Location: Arkansas Children's Nutrition CenterTitle: Are early first trimester weights valid proxies for preconception weight?
|KRUKOWSKI, REBECCA - University Of Tennessee|
|WEST, DELIA - University Of South Carolina|
|DICARLO, MARISHA - Arkansas Department Of Health|
|SHANKAR, KARTIK - Arkansas Children'S Nutrition Research Center (ACNC)|
|CLEVES, MARIO - Arkansas Children'S Nutrition Research Center (ACNC)|
|SAYLORS, MARIE - University Arkansas For Medical Sciences (UAMS)|
|ANDRES, ALINE - Arkansas Children'S Nutrition Research Center (ACNC)|
Submitted to: BMC Pregnancy & Childbirth
Publication Type: Peer Reviewed Journal
Publication Acceptance Date: 11/14/2016
Publication Date: 11/21/2016
Citation: Krukowski, R.A., West, D.S., DiCarlo, M., Shankar, K., Cleves, M.A., Saylors, M.E., Andres, A. 2016. Are early first trimester weights valid proxies for preconception weight? BMC Pregnancy & Childbirth. 16:357. doi:10.1186/s12884-016-1159-6.
Interpretive Summary: Preconception body mass index is used to determine gestational weight gain recommendations based upon the Institute of Medicine Recommendations which have been demonstrated to be critical for adequate maternal and child health. This study investigated whether preconception or first trimester weights are best in determining preconception body mass index and therefore gestational weight gain recommendations. Under identical measurement conditions, a preconception weight and two first trimester weights were obtained for 48 women. Although not ideal, assigning weight gain guidelines for pregnancy based on an early first trimester weight is suitable; with 90% of women being correctly classify for their gestational weight gain recommendations. These findings are important as excessive gestational weight gain has been linked to adverse maternal and child outcomes.
Technical Abstract: An accurate estimate of preconception weight is necessary for providing a gestational weight gain range based on the Institute of Medicine’s guidelines; however, an accurate and proximal preconception weight is not available for most women. We examined the validity of first trimester weights for estimating preconception body mass index category. Under identical measurement conditions, preconception weight and two first trimester weights (i.e., 4–10 and 12 weeks gestation) were obtained (n = 43). Our results showed that the 4–10 week and the 12 week weight correctly classified 95 and 91% women, respectively. Mean weight changes were relatively small overall (M= 0.74 +/- 1.99 kg at 4–10 weeks and M = 1.02 +/- 2.46 at 12 weeks). There was a significant difference in mean weight gain by body mass index category at 4–10 weeks (-0.09 +/- 1.86 kg for normal weight participants vs. 1.61 + 1.76 kg for overweight/obese participants, p = 0.01), but not at 12 weeks (0.53 +/- 2.29 kg for normal weight participants vs. 1.54 +/- 2.58 kg for overweight/obese participants). Assigning gestational weight gain guidelines based on an early first trimester weight resulted in 5–9% of women being misclassified depending on the gestational week the weight was obtained. Thus, most women are correctly classified based on a first trimester weight, particularly an early first trimester weight, although it is possible that modeling strategies could be developed to further improve estimates of preconception body mass index category.