title: Gestational weight gain in women with systemic lupus erythematosus.
abstract: Objective The objective of this study was to estimate the proportion of pregnant women with systemic lupus erythematosus meeting Institute of Medicine guidelines for gestational weight gain and determine correlates of adherence to guidelines. Methods Singleton, live births in the Hopkins Lupus Pregnancy Cohort 1987-2015 were included. Pre-pregnancy weight was the weight recorded 12 months prior to pregnancy/first trimester. Final weight was the last weight recorded in the third trimester. Adherence to Institute of Medicine guidelines (inadequate, adequate, or excessive) was based on pre-pregnancy body mass index. Fisher's exact test and analysis of variance determined factors associated with not meeting guidelines. Stepwise selection estimated predictors of gestational weight gain. Results Of the 211 pregnancies, 34%, 24% and 42% had inadequate, adequate and excessive gestational weight gain, respectively. In exploratory analyses, differences in Institute of Medicine adherence were observed by pre-pregnancy body mass index, race, elevated creatinine during pregnancy and pre-pregnancy blood pressure. Odds of inadequate and excessive gestational weight gain increased 12% with each 1 kg/m2increase in pre-pregnancy body mass index. Lower maternal education was associated with increased odds of inadequate and excessive gestational weight gain. Conclusions As in the general population, most women with systemic lupus erythematosus did not meet Institute of Medicine guidelines. Our results identified predictors of gestational weight gain to aid in targeted interventions to improve guideline adherence in this population.
authors.affiliation: 1 Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina Chapel Hill, Chapel Hill, USA.
authors.forename: A M
authors.initials: AM
authors.lastname: Eudy
authors.affiliation: 1 Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina Chapel Hill, Chapel Hill, USA.
authors.forename: A M
authors.initials: AM
authors.lastname: Siega-Riz
authors.affiliation: 1 Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina Chapel Hill, Chapel Hill, USA.
authors.forename: S M
authors.initials: SM
authors.lastname: Engel
authors.affiliation: 1 Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina Chapel Hill, Chapel Hill, USA.
authors.forename: N
authors.initials: N
authors.lastname: Franceschini
authors.affiliation: 2 Department of Biostatistics, Gillings School of Global Public Health, University of North Carolina Chapel Hill, Chapel Hill, USA.
authors.forename: A G
authors.initials: AG
authors.lastname: Howard
authors.affiliation: 3 Division of Rheumatology & Immunology, Duke University Medical Center, Durham, USA.
authors.forename: M E B
authors.initials: ME
authors.lastname: Clowse
authors.affiliation: 4 Division of Rheumatology, Johns Hopkins University School of Medicine, Baltimore, USA.
authors.forename: M
authors.initials: M
authors.lastname: Petri
mesh_terms: D000328:Adult; D015992:Body Mass Index; D005260:Female; D006801:Humans; D008180:Lupus Erythematosus, Systemic / Q000150:complications*; D009765:Obesity / Q000453:epidemiology*; D017410:Practice Guidelines as Topic; D011247:Pregnancy; D011248:Pregnancy Complications / Q000453:epidemiology*; D011263:Pregnancy Trimester, Third; D015430:Weight Gain
keywords: gestational weight gain; pregnancy; systemic lupus erythematosus