Abstract
ObjectivesTo compare gestational weight gain (GWG) trajectories of Brazilian women with three international charts used to monitor GWG, and to test whether there are differences in the classification of total GWG centiles between these charts. MethodsThis is a multiple combined cohort dataset with data from 10 Brazilian studies with repeated measures (mean of 6.9 measures) of GWG. Total GWG was obtained by the difference between the weight measured up to 14 days before delivery and the weight measured in the 1st trimester [Intergrowth-21st, I-chart] or the pre-pregnancy self-reported weight [Life-cycle project, L-charts; and Hutcheon, H-charts]. A total of 3,423 (23,340 observations) adult women with singleton pregnancies and free of hypertension and diabetes were included. We compared graphically the mean linear prediction (linear mixed-effect models) of Brazilian women GWG with the 50th centile of three international charts. The agreement of total GWG classification in < 10th, 10th–90th and > 90th centiles was tested using Cohen’s kappa coefficient according to Landis & Koch classification. ResultsWomen had a mean total GWG of 12.2 kg (SD: 5.8) and were, on average, 27.4 (SD: 5.8) years old. Pre-pregnancy normal weight women had a different pattern of GWG compared to I-chart, and the mean GWG of this group was slightly higher than the 50th centile of the L-chart. Underweight and obese women presented a different slope of GWG compared with the 50th centiles of H and L-charts. Pre-pregnancy overweight women presented a linear prediction that overlaps the 50th centile of the L-chart in the second half of pregnancy (Figure). It was observed a moderate agreement (kappa = 0.56) comparing the 10th, 10th–90th and 90th centiles classification between L and I-charts for normal weight women. L and H-charts presented a substantial agreement for underweight (kappa = 0.71), and moderate for overweight (kappa = 0.52) and obese women (kappa = 0.59). ConclusionsL-charts are the ones that most closely resemble the Brazilian GWG distribution, especially for overweight women. We observed moderate agreement in the GWG classification of women in the 10th and 90th centiles between charts, which may lead to different diagnosis of GWG depending on which chart is used. This is a first step to create new Brazilian GWG recommendations. Funding SourcesThe Brazilian National Council for Scientific and Technological Development and Bill and Melinda Gates Foundation (Grand Challenges Exploration). Supporting Tables, Images and/or Graphs▪
Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
