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Maternal underweight was linked to higher low-birth-weight, growth-restriction, and preterm-birth odds in Japan

Journal of epidemiology (PubMed)Aug 5, 2026

AI-summarized from the linked source. Educational brief, not medical advice.

Brief summary

A 34-study meta-analysis in Japanese singleton pregnancies associated pre-pregnancy underweight with higher odds of low birth weight, small for gestational age, and preterm birth.

What NurseJet pulled from the source

Compared with other pre-pregnancy weight groups in the included observational studies, BMI below 18.5 kg/m² was associated with 61% higher odds of low birth weight, 59% higher odds of small for gestational age, and 23% higher odds of preterm birth. Mean birth weight was about 115 g lower, but the associations do not establish causation or an individual patient's outcome.

Why this matters for nurses

Maternal-child nurses assess nutrition, weight trajectory, fetal growth, barriers to care, and readiness for follow-up across preconception and pregnancy care. The findings support nonstigmatizing risk awareness and timely referral while keeping counseling individualized.

Bedside takeaway

Use maternal underweight as one risk marker for individualized nutrition assessment, fetal surveillance, education, and follow-up.

How This Applies in Practice

Use this when: Assessing preconception or pregnancy care for a patient whose pre-pregnancy BMI is below 18.5 kg/m².

On your shift

  • Assess nutrition, weight history, intake, symptoms, food access, body-image concerns, and other barriers using a nonstigmatizing approach.
  • Trend the ordered maternal weight and fetal-growth measures and route concerning findings to the obstetric and nutrition team.
  • Use teach-back for the individualized nutrition, supplementation, surveillance, and follow-up plan.
Keep in mind: The pooled associations do not predict an individual outcome or define one weight-gain plan. Follow the obstetric protocol, facility policy, and provider orders.

Key takeaways

  • The review included 34 cohort and case-control studies of Japanese women with singleton pregnancies.
  • Pre-pregnancy underweight was associated with low birth weight, with a pooled odds ratio of 1.61.
  • Pooled odds ratios were 1.59 for small for gestational age and 1.23 for preterm birth.
  • Mean infant birth weight was 115.02 g lower in the underweight group across included studies.

Practice implications

  • Document pre-pregnancy weight history when available, assess nutrition and access barriers without stigma, and track ordered maternal and fetal surveillance. Reinforce the individualized nutrition and follow-up plan and escalate concerning weight trajectory, intake, or fetal-growth findings.

Limitations & cautions

  • The evidence came from observational cohort and case-control studies and cannot establish causation. The review focused on Japanese women with singleton pregnancies, so pooled estimates may not generalize to other populations, multiple gestations, or an individual patient's risk profile.
  • AI-summarized from the linked source. Review the original article before applying to practice.

Citations

Exact source links

Public citations are filtered to exact credible source pages. Homepage-only or invalid links stay in admin review and are not shown here.

Journal of epidemiology (PubMed)

Journal of epidemiology (PubMed). Impact of Maternal Underweight on Infant and Maternal Outcomes in Japanese Women: A Systematic Review and Meta-analysis.

Open original source

https://pubmed.ncbi.nlm.nih.gov/41423229/

Professional education only

This summary does not replace clinical judgment, facility policy, provider orders, or official guidelines. Verify practice changes against the original source and local protocol.

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