Meta Analysis: Effect of Inadequate Gestational Weight Gain on Low Birth Weight and Small for Gestational Age
DOI:
https://doi.org/10.26911/thejmch.2023.08.04.03Abstract
Background: Weight gain during pregnancy is related to optimizing health for both mother and baby. In addition, the increase in pregnancy weight is also an important indicator of maternal nutrition fulfillment during pregnancy and is a good measure to monitor fetal growth. This study aims to estimate the average effect of inadequate gestational weight gain on the risk of low birth weight and small for gestational age.
Subjects and Method: This was a systematic review and meta-analysis with PRISMA guideline and PICO model. Population: pregnant women. Intervention: inadequate gestational weight gain. Comparison: normal gestational weight gain. Outcome: low birth weight and small for gestational age. Online databases used are PubMed, SpringerLink, Scopus, and ProQuest with the keywords "Gestational Weight Gain" OR “Inadequate Weight Gain" AND "Low Birth Weight" OR "Birth Weight Infant” OR “Pregnancy Outcomes" AND "Small Gestational Age" AND "Multivariate" AND "Cohort". There were 19 cohort studies published in 2013-2022 that met the inclusion criteria. The analysis was conducted using the Review Manager 5.3 application.
Results: Meta-analysis using 19 cohort studies showed that pregnant women with inadequate weight gain had a risk of giving birth to infants with low birth weight 1.94 times compared to those with normal gestational weight (aOR= 1.94; CI 95%=1.74 to 2.16; p<0.001) and pregnant women with inadequate gestational weight gain had 1.69 times higher risk of giving birth to infants with small for gestational age than those with normal gestational weight (aOR= 1.69; 95% CI= 1.55 to 1.85; p<0.001).
Conclusion: Inadequate gestational weight gain increases the risk of low birth weight and small for gestational age.
Keywords: Pregnant women, gestational weight gain, low birth weight, small for gestational age
Correspondence: Maurizka Pitria Amrika Putranti. Master's Program in Public Health, Universitas Sebelas Maret. Jl. Ir. Sutami 36A, Surakarta 57126, Central Java, Indonesia. Email: maurizka27@gmail.com. Mobile: +6285290846373
References
Aji AS, Lipoteo NI, Yusrawati Y, Malik SG, Kusmayanti NA, Susanto I, Majidah NM, et al. (2022). Association between prepregnancy body mass index and gestational weight gain on pregnancy outcomes: a cohort study in Indonesian pregnant women. BMC Pregnancy and Childbirth. 22(492):1-12. https://doi.org/10.1186/s12884022048158.
Annie M, Dude MD, Grobman W, Haas D, Brian M, Mercer MD, Wapner R, et al. (2019). Gestational weight gain and pregnancy outcomes among nulliparous women. Am J Perinatol. 9(3): 1-9. https://doi.org/10.1055/s00391696640.
Badshah S, Mason L, McKelvie K, Payne R, Lisboa PJG (2018). Risk factors for low birthweight in the public-hospitals at Peshawar, NWFP-Pakistan. BMC Public Health. 197(08): 11-21. https://doi.org/10.1186/1471-2458-8-197.
CDC (2022) How much weight should you gain during pregnancy?. Retrieved fom: https://www.cdcgov/repro ductive-health/maternal-infant-health/pregnancy-weight-gain.
Chen CN, Chen HS, Hsu HC (2020). Maternal prepregnancy body mass index, gestational weight gain, and risk of adverse perinatal outcomes in Taiwan: a population-based birth cohort study. Int J Environ Res Public Health. 17(12):1-11. https://doi.org/:10.3390/ijerph17041221
Choi H, Lim JH, Lim NK, Ryu HM, Kwak DW, Chung JH, Park HJ, Park HY (2020). Impact of pre-pregnancy body mass index and gestational weight gain on the risk of maternal and infant pregnancy complications in Korean women. IJO. 46:59
Chung CGY, Rennae S, Taylor A, John MD, Thompson BI, Ngaire H, Anderson AI (2013). Gestational weight gain and adverse pregnancy outcomes in a nulliparous cohort. Eur J Obstet Gynecol. 167(13):149–153. http://dx.doiorg/10.1016 /j.ejogrb.2012.11.020
Critical Appraisal Skills Programme (2018). CASP (Cohort Study) Checklist. Retrieved from: https://caspuk.net/ images/checklist/documents/CASP-Cohort-Study-Checklist/CASP-Cohort-Study-Checklist_2018.pdf.
Deeks JJ, Higgins JPT, Altman DG (2021). Chapter 10: Analysing data and undertaking meta-analyses. In cochrane handbook for systematic reviews of interventions version 6.2. 1(9): 231-245.
Enomoto K, Aoki S, Toma R, Fujiwara K, Sakamaki K, Hirahara F (2016). Preg-nancy outcomes based on pre-pregnancy body mass index in Japanese women. Plos One. 11(6): 1-12. https://doi.org/10.1371/journal.pone.0157081
Fayed A, Hayfaa A, Wahabi, Esmaeil S, Elkouny R, Elmorshedy H, Bakhsh H (2022). Independent effect of gestational weight gain and prepregnancy obesity on pregnancy outcomes among Saudi women: a sub-cohort analysis from Riyadh mother and baby cohort study (RAHMA). Plos One. 17(1):1-14. doi: https://doi.org/10. 1371/journal.pone.0262437.
Goldstein RF, Abell SK, Ranasinha S, Misso M, Boyle JA, Black MH, Rode EL, et al. (2017). Association of gestational weight gain with maternal and infant outcomes: a systematic review and meta-analysis. JAMA. 317(21):2207–2225. doi: https://doi.org/10.1055/s00391696640.
He S, Allen JC, Razali NS, Chern BS, Tan KH (2022). Association between gestational weight gain and pregnancy outcomes in Singaporean population: a prospective cohort study. Eur J Obstet Gynecol Reprod Biol. 272(1): 160–165. doi: https://doi.org/10.1016/j.ejogrb.2022.03.031.
Hector D, Hebden L (2013). Prevention of excessive gestational weight gain: An e vidence review to inform policy and practice. Sydney by Scholarship. Retrieved from: https://core.ac.uk/download/pdf/41237141.pdf. Diakses Januari 2023.
Hung TH, Chen SF, Hsu JJ, Hsieh TT (2015). Gestational weight gain and risks for adverse perinatal outcomes: a retrospective cohort study based on the 2009 Institute of Medicine guidelines. The TJOG. 54(2015). 421-425. doi: http://doi.org/10.1016/j.tjog.2015.06.010.
Hung TH, Hsieh TT (2016). Pregestational body mass index, gestational weight gain, and risks for adverse pregnancy outcomes among Taiwanese women: A retrospective cohort study. The TJOG. 55(2016)575-581. doi: http://dx.doi. org/10.1016/j.tjog.2016.06.016.
Johnson CD, Jones S, Paranjothy S (2017). Reducing low birth weight: prioritizing action to address modifiable risk factors. J Public Health. 39(1). doi: https://doi.org/10.1093/pubmed/fdv212.
Li N, Liu E, Guo J, Pan L, Li B, Wang P, Liu J, et al. (2013). Maternal prepregnancy body mass index and gestational weight gain on pregnancy outcomes. PLoS One. 8(12):1-7. doi: https://doi.org/10.1371/journal.pone.0082310.
Li C, Liu Y, Zhang W (2015). Joint and independent associations of gestational weight gain and pre-pregnancy body mass index with outcomes of pregnancy in Chinese women: a retrospective cohort study. Plos One. 10(8): 1-15. doi: https://doi.org/10.1371/journal.pone.0136850.
Maisa N, Feghali MD, Janet M, Zantow E, Mission J, Steve N, Caritis MD, et al. (2019). Timing of gestational weight gain and adverse perinatal outcomes in overweight and obese women. 5(11): 1-9. doi: https://doi.org/961970.10. 1097/AOG.0000000000003234.
Murti B (2018). Prinsip dan metode riset epidemiologi (Epidemiological research principles and methods). Surakarta: UNS Press.
Ota E, Togoobaatar G, Morisaki N, Vogel J, Pileggi C (2014). Risk factors and adverse perinatal outcomes among-term and preterm infants born small-for- gestational-age: secondary analyses of the WHO multi-country survey on maternal and newborn health. PLos ONE. 9(8):1–10. doi: https://doi.org/10.1371/journal
Rafei RE, Hussein AA, Charafeddine L, Nakad P, Bizri AA, Hamod D, Khalid AY (2016). Association of pre-pregnancy body mass index and gestational weight gain with preterm births and fetal size: an observational study from Lebanon. Paediatr Perinat Epidemiol. 30(3):38–45. doi: https://doi. org/0.1111/ppe.12249
Siega-Riz, AM, Viswanathan M, Moos MK, Deierlein A, Mumford, S, Knaack J, Thieda P, et al. (2019). a systematic review of outcomes of maternal weight gain according to the Institute of Medicine recommendations: birth-weight, fetal growth, and postpartum weight retention. Am J Obstet Gynecol. 201(4). doi: https://doi.org/10.1016/j.ajog.2009. 07.002.
Soltani H, Lipoteo NI, Fair FJ, Yusrawati Y (2017). Pre-pregnancy body mass index and gestational weight gain and their effects on pregnancy and birth outcomes: a cohort study in West Sumatra, Indonesia. BMC Women's Health. 17(102). 1-12. doi: https://doi.org/10.1186/s1290501704552.
Su WJ, Chen YL, Huang PY, Shi XL, Yan FF, Chen Z, Yan B, et al. (2019). Effects of prepregnancy body mass index, weight gain, and gestational diabetes mellitus on pregnancy outcomes: a population-based study in Xiamen, China: 2011-2018. Ann Nutr Metab: 75(1): 31–38. doi: https://doi.org/10.1186/s12884022048158
Sun Y, Shen Z, Zhan Y, Wang Y, Ma S, Zhang S, Liu J, et al. (2020). Effects of pre-pregnancy body mass index and gestational weight gain on maternal and infant complications. BMC Pregnancy and Childbirth. 20(390);1-13. doi: https://doi.org/10.1186/s1288402003071y.
Tela FG, Bezabih AM, Adhanu AK (2019). Effect of pregnancy weight gain on infant birth weight among mothers attending antenatal care from private clinics in Mekelle City, Northern Ethiopia: a facility-based follow-up study. Plos One. 14(3):1-10. doi: https://doi.org/10.1371/ journal.pone.0212424.
Wang D, Wang M, Darling AM, Perumal N, Liu E, Danaei G, Fawzi WW (2020). Gestational weight gain in low-income and middle-income countries: a modelling analysis using nationally representative data. BMJ Glob Heal. 5-(11):1–9. doi: https://doi.org/10.1136/bmjgh2020003423.
Wu W, Luo D, Ruan X, Gu C, Lu W, Lian K, Mu X (2022). Polymorphisms in gene MTHFR modify the association between gestational weight gain and ad-verse birth outcomes. Front. Nutr. 9(8):1-11. doi: https://doi.org/10. 3389/fnut.2022.919651.
WHO (2014). Low birth weight policy brief. Department of nutrition for health and development. 1–8. Retrieved from: https://www.who.int/nutrition. Diakses March 2023.
WHO (2016) Global nutrition targets 2025 low birth weight policy brief. Retrieved from: https://apps.who.int/nutri tion/publications/globaltargets2025_policybrief_lbw/en/ index.html.
Yang J, Wang M, Deirdre K, Tobias, Janet W, Edwards R, Darling AM, et al. (2022) Gestational weight gain during the second and third trimesters and adverse pregnancy outcomes, results from a prospective pregnancy cohort in urban Tanzania. Reproductive Health. 9(140): 1-11. doi: https://doi.org/10.1186/s12978022014417.
Zhang CX, Lai JQ, Liu KY, Yang NH, Zeng G, Mao LM, Li ZN, et al. (2021). Optimal gestational weight gain in Chinese pregnant women by Chinese-specific BMI categories: a multicentre prospective cohort study. Public Health Nutr. 24(11): 3210–3220. doi: https://doi.org/10.1017/S136898 0021001622.
Zhao R, Xu L, Wu ML, Huang SH, Cao XJ (2018). Maternal prepregnancy body mass index, gestational weight gain influence birth weight. Women and Birth. 31(8):20-25. doi: http://dx.doi.org/10.1016/j.wombi.2017.06.003.
