title: Nutritional status of pregnant women: prevalence and associated pregnancy outcomes.
abstract: BACKGROUND
  Although obesity is well recognized as a current public health problem, its prevalence and impact among pregnant women have been less investigated in Brazil. The objective of the study was to evaluate the impact of pre-obesity and obesity among pregnant women, describing its prevalence and risk factors, and their association with adverse pregnancy outcomes.
  
  
  METHODS
  A cohort of 5,564 pregnant women, aged 20 years or more, enrolled at approximately 20 to 28 weeks of pregnancy, seen in prenatal public clinics of six state capitals in Brazil were followed up, between 1991 and 1995. Prepregnancy weight, age, educational level and parity were obtained from a standard questionnaire. Height was measured in duplicate and the interviewer assigned the skin color. Nutritional status was defined using body mass index (BMI), according to World Health Organization (WHO) criteria. Odds ratios and 95% confidence interval were calculated using logistic regression.
  
  
  RESULTS
  Age-adjusted prevalences (and 95% CI) based on prepregnancy weight were: underweight 5.7% (5.1%-6.3%), overweight 19.2% (18.1%-20.3%), and obesity 5.5% (4.9%-6.2%). Obesity was more frequently observed in older black women, with a lower educational level and multiparous. Obese women had higher frequencies of gestational diabetes, macrosomia, hypertensive disorders, and lower risk of microsomia.
  
  
  CONCLUSIONS
  Overweight nutritional status (obesity and pre-obesity) was seen in 25% of adult pregnant women and it was associated with increased risk for several adverse pregnancy outcomes, such as gestational diabetes and pre-eclampsia.
authors.affiliation: Departamento de Medicina Social, Faculdade de Medicina, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brasil.
authors.forename: L B
authors.initials: LB
authors.lastname: Nucci
authors.forename: M I
authors.initials: MI
authors.lastname: Schmidt
authors.forename: B B
authors.initials: BB
authors.lastname: Duncan
authors.forename: S C
authors.initials: SC
authors.lastname: Fuchs
authors.forename: E T
authors.initials: ET
authors.lastname: Fleck
authors.forename: M M
authors.initials: MM
authors.lastname: Santos Britto
mesh_terms: D000328:Adult; D001938:Brazil / Q000453:epidemiology; D016640:Diabetes, Gestational / Q000453:epidemiology / Q000209:etiology; D005260:Female; D006801:Humans; D009752:Nutritional Status; D009765:Obesity / Q000150:complications / Q000453:epidemiology*; D011225:Pre-Eclampsia / Q000453:epidemiology / Q000209:etiology; D011247:Pregnancy / Q000502:physiology*; D011248:Pregnancy Complications / Q000453:epidemiology* / Q000209:etiology; D011256:Pregnancy Outcome; D015995:Prevalence; D012307:Risk Factors