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

Part of: DOHaD on International Women's Day 2020

Published online by Cambridge University Press:  09 November 2018

C. J. Bennett ,
R. E. Walker ,
M. L. Blumfield ,
J. Ma ,
F. Wang ,
Y. Wan ,
S. M. Gwini  and
H. Truby
C. J. Bennett*
Affiliation:
Department of Nutrition and Dietetics, Faculty of Medicine, Nursing and Health Sciences, School of Clinical Sciences, Monash University, Clayton, VIC, Australia
R. E. Walker
Affiliation:
Department of Nutrition and Dietetics, Faculty of Medicine, Nursing and Health Sciences, School of Clinical Sciences, Monash University, Clayton, VIC, Australia
M. L. Blumfield
Affiliation:
Department of Nutrition and Dietetics, Faculty of Medicine, Nursing and Health Sciences, School of Clinical Sciences, Monash University, Clayton, VIC, Australia
J. Ma
Affiliation:
Institute of Nutrition and Food Hygiene, School of Public Health, Lanzhou University, Lanzhou, China
F. Wang
Affiliation:
Department of Food Science and Nutrition, Zhejiang University, Hangzhou, China
Y. Wan
Affiliation:
Department of Food Science and Nutrition, Zhejiang University, Hangzhou, China
S. M. Gwini
Affiliation:
School of Public Health and Preventive Medicine, Monash University, Clayton, VIC, Australia
H. Truby
Affiliation:
Department of Nutrition and Dietetics, Faculty of Medicine, Nursing and Health Sciences, School of Clinical Sciences, Monash University, Clayton, VIC, Australia
*
Address for correspondence: C. J. Bennett, Be Active Sleep Eat (BASE) Facility, Department of Nutrition and Dietetics, Faculty of Health and Medicine, Monash University, Level 1, 268 Ferntree Gully Rd, Notting Hill, VIC 3186, Australia. E-mail: Christie.bennett@monash.edu
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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

birthweightgestational weight gainmacrosomia and large for gestational agepregnancy
Type
Review
Information
Journal of Developmental Origins of Health and Disease , Volume 10 , Issue 4 , August 2019 , pp. 387 - 405
Copyright
© Cambridge University Press and the International Society for Developmental Origins of Health and Disease 2018 

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