Document Detail


The bias in current measures of gestational weight gain.
MedLine Citation:
PMID:  22324496     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Conventional measures of gestational weight gain (GWG), such as average rate of weight gain, are likely to be correlated with gestational duration. Such a correlation could introduce bias to epidemiological studies of GWG and adverse perinatal outcomes because many perinatal outcomes are also correlated with gestational duration. This study aimed to quantify the extent to which currently used GWG measures may bias the apparent relationship between maternal weight gain and risk of preterm birth. For each woman in a provincial perinatal database registry (British Columbia, Canada, 2000-2009), a total GWG was simulated such that it was uncorrelated with risk of preterm birth. The simulation was based on serial antenatal GWG measurements from a sample of term pregnancies. Simulated GWGs were classified using three approaches: total weight gain (kg), average rate of weight gain (kg/week) or adequacy of GWG in relation to Institute of Medicine recommendations. Their association with preterm birth ≤32 weeks was explored using logistic regression. All measures of GWG induced an apparent association between GWG and preterm birth ≤32 weeks even when, by design, none existed. Odds ratios in the lowest fifths of each GWG measure compared with the middle fifths ranged from 4.4 [95% confidence interval (CI) 3.6, 5.4] (total weight gain) to 1.6 [95% CI 1.3, 2.0] (Institute of Medicine adequacy ratio). Conventional measures of GWG introduce serious bias to the study of maternal weight gain and preterm birth. A new measure of GWG that is uncorrelated with gestational duration is needed.
Authors:
Jennifer A Hutcheon; Lisa M Bodnar; K S Joseph; Barbara Abrams; Hyagriv N Simhan; Robert W Platt
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2012-01-16
Journal Detail:
Title:  Paediatric and perinatal epidemiology     Volume:  26     ISSN:  1365-3016     ISO Abbreviation:  Paediatr Perinat Epidemiol     Publication Date:  2012 Mar 
Date Detail:
Created Date:  2012-02-13     Completed Date:  2012-05-22     Revised Date:  2013-05-13    
Medline Journal Info:
Nlm Unique ID:  8709766     Medline TA:  Paediatr Perinat Epidemiol     Country:  England    
Other Details:
Languages:  eng     Pagination:  109-16     Citation Subset:  IM    
Copyright Information:
© 2012 Blackwell Publishing Ltd.
Affiliation:
Department of Obstetrics & Gynaecology, University of British Columbia, Vancouver, Canada. jhutcheon@cfri.ca
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MeSH Terms
Descriptor/Qualifier:
Adult
Bias (Epidemiology)
Birth Weight
Body Mass Index
British Columbia
Female
Gestational Age
Humans
Infant, Newborn
Models, Theoretical
Pregnancy
Pregnancy Complications*
Premature Birth / etiology*
Risk Factors
Weight Gain*
Young Adult
Grant Support
ID/Acronym/Agency:
R21 HD067851/HD/NICHD NIH HHS; //Canadian Institutes of Health Research

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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