Skip to main content
SpringerLink
Log in

Pre-Pregnancy Body Mass Index and Weight Gain During Pregnancy: Relations with Gestational Diabetes and Hypertension, and Birth Outcomes

  • Published:
Maternal and Child Health Journal Aims and scope Submit manuscript

Abstract

To study the relationship between pre-pregnancy body mass index (BMI) and weight gain during pregnancy with pregnancy and birth outcomes, with a focus on gestational diabetes and hypertension and their role in the association with fetal growth. We studied 1,884 mothers and offspring from the Eden mother–child cohort. Weight before pregnancy (W1) and weight after delivery (W2) were collected and we calculated BMI and net gestational weight gain (netGWG = (W2 − W1)/(weeks of gestation)). Gestational diabetes, hypertension gestational age and birth weight were collected. We used multivariate linear or logistic models to study the association between BMI, netGWG and pregnancy and birth outcomes, adjusting for center, maternal age and height, parity and average number of cigarettes smoked per day during pregnancy. High BMI was more strongly related to the risk of giving birth to a large-for-gestational-age (LGA) baby than high netGWG (odds ratio OR [95% CI] of 3.23 [1.86–5.60] and 1.61 [0.91–2.85], respectively). However, after excluding mothers with gestational diabetes or hypertension the ORs for LGA, respectively weakened (OR 2.57 [1.29–5.13]) for obese women and strengthened for high netGWG (OR 2.08 [1.14–3.80]). Low in comparison to normal netGWG had an OR of 2.18 [1.20–3.99] for pre-term birth, which became stronger after accounting for blood pressure and glucose disorders (OR 2.70 [1.37–5.34]). Higher net gestational weight gain was significantly associated with an increased risk of LGA only after accounting for blood pressure and glucose disorders. High gestational weight gain should not be neglected in regard to risk of LGA in women without apparent risk factors.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Charles, M. A., Eschwege, E., & Basdevant, A. (2008). Monitoring the obesity epidemic in France: The obepi surveys 1997–2006. Obesity (Silver Spring), 16, 2182–2186.

    Article  Google Scholar 

  2. Castro, L. C., & Avina, R. L. (2002). Maternal obesity and pregnancy outcomes. Current Opinion in Obstetrics and Gynecology, 14, 601–606.

    Article  PubMed  Google Scholar 

  3. Yu, C. K., Teoh, T. G., & Robinson, S. (2006). Obesity in pregnancy. BJOG, 113, 1117–1125.

    Article  PubMed  CAS  Google Scholar 

  4. Raatikainen, K., Heiskanen, N., & Heinonen, S. (2006). Transition from overweight to obesity worsens pregnancy outcome in a BMI-dependent manner. Obesity (Silver Spring), 14, 165–171.

    Article  Google Scholar 

  5. Heslehurst, N., Simpson, H., Ells, L. J., Rankin, J., Wilkinson, J., Lang, R., et al. (2008). The impact of maternal BMI status on pregnancy outcomes with immediate short-term obstetric resource implications: A meta-analysis. Obesity Reviews, 9(6), 635–638.

    Article  PubMed  CAS  Google Scholar 

  6. Andreasen, K. R., Andersen, M. L., & Schantz, A. L. (2004). Obesity and pregnancy. Acta Obstetricia et Gynecologica Scandinavica, 83, 1022–1029.

    PubMed  Google Scholar 

  7. Bodnar, L. M., Ness, R. B., Markovic, N., & Roberts, J. M. (2005). The risk of preeclampsia rises with increasing prepregnancy body mass index. Annals of Epidemiology, 15, 475–482.

    Article  PubMed  Google Scholar 

  8. Ehrenberg, H. M., Mercer, B. M., & Catalano, P. M. (2004). The influence of obesity and diabetes on the prevalence of macrosomia. American Journal of Obstetrics and Gynecology, 191, 964–968.

    Article  PubMed  CAS  Google Scholar 

  9. Rosenberg, T. J., Garbers, S., Lipkind, H., & Chiasson, M. A. (2005). Maternal obesity and diabetes as risk factors for adverse pregnancy outcomes: Differences among 4 racial/ethnic groups. American Journal of Public Health, 95, 1545–1551.

    Article  PubMed  Google Scholar 

  10. Grisaru-Granovsky, S., Halevy, T., Eidelman, A., Elstein, D., & Samueloff, A. (2007). Hypertensive disorders of pregnancy and the small for gestational age neonate: Not a simple relationship. American Journal of Obstetrics and Gynecology, 196, 335.e1–e5.

    Google Scholar 

  11. Steer, P. J., Little, M. P., Kold-Jensen, T., Chapple, J., & Elliott, P. (2004). Maternal blood pressure in pregnancy, birth weight, and perinatal mortality in first births: Prospective study. BMJ, 329, 1312.

    Article  PubMed  Google Scholar 

  12. Hedderson, M. M., Weiss, N. S., Sacks, D. A., Pettitt, D. J., Selby, J. V., Quesenberry, C. P., et al. (2006). Pregnancy weight gain and risk of neonatal complications: Macrosomia, hypoglycemia, and hyperbilirubinemia. Obstetrics and Gynecology, 108, 1153–1161.

    Article  PubMed  Google Scholar 

  13. Nohr, E. A., Vaeth, M., Baker, J. L., Sorensen, T., Olsen, J., & Rasmussen, K. M. (2008). Combined associations of prepregnancy body mass index and gestational weight gain with the outcome of pregnancy. The American Journal of Clinical Nutrition, 87, 1750–1759.

    PubMed  CAS  Google Scholar 

  14. Institute of Medicine. (1990). Nutrition during pregnancy. Washington, DC: The National Academy Press.

    Google Scholar 

  15. Dietz, P. M., Callaghan, W. M., & Sharma, A. J. (2009). High pregnancy weight gain and risk of excessive fetal growth. American Journal of Obstetrics and Gynecology, 201, 51.e1–e6.

    Google Scholar 

  16. Nohr, E. A., Vaeth, M., Baker, J. L., Sorensen, T. I., Olsen, J., & Rasmussen, K. M. (2009). Pregnancy outcomes related to gestational weight gain in women defined by their body mass index, parity, height, and smoking status. The American Journal of Clinical Nutrition, 90, 1288–1294.

    Article  PubMed  CAS  Google Scholar 

  17. 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, 170–177.

    Article  PubMed  Google Scholar 

  18. Rode, L., Hegaard, H. K., Kjaergaard, H., Moller, L. F., Tabor, A., & Ottesen, B. (2007). Association between maternal weight gain and birth weight. Obstetrics and Gynecology, 109, 1309–1315.

    Article  PubMed  Google Scholar 

  19. Edwards, L. E., Hellerstedt, W. L., Alton, I. R., Story, M., & Himes, J. H. (1996). Pregnancy complications and birth outcomes in obese and normal-weight women: Effects of gestational weight change. Obstetrics and Gynecology, 87, 389–394.

    Article  PubMed  CAS  Google Scholar 

  20. Thorsdottir, I., & Birgisdottir, B. E. (1998). Different weight gain in women of normal weight before pregnancy: Postpartum weight and birth weight. Obstetrics and Gynecology, 92, 377–383.

    Article  PubMed  CAS  Google Scholar 

  21. Kramer, M. S., McLean, F. H., Eason, E. L., & Usher, R. H. (1992). Maternal nutrition and spontaneous preterm birth. American Journal of Epidemiology, 136, 574–583.

    PubMed  CAS  Google Scholar 

  22. Schieve, L. A., Cogswell, M. E., & Scanlon, K. S. (1999). Maternal weight gain and preterm delivery: Differential effects by body mass index. Epidemiology, 10, 141–147.

    Article  PubMed  CAS  Google Scholar 

  23. Mamelle, N., Munoz, F., & Grandjean, H. (1996). Fetal growth from the AUDIPOG study. I. Establishment of reference curves. Journal of Gynecology, Obstetrics and Biological Reproduction (Paris), 25, 61–70.

    CAS  Google Scholar 

  24. Rowland, M. L. (1990). Self-reported weight and height. The American Journal of Clinical Nutrition, 52, 1125–1133.

    PubMed  CAS  Google Scholar 

  25. Guelinckx, I., Devlieger, R., Beckers, K., & Vansant, G. (2008). Maternal obesity: Pregnancy complications, gestational weight gain and nutrition. Obesity Reviews, 9, 140–150.

    Article  PubMed  CAS  Google Scholar 

  26. Catalano, P. M., Roman, N. M., Tyzbir, E. D., Merritt, A. O., Driscoll, P., & Amini, S. B. (1993). Weight gain in women with gestational diabetes. Obstetrics and Gynecology, 81, 523–528.

    PubMed  CAS  Google Scholar 

  27. Nohr, E. A., Bech, B. H., Vaeth, M., Rasmussen, K. M., Henriksen, T. B., & Olsen, J. (2007). Obesity, gestational weight gain and preterm birth: A study within the Danish national birth cohort. Paediatric and Perinatal Epidemiology, 21, 5–14.

    Article  PubMed  Google Scholar 

  28. Siega-Riz, A. M., Adair, L. S., & Hobel, C. J. (1996). Maternal underweight status and inadequate rate of weight gain during the third trimester of pregnancy increases the risk of preterm delivery. Journal of Nutrition, 126, 146–153.

    PubMed  CAS  Google Scholar 

  29. Hickey, C. A., Cliver, S. P., McNeal, S. F., Hoffman, H. J., & Goldenberg, R. L. (1995). Prenatal weight gain patterns and spontaneous preterm birth among nonobese black and white women. Obstetrics and Gynecology, 85, 909–914.

    Article  PubMed  CAS  Google Scholar 

  30. Trotter, L. J., Bowen, D. J., & Beresford, S. A. (2010). Testing for racial/ethnic differences in the association between childhood socioeconomic position and adult adiposity. American Journal of Public Health, 100, 1088–1094.

    Article  PubMed  Google Scholar 

  31. Blondel, B., Supernant, K., Du Mazaubrun, C., & Breart, G. (2006). Trends in perinatal health in metropolitan France between 1995 and 2003: Results from the national perinatal surveys. Journal of Gynecology, Obstetrics and Biological Reproduction (Paris), 35, 373–387.

    CAS  Google Scholar 

  32. Ay, L., Kruithof, C. J., Bakker, R., Steegers, E. A., Witteman, J. C., Moll, H. A., et al. (2009). Maternal anthropometrics are associated with fetal size in different periods of pregnancy and at birth. The generation R study. BJOG, 116, 953–963.

    Article  PubMed  CAS  Google Scholar 

  33. Frederick, I. O., Williams, M. A., Sales, A. E., Martin, D. P., & Killien, M. (2008). Pre-pregnancy body mass index, gestational weight gain, and other maternal characteristics in relation to infant birth weight. Maternal and Child Health Journal, 12, 557–567.

    Article  PubMed  Google Scholar 

  34. Dietz, P. M., Callaghan, W. M., Smith, R., & Sharma, A. J. (2009). Low pregnancy weight gain and small for gestational age: A comparison of the association using 3 different measures of small for gestational age. American Journal of Obstetrics and Gynecology, 201, 53.e1–e7.

    Google Scholar 

  35. Wise, L. A., Palmer, J. R., Heffner, L. J., & Rosenberg, L. (2010). Prepregnancy body size, gestational weight gain, and risk of preterm birth in African-American women. Epidemiology, 21, 243–252.

    Article  PubMed  Google Scholar 

  36. Sermer, M., Naylor, C. D., Gare, D. J., Kenshole, A. B., Ritchie, J. W., Farine, D., et al. (1995). Impact of increasing carbohydrate intolerance on maternal-fetal outcomes in 3637 women without gestational diabetes. The Toronto tri-hospital gestational diabetes project. American Journal of Obstetrics and Gynecology, 173, 146–156.

    Article  PubMed  CAS  Google Scholar 

  37. Jensen, D. M., Damm, P., Sorensen, B., Molsted-Pedersen, L., Westergaard, J. G., Klebe, J., et al. (2001). Clinical impact of mild carbohydrate intolerance in pregnancy: A study of 2904 nondiabetic Danish women with risk factors for gestational diabetes mellitus. American Journal of Obstetrics and Gynecology, 185, 413–419.

    Article  PubMed  CAS  Google Scholar 

Download references

Acknowledgments

We are indebted to the participating families and to the midwife research assistants for data collection. We acknowledge all the funding sources for the EDEN study: Fondation pour la Recherche Médicale (FRM), French Ministry of Research: IFR and Cohort program, INSERM Nutrition Research Program, French Ministry of Health Perinatality Program, French Agency for Environment Security (AFFSET), French National Institute for Population Health Surveillance (INVS), Paris–Sud University, French National Institute for Health Education (INPES), Nestlé, Mutuelle Générale de l’Education Nationale (MGEN), French speaking association for the study of diabetes and metabolism (Alfediam), National Agency for Research (ANR non thematic program), National Institute for Research in Public Health (IRESP: TGIR cohorte santé 2008 program).

Conflict of interest

Authors have no conflict of interest to declare.

Author information

Authors and Affiliations

  1. INSERM, CESP Centre for Research in Epidemiology and Population Health, UMRS 1018, Epidemiology of Diabetes, Obesity and Chronic Kidney Disease Over the Lifecourse, 94807, Villejuif, France

    B. Heude, A. Forhan & M. A. Charles

  2. University Paris-Sud, UMRS 1018, 94807, Villejuif, France

    B. Heude, A. Forhan & M. A. Charles

  3. University Hospital of Nancy, Regional Maternity, Nancy, France

    O. Thiébaugeorges, B. Foliguet & M. Schweitzer

  4. Gynaecology and Obstetrics Department, University Hospital of Poitiers, Poitiers, France

    V. Goua & G. Magnin

  5. INSERM, UMRS 953, Epidemiologic Research on Perinatal and Women’s and Children’s Health, 94807, Villejuif, France

    M. Kaminski

  6. UPMC Univ Paris 06, UMRS 953, 75005, Paris, France

    M. Kaminski

  7. INSERM U1018 Equipe 10, 16 Avenue Paul Vaillant Couturier, 94807, Villejuif cedex, France

    B. Heude

Authors
  1. B. Heude
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. O. Thiébaugeorges
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. V. Goua
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. A. Forhan
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. M. Kaminski
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. B. Foliguet
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. M. Schweitzer
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. G. Magnin
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. M. A. Charles
    View author publications

    You can also search for this author in PubMed Google Scholar

Consortia

The EDEN Mother–Child Cohort Study Group

Corresponding author

Correspondence to B. Heude.

Additional information

The EDEN Mother–Child Study group: M. A. Charles, M. de Agostini, A. Forhan, B. Heude, P. Ducimetière, M. Kaminski, M. J. Saurel-Cubizolles, P. Dargent, X. Fritel, B. Larroque, N. Lelong, L. Marchand, C. Nabet, I. Annesi-Maesano, R. Slama, V. Goua, G. Magnin, R. Hankard, O. Thiebaugeorges, M. Schweitzer, B. Foliguet, and N. Job-Spira.

Ethics Approval: The study was approved by the ethics committee (CCPPRB) of Kremlin Bicêtre and by the Data Protection Authority “Comission Nationale de l’Informatique et des Libertés” (CNIL). Written consents were obtained from the mother for herself at inclusion and for her newborn child after delivery.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Heude, B., Thiébaugeorges, O., Goua, V. et al. Pre-Pregnancy Body Mass Index and Weight Gain During Pregnancy: Relations with Gestational Diabetes and Hypertension, and Birth Outcomes. Matern Child Health J 16, 355–363 (2012). https://doi.org/10.1007/s10995-011-0741-9

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10995-011-0741-9

Keywords

Search

Navigation