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Article: A systematic review and metaanalysis of energy intake and weight gain in pregnancy

TitleA systematic review and metaanalysis of energy intake and weight gain in pregnancy
Authors
KeywordsEnergy intake
First trimester
Gestational weight gain
Pregnancy
Third trimester
Issue Date2016
PublisherMosby, Inc. The Journal's web site is located at http://www.elsevier.com/locate/ajog
Citation
American Journal of Obstetrics and Gynecology, 2016, v. 214 n. 4, p. 465-483 How to Cite?
AbstractBACKGROUND: Gestational weight gain within the recommended range produces optimal pregnancy outcomes, yet many women exceed the guidelines. Official recommendations to increase energy intake by ∼ 1000 kJ/day in pregnancy may be excessive. OBJECTIVE: To determine by metaanalysis of relevant studies whether greater increments in energy intake from early to late pregnancy corresponded to greater or excessive gestational weight gain. DATA SOURCES: We systematically searched electronic databases for observational and intervention studies published from 1990 to the present. The databases included Ovid Medline, Cochrane Library, Excerpta Medica DataBASE (EMBASE), Cumulative Index to Nursing and Allied Health Literature (CINAHL), and Science Direct. In addition we hand-searched reference lists of all identified articles. STUDY ELIGIBILITY CRITERIA: Studies were included if they reported gestational weight gain and energy intake in early and late gestation in women of any age with a singleton pregnancy. Search also encompassed journals emerging from both developed and developing countries. STUDY APPRAISAL AND SYNTHESIS METHODS: Studies were individually assessed for quality based on the Quality Criteria Checklist obtained from the Evidence Analysis Manual: Steps in the academy evidence analysis process. Publication bias was plotted by the use of a funnel plot with standard mean difference against standard error. Identified studies were meta-analyzed and stratified by body mass index, study design, dietary methodology, and country status (developed/developing) by the use of a random-effects model. RESULTS: Of 2487 articles screened, 18 studies met inclusion criteria. On average, women gained 12.0 (2.8) kg (standardized mean difference = 1.306, P < .0005) yet reported only a small increment in energy intake that did not reach statistical significance (∼475 kJ/day, standard mean difference = 0.266, P = .016). Irrespective of baseline body mass index, study design, dietary methodology, or country status, changes in energy intake were not significantly correlated to the amount of gestational weight gain (r = 0.321, P = .11). CONCLUSION: Despite rapid physiologic weight gain, women report little or no change in energy intake during pregnancy. Current recommendations to increase energy intake by ∼ 1000 kJ/day may, therefore, encourage excessive weight gain and adverse pregnancy outcomes.
Persistent Identifierhttp://hdl.handle.net/10722/225476
ISSN
2015 Impact Factor: 4.681
2015 SCImago Journal Rankings: 2.255

 

DC FieldValueLanguage
dc.contributor.authorJebeile, H-
dc.contributor.authorMijatovic, J-
dc.contributor.authorLouie, CYJ-
dc.contributor.authorPrvan, T-
dc.contributor.authorBrand-Miller, JC-
dc.date.accessioned2016-05-18T01:00:57Z-
dc.date.available2016-05-18T01:00:57Z-
dc.date.issued2016-
dc.identifier.citationAmerican Journal of Obstetrics and Gynecology, 2016, v. 214 n. 4, p. 465-483-
dc.identifier.issn0002-9378-
dc.identifier.urihttp://hdl.handle.net/10722/225476-
dc.description.abstractBACKGROUND: Gestational weight gain within the recommended range produces optimal pregnancy outcomes, yet many women exceed the guidelines. Official recommendations to increase energy intake by ∼ 1000 kJ/day in pregnancy may be excessive. OBJECTIVE: To determine by metaanalysis of relevant studies whether greater increments in energy intake from early to late pregnancy corresponded to greater or excessive gestational weight gain. DATA SOURCES: We systematically searched electronic databases for observational and intervention studies published from 1990 to the present. The databases included Ovid Medline, Cochrane Library, Excerpta Medica DataBASE (EMBASE), Cumulative Index to Nursing and Allied Health Literature (CINAHL), and Science Direct. In addition we hand-searched reference lists of all identified articles. STUDY ELIGIBILITY CRITERIA: Studies were included if they reported gestational weight gain and energy intake in early and late gestation in women of any age with a singleton pregnancy. Search also encompassed journals emerging from both developed and developing countries. STUDY APPRAISAL AND SYNTHESIS METHODS: Studies were individually assessed for quality based on the Quality Criteria Checklist obtained from the Evidence Analysis Manual: Steps in the academy evidence analysis process. Publication bias was plotted by the use of a funnel plot with standard mean difference against standard error. Identified studies were meta-analyzed and stratified by body mass index, study design, dietary methodology, and country status (developed/developing) by the use of a random-effects model. RESULTS: Of 2487 articles screened, 18 studies met inclusion criteria. On average, women gained 12.0 (2.8) kg (standardized mean difference = 1.306, P < .0005) yet reported only a small increment in energy intake that did not reach statistical significance (∼475 kJ/day, standard mean difference = 0.266, P = .016). Irrespective of baseline body mass index, study design, dietary methodology, or country status, changes in energy intake were not significantly correlated to the amount of gestational weight gain (r = 0.321, P = .11). CONCLUSION: Despite rapid physiologic weight gain, women report little or no change in energy intake during pregnancy. Current recommendations to increase energy intake by ∼ 1000 kJ/day may, therefore, encourage excessive weight gain and adverse pregnancy outcomes.-
dc.languageeng-
dc.publisherMosby, Inc. The Journal's web site is located at http://www.elsevier.com/locate/ajog-
dc.relation.ispartofAmerican Journal of Obstetrics and Gynecology-
dc.rightsPosting accepted manuscript (postprint): © <year>. This manuscript version is made available under the CC-BY-NC-ND 4.0 license http://creativecommons.org/licenses/by-nc-nd/4.0/-
dc.subjectEnergy intake-
dc.subjectFirst trimester-
dc.subjectGestational weight gain-
dc.subjectPregnancy-
dc.subjectThird trimester-
dc.titleA systematic review and metaanalysis of energy intake and weight gain in pregnancy-
dc.typeArticle-
dc.identifier.emailLouie, CYJ: h0115648@graduate.hku.hk-
dc.identifier.authorityLouie, CYJ=rp02118-
dc.description.naturelink_to_subscribed_fulltext-
dc.identifier.doi10.1016/j.ajog.2015.12.049-
dc.identifier.pmid26739796-
dc.identifier.volume214-
dc.identifier.issue4-
dc.identifier.spage465-
dc.identifier.epage483-
dc.publisher.placeUnited States-

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