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Preconceptional and gestational weight trajectories and risk of delivering a small-for-gestational-age baby in rural Gambia.
- Source :
- American Journal of Clinical Nutrition; 6/1/2017, Vol. 105 Issue 6, p1474-1482, 9p, 1 Diagram, 4 Charts, 1 Graph
- Publication Year :
- 2017
-
Abstract
- Background: Maternal nutritional status is a key determinant of small for gestational age (SGA), but some knowledge gaps remain, particularly regarding the role of the energy balance entering pregnancy. Objective: We investigated how preconceptional and gestational weight trajectories (summarized by individual-level traits) are associated with SGA risk in rural Gambia. Design: The sample comprised 670 women in a trial with serial weight data (7310 observations) that were available before and during pregnancy. Individual trajectories from 6 mo before conception to 30 wk of gestation were produced with the use of multilevel modeling. Summary traits were expressed as weight z scores [weight z score at 3 mo preconception (zwt<subscript>-3 mo</subscript>), weight z score at conception, weight z score at 3 mo postconception, weight z score at 7 mo post-conception (zwt<subscript>+7 mo</subscript>), and conditional measures that represented the change from the preceding time] and were related to SGA risk with the use of Poisson regression with confounder adjustment; linear splines were used to account for nonlinearity. Results: Maternal weight at each time point had a consistent nonlinear relation with SGA risk. For example, the zwt<subscript>-3 mo</subscript> estimate was stronger in women with values ≤0.5 (RR: 0.736; 95% CI: 0.594, 0.910) than in women with values >0.5 (RR: 0.920; 95% CI: 0.682, 1.241). The former group had the highest observed SGA prevalence. Focusing on weight change, only conditional zwt<subscript>+7 mo</subscript> was associated with SGA and only in women with values >-0.5 (RR: 0.579; 95% CI: 0.463, 0.724). Conclusions: Protection against delivering an SGA neonate offered by greater preconceptional or gestational weight may be most pronounced in more undernourished and vulnerable women. Independent of this possibility, greater second- and third-trimester weight gain beyond a threshold may be protective. This trial was registered at http://www.isrctn.com/ as ISRCTN49285450. [ABSTRACT FROM AUTHOR]
- Subjects :
- LOW birth weight -- Risk factors
BIRTH size
TRAJECTORY measurements
MATERNAL nutrition
GESTATIONAL age
HUMAN bioenergetics
FETAL growth disorders
NUTRITION in pregnancy
FETAL development
BODY weight
CLINICAL trials
DATE of conception
CONFIDENCE intervals
EVALUATION of medical care
POISSON distribution
PREGNANCY
WOMEN'S health
WEIGHT gain
RELATIVE medical risk
NUTRITIONAL status
Subjects
Details
- Language :
- English
- ISSN :
- 00029165
- Volume :
- 105
- Issue :
- 6
- Database :
- Complementary Index
- Journal :
- American Journal of Clinical Nutrition
- Publication Type :
- Academic Journal
- Accession number :
- 123446364
- Full Text :
- https://doi.org/10.3945/ajcn.116.144196