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Cited by 122Gestational Diabetes Research and ManagementMaternal and Neonatal HealthcareBirth, Development, and Health

Weight Loss Instead of Weight Gain within the Guidelines in Obese Women during Pregnancy: A Systematic Review and Meta-Analyses of Maternal and Infant Outcomes

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Kapadia, Mufiza Zia, Park, Christina K., Beyene, Joseph, Giglia, Lucy, Maxwell, Cindy, McDonald, Sarah D.·2015·PLOS ONE
DOI 10.1371/journal.pone.0132650PMC PMC4509670
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Abstract

BACKGROUND: Controversy exists about how much, if any, weight obese pregnant women should gain. While the revised Institute of Medicine guidelines on gestational weight gain (GWG) in 2009 recommended a weight gain of 5-9 kg for obese pregnant women, many studies suggested even gestational weight loss (GWL) for obese women. OBJECTIVES: A systematic review was conducted to summarize pregnancy outcomes in obese women with GWL compared to GWG within the 2009 Institute of Medicine guidelines (5-9 kg). DESIGN: Five databases were searched from 1 January 2009 to 31 July 2014. The Cochrane Handbook for Systematic Reviews of Interventions and the PRISMA Statement were followed. A modified version of the Newcastle-Ottawa scale was used to assess individual study quality. Small for gestational age (SGA), large for gestational age (LGA) and preterm birth were our primary outcomes. RESULTS: Six cohort studies were included, none of which assessed preterm birth. Compared to GWG within the guidelines, women with GWL had higher odds of SGA <10th percentile (adjusted odds ratio [AOR] 1.76; 95% confidence interval [CI] 1.45-2.14) and SGA <3rd percentile (AOR 1.62; 95% CI 1.19-2.20) but lower odds of LGA >90th percentile (AOR 0.57; 95% CI 0.52-0.62). There was a trend towards a graded relationship between SGA <10th percentile and each of three obesity classes (I: AOR 1.73; 95% CI 1.53-1.97; II: AOR 1.63; 95% CI 1.44-1.85 and III: AOR 1.39; 95% CI 1.17-1.66, respectively). CONCLUSION: Despite decreased odds of LGA, increased odds of SGA and a lack of information on preterm birth indicate that GWL should not be advocated in general for obese women.

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  • Gestational weight gain below guidelines was associated with a significant reduction in gestational hypertension risk in an analysis that drew on data from 18 cohort studies.

    “GWG below guidelines was associated with a significant reduction in GHT risk in an analysis that drew on data from 18 cohort studies. 62”

    From Overweight, obesity and excessive weight gain in pregnancy as risk factors for adverse pregnancy outcomes: A narrative review (2022) · cites this paper as [62]

    The Abstract (Results) says this review included six cohort studies, not 18. The Discussion reports no association between gestational weight loss and gestational hypertension in the single study assessing that outcome, contrary to the claimed significant reduction. The review specifically studied weight loss rather than all weight gain below guidelines. (LLM, conf=0.91)

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Cited by

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Authors
Kapadia, M. Z., Park, C. K., Beyene, J., Giglia, L., Maxwell, C., & McDonald, S. D.
Affiliations
  • McMaster University (CA)
  • Mount Sinai Hospital (CA)
Corresponding author
McDonald, Sarah D.
ORCID
McDonald, Sarah D.
Venue
PLOS ONE
Publisher
Public Library of Science (PLoS)
Published
2015-07-21
Volume
10
Issue
7
Pages
e0132650
ISSN
1932-6203 (ISSN-L)
DOI
10.1371/journal.pone.0132650
PMC
PMC4509670
OpenAlex
W1549059776
Cited by
122
References
7
Citations by year
2026: 7 · 2025: 8 · 2024: 8 · 2023: 10 · 2022: 16 · 2021: 14 · 2020: 9 · 2019: 15 · 2018: 16 · 2017: 8 · 2016: 8 · 2015: 3
FWCI
1.72
Type
journal article
Language
en
Open access
Licence
Locations
  • PLoS ONE (publishedVersion, cc-by)
  • Europe PMC (PubMed Central) (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • RePEc: Research Papers in Economics (submittedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion)
  • Figshare (submittedVersion, cc-by)
Funders
  • McMaster University
  • Canada Research Chairs (950-229920)
  • Canadian Institutes of Health Research (950-229920, KRS134301, CNI95357)
  • Division of Graduate Education
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 › Pediatrics, Perinatology and Child Health › Birth, Development, and Health
Keywords
gestational weight gain, maternal obesity, obese pregnant women, Institute of Medicine guidelines, small for gestational age, large for gestational age, preterm birth, infant outcomes
MeSH terms
Female, Humans, Infant, Newborn, Infant, Small for Gestational Age, Obesity, Pregnancy, Pregnancy Complications, Pregnancy Outcome, Weight Gain, Weight Loss, Premature Birth

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