Risk factors for maternal low weight gain during pregnancy and associations with offspring body size and fat distribution.

摘要

Low maternal weight gain during pregnancy is a recognized risk factor for impaired fetal growth. Low maternal weight gain during pregnancy has even been linked to adult morbidities such as obesity, cardiovascular disease and diabetes. Little is known, however, about risk factors for maternal low weight gain during specific trimesters, or about how trimester-specific low weight gain is related to the likelihood of delivering a small-for-gestational-age (SGA) infant. Still less is known about how trimester-specific maternal low weight gain may affect offspring body size and composition during childhood, independent of size at birth.; The study population (n=984) for the present research was sampled from two metropolitan Atlanta hospitals, one located in the inner-city, one in a suburban environment. We first examined risk factors for trimester-specific low weight gain in a subset of 691 black and white women with prenatal care weight gain information for at least one trimester. The independent contribution of low weight gain in each trimester on the likelihood of an SGA delivery was then examined in a subset of 501 black and white women who had prenatal care weight gain information available for each trimester. Finally, in a subset sampled at offspring age 41/2 years (n=468), the association between low weight gain in each trimester and offspring body size and fat distribution was examined.; Associations between maternal prepregnancy body mass index (BMI), race, parity and low weight gain differed by trimester. In the 1st trimester, overweight white women and primiparous women were most likely to have low weight gain (Odds Ratio [OR], 95% Confidence Interval [CI] = 1.99, 1.04-2.87 and 1.88, 1.23-14.72, respectively). During the 2nd trimester, black women, in general, were at increased risk of low weight gain. The likelihood of 2nd trimester low weight gain was particularly strong among underweight black women (OR,95%CI=6.22, 2.83-14.72) and overweight black women (OR,95%CI=3.87, 2.11-7.10). During the 3rd trimester, underweight white women (OR,95%CI=3.26, 1.86-5.70) and grand multiparous women (OR,95%CI=2.29, 1.43-3.66) had the greatest likelihood of low weight gain. (Abstract shortened by UMI.)