(12-10-10) The association between pregnancy weight gain and birthweight: a within-family comparison.

Ludwig DS, Currie J.


Department of Medicine, Children's Hospital, Boston, MA 02115, USA. david.
[email protected]
Comment in:

Lancet. 2010 Sep 18;376(9745):937-8.
Abstract
BACKGROUND: Excessive weight gain during pregnancy seems to increase
birthweight and the offspring's risk of obesity later in life. However, this
association might be confounded by genetic and other shared effects. We aimed
to examine the association between maternal weight gain and birthweight using
state-based birth registry data that allowed us to compare several pregnancies
in the same mother.

METHODS: In this population-based cohort study, we used vital statistics
natality records to examine all known births in Michigan and New Jersey, USA,
between Jan 1, 1989, and Dec 31, 2003. From an initial sample of women with
more than one singleton birth in the database, we made the following
exclusions: gestation less than 37 weeks or 41 weeks or more; maternal
diabetes; birthweight less than 500 g or more than 7000 g; and missing data for
pregnancy weight gain. We examined how differences in weight gain that occurred
during two or more pregnancies for each woman predicted the birthweight of her
offspring, using a within-subject design to reduce confounding to a minimum.

FINDINGS: Our analysis included 513 501 women and their 1 164 750 offspring.
We noted a consistent association between pregnancy weight gain and birthweight
(? 7?35, 95% CI 7?10-7?59, p<0?0001). Infants of women who gained more than 24
kg during pregnancy were 148?9 g (141?7-156?0) heavier at birth than were
infants of women who gained 8-10 kg. The odds ratio of giving birth to an
infant weighing more than 4000 g was 2?26 (2?09-2?44) for women who gained more
than 24 kg during pregnancy compared with women who gained 8-10 kg.

INTERPRETATION: Maternal weight gain during pregnancy increases birthweight
independently of genetic factors. In view of the apparent association between
birthweight and adult weight, obesity prevention efforts targeted at women
during pregnancy might be beneficial for offspring.

FUNDING: US National Institutes of Health.

Source: Lancet. 2010 Sep 18;376(9745):984-90. Epub 2010 Aug 4.

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