Composition of gestational weight gain impacts maternal fat retention and infant birth weight

https://doi.org/10.1067/S0002-9378(03)00596-9Get rights and content

Abstract

Objective

The purpose of this study was to evaluate how changes in gestational weight and body composition affect infant birth weight and maternal fat retention after delivery in underweight, normal-weight and overweight women.

Study design

We assessed the body composition of 63 women (low body mass index, 17 women; normal body mass index, 34 women; and high body mass index, 12 women) on the basis of measurements of total body nitrogen by prompt-gamma activation analysis, total body potassium by whole body counting, and a multicomponent model based on total body water by deuterium dilution, body volume by densitometry, and bone mineral content by dual energy x-ray absorptiometry (DXA) before pregnancy, at 9, 22, and 36 weeks of gestation, and at 2, 6, and 27 weeks after delivery. Infant weight and length were recorded at birth; infant anthropometry and body composition by DXA were assessed at 2 and 27 weeks of age.

Results

Gestational weight gain was correlated significantly with gains in total body water, total body potassium, protein, fat-free mass, and fat mass (P = .001-.003). Gains in total body water, total body potassium, protein and fat-free mass did not differ among body mass index groups; however, fat mass gain was higher in the high body mass index group (P = .03). Birth weight was correlated positively with gain in total body water, total body potassium, and fat-free mass (P<.01), but not fat mass. Postpartum weight and fat retention were correlated positively with gestational weight gain (P = .001) and fat mass gain (P = .001) but not with total body water, total body potassium, or fat-free mass gain.

Conclusion

Appropriate, but not excessive, gestational weight gain is needed to optimize infant birth weight and minimize maternal postpartum fat retention.

Section snippets

Study design and subjects

Subjects were classified as underweight, normal weight, or overweight in the low-BMI (≤19.8 kg/m2), normal-BMI (19.8-26.0 kg/m2), or high-BMI (≥26.0 kg/m2) groups, respectively, according to IOM categories.1 Enrollment criteria included nonsmoking, aged 18 to 40 years, parity not >4, physically active (ie, 20-30 minutes of moderate exercise at least three times per week), and no long-term medications or alcohol/drug abuse. At enrollment, the women were not anemic, normoglycemic, and

Subject description

Of the 63 pregnant women who completed the study, 17 were classified as underweight, 34 as normal weight, and 12 as overweight before pregnancy. There were no significant differences in age, ethnicity, family income, attained level of education, or gravidity/parity among the low-, normal-, and high-BMI groups. Mean age was 31±4 years (range, 21-39 year). Ethnic distribution was 77% white, 10% African American, 10% Hispanic and 3% Asian. Mean age at menarche was 12.9±1.4 years. Median (range)

Comment

Our results confirm the known relationship between infant birth weight and GWG.1 The accretion of TBW, TBK, protein, FFM, and FM was shown to be related linearly to GWG; but only the FFM components, not FM, positively affected birth weight. GWG above IOM recommendations lead to excess postpartum fat retention. Our results also demonstrate no net postpartum retention of TBK or TBN, but a slight decline in BMC, were attributable to pregnancy.

In this study, the components of GWG were measured by

Acknowledgements

We thank the women who participated in this study and Carolyn Heinz and Marilyn Navarrete for study coordination, Sopar Seributra for nursing support, Sandra Kattner for dietary support, and Maurice Puyau, Firoz Vohra, Anne Adolph, Roman Shypailo, JoAnn Pratt, and Shide Zhang for technical assistance.

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    Supported by federal funds from the US Department of the Army under grant No. DAMD 17-95-1-5070 and from the US Department of Agriculture/Agriculture Research Service under Cooperative Agreement No. 58-6250-6001.

    The contents of this article do not necessarily reflect the views or policies of the Army or the USDA, nor does mention of trade names, commercial products, or organizations imply endorsement by the US government.

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