The Indian Journal of Nutrition and Dietetics

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Incidence and Risk Factors of Excess Gestational Weight Gain in Indian Women


Affiliations
1 Department of Clinical Nutrition and Dietetics, Fernandez Hospital Foundation, Hyderabad, Telangana - 500 001, India
2 Department of Statistics, Fernandez Hospital Foundation, Hyderabad, Telangana - 500 001, India
     

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Excess Gestational Weight Gain (EGWG) increases risks of adverse obstetric outcomes, long-term obesity and metabolic disorders in mothers and children. The objective was to identify the incidence and risk factors of EGWG in the Indian context in order to develop effective preventative measures. A prospective cohort study was done to evaluate Gestational Weight Gain (GWG) in pregnant women who have completed a validated knowledge survey on GWG in 4 urban maternity tertiary centres and subsequently delivered at the same centres. Chi square test and Fisher’s exact test were used to identify risk factors associated with EGWG. 245 women completed the study. Gestational weight gain was classified as per the Institute of Medicine BMI-specific recommendations. Of the total women surveyed, 37.5% exceeded the GWG recommendation. The overweight and obese women constituted 50.2% of the entire population. In the overweight-obese category, 52% of women exceeded GWG recommendations. Risk factors for EGWG were high pre-pregnancy BMI (P<0.001), underestimation of pre-pregnancy weight category (P=0.003) and overestimation of GWG recommendations (P<0.001). In overweight-obese women, primiparity also increased risk of EGWG (P=0.04). Maternal age, education and perception of EGWG associated risks did not influence GWG. Ensuring women begin their pregnancies at a normal weight and provision of individualised GWG related counselling, either pre-conception or in the early stages of pregnancy may help foster appropriate weight gain in pregnancy. A modification in the current model of care involving detailed screening and nutritional counselling at the first visit itself could ensure effectiveness.


Keywords

Excess Gestational Weight Gain, Incidence, Risk Factors, Pregnancy, Obesity.
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  • World Health Organization (WHO). Obesity and overweight. (2018). Retrieved from http://www.who.int/en/news-room/fact-sheets/detail/obesity-and-overweight (accessed on 8th September, 2018)

  • Meshram, I., Balakrishna, N., Sreeramakrishna, K., Rao, K., Kumar, R., Arlappa, N., et al. Trends in nutritional status and nutrient intakes and correlates of overweight/obesity among rural adult women (>18–60 years) in India: National Nutrition Monitoring Bureau (NNMB) national surveys. Public Health Nutr., 2015, 19, 767-776. doi: 10.1017/s1368980015002268

  • Goldstein, R., Abell, S., Ranasinha, S., Misso, M., Boyle, J., Black, M., et al. Association of gestational weight gain with maternal and infant outcomes. JAMA, 2017, 317, 2207. doi: 10.1001/jama.2017.3635

  • American College of Obstetricians and Gynecologists. ACOG Committee opinion no. 548: weight gain during pregnancy. Obstet. Gynecol., 2013, 121, 210. doi: 10.1097/01.aog.0000425668.87506.4c

  • Samura, T., Steer, J., Michelis, L., Carroll, L., Holland, E. and Perkins, R. Factors associated with excessive gestational weight gain: Review of current literature. Glob. Adv. Health. Med., 2016, 5, 87-93. doi: 10.7453/gahmj.2015.094

  • Kapadia, M., Gaston, A., Van Blyderveen, S., Schmidt, L., Beyene, J., McDonald, H. and McDonald, S. Psychological antecedents of excess gestational weight gain: A systematic review. BMC. Preg. Childbirth, 2015, 15. doi: 10.1186/s12884-015-0535-y

  • Vanstone, M., Kandasamy, S., Giacomini, M., DeJean, D. and McDonald, S. Pregnant women’s perceptions of gestational weight gain: A systematic review and meta-synthesis of qualitative research. Mat. Child Nutr., 2016, 13, e12374. doi: 10.1111/mcn.12374

  • World Health Organisation, Expert Consultation. Appropriate body-mass index for Asian populations and its implications for policy and intervention strategies. The Lancet, 2004, 363, 157-163. doi: 10.1016/s0140-6736(03)15268-3

  • Lindberg, S., Anderson, C., Pillai, P., Tandias, A., Arndt, B. and Hanrahan, L. Prevalence and predictors of unhealthy weight gain in pregnancy. WMJ: official publication of the State Medical Society of Wisconsin, 2016, 111, 233-237.

  • Popa, A., Popescu, R. and Botnariu, G. Adequate weight gain in pregnancy: An analysis of its determinants in a cross-sectional study. SrpskiArhivZaCelokupnoLekarstvo, 2014, 142, 695-702. doi: 10.2298/sarh1412695p

  • Ministry of Health and Family Welfare. National Family Health Survey - 4 Fact Sheet India. (2016). Retrieved from http://rchiips.org/NFHS/pdf/NFHS4/India.pdf (accessed on 8th September, 2018)

  • Sui, Z., Turnbull, D. and Dodd, J. Effect of body image on gestational weight gain in overweight and obese women. Women and Birth, 2013, 26, 267-272. doi: 10.1016/j.wombi.2013.07.001

  • Herring, S., Oken, E., Haines, J., Rich-Edwards, J., Rifas-Shiman, S., Kleinman ScD, K. and Gillman, M. Misperceived pre-pregnancy body weight status predicts excessive gestational weight gain: findings from a US cohort study. BMC Preg. Childbirth, 2008, 8. doi: 10.1186/1471-2393-8-54

  • Shub, A., Huning, E., Campbell, K. and McCarthy, E. Pregnant women’s knowledge of weight, weight gain, complications of obesity and weight management strategies in pregnancy. BMC Research Notes, 2013, 6, 278. doi: 10.1186/1756-0500-6-278

  • Gaudet, L., Gruslin, A. and Magee, L. Weight in pregnancy and its implications: what women report. J. Obstet. Gynaecol. Canada, 2011, 33, 227-234. doi:10.1016/s1701-2163(16)34823-x

  • Jeffs, E., Haszard, J.J., Sharp, B., Gullam, J. and Paterson, H. Pregnant women lack accurate knowledge of their BMI and recommended gestational weight gain. The New Zealand Med. J. (Online), 2016, 129, 37.

  • Stotland, N., Haas, J., Brawarsky, P., Jackson, R., Fuentes-Afflick, E. and Escobar, G. Body mass index, provider advice and target gestational weight gain. Obstet. Gynecol., 2005, 105, 633-638.doi: 10.1097/01.aog.0000152349.84025.35

  • Brown, A. and Avery, A. Healthy weight management during pregnancy: what advice and information is being provided. J. Human Nutr. Diet., 2012, 25, 378-387.doi: 10.1111/j.1365-277x.2012.01231.x

  • Arinze, N., Karp, S. and Gesell, S. Evaluating provider advice and women’s beliefs on total weight gain during pregnancy. J. Immig. Minority Health, 2015, 18, 282-286. doi: 10.1007/s10903-015-0162-8


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  • Incidence and Risk Factors of Excess Gestational Weight Gain in Indian Women

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Authors

Aishwarya Kanneganti
Department of Clinical Nutrition and Dietetics, Fernandez Hospital Foundation, Hyderabad, Telangana - 500 001, India
Aakash Chowdhury
Department of Statistics, Fernandez Hospital Foundation, Hyderabad, Telangana - 500 001, India
Asma Sajid
Department of Clinical Nutrition and Dietetics, Fernandez Hospital Foundation, Hyderabad, Telangana - 500 001, India
Latha Sashi
Department of Clinical Nutrition and Dietetics, Fernandez Hospital Foundation, Hyderabad, Telangana - 500 001, India

Abstract


Excess Gestational Weight Gain (EGWG) increases risks of adverse obstetric outcomes, long-term obesity and metabolic disorders in mothers and children. The objective was to identify the incidence and risk factors of EGWG in the Indian context in order to develop effective preventative measures. A prospective cohort study was done to evaluate Gestational Weight Gain (GWG) in pregnant women who have completed a validated knowledge survey on GWG in 4 urban maternity tertiary centres and subsequently delivered at the same centres. Chi square test and Fisher’s exact test were used to identify risk factors associated with EGWG. 245 women completed the study. Gestational weight gain was classified as per the Institute of Medicine BMI-specific recommendations. Of the total women surveyed, 37.5% exceeded the GWG recommendation. The overweight and obese women constituted 50.2% of the entire population. In the overweight-obese category, 52% of women exceeded GWG recommendations. Risk factors for EGWG were high pre-pregnancy BMI (P<0.001), underestimation of pre-pregnancy weight category (P=0.003) and overestimation of GWG recommendations (P<0.001). In overweight-obese women, primiparity also increased risk of EGWG (P=0.04). Maternal age, education and perception of EGWG associated risks did not influence GWG. Ensuring women begin their pregnancies at a normal weight and provision of individualised GWG related counselling, either pre-conception or in the early stages of pregnancy may help foster appropriate weight gain in pregnancy. A modification in the current model of care involving detailed screening and nutritional counselling at the first visit itself could ensure effectiveness.


Keywords


Excess Gestational Weight Gain, Incidence, Risk Factors, Pregnancy, Obesity.

References





DOI: https://doi.org/10.21048/ijnd.2019.56.3.23207