ArticlePaediatric and perinatal epidemiology2015
Comparison of gestational weight gain z-scores and traditional weight gain measures in relation to perinatal outcomes.
Article in Paediatric and perinatal epidemiology, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 38 papers, 2 of them syntheses that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
38 citing papers in PubMed, 2 syntheses or guidelines pooled it, 58 citations in OpenAlex.
- Suboptimal gestational weight gain and neonatal outcomes in low and middle income countries: individual participant data meta-analysis.BMJ (Clinical research ed.) · 2023Pooled it
- Impact of maternal body mass index and gestational weight gain on pregnancy complications: an individual participant data meta-analysis of European, North American and Australian cohorts.BJOG : an international journal of obstetrics and gynaecology · 2019Pooled it
- Fortified Balanced Energy-Protein Supplementation, Maternal Anemia, and Gestational Weight Gain: A Randomized Controlled Efficacy Trial among Pregnant Women in Rural Burkina Faso.The Journal of nutrition · 2022Trial
- Multivitamin Supplementation Is Associated with Greater Adequacy of Gestational Weight Gain among Pregnant Women in Tanzania.The Journal of nutrition · 2022Trial
- Gestational weight gain, cardiometabolic health, and long-term weight retention at 17 years post delivery.Obesity (Silver Spring, Md.) · 2025Article
- Predictors of inadequate and excessive gestational weight gain in women: a retrospective longitudinal observational study.BMJ open · 2025Observational
- Methods for modeling gestational weight gain: empirical application using electronic health record data from a safety net population.BMC pregnancy and childbirth · 2025Article
- The association between self-reported total gestational weight gain by pre-pregnancy body mass index and moderate to late preterm birth.BMC pregnancy and childbirth · 2025Article
- Association between gestational weight gain and adverse pregnancy outcomes: cohort analysis from South Asia and Sub-Saharan Africa.BMJ public health · 2025Article
- The Causal Effect of Increasing Area-Level Income on Birth Outcomes and Pregnancy-Related Health: Estimates From the Marcellus Shale Boom Economy.Demography · 2024Article
- Trimester-specific rate of gestational weight loss or gain and birth size: differences by prepregnancy BMI.Obesity (Silver Spring, Md.) · 2024Article
- Investigating the Shape and Strength of the Relationship Between Maternal Weight Gain and Gestational Age at Delivery in Twin and Singleton Pregnancies.American journal of epidemiology · 2023Article
- Body Mass Index, Adverse Pregnancy Outcomes, and Cardiovascular Disease Risk.Circulation research · 2023Article
- Early Gestational Weight Gain and the Risk of Preeclampsia in Dichorionic Twin Pregnancies.American journal of perinatology · 2023Article
- Maternal exposure to phthalates and total gestational weight gain in the LIFECODES birth cohort.Reproductive toxicology (Elmsford, N.Y.) · 2023Article
- Rates of maternal weight gain over the course of pregnancy and offspring risk of neurodevelopmental disorders.BMC medicine · 2023Article
- Association between gestational weight gain and preterm birth and post-term birth: a longitudinal study from the National Vital Statistics System database.BMC pediatrics · 2023Article
- Effect of pregnancy on female gait characteristics: a pilot study based on portable gait analyzer and induced acceleration analysis.Frontiers in physiology · 2023Article
- Pre-pregnancy body mass index, gestational weight gain and postnatal growth in preterm infants.Journal of perinatology : official journal of the California Perinatal Association · 2021Article
- Comparison of methods for interpolating gestational weight gain between clinical visits in twin and singleton pregnancies.Annals of epidemiology · 2021Article
Corrections and comments
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Authors and funding
5 authors at 3 institutions in 2 countries.
Funding
Abstract
backgroundConventional measures of gestational weight gain (GWG) are correlated with pregnancy duration, and may induce bias to studies of GWG and perinatal outcomes. A maternal weight-gain-for-gestational-age z-score chart is a new tool that allows total GWG to be classified as a standardised z-score that is independent of gestational duration. Our objective was to compare associations with perinatal outcomes when GWG was assessed using gestational age-standardised z-scores and conventional GWG measures.
methodsWe studied normal-weight (n=522 120) and overweight (n=237 923) women who delivered liveborn, singleton infants in Pennsylvania, 2003-11. GWG was expressed using gestational age-standardised z-scores and three traditional measures: total GWG (kg), rate of GWG (kg per week of gestation), and the GWG adequacy ratio (observed GWG/GWG recommended by the Institute of Medicine). Log-binomial regression models were used to assess associations between GWG and preterm birth, and small- and large-for-gestational-age births, while adjusting for race/ethnicity, education, smoking, and other confounders.
resultsThe association between GWG z-score and preterm birth was approximately U-shaped. The risk of preterm birth associated with weight gain <10th percentile of each measure was substantially overestimated when GWG was classified using total kilogram and was moderately overestimated using rate of GWG or GWG adequacy ratio. All GWG measures had similar associations with small- or large-for-gestational-age birth.
conclusionsOur findings suggest that studies of gestational age-dependent outcomes misspecify associations if total GWG, rate of GWG, or GWG adequacy ratio are used. The potential for gestational age-related bias can be eliminated by using z-score charts to classify total GWG.
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