Gestational weight gain standards based on the women enrolled in the Fetal Growth Longitudinal Study of the INTERGROWTH-21st Project: a prospective longitudinal cohort study

Leila Cheikh Ismail; Deborah C Bishop; Ruyan Pang; Eric O Ohuma; Gilberto Kac; Barbara Abrams; Kathleen  Rasmussen; Fernando C Barros; Jane Hirst; Ann Lambert; Aris T Papageorghiou; William Stones; Yasmin A Jaffer; Douglas G Altman; J Alison Noble; Maria Rosa Giolito; Michael G Gravett; Manorama Purwar; Stephen H Kennedy; Zulfiqar A Bhutta; José Villar

doi:10.1136/bmj.i555

Gestational weight gain standards based on the women enrolled in the Fetal Growth Longitudinal Study of the INTERGROWTH-21st Project: a prospective longitudinal cohort study

Leila Cheikh Ismail, Deborah C Bishop, Ruyan Pang, Eric O Ohuma, Gilberto Kac, Barbara Abrams, Kathleen Rasmussen, Fernando C Barros, Jane Hirst, Ann Lambert, Aris T Papageorghiou, William Stones, Yasmin A Jaffer, Douglas G Altman, J Alison Noble, Maria Rosa Giolito, Michael G Gravett, Manorama Purwar, Stephen H Kennedy, Zulfiqar A BhuttaJosé Villar

School of Medicine

Research output: Contribution to journal › Article › peer-review

Abstract

OBJECTIVE To describe maternal gestational weight gain (GWG) patterns in healthy pregnancies with good maternal and perinatal outcomes of women enrolled in the Fetal Growth Longitudinal Study of the INTERGROWTH-21st Project. DESIGN Prospective, longitudinal, observational multi-country study.SETTING Eight geographically diverse urban regions in Brazil, China, India, Italy, Kenya, Oman, UK and USA, April 2009 to March 2014. PARTICIPANTS Healthy, well-nourished and educated women, enrolled in the Fetal Growth Longitudinal Study component of the INTERGROWTH-21st Project, who had a body mass index (BMI) of ≥18.50 to ≤24.99 kg/m² in the first trimester of pregnancy.MAIN OUTCOME MEASURES Maternal weight was measured using standardised methodology and identical equipment every 5±1 weeks from the first antenatal visit (<14+0 weeks’ gestation) to delivery. After ensuring that data from the study sites could be pooled, a multi-level, mixed effect, linear regression analysis for repeated measures, adjusted for gestational age was applied to produce the GWG values. RESULTS The within-site variance (59.6%) was six times higher than the between-sites’ variance (9.6%). Total mean GWG at 40 weeks’ gestation was 13.7 (SD 4.5) kg for women with a normal first trimester BMI. Fitted 3rd, 10th, 25th, 50th, 75th, 90th, and 97th smoothed GWG centiles by exact week of gestation are provided with equations for the mean and standard deviation to calculate any desired centiles according to gestational age in exact weeks. CONCLUSIONS This is the largest standardised study of healthy, well-nourished women ever to monitor GWG prospectively in a multi-country setting. The centiles generated are very robust and should help guide recommendations on optimal GWG worldwide.

Original language	English
Article number	i555
Number of pages	10
Journal	British Medical Journal
Volume	352
DOIs	https://doi.org/10.1136/bmj.i555
Publication status	Published - 29 Feb 2016

Keywords

Pregnancy
Weight gain
Reference standards
Normal body weight

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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Ismail, L. C., Bishop, D. C., Pang, R., Ohuma, E. O., Kac, G., Abrams, B., Rasmussen, K., Barros, F. C., Hirst, J., Lambert, A., Papageorghiou, A. T., Stones, W., Jaffer, Y. A., Altman, D. G., Noble, J. A., Giolito, M. R., Gravett, M. G., Purwar, M., Kennedy, S. H., ... Villar, J. (2016). Gestational weight gain standards based on the women enrolled in the Fetal Growth Longitudinal Study of the INTERGROWTH-21st Project: a prospective longitudinal cohort study. British Medical Journal, 352, Article i555. https://doi.org/10.1136/bmj.i555

@article{091a805745dd4ab29f55a01ed5f85cc2,

title = "Gestational weight gain standards based on the women enrolled in the Fetal Growth Longitudinal Study of the INTERGROWTH-21st Project: a prospective longitudinal cohort study",

abstract = "OBJECTIVE To describe maternal gestational weight gain (GWG) patterns in healthy pregnancies with good maternal and perinatal outcomes of women enrolled in the Fetal Growth Longitudinal Study of the INTERGROWTH-21st Project. DESIGN Prospective, longitudinal, observational multi-country study.SETTING Eight geographically diverse urban regions in Brazil, China, India, Italy, Kenya, Oman, UK and USA, April 2009 to March 2014. PARTICIPANTS Healthy, well-nourished and educated women, enrolled in the Fetal Growth Longitudinal Study component of the INTERGROWTH-21st Project, who had a body mass index (BMI) of ≥18.50 to ≤24.99 kg/m2 in the first trimester of pregnancy.MAIN OUTCOME MEASURES Maternal weight was measured using standardised methodology and identical equipment every 5±1 weeks from the first antenatal visit (<14+0 weeks{\textquoteright} gestation) to delivery. After ensuring that data from the study sites could be pooled, a multi-level, mixed effect, linear regression analysis for repeated measures, adjusted for gestational age was applied to produce the GWG values. RESULTS The within-site variance (59.6%) was six times higher than the between-sites{\textquoteright} variance (9.6%). Total mean GWG at 40 weeks{\textquoteright} gestation was 13.7 (SD 4.5) kg for women with a normal first trimester BMI. Fitted 3rd, 10th, 25th, 50th, 75th, 90th, and 97th smoothed GWG centiles by exact week of gestation are provided with equations for the mean and standard deviation to calculate any desired centiles according to gestational age in exact weeks. CONCLUSIONS This is the largest standardised study of healthy, well-nourished women ever to monitor GWG prospectively in a multi-country setting. The centiles generated are very robust and should help guide recommendations on optimal GWG worldwide. ",

keywords = "Pregnancy, Weight gain, Reference standards, Normal body weight",

author = "Ismail, {Leila Cheikh} and Bishop, {Deborah C} and Ruyan Pang and Ohuma, {Eric O} and Gilberto Kac and Barbara Abrams and Kathleen Rasmussen and Barros, {Fernando C} and Jane Hirst and Ann Lambert and Papageorghiou, {Aris T} and William Stones and Jaffer, {Yasmin A} and Altman, {Douglas G} and Noble, {J Alison} and Giolito, {Maria Rosa} and Gravett, {Michael G} and Manorama Purwar and Kennedy, {Stephen H} and Bhutta, {Zulfiqar A} and Jos{\'e} Villar",

note = "This project was supported by a generous grant from the Bill & Melinda Gates Foundation to the University of Oxford, for which we are very grateful. ",

year = "2016",

month = feb,

day = "29",

doi = "10.1136/bmj.i555",

language = "English",

volume = "352",

journal = "British Medical Journal",

issn = "0959-8138",

publisher = "BMJ Publishing Group Ltd",

}

Ismail, LC, Bishop, DC, Pang, R, Ohuma, EO, Kac, G, Abrams, B, Rasmussen, K, Barros, FC, Hirst, J, Lambert, A, Papageorghiou, AT, Stones, W, Jaffer, YA, Altman, DG, Noble, JA, Giolito, MR, Gravett, MG, Purwar, M, Kennedy, SH, Bhutta, ZA & Villar, J 2016, 'Gestational weight gain standards based on the women enrolled in the Fetal Growth Longitudinal Study of the INTERGROWTH-21st Project: a prospective longitudinal cohort study', British Medical Journal, vol. 352, i555. https://doi.org/10.1136/bmj.i555

TY - JOUR

T1 - Gestational weight gain standards based on the women enrolled in the Fetal Growth Longitudinal Study of the INTERGROWTH-21st Project

T2 - a prospective longitudinal cohort study

AU - Ismail, Leila Cheikh

AU - Bishop, Deborah C

AU - Pang, Ruyan

AU - Ohuma, Eric O

AU - Kac, Gilberto

AU - Abrams, Barbara

AU - Rasmussen, Kathleen

AU - Barros, Fernando C

AU - Hirst, Jane

AU - Lambert, Ann

AU - Papageorghiou, Aris T

AU - Stones, William

AU - Jaffer, Yasmin A

AU - Altman, Douglas G

AU - Noble, J Alison

AU - Giolito, Maria Rosa

AU - Gravett, Michael G

AU - Purwar, Manorama

AU - Kennedy, Stephen H

AU - Bhutta, Zulfiqar A

AU - Villar, José

N1 - This project was supported by a generous grant from the Bill & Melinda Gates Foundation to the University of Oxford, for which we are very grateful.

PY - 2016/2/29

Y1 - 2016/2/29

N2 - OBJECTIVE To describe maternal gestational weight gain (GWG) patterns in healthy pregnancies with good maternal and perinatal outcomes of women enrolled in the Fetal Growth Longitudinal Study of the INTERGROWTH-21st Project. DESIGN Prospective, longitudinal, observational multi-country study.SETTING Eight geographically diverse urban regions in Brazil, China, India, Italy, Kenya, Oman, UK and USA, April 2009 to March 2014. PARTICIPANTS Healthy, well-nourished and educated women, enrolled in the Fetal Growth Longitudinal Study component of the INTERGROWTH-21st Project, who had a body mass index (BMI) of ≥18.50 to ≤24.99 kg/m2 in the first trimester of pregnancy.MAIN OUTCOME MEASURES Maternal weight was measured using standardised methodology and identical equipment every 5±1 weeks from the first antenatal visit (<14+0 weeks’ gestation) to delivery. After ensuring that data from the study sites could be pooled, a multi-level, mixed effect, linear regression analysis for repeated measures, adjusted for gestational age was applied to produce the GWG values. RESULTS The within-site variance (59.6%) was six times higher than the between-sites’ variance (9.6%). Total mean GWG at 40 weeks’ gestation was 13.7 (SD 4.5) kg for women with a normal first trimester BMI. Fitted 3rd, 10th, 25th, 50th, 75th, 90th, and 97th smoothed GWG centiles by exact week of gestation are provided with equations for the mean and standard deviation to calculate any desired centiles according to gestational age in exact weeks. CONCLUSIONS This is the largest standardised study of healthy, well-nourished women ever to monitor GWG prospectively in a multi-country setting. The centiles generated are very robust and should help guide recommendations on optimal GWG worldwide.

AB - OBJECTIVE To describe maternal gestational weight gain (GWG) patterns in healthy pregnancies with good maternal and perinatal outcomes of women enrolled in the Fetal Growth Longitudinal Study of the INTERGROWTH-21st Project. DESIGN Prospective, longitudinal, observational multi-country study.SETTING Eight geographically diverse urban regions in Brazil, China, India, Italy, Kenya, Oman, UK and USA, April 2009 to March 2014. PARTICIPANTS Healthy, well-nourished and educated women, enrolled in the Fetal Growth Longitudinal Study component of the INTERGROWTH-21st Project, who had a body mass index (BMI) of ≥18.50 to ≤24.99 kg/m2 in the first trimester of pregnancy.MAIN OUTCOME MEASURES Maternal weight was measured using standardised methodology and identical equipment every 5±1 weeks from the first antenatal visit (<14+0 weeks’ gestation) to delivery. After ensuring that data from the study sites could be pooled, a multi-level, mixed effect, linear regression analysis for repeated measures, adjusted for gestational age was applied to produce the GWG values. RESULTS The within-site variance (59.6%) was six times higher than the between-sites’ variance (9.6%). Total mean GWG at 40 weeks’ gestation was 13.7 (SD 4.5) kg for women with a normal first trimester BMI. Fitted 3rd, 10th, 25th, 50th, 75th, 90th, and 97th smoothed GWG centiles by exact week of gestation are provided with equations for the mean and standard deviation to calculate any desired centiles according to gestational age in exact weeks. CONCLUSIONS This is the largest standardised study of healthy, well-nourished women ever to monitor GWG prospectively in a multi-country setting. The centiles generated are very robust and should help guide recommendations on optimal GWG worldwide.

KW - Pregnancy

KW - Weight gain

KW - Reference standards

KW - Normal body weight

U2 - 10.1136/bmj.i555

DO - 10.1136/bmj.i555

M3 - Article

SN - 0959-8138

VL - 352

JO - British Medical Journal

JF - British Medical Journal

M1 - i555

ER -

Gestational weight gain standards based on the women enrolled in the Fetal Growth Longitudinal Study of the INTERGROWTH-21st Project: a prospective longitudinal cohort study

Abstract

Keywords

UN SDGs

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