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A M Siega-Riz

Publications and source records attributed to A M Siega-Riz.

22 records · Page 2Linked to original sources

Maternal underweight status and inadequate rate of weight gain during the third trimester of pregnancy increases the risk of preterm delivery.

This study examines the differences in the pattern of weight gain according to trimesters of pregnancy for women who delivered term vs. preterm and analyzes the independent effect of prepregnancy weight status and rate of weight gain on delivering preterm. The differential effects of these variables on the etiological pathways of prematurity (preterm labor and preterm rupture of the amniotic membranes) were also examined. Data were collected prospectively from 7589 pregnant women receiving care in public health clinics in the West Los Angeles area. Eighty percent of women identified themselves as being of Hispanic origin. Multivariate logistic regression techniques were used to isolate the role of each nutritional variable from other factors that may influence birth outcome. Women who delivered preterm had patterns of weight gain similar to women delivering term infants. Underweight status (body mass index < 19.8 kg/m2) before pregnancy nearly doubled the likelihood of delivering preterm [adjusted odds ratio (AOR) 1.98, 95% confidence interval (CI) = 1.33, 2.98). Inadequate weight gain in the third trimester defined as < 0.34, 0.35, 0.30 and 0.30 kg/wk for underweight, normal weight, overweight and obese women, respectively, increased the risk by a similar magnitude (AOR 1.91, 95% CI = 1.40, 2.61). Slight differentiation of these risk factors occurred when analyzing the etiological pathways of preterm birth. Preconceptional nutrition counseling and promotion of adequate weight gain during the third trimester of pregnancy should be components of public health programs designed to decrease the prevalence of preterm birth.

Adolescent↗

Institute of Medicine maternal weight gain recommendations and pregnancy outcome in a predominantly Hispanic population.

OBJECTIVES: To describe gestational weight gain patterns by pre-pregnancy weight and trimester of pregnancy, and to examine the risk of preterm birth associated with pre-pregnancy weight and gestational weight gain using various definitions of adequacy based on the Institute of Medicine (IOM) standard. METHODS: We used data collected prospectively from 8736 pregnant women receiving care in public health clinics in the West Los Angeles area. Pre-pregnancy weight was based on self-report obtained at the initial visit. Maternal weight was measured at each prenatal visit, allowing for the calculation of total weight gain and the rate of weight gain during each trimester. RESULTS: Women underweight before pregnancy (body mass index less than 19.8) had the greatest risk of delivering preterm (crude relative risk 1.7, P < .05). Similarities in patterns of weight gain were seen between women of low weight and normal pre-pregnancy weight status, as well as between overweight and obese women. Compared to the IOM recommendations for total weight gain, 47.8% of underweight women and 36.6% of normal-weight women gained the recommended amount. In contrast, 52% and more than 75% of overweight and obese women, respectively, had excessive gains. Inadequate weight gain during the third trimester as opposed to excessive gain, defined specifically for each pre-pregnancy weight status, was predictive of preterm birth. CONCLUSIONS: Weight monitoring during pregnancy continues to have clinical applications for the prediction of poor birth outcomes. Weight gain less than 90% the IOM recommendation in the third trimester may serve as an indicator for identifying women at risk of delivering preterm.

Academies and Institutes↗

Biological determinants of pregnancy weight gain in a Filipino population.

Patterns of pregnancy weight gain and predictors of first trimester and total weight gain were investigated in a sample of 1367 women from Cebu, Philippines, with pregnancy intervals of < 2 y. The mean total weight gain based on actual measurements of prepregnant weight was 8.4 kg. Controlling for gestational week when weight was measured, multivariate-regression models predicted higher first trimester weight gain with higher parity, lower prepregnant body mass index (BMI), and longer nonpregnant intervals. Higher total weight gain was associated with longer nonpregnant intervals, lower prepregnant BMI, taller maternal stature, and relatively high dietary energy intakes. Lactation into the third trimester of pregnancy and maternal age over 35 y had significant negative effects on total weight gain. Given the importance of maternal weight gain in predicting birth outcome, this study provides information on modifiable risk factors that should be considered when developing maternal-infant health policy and programs.

Adolescent↗