TY - JOUR

T1 - The Impact of Excluding Adverse Neonatal Outcomes on the Creation of Gestational Weight Gain Charts Among Women from Low- and Middle-income Countries with Normal and Overweight BMI

AU - Rangel Bousquet Carrilho, Thais

AU - Wang, Dongqing

AU - Hutcheon, Jennifer A.

AU - Wang, Molin

AU - Fawzi, Wafaie W.

AU - Kac, Gilberto

AU - Accrombessi, Manfred

AU - Adu-Afarwuah, Seth

AU - Alves, João Guilherme

AU - Leal de Araújo, Carla Adriane

AU - Arifeen, Shams

AU - Artes, Rinaldo

AU - Ashorn, Per

AU - Ashorn, Ulla

AU - Assefa, Nega

AU - Ayoola, Omolola Olukemi

AU - Azizi, Fereidoun

AU - Bawah, Ahmed Tijani

AU - Behboudi-Gandevani, Samira

AU - Berhane, Yemane

AU - Bernstein, Robin

AU - Bhutta, Zulfiqar

AU - Briand, Valérie

AU - Calvo, Elvira Beatriz

AU - Cardoso, Marly Augusto

AU - Cheng, Yue

AU - Chico-Barba, Gabriela

AU - Clayton, Peter Ellis

AU - Collins, Shalean M.

AU - Costello, Anthony M.

AU - Cruickshank, John Kennedy

AU - Devakumar, Delanjathan

AU - Dewey, Kathryn G.

AU - Dwarkanath, Pratibha

AU - Estrada-Gutierrez, Guadalupe

AU - Fair, Frankie J.

AU - Farias, Dayana Rodrigues

AU - Friis, Henrik

AU - Ghosh, Shibani

AU - Girard, Amy Webb

AU - Gomo, Exnevia

AU - Gondwe, Austrida

AU - Hallamaa, Lotta

AU - Hambidge, K. Michael

AU - Hussein, Hawawu

AU - Huybregts, Lieven

AU - Iqbal, Romaina

AU - Katz, Joanne

AU - Khatry, Subarna K.

AU - Kolsteren, Patrick

AU - members of the GWG Pooling Project Consortium

N1 - Publisher Copyright: © 2024 American Society for Nutrition

PY - 2024

Y1 - 2024

N2 - Background: Existing gestational weight gain (GWG) charts vary considerably in their choice of exclusion/inclusion criteria, and it is unclear to what extent these criteria create differences in the charts’ percentile values. Objectives: We aimed to establish the impact of including/excluding pregnancies with adverse neonatal outcomes when constructing GWG charts. Methods: This is an individual participant data analysis from 31 studies from low- and middle-income countries. We created a dataset that included all participants and a dataset restricted to those with no adverse neonatal outcomes: preterm < 37 wk, small or large for gestational age, low birth weight < 2500 g, or macrosomia > 4000 g. Quantile regression models were used to create GWG curves from 9 to 40 wk, stratified by prepregnancy BMI, in each dataset. Results: The dataset without the exclusion criteria applied included 14,685 individuals with normal weight and 4831 with overweight. After removing adverse neonatal outcomes, 10,479 individuals with normal weight and 3466 individuals with overweight remained. GWG distributions at 13, 27, and 40 wk were virtually identical between the datasets with and without the exclusion criteria, except at 40 wk for normal weight and 27 wk for overweight. For the 10th and 90th percentiles, the differences between the estimated GWG were larger for overweight (∼1.5 kg) compared with normal weight (<1 kg). Removal of adverse neonatal outcomes had minimal impact on GWG trajectories of normal weight. For overweight, the percentiles estimated in the dataset without the criteria were slightly higher than those in the dataset with the criteria applied. Nevertheless, differences were <1 kg and virtually nonexistent at the end of pregnancy. Conclusions: Removing pregnancies with adverse neonatal outcomes has little or no influence on the GWG trajectories of individuals with normal and overweight.

AB - Background: Existing gestational weight gain (GWG) charts vary considerably in their choice of exclusion/inclusion criteria, and it is unclear to what extent these criteria create differences in the charts’ percentile values. Objectives: We aimed to establish the impact of including/excluding pregnancies with adverse neonatal outcomes when constructing GWG charts. Methods: This is an individual participant data analysis from 31 studies from low- and middle-income countries. We created a dataset that included all participants and a dataset restricted to those with no adverse neonatal outcomes: preterm < 37 wk, small or large for gestational age, low birth weight < 2500 g, or macrosomia > 4000 g. Quantile regression models were used to create GWG curves from 9 to 40 wk, stratified by prepregnancy BMI, in each dataset. Results: The dataset without the exclusion criteria applied included 14,685 individuals with normal weight and 4831 with overweight. After removing adverse neonatal outcomes, 10,479 individuals with normal weight and 3466 individuals with overweight remained. GWG distributions at 13, 27, and 40 wk were virtually identical between the datasets with and without the exclusion criteria, except at 40 wk for normal weight and 27 wk for overweight. For the 10th and 90th percentiles, the differences between the estimated GWG were larger for overweight (∼1.5 kg) compared with normal weight (<1 kg). Removal of adverse neonatal outcomes had minimal impact on GWG trajectories of normal weight. For overweight, the percentiles estimated in the dataset without the criteria were slightly higher than those in the dataset with the criteria applied. Nevertheless, differences were <1 kg and virtually nonexistent at the end of pregnancy. Conclusions: Removing pregnancies with adverse neonatal outcomes has little or no influence on the GWG trajectories of individuals with normal and overweight.

KW - adverse neonatal outcomes

KW - gestational weight gain

KW - reference

KW - standards

U2 - 10.1016/j.ajcnut.2024.03.016

DO - 10.1016/j.ajcnut.2024.03.016

M3 - Journal article

C2 - 38522618

AN - SCOPUS:85190540150

JO - American Journal of Clinical Nutrition

JF - American Journal of Clinical Nutrition

SN - 0002-9165

ER -