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**2** 

*Japan* 

Hiroko Watanabe

**The Effect of Prepregnancy Body Mass Index** 

**and Gestational Weight Gain on Birth Weight** 

Birth weight is an important predictor in infant mortality and morbidity, growth, development and wellbeing in adult life (Goldfrey & Barker, 2000). Reduced-size-at-birth infants, which include low birth weight (LBW: birth weight <2,500 g) and small-forgestational age (SGA: below the 10th percentile for gestational age) infants, are at greater risk of having reduced educational capacity, school performance, and intellectual

Some adult health risks also have a clear negative correlation with infant birth weight. In 1980', Barker & Osmond in the UK reported that differences around the UK in neonatal mortality as maker for LBW in 1921-1925 predicted death rates from stroke and heart disease in 1968-1978 (Barker & Osmond, 1986). They found that LBW and weight at one year were associated with an increased risk of death from cardiovascular disease. There was an approximate two times of the mortality rate from the highest to the lowest extremes of birth

Over recent decades, accumulating evidence around the world has suggested that LBW may be associated with an increased risk of subsequent development of a variety of complications in adulthood including cardiovascular disease, non-insulin-dependent diabetes mellitus, hypertension, and dyslipidemia (Li et al., 1998; Rich-Edwards et al., 1999). These studies have led to discoveries of the developmental, fetal origins of adult health and disease; fetal programming theory states that fetal growth restriction, secondary to under nutrition, has long-lasting physiologic and structural effects that predispose the fetus to diseases later in life. On the other hand, high birth weight relates to complications during delivery including shoulder dystocia and caesarean sections and to obesity during child- and adulthood (Stotland et al., 2004; Weiss et al., 2004). Increased numbers of high birth weight infants (>4,000 g) and large-for-gestational age infants (LGA; birth weight above the 90th percentile for gestational age) have been reported in North America and Europe (Kramer et al., 2002; Surkan et al., 2004). In the past three decades, there has been a 116 g increase in singleton birth weight (Catalano, 2007). Fetal growth is affected by maternal obesity and by mothers being overweight during pregnancy. Recent evidence suggests that LGA infants are also at increased risk for childhood and subsequent adult obesity as well as type two diabetes (Parsons et al., 2001). Thus, birth weight may be an important parameter of adult disease.

a

development than are infants of normal birth weight (Lagerstrom et al., 1991).

**1. Introduction** 

weight (Barker et al., 1989).

*Department of Clinical Nursing, Shiga University of Medical Science* 

