AUTHOR=Mogensen Christina Sonne , Zingenberg Helle , Svare Jens , Astrup Arne , Magkos Faidon , Geiker Nina Rica Wium 

TITLE=Gestational weight gain in women with pre-pregnancy overweight or obesity and anthropometry of infants at birth

JOURNAL=Frontiers in Pediatrics

VOLUME=Volume 11 - 2023

YEAR=2023

URL=https://www.frontiersin.org/journals/pediatrics/articles/10.3389/fped.2023.1142920

DOI=10.3389/fped.2023.1142920

ISSN=2296-2360

ABSTRACT=Objective: To examine the association of gestational weight gain (GWG) among women with pre-pregnancy overweight or obesity with infant weight and BMI z-score at birth.
Methods: This study is a secondary analysis of a randomized controlled trial including data from 208 infants at birth born by mothers with pre-pregnancy BMI between 28-45 kg/m2 who completed the APPROACH study (randomized to a high-protein low-glycemic index diet or a moderate-protein moderate-glycemic index diet). This analysis pooled the two diet treatment groups together and data were analyzed using a linear mixed model.
Results: Limiting GWG by 1 kg was associated with lower birthweight (-16g,P=0.003), BMI z-score (-0.03SD,P=0.019), weight z-score (-0.03SD,P=0.004), and infant abdominal circumference (-0.06cm,P=0.039). Infants born by mothers whose GWG was ≤9 kg weighed less (122g,95%CI: 6 to 249,P=0.040), had similar BMI z-score (0.2SD, 95%CI: -0.06 to 0.55,P=0.120), and lower incidence of emergency cesarean deliveries (11.5% vs 23.1%,P=0.044) compared to infants born by mothers whose GWG was >9 kg. When women were classified into GWG quartiles, women in Q1 (GWG range: -7.0 to 3.2kg) gave birth to smaller infants (3420g, P=0.015) with lower BMI z-score (-0.5SD,P=0.041) than women in Q2 (3.3 to 7.1kg), Q3 (7.2 to 10.9kg) and Q4 (11.1 to 30.2kg). 
Conclusions: Limiting GWG among women with pre-pregnancy overweight or obesity was associated with lower infant weight, BMI z-score, weight z-score, and abdominal circumference at birth. Moreover, GWG below the Institute of Medicine guideline of a maximum of 9 kg was associated with lower birthweight and fewer emergency cesarean deliveries.