Gestational weight gain charts: results from the Brazilian Maternal and Child Nutrition Consortium

Abstract

Background Monitoring gestational weight gain (GWG) is fundamental to ensure a successful pregnancy for the mother and the offspring. There are several international GWG charts, but just a few for low- and middle-income countries. Objectives To construct GWG charts according to pre-pregnancy BMI for Brazilian women. Methods This is an individual patient data analysis using the Brazilian Maternal and Child Nutrition Consortium data, comprising 21 cohort studies. External validation was performed using “Birth in Brazil,” a nationwide study. We selected adult women with singleton pregnancies who were free of infectious and chronic diseases, gestational diabetes, and hypertensive disorders; who delivered a live birth at term; and whose children were adequate for gestational age, and with a birth weight between 2500–4000 g. Maternal self-reported pre-pregnancy weight and weight measured between 10–40 weeks of gestation were used to calculate GWG. Generalized Additive Models for Location, Scale and Shape were fitted to create GWG charts according to gestational age, stratified by pre-pregnancy BMI. Results The cohort included 7086 women with 29,323 weight gain measurements to construct the charts and 4711 women with 31,052 measurements in the external validation. The predicted medians for GWG at 40 weeks, according to pre-pregnancy BMI, were: underweight, 14.1 kg (IQR, 10.8–17.5 kg); normal weight, 13.8 kg (IQR, 10.7–17.2 kg); overweight, 12.1 kg (IQR, 8.5–15.7 kg); obesity, 8.9 kg (IQR, 4.8–13.2 kg). The 10th, 25th, 50th, 75th, and 90th percentiles were estimated. Results for internal and external validation showed that the percentages below the selected percentiles were close to those expected. Conclusions The charts proposed provide a description of GWG patterns according to gestational age and pre-pregnancy BMI among healthy Brazilian women with good neonatal outcomes. The external validation indicates that this new tool can be used to monitor GWG in the primary health-care setting and to test potential recommended values.

Gestational weight gain and adverse maternal and perinatal outcomes among women with gestational diabetes mellitus according to International Association of Diabetes and Pregnancy Study Group (IADPSG) criteria: A cross sectional study

“…The IOM guidelines for GWG are the most widely used worldwide, including in Brazil, given the absence of any national recommendations [26]. Recently, gestational weight gain curves for Brazilian women were published, but have not yet been implemented [27,28].…”

Association between Prenatal Care and Gestational Weight Gain: Cross-Sectional Study in a Low-Income Area of Rio de Janeiro

“…A média do GPG em estudos brasileiros e internacionais varia de 11 a 15 kg. 12,31,41 Observou-se também que 36,5%, 31,0% e 32,5% das mulheres ganharam peso adequado, insuficiente e excessivo, respectivamente. Essa estimativa é consistente tanto com estudos anteriores no Brasil quanto com estudos internacionais.…”

Home-Prepared Meal Consumption Is Associated with Healthy Food Choices in Pregnant Women Followed Up by Primary Health Care

“…The information was used to classify gestational weight gain; as proposed by Kac et al (2021), Brazilian women 10 weeks into gestation and those less than 10 weeks were not considered in the GWG analysis [ 14 ]. For this study, it was considered below the expected GWG <25th percentile; according to the expected GWG between the 25th percentile and the 75th percentile; and above expected-or excessive-GWG percentiles >75.…”