Abstract
This article aims to evaluate the associated factors with excessive weight gain in pregnant women from Maceió, the capital of Alagoas, Northeastern Brazil. Cross-sectional study with pregnant women attended in public health in the city of Maceió in 2014, of which socioeconomic, clinical (glycemia, capillary hemoglobin, and blood pressure measurement), dietary, and anthropometric data, including in the latter gestational weight gain, classified as insufficient, adequate and excessive according to the US Institute of Medicine, were collected. The combination of excessive weight gain with the independent variables was tested using the Poisson regression expressed by the Prevalence Ratio (PR) and a 95% confidence interval (CI95%). We studied 403 pregnant women with a mean age of 24.08 ± 6.01 years, with 19.9% of them displayed insufficient weight gain; 14.1% displayed adequate weight gain, and 66.0% displayed excessive weight gain, that was associated with maternal hyperglycemia (PR = 1.35; CI95% = 1.17 to 1.57; p < 0.001). Excessive weight gain is common among pregnant women evaluated with the association of this variable with maternal hyperglycemia.
Highlights
The anthropometric evaluation in pregnancy is a low-cost and very useful procedure for the establishment of early and effective interventions during prenatal care, with a view to reduce maternal and fetal risks, where gestational weight gain should be used as an indicator of maternal nutritional status[1].The World Health Organization (WHO) and the Institute of Medicine of the United States (IOM-USA)[2] recommend ranges of gestational weight gain, differentiated according to the pre-gestational maternal nutritional status; this recommendation was adopted by the Brazilian Ministry of Health[3]
We studied 403 pregnant women with a mean age of 24.08 ± 6.01 years, with 19.9% of them displayed insufficient weight gain; 14.1% displayed adequate weight gain, and 66.0% displayed excessive weight gain, that was associated with maternal hyperglycemia (PR = 1.35; CI 95% = 1.17 to 1.57; p < 0.001)
A similar result was found in a study carried out in Southern Brazil where a higher risk of excessive weight gain was observed in pregnant women with pre-gestational overweight and obesity (RR 1.75, 95% CI 1.48-2.07 and RR: 1.55, 95% CI: 1.23-1.96, respectively)[22], and in another study conducted with women in Scotland, UK, where significant associations were found between high maternal body mass index (BMI) and excessive weight gain[24], and in the study with pregnant women in Rio Grande do Sul, where was observed that overweight women at conception had the lowest proportion of healthy weight gain during pregnancy[20]
Summary
The anthropometric evaluation in pregnancy is a low-cost and very useful procedure for the establishment of early and effective interventions during prenatal care, with a view to reduce maternal and fetal risks, where gestational weight gain should be used as an indicator of maternal nutritional status[1]. A systematic review of the epidemiology of weight gain during pregnancy states that its excessive form raises the maternal risk of obesity in the postpartum period, contributing to the increased prevalence of this condition[4]. It increases the chance of gestational diabetes mellitus, hypertensive disorders and there are reports of fetal cases of macrosomia, cephalopelvic disproportion, and perinatal asphyxia[5,6]. The impairment of health and nutritional states has been described as factors associated with this outcome[7,8,9]
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