Testing the Institute of Medicine (IOM) recommendations on maternal reproductive health and associated neonatal characteristics in a transitional, Mediterranean population

Ann Hum Biol. 2022 Mar;49(2):91-99. doi: 10.1080/03014460.2022.2080863. Epub 2022 Jun 20.


Background: High pre-pregnancy body mass index (BMI) and excessive gestational weight gain (GWG) are significant risk factors for maternal and neonatal health.

Aim: To assess pre-pregnancy BMI and GWG during pregnancy and their association with different maternal and neonatal characteristics in the transitional Mediterranean population from the Eastern Adriatic islands.

Subjects and methods: Two hundred and sixty-two mother-child dyads from the CRoatian Islands' Birth Cohort Study (CRIBS) were included in the study. Chi-square test, ANOVA, and regression analysis were used to test the association between selected characteristics.

Results: In total, 22% of women entered pregnancy as overweight/obese and 46.6% had excessive GWG. Pre-pregnancy overweight and obesity were significantly associated with elevated triglycerides uric acid levels, and decreased HDL cholesterol in pregnancy. Excessive GWG was associated with elevated fibrinogen and lipoprotein A levels. Women with high pre-pregnancy BMI and GWG values were more likely to give birth to babies that were large for gestational age (LGA), additionally confirmed in the multiple logistic regression model.

Conclusion: High maternal pre-pregnancy BMI and excessive GWG were both significantly associated with deviated biochemical parameters and neonatal size. More careful monitoring of maternal nutritional status can lead to better pre- and perinatal maternal healthcare.

Keywords: CRIBS cohort study; Eastern Adriatic islands; Mediterranean; biochemical profile LGA; gestational weight gain (GWG); pre-pregnancy BMI.

MeSH terms

  • Body Mass Index
  • Cohort Studies
  • Female
  • Humans
  • Infant, Newborn
  • National Academies of Science, Engineering, and Medicine, U.S., Health and Medicine Division
  • Obesity / epidemiology
  • Obesity / etiology
  • Overweight* / epidemiology
  • Pregnancy
  • Pregnancy Outcome / epidemiology
  • Reproductive Health*
  • United States
  • Weight Gain