Abstract
ObjectivesThe objective of this study was to estimate the magnitude and determinants of inadequate weight gain in the third-trimester among rural women in Matlab, Bangladesh.MethodsThe study analyzed data on weight gain in the third trimester in 1,883 pregnant women in Matlab, Bangladesh. All these women were admitted to Matlab hospital of the International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b) for childbirth during 2012–2014, and they had singleton live births at term. Data were retrieved from the electronic databases of Matlab Health and Demographic Surveillance System and Matlab hospital. A multivariable logistic regression for inadequate weight gain in the third trimester (≤4 kg) was built with sociodemographic, environmental and maternal factors as predictors.ResultsOne thousand and twenty-six (54%) pregnant women had inadequate weight gain in the third trimester. In the multivariable model, short stature turned out to be the most robust risk factor for inadequate weight gain in the third trimester (OR = 2.5; 95% CI 1.8, 3.5 for short compared to tall women). Pre-third-trimester BMI was inversely associated with insufficient weight gain (OR = 0.96; 95% CI 0.93, 0.99 for 1 unit increase in BMI). Other risk factors for inadequate weight gain in the third trimester were advanced age (OR = 1.9; 95% CI 1.2, 3.1 for ≥35 years compared to ≤19 years), parity (OR = 1.5; 95% CI 1.2, 1.9 for multipara compared to nulliparous women), low socioeconomic status (OR = 1.7; 95% CI 1.2, 2.3 for women in the lowest compared to women in the highest wealth quintile), low level of education (OR = 1.6; 95% CI 1.2, 2.1 for ≤5 years compared to ≥10 years of education), belonging to the Hindu religious community (OR = 1.8; 95% CI 1.3, 2.5), consuming arsenic-contaminated water (OR = 1.4; 95% CI 1.1, 1.9), and conceiving during monsoon or dry season compared to summer (OR = 1.4; 95% CI 1.1, 1.8).ConclusionsAmong rural Bangladeshi women in Matlab, third-trimester weight gain was in general poor. Maternal characteristics such as short stature, low BMI, advanced age, parity, low level of education and socioeconomic status, being Hindu, intake of arsenic contaminated water, and conceiving during monsoon or dry season were the risk factors for inadequate weight gain in the third trimester. Special attention should be given during prenatal care to women with the risk factors identified in this study.
Highlights
Appropriate weight gain during pregnancy contributes positively to both maternal and fetal outcomes [1]
Special attention should be given during prenatal care to women with the risk factors identified in this study
Hediger et al have shown that late inadequate weight gain among adolescents increases the risk of delivering preterm as well as low birth weight infants independent of achieving adequate total gestational weight gain [5]
Summary
Appropriate weight gain during pregnancy contributes positively to both maternal and fetal outcomes [1]. Evidence suggests that weight gain during the second half of the pregnancy is more important, in terms of fetal outcomes. Hediger et al have shown that late inadequate weight gain (during 24 weeks of gestation to childbirth) among adolescents increases the risk of delivering preterm as well as low birth weight infants independent of achieving adequate total gestational weight gain [5]. The work of Lawton et al indicates that poor maternal weight gain between 28 and 32 weeks of gestation results in infants born small for gestational age [7]. Durie et al have shown that suboptimal second- and third-trimester rates of gestational weight gain increases the risk of delivering small-for-gestational-age infants [8]. Raje and Ghugre have demonstrated that weight gain in the third trimester is substantially correlated with the birth weight of the infant irrespective of maternal nutritional status [10]
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