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Pre-pregnancy Body Mass Index, Gestational Weight Gain, and Other Maternal Characteristics in Relation to Infant Birth Weight

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Abstract

Objectives Infant birth weight is influenced by modifiable maternal pre-pregnancy behaviors and characteristics. We evaluated the relationship among pre-pregnancy body mass index (BMI), gestational weight gain, and infant birth weight, in a prospective cohort study. Methods Women were enrolled at ≤20 weeks gestation, completed in-person interviews and had their medical records reviewed after delivery. Infant birth weight was first analyzed as a continuous variable, and then grouped into Low birth weight (LBW) (<2,500 g), normal birth weight (2,500–3,999 g), and macrosomia (≥4,000 g) in categorical analysis. Pre-pregnancy BMI and gestational weight gain were categorized based on Institute of Medicine BMI groups and gestational weight gain guidelines. Associations among infant birth weight and pre-pregnancy BMI, gestational weight gain, and other factors were evaluated using multivariate regression. Risk ratios were estimated using generalized linear modeling procedures. Results Pre-pregnancy BMI was independently and positively associated with infant birth weight (β = 44.7, P = 0.001) after adjusting for confounders, in a quadratic model. Gestational weight gain was positively associated with infant birth weight (β = 19.5, P < 0.001). Lower infant birth weight was associated with preterm birth (β = −965.4, P < 0.001), nulliparity (β = −48.6, P = 0.015), and female babies (β = −168.7, P < 0.001). Less than median gestational weight gain was associated with twice the risk of LBW (RR = 2.04, 95% CI 1.34–3.11). Risk of macrosomia increased with increasing pre-pregnancy BMI and gestational weight gain (P for linear trend <0.001). Conclusions These findings support the need to balance pre-pregnancy weight and gestational weight gain against the risk of LBW and macrosomia among lean and obese women, respectively.

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Acknowledgements

This research was supported in part by an award from the National Institutes of Health (HD 32562). We would like to acknowledge participants of the Omega Study for their voluntary participation in the study. The authors would like to thank Center for Perinatal Studies staff for their expert technical assistance.

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Authors and Affiliations

  1. Department of Health Services, University of Washington School of Public Health and Community Medicine, Seattle, WA, USA

    Ihunnaya O. Frederick, Anne E. Sales & Diane P. Martin

  2. Swedish Medical Center, Center for Perinatal Studies, 1124 Columbia Street, Suite 750, Seattle, WA, 98104, USA

    Ihunnaya O. Frederick & Michelle A. Williams

  3. Department of Epidemiology, University of Washington School of Public Health and Community Medicine, Seattle, WA, USA

    Michelle A. Williams

  4. Veterans’ Administration Puget Sound Health Care Systems, Seattle, WA, USA

    Anne E. Sales

  5. Faculty of Nursing, University of Alberta, Edmonton, AB, Canada

    Anne E. Sales

  6. Department of Family and Child Health Nursing, University of Washington School of Nursing, Seattle, WA, USA

    Marcia Killien

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  1. Ihunnaya O. Frederick
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  2. Michelle A. Williams
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Correspondence to Ihunnaya O. Frederick.

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Frederick, I.O., Williams, M.A., Sales, A.E. et al. Pre-pregnancy Body Mass Index, Gestational Weight Gain, and Other Maternal Characteristics in Relation to Infant Birth Weight. Matern Child Health J 12, 557–567 (2008). https://doi.org/10.1007/s10995-007-0276-2

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  • DOI: https://doi.org/10.1007/s10995-007-0276-2

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