J Clin Med Res

Journal of Clinical Medicine Research, ISSN 1918-3003 print, 1918-3011 online, Open Access

Article copyright, the authors; Journal compilation copyright, J Clin Med Res and Elmer Press Inc

Journal website http://www.jocmr.org

Original Article

Volume 8, Number 11, November 2016, pages 787-792

Optimal Weight Gain During Pregnancy in Japanese Women

**Table 1.** Clinical Characteristics of the Underweight Women With the Optimal Weight Gain Recommended in the JMHLW and IOM Guidelines
Characteristics	Weight gain during pregnancy
Data are presented as mean ± standard deviation or number (percentages). *P < 0.05 vs. IOM group. JMHLW: Japanese Ministry of Health, Labour and Welfare; IOM: Institute of Medicine.
Number	204	127
Maternal age
< 20 years old	1 (0.5%)*	5 (3.9%)
≥ 40 years old	27 (13.2%)*	7 (5.5%)
Primiparous women	104 (51.0%)*	80 (63.0%)
Maternal height (cm)	159 ± 6.3	159 ± 4.9
Maternal weight at pre-pregnancy (kg)	43.7 ± 3.8	43.4 ± 3.3
Body mass index at pre-pregnancy	17.2 ± 0.7	17.2 ± 0.8
Maternal weight at delivery (kg)	54.2 ± 4.2*	58.1 ± 3.8

Table 1. Clinical Characteristics of the Underweight Women With the Optimal Weight Gain Recommended in the JMHLW and IOM Guidelines

Characteristics

Weight gain during pregnancy

9 - 12 kg (JMHLW guideline)

12.7 - 18.1 kg (IOM guideline)

Data are presented as mean ± standard deviation or number (percentages). *P < 0.05 vs. IOM group. JMHLW: Japanese Ministry of Health, Labour and Welfare; IOM: Institute of Medicine.

Number

204

127

Maternal age

< 20 years old

1 (0.5%)*

5 (3.9%)

≥ 40 years old

27 (13.2%)*

7 (5.5%)

Primiparous women

104 (51.0%)*

80 (63.0%)

Maternal height (cm)

159 ± 6.3

159 ± 4.9

Maternal weight at pre-pregnancy (kg)

43.7 ± 3.8

43.4 ± 3.3

Body mass index at pre-pregnancy

17.2 ± 0.7

17.2 ± 0.8

Maternal weight at delivery (kg)

54.2 ± 4.2*

58.1 ± 3.8

**Table 2.** Perinatal Outcomes of the Underweight Women With the Optimal Weight Gain Recommended in the JMHLW and IOM Guidelines
Characteristics	Weight gain during pregnancy	P-value*	Odds ratio	95% confidence interval
Data are presented as number (percentages). *P < 0.05 vs. IOM group. JMHLW: Japanese Ministry of Health, Labour and Welfare; IOM: Institute of Medicine.
Number	204	127
Hypertensive disorders	6 (2.9%)	5 (3.9%)	0.75	0.74	0.23 - 2.33
Gestational diabetes mellitus	0 (0%)	8 (6.3%)	< 0.01	0	0 - 0.28
Preterm delivery	20 (9.8%)	2 (1.6%)	< 0.01	6.79	1.73 - 26.57
Cesarean delivery	43 (21.1%)	25 (9.7%)	0.78	1.09	0.63 - 1.89
Neonatal birth weight
< 2,500 g	33 (16.2%)	9 (7.1%)	0.02	2.53	1.18 - 5.40
≥ 4,000 g	0 (0%)	1 (0.8%)	0.38	0	0 - 2.39
Postpartum hemorrhage ≥ 1,000 mL	15 (7.4%)	13 (10.2%)	0.42	0.70	0.32 - 1.49

Table 2. Perinatal Outcomes of the Underweight Women With the Optimal Weight Gain Recommended in the JMHLW and IOM Guidelines

Characteristics

Weight gain during pregnancy

P-value*

Odds ratio

95% confidence interval

9 - 12 kg (JMHLW guideline)

12.7 - 18.1 kg (IOM guideline)

Data are presented as number (percentages). *P < 0.05 vs. IOM group. JMHLW: Japanese Ministry of Health, Labour and Welfare; IOM: Institute of Medicine.

Number

204

127

Hypertensive disorders

6 (2.9%)

5 (3.9%)

0.75

0.74

0.23 - 2.33

Gestational diabetes mellitus

0 (0%)

8 (6.3%)

< 0.01

0 - 0.28

Preterm delivery

20 (9.8%)

2 (1.6%)

< 0.01

6.79

1.73 - 26.57

Cesarean delivery

43 (21.1%)

25 (9.7%)

0.78

1.09

0.63 - 1.89

Neonatal birth weight

< 2,500 g

33 (16.2%)

9 (7.1%)

0.02

2.53

1.18 - 5.40

≥ 4,000 g

0 (0%)

1 (0.8%)

0.38

0 - 2.39

Postpartum hemorrhage ≥ 1,000 mL

15 (7.4%)

13 (10.2%)

0.42

0.70

0.32 - 1.49

**Table 3.** Clinical Characteristics of the Normal-Weight Women With the Optimal Weight Gain Recommended in the JMHLW and IOM Guidelines
Characteristics	Weight gain during pregnancy
Data are presented as mean ± standard deviation or number (percentages). *P < 0.05 vs. IOM group. JMHLW: Japanese Ministry of Health, Labour and Welfare; IOM: Institute of Medicine.
Number	2,136	1,348
Maternal age
< 20 years old	34 (1.6%)	29 (2.2%)
≥ 40 years old	269 (12.6%)*	112 (8.3%)
Primiparous women	1,064 (49.8%)	695 (51.6%)
Maternal height (cm)	158 ± 5.4	159 ± 5.3
Maternal weight at pre-pregnancy (kg)	51.7 ± 5.3	52.5 ± 5.4
Body mass index at pre-pregnancy	20.6 ± 1.7	20.7 ± 1.7
Maternal weight at delivery (kg)	61.3 ± 5.5*	65.6 ± 5.6

Table 3. Clinical Characteristics of the Normal-Weight Women With the Optimal Weight Gain Recommended in the JMHLW and IOM Guidelines

Characteristics

Weight gain during pregnancy

7 - 12 kg (JMHLW guideline)

11.3 - 15.9 kg (IOM guideline)

Data are presented as mean ± standard deviation or number (percentages). *P < 0.05 vs. IOM group. JMHLW: Japanese Ministry of Health, Labour and Welfare; IOM: Institute of Medicine.

Number

2,136

1,348

Maternal age

< 20 years old

34 (1.6%)

29 (2.2%)

≥ 40 years old

269 (12.6%)*

112 (8.3%)

Primiparous women

1,064 (49.8%)

695 (51.6%)

Maternal height (cm)

158 ± 5.4

159 ± 5.3

Maternal weight at pre-pregnancy (kg)

51.7 ± 5.3

52.5 ± 5.4

Body mass index at pre-pregnancy

20.6 ± 1.7

20.7 ± 1.7

Maternal weight at delivery (kg)

61.3 ± 5.5*

65.6 ± 5.6

**Table 4.** Perinatal Outcomes of the Normal-Weight Women With the Optimal Weight Gain Recommended in the JMHLW and IOM Guideline
Characteristics	Weight gain during pregnancy	P-value*	Odds ratio	95% confidence interval
Data are presented as number (percentages). *P < 0.05 vs. IOM group. JMHLW: Japanese Ministry of Health, Labour and Welfare; IOM: Institute of Medicine.
Number	2,136	1,348
Hypertensive disorders	143 (6.7%)	118 (8.8%)	0.03	0.75	0.58 - 0.94
Gestational diabetes mellitus	37 (1.7%)	19 (1.4%)	0.49	1.23	0.71 - 2.14
Preterm delivery	135 (6.3%)	51 (3.8%)	< 0.01	1.71	1.23 - 2.38
Cesarean delivery	398 (18.6%)	282 (20.9%)	0.1	0.87	0.73 - 1.03
Neonatal birth weight
< 2,500 g	227 (10.6%)	87 (6.5%)	< 0.01	1.72	1.33 - 2.23
≥ 4,000 g	7 (0.3%)	21 (1.6%)	< 0.01	0.21	0.09 - 0.48
Postpartum hemorrhage ≥ 1,000 mL	152 (7.1%)	155 (11.5%)	< 0.01	0.59	0.47 - 0.75

Table 4. Perinatal Outcomes of the Normal-Weight Women With the Optimal Weight Gain Recommended in the JMHLW and IOM Guideline

Characteristics

Weight gain during pregnancy

P-value*

Odds ratio

95% confidence interval

7 - 12 kg (JMHLW guideline)

11.3 - 15.9 kg (IOM guideline)

Data are presented as number (percentages). *P < 0.05 vs. IOM group. JMHLW: Japanese Ministry of Health, Labour and Welfare; IOM: Institute of Medicine.

Number

2,136

1,348

Hypertensive disorders

143 (6.7%)

118 (8.8%)

0.03

0.75

0.58 - 0.94

Gestational diabetes mellitus

37 (1.7%)

19 (1.4%)

0.49

1.23

0.71 - 2.14

Preterm delivery

135 (6.3%)

51 (3.8%)

< 0.01

1.71

1.23 - 2.38

Cesarean delivery

398 (18.6%)

282 (20.9%)

0.1

0.87

0.73 - 1.03

Neonatal birth weight

< 2,500 g

227 (10.6%)

87 (6.5%)

< 0.01

1.72

1.33 - 2.23

≥ 4,000 g

7 (0.3%)

21 (1.6%)

< 0.01

0.21

0.09 - 0.48

Postpartum hemorrhage ≥ 1,000 mL

152 (7.1%)

155 (11.5%)

< 0.01

0.59

0.47 - 0.75

**Table 5.** Clinical Characteristics of the Overweight Women With the Optimal Weight Gain Recommended in the JASSO and IOM Guidelines
Characteristics	Weight gain during pregnancy
Data are presented as mean ± standard deviation or number (percentages). *P < 0.05 vs. IOM group. JASSO: Japan Society for the Study of Obesity; IOM: Institute of Medicine.
Number	141	161
Maternal height (cm)	158 ± 6.0	158 ± 5.6
Maternal weight at pre-pregnancy (kg)	67.7 ± 6.6	67.1 ± 6.4
Body mass index at pre-pregnancy	27.2 ± 1.5	26.8 ± 1.3
Maternal weight at delivery (kg)	71.3 ± 6.7*	76.3 ± 6.6
Maternal age
< 20 years old	2 (1.4%)	1 (0.6%)
≥ 40 years old	21 (14.9%)	21 (13.0%)
Primiparous women	59 (41.8%)	61 (37.9%)
Maternal height (cm)	158 ± 6.0	158 ± 5.6

Table 5. Clinical Characteristics of the Overweight Women With the Optimal Weight Gain Recommended in the JASSO and IOM Guidelines

Characteristics

Weight gain during pregnancy

≤ 7 kg (JSSO guideline)

6.8 - 11.3 kg (IOM guideline)

Data are presented as mean ± standard deviation or number (percentages). *P < 0.05 vs. IOM group. JASSO: Japan Society for the Study of Obesity; IOM: Institute of Medicine.

Number

141

161

Maternal height (cm)

158 ± 6.0

158 ± 5.6

Maternal weight at pre-pregnancy (kg)

67.7 ± 6.6

67.1 ± 6.4

Body mass index at pre-pregnancy

27.2 ± 1.5

26.8 ± 1.3

Maternal weight at delivery (kg)

71.3 ± 6.7*

76.3 ± 6.6

Maternal age

< 20 years old

2 (1.4%)

1 (0.6%)

≥ 40 years old

21 (14.9%)

21 (13.0%)

Primiparous women

59 (41.8%)

61 (37.9%)

Maternal height (cm)

158 ± 6.0

158 ± 5.6

**Table 6.** Perinatal Outcomes of the Overweight Women With the Optimal Weight Gain Recommended in the JASSO and IOM Guidelines
Characteristics	Weight gain during pregnancy	P-value*	Odds ratio	95% confidence interval
Data are presented as number (percentages). *P < 0.05 vs. IOM group. JASSO: Japan Society for the Study of Obesity; IOM: Institute of Medicine.
Number	141	161
Primiparous women	59 (41.8%)	61 (37.9%)
Hypertensive disorders	25 (17.7%)	13 (8.1%)	0.01	2.45	1.21 - 4.95
Gestational diabetes mellitus	15 (10.6%)	9 (5.6%)	0.14	2.01	0.87 - 4.65
Preterm delivery	9 (6.4%)	2 (1.2%)	0.03	5.42	1.29 - 22.59
Cesarean delivery	45 (31.9%)	63 (39.1%)	0.23	0.73	0.45 - 1.17
Neonatal birth weight
< 2,500 g	15 (10.6%)	7 (4.3%)	0.04	2.62	1.06 - 6.44
≥ 4,000 g	4 (2.8%)	2 (1.2%)	0.42	2.32	0.49 - 10.99
Postpartum hemorrhage ≥ 1,000 mL	17 (5.0%)	16 (3.7%)	0.58	1.24	0.61 - 2.53

Table 6. Perinatal Outcomes of the Overweight Women With the Optimal Weight Gain Recommended in the JASSO and IOM Guidelines

Characteristics

Weight gain during pregnancy

P-value*

Odds ratio

95% confidence interval

≤ 7 kg (JSSO guideline)

6.8 - 11.3 kg (IOM guideline)

Data are presented as number (percentages). *P < 0.05 vs. IOM group. JASSO: Japan Society for the Study of Obesity; IOM: Institute of Medicine.

Number

141

161

Primiparous women

59 (41.8%)

61 (37.9%)

Hypertensive disorders

25 (17.7%)

13 (8.1%)

0.01

2.45

1.21 - 4.95

Gestational diabetes mellitus

15 (10.6%)

9 (5.6%)

0.14

2.01

0.87 - 4.65

Preterm delivery

9 (6.4%)

2 (1.2%)

0.03

5.42

1.29 - 22.59

Cesarean delivery

45 (31.9%)

63 (39.1%)

0.23

0.73

0.45 - 1.17

Neonatal birth weight

< 2,500 g

15 (10.6%)

7 (4.3%)

0.04

2.62

1.06 - 6.44

≥ 4,000 g

4 (2.8%)

2 (1.2%)

0.42

2.32

0.49 - 10.99

Postpartum hemorrhage ≥ 1,000 mL

17 (5.0%)

16 (3.7%)

0.58

1.24

0.61 - 2.53

**Table 7.** Clinical Characteristics of the Obese Women With the Optimal Weight Gain Recommended in the JASSO and IOM Guidelines
Characteristics	Weight gain during pregnancy
Data are presented as mean ± standard deviation or number (percentages). *P < 0.05 vs. IOM group. JASSO: Japan Society for the Study of Obesity; IOM: Institute of Medicine.
Number	61	41
Maternal age
< 20 years old	1 (1.6%)	1 (2.4%)
≥ 40 years old	8 (13.1%)	7 (17.1%)
Primiparous women	25 (41.0%)	21 (51.2%)
Maternal height (cm)	158 ± 6.6	156 ± 4.4
Maternal weight at pre-pregnancy (kg)	83.5 ± 9.5	81.0 ± 7.9
Body mass index at pre-pregnancy	33.5 ± 3.0	33.3 ± 2.5
Maternal weight at delivery (kg)	84.3 ± 7.8*	88.0 ± 7.4

Table 7. Clinical Characteristics of the Obese Women With the Optimal Weight Gain Recommended in the JASSO and IOM Guidelines

Characteristics

Weight gain during pregnancy

≤ 5 kg (JSSO guideline)

5.0 - 9.1 kg (IOM guideline)

Data are presented as mean ± standard deviation or number (percentages). *P < 0.05 vs. IOM group. JASSO: Japan Society for the Study of Obesity; IOM: Institute of Medicine.

Number

Maternal age

< 20 years old

1 (1.6%)

1 (2.4%)

≥ 40 years old

8 (13.1%)

7 (17.1%)

Primiparous women

25 (41.0%)

21 (51.2%)

Maternal height (cm)

158 ± 6.6

156 ± 4.4

Maternal weight at pre-pregnancy (kg)

83.5 ± 9.5

81.0 ± 7.9

Body mass index at pre-pregnancy

33.5 ± 3.0

33.3 ± 2.5

Maternal weight at delivery (kg)

84.3 ± 7.8*

88.0 ± 7.4

**Table 8.** Perinatal Outcomes of the Obese Women With the Optimal Weight Gain Recommended in the JASSO and IOM Guidelines
Characteristics	Weight gain during pregnancy	P-value*	Odds ratio	95% confidence interval
Data are presented as number (percentages). *P < 0.05 vs. IOM group. JASSO: Japan Society for the Study of Obesity; IOM: Institute of Medicine.
Number	61	41
Hypertensive disorders	14 (23.0%)	11 (26.8%)	0.82	0.81	0.33 - 1.99
Gestational diabetes mellitus	14 (23.0%)	3 (7.3%)	0.07	3.77	1.07 - 9.94
Preterm delivery	4 (6.6%)	4 (9.8%)	0.71	0.65	0.17 - 2.53
Cesarean delivery	17 (27.9%)	17 (41.5%)	0.19	0.55	0.24 - 1.25
Neonatal birth weight
< 2,500 g	1 (1.6%)	2 (4.9%)	0.56	0.33	0.04 - 2.52
≥ 4,000 g	2 (3.3%)	1 (2.4%)	0.99	1.36	0.17 - 10.65
Postpartum hemorrhage ≥ 1,000 mL	6 (9.8%)	7 (17.1%)	0.37	0.53	0.17 - 1.64

Table 8. Perinatal Outcomes of the Obese Women With the Optimal Weight Gain Recommended in the JASSO and IOM Guidelines

Characteristics

Weight gain during pregnancy

P-value*

Odds ratio

95% confidence interval

≤ 5 kg (JSSO guideline)

5.0 - 9.1 kg (IOM guideline)

Data are presented as number (percentages). *P < 0.05 vs. IOM group. JASSO: Japan Society for the Study of Obesity; IOM: Institute of Medicine.

Number

Hypertensive disorders

14 (23.0%)

11 (26.8%)

0.82

0.81

0.33 - 1.99

Gestational diabetes mellitus

14 (23.0%)

3 (7.3%)

0.07

3.77

1.07 - 9.94

Preterm delivery

4 (6.6%)

4 (9.8%)

0.71

0.65

0.17 - 2.53

Cesarean delivery

17 (27.9%)

17 (41.5%)

0.19

0.55

0.24 - 1.25

Neonatal birth weight

< 2,500 g

1 (1.6%)

2 (4.9%)

0.56

0.33

0.04 - 2.52

≥ 4,000 g

2 (3.3%)

1 (2.4%)

0.99

1.36

0.17 - 10.65

Postpartum hemorrhage ≥ 1,000 mL

6 (9.8%)

7 (17.1%)

0.37

0.53

0.17 - 1.64