Association of Pregestational BMI and Gestational Weight Gain with Maternal and Neonatal Outcomes in Adolescents and Adults from Mexico City.

Reyna Sámano,Estela Godínez-Martínez,Oralia Nájera-Medina,Hugo Martínez-Rojano,Luis Ortiz-Hernandez,María Hernández-Trejo,Cristopher Hurtado-Solache,Gabriela Chico-Barba,María Eugenia Flores-Quijano

doi:10.3390/ijerph19010280

Abstract

During pregnancy, adolescents experience physiological changes different from adults because they have not concluded their physical growth. Therefore, maternal and neonatal outcomes may not be the same. This paper aimed to analyze the association between pregestational BMI (pBMI) and gestational weight gain (GWG) with maternal and neonatal outcomes in adolescent and adult pregnant women. The authors performed an observational study that included 1112 women, where 52.6% (n = 585) were adolescents. Sociodemographic information, pBMI, GWG, neonatal anthropometric measures, and maternal and neonatal outcomes were obtained. Adolescent women had a mean lower (21.4 vs. 26.2, p ≤ 0.001) pBMI than adults and a higher gestational weight gain (12.3 vs. 10.7 kg, p ≤ 0.001). According to Poisson regression models, gestational diabetes is positively associated with insufficient GWG and with pregestational obesity. Furthermore, the probability of developing pregnancy-induced hypertension increased with pBMI of obesity compared to normal weight. Preeclampsia, anemia, and preterm birth were not associated with GWG. Insufficient GWG was a risk factor, and being overweight was a protective factor for low birth weight and small for gestational age. We conclude that pBMI, GWG, and age group were associated only with gestational diabetes and low birth weight.

Highlights

The Institute of Medicine (IOM) gestational weight gain guidelines recommend weight gain ranges for each pre-pregnancy body mass index category associated with a low prevalence of some maternal and neonatal adverse outcomes
Pregestational overweight and obesity and excessive gestational weight gain were more common in pregnant adults than in adolescents
Our study showed a higher frequency of gestational diabetes in adults and even in adolescent women, compared to data from Mexican studies [5,39], where the prevalence ranged from 1% to 3.4% compared with the 14.5% from our research

Summary

Introduction

The Institute of Medicine (IOM) gestational weight gain guidelines recommend weight gain ranges for each pre-pregnancy body mass index (pBMI) category associated with a low prevalence of some maternal and neonatal adverse outcomes. These guidelines propose that adolescent pregnant women be categorized using BMI cutoff points for adults and be advised to gain within the same weight gain ranges [1]. Research has shown that some adolescents may stop or continue their physical growth during pregnancy [2], depending.

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