Determinant factors of insufficient and excessive gestational weight gain and maternal-child adverse outcomes.
OBJECTIVE
To estimate the magnitude and determinant factors of insufficient and excessive gestational weight gain (GWG) and its relation with maternal-child adverse outcomes.


METHODS
This was a prospective study with 173 pregnant women and their newborns monitored at a primary health care facility in Rio de Janeiro. Multinomial regression models were employed, having as the outcome the adequacy of GWG (insufficient, adequate, or excessive). Covariables were classified as biological, socioeconomic, reproductive, behavioral, and nutritional.


RESULTS
Forty-one percent of pregnant women had insufficient GWG and 22.0% had excessive GWG. Pregestational overweight was associated with insufficient GWG (odds ratio [OR] 0.19, 95% confidence interval [CI] 0.05-0.78), and pregestational obesity was associated with excessive GWG (OR 4.66, 95% CI 1.34-19.08). Also associated with insufficient GWG were a stature <157 cm (OR 2.25, 95% CI 1.03-4.93) and ages 25-29 y (OR 3.70, 95% CI 1.26-10.84) and >or=30 y (OR 2.88, 95% CI 1.13-7.35) compared with the reference group (18-24 y). Age <12 y at menarche (OR 4.97, 95% CI 1.51-16.30) and being a former smoker (OR 5.18, 95% CI 1.62-16.52) demonstrated an association with excessive GWG compared with non-smokers (reference group). Sixty percent of pregnant women with excessive GWG delivered by cesarean section compared with 39.8% with adequate or insufficient GWG (P < 0.05). Prevalence of macrosomia in the excessive GWG group was 23.5% compared with 4.5% for pregnant women with insufficient GWG (P < 0.001).


CONCLUSIONS
Different determinant factors related to insufficient and excessive GWG were observed, which can be identified in the beginning of pregnancy, thus predicting unfavorable gestational outcomes. An increased percentage of women presented GWGs outside recommended levels.
Rodrigues
Patricia Lima
PL
Institute of Nutrition Josué de Castro, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil.
de Oliveira
Lívia Costa
LC
Brito
Alexandre dos Santos
Ados S
Kac
Gilberto
G
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D001827:Body Height; D001938:Brazil / Q000453:epidemiology; D002585:Cesarean Section / Q000706:statistics & numerical data; D005260:Female; D005320:Fetal Macrosomia / Q000453:epidemiology / Q000209:etiology; D006801:Humans; D007231:Infant, Newborn; D008572:Menarche; D009765:Obesity / Q000150:complications*; D050177:Overweight / Q000150:complications*; D011247:Pregnancy / Q000502:physiology*; D011248:Pregnancy Complications / Q000453:epidemiology; D011256:Pregnancy Outcome; D015995:Prevalence; D011446:Prospective Studies; D012044:Regression Analysis; D012907:Smoking; D015430:Weight Gain; D055815:Young Adult