Determinants Of Gestational Weight Gain Research Articles

Association between Gestational Weight Gain and Maternal and Birth Outcomes in Northern Ghana.

Although inappropriate gestational weight gain is considered closely related to adverse maternal and birth outcomes globally, little evidence was found in low- and middle-income countries. Study Objectives. This study is aimed at identifying the determinants of gestational weight gain and examine the association between gestational weight gain and maternal and birth outcomes in the Northern Region of Ghana. Study Methods. The study used a facility-based cross-sectional study design involving 611 antenatal and delivery records in Tatale district, Tamale west, and Gushegu municipal hospitals. A two-stage sampling method involving cluster and simple random sampling was employed. Descriptive statistical analysis and measures of central tendency were used to describe the sample. The multinomial logistic regression model was used to determine the determinants of gestational weight gain and its association with maternal and birth outcomes. Among the 611 women included in the study, 516 (84.45%) had inadequate gestational weight gain, and 19 (3.11%) had excessive gestational weight gain. The gestational weight gain ranged from 2 kg to 25 kg with a mean of 7.26 ± 3.70 kg. The risk factor for inadequate gestational weight gain was low prepregnancy BMI (adjusted odds ratio (AOR) = 1.33, 95% CI = 1.18 - 2.57, P = 0.002). Pregnant women who had inadequate gestational weight gain were significantly less likely to deliver through caesarean section (AOR = 0.27, 95% CI = 0.12 - 0.61, P = 0.002), and those who had excessive weight gain were more likely to undergo caesarean section (AOR = 19.81, 95% CI = 5.38 - 72.91, P = 0.001). The odds of premature delivery (birth < 37 weeks) among pregnant women with inadequate weight gain were 2.88 (95% CI = 1.27 - 6.50, P = 0.011). Furthermore, subjects who had excessive weight gain were 43.80 times more likely to give birth to babies with macrosomia (95% CI = 7.07 - 271.23, P = 0.001). Inappropriate gestational weight gain is prevalent in Ghana, which is associated with caesarean section, preterm delivery, delivery complications, and macrosomia. Urgent policy interventions are needed to improve on the frequent monitoring and management of gestational weight gain of pregnant women till term.

Determinants of Gestational Weight Gain and Its Impact on Offspring Adiposity at Age 2 Years

Determinants of Gestational Weight Gain and Its Impact on Offspring Adiposity at Age 2 Years

Prevalence and determinants of gestational weight gain among pregnant women in Niger.

Low gestational weight gain (GWG) and low mid‐upper arm circumference (MUAC) are associated with adverse pregnancy outcomes. We aimed to assess the prevalence and determinants of low GWG and low MUAC among pregnant women in rural Zinder, Niger. A community‐based survey was conducted among 1,384 pregnant women in the catchment areas of 18 integrated health centers in the region of Zinder, Niger. Weight and MUAC were measured during an in‐home visit and again 1 month later, when haemoglobin concentration and micronutrient status were also assessed. The prevalence of low GWG was defined based on the 2009 United States Institute of Medicine (U.S. IOM) guidelines (<0.35 kg/week) and less than the third centile of the International Fetal and Newborn Growth Consortium for the 21st Century (INTERGROWTH‐21st) standards. Factors associated with GWG and MUAC were identified using logistic regression models adjusting for season, village, and gestational age. The median (interquartile range) age was 25.0 (20.7, 30.0) years, and 16.4% were ≤19 years. The prevalence of low GWG were 62.9% and 27.5% according to 2009 IOM and less than the third INTERGROWTH‐21st centile, respectively; 24.9% had low MUAC. Higher α‐1‐acid glycoprotein (OR = 1.7, 95% CI [1.1, 2.8]) and C‐reactive protein (OR = 1.2, 95% CI [1.02, 1.50]) increased the odds of low GWG. Adolescents (OR = 2.7, 95% CI [1.8, 4.0]), housewives (OR = 1.97, 95% CI [1.36, 2.86]), and those who reported recent food assistance (OR = 1.80, 95% CI [1.04, 3.11]) had higher odds of low MUAC. Prevalence of low GWG and low MUAC was high among pregnant women. Determinants of GWG and MUAC included socio‐economic, demographic, and biological factors, although only markers of inflammation were consistent predictors across different definitions of low GWG.

Social Determinants of Gestational Weight Gain in an Obese, Low-Income Population.

To examine how social support factors affect compliance with gestational weight gain (GWG) recommendations in an obese, low-income, predominantly minority population. A retrospective cohort of 772 pregnant women with body mass index > 30 was reviewed. Univariate and multinomial logistic regression analyses were used to compare GWG with pregnancy planning, relationship status, participation in group prenatal care, nutritional education, and demographic factors. Subgroup analysis was performed to determine if differences existed in entry into prenatal care. Planned nature of pregnancy, relationship status, nutritional education, and group prenatal care did not significantly affect GWG. Women with planned pregnancies and in group prenatal care had their first appointment during the first trimester at a higher rate than those with unplanned pregnancy and in traditional care, respectively. Regardless of timing of nutrition consult, GWG was not affected. Nulliparous patients and Class 1 obese patients were more likely to have excessive GWG. Social support factors in this study did not individually affect compliance with GWG recommendations in a low-income, obese pregnant population, although some factors were associated with earlier entry to prenatal care. Multimodal, longitudinal programs are likely necessary to achieve increased compliance with GWG recommendations in this population.

An Exploration of the Determinants of Gestational Weight Gain in African American Women: Genetic Factors and Energy Expenditure.

Excessive gestational weight gain (GWG) has a long-term impact on women's body weight and contributes to the development of obesity in the mother and her child. Many risk factors for GWG have been identified, but to date, only 6-33.8% of the variance in GWG has been explained. The purpose of this study was to evaluate the overall variance of GWG that can be explained by including weight-adjusted resting metabolic rate (aRMR) and a genetic risk score constructed on obesity-related genes in addition to sociodemographic and lifestyle factors. In this observational study involving 55 African American women, data collected/measured during pregnancy included sociodemographic factors, medical information, lifestyle factors, aRMR, and seven obesity-related genes. Multivariable linear regression was performed to evaluate the variance in GWG explained by the potential risk factors listed above. The mean GWG was 15 kg (±7.5 kg), and 63.6% of women gained more than the Institute of Medicine's GWG recommendations. The final regression model explained 53.3% of the variance in GWG. Higher genetic risk score, lower aRMR, and higher dietary intake of total energy and percentage of fat were significantly associated with increased GWG ( p < .05). These factors explained 18% additional variance in GWG over that explained by significant sociodemographic and lifestyle factors in the analysis (i.e., maternal age, prepregnancy body mass index, parity, illegal drug use, and education). Overall, our results indicate that the genetic risk score, aRMR, and dietary intake have a substantial impact on GWG in African American women.

Ganancia de peso gestacional y retención de peso posparto en una cohorte de mujeres en Aragón (España).

To describe gestational weight gain and postpartum weight retention in women classified by pre-pregnancy body mass index BMI). Prospective cohort study with a sample of 301 women. Weight was evaluated throughout pregnancy and puerperium. Multilinear regression models were performed to assess determinants of gestational weight gain and postpartum weight retention by pre-gestationalBMI categories. During pregnancy, 36.5% of the participants gained more weight than recommended, and 90% retained weight at six months after childbirth. Slim women had greater weight gain during pregnancy and retained more postpartum weight. Age, parity, miscarriage history, pre-gestational BMI, origin and place of residence were independently associated with gestational weight gain. Postpartum weight retention was directly related to gestational weight gain and inversely with breastfeeding duration. Pre-gestational BMI is a predictor of gestational weight gain. Also, gestational weight gain is a predictor of postpartum weight retention. Educational programs focused on promoting healthy behaviors are needed both in pregnancy and postpartum.

Determinants of gestational weight gain: The impact of diet, genes, and energy expenditure

BackgroundExcessive gestational weight gain (GWG) has a long‐term impact on women's weight retention and contributes to the development of obesity in the mother and child. Many risk factors for GWG have been identified, but to date only 6%–33.8% of the variance in GWG has been explained.ObjectiveThe purpose of this study was to evaluate the overall variance of GWG that can be explained by adding resting metabolic rate (RMR) and a genetic score constructed on obesity‐related genes in addition to the sociodemographic and lifestyle factors.DesignThis study is an observational study of 55 African American women. Data collected or measured during pregnancy include: sociodemographic factors, medical information, lifestyle factors (i.e. dietary intake and physical activity), RMR, and seven obesity‐related genes. Linear regression was performed to evaluate the variance of GWG explained by potential risk factors listed above (e.g. prepregnancy body mass index, estimated gestational age, and gestational diabetes).ResultsThe mean GWG was 32.6 (±17.3) pounds and 61.8% women gained above the Institute of Medicine GWG guidelines. The final multivariable regression model explained 65.5% (adjusted R2 = 0.566) of the variance in GWG. Five factors that explained the leading amount of GWG variance were total energy intake (10.9%, p=0.001), genetic score (9.7%, p=0.002), percentage of calories from fat (8.7%, p=0.003), RMR per kilogram body weight (4.1%, p=0.028), and parity (3.7%, p=0.035). The minor allele at rs7498665 in the SH2B1 gene also had a protective additive effect on GWG (p=0.04).ConclusionsDietary intake, the genetic score, and RMR were significantly associated with weight gain during pregnancy and explained a substantial amount of GWG variance.Support or Funding InformationThis work was supported by the National Center for Research Resources, a component of the National Institutes of Health grant KL2 RR024136‐03 and National Institute of Nursing Research grant K23NR010748.

Gestational weight gain and its related social and demographic factors in health care settings of rural and urban areas in northwest Iran

ABSTRACTThe current study was aimed to evaluate gestational weight gain and its socio-demographic determinants among pregnant women in north-west of Iran. In the current cross-sectional study, four hundred eighty one pregnant women aged 26.12 ± 7.45 years were enrolled. Data on pre-pregnancy weight, height, age, educational attainment, parity, household size, hemoglobin status and total pregnancy weight gain were extracted from routine health center records. The pregnant women were categorized based on their pre-pregnancy body mass index (BMI) as underweight, normal weight and overweight or obese according to the 2009 Institute of Medicine (IOM) recommendations. Participants were also classified according to their educational level into three ‘some school’, ‘high school’ and ‘college’ groups. Gestational weight gain in 27.6% of pregnant women was in normal IOM recommended range; while, weight gain in 49% and 23.2% of pregnant women was below and above recommended range respectively. Women with high educational attainment (≥12 years) have significantly higher weight gain compared with low-educated women (<12 years) (P < 0.001). Age was in negative relationship with gestational weigh gain even after adjusting for confounder effects of residency, educational attainment and household size (r = 0.2, P < 0.001). Our data showed a high prevalence of abnormal gestational weight gain in pregnant women attending to public health centers in northwest of Iran. Moreover educational level, parity and age were significant determinants of gestational weight gain in pregnancy. Special attention should be focused on prenatal nutritional status and health care programs in current health care services in Iran.

Pattern and determinants of gestational weight gain an important predictor of infant birth weight in a developing country.

The study aimed to determine correlates of gestational weight gain and infant birth weight of pregnant women attending antenatal clinics in public primary health care facilities in lfe Central and East Local Government Areas of Osun State, Nigeria. Over 1000 women were recruited during booking and antenatal clinic and followed up till delivery. Chi square was used in the bivariate analysis of association between gestational weight gain, pre pregnancy BMI and demographic characteristics. The correlates of gestational weight gain and infant birth weight were determined by linear regression analysis.Eight percent are underweight, 10.3% are overweight or obese, 78% had a weight gain less than 7kg and 0.5% had a weight gain above 11.5kg. Ninety seven percent gained less than recommended weight, only 3% of the women gained the recommended weight for their pre pregnant BMI mostly the obese women. Twenty eight percent of the women had infant weight within normal (2.5kg and above). The infant weight increases with the gestational age, maternal age and parity but decreases with gestational weight gain though not significant. Maternal age and parity were significant predictors of gestational weight gain and pre pregnancy BMI was a significant predictor of infant birth weight.The gestational weight gain and infant weight reduces as the pre pregnant BMI increases. Most of the women had low birth weight babies. There is a need to educate mothers on good weight before conception in order to improve birth outcome in view of other factors not looked into in the present study.

Macronutrient and sociodemographic determinants of gestational weight gain among HIV-negative women in Tanzania.

The effect of dietary macronutrient composition on the rate of gestational weight gain among women in sub-Saharan Africa is unclear. To examine the effect of macronutrient intake on the rate of gestational weight gain among HIV-negative women in Tanzania. The weights of 8,428 women were measured monthly from 12 weeks of gestation to term. Prenatal dietary intake was estimated as the cumulative average of multiple 24-hour dietary recalls. The association between energy intake and percentage of energy from carbohydrate, protein, and total fat and rate of weight gain (grams per month) was estimated from generalized estimating equation models. Macronutrient effects were adjusted for total energy using the nutrient density model and maternal age, maternal height, maternal mid-upper-arm circumference, parity, marital status, maternal occupation, maternal education, household wealth, season, and treatment regimen assignment. Body mass index (BMI) was considered as a confounder and a potential modifier of the effect of macronutrient intake on gestational weight gain. A 6 g/month increase in rate of weight gain was associated with every 100-kcal increment in daily total energy intake (95% CI, 1 to 12; p = .03). Analyses substituting 5% of energy from fat by protein showed that weight gain would decrease by 72 g/month (95% CI, 6 to 140; p = .03); substituting 5% of energy from carbohydrate by protein decreased gain by 70 g/month (95% CI, 15 to 124; p = .01). Baseline BMI did not modify these associations. Further research on the effects of macronutrient composition on gestational weight gain is needed to inform the design of supplementation programs for women in developing countries.

Determinants of gestational weight gain with special respect to maternal stature height and its consequences for newborn vital parameters

An appropriate gestational weight gain is an essential factor of female reproductive success because gestational weight gain influences newborn size but also maternal and infant morbidity and mortality. This paper aims to analyze the impact of maternal somatic factors, first of all maternal stature height, on gestational weight gain. Additionally the effect of gestational weight gain and other maternal somatic factors on newborn size was tested. In the present study the data of 12,661 term birth which have taken place in Vienna, Austria were analyzed. Maternal and newborn somatometric features such as prepregnancy weight status, maternal stature height, birth weight, birth length and head circumference were included. Nearly 65% of the women gained appropriate weight during pregnancy. About 20% showed an excessive, less than 15% an inappropriate gestational weight gain. Gestational weight gain was influenced significantly by prepregnancy weight status, maternal stature height, maternal age, but also nicotine consumption during pregnancy. A significant association between gestational weight gain and newborn somatometrics could be stated. It could be shown that gestational weight gain is influenced by several maternal somatic but also behavioral factors. Newborn size is associated with gestational weight gain.

Determinants of Gestational Weight Gain and Internet Usage among Vermont WIC Participants

Determinants of Gestational Weight Gain and Internet Usage among Vermont WIC Participants

Predictors of Excessive and Inadequate Gestational Weight Gain in Hispanic Women

Factors influencing gestational weight gain are incompletely understood, particularly among Hispanic women. We assessed medical, sociodemographic, behavioral, and psychosocial predictors of overall gestational weight gain, as well as gains below, within, or above the range recommended by the Institute of Medicine (IOM) within a prospective study of 770 Hispanic (predominantly Puerto Rican) prenatal care patients at a large tertiary care facility in Western Massachusetts. One third of women gained within the recommended range, 22% gained below, and 45% gained above the range. In multivariate analysis, women in the highest category of BMI (P(trend)<0.001) and parity (P(trend)<0.001) gained on average 9 lbs less than those in the lowest category. Increasing time in residence in the continental United States (P(trend)<0.01) as well as a number of prenatal care visits (P(trend)=0.03) were positively associated with weight gain. Overweight women (odds ratio (OR)=2.2, 95% confidence interval (CI) 1.3, 3.8) and those over age 30 years (OR=2.5, 95% CI 1.2, 5.0) were more likely to gain above the IOM range as compared to normal-weight women and those aged 20-24, respectively. Women with <10 years of residence in the United States were 50% less likely to gain above the IOM range as compared to third-generation women (95% CI 0.3, 0.9). Findings identify determinants of gestational weight gain which can form the basis of targeted interventions in this rapidly growing ethnic group.

Determinants of gestational weight gain outside the recommended ranges among black and white women

To identify factors influencing risk of gaining outside the Institute of Medicine recommendations for pregnancy weight gain, and to determine whether these factors differ by race. Multivariate methods were used to identify risk factors for under- and over-gain among 2617 black and 1253 white women delivering at the Johns Hopkins Hospital during 1987-1989. Only 28.2% of black women and 32.5% of white women gained the recommended amounts of weight during pregnancy. Maternal pre-pregnancy body mass index (BMI), height, parity, education, smoking, hypertension, duration of pregnancy, and fetal sex influenced risk for under-gain or over-gain. Black women were 1.51 (95% confidence interval [CI] 1.23-1.85) times more likely to under-gain, but 0.89 (95% CI 0.74-1.08) times less likely to over-gain than white women. No interactions were found between any factor examined and BMI or race. Only about one-third of women are gaining the recommended amounts of weight during pregnancy. Black women are at increased risk for gaining less weight than recommended, and selected maternal characteristics associated with race do not explain this difference. Further, risk factors for under-or over-gain do not differ between black and white women.