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Excess gestational weight gain ups obesity risk.

STOCKHOLM -- Women whose gestational weight gain exceeded current recommendations have a significantly increased risk for being overweight or obese 2 decades later, according to an analysis of 2,000 Australian women.

"The findings suggest that the amount of weight gained during pregnancy is an independent predictor of later weight development. This is the first study to show that excess pregnancy weight gain tends to persist for decades," Abdullah Al Mamun, Ph.D., said at the meeting. "Most women are probably unaware if their weight gain is too much. We need to increase awareness of this," said Dr. Al Mamun, an epidemiologist at the University of Queensland in Herston, Australia.

For many years, the long-term health consequences of gestational weight gain did not receive as much attention as the impact of weight gain on the child's health and shorter-term maternal health, although that began to change about 5 years ago, commented Dr. W. Philip T. James, a nutritionist at the London School of Hygiene and Tropical Medicine and president of the International Association for the Study of Obesity. The U.S. Institute of Medicine (IOM) issued revised recommendations for weight gain during pregnancy in May last year.

Dr. Al Mamun and his associates examined the long-term weight associations with gestational weight gain in 2,055 women who gave birth in Brisbane, Australia, during 1981-1983, part of the full group of more than 7,000 women who delivered in a Brisbane hospital in those years. The researchers examined medical records for each woman in the study 21 years after the index pregnancy. Next, they correlated the prevalence of overweight and obesity at that time with compliance with the 2009 IOM revised weight-gain guidelines. They applied the 2009 standards to a cohort of women who carried their pregnancies more than 25 years before the revision appeared.

For women pregnant with singletons, the 2009 standards call for gestational weight gains that range from 28-40 pounds for women underweight at conception, with a body mass index (BMI) of less than 18.5 kg/[m.sup.2], to 11-20 pounds in obese women with a BMI of at least 30 kg/[m.sup.2]. For women with a normal BMI, the IOM recommended a gain of 25-35 pounds.

Based on contemporary standards, a third of the women gained too much weight during pregnancy, 26% gained too little, and 41% were just right.

The analysis showed that for every 0.1-kg/week excess weight gain during pregnancy (or 4-kg excess for the entire pregnancy), BMI had increased by 0.5 kg/[m.sup.2] 21 years later. The women who exceeded the IOM recommendations had a 2-fold increased rate of being overweight and a 4.5-fold greater risk for being obese 21 years later compared with the women whose weight gains fell within current guidelines. The odds ratios came from multivariate analyses that controlled for maternal age, prepregnancy BMI, education, smoking, parity, diabetes, method of delivery, breast feeding, and menopausal status.


Major Finding: Women who exceeded the 2009 Institute of Medicine's gestational weight gain guidelines had a 4.5-fold increased risk of being obese 21 years later.

Data Source: Review of 2,055 women who delivered at hospitals in Brisbane, Australia, during 1981-1983.

Disclosures: Dr. Al Mamun and his associates all said that they had no disclosures.

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Title Annotation:ENDOCRINOLOGY
Author:Zoler, Mitchel L.
Publication:Internal Medicine News
Geographic Code:8AUST
Date:Aug 1, 2010
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