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Background: Gestational weight gain (GWG) is known to be a potential risk factor for short-term postpartum weight retention (PPWR) and thus for overweight in women. Does GWG also determine the long-term risk of overweight in women?, Objective: We aimed to study the short- and long-term effects of GWG in accordance with the Institute of Medicine (IOM) recommendations on postpartum weight retention., Design: We systematically reviewed 5 databases and bibliographies of various publications supplemented by hand search for relevant articles published in English or German and performed meta-analyses to quantify the effect estimate of PPWR by using a random-effects model. We split the data into 4 categories of follow-up: <0.5, 0.5-1, ∼3, and ≥15 y., Results: Of 1770 search hits, 9 observational studies remained suitable for the analysis. PPWR increased after longer time spans after delivery irrespective of whether GWG had been below, within, or above the guidelines. Compared with women with GWG within the recommendations, those with a GWG above the recommendations retained an additional 3.06 kg (95% CI: 1.50, 4.63 kg) after 3 y and 4.72 kg (95% CI: 2.94, 6.50 kg) on average after ≥15 y postpartum. Inadequate GWG was associated with less PPWR (-2.99 kg; 95% CI: -3.72, -2.27 kg) <6 mo after pregnancy. This association faded over time and became nonsignificant (-1.41 kg; 95% CI: -3.03, 0.21 kg) after ≥15 y. The results remained stable in sensitivity analyses that accounted for changes in IOM criteria over time and potential effect modification by low social class. A funnel plot did not suggest publication bias., Conclusion: GWG in accordance with the IOM recommendations is associated with long-term effects on PPWR.

Background: Gestational weight gain (GWG) has been shown to be a risk factor for overweight in offspring. Aim of this study was to quantify the contributions of trimester-specific and total GWG on offspring's BMI and waist circumference (WC). This is of interest for the design of interventions targeted at women showing a high GWG in early pregnancy. Methods: In a retrospective cohort study data on GWG (total and by trimester, exposure), a number of potential confounders, and children's BMI z-scores and WC (outcomes) were analyzed using structural equation models to disentangle the trimester-specific direct effects of GWG and indirect effects mediated via total GWG. Results: 7313 mother child pairs with a children's mean age of 5.81 years were analyzed. Total effects (indirect + direct) of GWG (kg/week) on children's BMI z-score and WC (cm) were observed in all trimesters, most prominently in the second. The longitudinal effect of GWG is a composite of trimester-specific direct effects (on BMI: 0.105, 0.255, 0.002, on WC: 0.538, 1.64, 0.308) and total GWG (on BMI 0.608, on WC: 1.03) at the end of pregnancy. Conclusions: Both trimester-specific priming and total GWG explained offspring's anthropometrics. The results indicate, that reversal from additional weight gain attained early in pregnancy resulting in normal total GWG at the end of pregnancy might still contribute to a substantial reduction of offspring's BMI and WC. [ABSTRACT FROM AUTHOR]

Background: It is unknown how well the trimester-specific recommendations for gestational weight gain (GWG) given by the Institute of Medicine/National Research Council (IOM/NRC) identify women at risk of GWG outside IOM/NRC recommendations for total GWG. Objective: We assessed the prognostic value of trimester-specific cutoffs for inadequate or excessive total GWG in term pregnancies. Design: Data on prepregnancy weight and the temporal course of GWG were collected from medical records. A total of 7962 women were included in the final analysis. Main outcome measures were inadequate or excessive total GWG as defined by criteria of the IOM/NRC. Main exposures were GWG outside the IOM/NRC week-specific recommendations in the first, second, and third trimesters. Results: The prediction of gaining weight within the GWG recommendations increased with gestational age and was related to the maternal weight category and outcome. In the second trimester, inadequate GWG was predicted with a sensitivity of 49% and 60.2% and a positive predictive value (PPV) of 72.1% and 68.3% in underweight and normal-weight mothers, respectively. Excessive GWG was predicted with a sensitivity of 72.7% and 70.4% and a PPV of 94.3% and 93.3% in overweight and obese mothers, respectively. Conclusions: On the basis of second-trimester-specific guidelines, inadequate GWG can be predicted in underweight and normal- weight mothers, whereas excessive GWG can be predicted in overweight and obese mothers. Therefore, it appears possible to identify women at risk of gaining outside of the guideline as early as the second trimester. [ABSTRACT FROM AUTHOR]

Introduction: Previous studies suggested potential priming effects of gestational weight gain (GWG) on offspring's body composition in later life. However, consistency of these effects in normal weight, overweight and obese mothers is less clear. Methods: We combined the individual data of three German cohorts and assessed associations of total and excessive GWG (as defined by criteria of the Institute of Medicine) with offspring's mean body mass index (BMI) standard deviation scores (SDS) and overweight at the age of 5-6 years (total: n = 6,254). Quantile regression was used to examine potentially different effects on different parts of the BMI SDS distribution. All models were adjusted for birth weight, maternal age and maternal smoking during pregnancy and stratified by maternal pre-pregnancy weight status. Results: In adjusted models, positive associations of total and excessive GWG with mean BMI SDS and overweight were observed only in children of non- overweight mothers. For example, excessive GWG was associated with a mean increase of 0.08 (95% CI: 0.01, 0.15) units of BMI SDS (0.13 (0.02, 0.24) kg/m ² of 'real' BMI) in children of normal-weight mothers. The effects of total and excessive GWG on BMI SDS increased for higher- BMI children of normal-weight mothers. Discussion: Increased GWG is likely to be associated with overweight in offspring of non-overweight mothers. [ABSTRACT FROM AUTHOR]

Reducing gestational weight gain is possible and may avoid some obstetric, perinatal and long-term metabolic risks for the mother and offspring. Reducing gestational weight gain, however, is not a panacea for all outcomes and all pregnancies. More research is needed to identify mother-infant pairs who will benefit. [ABSTRACT FROM AUTHOR]