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Published in: BMC Pregnancy and Childbirth 1/2019

Open Access 01-12-2019 | Obesity | Research article

Are women in Singapore gaining weight appropriately during pregnancy: a prospective cohort study

Authors: Song He, John Carson Allen, Nurul Syaza Razali, Nyo Mie Win, Jun Jim Zhang, Mor Jack Ng, George Seow Heong Yeo, Bernard Su Min Chern, Kok Hian Tan

Published in: BMC Pregnancy and Childbirth | Issue 1/2019

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Abstract

Background

We aimed to study gestational weight gain (GWG) in a Singaporean population and compare it with Institute of Medicine (IOM) 2009 GWG guidelines.

Methods

Nine hundred twenty-six women with low-risk singleton pregnancy were enrolled in a prospective cohort study from 2010 to 2014 in a Singapore tertiary maternity hospital. Seven hundred twenty-four patients had maternal weight information till term pregnancy and were included in analysis. Participants were categorized according to their first antenatal visit body mass index (BMI) as underweight, normal weight, overweight and obese. Total GWG for each BMI group was calculated. Multivariate logistic regression was performed to determine the predictors of total GWG above and below IOM guidelines.

Results

Obese women had a mean total GWG (9.1 kg) that exceeded the upper limit IOM guidelines (9 kg). In multivariate analysis of predictors of total GWG above IOM guidelines, being overweight (adjusted OR: 3.91 [95% CI, 2.60–5.88]; p < .0001) and obese (adjusted OR: 4.78 [95% CI, 2.80, 8.15]; p < .0001) significantly increased the risks of gaining weight above IOM guidelines during pregnancy, compared to being normal weight.

Conclusions

Overweight and obesity are independent significant risk factors for gaining excessive gestational weight. Appropriate weight management for overweight and obese Singaporean women prior to and during pregnancy is important.
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Literature
1.
go back to reference Goldstein RF, Abell SK, Ranasinha S, Misso M, Boyle JA, Black MH, et al. Association of gestational weight gain with maternal and infant outcomes: a systematic review and meta-analysis. JAMA. 2017;317(21):2207–25.CrossRef Goldstein RF, Abell SK, Ranasinha S, Misso M, Boyle JA, Black MH, et al. Association of gestational weight gain with maternal and infant outcomes: a systematic review and meta-analysis. JAMA. 2017;317(21):2207–25.CrossRef
2.
go back to reference Siega-Riz AM, Viswanathan M, Moos M-K, Deierlein A, Mumford S, Knaack J, et al. A systematic review of outcomes of maternal weight gain according to the Institute of Medicine recommendations: birthweight, fetal growth, and postpartum weight retention. Am J Obstet Gynecol. 2009;201(4):339.e1–14.CrossRef Siega-Riz AM, Viswanathan M, Moos M-K, Deierlein A, Mumford S, Knaack J, et al. A systematic review of outcomes of maternal weight gain according to the Institute of Medicine recommendations: birthweight, fetal growth, and postpartum weight retention. Am J Obstet Gynecol. 2009;201(4):339.e1–14.CrossRef
3.
go back to reference Obstetricians AC of, Gynecologists, others. ACOG. Committee opinion no. 548: weight gain during pregnancy. Obstet Gynecol. 2013;121(1):210.CrossRef Obstetricians AC of, Gynecologists, others. ACOG. Committee opinion no. 548: weight gain during pregnancy. Obstet Gynecol. 2013;121(1):210.CrossRef
4.
go back to reference Institute of Medicine (US) and National Research Council (US) Committee to Reexamine IOM Pregnancy Weight Guidelines. In: Rasmussen KM, Yaktine AL, editors. Weight Gain During Pregnancy: Reexamining the Guidelines [Internet]. Washington (DC): National Academies Press (US); 2009. Cited 2019 Feb 6]. (The National Academies Collection: Reports funded by National Institutes of Health). Available from: http://www.ncbi.nlm.nih.gov/books/NBK32813/. Institute of Medicine (US) and National Research Council (US) Committee to Reexamine IOM Pregnancy Weight Guidelines. In: Rasmussen KM, Yaktine AL, editors. Weight Gain During Pregnancy: Reexamining the Guidelines [Internet]. Washington (DC): National Academies Press (US); 2009. Cited 2019 Feb 6]. (The National Academies Collection: Reports funded by National Institutes of Health). Available from: http://​www.​ncbi.​nlm.​nih.​gov/​books/​NBK32813/​.
5.
go back to reference Brawarsky P, Stotland NE, Jackson RA, Fuentes-Afflick E, Escobar GJ, Rubashkin N, et al. Pre-pregnancy and pregnancy-related factors and the risk of excessive or inadequate gestational weight gain. Int J Gynaecol Obstet Off Organ Int Fed Gynaecol Obstet. 2005;91(2):125–31.CrossRef Brawarsky P, Stotland NE, Jackson RA, Fuentes-Afflick E, Escobar GJ, Rubashkin N, et al. Pre-pregnancy and pregnancy-related factors and the risk of excessive or inadequate gestational weight gain. Int J Gynaecol Obstet Off Organ Int Fed Gynaecol Obstet. 2005;91(2):125–31.CrossRef
6.
go back to reference Godoy AC, Do NSL, Surita FG. A systematic review and meta-analysis of gestational weight gain recommendations and related outcomes in Brazil. Clinics (Sao Paulo). 2015;70(11):758–64.CrossRef Godoy AC, Do NSL, Surita FG. A systematic review and meta-analysis of gestational weight gain recommendations and related outcomes in Brazil. Clinics (Sao Paulo). 2015;70(11):758–64.CrossRef
7.
go back to reference Rosal MC, Wang ML, Moore Simas TA, Bodenlos JS, Crawford SL, Leung K, et al. Predictors of gestational weight gain among white and Latina women and associations with birth weight. J Pregnancy. 2016;2016:8984928.CrossRef Rosal MC, Wang ML, Moore Simas TA, Bodenlos JS, Crawford SL, Leung K, et al. Predictors of gestational weight gain among white and Latina women and associations with birth weight. J Pregnancy. 2016;2016:8984928.CrossRef
8.
go back to reference Stotland NE, Cheng YW, Hopkins LM, Caughey AB. Gestational weight gain and adverse neonatal outcome among term infants. Obstet Gynecol. 2006;108(3 Pt 1):635–43.CrossRef Stotland NE, Cheng YW, Hopkins LM, Caughey AB. Gestational weight gain and adverse neonatal outcome among term infants. Obstet Gynecol. 2006;108(3 Pt 1):635–43.CrossRef
9.
go back to reference Enomoto K, Aoki S, Toma R, Fujiwara K, Sakamaki K, Hirahara F. Pregnancy outcomes based on pre-pregnancy body mass index in Japanese women. PLoS One. 2016;11(6):e0157081.CrossRef Enomoto K, Aoki S, Toma R, Fujiwara K, Sakamaki K, Hirahara F. Pregnancy outcomes based on pre-pregnancy body mass index in Japanese women. PLoS One. 2016;11(6):e0157081.CrossRef
10.
go back to reference Hung T-H, Hsieh T-T. Pregestational body mass index, gestational weight gain, and risks for adverse pregnancy outcomes among Taiwanese women: a retrospective cohort study. Taiwan J Obstet Gynecol. 2016;55(4):575–81.CrossRef Hung T-H, Hsieh T-T. Pregestational body mass index, gestational weight gain, and risks for adverse pregnancy outcomes among Taiwanese women: a retrospective cohort study. Taiwan J Obstet Gynecol. 2016;55(4):575–81.CrossRef
11.
go back to reference Suzuki S. Gestational weight gain in Japanese women with favorable perinatal outcomes. J Clin Med Res. 2017 Jan;9(1):64–6.CrossRef Suzuki S. Gestational weight gain in Japanese women with favorable perinatal outcomes. J Clin Med Res. 2017 Jan;9(1):64–6.CrossRef
12.
go back to reference Suzuki S. Optimal weight gain during pregnancy in Japanese women. J Clin Med Res. 2016 Nov;8(11):787–92.CrossRef Suzuki S. Optimal weight gain during pregnancy in Japanese women. J Clin Med Res. 2016 Nov;8(11):787–92.CrossRef
13.
go back to reference Tanaka T, Ashihara K, Nakamura M, Kanda T, Fujita D, Yamashita Y, et al. Associations between the pre-pregnancy body mass index and gestational weight gain with pregnancy outcomes in Japanese women. J Obstet Gynaecol Res. 2014 May;40(5):1296–303.CrossRef Tanaka T, Ashihara K, Nakamura M, Kanda T, Fujita D, Yamashita Y, et al. Associations between the pre-pregnancy body mass index and gestational weight gain with pregnancy outcomes in Japanese women. J Obstet Gynaecol Res. 2014 May;40(5):1296–303.CrossRef
14.
go back to reference Xiong C, Zhou A, Cao Z, Zhang Y, Qiu L, Yao C, et al. Association of pre-pregnancy body mass index, gestational weight gain with cesarean section in term deliveries of China. Sci Rep. 2016 Nov 22;6:37168.CrossRef Xiong C, Zhou A, Cao Z, Zhang Y, Qiu L, Yao C, et al. Association of pre-pregnancy body mass index, gestational weight gain with cesarean section in term deliveries of China. Sci Rep. 2016 Nov 22;6:37168.CrossRef
15.
go back to reference Lim WY, Saw SM, Tan KH, Yeo GS, Kwek KY. A cohort evaluation on arterial stiffness and hypertensive disorders in pregnancy. BMC Pregnancy Childbirth. 2012;12:160.CrossRef Lim WY, Saw SM, Tan KH, Yeo GS, Kwek KY. A cohort evaluation on arterial stiffness and hypertensive disorders in pregnancy. BMC Pregnancy Childbirth. 2012;12:160.CrossRef
16.
go back to reference Cedergren MI. Optimal gestational weight gain for body mass index categories. Obstet Gynecol. 2007 Oct;110(4):759–64.CrossRef Cedergren MI. Optimal gestational weight gain for body mass index categories. Obstet Gynecol. 2007 Oct;110(4):759–64.CrossRef
18.
go back to reference Hales CM, Fryar CD, Carroll MD, Freedman DS, Ogden CL. Trends in obesity and severe obesity prevalence in US youth and adults by sex and age, 2007-2008 to 2015-2016. JAMA. 2018 Apr 24;319(16):1723.CrossRef Hales CM, Fryar CD, Carroll MD, Freedman DS, Ogden CL. Trends in obesity and severe obesity prevalence in US youth and adults by sex and age, 2007-2008 to 2015-2016. JAMA. 2018 Apr 24;319(16):1723.CrossRef
19.
go back to reference Lee YS, Biddle S, Chan MF, Cheng A, Cheong M, Chong YS, et al. Health promotion board–Ministry of Health clinical practice guidelines: obesity. Singap Med J. 2016 Jun;57(6):292.CrossRef Lee YS, Biddle S, Chan MF, Cheng A, Cheong M, Chong YS, et al. Health promotion board–Ministry of Health clinical practice guidelines: obesity. Singap Med J. 2016 Jun;57(6):292.CrossRef
20.
go back to reference Ee TX, Allen JC, Malhotra R, Koh H, Østbye T, Tan TC. Determining optimal gestational weight gain in a multiethnic Asian population. J Obstet Gynaecol Res. 2014;40(4):1002–8.CrossRef Ee TX, Allen JC, Malhotra R, Koh H, Østbye T, Tan TC. Determining optimal gestational weight gain in a multiethnic Asian population. J Obstet Gynaecol Res. 2014;40(4):1002–8.CrossRef
21.
go back to reference Expert Consultation WHO. Appropriate body-mass index for Asian populations and its implications for policy and intervention strategies. Lancet Lond Engl. 2004;363(9403):157–63.CrossRef Expert Consultation WHO. Appropriate body-mass index for Asian populations and its implications for policy and intervention strategies. Lancet Lond Engl. 2004;363(9403):157–63.CrossRef
22.
go back to reference Du M-K, Ge L-Y, Zhou M-L, Ying J, Qu F, Dong M-Y, et al. Effects of pre-pregnancy body mass index and gestational weight gain on neonatal birth weight. J Zhejiang Univ Sci B. 2017 Mar;18(3):263–71.CrossRef Du M-K, Ge L-Y, Zhou M-L, Ying J, Qu F, Dong M-Y, et al. Effects of pre-pregnancy body mass index and gestational weight gain on neonatal birth weight. J Zhejiang Univ Sci B. 2017 Mar;18(3):263–71.CrossRef
23.
go back to reference Yang S, Peng A, Wei S, Wu J, Zhao J, Zhang Y, et al. Pre-pregnancy body mass index, gestational weight gain, and birth weight: a cohort study in China. PLoS One. 2015;10(6):e0130101.CrossRef Yang S, Peng A, Wei S, Wu J, Zhao J, Zhang Y, et al. Pre-pregnancy body mass index, gestational weight gain, and birth weight: a cohort study in China. PLoS One. 2015;10(6):e0130101.CrossRef
24.
go back to reference Liu Y, Dai W, Dai X, Li Z. Prepregnancy body mass index and gestational weight gain with the outcome of pregnancy: a 13-year study of 292,568 cases in China. Arch Gynecol Obstet. 2012 Oct;286(4):905–11.CrossRef Liu Y, Dai W, Dai X, Li Z. Prepregnancy body mass index and gestational weight gain with the outcome of pregnancy: a 13-year study of 292,568 cases in China. Arch Gynecol Obstet. 2012 Oct;286(4):905–11.CrossRef
25.
go back to reference Rong K, Yu K, Han X, Szeto IMY, Qin X, Wang J, et al. Pre-pregnancy BMI, gestational weight gain and postpartum weight retention: a meta-analysis of observational studies. Public Health Nutr. 2015 Aug;18(12):2172–82.CrossRef Rong K, Yu K, Han X, Szeto IMY, Qin X, Wang J, et al. Pre-pregnancy BMI, gestational weight gain and postpartum weight retention: a meta-analysis of observational studies. Public Health Nutr. 2015 Aug;18(12):2172–82.CrossRef
26.
go back to reference Fuemmeler BF, Wang L, Iversen ES, Maguire R, Murphy SK, Hoyo C. Association between Prepregnancy body mass index and gestational weight gain with size, tempo, and velocity of infant growth: analysis of the newborn epigenetic study cohort. Child Obes. 2016 May 2;12(3):210–8.CrossRef Fuemmeler BF, Wang L, Iversen ES, Maguire R, Murphy SK, Hoyo C. Association between Prepregnancy body mass index and gestational weight gain with size, tempo, and velocity of infant growth: analysis of the newborn epigenetic study cohort. Child Obes. 2016 May 2;12(3):210–8.CrossRef
27.
go back to reference Angkurawaranon C, Jiraporncharoen W, Chenthanakij B, Doyle P, Nitsch D. Urban environments and obesity in Southeast Asia: a systematic review, meta-analysis and meta-regression. PLoS One. 2014;9(11):e113547.CrossRef Angkurawaranon C, Jiraporncharoen W, Chenthanakij B, Doyle P, Nitsch D. Urban environments and obesity in Southeast Asia: a systematic review, meta-analysis and meta-regression. PLoS One. 2014;9(11):e113547.CrossRef
28.
go back to reference Jan Mohamed HJB, Yap RWK, Loy SL, Norris SA, Biesma R, Aagaard-Hansen J. Prevalence and determinants of overweight, obesity, and type 2 diabetes mellitus in adults in Malaysia. Asia Pac J Public Health. 2015 Mar;27(2):123–35.CrossRef Jan Mohamed HJB, Yap RWK, Loy SL, Norris SA, Biesma R, Aagaard-Hansen J. Prevalence and determinants of overweight, obesity, and type 2 diabetes mellitus in adults in Malaysia. Asia Pac J Public Health. 2015 Mar;27(2):123–35.CrossRef
Metadata
Title
Are women in Singapore gaining weight appropriately during pregnancy: a prospective cohort study
Authors
Song He
John Carson Allen
Nurul Syaza Razali
Nyo Mie Win
Jun Jim Zhang
Mor Jack Ng
George Seow Heong Yeo
Bernard Su Min Chern
Kok Hian Tan
Publication date
01-12-2019
Publisher
BioMed Central
Published in
BMC Pregnancy and Childbirth / Issue 1/2019
Electronic ISSN: 1471-2393
DOI
https://doi.org/10.1186/s12884-019-2443-z

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