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Pregnancy outcomes and the use of two standards to assess adequacy of maternal body mass index in early gestation

Part of: Ibero-American DOHaD

Published online by Cambridge University Press:  09 September 2015

F. Mardones ,
P. Rosso ,
L. Villarroel ,
J. Bacallao ,
A. Dominguez ,
A. Passi ,
I. Rojas ,
M. Farias  and
P. Margozzini
F. Mardones*
Affiliation:
Department of Public Health, School of Medicine, Pontificia Universidad Catolica de Chile, Santiago, Chile
P. Rosso
Affiliation:
Department of Paediatrics, School of Medicine, Faculty of Medicine, Pontificia Universidad Catolica de Chile, Chile
L. Villarroel
Affiliation:
Department of Public Health, School of Medicine, Pontificia Universidad Catolica de Chile, Santiago, Chile
J. Bacallao
Affiliation:
Instituto Superior de Ciencias Medicas, La Habana, Cuba
A. Dominguez
Affiliation:
Department of Public Health, School of Medicine, Pontificia Universidad Catolica de Chile, Santiago, Chile
A. Passi
Affiliation:
Department of Public Health, School of Medicine, Pontificia Universidad Catolica de Chile, Santiago, Chile
I. Rojas
Affiliation:
Clinica Santa Maria, Maternity Hospital, Santiago, Chile
M. Farias
Affiliation:
Department of Obstetrics and Gynaecology, School of Medicine, Pontificia Universidad Catolica de Chile, Chile
P. Margozzini
Affiliation:
Department of Public Health, School of Medicine, Pontificia Universidad Catolica de Chile, Santiago, Chile
*
*Address for correspondence: F. Mardones, Department of Public Health, School of Medicine, Pontificia Universidad Catolica de Chile, Marcoleta 434, Santiago 833-0073, Chile. (Email mardones@med.puc.cl)
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Abstract

The maternal weight gain chart proposed by Rosso and Mardones (RM) was subsequently modified by Atalah et al. (AEA). Both charts are widely used in Latin America. The purpose of this study was to compare birth length (BL) and birth weight (BW) outcomes of both charts. A prospective study of pregnant women and their offspring’s was performed in Santiago, Chile. From a total sample of 27,613 pregnant women a sub-sample of 11,465 term healthy singleton pregnant women was selected for additional analyses. κ statistics was used to study the degree of agreement of both charts in the diagnosis of maternal nutritional status. Obese and underweight women were classified using both standards at the beginning of pregnancy and compared in terms of BL<50 cm, BW<3000 g and BW>4250 g proportions. Sensitivity and specificity values of at risk newborns, whose categories were considered as gold standard, were obtained for obese and underweight women of each chart. There was a moderate agreement in the nutritional classification of these charts. Proportions of BL<50 cm and both BW<3000 g and>4250 g were similar at each nutritional category; however, absolute figures for at risk newborns were much higher in the RM underweight and obese women. The RM chart showed higher sensitivity values than the AEA chart. The higher sensitivity of the RM chart would support its use for prevention purposes. This chart is advisable for Latin American countries and also for most developing countries.

Keywords

birth lengthbirth weightmaternal body mass indexnutrition during pregnancy
Type
Original Article
Information
Journal of Developmental Origins of Health and Disease , Volume 7 , Issue 1: Themed Issue: The Gut Microbiome and Immunity: How it is Shaped by Early Life , February 2016 , pp. 83 - 89
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Copyright
© Cambridge University Press and the International Society for Developmental Origins of Health and Disease 2015 

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References

1. Institute of Medicine, National Academy of Sciences. Nutrition During Pregnancy (eds. Committee on Nutritional Status during Pregnancy and Lactation), 1990. National Academy Press: Washington, DC.Google Scholar
2. Rosso, P. Nutrition and Metabolism in Pregnancy, 1990. Oxford University Press: New York.Google Scholar
3. Gluckman, P, Hanson, M, Seng, CY, Bardsley, A. Pre-conception maternal body composition and gestational weight gain. In Nutrition & Lifestyle for Pregnancy and Breastfeeding (eds. Gluckman P, Hanson M, Seng CY, Bardsley A), 2014; pp. 216–220. Oxford University Press: Oxford.Google Scholar
4. Nohr, EA, Vaeth, M, Baker, JL, et al. Combined associations of prepregnancy body mass index and gestational weight gain with the outcome of pregnancy. Am J Clin Nutr. 2008; 87, 1750–1759.CrossRefGoogle ScholarPubMed
5. Dietz, PM, Callaghan, WM, Sharma, AJ. High pregnancy weight gain and risk of excessive fetal growth. Am J Obstet Gynecol. 2009; 201, 51.e1–6.CrossRefGoogle ScholarPubMed
6. World Health Organization. Interim report of the commission on ending childhood obesity. Geneva, 2015. Retrieved 15 July 2015 from http://www.who.int/end-childhood-obesity/commission-ending-childhood-obesity-interim-report.pdf Google Scholar
7. Poston, L. Maternal obesity, gestational weight gain and diet as determinants of offspring long term health. Best Pract Res Clin Endocrinol Metab. 2012; 26, 627–639.CrossRefGoogle ScholarPubMed
8. Mardones, F, Rosso, P. A weight gain chart for pregnant women designed in Chile. Matern Child Nutr. 2005; 1, 77–90.Google Scholar
9. Atalah, E, Castillo, C, Castro, R, Aldea, A. Proposal of a new standard for the nutritional assessment of pregnant women. Rev Méd Chile. 1997; 125, 1429–1436.Google ScholarPubMed
10. Ministry of Health, Chile, Department of Statistics and Information (DEIS). National nutrition information, various years. Pregnant women according to nutritional status (Gestantes en control, según estado nutricional SNSS 2010), 2015. Retrieved 15 July 2015 from http://intradeis.minsal.cl/reportesrem/2010/PBC_GESTANTES_NUTRICION_2/Export.aspx Google Scholar
11. Araya, M, Padilla, O, Garmendia, M-L, Atalah, E, Uauy, R. Prevalence of obesity among Chilean women in childbearing ages. Rev Méd Chile. 2014; 142, 1440–1448.Google Scholar
12. Scott, C, Andersen, CT, Valdez, N, et al. No global consensus: a cross-sectional survey of maternal weight policies. BMC Pregnancy Childbirth. 2014; 14, 167.Google Scholar
13. Mardones, F, García-Huidobro, T, Ralph, C, et al. Combined influence of preconception body mass index and gestational weight gain on fetal growth. Rev Med Chile. 2011; 139, 710–716.Google Scholar
14. Mardones, F, Arnaiz, P, Barja, S, et al. Nutritional status, metabolic syndrome and insulin resistance in children from Santiago (Chile). Nutr Hosp. 2013; 28, 1999–2005.Google Scholar
15. Pan American Health Organization. AIEPI Neonatal Interventions Based on Evidence, 2nd edn. 2010. Pan American Health Organization: Washington, DC.Google Scholar
16. Thomson, AM. Fetal growth. In Obstetrical Epidemiology (eds. Barron SL, Thomson AM), 1983; pp. 89–142. Academic Press Inc. Ltd: London.Google Scholar
17. Puffer, RR, Serrano, CV. Patterns of Birth Weight. PAHO. Scientific Publication No. 504, 1987; pp. 9–43. Pan American Health Organization: Washington, DC.Google Scholar
18. Mardones, F, Villarroel, L, Karzulovic, L, et al. Association of perinatal factors and obesity in 6-8 years old Chilean children. Int J Epidemiol. 2008; 37, 902–910.CrossRefGoogle ScholarPubMed
19. Mardones, F, Villarroel, L, Arnaiz, P, et al. Prenatal growth and metabolic syndrome components among Chilean children. J Dev Orig Health Dis 2012; 3, 237–244.Google Scholar
20. Villarroel, L, Karzulovic, L, Manzi, J, Eriksson, JG, Mardones, F. Association of perinatal factors and school performance in primary school Chilean children. J Dev Orig Health Dis. 2013; 4, 232–238.CrossRefGoogle ScholarPubMed
21. Mardones, F, Arnaiz, P, Pacheco, P, et al. Associations of prenatal growth with metabolic syndrome, insulin resistance and nutritional status in Chilean children. Biomed Res Int. 2014; 2014, 472017.CrossRefGoogle ScholarPubMed
22. Landis, JR, Koch, GG. The measurement of observer agreement for categorical data. Biometrics. 1977; 33, 159–174.Google Scholar
23. World Health Organization. Diet, nutrition and chronic disease in context. In Diet, Nutrition and the Prevention of Chronic Diseases (WHO Technical report series No 916), Report of a joint WHO/FAO expert consultation, Geneva, 28 January -- 1 February 2002; pp. 30–53. World Health Organization: Geneva.Google Scholar
24. Adair, LS. Long term consequences of nutrition and growth in early childhood and possible preventive interventions. In International Nutrition: Achieving Millennium Goals and Beyond. Nestlé Nutrition Institute Workshop Series/Vol. 78 (eds. Black RE, Singhal A, Uauy R), 2014; pp. 111–120. Nestec Ltd. Vevey and Karger: Basel.Google Scholar
25. Oken, E, Kleinman, KP, Belfort, MB, Hammitt, JK, Gillman, MW. Associations of gestational weight gain with short- and longer-term maternal and child health outcomes. Am J Epidemiol. 2009; 170, 173–180.Google Scholar
26. Yang, Z, Huffman, SL. Nutrition in pregnancy and early childhood and associations with obesity in developing countries. Matern Child Nutr. 2013; 9(Suppl. 1), 105–119.Google Scholar
27. Langley-Evans, SC, Hall Moran, V. Childhood obesity: risk factors, prevention and management. Matern Child Nutr. 2014; 10, 453–455.Google Scholar
28. Langley-Evans, SC. Nutrition in early life and the programming of adult disease: a review. J Hum Nutr Diet. 2014; 25, 453–459.Google Scholar
29. Mardones, F, Urrutia, MT, Villarroel, L, et al. Effects of a dairy product fortified with multiple micronutrients and omega-3 fatty acids on birth weight and gestation duration in pregnant Chilean women. Public Health Nutr. 2008; 11, 30–40.Google Scholar
30. Mardones-Santander, F, Rosso, P, Stekel, A, et al. Effect of a milk-based food supplement on maternal nutritional status and fetal growth in underweight Chilean women. Am J Clin Nutr 1988; 47, 413–419.Google Scholar
31. Institute of Medicine, National Academy of Sciences. Weight Gain During Pregnancy: Reexamining the Guidelines (eds. Committee on Nutritional Status during Pregnancy and Lactation), 2009. National Academy Press: Washington, DC.Google Scholar
32. Martorell, R. Maternal height as an indicator of risk. In Maternal Nutrition and Pregnancy Outcomes. Anthropometric Assessment (eds. Krasovec K, Anderson MA), 1991; pp. 104–111. Pan American Health Organization: Washington, DC.Google Scholar
33. Working group. Summary and recommendations. In Maternal Nutrition and Pregnancy Outcomes. Anthropometric Assessment (eds. Krasovec, K, Anderson, MA), 1991; pp. 112–118. Pan American Health Organization: Washington, DC.Google Scholar
34. Ministry of Health, Chile, Department of Statistics and Information (DEIS). Natality variables of national live births, 2011 (Estadísticas de natalidad 2011), 2015. Retrieved 3 July 2015 from http://www.deis.cl/?page_id=3295 Google Scholar
35. Garmendia, ML, Corvalan, C, Uauy, R. Assessing the public health impact of developmental origins of health and disease (DOHaD) nutrition interventions. Ann Nutr Metab. 2014; 64, 226–230.Google Scholar
36. Rose, G. Sick individuals and sick populations. Int J Epidemiol. 2001; 30, 427–432.CrossRefGoogle ScholarPubMed