Gestational Weight Gain and Maternal Diet Composition [272

Abstract

INTRODUCTION: Obesity (body mass index [BMI, calculated as weight (kg)/[height (m)]2] greater than 30) affects 32% of women of reproductive age. Excessive gestational weight gain and obesity are each linked to poor maternal and fetal outcomes including macrosomia and increased incidence of obesity and diabetes among offspring. Our study looks at the relationships between maternal diet and gestational weight gain. METHODS: Forty-one women with term (greater than 37 weeks of gestation) uncomplicated singleton gestations were enrolled who met prepregnancy BMI criteria for normal (n=11), overweight (n=15), and obese (n=15) status. Each completed three 24-hour food frequency questionnaires, which were evaluated using the Healthy Eating Index. Gestational weight gain was measured using self-reported prepregnancy weight or weight at the first prenatal visit and weight at time of delivery and was assessed by Institute of Medicine 2009 gestational weight gain recommendations. Statistical analysis included linear regression and one-way analysis of variance. RESULTS: The average gestational weight gain was 10.5 kg (−13.5 to 30.7 kg). Seven of 41 women had excessive gestational weight gain. There was a statistically significant difference in gestational weight gain by BMI group (P=.015) with overweight women having the highest gestational weight gain (mean 13.7 kg) and obese women the lowest (mean 6.8 kg). Increased total carbohydrate consumption (g) and percent intake of carbohydrates was associated with increased gestational weight gain (P<.005, r2=0.19, and P=.015, r2=0.14, respectively) regardless of BMI category. There was no association between total fat, total protein, total calorie intake, or Healthy Eating Index score and gestational weight gain. CONCLUSION: These results suggest that pregnant women with excessive carbohydrate intake are at increased risk of excess gestational weight gain and poor outcomes. Dietary intake is a potential target for education and intervention.