Maternal weight change before pregnancy in relation to birthweight and risks of adverse pregnancy outcomes
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Maternal weight change before pregnancy can be considered as an indicator of maternal energy balance and nutritional status before conception, and may be involved in early life programming. We aimed to investigate the association of maternal Weight Change Before Pregnancy (WCBP) with fetal growth and adverse pregnancy outcomes. Data are from the French EDEN mother–child cohort where 1,756 mother–child pairs had information on mother’s weight at 20 years, weight just before pregnancy, fetal anthropometry at second and third trimesters, infant’s birthweight and pregnancy complications. The average annual WCBP between 20 years and start of pregnancy (in kg/year) was categorized as: “Weight Loss” (n = 320), “Moderate weight gain” (n = 721) and “High weight gain” (n = 715). The associations of WCBP with fetal and newborn characteristics and with adverse pregnancy outcomes were analyzed, adjusting for maternal and pregnancy characteristics, including the mother’s prepregnancy BMI. Interactions between WCBP and prepregnancy BMI were tested. Birthweight and estimated fetal weight in the third trimester increased significantly with increasing WCBP in mothers with BMI <25 kg/m2. In these mothers, weight loss before pregnancy was associated with a higher risk of newborns small for gestational age (SGA). Whatever the prepregnancy BMI, WCBP was positively associated with a maternal risk of gestational diabetes and hypertension. The ponderal history of mothers before pregnancy can impact on fetal growth and on pregnancy outcomes such as gestational diabetes or hypertension. Our analysis is the first to report that in non-overweight women, those who lost weight before pregnancy are at higher risk of having SGA newborns.
KeywordsWeight change Birthweight Adverse pregnancy outcomes
The EDEN Study is funded by grants from the Foundation for Medical Research, the French Ministry of Research: the Institut Fédératif de Recherche program, the Institut National de la Santé et de la Recherche Médicale Human Nutrition National Research Program, and the Diabetes National Research Program (via a collaboration with the French Association for Diabetes Research), the French Ministry of Health Perinatality Program, the French Agency for Environment Security, the French National Institute for Population Health Surveillance, the Paris–Sud University, the French National Institute for Health Education, Nestlé, the National Education Health Insurance (MGEN), the French Speaking Association for the Study of Diabetes and Metabolism, the National Agency for Research (nonthematic program), and the National Institute for Research in Public Health (TGIR health cohort 2008 program). We thank Beverley Balkau who reviewed the manuscript for content and language.
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