Association between gestational age-specific weight gain in pregnancy and risk of adverse perinatal outcomes: a secondary analysis of the INTERBIO-21st Fetal Study
1
Issued Date
2025-01-01
Resource Type
ISSN
00029165
eISSN
19383207
Scopus ID
2-s2.0-105004813670
Pubmed ID
40250762
Journal Title
American Journal of Clinical Nutrition
Rights Holder(s)
SCOPUS
Bibliographic Citation
American Journal of Clinical Nutrition (2025)
Suggested Citation
Jabin N., Malla L., Otieno G., Ismail L.C., Barros F.C., Berkley J., Carvalho M., Munim S., Norris S., Nosten F., Papageorghiou A.T., Kennedy S.H., Villar J., Ohuma E.O. Association between gestational age-specific weight gain in pregnancy and risk of adverse perinatal outcomes: a secondary analysis of the INTERBIO-21st Fetal Study. American Journal of Clinical Nutrition (2025). doi:10.1016/j.ajcnut.2025.04.012 Retrieved from: https://repository.li.mahidol.ac.th/handle/123456789/110259
Title
Association between gestational age-specific weight gain in pregnancy and risk of adverse perinatal outcomes: a secondary analysis of the INTERBIO-21st Fetal Study
Author's Affiliation
The Aga Khan University Kenya
Mahidol Oxford Tropical Medicine Research Unit
University of Sharjah
The Aga Khan University
London School of Hygiene & Tropical Medicine
University of Oxford
University of the Witwatersrand, Johannesburg
Universidade Federal de Pelotas
Nuffield Department of Medicine
University of Oxford Medical Sciences Division
Kenya Paediatric Research Consortium
Mahidol Oxford Tropical Medicine Research Unit
University of Sharjah
The Aga Khan University
London School of Hygiene & Tropical Medicine
University of Oxford
University of the Witwatersrand, Johannesburg
Universidade Federal de Pelotas
Nuffield Department of Medicine
University of Oxford Medical Sciences Division
Kenya Paediatric Research Consortium
Corresponding Author(s)
Other Contributor(s)
Abstract
Background: Gestational weight gain (GWG) is a potentially modifiable factor that can influence perinatal health outcomes. Objectives: This study aims to investigate the association between gestational age (GA)-specific weight gain and adverse perinatal outcomes. Methods: This study is a secondary analysis of the INTERBIO-21st Fetal Study, a prospective, longitudinal cohort conducted from 8 February, 2012 to 30 November, 2019, across 6 sites in Brazil, Kenya, Pakistan, South Africa, Thailand, and the United Kingdom. A total of 3354 pregnant females, aged ≥18 y with a body mass index (BMI) <35 kg/m2, initiated antenatal care before 14 wk of gestation. Weight was measured at 5 ± 1 wk intervals from 14 to 40 wk. GWG was assessed using the GA-specific INTERGROWTH-21st and BMI-specific Institute of Medicine (IOM) guidelines. Adverse outcomes included gestational diabetes mellitus (GDM), pregnancy-induced hypertension (PIH), emergency cesarean delivery, low birthweight (LBW), preterm birth, small or large for gestational age (SGA), macrosomia, and birth length or head circumference (HC) <10th or >90th centile. Results: Inadequate GWG was prevalent, with 53% (n = 1767) below the 25th centile of INTERGROWTH-21st standards and 62% (n = 2079) below IOM guidelines. Compared with GWG between 25th and 75th centile (n = 370), females with GWG <25th centile (n = 1767) had a higher odds of SGA [odds ratio (OR) = 2.7, 95% confidence interval (CI): 2.2, 3.4], birth HC < 10th centile (OR: 2.4, 95% CI: 1.8, 3.2), GDM (OR: 1.9, 95% CI: 1.3, 2.7), LBW (OR: 1.9, 95% CI: 1.5, 2.4), and birth length <10th centile (OR: 1.7, 95% CI: 1.4, 2.1). Similarly, females with GWG >75th centile (n = 458) had higher odds for emergency cesarean section (OR: 1.7, 95% CI: 1.1, 2.7) and PIH (OR: 1.5, 95% CI: 1.1, 1.9). Conclusions: Appropriate-for-age-specific GWG between the 25th and 75th centiles standards is associated with reduced adverse outcomes, highlighting the importance of tailored guidelines for optimal maternal and neonatal health.