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A Literature Review of Gestational Weight Restriction Among Individuals with Obesity and its Association with Neonatal Outcomes

Shepherd, Sarah Helen (2023) A Literature Review of Gestational Weight Restriction Among Individuals with Obesity and its Association with Neonatal Outcomes. Master Essay, University of Pittsburgh.

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Abstract

Background: The prevalence of obesity continues to rise worldwide and affects many reproductive aged individuals. The 2009 Institute of Medicine (IOM) recommends pregnant persons with obesity, regardless of obesity severity, gain 5-9 kilograms (kg) during pregnancy to balance the effect of obesity on adverse neonatal outcomes. New evidence suggests gestational weight gain recommendations should vary by class of obesity to balance the effect of gestational weight gain on adverse maternal and neonatal outcomes. Recent research suggests the IOM guidelines may be too high for pregnant persons with obesity, and gestational weight restriction, defined as low gestational weight gain (0-4.9 kg) or gestational weight loss (< 0 kg), may be beneficial. However, the safety of gestational weight restriction is unknown.
Methods: A literature search of the National Library of Medicine yielded twelve articles, ten observational studies and two intervention studies, examining the association between gestational weight restriction and adverse neonatal outcomes. The neonatal outcomes assessed were small-for-gestational age, large-for-gestational age, macrosomia, preterm birth, and stillbirth.
Findings: The observational studies reported mixed results for the effect of gestational weight restriction on most of the adverse neonatal outcomes. However, of the nine studies examining the association between gestational weight restriction and large-for-gestational age birth, all nine reported consistent findings. The nine studies suggest gestational weight restriction reduces or does not affect the risk of large-for-gestational age birth for pregnant persons with obesity compared to those who gained within the IOM recommendations. The two intervention studies reported weight restriction interventions did not increase the risk of adverse neonatal outcomes for pregnant persons with obesity in the intervention group compared to those in the control group.
Conclusion: Due to the inconsistency of findings for association between gestational weight restriction on the examined adverse neonatal outcomes, more studies are warranted to investigate the safety of gestational weight restriction for pregnant persons with obesity, and particularly those with class III obesity. As the prevalence of obesity rises globally, it is of public health importance to evaluate the safety of gestational weight restriction to balance the risks of adverse neonatal outcomes associated with obesity.


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Details

Item Type: Other Thesis, Dissertation, or Long Paper (Master Essay)
Status: Unpublished
Creators/Authors:
CreatorsEmailPitt UsernameORCID
Shepherd, Sarah Helensas676@pitt.edusas676
Contributors:
ContributionContributors NameEmailPitt UsernameORCID
Thesis advisorBodnar, Lisabodnar@edc.pitt.edubodnarUNSPECIFIED
Committee MemberHimes, Katherinehimeskp@upmc.eduUNSPECIFIEDUNSPECIFIED
Committee MemberParisi, Sarasmp101@pitt.edusmp101UNSPECIFIED
Date: 5 January 2023
Date Type: Completion
Submission Date: 16 December 2022
Access Restriction: 2 year -- Restrict access to University of Pittsburgh for a period of 2 years.
Number of Pages: 46
Institution: University of Pittsburgh
Schools and Programs: School of Public Health > Epidemiology
Degree: MPH - Master of Public Health
Thesis Type: Master Essay
Refereed: Yes
Uncontrolled Keywords: N/A
Date Deposited: 05 Jan 2023 15:43
Last Modified: 05 Jan 2023 15:43
URI: http://d-scholarship.pitt.edu/id/eprint/44040

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