Implications of Excessive Gestational Weight Gain Karen H

Implications of Excessive Gestational Weight Gain Karen H. Morin, PhD, RN, ANEF, FAAN

he Institute of Medicine’s children whose mothers had excessive critical role that prepregnant weight, (2009) guidelines for weight GWG. Minority women are at as well as GWG, play on future out- Tgain during pregnancy provided increased risk of excessive GWG comes for the woman and her child. upper limits that were lacking in ear- (Arinze, Karp, & Gesell, 2015). Total Such discussions become even more lier guidelines. Of particular impor- GWG has been found to be positively important given recent evidence that tance were recommendations limiting associated with childhood size and “overweight and obese women still gestational weight gain (GWG) in adiposity, but only marginally associ- have personal weight gain targets in women with a body mass index ated with obesity. Similar fi ndings excess of clinical guidelines” (Arinze (BMI) greater than 30. Although were reported by Poston (2012). et al., 2015, np), even when health- guideline information has been Maternal prepregnant weight and care providers discussed appropriate widely distributed to both profes- GWG infl uence weight outcomes of weight gain parameters. ✜ sional and lay audiences, adherence infants later in life. Effects of excessive to the recommendations continues to GWG are not limited to child size and Karen H. Morin is a Professor Emer- be problematic. In a recent retrospec- adiposity. Hrolfsdottir et al. (2015) ita, University of Wisconsin, and Vis- tive study of all nulliparous women report modest adverse associations iting Professor, University of West of with term singleton vertex live births between GWG in women who were Georgia, and an Editorial Board in 2011 and 2012 in the United normal weight starting pregnancy and Member of MCN. She can be reached via e-mail at [email protected] The author declares no confl ict of Excessive gestational weight gain may infl uence interest. long-term child health outcomes. DOI:10.1097/NMC.0000000000000161

References States, some women in all BMI cate- select biomarkers of cardiovascular Arinze, N. V., Karp, S. M., & Gesell, S. B. (2015). Evaluating provider advice and women’s gories were found to have higher than health in their children. Interestingly, beliefs on total weight gain during preg- recommended GWG (Truong, Lee, this association was limited to male nancy. Journal of Immigrant Minority Caugey, & Chen, 2015). Predictably, children. In female children, GWG Health. Epub ahead of print. doi:10.1007/ s10909-015-0162-8 women who gained >20 lb over the was inversely associated with levels of Hrolfsdottir, L., Rytter, D., Olsen, S. F., Bech, B. recommended guidelines for their total cholesterol and low-density lipo- H., Maslova, E., Henriksen, T. B., & Hall- dorsson, T. I. (2015). Gestational weight BMI category and their babies experi- protein levels. Poston (2012) reports gain in normal weight women and off- enced more complications during and that greater GWG is associated with spring cardio-metabolic risk factors at 20 after birth (Truong et al.). Gestational higher blood pressure in 3-year- years of age. International Journal of Obesity, 39(4), 671-676. doi:10.1038/ weight gain and obesity have long- old children and at 21 years of age; ijo.2014.179 term consequences for infants. GWG also may be associated with Institute of Medicine. (2009). Weight gain an increased risk of inherited Type 1 during pregnancy: Reexamining the guidelines (Report Brief). Washington, diabetes. DC: National Academies Press. What are the childhood Poston, L. (2012). Gestational weight gain: In- consequences of fl uences on the long-term health of the What does this child. Current Opinion in Clinical Nutrition excessive gestational and Metabolic Care, 15(3), 252-257. information mean doi:10.1097/MCO.0b013e3283527cf2 weight gain Truong, Y. N., Yee, L. M., Caughey, A. B., & for nurses? Cheng, Y. W. (2015). Weight gain in preg- and obesity? Nurses interact with women in a nancy: Does the Institute of Medicine have In one study both prepregnant BMI variety of settings and situations. it right? American Journal of Obstetrics & Gynecology, 212(3), 362.e1-8. doi:10.1016/j. and excessive GWG were associated Frequently those interactions occur ajog.2015.01.027 with childhood obesity and adiposity when women are not pregnant. Tak- Widen, E. M., Whyatt, R. M., Hoepner, L. A., Mueller, N. T., Ramirez-Carvey, J., Oberfi eld, among African American and ing advantage of the opportunity in S. E., …, Rundle, A. G. (2015). Gestational Dominican children in the Bronx and every patient interaction to discuss weight gain and obesity, adiposity and body northern Manhattan (Widen et al., benefi ts of a healthy weight, one that size in African-American and Dominican children in the Bronx and Northern Manhat- 2015). Odds of childhood obesity falls within a normal weight BMI tan. Maternal & Child Nutrition. doi:10.1111 / were almost three times as great for category, is one way to reinforce the mcn.12174

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