Skip to main content

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

Maternal and Child Health Journal volume 12, pages 557–567 (2008)Cite this article

Abstract

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.

This is a preview of subscription content, access via your institution.

Access options

Buy single article

Instant access to the full article PDF.

43,34 €

Price includes VAT (Finland)
Tax calculation will be finalised during checkout.

References

  1. Godfrey, K. M., & Barker, D. J. (2000). Fetal nutrition and adult disease. American Journal of Clinical Nutrition, 71, 1344S–1352S.

    PubMed  CAS  Google Scholar 

  2. Boucher, B. J. (2002). Determinants of size at birth. QJM: Monthly Journal of the Association of Physicians, 95, 331–333.

    PubMed  CAS  Google Scholar 

  3. Thame, M., Osmond, C., Wilks, R. J., Bennett, F. I., McFarlene-Anderson, N., & Forrester, T. E. (2000). Blood pressure is related to placental volume and birth weight. Hypertension, 35, 662–667.

    PubMed  CAS  Google Scholar 

  4. Martyn, C. N., Barker, D. J., Jespersen, S., Greenwald, S., Osmond, C., & Berry, C. (1995). Growth in utero, adult blood pressure, and arterial compliance. British Heart Journal, 73(2), 116–121.

    PubMed  Article  CAS  Google Scholar 

  5. Kramer, M. S., Morin, I., Yang, H., Platt, R. W., Usher, R., McNamara, H., Joseph, K. S., & Wen, S. W. (2002). Why are babies getting bigger? Temporal trends in fetal growth and its determinants. Journal of Pediatrics, 141, 538–542.

    PubMed  Article  Google Scholar 

  6. Thorsdottir, I., Torfadottir, J. E., Birgisdottir, B. E., & Geirsson, R. T. (2002). Weight gain in women of normal weight before pregnancy: Complications in pregnancy or delivery and birth outcome. Obstetrics and Gynecology, 99, 799–806.

    PubMed  Article  Google Scholar 

  7. Bergmann, R. L., Richter, R., Bergmann, K. E., Plagemann, A., Brauer, M., & Dudenhausen, J. W. (2003). Secular trends in neonatal macrosomia in Berlin: Influences of potential determinants. Pediatrics and Perinatal Epidemiology, 17, 244–249.

    Article  Google Scholar 

  8. Emanuel, I., Kimpo, C., & Moceri, V. (2004). The association of maternal growth and socio-economic measures with infant birth weight in four ethnic groups. International Journal of Epidemiology, 33, 1236–1242.

    PubMed  Article  Google Scholar 

  9. Ferland, S., & O’Brien, H. T. (2003). Maternal dietary intake and pregnancy outcome. Journal of Reproductive Medicine, 48(2), 86–94.

    PubMed  Google Scholar 

  10. Matthews, F., Youngman, L., & Neil, A. (2004). Maternal circulating nutrient concentrations in pregnancy: implications for birth and placental weights of term infants. American Journal of Clinical Nutrition, 79, 103–110.

    Google Scholar 

  11. Rogers, I., Emmett, P., Ness, A., & Golding, J. (2004). Maternal fish intake in late pregnancy and the frequency of low birth weight and intrauterine growth retardation in a cohort of British infants. Journal of Epidemiology and Community Health, 58, 486–492.

    PubMed  Article  CAS  Google Scholar 

  12. Friis, H., Gomo, E., Nyazema, N., Ndhlovu, P., Krarup, H., Koestel, P., & Michaelson, K. F. (2004). Effect of multimicronutrient supplementation on gestational length and birth size: A randomized, placebo-controlled, double-blinded effectiveness trial in Zimbabwe. American Journal of Clinical Nutrition, 80, 178–184.

    PubMed  CAS  Google Scholar 

  13. Boulet, S. L., Alexander, G. R., Salihu, H. M., & Pass, M. (2003). Macrosomic births in the United States: Determinants, outcomes, and proposed grades of risk. American Journal of Obstetrics and Gynecology, 188, 1372–1378.

    PubMed  Article  Google Scholar 

  14. Institute of Medicine. (1990). Subcommittee on nutritional status and weight gain during pregnancy. Nutrition during pregnancy, Part I. Weight gain. Washington DC: National Academy Press.

    Google Scholar 

  15. Merchant, S. S., Momin, I. A., Sewani, A. A., & Zuberi, N. F. (1999). Effect of prepregnancy body mass index and gestational weight gain on birth weight. Journal of Pakistan Medicine Association, 49(1), 23–25.

    CAS  Google Scholar 

  16. Neufeld, L. M., Haas, J. D., Grajeda, R., & Martorell, R. (2004). Changes in maternal weight from the first to second trimester of pregnancy are associated with fetal growth and infant length at birth. American Journal of Clinical Nutrition, 79, 646–652.

    PubMed  CAS  Google Scholar 

  17. Brown, J. E., Murtaugh, M. A., Jacobs, D. R., & Margellos, H. C. (2002). Variation in newborn size according to pregnancy weight change by trimester. American Journal of Clinical Nutrition, 76, 205–209.

    PubMed  CAS  Google Scholar 

  18. Thame, M., Osmond, C., Bennett, F., Wilks, R., & Forrester, T. (2004). Fetal growth is directly related to maternal anthropometry and placental volume. European Journal of Clinical Nutrition, 58, 894–900.

    PubMed  Article  CAS  Google Scholar 

  19. Bracero, L. A., & Byrne, D. W. (1998). Optimal maternal weight gain during singleton pregnancy. Gynecologic and Obstetric Investigation, 46, 9–16.

    PubMed  Article  CAS  Google Scholar 

  20. Feigs, D. S., & Naylor, C. D. (1998). Eating for two: Are guidelines for weight gain during pregnancy too liberal? Lancet, 351, 1054–1055.

    Article  Google Scholar 

  21. Dietz, P. M., Callaghan, W. M., Cogswell, M. E., Morrow, B., Ferre, C., & Schieve, L. A. (2006). Combined effects of prepregnancy body mass index and weight gain during pregnancy on the risk of preterm delivery. Epidemiology, 17(2), 170–177.

    PubMed  Article  Google Scholar 

  22. Kirchengast, S., Hartmann, B., Schweppe, K. W., & Husslein, P. (1998). Impact of maternal body build characteristics on newborn size in two different European populations. Human Biology, an International Record of Research, 70(4), 761–774.

    CAS  Google Scholar 

  23. Hernan, M. A., Hernandez-Diaz, S., Werler, M. W., & Mitchell, A. A. (2002). Causal knowledge as a prerequisite for confounding evaluation: An application to birth defects epidemiology. American Journal of Epidemiology, 155(2), 176–184.

    PubMed  Article  Google Scholar 

  24. Greenland, S., & Brumback, B. (2002). An overview of relations among causal modelling methods. International Journal of Epidemiology, 31, 1030–1037.

    PubMed  Article  Google Scholar 

  25. Rothman, K. J., & Greenland, S. (1998). Modern epidemiology (2nd ed.). Philadelphia: Lippincott-Raven Publishers.

    Google Scholar 

  26. Kennedy, P. (1998). A guide to econometrics (4th ed.). Cambridge, MA: The MIT Press.

    Google Scholar 

  27. Wooldridge, J. M. (2002). Econometric analysis of cross section and panel data. Cambridge, MA: The MIT Press.

    Google Scholar 

  28. Zhou, W., & Olsen, J. (1997). Gestational weight gain as a predictor of birth and placenta weight according to pre-pregnancy body mass index. Acta Obstetricia et Gynecologica Scandinavica, 76, 300–307.

    PubMed  CAS  Google Scholar 

  29. Neggers, Y., & Goldenberg, R. L. (2003). Some thoughts on body mass index, micronutrient intakes and pregnancy outcome. Journal of Nutrition, 133, 1737S–1740S.

    PubMed  CAS  Google Scholar 

  30. Secker-Walker, R. H., & Vacek, P. M. (2003). Relationships between cigarette smoking during pregnancy, gestational age, maternal weight gain, and infant birthweight. Addictive Behavior, 28, 55–66.

    Article  Google Scholar 

  31. Rosenberg, T. J., Garbers, S., Chavkin, W., & Chiasson, M. A. (2003). Prepregnancy weight and adverse perinatal outcomes in an ethnically diverse population. Obstetrics and Gynecology, 102(5), 1022–1027.

    PubMed  Article  Google Scholar 

  32. Stewart, A. L. (1982). The reliability and validity of self-reported weight and height. Journal of Chronic Disease, 35, 295–309.

    Article  CAS  Google Scholar 

  33. Willett, W. C. (1998). Nutritional epidemiology (2nd ed.). New York: Oxford University Press.

    Google Scholar 

Download references

Acknowledgements

This research was supported in part by an award from the National Institutes of Health (HD 32562). We would like to acknowledge participants of the Omega Study for their voluntary participation in the study. The authors would like to thank Center for Perinatal Studies staff for their expert technical assistance.

Author information

Affiliations

  1. Department of Health Services, University of Washington School of Public Health and Community Medicine, Seattle, WA, USA

    Ihunnaya O. Frederick, Anne E. Sales & Diane P. Martin

  2. Swedish Medical Center, Center for Perinatal Studies, 1124 Columbia Street, Suite 750, Seattle, WA, 98104, USA

    Ihunnaya O. Frederick & Michelle A. Williams

  3. Department of Epidemiology, University of Washington School of Public Health and Community Medicine, Seattle, WA, USA

    Michelle A. Williams

  4. Veterans’ Administration Puget Sound Health Care Systems, Seattle, WA, USA

    Anne E. Sales

  5. Faculty of Nursing, University of Alberta, Edmonton, AB, Canada

    Anne E. Sales

  6. Department of Family and Child Health Nursing, University of Washington School of Nursing, Seattle, WA, USA

    Marcia Killien

Authors
  1. Ihunnaya O. Frederick
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Michelle A. Williams
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Anne E. Sales
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Diane P. Martin
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Marcia Killien
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Ihunnaya O. Frederick.

Rights and permissions

Reprints and Permissions

About this article

Cite this article

Frederick, I.O., Williams, M.A., Sales, A.E. et al. Pre-pregnancy Body Mass Index, Gestational Weight Gain, and Other Maternal Characteristics in Relation to Infant Birth Weight. Matern Child Health J 12, 557–567 (2008). https://doi.org/10.1007/s10995-007-0276-2

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10995-007-0276-2

Keywords

  • Body mass index
  • Weight gain
  • Birth weight
  • Cohort study