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The goal of this study was to quantify the degree of bias that conventional gestational weight gain measures may introduce to the apparent relationship between gestational weight gain and risk of preterm birth ��32 weeks. Pregnancy information on a large population-based cohort of pregnant women was obtained from the British Columbia (BC) Perinatal Database Registry, which contains mTOR inhibitor obstetrical and neonatal clinical chart data on all births in this Canadian province.13 The characteristics of these women are provided in Appendix?A. Analyses were restricted to women with a normal-weight prepregnancy BMI (18.5�C24.9?kg/m2, inclusive), and stillbirths were excluded. Very preterm birth was defined as a livebirth ��32 completed weeks of gestation. Sensitivity analyses were conducted using an ALG1 outcome of any preterm birth (livebirth Selleckchem PD-1/PD-L1 Inhibitor 3 cohort delivered at term, estimates of the week-specific means and standard deviations of gestational weight gains at preterm gestational ages were independent of the risk of preterm birth. In the second step of our simulation, the week-specific means and standard deviations of gestational weight gain were used to simulate a total gestational weight gain for women in our BC cohort based on their gestational age at delivery. For example, in the Magee-Womens cohort, the average gestational weight gain by 28 weeks was 11.0?kg with a standard deviation of 4.3?kg. A total gestational weight gain for each woman in the BC cohort who delivered at 28 weeks was simulated by drawing a random sample from a normal distribution with a mean of 11.0?kg and a standard deviation of 4.3?kg.