Inadequacy of gestational weight gain during high-risk pregnancies is not associated with household food insecurity

Aléxia Vieira De Abreu Rodrigues,Ana Lúcia Pires Augusto,Rosana Salles-Costa

doi:10.1186/s12884-021-03950-y

Aléxia Vieira De Abreu Rodrigues, Ana Lúcia Pires Augusto + Show 1 more

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https://doi.org/10.1186/s12884-021-03950-y

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Abstract

BackgroundInadequate gestational weight gain (GWG) is associated with adverse outcomes in maternal and child health and can be enhanced by social inequalities, such as lower education and household food insecurity (HFI). Women are more vulnerable to HFI, which has been associated with negative health effects for pregnant women during the prenatal and puerperal periods, particularly in regard to the aggravation of pregnancy risks. This study investigated the association between sociodemographic characteristics and HFI with respect to adequacy of total GWG among women with high-risk pregnancies.MethodsThis was a prospective cohort study that evaluated the total GWG of 169 pregnant women. The women were seen at a public university hospital in the metropolitan region of Rio de Janeiro (Brazil). Their sociodemographic and gestational characteristics and the Brazilian Scale of Domestic Food Insecurity were investigated. To estimate the total GWG, the difference between the patient weight at the last prenatal visit and the initial patient weight was verified, with both collected from the medical records of the pregnant women. The classification of the total GWG considered the recommendations of the Institute of Medicine (IOM) (2009). A multinomial logistic regression model assessed the risk (odds ratio; OR) and confidence intervals (CI 95%)) of insufficient and excessive GWG with exposure to HFI and other covariates (p value <0.05).ResultsInsufficient and excessive GWG were observed in 27.8% and 47.9% of the pregnant women, respectively. More than half of the women (74.6%) had a high education level. Exposure to mild HFI occurred in 44.2% of the women. After adjustment, the HFI was not associated with insufficient or excessive GWG. The educational level of women was the only variable significantly associated with a lower risk of GWG insufficiency (OR: 0.10; 95% CI: 0.01–0.89).ConclusionsIn this population, higher maternal education was a protective factor against insufficient GWG. We highlight the importance of additional health support and counseling for women in the most vulnerable social conditions, considering the importance of access to information for reducing health risks.

Highlights

Inadequate gestational weight gain (GWG) is associated with adverse outcomes in maternal and child health and can be enhanced by social inequalities, such as lower education and household food insecurity (HFI)
Insufficient or excessive gestational weight gain (GWG) can threaten maternal and child health [3, 4], contributing to the presence of unfavorable gestational outcomes, in women classified as having high-risk pregnancies [5]
Studies performed to assess the effects of HFI on weight gain during pregnancy observed that HFI was related to both the possibility of insufficient weight gain [11] and metabolic adaptations that increase the risk of obesity [12]

Summary

Introduction

Inadequate gestational weight gain (GWG) is associated with adverse outcomes in maternal and child health and can be enhanced by social inequalities, such as lower education and household food insecurity (HFI). Insufficient or excessive gestational weight gain (GWG) can threaten maternal and child health [3, 4], contributing to the presence of unfavorable gestational outcomes, in women classified as having high-risk pregnancies [5]. As determinants of maternal health, sociodemographic conditions, such as limited access to health care [6,7,8], play an important role during pregnancy [9] Unfavorable aspects, such as less education, the absence of paid work and a low family income, are described in the literature as social determinants associated with insufficient or excessive GWG [2, 9]. Studies performed to assess the effects of HFI on weight gain during pregnancy observed that HFI was related to both the possibility of insufficient weight gain [11] and metabolic adaptations that increase the risk of obesity [12]

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