Hostname: page-component-78c5997874-s2hrs Total loading time: 0 Render date: 2024-11-04T20:31:13.512Z Has data issue: false hasContentIssue false
  • English
  • Français

Examining the trimester-specific effects of low gestational weight gain on birthweight: the BOSHI study

Published online by Cambridge University Press:  22 April 2020

Mari S. Oba Open the ORCID record for Mari S. Oba [Opens in a new window] ,
Yoshitaka Murakami ,
Michihiro Satoh ,
Takahisa Murakami ,
Mami Ishikuro ,
Taku Obara ,
Kazuhiko Hoshi ,
Yutaka Imai ,
Takayoshi Ohkubo  and
Hiroto Metoki
Mari S. Oba*
Affiliation:
Department of Medical Statistics, Faculty of Medicine, Toho University, Tokyo, Japan
Yoshitaka Murakami
Affiliation:
Department of Medical Statistics, Faculty of Medicine, Toho University, Tokyo, Japan
Michihiro Satoh
Affiliation:
Division of Public Health, Hygiene and Epidemiology, Faculty of Medicine, Tohoku Medical and Pharmaceutical University, Miyagi, Japan
Takahisa Murakami
Affiliation:
Division of Public Health, Hygiene and Epidemiology, Faculty of Medicine, Tohoku Medical and Pharmaceutical University, Miyagi, Japan
Mami Ishikuro
Affiliation:
Department of Preventive Medicine and Epidemiology, Tohoku Medical Megabank Organization, Tohoku University, Miyagi, Japan
Taku Obara
Affiliation:
Department of Pharmacy, Tohoku University Hospital, Miyagi, Japan
Kazuhiko Hoshi
Affiliation:
Department of Gynecology and Obstetrics, Suzuki Memorial Hospital, Miyagi, Japan
Yutaka Imai
Affiliation:
Tohoku Institute for Management of Blood Pressure, Miyagi, Japan
Takayoshi Ohkubo
Affiliation:
Tohoku Institute for Management of Blood Pressure, Miyagi, Japan Department of Hygiene and Public Health, School of Medicine, Teikyo University, Tokyo, Japan
Hiroto Metoki
Affiliation:
Division of Public Health, Hygiene and Epidemiology, Faculty of Medicine, Tohoku Medical and Pharmaceutical University, Miyagi, Japan
*
Address for correspondence: Mari S. Oba, 5-21-16 Omori-nishi, Ota-ku, Tokyo, Japan143-8540. Email: mari.oba@med.toho-u.ac.jp
Get access Rights & Permissions [Opens in a new window]

Abstract

Low gestational weight gain (GWG) is a known risk factor of low birthweight. Although studies have previously examined the associations between GWG and birthweight, the period-specific effects of low GWG in each trimester remain unclear. This study aimed to quantify the trimester-specific direct effects of low GWG in Japanese women on birthweight. Using perinatal data from a cohort study, we analyzed pregnant women delivered at an obstetrics/gynecology hospital between October 2006 and May 2010. We focused on women with a pre-pregnancy body mass index (BMI) below 25 kg/m2. The exposure was low GWG. The gestation period was subdivided into trimesters, and the direct effects of low trimester-specific GWG on birthweight were estimated using marginal structural models. These models were guided by a direct acyclic graph that incorporated potential confounders, including pre-pregnancy BMI, age, smoking during pregnancy, height, and parity. We analyzed 563 women and their families. The mean cumulative GWG by the end of the first, second, and third trimesters was 0.9, 6.2, and 10.7 kg, respectively. Approximately 14.0% of the women gained total weight below the range recommended by Japanese Ministry of Health, Labour and Welfare. The direct effects of low GWG on birthweight were 65.9 g (95% confidence interval: 11.4, 120.5), −195.4 g (−263.4, −127.4), and −188.8 g (−292.0, −85.5) for the first, second, and third trimesters, respectively. Insufficient weight gain in the second and third trimesters had a negative impact on birthweight after adjusting for pre-pregnancy BMI and other covariates.

Keywords

Gestational weight gainbirthweightmarginal structural modeldirected acyclic graph
Type
Original Article
Information
Journal of Developmental Origins of Health and Disease , Volume 12 , Issue 2 , April 2021 , pp. 280 - 285
Check for updates
Copyright
© Cambridge University Press and the International Society for Developmental Origins of Health and Disease 2020

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Han, Z, Lutsiv, O, Mulla, S, et al. Low gestational weight gain and the risk of preterm birth and low birthweight: a systematic review and meta-analyses. Acta Obstet Gynecol Scand. 2011; 90, 935–954.CrossRefGoogle ScholarPubMed
Goldstein, RF, Abell, SK, Ranasinha, S, et al. Association of gestational weight gain with maternal and infant outcomes: a systematic review and meta-analysis. J Am Med Assoc. 2017; 317, 2207–2225.CrossRefGoogle ScholarPubMed
American College of Obstetricians and Gynecologists. Committee opinion no 548: weight gain during pregnancy. Obstet Gynecol. 2013; 121, 210–212.CrossRefGoogle Scholar
Goldstein, RF, Abell, SK, Ranasinha, S, et al. Gestational weight gain across continents and ethnicity: systematic review and meta-analysis of maternal and infant outcomes in more than one million women. BMC Med. 2018; 16, 153–166.CrossRefGoogle ScholarPubMed
Enomoto, K, Aoki, S, Toma, R, Fujiwara, K, Sakamaki, K, Hirahara, F. Pregnancy outcomes based on pre-pregnancy body mass index in Japanese women. PLoS One 2016; 11, e0157081.CrossRefGoogle ScholarPubMed
Morisaki, N, Nagata, C, Jwa, SC, et al. Pre-pregnancy BMI specific optimal gestational weight gain for women in Japan. J Epidemiol. 2017; 27, 492–498.CrossRefGoogle ScholarPubMed
Promotion Council for Healthy Parents and Children 21, Ministry of Health, Labour and Welfare. Ninsanpu no tame no shokuseikatu shishin (Guidelines of dietary intake for pregnant women). 2006. https://www.mhlw.go.jp/houdou/2006/02/h0201-3a.html. [last accessed 1 July 2019].Google Scholar
Director-general for statistics and information policy. Vital statistics in Japan: Trends up to 2016. Ministry of Health, Labour and Welfare. https://www.mhlw.go.jp/english/database/db-hw/dl/81-1a2en.pdf [last accessed 1 July 2019].Google Scholar
Ohmi, H, Hirooka, K, Hata, A, Mochizuki, Y. Recent trend of increase in proportion of low birthweight infants in Japan. Int J Epidemiol. 2001; 30, 1269–1271.CrossRefGoogle ScholarPubMed
Morisaki, N, Kawachi, I, Oken, E, Fujiwara, T. Social and anthropometric factors explaining racial/ethnical differences in birth weight in the United States. Sci Rep. 2017; 7, 46657.CrossRefGoogle ScholarPubMed
Sridhar, SB, Xu, F, Hedderson, MM. Trimester-specific gestational weight gain and infant size for gestational age. PLoS One 2016; 11, e0159500.CrossRefGoogle ScholarPubMed
Wander, PL, Sitlani, CM, Badon, SE, Siscovick, DS, Williams, MA, Enquobahrie, DA. Associations of early and late gestational weight gain with infant birth size. Matern Child Health J. 2015; 19, 2462–2469.CrossRefGoogle ScholarPubMed
Margerison-Zilko, CE, Shrimali, BP, Eskenazi, B, Lahiff, M, Lindquist, AR, Abrams, BF. Trimester of maternal gestational weight gain and offspring body weight at birth and age five. Matern Child Health J. 2012; 16, 1215–1223.CrossRefGoogle ScholarPubMed
Andersen, CS, Gamborg, M, Sørensen, TI, Nohr, EA. Weight gain in different periods of pregnancy and offspring’s body mass index at 7 years of age. Int J Pediatr Obes. 2011; 6, e179–186.CrossRefGoogle ScholarPubMed
Bayer, O, Ensenauer, R, Nehring, I, von Kries, R. Effects of trimester-specific and total gestational weight gain on children’s anthropometrics. BMC Pregnancy Childbirth. 2014; 14, 351–357.CrossRefGoogle ScholarPubMed
Hivert, MF, Rifas-Shiman, SL, Gillman, MW, Oken, E. Greater early and mid-pregnancy gestational weight gains are associated with excess adiposity in mid-childhood. Obesity. 2016; 24, 1546–1553.CrossRefGoogle ScholarPubMed
Karachaliou, M, Georgiou, V, Roumeliotaki, T, et al. Association of trimester-specific gestational weight gain with fetal growth, offspring obesity, and cardiometabolic traits in early childhood. Am J Obstet Gynecol. 2015; 212, 502.e1–14.CrossRefGoogle ScholarPubMed
Cole, SR, Platt, RW, Schisterman, EF, et al. Illustrating bias due to conditioning on a collider. Int J Epidemiol. 2010; 39, 417–420.CrossRefGoogle ScholarPubMed
Whitcomb, BW, Schisterman, EF, Perkins, NJ, Platt, RW. Quantification of collider-stratification bias and the birthweight paradox. Paediatr Perinat Epidemiol. 2009; 23, 394–402.CrossRefGoogle ScholarPubMed
Bandoli, G, Palmsten, K, Flores, KF, Chambers, CD. Constructing causal diagrams for common perinatal outcomes: benefits, limitations and motivating examples with maternal antidepressant use in pregnancy. Paediatr Perinat Epidemiol. 2016; 30, 521–528.CrossRefGoogle ScholarPubMed
Howe, LD, Smith, AD, Macdonald-Wallis, C, et al. Relationship between mediation analysis and the structured life course approach. Int J Epidemiol. 2016; 45, 1280–1294.Google ScholarPubMed
Metoki, H, Ohkubo, T, Watanabe, Y, et al. Seasonal trends of blood pressure during pregnancy in Japan: the babies and their parents’ longitudinal observation in Suzuki Memorial Hospital in Intrauterine Period study. J Hypertens. 2008; 26, 2406–2413.CrossRefGoogle ScholarPubMed
Ishikuro, M, Obara, T, Metoki, H, et al. Parity as a factor affecting the white-coat effect in pregnant women: the BOSHI study. Hypertens Res. 2015; 38, 770–775.CrossRefGoogle ScholarPubMed
Deputy, NP, Sharma, AJ, Kim, SY, Hinkle, SN. Prevalence and characteristics associated with gestational weight gain adequacy. Obstet Gynecol. 2015; 125, 773–781.CrossRefGoogle ScholarPubMed
Hunt, KJ, Alanis, MC, Johnson, ER, Mayorga, ME, Korte, JE. Maternal pre-pregnancy weight and gestational weight gain and their association with birthweight with a focus on racial differences. Matern Child Health J. 2013; 17, 85–94.CrossRefGoogle ScholarPubMed
Huang, X, Tan, H, Cai, M, Shi, T, Mi, C, Lei, J. Gestational weight gain in Chinese women - results from a retrospective cohort in Changsha, China. BMC Pregnancy Childbirth. 2018; 18, 185–194.CrossRefGoogle ScholarPubMed
Fujiwara, K, Aoki, S, Kurasawa, K, Okuda, M, Takahashi, T, Hirahara, F. Associations of maternal pre-pregnancy underweight with small-for-gestational-age and spontaneous preterm birth, and optimal gestational weight gain in Japanese women. J Obstet Gynaecol Res. 2014; 40, 988–994.CrossRefGoogle ScholarPubMed
Pölzlberger, E, Hartmann, B, Hafner, E, Stümpflein, I . Maternal height and pre-pregnancy weight status are associated with fetal growth patterns and newborn size. J Biosoc Sci. 2017; 49, 392–407 CrossRefGoogle ScholarPubMed
Robins, JM, Hernan, MA, Brumback, B. Marginal structural models and causal inference in epidemiology. Epidemiology. 2000; 11, 550–560.CrossRefGoogle ScholarPubMed
VanderWeele, TJ. Marginal structural models for the estimation of direct and indirect effect. Epidemiology. 2009; 20, 18–26.CrossRefGoogle Scholar
Pugh, SJ, Albert, PS, Kim, S, et al. Patterns of gestational weight gain and birthweight outcomes in the Eunice Kennedy Shriver National Institute of Child Health and Human Development Fetal Growth Studies-Singletons: a prospective study. Am J Obstet Gynecol. 2017; 217, 346.e1–11.CrossRefGoogle ScholarPubMed
McDonald, SD, Han, Z, Mulla, S, et al. High gestational weight gain and the risk of preterm birth and low birth weight: a systematic review and meta-analysis. J Obstetr Gynaecol Can. 2011; 33, 1223–1233.CrossRefGoogle ScholarPubMed
Tsai, YL, Chen, LC, Seow, KM, Chong, KM. The recommendations of the American Institute of Medicine (IOM) for normal and underweight women to reduce the risk of low birth weight. Taiwanese J Obstet Gynecol. 2015; 54, 1–7.CrossRefGoogle ScholarPubMed
Liang, H, Yin, C, Dong, X, Acharya, G, Li, X. Clusters of week-specific maternal gestational weight gain pattern and their association with birthweight: an observational cohort study. Acta Obstetricia et Gynecologica Scandinavica 2017; 96, 1251–1260.CrossRefGoogle Scholar
Sharma, AJ, Vesco, KK, Bulkley, J, et al. Associations of gestational weight gain with preterm birth among underweight and normal weight women. Matern Child Health J. 2015; 19, 2066–2073.CrossRefGoogle ScholarPubMed
Ruchat, SM, Allard, C, Doyon, M, et al. Timing of excessive weight gain during pregnancy modulates newborn anthropometry. J Obstet Gynaecol Can. 2016; 38, 108–117.CrossRefGoogle ScholarPubMed
De Stavola, BL, Nitsch, D, dos Santos Silva, I, et al. Statistical issues in life course epidemiology. Am J Epidemiol. 2006; 163, 84–96.CrossRefGoogle ScholarPubMed
La Bastide-van Gemert, S, Stolk, RP, van den Heuvel, ER, Fidler, V. Causal inference algorithms can be useful in life course epidemiology. J Clin Epidemiol. 2014; 67, 190–198.CrossRefGoogle ScholarPubMed
Hutcheon, JA, Bodnar, LM. Good practices for observational studies of maternal weight and weight gain in pregnancy. Paediatr Perinat Epidemiol. 2018; 32, 152–160.CrossRefGoogle ScholarPubMed
Brand, JS, Gaillard, R, West, J, et al. Associations of maternal quitting, reducing, and continuing smoking during pregnancy with longitudinal fetal growth: Findings from Mendelian randomization and parental negative control studies. PLoS Med. 2019; 16, e1002972.CrossRefGoogle ScholarPubMed
Knop, MR, Geng, TT, Gorny, AW, et al. Birth Weight and Risk of Type 2 Diabetes Mellitus, Cardiovascular Disease, and Hypertension in Adults: A Meta-Analysis of 7 646 267 Participants From 135 Studies. J Am Heart Assoc. 2018; 7, e008870.CrossRefGoogle ScholarPubMed
Supplementary material: File

Oba et al. Supplementary Materials

Oba et al. Supplementary Materials

Download Oba et al. Supplementary Materials(File)
File 20.9 KB