A systematic review and meta-analysis of gestational weight gain recommendations and related outcomes in Brazil

Abstract

Worldwide, different guidelines are used to assess the adequacy of gestational weight gain. This study identified the recommendations for gestational weight gain in Brazilian women. We also determined the proportion of women with adequate weight gain in accordance with these recommendations and the associated perinatal outcomes.A systematic review was performed. A computerized search was conducted utilizing the following databases: PubMed, MEDLINE, Web of Science, Embase, SciELO and Google Scholar. Observational studies of healthy, Brazilian, pregnant women were included. Studies were excluded if they did not provide pregestational weight and gestational weight gain or if they studied women with comorbid conditions. A meta-analysis was performed to evaluate the odds ratio of inadequate (insufficient or excessive) gestational weight gain.Seventeen studies were included in the systematic review and four studies were included in the meta-analysis. The most widely used recommendations were from the Institute of Medicine. Excessive gestational weight gain was associated with fetal macrosomia and high rates of cesarean delivery. Overweight women had a higher risk of excessive gestational weight gain than eutrophic women (OR=2.80, 95%CI=2.22-3.53).There are no standardized recommendations concerning gestational weight gain based on Brazilian population-based data. Many Brazilian women are overweight or obese at the beginning of pregnancy. Overweight pregnant women have a higher risk of excessive gestational weight gain. Excessive gestational weight gain was associated with cesarean delivery and fetal macrosomia.

Effect of Obesity on Gestational and Perinatal Outcomes

“…It is known that women who gain weight excessively or inadequately during pregnancy are at increased risks of poor maternal and child health outcomes. [39][40][41][42] In summary, our study shows that the obese women were older than the controls, and that obesity in early pregnancy increased the risk of hyperglycemic disorders, hypertensive disorders, cesarean delivery, fetal macrosomia, and fetal acidosis.…”

Macronutrient Preload effect on Glycaemic Control and Pregnancy Outcome in Gestational Diabetes Mellitus

“…Bodyweight is a controllable factor and active gestational body mass control is important for prevention of fetal macrosomia. As the patients with pre-gestational BMI≥24kg/m 2 more easily will increase weight above recommended limits during pregnancy [24], weight control for such patients is important, and may further reduce the risk of fetal macrosomia. This may be the reason for the better pregnancy outcome in the intervention group than control group.…”

Gestational Diabetes Mellitus (Based on the Results of A screening Study in the Moscow Region)

“…Во второй половине беремен-ности у женщин с макросомией нет указаний на пероральный глюкозотолерантный тест или по-вторное исследование глюкозы крови натощак, поэтому невозможно исключить гипергликемию как причину развития макросомии. Кроме ИМТ и ГСД на развитие макросомии может влиять избыточная прибавка массы тела во время беременности [12,13]. У женщин с ма-кросомией общая прибавка массы тела за время беременности была статистически значимо выше, чем у беременных без макросомии (14,9 ± 6 про-тив 10,4 ± 4,6 кг; р = 0,015).…”