Maternal and Child Health Journal

, Volume 12, Issue 5, pp 557–567 | Cite as

Pre-pregnancy Body Mass Index, Gestational Weight Gain, and Other Maternal Characteristics in Relation to Infant Birth Weight

  • Ihunnaya O. Frederick
  • Michelle A. Williams
  • Anne E. Sales
  • Diane P. Martin
  • Marcia Killien


Objectives Infant birth weight is influenced by modifiable maternal pre-pregnancy behaviors and characteristics. We evaluated the relationship among pre-pregnancy body mass index (BMI), gestational weight gain, and infant birth weight, in a prospective cohort study. Methods Women were enrolled at ≤20 weeks gestation, completed in-person interviews and had their medical records reviewed after delivery. Infant birth weight was first analyzed as a continuous variable, and then grouped into Low birth weight (LBW) (<2,500 g), normal birth weight (2,500–3,999 g), and macrosomia (≥4,000 g) in categorical analysis. Pre-pregnancy BMI and gestational weight gain were categorized based on Institute of Medicine BMI groups and gestational weight gain guidelines. Associations among infant birth weight and pre-pregnancy BMI, gestational weight gain, and other factors were evaluated using multivariate regression. Risk ratios were estimated using generalized linear modeling procedures. Results Pre-pregnancy BMI was independently and positively associated with infant birth weight (β = 44.7, P = 0.001) after adjusting for confounders, in a quadratic model. Gestational weight gain was positively associated with infant birth weight (β = 19.5, P < 0.001). Lower infant birth weight was associated with preterm birth (β = −965.4, P < 0.001), nulliparity (β = −48.6, P = 0.015), and female babies (β = −168.7, P < 0.001). Less than median gestational weight gain was associated with twice the risk of LBW (RR = 2.04, 95% CI 1.34–3.11). Risk of macrosomia increased with increasing pre-pregnancy BMI and gestational weight gain (P for linear trend <0.001). Conclusions These findings support the need to balance pre-pregnancy weight and gestational weight gain against the risk of LBW and macrosomia among lean and obese women, respectively.


Body mass index Weight gain Birth weight Cohort study 


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Copyright information

© Springer Science+Business Media, LLC 2007

Authors and Affiliations

  • Ihunnaya O. Frederick
    • 1
    • 2
  • Michelle A. Williams
    • 2
    • 3
  • Anne E. Sales
    • 1
    • 4
    • 5
  • Diane P. Martin
    • 1
  • Marcia Killien
    • 6
  1. 1.Department of Health ServicesUniversity of Washington School of Public Health and Community MedicineSeattleUSA
  2. 2.Swedish Medical CenterCenter for Perinatal StudiesSeattleUSA
  3. 3.Department of EpidemiologyUniversity of Washington School of Public Health and Community MedicineSeattleUSA
  4. 4.Veterans’ Administration Puget Sound Health Care SystemsSeattleUSA
  5. 5.Faculty of NursingUniversity of AlbertaEdmontonCanada
  6. 6.Department of Family and Child Health NursingUniversity of Washington School of NursingSeattleUSA

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