Maternal anthropometry: trends and inequalities in four population-based birth cohorts in Pelotas, Brazil, 1982–2015

Abstract Background Pre-pregnancy nutritional status and weight gain during pregnancy have short- and long-term consequences for the health of women and children. This study was aimed at evaluating maternal height,- and overweight or obesity at the beginning of the pregnancy and gestational weight gain, according to socioeconomic status and maternal skin colour of mothers in Pelotas, a southern Brazilian city, in 1982, 1993, 2004 and 2015. Methods In 1982, 1993, 2004 and 2015, the maternity hospitals in Pelotas were visited daily, all deliveries were identified and mothers who lived in the urban area of the city were interviewed. Maternal weight at the beginning of the pregnancy was self-reported by the mother or obtained from the antenatal card. Maternal height was collected from the maternity records or measured by the research team. Overweight or obesity was defined by a body mass index ≥25 kg/m2. Gestational weight gain was evaluated according to the Institute of Medicine guidelines. Results In the four cohorts, we evaluated 19 931 women. From 1982 to 2015, the prevalence of overweight or obesity at the beginning of the pregnancy increased from 22.1% to 47.0% and height increased by an average of 5.2 cm, whereas gestational weight gain did not change. Socioeconomic status was positively associated with maternal height, and the difference between the poorest and the wealthiest decreased. Overweight or obesity was lower among those mothers in the extreme categories of family income. Conclusions Over the 33-year span, mothers were taller at the beginning of the pregnancy, but the prevalence of overweight or obesity more than doubled.

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Pre-Pregnancy Obesity, Excessive Gestational Weight Gain, and the Risk of Pregnancy-Induced Hypertension and Gestational Diabetes Mellitus

Journal of Clinical Medicine ◽

10.3390/jcm9061980 ◽

2020 ◽

Vol 9 (6) ◽

pp. 1980 ◽

Cited By ~ 4

Author(s):

Małgorzata Lewandowska ◽

Barbara Więckowska ◽

Stefan Sajdak

Keyword(s):

Weight Gain ◽

Pregnant Women ◽

Gestational Weight Gain ◽

Pregnancy Complications ◽

Gestational Hypertension ◽

Institute Of Medicine ◽

Maternal Weight ◽

Odds Ratios ◽

Gestational Weight ◽

The Relationship

Excessive pre-pregnancy weight is a known risk factor of pregnancy complications. The purpose of this analysis was to assess the relationship between several categories of maternal weight and the risk of developing hypertension and diabetes in pregnancy, and the relationship of these complications with the results of the newborn. It was carried out in a common cohort of pregnant women and taking into account the influence of disturbing factors. Our analysis was conducted in a prospective cohort of 912 Polish pregnant women, recruited during 2015–2016. We evaluated the women who subsequently developed diabetes with dietary modification (GDM-1) (n = 125) and with insulin therapy (GDM-2) (n = 21), as well as the women who developed gestational hypertension (GH) (n = 113) and preeclampsia (PE) (n = 24), compared to the healthy controls. Odds ratios of the complications (and confidence intervals (95%)) were calculated in the multivariate logistic regression. In the cohort, 10.8% of the women had pre-pregnancy obesity (body mass index (BMI) ≥ 30 kg/m2), and 36.8% had gestational weight gain (GWG) above the range of the Institute of Medicine recommendation. After correction for excessive GWG and other confounders, pre-pregnancy obesity (vs. normal BMI) was associated with a higher odds ratio of GH (AOR = 4.94; p < 0.001), PE (AOR = 8.61; p < 0.001), GDM-1 (AOR = 2.99; p < 0.001), and GDM-2 (AOR = 11.88; p <0.001). The threshold risk of development of GDM-2 occurred at lower BMI values (26.9 kg/m2), compared to GDM-1 (29.1 kg/m2). The threshold point for GH was 24.3 kg/m2, and for PE 23.1 kg/m2. For GWG above the range (vs. GWG in the range), the adjusted odds ratios of GH, PE, GDM-1, and GDM-2 were AOR = 1.71 (p = 0.045), AOR = 1.14 (p = 0.803), AOR = 0.74 (p = 0.245), and AOR = 0.76 (p = 0.672), respectively. The effect of maternal edema on all the results was negligible. In our cohort, hypertension and diabetes were associated with incorrect birth weight and gestational age at delivery. Conclusions: This study highlights the importance and influence of excessive pre-pregnancy maternal weight on the risk of pregnancy complications such as diabetes and hypertension which can impact fetal outcomes.

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

Revista de Nutrição ◽

10.1590/1678-98652016000400001 ◽

2016 ◽

Vol 29 (4) ◽

pp. 445-455 ◽

Cited By ~ 5

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.

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The relationship between gestational weight gain and fetal growth: time to take stock?

Journal of Perinatal Medicine ◽

10.1515/jpm-2013-0209 ◽

2014 ◽

Vol 42 (4) ◽

Cited By ~ 8

Author(s):

Amy C. O’Higgins ◽

Anne Doolan ◽

Laura Mullaney ◽

Niamh Daly ◽

Daniel McCartney ◽

...

Keyword(s):

Weight Gain ◽

Gestational Weight Gain ◽

Fetal Growth ◽

Maternal Obesity ◽

Current Evidence ◽

Growth Time ◽

Institute Of Medicine ◽

Maternal Weight ◽

Gestational Weight ◽

The Relationship

AbstractThe aim of this article is to review the current evidence on gestational weight gain (GWG). Maternal obesity has emerged as one of the great challenges in modern obstetrics as it is becoming increasingly common and is associated with increased maternal and fetal complications. There has been an upsurge of interest in GWG with an emphasis on the relationship between excessive GWG and increased fetal growth. Recent recommendations from the Institute of Medicine in the USA have revised downwards the weight gain recommendations in pregnancy for obese mothers. We believe that it is time to take stock again about the advice that pregnant women are given about GWG and their lifestyle before, during, and after pregnancy. The epidemiological links between excessive GWG and aberrant fetal growth are weak, particularly in obese women. There is little evidence that intervention studies decrease excessive GWG or improve intrauterine fetal growth. Indeed, there is a potential risk that inappropriate interventions during the course of pregnancy may lead to fetal malnutrition that may have adverse clinical consequences, both in the short- and long-term. It may be more appropriate to shift the focus of attention from monitoring maternal weight to increasing physical activity levels and improving nutritional intakes.

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

Physiology Journal ◽

10.1155/2014/956960 ◽

2014 ◽

Vol 2014 ◽

pp. 1-6 ◽

Cited By ~ 5

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.

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

BMC Pregnancy and Childbirth ◽

10.1186/s12884-020-03519-1 ◽

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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Efficacious lifestyle interventions for appropriate gestational weight gain in women with overweight or obesity set in the health care system: a scoping review

The Journal of Maternal-Fetal & Neonatal Medicine ◽

10.1080/14767058.2021.1914576 ◽

2021 ◽

pp. 1-14

Author(s):

Cristina S. Barroso ◽

Andrew Yockey ◽

Emoni Degon ◽

Pragya Gautam Poudel ◽

Susan D. Brown ◽

...

Keyword(s):

Health Care ◽

Weight Gain ◽

Gestational Weight Gain ◽

Health Care System ◽

Scoping Review ◽

Lifestyle Interventions ◽

Gestational Weight ◽

System A ◽

Overweight Or Obesity ◽

Care System

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Review of Trimester-Specific Gestational Weight Gain and Childhood Adiposity

Journal of Nepal Paediatric Society ◽

10.3126/jnps.v34i1.8429 ◽

2014 ◽

Vol 34 (1) ◽

pp. 48-53

Author(s):

K Thapa

Keyword(s):

Weight Gain ◽

Childhood Obesity ◽

Gestational Weight Gain ◽

Future Research ◽

Institute Of Medicine ◽

Short Term ◽

Global Epidemic ◽

Targeted Interventions ◽

Gestational Weight ◽

Childhood Adiposity

Childhood obesity is a global epidemic and a major public health challenge. There has been increasing evidence that intrauterine exposures, such as alcohol, smoking, and maternal nutritional status, may affect both the long and short term health consequences of the mother and offspring. Childhood adiposity may be affected by the mother’s pre-pregnancy weight and her weight gain during pregnancy. Consequently, interventions may need to start before conception of the child to prevent childhood obesity. In 2009, the Institute of Medicine updated its gestational weight gain recommendations by incorporating rates of gestational weight gain in the second and third trimesters based on the mother’s pre-pregnancy Body Mass Index. There is extensive research on the association between total gestational weight gain and short-term offspring adiposity. However, this review focuses on the association between trimester-specific gestational weight gain and childhood adiposity for singleton pregnancies with respect to the Institute of Medicine’s newly defined weight gain recommendations as very few studies have examined the association between the gestational weight gain during each trimester and childhood adiposity. Identifying the trimester that is most associated with childhood adiposity may help in the development of targeted interventions, guide physician’s nutritional and weight-gain recommendations for child-bearing mothers, and direct future research. DOI: http://dx.doi.org/10.3126/jnps.v34i1.8429 J Nepal Paediatr Soc 2014;34(1):48-53

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The Behavioral Wellness in Pregnancy study: a randomized controlled trial of a multi-component intervention to promote appropriate weight gain

American Journal of Clinical Nutrition ◽

10.1093/ajcn/nqy359 ◽

2019 ◽

Vol 109 (4) ◽

pp. 1071-1079

Author(s):

Lyndi M Buckingham-Schutt ◽

Laura D Ellingson ◽

Spyridoula Vazou ◽

Christina G Campbell

Keyword(s):

Weight Gain ◽

Gestational Weight Gain ◽

Behavioral Intervention ◽

Controlled Trial ◽

Institute Of Medicine ◽

Weight Retention ◽

Gestational Weight ◽

Randomized Controlled ◽

Prepregnancy Weight ◽

The Face

ABSTRACT Background Adequate weight gain during pregnancy is important to both maternal and fetal outcomes. To date, randomized controlled trials have not been effective at increasing the proportion of women meeting gestational weight-gain guidelines. Objectives The aim of this study was to determine whether a multi-component behavioral intervention with a Registered Dietitian Nutritionist significantly improves the proportion of women who adhere to the 2009 Institute of Medicine weight-gain guidelines. Methods Participants were randomly assigned to usual care (UC; n = 24) or intervention (n = 23) between 8 and 14 weeks of gestation. The intervention included a minimum of 6 one-on-one counseling sessions over ∼30 wk focusing on healthy diet and physical activity (PA) goals. In addition to the face-to-face visits, weekly communication via email supported healthy eating, PA, and appropriate weight gain. Gestational weight gain, PA, and diet were assessed at 8–14, 26–28, and 34–36 weeks of gestation; weight retention was measured 2 mo postpartum. Results The proportion of women meeting the guidelines was significantly greater in those receiving the intervention than UC (60.8% compared with 25.0%, OR: 4.7; 95% CI: 1.3, 16.2; P = 0.019). Furthermore, 36.4% of the intervention women were at or below their prepregnancy weight at 2 mo postpartum compared with 12.5% in the UC group (P = 0.05). Conclusions A multi-component behavioral intervention improved adherence to the 2009 Institute of Medicine weight-gain guidelines. This trial was registered with clinicaltrials.gov as NCT02168647.

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