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Gestational weight gain standards based on women enrolled in the Fetal Growth Longitudinal Study of the INTERGROWTH-21st Project: a prospective longitudinal cohort study.

Cheikh Ismail, L; Bishop, DC; Pang, R; Ohuma, EO; Kac, G; Abrams, B; Rasmussen, K; Barros, FC; Hirst, JE; Lambert, A; et al. Cheikh Ismail, L; Bishop, DC; Pang, R; Ohuma, EO; Kac, G; Abrams, B; Rasmussen, K; Barros, FC; Hirst, JE; Lambert, A; Papageorghiou, AT; Stones, W; Jaffer, YA; Altman, DG; Noble, JA; Giolito, MR; Gravett, MG; Purwar, M; Kennedy, SH; Bhutta, ZA; Villar, J (2016) Gestational weight gain standards based on women enrolled in the Fetal Growth Longitudinal Study of the INTERGROWTH-21st Project: a prospective longitudinal cohort study. BMJ, 352. i555. ISSN 1756-1833 https://doi.org/10.1136/bmj.i555
SGUL Authors: Papageorghiou, Aris

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Abstract

OBJECTIVE:  To describe patterns in maternal gestational weight gain (GWG) in healthy pregnancies with good maternal and perinatal outcomes. DESIGN:  Prospective longitudinal observational study. SETTING:  Eight geographically diverse urban regions in Brazil, China, India, Italy, Kenya, Oman, United Kingdom, and United States, April 2009 to March 2014. PARTICIPANTS:  Healthy, well nourished, and educated women enrolled in the Fetal Growth Longitudinal Study component of the INTERGROWTH-21(st) Project, who had a body mass index (BMI) of 18.50-24.99 in the first trimester of pregnancy. MAIN OUTCOME MEASURES:  Maternal weight measured with standardised methods and identical equipment every five weeks (plus/minus one week) from the first antenatal visit (<14 weeks' gestation) to delivery. After confirmation that data from the study sites could be pooled, a multilevel, linear regression analysis accounting for repeated measures, adjusted for gestational age, was applied to produce the GWG values. RESULTS:  13 108 pregnant women at <14 weeks' gestation were screened, and 4607 met the eligibility criteria, provided consent, and were enrolled. The variance within sites (59.6%) was six times higher than the variance between sites (9.6%). The mean GWGs were 1.64 kg, 2.86 kg, 2.86 kg, 2.59 kg, and 2.56 kg for the gestational age windows 14-18(+6) weeks, 19-23(+6) weeks, 24-28(+6) weeks, 29-33(+6) weeks, and 34-40(+0) weeks, respectively. Total mean weight gain at 40 weeks' gestation was 13.7 (SD 4.5) kg for 3097 eligible women with a normal BMI in the first trimester. Of all the weight measurements, 71.7% (10 639/14 846) and 94.9% (14 085/14 846) fell within the expected 1 SD and 2 SD thresholds, respectively. Data were used to determine fitted 3rd, 10th, 25th, 50th, 75th, 90th, and 97th smoothed GWG centiles by exact week of gestation, with equations for the mean and standard deviation to calculate any desired centiles according to gestational age in exact weeks. CONCLUSIONS:  Weight gain in pregnancy is similar across the eight populations studied. Therefore, the standards generated in this study of healthy, well nourished women may be used to guide recommendations on optimal gestational weight gain worldwide.

Item Type: Article
Additional Information: This is an Open Access article distributed in accordance with the terms of the Creative Commons Attribution (CC BY 3.0) license, which permits others to distribute, remix, adapt and build upon this work, for commercial use, provided the original work is properly cited. See: http://creativecommons.org/licenses/by/3.0/.
Keywords: General & Internal Medicine
SGUL Research Institute / Research Centre: Academic Structure > Institute of Medical & Biomedical Education (IMBE)
Academic Structure > Institute of Medical & Biomedical Education (IMBE) > Centre for Clinical Education (INMECE )
Journal or Publication Title: BMJ
ISSN: 1756-1833
Language: eng
Dates:
DateEvent
29 February 2016Published
Publisher License: Creative Commons: Attribution 3.0
Projects:
Project IDFunderFunder ID
UNSPECIFIEDBill and Melinda Gates Foundationhttp://dx.doi.org/10.13039/100000865
PubMed ID: 26926301
Go to PubMed abstract
URI: https://openaccess.sgul.ac.uk/id/eprint/107863
Publisher's version: https://doi.org/10.1136/bmj.i555

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