Melissa S Bauserman, Department of Pediatrics, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
Carla M Bann, RTI International, Durham, NC, United States
K Michael Hambidge, Section of Nutrition, Department of Pediatrics, University of Colorado School of Medicine, Aurora, CO, United States
Ana L Garces, INCAP (Institute of Nutrition of Central America and Panama), Guatemala City, Guatemala
Lester Figueroa, INCAP (Institute of Nutrition of Central America and Panama), Guatemala City, Guatemala
Jamie L Westcott, Section of Nutrition, Department of Pediatrics, University of Colorado School of Medicine, Aurora, CO, United States
Jackie K Patterson, Department of Pediatrics, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
Elizabeth M McClure, RTI International, Durham, NC, United States
Vanessa R Thorsten, RTI International, Durham, NC, United States
Sumera Ali Aziz, Department of Community Health Sciences, Aga Khan University, Karachi, Pakistan
Sarah Saleem, Department of Community Health Sciences, Aga Khan University, Karachi, Pakistan
Robert L Goldenberg, Department of Obstetrics and Gynecology, Columbia University, New York, NY, United States
Richard Derman, Department of Global Affairs, Thomas Jefferson University, Philadelphia, PA, United StatesFollow
Veena Herekar, KLE Academy of Higher Education and Research's Jawaharlal Nehru Medical College, Karnataka, Belagavi, India
Manjunath Somannavar, KLE Academy of Higher Education and Research's Jawaharlal Nehru Medical College, Karnataka, Belagavi, India
Marion W Koso-Thomas, Pregnancy and Perinatology Branch, National Institute of Child Health and Human Development/NIH, Bethesda, MD, United States
Adrien L Lokangaka, Kinshasa School of Public Health, Kinshasa, Democratic Republic Congo
Antoinette K Tshefu, Kinshasa School of Public Health, Kinshasa, Democratic Republic Congo
Nancy F Krebs, Section of Nutrition, Department of Pediatrics, University of Colorado School of Medicine, Aurora, CO, United States
Carl L Bose, Department of Pediatrics, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
Shivaprasad Goudar, KLE Academy of Higher Education and Research's Jawaharlal Nehru Medical College, Karnataka, Belagavi, India
Sangappa Dhaded, KLE Academy of Higher Education and Research's Jawaharlal Nehru Medical College, Karnataka, Belagavi, India
Bhalchandra Kodkany, KLE Academy of Higher Education and Research's Jawaharlal Nehru Medical College, Karnataka, Belagavi, India
Omrana Pasha, Department of Community Health Sciences, Aga Khan University, Karachi, Pakistan
Abhik Das, RTI International, Durham, NC, United States
Menachem Miodovnik, Pregnancy and Perinatology Branch, National Institute of Child Health and Human Development/NIH, Bethesda, MD, United States
N K Raju Tonse, Pregnancy and Perinatology Branch, National Institute of Child Health and Human Development/NIH, Bethesda, MD, United States

Document Type

Article

Publication Date

8-1-2021

Comments

This article is the author's final published version in American Journal of Clinical Nutrition, Volume 114, Issue 2, August 2021, Pages 804 - 812

The published version is available at https://doi.org/10.1093/ajcn/nqab086

Copyright © The Author(s) 2021. Published by Oxford University Press on behalf of the American Society for Nutrition.

This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted reuse, distribution, and reproduction in any medium, provided the original work is properly cited

Abstract

BACKGROUND: Adequate gestational weight gain (GWG) is essential for healthy fetal growth. However, in low- and middle-income countries, where malnutrition is prevalent, little information is available about GWG and how it might be modified by nutritional status and interventions.

OBJECTIVE: We describe GWG and its associations with fetal growth and birth outcomes. We also examined the extent to which prepregnancy BMI, and preconception and early weight gain modify GWG, and its effects on fetal growth.

METHODS: This was a secondary analysis of the Women First Trial, including 2331 women within the Democratic Republic of Congo (DRC), Guatemala, India, and Pakistan, evaluating weight gain from enrollment to ∼12 weeks of gestation and GWG velocity (kg/wk) between ∼12 and 32 weeks of gestation. Adequacy of GWG velocity was compared with 2009 Institute of Medicine recommendations, according to maternal BMI. Early weight gain (EWG), GWG velocity, and adequacy of GWG were related to birth outcomes using linear and Poisson models.

RESULTS: GWG velocity (mean ± SD) varied by site: 0.22 ± 0.15 kg/wk in DRC, 0.30 ± 0.23 in Pakistan, 0.31 ± 0.14 in Guatemala, and 0.39 ± 0.13 in India, (P <0.0001). An increase of 0.1 kg/wk in maternal GWG was associated with a 0.13 cm (95% CI: 0.07, 0.18, P <0.001) increase in birth length and a 0.032 kg (0.022, 0.042, P <0.001) increase in birth weight. Compared to women with inadequate GWG, women who had adequate GWG delivered newborns with a higher mean length and weight: 47.98 ± 2.04 cm compared with 47.40 ± 2.17 cm (P <0.001) and 2.864 ± 0.425 kg compared with 2.764 ± 0.418 kg (P <0.001). Baseline BMI, EWG, and GWG were all associated with birth length and weight.

CONCLUSIONS: These results underscore the importance of adequate maternal nutrition both before and during pregnancy as a potentially modifiable factor to improve fetal growth.

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This work is licensed under a Creative Commons Attribution 4.0 License.

Additional Files
Gestational weight_supplemental_file.pdf (198 kB)

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English

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