Adequate Weight Gain during Pregnancy by Pre-Pregnancy Body Mass Index: Who Gets It Right? [19C

Abstract

INTRODUCTION: In 2009, the IOM issued new guidelines for gestational weight gain (GWG), based on pre-pregnancy body mass index (PPBMI). This study was conducted to understand who is currently meeting these recommendations, exploring sociodemographic characteristics. METHODS: Using 2015 vital statistics (birth) data collected by the National Center for Health Statistics, GWG was calculated using pre-pregnancy weight and delivery weight to determine inadequate, adequate, and excess GWG categories by PPBMI, per the new guidelines. Chi-square tests and multivariate logistic regression analyses were used to assess the 12-category GWG/PPBMI variable by age, race/ethnicity, education, marital status, insurance at delivery, WIC receipt, trimester prenatal care began and smoking status. RESULTS: Of 3,404,491 singleton deliveries with complete information on PPBMI and GWG, 3.6% were underweight, 45.2% were normal weight, 25.9% were overweight, and 25.3% were obese pre-pregnancy. Percentages of meeting the IOM guidelines ranged from 23.7% among obese women to 42.9% among underweight women; among obese women, 54.1% gained more than the recommended weight during pregnancy. All socio-demographic variables were significantly associated with not meeting the GWG recommendations. Compared to obese women who followed the recommendation, those who gained more were more likely to be younger [OR = 1.355 (95% CI: 1.317-1.394] and were less likely to have entered prenatal care in the first trimester [OR = 0.808 (95% CI: 0.787-0.829]. CONCLUSION: In this study, GWG outside of the IOM recommendations was associated with key demographic risk factors. Additional resources may be needed to help these populations better achieve healthy weight gain during pregnancy.