Association between gestational weight gain and pregnancy outcome

Authors

  • Danielle Góes da Silva Universidade Federal de Sergipe
  • Nayara Bispo Macedo Universidade Federal de Sergipe

DOI:

https://doi.org/10.15448/1980-6108.2014.3.16682

Keywords:

PREGNANCY, OVERWEIGHT, OBESITY, WEIGHT GAIN, PREGNANCY OUTCOME.

Abstract

AIMS: To evaluate the association between gestational weight gain and pregnancy outcome. METHODS: A cross-sectional study evaluated postpartum women from a maternity ward in a hospital located in Aracaju, Sergipe, Brazil, from March to June 2012. Data were obtained through interviews, medical records and records of prenatal care. Pregnancy-related variables, conditions of the newborn, weight retention in the postpartum period and breastfeeding were investigated. Based on the classification of gestational weight gain as recommended by the Institute of Medicine, three groups were formed: 1) group with insufficient weight gain; 2) group with adequate weight gain; and 3) group with excessive gain. Statistical analysis used chi-square and analysis of variance, with a level of statistical significance less than 5%. RESULTS: At all 158 women were included in the study. There was a high percentage of women entering pregnancy with overweight/obesity (30.4%), however, those with low pre-pregnancy weight did not gain excessive weight during their gestational period. Excessive gain was associated with greater weight and length of the newborn, higher prevalence of fetal macrosomy, increased maternal body mass index and higher postpartum weight retention in the third month after birth. Difficulty with breastfeeding in the third month postpartum occurred in 4.5% of mothers with adequate weight gain during pregnancy but it occurred in 33.3% of women with excessive weight gain (p = 0.025). A cesarean section was done in 20% of the women with insufficient gestational weight gain, in 40% of those who gained weight adequately and in 47% of those with excessive weight gain (p = 0.012). CONCLUSIONS: Excessive gestational weight gain was associated with higher average weight and prevalence of macrosomy in neonates, cesarean section, maternal weight retention in the postpartum and breastfeeding difficulty.

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References

Langford A, Joshu C, Chang JJ, Myles T, Leet T. Does gestational weight gain affect the risk of adverse maternal and infant outcomes in overweight woman? Matern Child Health J. 2011 Oct;15(7):860-5. doi: 10.1007/s10995-008-0318-4.

Blomberg M. Maternal and neonatal outcomes among obese women with weight gain below the new institute of medicine recommendations. Obstet Gynecol. 2011 May;117(5):1065-70. doi: 10.1097/AOG.0b013e318214f1d1.

Olson G, Blackwell SC. Optimization of gestational weight gain in the obese gravida: a review. Obstet Gynecol Clin North Am. 2011 Jun;38(2):397-407. doi: doi:10.1016/j.ogc.2011.03.003.

Mattar R, Torloni MR, Betrán AP, Merialdi M. Obesidade e gravidez. Rev Bras Ginecol Obstet. 2009 Mar; 31(3):107-110.

Wrotniak BH, Shults J, Butts S, Stettler N. Gestational weight gain and risk of overweight in the offspring at age 7y in a multicenter, multiethnic cohort study. Am J Clin Nutr. 2008 Jun;87(6):1818-24.

Ludwig DS, Currie J. The association between pregnancy weight gain and birthweight: a within-family comparison. Lancet. 2010 Sep;376(9745):984-90. doi:10.1016/S0140-6736(10)60751-9.

Bowers K, Laughon SK, Kiely M, Brite J, Chen Z, Zhang C. Gestational diabetes, pre-pregnancy obesity and pregnancy weight gain in relation to excess fetal growth: variations by race/ethnicity. Diabetologia. 2013 Jun;56(6):1263-71. doi: 10.1007/s00125-013-2881-5.

Dello Russo M, Ahrens W, De Vriendt T, Marild S, Molnar D, Moreno LA, et al. Gestational weight gain and adiposity, fat distribution, metabolic profile, and blood pressure in offspring: the IDEFICS project. Int J Obes (Lond). 2013 Jul;37(7):914-9. doi: 10.1038/ijo.2013.35. Epub 2013 Apr 9.

Oken E, Taveras EM, Kleinman KP, Rich-edwards JW, Gillman MW. Gestational weight gain and child adiposity at age 3 years. Am J Obstet Gynecol. 2007 Apr;196(4):322.

Oken E, Rifas-Shiman SL, Field AE, Frazier AL, Gillman MW. Maternal gestational weight gain and offspring weight in adolescence. Obstet Gynecol. 2008 Nov;112(5):999-1006. doi:10.1097/AOG.0b013e31818a5d50.

Cohen TR, Koski KG. Limiting excess weight gain in healthy pregnant women: importance of energy intakes, physical activity, and adherence to gestational weight gain guidelines. J Pregnancy. 2013;2013:787032. http://dx.doi.org/10.1155/2013/787032.

Institute of Medicine, National Research Council. Weight gain during pregnancy: reexamining the guidelines. Washington (DC): National Academy Press; 2009. Disponível em: <http://www.iom.edu/~/media/Files/Report%20Files/2009/Weight-Gain-During-Pregnancy-Reexamining-the-Guidelines/Report%20Brief%20-%20Weight%20Gain%20During%20Pregnancy.pdf>. Acesso em: 16 de dezembro de 2013.

World Health Organization. Division of Noncommunicable Diseases. Programme of Nutrition Family and Reproductive Health. Obesity: preventing and managing the global epidemic: report of a WHO consultation on obesity. Geneva: WHO; 1998. Disponível em: < http://whqlibdoc.who.int/hq/1998/WHO_NUT_NCD_98.1_(p1-158).pdf>. Acesso em: 16 de dezembro de 2013.

Atalah SE, Castillo CL, Castro RS, Aldea PA. Propuesta de um nuevo estandar de evaluación nutricional en embarazadas. Rev Med Chile. 1997;125(12):1429-36.

Drehmer M. Ganho de peso gestacional, desfechos adversos da gravidez e retenção de peso pós-parto [dissertação]. Porto Alegre: Universidade Federal do Rio Grande do Sul; 2010. 233p. Disponível em: < http://www.lume.ufrgs.br/bitstream/handle/10183/26934/000762655.pdf?sequence=1>.

Marano D, Gama SGN, Pereira APE, Souza Junior PRBJ. Adequação do ganho ponderal de gestantes em dois municípios do estado do Rio de Janeiro (RJ), Brasil, 2008. Rev Bras Ginecol Obstet. 2012; 34(8):386-393.

Fazio ES, Nomura RMY, Dias MCG, Zugaib M. Consumo dietético de gestantes e ganho ponderal materno após aconselhamento nutricional. Rev Bras Ginecol Obstet. 2011 Fev; 33(3):87-92.

Park S, Sappenfield WM, Bish C, Salihu H, Goodman D, Bensyl DM. Assessment of the Institute of Medicine recommendations for weight gain during pregnancy: Florida, 2004-2007. Matern Child Health J. 2011 Apr;15(3):289-301. doi: 10.1007/s10995-010-0596-5.

Crane JM, White J, Murphy P, Burrage L, Hutchens D. The effect of gestational weight gain by body mass index on maternal and neonatal outcomes. J Obstet Gynaecol Can. 2009 Jan;31(1):28-35.

Rasmussen KM, Kjolhede CL. Prepregnant overweight and obesity diminish the prolactin response to suckling in the first week postpartum. Pediatrics. 2004 May;113(5):e465-71.

Liu J, Smith MG, Dobre MA, Ferguson JE. Maternal obesity and breast-feeding practices among white and black women. Obesity (Silver Spring). 2010 Jan;18(1):175-82. doi:10.1038/oby.2009.182.

Ayerza Casas A, Rodríguez Martínez G, Samper Villagrasa MP, Murillo Arnal P, Alvarez Sauras ML, Moreno Aznar LA et al. Características nutricionales de los recién nacidos de madres con sobrepeso y obesidad. An Pediatr (Barc). 2011 Sep;75(3):175-81. doi:10.1016/j.anpedi.2011.03.001.

Wojcicki JM. Maternal prepregnancy body mass index and initiation and duration of breastfeeding: a review of the literature. J Womens Health. 2011 Mar; 20(3):341-7. doi: 10.1089=jwh.2010.2248.

Rasmussen KM. Association of maternal obesity before conception with poor lactation performance. Annu Rev Nutr. 2007; 27:103-21.

Castro MBT, Kac G, Sichieri R. Determinantes nutricionais e sóciodemográficos da variação de peso no pós-parto: uma revisão da literatura. Rev Bras Saúde Mater Infant. 2009 Abr/Jun; 9(2):125-137.

Vitolo MR, Bueno MSF, Gama CM. Impacto de um programa de orientação dietética sobre a velocidade de ganho de peso de gestantes atendidas em unidades de saúde. Rev Bras Ginecol Obstet. 2011 Jan; 33(1):13-19.

Published

2014-08-13

How to Cite

da Silva, D. G., & Macedo, N. B. (2014). Association between gestational weight gain and pregnancy outcome. Scientia Medica, 24(3), 229–236. https://doi.org/10.15448/1980-6108.2014.3.16682

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Section

Original Articles