Gestational weight gain, nutritional status and blood pressure in pregnant women

OBJECTIVE: To evaluate whether weekly gestational weight gain is associated with anemia, vitamin A insufficiency, and blood pressure levels in the third trimester of pregnancy. METHODS: A prospective study with 457 pregnant women attending primary care in Cruzeiro do Sul, Acre. The weekly gestational weight gain rate measured between the second and third trimesters was classified as insufficient, adequate, and excessive according to the recommendations of the Institute of Medicine 2009. The outcomes at the beginning of the third gestational trimester were: anemia (Hb < 110 g/L), vitamin A insufficiency (serum retinol<1.05 μmol/L) and blood pressure levels (continuous values, in mmHg). Age-adjusted prevalence ratios, schooling, and use of vitamin and mineral supplements were calculated in Poisson regression models with robust variance. RESULTS: A total of 18.6% of pregnant women had insufficient weekly weight gain, and 59.1% had excessive weight gain. The frequencies of anemia, vitamin A insufficiency and hypertension (systolic blood pressure ≥ 140 mmHg or diastolic ≥ 90 mmHg) were 17.5%, 13.4%, and 0.6%, respectively. The prevalence ratios for anemia among pregnant women with insufficient and excessive weight gain were 0.41 (95%CI 0.18–0.93) and 1.00 (95%CI 0.63–1.59), respectively, when compared to pregnant women with adequate weight gain. For vitamin A insufficiency, the adjusted prevalence ratio was significantly higher among pregnant women with insufficient weight gain (2.85, 95%CI 1.55–5.24) and no difference for excessive weight gain (1.53, 95%CI 0.84–2.74) when compared to pregnant women with adequate weight gain. Pregnant women with excessive weight gain had higher mean systolic blood pressure (111.10; 95%CI 109.9–112.2) when compared to pregnant women with insufficient weight gain (107.50; 95%CI 105.4–109.6) and adequate (106.20; 95%CI 104.3–108.20). CONCLUSIONS: Insufficient weekly gestational weight gain was associated with the risk of vitamin A insufficiency. Excessive weight gain, in turn, was associated with higher blood pressure values at the beginning of the third gestational trimester.

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Dynamics of Gestational Weight Gain in Women with Different Pre-pregnancy Body Weight

Galician Medical Journal ◽

10.21802/gmj.2017.4.7 ◽

2018 ◽

Vol 24 (4) ◽

Author(s):

Svitlana Ostafiichuk

Keyword(s):

Body Weight ◽

Weight Gain ◽

Pregnant Women ◽

Gestational Weight Gain ◽

Weight Retention ◽

National Guidelines ◽

Excessive Weight Gain ◽

Gestational Weight ◽

Excessive Weight ◽

Weight Gain During Pregnancy

International and national guidelines regulate the gestational weight gain (GWG), depending on the pre-pregnancy body mass index (BMI). Insufficient weight gain increases rate of delivery of small weight babies, and excessive GWG is associated with macrosomia, postpartum weight retention and obesity. Objective: Our objective was to assess the dynamics of GWG in women of different pre-pregnancy body weight.Material and methods: 219 pregnant women with different pre-pregnancy BMI were examined. In 45 ((20.5±2.7) %) patients were diagnosed insufficient, in 100 ((45.7±3.4) %) – normal and in 74 ((33.8±3.2) %) – excessive weight gain during pregnancy period. BMI was calculated by using the standard formula of person’s weight in kilograms divided by the square of her height in meters (kg/m2). Total weight gain was calculated by subtracting the pre-pregnancy weight from the last measured weight before delivery. Statistical analyses were carried out using Statistical program “Statistica 5.5”.Results: It has been established that the women with higher pre-pregnancy BMI have the lower weight gain during the gestation period r = -0.25 (p<0.001). Normal weight women have the highest level of GWG, while pregnant women with obesity have minimal level. However, underweight patients are in the higher risk of pathologically low GWG while overweight and obese women have greater risk of excessive GWG. The dynamics of weight gain during pregnancy shows that deficiency or absent weight gain in the first trimester is associated with an insufficient weight gain to the end of pregnancy r=0.58 (p<0.001). Conversely, rapid onset of excessive weight gain up to 12 weeks of gestation leads to further excessive GWG r = 0.77 (p<0.001).Conclusions: Body weight before pregnancy is an independent determinant of GWG. Adequate weight gain during pregnancy does not lead to obesity in women of all groups, while pathologically low and high GWG leads to inadequate accumulation of adipose tissue, which has negatively affects on the metabolism of maternal and fetal organisms.

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The influence of pre-pregnancy body mass index and gestational weight gain on pregnancy outcomes in two-child women

10.21203/rs.2.16978/v1 ◽

2019 ◽

Author(s):

Hanqing Chen ◽

Suhua Zou ◽

Zhuyu Li ◽

Jianbo Yang ◽

Jian Cai ◽

...

Keyword(s):

Body Mass Index ◽

Weight Gain ◽

Gestational Weight Gain ◽

Body Mass ◽

Perinatal Outcomes ◽

Normal Weight ◽

Excessive Weight Gain ◽

Gestational Weight ◽

Excessive Weight ◽

Weight Gain During Pregnancy

Abstract Background Pre-pregnancy body mass index and gestational weight gain were related to perinatal outcomes. It was not know the changes of pre-pregnancy body mass index, weight gain during pregnancy and its effect on perinatal outcomes in two-child women.Methods This was a retrospective study. Data of single term women delivered in the First Affiliated Hospital of Sun Yat-sen University were collected from July 2017 to June 2018. Gestational weight gain criteria of the American Institute of Medical Research and pre-pregnancy body mass index classes were used to evaluate the effects on pregnancy outcomes.Results A total of 3049 cases were enrolled in the study. Overweight cases was 9.0% and obesity was 2.4%. The weight gain of the two-child women was less than that of primipara(12.4±3.9vs13.3±4.0kg, P<0.001). The proportion of primipara with excessive weight gain was higher compared to two-child women(20.1%versus17.3%, P<0.001). There were 40.0% overweight primipara and 55.2% of two-child women had excessive weight gain. And 40.5% primipara and 54.5% two-child women of obesity had excessive weight gain during pregnancy. Obese primipara increased the risk of pre-eclampsia (aOR2.38, 95%CI 0.76-7.46). And the odds of diabetes mellitus and large for gestational age also increased in this group (aOR3.49, 95%CI 1.46-8.35 and aOR7.65, 95%CI 1.83-31.97, respectively). Two-child women had similar results. Underweight primipara with excessive weight gain increased the pre-eclampsia risk (aOR2.26, 95%CI 0.29-17.46). Normal weight and overweight/obese primipara also had similar results. But in two-child women, only overweight/obesity increased the risk of pre-eclampsia (aOR2.01, 95%CI 0.41-9.98). Underweight two-child women with less weight gain increased the risk of diabetes(aOR2.06, 95%CI 0.43-9.8). Two-child women with overweight/obese increased the odds of LGA even if they had less weight gain(aOR2.58, 95%CI 0.11-63.22). Normal weight primipara and two-child women with overweight and obese with excessive weight gain had similar results. On the other way, underweight primipara with less weight gain increased the risk of SGA(aOR1.74, 95%CI 0.81-3.76).Conclusions Gestational weight gain of two-child women was less than primipara. Overweight/obese women with excessive weight gain of two-child women increased the risk of adverse outcomes.

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Consumption of Ultraprocessed Foods by Pregnant Women with Diabetes Mellitus (P11-021-19)

Current Developments in Nutrition ◽

10.1093/cdn/nzz048.p11-021-19 ◽

2019 ◽

Vol 3 (Supplement_1) ◽

Author(s):

Patricia Padilha ◽

Carolina Felizardo ◽

Claudia Saunders ◽

Letícia Cunha ◽

Amanda Pinheiro ◽

...

Keyword(s):

Diabetes Mellitus ◽

Weight Gain ◽

Glycemic Control ◽

Pregnant Women ◽

Gestational Weight Gain ◽

Caloric Intake ◽

Third Trimester ◽

Daily Consumption ◽

Gestational Weight ◽

The Third

Abstract Objectives To evaluate the consumption of ultraprocessed foods (UPF)by pregnant women with previous diabetes mellitus (DM) in use of the method of counting carbohydrates, besides investigating their association with the outcomes of total gestational weight gain and glycemic control. Methods A cohort study developed in a reference maternity hospital in the city of Rio de Janeiro, Brazil, with adult pregnant women with single fetus, with a diagnosis of DM prior to pregnancy, without other chronic morbidities. Food consumption was assessed by the semi-quantitative frequency of consumption questionnaire in the second and third quarters and the NOVA classification was used to identify the consumed of UPF. Measurements of weight were measured at all consultations and laboratory tests were evaluated at each gestational trimester. The multivariate linear regression was used in the analysis. Results Pregnant women (n = 42) presented mean total gestational gain of 12.02 ± 4.8 kg, 65.8% of them with inadequacy. The daily consumption of UPF was 317.29 ± 187.28 Kcal and 272.37 ± 170.55 Kcal, respectively, representing 16.9 ± 7.7% and 15.2 ± 10% of the average daily energy consumption. The increase of every 1 kcal in the caloric intake from UPF in the third trimester increased the glycated hemoglobin in the third trimester (β = 0.007, P = 0.025), 0.14mg/dL of postprandial 1-hour glycemia in the third trimester (β = 0.143, P = 0.011) and 0.11 kg in the total gestational weight gain (β = 0.11, P = 0.006). No associations were found for ultraprocessed foods consumption in the second trimester. Conclusions Ultraprocessed foods consumption was associated with the gestational endpoints glycemic control and total weight gain. It is necessary to intensify the strategies of orientation and nutritional education for pregnant women with previous DM in use of the method of counting carbohydrates. Funding Sources FAPERJ.

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When and How Should Chinese Pregnant Women Exercise? A Longitudinal Study in China

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph17010180 ◽

2019 ◽

Vol 17 (1) ◽

pp. 180

Author(s):

Mi Xiang ◽

Masayuki Konishi ◽

Huanhuan Hu ◽

Mio Nishimaki ◽

Hyeon-Ki Kim ◽

...

Keyword(s):

Physical Activity ◽

Weight Gain ◽

Longitudinal Study ◽

Pregnant Women ◽

Energy Intake ◽

Gestational Weight Gain ◽

Moderate Intensity ◽

Third Trimester ◽

Gestational Weight ◽

The Third

This study aimed to examine when and how physical activity (PA) influences gestational weight gain (GWG) and infant birthweight (BW) by considering the PA’s total volume, timing, intensity, and type, controlling for the influence of energy intake. A total of 1272 participants in different stages of pregnancy were recruited from hospital. The associations between PA and GWG or BW in the latter half of pregnancy were significant. Women with the highest PA volume in the third trimester had significantly lower risks of inadequate and excessive GWG by 69% (OR = 0.31, 95%CI: 0.10–0.91) and 67% (OR = 0.33, 95% CI: 0.12–0.91), respectively, compared to women in the lowest quartile. Women who achieved the recommended moderate intensity of PA during their second and third trimesters, independent of total volume of PA, had infants with significantly lower BWs compared to those who did not (β = −0.15, SE = 66.33, p = 0.04; β = −0.20, SE = 64.54, p = 0.01, respectively). Therefore, the effects of total volume and intensity of PA on GWG and BW were different. Interventions to prevent inappropriate GWG and macrosomia may need to set different priorities and timing regarding total volume or intensity of PA.

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The Effects of Pre-Pregnancy Body Mass Index and Gestational Weight Gain on the Risk of Preeclampsia at a Tertiary Referral Hospital, Northern Tanzania

10.21203/rs.3.rs-114602/v1 ◽

2020 ◽

Author(s):

Nelago Tukondjeni Amagulu ◽

Bariki Mchome ◽

Julius Pius Alloyce ◽

Kingsly Tobi ◽

Eusebius Maro

Keyword(s):

Weight Gain ◽

Gestational Weight Gain ◽

Multinomial Logistic Regression ◽

Normal Weight ◽

Excessive Weight Gain ◽

Gestational Weight ◽

Excessive Weight ◽

Northern Tanzania ◽

Increased Risk ◽

In Pregnancy

Abstract Background: Pre/eclampsia and other hypertensive disorders of pregnancy contributed to 18% of the maternal mortality reported in Northern Tanzanian. There is increasing prevalence of obesity in Tanzania which is related to excessive weight gain in pregnancy. Both high BMI and excessive gestation weight gain are identified to increase risk of PE and subtypes, however this is still inconclusive and little is known about the joint effect of pre-pregnancy BMI and GWG on risk of PE and its subtypes in Africa. We evaluated the independent and joint effects of pre-pregnancy BMI and GWG on the risk of pre-eclampsia and its subtypes among women who delivered at Kilimanjaro Christian Medical Center (KCMC) from October 2018 to May 2019, Northern Tanzania.Methods: We performed a retrospective birth cohort study from October 2018 to May 2019 at KCMC, Tanzania. Pre-pregnancy BMI was categorized using WHO categories into Underweight (˂ 18.5kg/m²), Normal weight (18.5-24.9kg/m²), Overweight (25-29.9kg/m²) and Obese (≥ 30kg/m²). Gestational Weight Gain (GWG) was categorized using the 2009 Institute of Medicine (IOM) guidelines into Inadequate, Adequate and Excessive weight gain in pregnancy. Multinomial logistic regression analysis was used to adjust for confounders using relative risk, 95% confidence interval for the risk ratios (RR) that did not cross 1 and p<0.05 were regarded statistically significant.Results: Among the 1309 women analysed, 5.3% were Underweight, 51.1% Normal weight, 26.9% Overweight and 16.7% were Obese. About 43.5% had excessive GWG. Women with PE were 9.5%. Both obesity and excessive GWG independently increased risk of PE with adjusted RR=2.42, 95%CI: 1.48-3.96 and RR=1.77, 95%CI: 1.16-2.69 when compared to normal BMI and adequate GWG respectively. Jointly, Obesity and Excessive GWG had the highest risk of PE (ARR=4.95, 95%CI: 2.21-11.10). The increased risk was similar for Mild PE (MPE), Severe PE or eclampsia (SP/E) and Late Onset PE (LOPE). No association was found for Early Onset PE (EOPE).Conclusion: Pre-pregnancy Obesity and Excessive GWG independently and jointly increases risk for PE and the risk varies by PE subtype.

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Gestational weight gain and pregnancy outcome in women with excessive pre-pregnancy body mass index

10.36811/ojgor.2019.110001 ◽

2019 ◽

pp. 01-07

Author(s):

Magdalena Smyka ◽

Katarzyna Kosinska- Kaczynska ◽

Damian Warzecha ◽

Miroslaw Wielgos

Keyword(s):

Body Mass Index ◽

Weight Gain ◽

Gestational Weight Gain ◽

Body Mass ◽

Gestational Age ◽

Perinatal Outcomes ◽

Obese Women ◽

Excessive Weight Gain ◽

Gestational Weight ◽

Excessive Weight

Aim: To evaluate the effects of gestational weight gain on perinatal outcomes in woman with excessive pre-gravid body mass index. Material and Methods: The study group consisted of 197 overweight or obese women who delivered full-term newborns at the 1st Department of Obstetrics and Gynecology, Medical University of Warsaw. Group A included 89 (45.2%) women with inadequate or adequate weight gain. Group B included 108 patients (54.8%) with excessive weight gain during pregnancy. Results: No significant differences in the occurrence of gestational diabetes, hypertension or intrahepatic cholestasis between the analyzed groups were observed. Excessive weight gain was positively correlated with the incidence of cesarean delivery (67.6% vs 32.4%, p=0.009), newborns’ birthweight (3627g±519 vs 3406g±521, p=0.009) and the risk of low for gestational age infants (26.9% vs 12.4%, p=0.01). The highest risk of low for gestational age new born was related to gestational weight gain of about 15 kg. Appropriate preconception counselling for overweight and obese women may reduce the risk of low for gestational age infants.

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Gestational Weight Gain Particularly Affects the Risk of Large for Gestational Age Infants in Non-obese Mothers

Geburtshilfe und Frauenheilkunde ◽

10.1055/a-0891-0919 ◽

2019 ◽

Vol 79 (11) ◽

pp. 1183-1190 ◽

Cited By ~ 1

Author(s):

Friederike Weschenfelder ◽

Thomas Lehmann ◽

Ekkehard Schleussner ◽

Tanja Groten

Keyword(s):

Risk Factor ◽

Weight Gain ◽

Gestational Weight Gain ◽

Gestational Age ◽

Significant Risk ◽

Normal Weight ◽

Large For Gestational Age ◽

Excessive Weight Gain ◽

Gestational Weight ◽

Excessive Weight

Abstract Introduction The birth of a large for gestational age (LGA) infant is a significant risk factor for birth complications and maternal morbidity and an even higher risk factor for offspring obesity, metabolic syndrome and cardiovascular disease in later life. Relevant factors affecting the risk of delivering an LGA infant are maternal pre-gravid obesity, excessive gestational weight gain exceeding the recommendations of the Institute of Medicine (IOM) and diabetes in pregnancy. We aimed to determine what matters most in terms of the risk of fetal overgrowth. Materials and Methods We performed a database analysis of 12 701 singleton term deliveries documented in our university hospital birth registry from 2003 to 2014. Multivariate logistic regression analysis was used to determine the adjusted odds ratios. Results Excessive weight gain had the strongest impact on LGA (OR: 1.249 [95% CI: 1.018 – 1.533]) compared to maternal pre-gravid body mass index (BMI) (OR: 1.083 [95% CI: 1.066 – 1.099]) and diabetes (OR: 1.315 [95% CI: 0.997 – 1.734]). Keeping gestational weight gain within the recommendations of the IOM resulted in a risk reduction for LGA of 20% (OR: 0.801 [95% CI: 0.652 – 0.982]). The risk for LGA increases by 6.9% with each kg weight gain. Normal weight women (BMI 18.5 – 24.9 kg/m2) and moderately overweight women (BMI 25 – 29.9 kg/m2) showed the highest increase in LGA rates per kg weight gain during pregnancy (OR: 1.078 [95% CI: 1.052 – 1.104] and OR: 1.058 [95% CI: 1.026 – 1.09], resp.). Only in underweight (< 18.5 kg/m2) and normal weight women the risk of LGA birth is strongly influenced by diabetes (OR 11.818 [95% CI: 1.156–120.782] and 1.564 [95% CI: 1.013–2.415]). Conclusion Excessive weight gain is particularly important for non-obese women. These women are therefore a target cohort for intervention, as each prevented additional kilogram weight gain reduces the risk of LGA by more than 5%.

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Factors Associated With Rates of Gestational Weight Gain Among Pregnant Women in West Sumatera, Indonesia

Current Developments in Nutrition ◽

10.1093/cdn/nzab046_118 ◽

2021 ◽

Vol 5 (Supplement_2) ◽

pp. 821-821

Author(s):

Isman Susanto ◽

Nur Indrawaty Lipoeto ◽

Arif Sabta Aji

Keyword(s):

Weight Gain ◽

Pregnant Women ◽

Gestational Weight Gain ◽

Calorie Intake ◽

P Value ◽

Institute Of Medicine ◽

Third Trimester ◽

Factors Associated ◽

Gestational Weight ◽

The Third

Abstract Objectives Gestational weight gain (GWG) is an important anthropometric indicator for maternal nutritional status. This study analyzed to determine factors associated with rates of gestational weight gain among women in the third trimester in West Sumatera, Indonesia. Methods This cross-sectional study was conducted among healthy pregnant women in the third trimester in West Sumatera, Indonesia. A total 195 pregnant women attending at each public health center were enrolled in the present study from September 2017 to March 2018. Information regarding demographic characteristics, obstetrical history, physical activity, calorie intake, and anthropometric was assessed through direct interview. GWG rates were determined based on recommendations of Institute of Medicine (IOM) 2009. Results Of the 195 pregnant women, more than half of the women were GWG inadequate 53.3%, adequate 34.4%, and excessive 12.3%. Prepregnancy BMI were overweight/obese 43.1%, normal 46.7%, underweight 10.3%. The multinomial logistic model indicates than women who were overweight or obese at pre-pregnancy were 17 times more likely to have excessive GWG rate (p-value < 0.01) as compared to women who were pre-pregnancy normal weight. Conclusions Women who were overweight/obese at pre-pregnancy were at-risk of having excessive GWG rate, which underlines the importance of targeting these women for pre-conception counseling or health education on GWG. Funding Sources Indonesian Danone Institute Foundation.

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Part of the Fat Component in the Structure of Gestational Weight Gain

Galician Medical Journal ◽

10.21802/gmj.2018.1.12 ◽

2018 ◽

Vol 25 (1) ◽

Author(s):

Svitlana Ostafiichuk

Keyword(s):

Body Composition ◽

Weight Gain ◽

Pregnant Women ◽

Gestational Weight Gain ◽

Fat Mass ◽

First Trimester ◽

The Body ◽

Third Trimester ◽

Gestational Weight ◽

The Third

Gestational weight gain (GWG), which is more or less of the recommended guidelines, has serious short- and long-term negative consequences for the health of the mother and children. Determining the dynamics of body composition during pregnancy is important for full antenatal care in order to prevent pathological weight gain and prevention of gestational complications.Objective: Our goal was to determine the proportion of fat component in the structure of GWG in women with normal body weight before pregnancy. Design: 153 pregnant women aged 18-43 years with normal pre-pregnancy body mass index (pBMI) were examined. BMI was calculated by using the standard formula of person’s weight in kilograms divided by the square of his height in meters (kg/m2). Total weight gain was calculated by subtracting the pre-pregnancy weight from the last measured weight before delivery. The body composition (fat mass (FM), fat-free mass (FFM), and the percentage of fat mass (%FM)) was calculated on the basis of bioelectrical impedance analysis (BIA) using the ‘DIAMANT-AIST’ analyzer (St. Petersburg). Statistical analyses were carried out using Statistical program "Statistica 5.5".Results: It has been established that in women of normal weight before pregnancy, GWG was directly proportional to an increase in the fraction of FM (r=0.87; p<0.001). In pregnant with the recommended GWG, FM increased monotonous in the first and second trimesters and subsequently stabilized. In patients with insufficient GWG, fat component increased similarly (p>0.05), however, it was accompanied by low growth of the FFM, especially in the third trimester (p<0.05). Pregnant women with excessive GWG were more likely to gain weight in the first trimester mainly due to the accumulation of FM (p<0.05), and this tendency remained until delivery r=0.99 (p<0.01).Conclusion: In women with normal GWG there is a monotonous increase in fat component in the first and second trimesters, and subsequently stabilized, which promotes adequate weight reduction after childbirth. In patients with high GWG, the excessive increase in the proportion of FM and, consequently, a rapid increase in weight in the first trimester of pregnancy, initiates further accumulation of adipose tissue and slows down its reduction in the postpartum period. In pregnant women with low weight gain there is adequate increase of FM but an insufficient increase of FFM, especially in the third trimester, which leads to the development of placental hypoplasia and small-for-gestational age.

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