Associação entre ganho de peso gestacional e prognóstico da gestação

Abstract

AIMS: To evaluate the association between gestational weight gain and pregnancy outcome. METHODS: A cross-sectional study evaluated postpartum women from a maternity ward in a hospital located in Aracaju, Sergipe, Brazil, from March to June 2012. Data were obtained through interviews, medical records and records of prenatal care. Pregnancy-related variables, conditions of the newborn, weight retention in the postpartum period and breastfeeding were investigated. Based on the classification of gestational weight gain as recommended by the Institute of Medicine, three groups were formed: 1) group with insufficient weight gain; 2) group with adequate weight gain; and 3) group with excessive gain. Statistical analysis used chi-square and analysis of variance, with a level of statistical significance less than 5%. RESULTS: At all 158 women were included in the study. There was a high percentage of women entering pregnancy with overweight/obesity (30.4%), however, those with low pre-pregnancy weight did not gain excessive weight during their gestational period. Excessive gain was associated with greater weight and length of the newborn, higher prevalence of fetal macrosomy, increased maternal body mass index and higher postpartum weight retention in the third month after birth. Difficulty with breastfeeding in the third month postpartum occurred in 4.5% of mothers with adequate weight gain during pregnancy but it occurred in 33.3% of women with excessive weight gain (p = 0.025). A cesarean section was done in 20% of the women with insufficient gestational weight gain, in 40% of those who gained weight adequately and in 47% of those with excessive weight gain (p = 0.012). CONCLUSIONS: Excessive gestational weight gain was associated with higher average weight and prevalence of macrosomy in neonates, cesarean section, maternal weight retention in the postpartum and breastfeeding difficulty.