Table 3.
GWG (classified as appropriate/inappropriate by IOM guidelines) and maternal and neonatal adiposity measurements
| Outcome variables | Control mean ± SD / n (%) | Intervention, mean ± SD / n (%) | Unadjusted IRR (95% CI) | Model 1, adjusted IRR (95% CI) | Model 2, adjusted IRR (95% CI) | Model 3, adjusted IRR (95% CI) |
|---|---|---|---|---|---|---|
| MATERNAL OUTCOMES | ||||||
|
| ||||||
| Second and third trimesters GWG | ||||||
|
| ||||||
| Appropriate weekly GWG: baseline to 36 weeks (n=31) | 3 (18.8) | 4 (26.7) | 1.42 (0.32, 6.35) | 1.03 (0.20, 5.30) | 1.51 (0.31, 7.45) | 1.14 (0.20, 6.67) |
| Appropriate weekly GWG: baseline to 36 weeks (Complete case n=20) | 3 (25.0) | 4 (50.0) | 1.53 (0.45, 8.94) | 1.59 (0.31, 8.14) | 2.00 (0.43, 9.31) | 1.51 (0.26, 8.90) |
| Appropriate weekly GWG: baseline to delivery (n=31) | 2 (12.5) | 4 (26.7) | 2.13 (0.39, 11.65) | 1.04 (0.17, 6.49) | 2.20 (0.37, 13.29) | 1.14 (0.15, 8.91) |
| Appropriate total GWG: baseline to delivery (n=31) | 4 (25.0) | 6 (40.0) | 1.60 (0.45, 5.67) | 1.59 (0.40, 6.33) | 1.69 (0.44, 6.48) | 1.67 (0.40, 6.94) |
|
| ||||||
| Control Mean ± SD / n (%) | Intervention, Mean ± SD / n (%) | Unadjusted Beta coefficient (95% CI) | Model 1, adjusted Beta coefficient (95% CI) | Model 2, adjusted Beta coefficient (95% CI) | Model 3, adjusted Beta coefficient (95% CI) | |
|
| ||||||
| Maternal circumferences (36 weeks visit minus baseline, cm) | ||||||
|
| ||||||
| Neck | 0.64±1.35 | 0.16±1.18 | −0.48 (−1.64, 0.67) | −0.11 (−1.32, 1.11) | −0.53(−1.75, 0.68) | −0.09 (−1.42, 1.24) |
| Arm | −0.09±2.62 | −0.50±2.65 | −0.40 (−2.76, 1.95) | −0.13 (−2.75, 2.50) | −0.75 (−3.14, 1.65) | −0.62 (−3.39, 2.15) |
| Thigh | 1.98±4.29 | −1.29±2.60 | −3.27 (−6.61, 0.06) | −4.26 (−7.82,−0.71) | −3.69 (−7.12, −0.25) | −5.21 (−8.84,−1.59) |
| Hip | 4.14±5.33 | 7.47±7.81 | 3.33 (−2.40, 9.07) | 3.45 (−2.99, 9.89) | 3.93 (−2.02, 9.88) | 4.47 (−2.41, 11.34) |
|
| ||||||
| Gestational age at birtha | 38,4 (34,1/41,1) | 37,5 (26,4/40,0) | – | – | – | – |
|
| ||||||
| NEONATAL OUTCOMES | ||||||
|
| ||||||
| Birthweight for length (WHO WFL z-scores) | ||||||
|
| ||||||
| All | −0.05±1.26 | −0.59±1.69 | −0.54 (−1.80, 0.72) | −0.63 (−2.07, 0.81) | −0.62 (−1.97, 0.74) | −0.76 (−2.34, 0.83) |
| Females (n=8) | −0.44±1.72 | 0.52±1.16 | 0.96 (−1.01, 2.93) | 0.27 (−3.09, 3.64) | 0.20 (−1.69, 2.09) | −0.83 (−3.85, 2.19) |
| Males (n=13) | 0.08±1.17 | −1.98±1.10 | −2.06 (−3.41,−0.70) | −1.93 (−3.17, −0.69) | −1.96 (−3.42, −0.50) | −1.74 (−3.04, −0.43) |
|
| ||||||
| Birthweight Z-score | ||||||
|
| ||||||
| All | −0.30±0.80 | −0.25±0.91 | 0.05 (−0.57, 0.66) | 0.15 (−0.52, 0.82) | −0.02 (−0.69, 0.65) | −0.08 (−0.64, 0.80) |
| Females (n=14) | −0.65±0.59 | −0.02±1.04 | 0.62 (−0.37, 1.62) | 0.85 (−0.35, 2.05) | 0.70 (−0.48, 1.88) | 0.90 (−0.46, 2.27) |
| Males (n=16) | −0.12±0.86 | −0.60±0.58 | −0.47 (−1.25, 0.31) | −0.40 (−1.21, 0.41) | −0.59 (−1.42, 0.24) | −0.52 (−1.38, 0.34) |
|
| ||||||
| Ponderal index (kg/m3) | ||||||
|
| ||||||
| All | 2.6±0.3 | 2.5±0.5 | −0.13 (−0.42, 0.16) | −0.17(−0.48, 0.15) | −0.14 (−0.45, 0.18) | −0.18 (−0.52, 0.16) |
| Females (n=14) | 2.5±0.4 | 2.7±0.4 | 0.19 (−0.25, 0.63) | 0.09 (−0.43, 0.62) | 0.24 (−0.28, 0.76) | 0.15 (−0.45, 0.74) |
| Males (n=15) | 2.7±0.3 | 2.1±0.4 | −0.54 (−0.88,−0.20) | −0.53 (−0.87, −0.19) | −0.56 (−0.92, −0.20) | −0.54 (−0.91,−0.18) |
|
| ||||||
| SGA | 4 (26.7) | 1 (6.7) | 0.27 (0.03, 2.39) | 0.27 (0.03, 2.76) | 0.26 (0.03, 2.72) | 0.26 (0.02, 3.42) |
|
| ||||||
| LGA | 0 (0.0) | 1 (6.7) | – | – | – | – |
|
| ||||||
| Neonatal circumferences (cm) (n=27) | ||||||
|
| ||||||
| Head (growth measure) | 32.7±2.5 | 32.8±2.6 | 0.18 (−1.76, 2.12) | 0.16 (−1.93.,2.26) | −0.15 (−2.15, 1.86) | −0.19 (−2.37, 1.98) |
| Arm | 9.0±0.8 | 8.9±1.5 | −0.11 (−1.01, 0.80) | −0.19 (−1.16, 0.79) | −0.20 (−1.15, 0.75) | −0.30 (−1.32, 0.73) |
| Abdomen | 27.4±2.6 | 27.9±3.7 | 0.59 (−1.82, 2.99) | 0.56 (−2.04, 3.15) | 0.45 (−2.09, 3.00) | 0.41 (−2.35, 3.16) |
| Thigh | 13.4±1.3 | 13.4±2.7 | 0.03 (−1.56, 1.61) | −0.09 (−1.80, 1.61) | −0.30 (−1.91, 1.31) | −0.47 (−2.20, 1.27) |
|
| ||||||
| Skinfolds (mm) (n=27) | ||||||
|
| ||||||
| Triceps | 4.4±1.1 | 4.6±1.2 | 0.24 (−0.65, 1.12) | 0.01 (−0.90. 0.92) | 0.20 (−0.74, 1.14) | −0.04 (−1.01, 0.93) |
| Subscapular | 4.4±0.9 | 4.6±1.2 | 0.22 (−0.58, 1.01) | −0.08 (−0.86, 0.70) | 0.15 (−0.69, 0.99) | −0.17 (−1.00, 0.65) |
| Suprailiac | 4.0±1.0 | 4.0±1.0 | 0.03 (−0.70, 0.76) | −0.02 (−0.81, 0.76) | −0.002 (−0.775, 0.771) | −0.06 (−0.90, 0.77) |
| Thigh | 5.5±1.3 | 6.0±1.9 | 0.51 (−0.71, 1.73) | 0.29 (−1.00, 1.58) | 0.37 (−0.91, 1.64) | 0.12 (−1.23, 1.47) |
Notes: Bold italics highlight significant results. LGA is defined as birthweight <10th percentile or >90th percentile for GA, according to the WHO infant weight charts by gender in full-term newborns; GA adjustment was only performed for premature infants, who were evaluated using gender adjusted Fenton growth curves; Model 1 includes maternal age at baseline; Model 2 includes baseline maternal BMI status; Model 3 includes maternal age and BMI at baseline;
a
Median (Minimum, Maximum).
Abbreviations: BMI, body mass index; GA, gestational age; GWG, gestational weight gain; IOM, Institute of Medicine; LGA, large for GA; IRR, incidence rate ratio; SGA, small for GA; WFL, weight-for-length.