A new chart to monitor weight gain during pregnancy

Abstract

A new chart to monitor maternal weight gain during pregnancy is presented. The chart is based on the adequacy of maternal weight for height, as suggested by a modified table of weight for average frame size, and the data were derived from a low-income racially-mixed population living in New York City. A nomogram accompanies the chart and is used to calculate values of percentage of "standard weight" at various gestational ages. The chart establishes a desirable weight near term which is equivalent to 120 percent of "standard weight" for women with a pre-pregnancy weight equal to or lower than 100 percent of "standard weight". For women with pre-pregnancy weight above 100% of "standard weight" the desirable weight near term varies according to the initial weight but includes a minimal weight gain of 7 kg for women with pre-pregnancy weight over 120% of standard. Women who attained or exceeded body weight near term equivalent to 120 percent of "standard weight" in low income populations in the US and Chile delivered infants with significantly higher mean birth weight than those from mothers who did not meet this goal.

Assessment of weight gain during pregnancy in general prenatal care services in Brazil

“…The upper limit of the ideal weight (or BMI) for a woman who wants to become pregnant and the maximum ideal weight gain during pregnancy have received relatively little study (IOM, 1990;Rosso, 1985). As the mother is the only source of fetal nutrition, traditional concern has focussed upon being underweight for pre-pregnancy and low weight gain during pregnancy (Cnattingius et al, 1998).…”

Anthropometric assessment of nutritional status in Brazilian pregnant women

“…In 1985, Chilean researcher Pedro Rosso proposed a method for monitoring gestational weight gain, based on a maternal weight-for-height adequacy curve derived from a cohort study of 262 pregnant women (mostly black and of Hispanic origin), to help predict birth weight (25). The Rosso curve was used for many years by the Brazilian public health services network as a tool for monitoring pregnant women's weight gain but was eventually replaced due to its low specificity, which had resulted in a low-weight positive diagnosis for pregnant women with adequate nutritional status (26).…”

“…In the late 1990s, Atalah et al (39) proposed a new method for anthropometric assessment of pregnant women based on the gestational BMI from the 10th to the 42nd week and constructed from theoretical projections and population data from a prospective study conducted in Chile as an alternative approach to Rosso's curve (25). The study sample included 665 pregnant women in the 18-35 year age group, with parity less than 4, absence of chronic diseases that affect fetal growth, and prenatal care beginning before the 14th gestational week (39).…”

Considerações sobre o plano de combate à fome e à miséria

“…No que tange às gestantes, imaginamos que o indicador a ser utilizado seja peso/estatura segundo semana gestacional, tomando como ponto de corte a linha inferior do gráfico de Rosso (Rosso, 1985), abaixo da qual localizam--se as gestantes com risco de darem à luz filhos com baixo peso ao nascer. Sabemos que é polêmica a utilização deste gráfico, uma vez que parece haver superestimação na predição de risco de baixo peso, particularmente em relação às gestantes adolescentes, grupo em que o instrumento vem também sendo utilizado, embora não tenha sido criado para tal.…”

“…Em relação aos indicadores e pontos de corte, sugerimos que sejam utilizados os já preconizados pelo Inan para fins de VN (MS/Inan, 1991b): (a) o indicador peso/idade para a população infantil, sendo assumidos como pontos de corte os percentis 10 e 3, com atenção prioritária para aquelas localizadas abaixo do percentil 3, e (b) o indicador peso/estatura segundo semana gestacional, tomando como ponto de corte a linha inferior do gráfico de Rosso (Rosso, 1985).…”