Association between pre-pregnancy body mass index and gestational weight gain on pregnancy outcomes: a cohort study in Indonesian pregnant women

Abstract

Background Pre-pregnancy BMI (PP BMI) and gestational weight gain (GWG) are prominent anthropometric indicators for maternal nutritional status and are related to an increased risk of adverse pregnancy outcomes. This study aimed to determine the factors affecting total GWG, PP BMI and pregnancy outcomes among pregnant women in West Sumatra, Indonesia. Methods This observational analysis was conducted among healthy women in the Vitamin D Pregnant Mother (VDPM) cohort study. A total of 195 pregnant women and their newborn babies were enrolled, and information regarding their socio-demographic characteristics, obstetric history, dietary intake and anthropometric data were assessed through direct interviews. Furthermore, the Institute of Medicine (IOM) 2009 guidelines were used to obtain the total GWG. Results PP BMI was used to categorise the 195 pregnant women as overweight/obese (43.1%), normal (46.7%) and underweight (10.2%). There were 53.3%, 34.4% and 12.3% of women who had inadequate, adequate and excessive GWG, respectively. The multinomial logistic regression model indicated that overweight or obese women at the pre-pregnancy stage were 4.09 times more likely to have an excessive rate of GWG (AOR = 4.09, 95% CI: 1.38–12.12, p = 0.011) than those whose weight was normal. Furthermore, women with excessive GWG were 27.11 times more likely to have a baby with macrosomia (AOR = 27.11, 95% CI: 2.99–245.14) (p = 0.001) and those with inadequate GWG were 9.6 times more likely to give birth to a baby with low birth weight (LBW) (AOR = 9.60, 95% CI; 0.88–105.2) (p = 0.002). Conclusions This study demonstrates that the malnutrition status prior to pregnancy and inadequate or excessive GWG status during pregnancy as significant risk factors for developing adverse pregnancy outcomes. These findings highlight the importance of providing information, preconception counselling and health education on weight management for healthy pregnancies.

Impact of Gestational Weight Gain on Pregnancy Outcome

“…In agreement with the current study, Aji et al [5] reported that total GWG and birth weight were significantly correlated with the prepregnancy BMI category. Also, Wang et al [7] reported that obese women have significantly higher age, weight, and fetal birth weight than non-obese women.…”

“…In line with the current study, Aji et al [5] aimed to identify the variables influencing 195 pregnant women's total GWG, prepregnancy BMI (PP BMI), and pregnancy outcomes. They discovered that the pregnant women's average age was 29.7 ± 5.6 years.…”

“…However, Aji et al . [5] reported that there was no significant correlation between the Institute of Medicine (IOM) weight gain recommendation and SGA, but there was a significant correlation with LBW < 2.50 kg and macrosomia> 4.0 kg. The disagreement may be caused by the various study settings and sample sizes.…”

Effect of gestational weight gain on postpartum pelvic floor function in twin primiparas: a single-center retrospective study in China

“…Possibly due to differences in study populations and follow-up time, more studies have found the opposite: the effects of postpartum SUI on women's health are sustained, and over time, the cumulative incidence of SUI increases signi cantly [39,[42][43][44][45][46]. Other studies have found that the persistence of postpartum SUI is caused by higher BMI and excessive GWG in pregnant women [14,39,47,48]. From these results, it is clear that control of excessive GWG is essential for the prevention of postpartum SUI.…”

“…With the increase in gestational age, GWG is a normal physiological process of pregnancy development [13]. Adequate GWG can reduce the incidence of maternal and neonatal complications [14][15][16]. In 2009, the Institute of Medicine (IOM) published GMG guidelines and developed different criteria for GWG of singleton and twin pregnant women to promote GWG control in the normal range [17].…”