{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T03:29:59Z","timestamp":1792726199512,"version":"4.5.0"},"reference-count":39,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2024,11,5]],"date-time":"2024-11-05T00:00:00Z","timestamp":1730764800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100000024","name":"Canadian Institutes of Health Research","doi-asserted-by":"publisher","award":["202010PJV\/456020"],"award-info":[{"award-number":["202010PJV\/456020"]}],"id":[{"id":"10.13039\/501100000024","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Obesity"],"published-print":{"date-parts":[[2024,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>There is no clear evidence on the risk of gestational weight loss (GWL) for individuals with obesity. Our study aimed to assess the association between GWL and adverse perinatal outcomes among individuals with obesity.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This population\u2010based retrospective cohort study examined individuals with prepregnancy BMI\u2009\u2265\u200930\u2009kg\/m<jats:sup>2<\/jats:sup> who had a singleton pregnancy, using Ontario, Canada, birth registry data from 2012 to 2020. The primary outcome was a composite of adverse outcomes, including perinatal death and neonatal morbidity. The association between GWL and risk of adverse perinatal outcomes was estimated using generalized estimating equation models and restricted cubic spline regression analysis. Stratified analysis was conducted by obesity class.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Of the 157,205 individuals with obesity, 6.1% experienced GWL. Compared with adequate gestational weight gain, GWL was associated with an increased risk of a composite of adverse perinatal outcomes (adjusted risk ratio: 1.31; 95% CI: 1.22\u20131.39). Similar results were observed in the stratified analysis. Restricted cubic spline regression analysis revealed that average weekly gestational weight changes displayed a nonlinear U\u2010shaped association, with a higher risk of a composite of adverse perinatal outcomes noted in the extremities, particularly toward GWL and excessive weight gain.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Our findings suggest that GWL may increase the risk of adverse perinatal outcomes across all obesity classes.<\/jats:p><\/jats:sec>","DOI":"10.1002\/oby.24143","type":"journal-article","created":{"date-parts":[[2024,11,5]],"date-time":"2024-11-05T07:19:36Z","timestamp":1730791176000},"page":"2376-2387","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Risk related to gestational weight loss among individuals with obesity: a population\u2010based cohort study"],"prefix":"10.1002","volume":"32","author":[{"given":"Yanfang","family":"Guo","sequence":"first","affiliation":[{"name":"Clinical Epidemiology Program Ottawa Hospital Research Institute  Ottawa Ontario Canada"},{"name":"Better Outcomes Registry and Network (BORN) Ontario Children's Hospital of Eastern Ontario  Ottawa Ontario Canada"},{"name":"School of Epidemiology and Public Health University of Ottawa  Ottawa Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5269-7207","authenticated-orcid":false,"given":"Sara C. 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J.","family":"Dingwall\u2010Harvey","sequence":"additional","affiliation":[{"name":"Clinical Epidemiology Program Ottawa Hospital Research Institute  Ottawa Ontario Canada"},{"name":"Better Outcomes Registry and Network (BORN) Ontario Children's Hospital of Eastern Ontario  Ottawa Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark C.","family":"Walker","sequence":"additional","affiliation":[{"name":"Clinical Epidemiology Program Ottawa Hospital Research Institute  Ottawa Ontario Canada"},{"name":"Better Outcomes Registry and Network (BORN) Ontario Children's Hospital of Eastern Ontario  Ottawa Ontario Canada"},{"name":"School of Epidemiology and Public Health University of Ottawa  Ottawa Ontario Canada"},{"name":"Department of Obstetrics, Gynecology &amp; Newborn Care The Ottawa Hospital  Ottawa Ontario Canada"},{"name":"Department of Obstetrics and Gynecology University of Ottawa  Ottawa Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shi Wu","family":"Wen","sequence":"additional","affiliation":[{"name":"Clinical Epidemiology Program Ottawa Hospital Research Institute  Ottawa Ontario Canada"},{"name":"School of Epidemiology and Public Health University of Ottawa  Ottawa Ontario Canada"},{"name":"Department of Obstetrics, Gynecology &amp; Newborn Care The Ottawa Hospital  Ottawa Ontario Canada"},{"name":"Department of Obstetrics and Gynecology University of Ottawa  Ottawa Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel J.","family":"Corsi","sequence":"additional","affiliation":[{"name":"Clinical Epidemiology Program Ottawa Hospital Research Institute  Ottawa Ontario Canada"},{"name":"Better Outcomes Registry and Network (BORN) Ontario Children's Hospital of Eastern Ontario  Ottawa Ontario Canada"},{"name":"School of Epidemiology and Public Health University of Ottawa  Ottawa Ontario Canada"},{"name":"Department of Obstetrics and Gynecology University of Ottawa  Ottawa Ontario Canada"},{"name":"Children's Hospital of Eastern Ontario Research Institute  Ottawa Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,11,5]]},"reference":[{"key":"e_1_2_8_2_1","volume-title":"Health E\u2010Stats","author":"Fryar CD","year":"2020"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12884-020-03335-7"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1161\/JAHA.120.020717"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10995-008-0349-x"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(24)00255-1"},{"key":"e_1_2_8_7_1","volume-title":"Weight Gain During Pregnancy: Reexamining the Guidelines","author":"Institute of Medicine (IOM)","year":"2009"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41366-023-01382-6"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1002\/oby.23693"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.3945\/ajcn.2009.29008"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1002\/oby.21335"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2014.03.011"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0000000000000677"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0b013e318214f1d1"},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.AOG.0000278819.17190.87"},{"key":"e_1_2_8_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2014.02.004"},{"key":"e_1_2_8_17_1","doi-asserted-by":"publisher","DOI":"10.1038\/oby.2009.289"},{"key":"e_1_2_8_18_1","unstructured":"National Institute for Health and Care Excellence (NICE).Clinical Guideline [CG189]. 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