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The Impact of Higher Than Recommended Gestational Weight Gain on Fetal Growth and Perinatal Risk Factors—The IOM Criteria Reconsidered

Author

Listed:
  • Sylvia Kirchengast

    (Department of Evolutionary Anthropology, University of Vienna, 1030 Vienna, Austria)

  • Josef Fellner

    (Department of Evolutionary Anthropology, University of Vienna, 1030 Vienna, Austria)

  • Julia Haury

    (Department of Evolutionary Anthropology, University of Vienna, 1030 Vienna, Austria)

  • Magdalena Kraus

    (Department of Evolutionary Anthropology, University of Vienna, 1030 Vienna, Austria)

  • Antonia Stadler

    (Department of Evolutionary Anthropology, University of Vienna, 1030 Vienna, Austria)

  • Teresa Schöllauf

    (Department of Evolutionary Anthropology, University of Vienna, 1030 Vienna, Austria)

  • Beda Hartmann

    (Department of Gynecology and Obstetrics, Clinic Donaustadt, 1030 Vienna, Austria)

Abstract

A too-high gestational weight gain, in combination with steadily increasing obesity rates among women of reproductive age, represents an enormous obstetrical problem, as obesity and high gestational weight gain are associated with enhanced fetal growth, low vital parameters, and increased cesarean section rates. This medical record-based study investigates the association patterns between too-low as well as too-high gestational weight gain, according to the 2009 Institute of Medicine (IOM) guidelines, and fetal growth, as well as birth mode and pregnancy outcome. The data of 11,755 singleton births that had taken place between 2010 and 2020 at the Public Clinic Donaustadt in Vienna, Austria, were analyzed. Birth weight, birth length, head circumference, APGAR scores, and pH values of the arterial umbilical cord blood described fetal growth as well as the vital parameters after birth. Gestational weight gain was classified as too low, recommended, or too high according to the different weight status categories of the IOM guidelines. Birth weight, birth length, and head circumference of the newborn were significantly increased ( p < 0.001) among underweight, normal-weight, and overweight women who gained more weight than recommended. Among obese women, only birthweight was significantly ( p < 0.001) higher among women who gained more weight than recommended. Furthermore, a too-high gestational weight gain was significantly associated with an increased risk of macrosomia and emergency cesarean sections among underweight, normal-weight, and overweight women, but not among obese ones. Obese and morbidly obese women experiencing excessive gestational weight gain showed no significantly increased risk of macrosomia or emergency cesarean section. However, among obese mothers, a too-low gestational weight gain reduced the risk of emergency cesarean sections significantly ( p = 0.010). Consequently, the IOM recommendations for gestational weight gain fit only partly for pregnant women in Austria. In the case of obese and morbidly obese women, new guidelines for optimal pregnancy weight gain should be considered.

Suggested Citation

  • Sylvia Kirchengast & Josef Fellner & Julia Haury & Magdalena Kraus & Antonia Stadler & Teresa Schöllauf & Beda Hartmann, 2024. "The Impact of Higher Than Recommended Gestational Weight Gain on Fetal Growth and Perinatal Risk Factors—The IOM Criteria Reconsidered," IJERPH, MDPI, vol. 21(2), pages 1-14, January.
    • Handle: RePEc:gam:jijerp:v:21:y:2024:i:2:p:147-:d:1328565
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    References listed on IDEAS

    as
    1. Sylvia Kirchengast & Beda Hartmann, 2018. "Recent Lifestyle Parameters Are Associated with Increasing Caesarean Section Rates among Singleton Term Births in Austria," IJERPH, MDPI, vol. 16(1), pages 1-13, December.
    2. Katharina Syböck & Beda Hartmann & Sylvia Kirchengast, 2023. "Maternal Prepregnancy Obesity Affects Foetal Growth, Birth Outcome, Mode of Delivery, and Miscarriage Rate in Austrian Women," IJERPH, MDPI, vol. 20(5), pages 1-13, February.
    3. Chi-Nien Chen & Ho-Sheng Chen & Heng-Cheng Hsu, 2020. "Maternal Prepregnancy Body Mass Index, Gestational Weight Gain, and Risk of Adverse Perinatal Outcomes in Taiwan: A Population-Based Birth Cohort Study," IJERPH, MDPI, vol. 17(4), pages 1-11, February.
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