pregnancy
  • Charts
  • References

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