Attenuation of maternal weight gain impacts infant birthweight: Systematic review and meta-analysis

C. J. Bennett, R. E. Walker, M. L. Blumfield, J. Ma, F. Wang, Y. Wan, S. M. Gwini, H. Truby

Research output: Contribution to journalArticleResearchpeer-review

Abstract

Despite many interventions aiming to reduce excessive gestational weight gain (GWG), it is currently unclear the impact on infant anthropometric outcomes. The aim of this review was to evaluate offspring anthropometric outcomes in studies designed to reduce GWG. A systematic search of seven international databases, one clinical trial registry and three Chinese databases was conducted without date limits. Studies were categorised by intervention type: diet, physical activity (PA), lifestyle (diet + PA), other, gestational diabetes mellitus (GDM) (diet, PA, lifestyle, metformin and other). Meta-analyses were reported as weighted mean difference (WMD) for birthweight and birth length, and risk ratio (RR) for small for gestational age (SGA), large for gestational age (LGA), macrosomia and low birth weight (LBW). Collectively, interventions reduced birthweight, risk of macrosomia and LGA by 71 g (WMD: 70.67, 95% CI 101.90 to 39.43, P<0.001), 16% (RR: 0.84, 95% CI 0.73-0.98, P=0.026) and 19% (RR: 0.81, 95% CI 0.69-0.96, P=0.015), respectively. Diet interventions decreased birthweight and LGA by 99 g (WMD 98.80, 95% CI 178.85 to 18.76, P=0.016) and 65% (RR: 0.35, 95% CI 0.17-0.72, P=0.004). PA interventions reduced the risk of macrosomia by 51% (RR: 0.49, 95% CI 0.26-0.92, P=0.036). In women with GDM, diet and lifestyle interventions reduced birthweight by 211 and 296 g, respectively (WMD: 210.93, 95% CI 374.77 to 46.71, P=0.012 and WMD:295.93, 95% CI 501.76 to 90.10, P=0.005, respectively). Interventions designed to reduce excessive GWG lead to a small reduction in infant birthweight and risk of macrosomia and LGA, without influencing the risk of adverse outcomes including LBW and SGA.

Original languageEnglish
Pages (from-to)1-19
Number of pages19
JournalJournal of Developmental Origins of Health and Disease
DOIs
Publication statusAccepted/In press - 1 Nov 2018

Keywords

  • birthweight
  • gestational weight gain
  • macrosomia and large for gestational age
  • pregnancy

Cite this

@article{648b45c42f8340c7a56c25a570d0de62,
title = "Attenuation of maternal weight gain impacts infant birthweight: Systematic review and meta-analysis",
abstract = "Despite many interventions aiming to reduce excessive gestational weight gain (GWG), it is currently unclear the impact on infant anthropometric outcomes. The aim of this review was to evaluate offspring anthropometric outcomes in studies designed to reduce GWG. A systematic search of seven international databases, one clinical trial registry and three Chinese databases was conducted without date limits. Studies were categorised by intervention type: diet, physical activity (PA), lifestyle (diet + PA), other, gestational diabetes mellitus (GDM) (diet, PA, lifestyle, metformin and other). Meta-analyses were reported as weighted mean difference (WMD) for birthweight and birth length, and risk ratio (RR) for small for gestational age (SGA), large for gestational age (LGA), macrosomia and low birth weight (LBW). Collectively, interventions reduced birthweight, risk of macrosomia and LGA by 71 g (WMD: 70.67, 95{\%} CI 101.90 to 39.43, P<0.001), 16{\%} (RR: 0.84, 95{\%} CI 0.73-0.98, P=0.026) and 19{\%} (RR: 0.81, 95{\%} CI 0.69-0.96, P=0.015), respectively. Diet interventions decreased birthweight and LGA by 99 g (WMD 98.80, 95{\%} CI 178.85 to 18.76, P=0.016) and 65{\%} (RR: 0.35, 95{\%} CI 0.17-0.72, P=0.004). PA interventions reduced the risk of macrosomia by 51{\%} (RR: 0.49, 95{\%} CI 0.26-0.92, P=0.036). In women with GDM, diet and lifestyle interventions reduced birthweight by 211 and 296 g, respectively (WMD: 210.93, 95{\%} CI 374.77 to 46.71, P=0.012 and WMD:295.93, 95{\%} CI 501.76 to 90.10, P=0.005, respectively). Interventions designed to reduce excessive GWG lead to a small reduction in infant birthweight and risk of macrosomia and LGA, without influencing the risk of adverse outcomes including LBW and SGA.",
keywords = "birthweight, gestational weight gain, macrosomia and large for gestational age, pregnancy",
author = "Bennett, {C. J.} and Walker, {R. E.} and Blumfield, {M. L.} and J. Ma and F. Wang and Y. Wan and Gwini, {S. M.} and H. Truby",
year = "2018",
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Attenuation of maternal weight gain impacts infant birthweight : Systematic review and meta-analysis. / Bennett, C. J.; Walker, R. E.; Blumfield, M. L.; Ma, J.; Wang, F.; Wan, Y.; Gwini, S. M.; Truby, H.

In: Journal of Developmental Origins of Health and Disease, 01.11.2018, p. 1-19.

Research output: Contribution to journalArticleResearchpeer-review

TY - JOUR

T1 - Attenuation of maternal weight gain impacts infant birthweight

T2 - Systematic review and meta-analysis

AU - Bennett, C. J.

AU - Walker, R. E.

AU - Blumfield, M. L.

AU - Ma, J.

AU - Wang, F.

AU - Wan, Y.

AU - Gwini, S. M.

AU - Truby, H.

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N2 - Despite many interventions aiming to reduce excessive gestational weight gain (GWG), it is currently unclear the impact on infant anthropometric outcomes. The aim of this review was to evaluate offspring anthropometric outcomes in studies designed to reduce GWG. A systematic search of seven international databases, one clinical trial registry and three Chinese databases was conducted without date limits. Studies were categorised by intervention type: diet, physical activity (PA), lifestyle (diet + PA), other, gestational diabetes mellitus (GDM) (diet, PA, lifestyle, metformin and other). Meta-analyses were reported as weighted mean difference (WMD) for birthweight and birth length, and risk ratio (RR) for small for gestational age (SGA), large for gestational age (LGA), macrosomia and low birth weight (LBW). Collectively, interventions reduced birthweight, risk of macrosomia and LGA by 71 g (WMD: 70.67, 95% CI 101.90 to 39.43, P<0.001), 16% (RR: 0.84, 95% CI 0.73-0.98, P=0.026) and 19% (RR: 0.81, 95% CI 0.69-0.96, P=0.015), respectively. Diet interventions decreased birthweight and LGA by 99 g (WMD 98.80, 95% CI 178.85 to 18.76, P=0.016) and 65% (RR: 0.35, 95% CI 0.17-0.72, P=0.004). PA interventions reduced the risk of macrosomia by 51% (RR: 0.49, 95% CI 0.26-0.92, P=0.036). In women with GDM, diet and lifestyle interventions reduced birthweight by 211 and 296 g, respectively (WMD: 210.93, 95% CI 374.77 to 46.71, P=0.012 and WMD:295.93, 95% CI 501.76 to 90.10, P=0.005, respectively). Interventions designed to reduce excessive GWG lead to a small reduction in infant birthweight and risk of macrosomia and LGA, without influencing the risk of adverse outcomes including LBW and SGA.

AB - Despite many interventions aiming to reduce excessive gestational weight gain (GWG), it is currently unclear the impact on infant anthropometric outcomes. The aim of this review was to evaluate offspring anthropometric outcomes in studies designed to reduce GWG. A systematic search of seven international databases, one clinical trial registry and three Chinese databases was conducted without date limits. Studies were categorised by intervention type: diet, physical activity (PA), lifestyle (diet + PA), other, gestational diabetes mellitus (GDM) (diet, PA, lifestyle, metformin and other). Meta-analyses were reported as weighted mean difference (WMD) for birthweight and birth length, and risk ratio (RR) for small for gestational age (SGA), large for gestational age (LGA), macrosomia and low birth weight (LBW). Collectively, interventions reduced birthweight, risk of macrosomia and LGA by 71 g (WMD: 70.67, 95% CI 101.90 to 39.43, P<0.001), 16% (RR: 0.84, 95% CI 0.73-0.98, P=0.026) and 19% (RR: 0.81, 95% CI 0.69-0.96, P=0.015), respectively. Diet interventions decreased birthweight and LGA by 99 g (WMD 98.80, 95% CI 178.85 to 18.76, P=0.016) and 65% (RR: 0.35, 95% CI 0.17-0.72, P=0.004). PA interventions reduced the risk of macrosomia by 51% (RR: 0.49, 95% CI 0.26-0.92, P=0.036). In women with GDM, diet and lifestyle interventions reduced birthweight by 211 and 296 g, respectively (WMD: 210.93, 95% CI 374.77 to 46.71, P=0.012 and WMD:295.93, 95% CI 501.76 to 90.10, P=0.005, respectively). Interventions designed to reduce excessive GWG lead to a small reduction in infant birthweight and risk of macrosomia and LGA, without influencing the risk of adverse outcomes including LBW and SGA.

KW - birthweight

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