Influence of Gestational Weight Gain on the Risk of Preterm Birth for Underweight Women Living in Food Deserts

2020 ◽  
Author(s):  
Juliana Madzia ◽  
David McKinney ◽  
Elizabeth Kelly ◽  
Emily DeFranco
Keyword(s):  
Weight Gain ◽  
Preterm Birth ◽  
Gestational Weight Gain ◽  
Food Access ◽  
Food Deserts ◽  
The United States ◽  
Population Based ◽  
Food Desert ◽  
Institute Of Medicine ◽  
Gestational Weight

Abstract Objective Preterm birth (PTB) and food insecurity are two of the most significant public health crises in the United States. Effects of being underweight among populations with low food security are not well understood. We assess whether the protective effect of gestational weight gain (GWG) for women with low prepregnancy body mass index (BMI) differs by accessibility to sources of healthy food. Study Design Population-based retrospective cohort study using Ohio birth records analyzing all live births, 2006 to 2015. Analyses were stratified by maternal BMI (underweight, normal, overweight, and obese), Institute of Medicine (IOM) recommended GWG (under vs. met), and whether the U.S. Department of Agriculture (USDA) classified the residential census tract for each birth as a food desert. Food access data were retrieved from the USDA's 2018 Food Access Research Atlas. Covariates were selected using least absolute shrinkage and selection operator regression. Logistic regression models estimated the risk ratio (RR) of PTB for each group based on under or exceeded recommended GWG (reference = met), adjusting for coexisting risk factors. Results Analysis was performed on 1,124,299 births. PTB risk was highest for underweight women below GWG recommendations (no food desert: 21.3%, RR = 2.15, 95% confidence interval [CI]: 1.81–2.57; food desert: 21.0%, RR = 1.46, 95% CI: 0.96–2.21). Underweight women living in food deserts who exceeded GWG recommendations had lower PTB risk than those who met GWG recommendations (13.5 vs. 14.3%, RR = 0.85, 95% CI: 0.51–1.41). Factors other than GWG significantly associated with PTB included in the adjusted analysis include maternal age and race, education, marital status, interpregnancy interval, and presence of prepregnancy diabetes or hypertension. Conclusion Underweight women who do not meet GWG recommendations are at high risk for PTB. Increasing pregnancy weight gain to a level that exceeds IOM recommendations was not associated with a reduction in PTB risk for underweight women who reside in food deserts compared with women who met GWG recommendations.

scholarly journals Gestational Weight Gain among Healthy Pregnant Women from Asia in Comparison with Institute of Medicine (IOM) Guidelines-2009: A Systematic Review

2019 ◽  
Vol 2019 ◽  
pp. 1-10 ◽  
Author(s):  
Priyanka Arora ◽  
Bani Tamber Aeri
Keyword(s):  
Systematic Review ◽  
Weight Gain ◽  
Birth Weight ◽  
Pregnant Women ◽  
Gestational Weight Gain ◽  
Gestational Age ◽  
The United States ◽  
Asian Women ◽  
Institute Of Medicine ◽  
Gestational Weight

In 1990, Institute of Medicine (IOM) recommended gestational weight gain (GWG) ranges for women in the United States primarily to improve infant birth weight. Changes in key aspects of reproductive health of women of child bearing age, a rising prevalence of obesity, and noncommunicable diseases prompted the revision of IOM guidelines in 2009. However, there is no such recommendation available for Asian women. This systematic review assesses the utility of IOM-2009 guidelines among Indian and other Asian pregnant women in terms of maternal and fetal outcomes. 624 citations were identified using PubMed and Google Scholar, out of which 13 were included. Prospective/retrospective studies of healthy Asian women with a singleton pregnancy which specifically examined fetal-maternal outcomes relative to IOM-2009 guidelines were included. Results. Majority of pregnant Indian women achieved less GWG than the recommendations whereas a mixed trend was noticed among the other Asian pregnant women. The most common fetal-maternal complications among the excessive GWG women were found to be macrosomia, large for gestational age and caesarean section followed by gestational diabetes and hypertension, whereas low birth weight, small for gestational age and preterm birth, was found to be associated with low GWG women. The findings highlight the need for appropriate GWG limits across the different body mass index levels specifically for Indians and other Asian population. However, there are not enough publications regarding the utility of IOM-2009 guidelines among the Indian and other Asian women. Thus, higher-quality researches are warranted in future to further validate the findings of the present review.

scholarly journals Healthy gestational weight gain prevalence and associated risk factors: A population-based study in the far South of Brazil

2016 ◽  
Vol 29 (4) ◽  
pp. 445-455 ◽  
Author(s):  
Luana Patricia MARMITT ◽  
Carla Vitola GONÇALVES ◽  
Juraci Almeida CESAR
Keyword(s):  
Weight Gain ◽  
Prenatal Care ◽  
Gestational Weight Gain ◽  
Rio Grande ◽  
Population Based ◽  
Institute Of Medicine ◽  
Healthy Weight ◽  
Gestational Weight ◽  
Maternity Hospitals ◽  
Weight Gain During Pregnancy

ABSTRACT Objective To measure and identify the factors associated with healthy weight gain during pregnancy in the municipality of Rio Grande, Rio Grande do Sul, Brazil. Methods This was a population-based, cross-sectional study that included all parturient women from the municipality who gave birth at its maternity hospitals in 2013. Information was collected by interview with the mothers in the first 48 hours following parturition and from the prenatal care cards. Healthy weight gain was evaluated according to the Institute of Medicine guidelines. Data analysis used Poisson regression with robust variance using previous hierarchical model. Results Among the 1,784 pregnant participants, 89% attended at least six prenatal care visits, and 32% had healthy weight gain during pregnancy. Higher education level and fewer children resulted in a higher prevalence ratio for healthy weight gain (p=0.003 and p=0.029, respectively). Underweight women at conception had a higher proportion of healthy weight gain (p<0.001). Despite extensive coverage, prenatal care did not affect healthy weight gain during pregnancy (p=0.104). Conclusion The low proportion of women with healthy gestational weight gain suggests a need of better prenatal care services. Women who are overweight, have lower education levels, and had had multiple pregnancies at conception need special attention.

scholarly journals Institute of Medicine 2009 Gestational Weight Gain Guideline Knowledge: Survey of Obstetrics/Gynecology and Family Medicine Residents of the United States

Birth ◽  
2013 ◽  
Vol 40 (4) ◽  
pp. 237-246 ◽  
Author(s):  
Tiffany A Moore Simas ◽  
Molly E Waring ◽  
Gina M T Sullivan ◽  
Xun Liao ◽  
Milagros C Rosal ◽  
...  
Keyword(s):  
United States ◽  
Weight Gain ◽  
Family Medicine ◽  
Gestational Weight Gain ◽  
The United States ◽  
Institute Of Medicine ◽  
Gestational Weight ◽  
Knowledge Survey ◽  
Family Medicine Residents

scholarly journals Institute of Medicine Recommendations on the Rate of Gestational Weight Gain and Perinatal Outcomes in Rural Bangladesh

2021 ◽  
Vol 18 (12) ◽  
pp. 6519
Author(s):  
S. M. Tafsir Hasan ◽  
Md Alfazal Khan ◽  
Tahmeed Ahmed
Keyword(s):  
Weight Gain ◽  
Preterm Birth ◽  
Gestational Weight Gain ◽  
Gestational Age ◽  
Neonatal Outcome ◽  
Perinatal Outcomes ◽  
Institute Of Medicine ◽  
Third Trimester ◽  
Gestational Weight ◽  
Iom Recommendations

Although validated in other parts of the world, the suitability of the U.S. Institute of Medicine (IOM) 2009 recommendations on gestational weight gain (GWG) for Bangladeshi women remains to be examined. We evaluated the association between the weekly rate of weight gain during the second and third trimester of pregnancy, categorized according to IOM recommendations, and adverse perinatal outcomes among 1569 pregnant women with singleton live births in rural Matlab, Bangladesh. Gaining weight at rates below the IOM recommendations was associated with higher odds of preterm birth (adjusted odds ratio (AOR) = 2.0, 95% CI: 1.1–3.6), low birth weight (AOR = 1.4, 95% CI: 1.03–2.0), small-for-gestational-age newborns (AOR = 1.3, 95% CI: 1.04–1.7), and poor neonatal outcome (severe neonatal morbidity or death, AOR = 2.4, 95% CI: 1.03–5.6). A GWG rate above the recommendations was associated with higher odds of cesarean delivery (AOR = 1.7, 95% CI: 1.1–2.6), preterm birth (AOR = 2.2, 95% CI: 1.1–4.4), large-for-gestational-age newborns (AOR = 5.9, 95% CI: 1.5–23.1), and poor neonatal outcome (AOR = 2.7, 95% CI: 1.04–7.0). Our results suggest that the IOM 2009 recommendations on GWG rate during the second and third trimester may be suitable for guiding rural Bangladeshi women in the prenatal period, although the women should aim for rates near the lower bound of the range.

scholarly journals A Population-Based Study on Gestational Weight Gain according to Body Mass Index in the Southeast of Brazil

2014 ◽  
Vol 2014 ◽  
pp. 1-6 ◽  
Author(s):  
Ana Carolina Godoy ◽  
Simony Lira Nascimento ◽  
Karina Tamy Kasawara ◽  
Nathalia Hatsue Oushiro ◽  
Fernanda Garanhani Surita
Keyword(s):  
Body Mass Index ◽  
Weight Gain ◽  
Gestational Weight Gain ◽  
Body Mass ◽  
Population Based ◽  
Reproductive Age ◽  
Institute Of Medicine ◽  
Population Based Study ◽  
Gestational Weight ◽  
Maternity Hospitals

Gestational weight gain (GWG) may interfere in perinatal outcomes and also cause future problems throughout woman’s life. The aim of this population-based study is to evaluate the GWG in Campinas city, southeast of Brazil. A total of 1052 women, who delivered in the three major maternity hospitals in Campinas, were interviewed during postpartum period. The general average of GWG was 13.08±6.08. Of total women, 13.6% were obese and 24.6% were overweight and, in these groups, 55.9% and 53.7%, respectively, exceeded GWG according to the Institute of Medicine recommendations. 6.2% of total women had low body mass index (BMI) and 35.5% in this group had insufficient GWG. Overweight and obese women had a higher risk of excessive GWG and delivery by c-section. The c-section rate was 58.9% and increased according to GWG. Prematurity was more prevalent first in obese and then in low BMI women. Considering the high BMI in women in reproductive age, it is necessary to take effective guidelines about lifestyle and nutritional orientation in order to help women reach adequate GWG. All of them could improve prenatal outcomes and women’s heath as a whole.

scholarly journals Gestational Weight Gain during Pregnancy as an Important Factor Influencing a Successful Trial of Labor following Two Previous Cesareans

2018 ◽  
Vol 36 (06) ◽  
pp. 588-593
Author(s):  
James Sargent ◽  
Leah Savitsky ◽  
Mekhala Dissanayake ◽  
Jamie Lo ◽  
Yvonne Cheng ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Weight Gain ◽  
Gestational Weight Gain ◽  
The United States ◽  
Induction Of Labor ◽  
Optimal Timing ◽  
Institute Of Medicine ◽  
Trial Of Labor ◽  
Gestational Weight ◽  
Successful Trial

Objective We sought to identify factors associated with a successful trial of labor (TOL) following two cesarean deliveries (CDs) in a contemporary North American cohort. Study Design This is a retrospective cohort study of term, nonanomalous, singleton, vertex pregnancies attempting a vaginal birth after cesarean (VBAC) following a history of two previous CDs in the United States from 2012 to 2014. Maternal and intrapartum factors were analyzed using chi-square tests and multivariable logistic regression. Results A total of 22,762 women met the inclusion criteria and underwent TOL. Of these, 12,192 (53.6%) had a VBAC. Using multivariate logistic regression, previous vaginal delivery and delivery at 40 to 41 weeks' gestation were associated with VBAC; maternal age, education, Medicaid insurance, non-Caucasian race/ethnicity, weight (overweight or obese), and gestational weight gain above the Institute of Medicine guidelines (adjusted odds ratio: 0.88; 95% confidence interval: 0.81–0.95) were associated with CD. Induction of labor did not affect the VBAC rate. Conclusion For those desiring a TOL after two previous CDs, prospective studies are needed to assess interventions that limit gestational weight gain as well as the safety and optimal timing of an induction of labor. The decision to attempt a TOL should be guided by counseling regarding the risks, benefits, and chances of a successful TOL.

Sources of Information About Gestational Weight Gain, Diet, and Exercise Among Brazilian Immigrant Women Living in the United States: A Cross-Sectional Study

2021 ◽  
pp. 1-41
Author(s):  
Ana Cristina Lindsay ◽  
Qun Le ◽  
Denise Lima Nogueira ◽  
Márcia M. T. Machado ◽  
Mary L. Greaney
Keyword(s):  
United States ◽  
Weight Gain ◽  
Gestational Weight Gain ◽  
The United States ◽  
The Internet ◽  
Sources Of Information ◽  
Cross Sectional ◽  
Gestational Weight ◽  
Diet And Exercise ◽  
First Time

Abstract Objectives: The objective of this study was to assess sources of information about gestational weight gain (GWG), diet, and exercise among first-time pregnant Brazilian women in the United States (US). Design: Cross-sectional survey. Setting: Massachusetts, United States. Participants: First-time pregnant Brazilian women. Results: Eighty-six women, the majority of whom were immigrants (96.5%) classified as having low-acculturation levels (68%), participated in the study. Approximately two-thirds of respondents had sought information about GWG (72.1%), diet (79.1%), and exercise (74.4%) via the internet. Women classified as having low acculturation levels were more likely to seek information about GWG via the internet (OR = 7.55; 95% CI: 1.41, 40.26) than those with high acculturation levels after adjusting for age and receiving information about GWG from healthcare provider (doctor or midwife). Moreover, many respondents reported seeking information about GWG (67%), diet (71%), and exercise (52%) from family and friends. Women who self-identified as being overweight pre-pregnancy were less likely to seek information about diet (OR = 0.32; 95% CI: 0.11, 0.93) and exercise (OR = 0.33; 95% CI: 0.11, 0.96) from family and friends than those who self-identified being normal weight pre-pregnancy. Conclusions: This is the first study to assess sources of information about GWG, diet, and exercise among pregnant Brazilian immigrants in the US. Findings have implications for the design of interventions and suggest the potential of mHealth intervention as low-cost, easy access option for delivering culturally and linguistically tailored evidence-based information about GWG incorporating behavioral change practices to this growing immigrant group.

scholarly journals Risk factors for excessive gestational weight gain in a UK population: a biopsychosocial model approach

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
S. M. Garay ◽  
L. A. Sumption ◽  
R. M. Pearson ◽  
R. M. John
Keyword(s):  
Risk Factors ◽  
Weight Gain ◽  
Gestational Weight Gain ◽  
Biopsychosocial Model ◽  
Elective Caesarean Section ◽  
Depression Symptoms ◽  
Institute Of Medicine ◽  
Contributing Factors ◽  
Gestational Weight ◽  
The Uk

Abstract Background Gestational weight gain (GWG) can have implications for the health of both mother and child. However, the contributing factors remain unclear. Despite the advantages of using a biopsychosocial approach, this approach has not been applied to study GWG in the UK. This study aimed to investigate the risk factors of excessive GWG in a UK population, employing a biopsychosocial model. Methods This study utilised data from the longitudinal Grown in Wales (GiW) cohort, which recruited women in late pregnancy in South Wales. Specifically, data was collected from midwife recorded notes and an extensive questionnaire completed prior to an elective caesarean section (ELCS) delivery. GWG was categorised according to Institute of Medicine (IOM) guidelines. The analysis was undertaken for 275 participants. Results In this population 56.0% of women had excessive GWG. Increased prenatal depression symptoms (Exp(B)=1.10, p=.019) and an overweight (Exp(B)=4.16, p<.001) or obese (Exp(B)=4.20, p=.010) pre-pregnancy BMI, consuming alcohol in pregnancy (Exp(B)=.37, p=.005) and an income of less than £18,000 (Exp(B)=.24, p=.043) and £25–43,000 (Exp(B)=.25, p=.002) were associated with excessive GWG. Conclusion GWG is complex and influenced by a range of biopsychosocial factors, with the high prevalence of excessive weight gain in this population a cause for concern. Women in the UK may benefit from a revised approach toward GWG within the National Health Service (NHS), such as tracking weight gain throughout pregnancy. Additionally, this research provides evidence for potential targets for future interventions, and potentially at-risk populations to target, to improve GWG outcomes.

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