Pregnancy weight gain by gestational age and stillbirth: a population‐based cohort study
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OBJECTIVE: To study the association between total and early pregnancy (<22 completed weeks) weight gain and risk of stillbirth, stratified by early-pregnancy body mass index (BMI). DESIGN: Population-based cohort study. SETTING: Stockholm-Gotland Region, Sweden. POPULATION: Pregnant women with singleton births (n = 160 560). METHODS: Pregnancy weight gain was standardised into gestational age-specific z-scores. For analyses of total pregnancy weight gain, a matched design with an incidence density sampling approach was used. Findings were also contrasted with current Institute of Medicine (IOM) weight gain recommendations. MAIN OUTCOME MEASURES: Stillbirth defined as fetal death at ≥22 completed weeks of gestation. RESULTS: For all BMI categories, there was no statistical association between total or early pregnancy weight gain and stillbirth within the range of a weight gain z-score of -2.0 SD to +2.0 SD. Among normal-weight women, the adjusted odds ratio of stillbirth for lower (-2.0 to -1.0 SD) and higher (+1.0 to +1.9 SD) total weight gain was 0.85 (95% CI; 0.48-1.49) and 1.03 (0.60-1.77), respectively, as compared with the reference category. Further, there were no associations between total or early pregnancy weight gain and stillbirth within the range of weight gain currently recommended by the IOM. For the majority of the BMI categories, the point estimates at the extremes of weight gain values (<-2.0SD and ≥2.0 SD) suggested protective effects of low weight gain and increased risks of high weight gain, but estimates were imprecise and not statistically significant. CONCLUSION: We found no associations between total or early pregnancy weight gain and stillbirth across the range of weight gain experienced by most women. TWEETABLE ABSTRACT: There was no association between weight gain during pregnancy and stillbirth among most women.
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Johansson et al. reported a greater risk of stillbirth with excessive GWG but only in women of normal weight pre-pregnancy.
“Johansson et al. 43 reported a greater risk of stillbirth with excessive GWG but only in women of normal weight pre‐pregnancy.”
From Overweight, obesity and excessive weight gain in pregnancy as risk factors for adverse pregnancy outcomes: A narrative review (2022) · cites this paper as [43]
The Results report a higher point estimate for stillbirth at extremely high total weight gain among normal-weight women, but its confidence interval includes no increase (aOR 1.63; 95% CI 0.37–7.11). The Conclusion calls this a trend requiring further study, not an established greater risk. The claim overstates the certainty of the finding and does not specify that it concerns extreme total weight gain. (LLM, conf=0.88)
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Cites
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Langley‐Evans, S. C., Pearce, J., & Ellis, S. (2022) · Journal of Human Nutrition and Dietetics · doi:10.1111/jhn.12999 · Cited by 288 · see citing works
The association between gestational weight gain z-score and stillbirth: a case-control study
Pickens, C. M., Hogue, C. J., Howards, P. P., Kramer, M. R., Badell, M. L., Dudley, D. J., Silver, R. M., Goldenberg, R. L., Pinar, H., Saade, G. R., et al. (2019) · BMC Pregnancy and Childbirth · doi:10.1186/s12884-019-2595-x · Cited by 11 · see citing works
- Authors
- Johansson, K., Hutcheon, J., Bodnar, L., Cnattingius, S., & Stephansson, O.
- Affiliations
- Karolinska Institutet (SE)
- Department of Obstetrics and Gynaecology University of British Columbia Vancouver Canada
- Department of Epidemiology Graduate School of Public Health University of Pittsburgh Pittsburgh Pennsylvania USA
- Corresponding author
- Johansson, K
- Venue
- BJOG: An International Journal of Obstetrics & Gynaecology
- Publisher
- Wiley
- Published
- 2017-12-28
- Volume
- 125
- Issue
- 8
- Pages
- 973-981
- ISSN
- 0306-5456 (ISSN-L)
- 1470-0328
- 1471-0528
- PMC
- PMC6032856
- OpenAlex
- W2769321084
- Cited by
- 28
- References
- 2
- Citations by year
- 2026: 2 · 2025: 2 · 2024: 3 · 2023: 7 · 2022: 4 · 2021: 3 · 2020: 3 · 2019: 1 · 2018: 1 · 2017: 1 · 2015: 1
- FWCI
- 1.93
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- Locations
- BJOG An International Journal of Obstetrics & Gynaecology (publishedVersion, cc-by-nc)
- Europe PMC (PubMed Central) (publishedVersion, other-oa)
- PubMed Central (publishedVersion, cc-by-nc)
- PubMed (publishedVersion)
- Funders
- Forskningsrådet om Hälsa, Arbetsliv och Välfärd (2014‐0073, 2015‐00251)
- Stockholms Läns Landsting (20140105, 20150179)
- Canadian Institutes of Health Research
- Michael Smith Foundation for Health Research
- Vetenskapsrådet (2013‐2429)
- Karolinska Institutet
- National Institute of Child Health and Human Development (R01 HD072008)
- Topics
- Health Sciences › Medicine › Obstetrics and Gynecology › Gestational Diabetes Research and Management
- Health Sciences › Health Professions › General Health Professions › Maternal and Neonatal Healthcare
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Obesity, Physical Activity, Diet
- Keywords
- gestational weight gain, stillbirth, body mass index, Institute of Medicine weight gain recommendations, fetal death, singleton pregnancy
- MeSH terms
- Gestational Weight Gain, Adult, Female, Fetal Death, Gestational Age, Humans, Pregnancy, Risk Factors, Sweden, Cohort Studies, Body Mass Index, Stillbirth, Young Adult
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