Abstract
ABSTRACT Objective To measure and identify the factors associated with healthy weight gain during pregnancy in the municipality of Rio Grande, Rio Grande do Sul, Brazil. Methods This was a population-based, cross-sectional study that included all parturient women from the municipality who gave birth at its maternity hospitals in 2013. Information was collected by interview with the mothers in the first 48 hours following parturition and from the prenatal care cards. Healthy weight gain was evaluated according to the Institute of Medicine guidelines. Data analysis used Poisson regression with robust variance using previous hierarchical model. Results Among the 1,784 pregnant participants, 89% attended at least six prenatal care visits, and 32% had healthy weight gain during pregnancy. Higher education level and fewer children resulted in a higher prevalence ratio for healthy weight gain (p=0.003 and p=0.029, respectively). Underweight women at conception had a higher proportion of healthy weight gain (p<0.001). Despite extensive coverage, prenatal care did not affect healthy weight gain during pregnancy (p=0.104). Conclusion The low proportion of women with healthy gestational weight gain suggests a need of better prenatal care services. Women who are overweight, have lower education levels, and had had multiple pregnancies at conception need special attention.
Highlights
Weight gain is a potentially modifiable risk factor during pregnancy[1]
The low proportion of women with healthy gestational weight gain suggests a need of better prenatal care services
In 2009, the United States Institute of Medicine (IOM) published new guidelines for gestational weight gain taking into account maternal and fetal outcomes during pregnancy and after parturition in order to determine healthy weight gain ranges based on pregestational Body Mass Index (BMI)[2]
Summary
Weight gain is a potentially modifiable risk factor during pregnancy[1]. Its monitoring is a widely used, inexpensive, and very useful procedure to reduce perinatal risks[2]. Weight gain during pregnancy reduces the occurrence of fetal macrosomia, surgical parturition, diabetes Mellitus, eclampsia, low birth weight, intrauterine growth restriction, prematurity, and other undesirable outcomes[1,3,4,5]. In 2009, the United States Institute of Medicine (IOM) published new guidelines for gestational weight gain taking into account maternal and fetal outcomes during pregnancy and after parturition in order to determine healthy weight gain ranges based on pregestational Body Mass Index (BMI)[2]. Based on the IOM guidelines, many women in low- and high-income countries are overweight at conception[6,7,8], and only one-third has healthy gestational weight gain[5,9,10]. In Brazil a single multicentric cohort study with 2,244 women conducted in four state capitals found prevalences of healthy weight gain in the second and third trimesters of 28.5 and 22.0%, ADEQUATE GESTATIONAL WEIGHT GAIN | 447
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