Timing of Maternal Weight Gain and Pregnancy Outcome

Abstract

The purpose of this study was to determine if the timing of weight gain in pregnancy significantly affected pregnancy outcome and if particular weight gain patterns impacted pregnancy outcome.The sample consisted of one hundred pregnant women receiving prenatal care at a county health department. Four subjects were disqualified due to missing data. All subjects started prenatal care during the first trimester and had at least one recorded weight for each trimester. A cluster analysis identified distinct common patterns of weight gain. Chi square and analysis of variance were utilized to identify variables associated with pattern of weight gain.Three distinct patterns of maternal weight gain were identified as Cluster 1, Cluster 2, or Cluster 3. Prepregnancy weight status (p=0.0001), Body Mass Index (p=0.001), race (p=0.015), the mother's health history (p=0.003), prepregnancy substance abuse (p=0.049), and five minute Apgar scores (p=0.036) were found to be associated with the weight gain pattern. Clusters 2 and 3 gained within the recommended guidelines of the Institute of Medicine, whereas Cluster 1 exceeded the recommended total. All three clusters had positive pregnancy outcomes as demonstrated by mean weeks gestations and infant birth weights.This study supports: (a) the importance of early prenatal care, with care originating in the first trimester; (b) the importance of promoting the use of the Institute of Medicine recommendations for the rate of with gain as well as those for total weight gain; (c) the importance of promoting strategies to help women stay within the weight gain range recommended for the prepregnancy BMI; and (d) avoiding substance abuse before and during pregnancy.