Abstract
BackgroundExcess gestational weight gain (GWG) leads to adverse short- and long-term consequences for women and their offspring. Evidence suggests that excess GWG in early pregnancy may be particularly detrimental, contributing to the intergenerational cycle of obesity. The primary outcome was to investigate the prevalence and predictors of excess GWG in early pregnancy, and if women understand the risks to themselves and their offspring stratified by maternal body mass index (BMI).MethodsThis was a secondary analysis (n = 2131) of a cross-sectional study (n = 2338) conducted over 6 months in 2015 of pregnant women attending antenatal clinics at four maternity hospitals across Sydney, Australia before 22 completed weeks gestation An self-completed questionnaire was used to investigate knowledge of expected weight gain in pregnancy, understanding of risks associated with excess GWG, self-reported anthropometric measures and socio-demographic data.ResultsOne third (34.2%) of women gained weight in excess of the recommendations by 22 completed weeks gestation. Women who were overweight (OR: 1.69, 95% CI: 1.33–2.14) or obese (OR: 1.64, 95% CI: 1.20–2.24) pre-pregnancy were more likely to gain excess weight in early pregnancy compared to normal weight women; as were women from lower socio-economic areas (OR: 1.89, 95% CI: 1.49–2.41). Half (51%) the women were unsure about the effect of excess GWG on their baby; 11% did not believe that excess GWG would affect the weight of the baby and 14% did not believe that excess GWG would affect longer term outcomes for their baby. Women who gained weight above the recommendations were significantly more likely to believe that excessive GWG in pregnancy would not have any adverse future effect on health outcomes or weight of their baby.ConclusionsThe women at particular risk of excess early GWG are those who are overweight and obese and/or residing in lower socio-economic areas. These women need to be targeted for appropriate counselling preconception or in early pregnancy. Given the significant adverse outcomes associated with excess GWG in early pregnancy, preconception or early pregnancy counselling with respect to GWG and intervention research regarding best approach remains a public health priority.
Highlights
Excess gestational weight gain (GWG) leads to adverse short- and long-term consequences for women and their offspring
Women who gained weight above the Institute of Medicine (IOM) recommendations were more likely to believe that excessive GWG in pregnancy would not have any adverse future effect on health outcomes of their baby (χ2 = 6.949; p < 0.05) or the weight of the baby (χ2 = 16.54; p < 0.005) (Table 6)
We found that in the first half of their pregnancy, more than one third of the cohort (32.4%) gained gestational weight outside the IOM recommendations for their body mass index (BMI) category and the overweight and obese women were more likely to overestimate the appropriate GWG for their baseline BMI
Summary
Excess gestational weight gain (GWG) leads to adverse short- and long-term consequences for women and their offspring. The primary outcome was to investigate the prevalence and predictors of excess GWG in early pregnancy, and if women understand the risks to themselves and their offspring stratified by maternal body mass index (BMI). In 2009, the United States Institute of Medicine (IOM) published updated guidelines to provide direction to health professionals around healthy GWG expectations [4] These guidelines are pre-pregnancy body mass index (BMI) specific and are used to guide clinicians when counselling women regarding weight gain in pregnancy. Excess early pregnancy weight gain, in particular, has been shown to be an independent risk factor for development of gestational diabetes and maternal hyperglycaemia [6, 11, 12]. While there should be minimal gain physiologically in the first trimester, excess first trimester weight gain has been shown to increase the risk of overweight and obesity in offspring in the first 4 years of life [13, 14]
Sign-in/Register to view highlights & summary 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.
