The effect of the 2009 revised U.S. guidelines for gestational weight gain on maternal and infant health: a quasi-experimental study

BMC Pregnancy and Childbirth

Research

Daniel F. Collin¹  Rita Hamad²  Richard Pulvera³ 

[1] Philip R. Lee Institute for Health Policy Studies, University of California San Francisco, 995 Potrero Avenue, Building 80, Ward 83, 94110, San Francisco, CA, USA;Philip R. Lee Institute for Health Policy Studies, University of California San Francisco, 995 Potrero Avenue, Building 80, Ward 83, 94110, San Francisco, CA, USA;Department of Family & Community Medicine, University of California San Francisco, 995 Potrero Avenue, Building 80, Ward 83, 94110, San Francisco, CA, USA;School of Public Health, University of California Berkeley, Berkeley, CA, USA;

关键词: Gestational weight gain;    Quasi-experimental studies;    Maternal health;    Infant health;    Pregnancy Risk Assessment Monitoring System;   

DOI  :  10.1186/s12884-023-05425-8

 received in 2022-10-10, accepted in 2023-02-03,  发布年份 2023

来源: Springer

【 摘 要 】

BackgroundExcess gestational weight gain (GWG) has adverse short- and long-term effects on the health of mothers and infants. In 2009, the US Institute of Medicine revised its guidelines for GWG and reduced the recommended GWG for women who are obese. There is limited evidence on whether these revised guidelines affected GWG and downstream maternal and infant outcomes.MethodsWe used data from the 2004–2019 waves of the Pregnancy Risk Assessment Monitoring System, a serial cross-sectional national dataset including over 20 states. We conducted a quasi-experimental difference-in-differences analysis to assess pre/post changes in maternal and infant outcomes among women who were obese, while “differencing out” the pre/post changes among a control group of women who were overweight. Maternal outcomes included GWG and gestational diabetes; infant outcomes included preterm birth (PTB), low birthweight (LBW), and very low birthweight (VLBW). Analysis began in March 2021.ResultsThere was no association between the revised guidelines and GWG or gestational diabetes. The revised guidelines were associated with reduced PTB (− 1.19% points, 95%CI: − 1.86, − 0.52), LBW (− 1.38% points 95%CI: − 2.07, − 0.70), and VLBW (− 1.30% points, 95%CI: − 1.68, − 0.92). Results were robust to several sensitivity analyses.ConclusionThe revised 2009 GWG guidelines were not associated with changes in GWG or gestational diabetes but were associated with improvements in infant birth outcomes. These findings will help inform further programs and policies aimed at improving maternal and infant health by addressing weight gain in pregnancy.

【 授权许可】

CC BY   
© The Author(s) 2023

【 图 表 】

Fig. 3