Prevalence and determinants of gestational weight gain among pregnant women in Niger

Abstract

Low gestational weight gain (GWG) and low mid-upper arm circumference (MUAC) are associated with adverse pregnancy outcomes. We aimed to assess the prevalence and determinants of low GWG and low MUAC among pregnant women in rural Zinder, Niger. A community-based survey was conducted among 1,384 pregnant women in the catchment areas of 18 integrated health centers in the region of Zinder, Niger. Weight and MUAC were measured during an in-home visit and again 1 month later, when haemoglobin concentration and micronutrient status were also assessed. The prevalence of low GWG was defined based on the 2009 United States Institute of Medicine (U.S. IOM) guidelines (<0.35 kg/week) and less than the third centile of the International Fetal and Newborn Growth Consortium for the 21st Century (INTERGROWTH-21st) standards. Factors associated with GWG and MUAC were identified using logistic regression models adjusting for season, village, and gestational age. The median (interquartile range) age was 25.0 (20.7, 30.0) years, and 16.4% were ≤19 years. The prevalence of low GWG were 62.9% and 27.5% according to 2009 IOM and less than the third INTERGROWTH-21st centile, respectively; 24.9% had low MUAC. Higher α-1-acid glycoprotein (OR = 1.7, 95% CI [1.1, 2.8]) and C-reactive protein (OR = 1.2, 95% CI [1.02, 1.50]) increased the odds of low GWG. Adolescents (OR = 2.7, 95% CI [1.8, 4.0]), housewives (OR = 1.97, 95% CI [1.36, 2.86]), and those who reported recent food assistance (OR = 1.80, 95% CI [1.04, 3.11]) had higher odds of low MUAC. Prevalence of low GWG and low MUAC was high among pregnant women. Determinants of GWG and MUAC included socioeconomic, demographic, and biological factors, although only markers of inflammation were consistent predictors across different definitions of low GWG. This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited. 1 of 15 2 of 15 OUÉDRAOGO ET AL. bs_bs_banner The prevalence of low GWG was high among pregnant women in the Zinder region of Niger, and the odds of low GWG were consistently associated with higher concentrations of markers of inflammation (AGP and CRP). A considerable proportion of pregnant women also had low MUAC. Considering the importance of adequate GWG and MUAC for maternal health and pregnancy outcomes, effective and cost-effective interventions (e.g., daily iron folic acid supplementation; Baltussen, Knai, & Sharan, 2004, behaviour change communication about nutrition; Lamstein et al., 2014, and balanced protein energy dietary supplementation; Imdad & Bhutta, 2012) to ensure adequate GWG and nutritional status should be considered. ACKNOWLEDGMENTSWe would like to thank the NiMaNu study team, the participants, the local communities, staff of the Zinder and Mirriah health districts, and the national steering committee. Our sincere appreciation goes to Pro-The authors declare that they have no conflicts of interest. CONTRIBUTIONSThe ...

Gestational weight gain and its effect on birth outcomes in sub-Saharan Africa: Systematic review and meta-analysis

“…Table 1 describes the characteristics of the studies included in this review. Five studies were from Nigeria [6,7,[42][43][44]; four from Cameroon [45][46][47][48]; four each from Ethiopia [2,35,49,50] and Ghana [39,[51][52][53]; two studies from South Africa [54,55] and Malawi [28,56]; and one each from Uganda [9], Kenya [57], Niger [58], Benin [40], and the Democratic Republic of Congo [59]. Based on a country's income status [60], two studies were from upper middleincome countries [54,55]; fourteen from lower middle-income countries [6, 7, 39, 42-48, 51-53, 57] and ten from low-income countries [2,9,28,35,40,49,50,56,58,59].…”

“…Sixteen studies [2, 7, 9, 28, 35, 42, 45, 47, 51-56, 58, 59] classified the outcome (GWG) according to the IOM recommendations, but for seven studies [6,39,40,43,44,48,50] standard criteria were not used to measure and classify the outcome, that is the authors classified weight gain using their own method. Three studies reported according to the International Fetal Newborn Growth Standards for the 21st Century (INTERGROWTH-21 st ) guidelines [52,57,58], of which two studies [52,58] used both IOM 2009 and INTERGROWTH-21 st guidelines. The authors of one study stated that they used the IOM classification, but they also reported normal weight gain as "women with BMIs between 18.5 kg/m 2 and 30 kg/m 2 and who gained 9 to 16 kg; excessive weight gain for those who gained weight above these ranges" [46].…”

“…Four studies [9,44,45,48] used self-reported pre-pregnancy weight while three studies [52,54,59] used weight after 20 weeks of gestation and one study [56] used weight at 24 weeks of gestation. It was not clear when and how pre-pregnancy weight was measured in two studies [46,58] (Table 1).…”

“…The percentage of women with adequate GWG ranged from 3% to 62% [7,42]. Nine of the 16 studies reported the percentage of women with inadequate GWG as >50% [2,7,9,28,35,52,56,58,59] https://doi.org/10.1371/journal.pone.0231889.g001 Table 1. Characteristics of the 21 studies reporting on gestational weight gain in relation to pre-pregnancy weight in sub-Saharan Africa, 2019.…”

“…65 [57]. According to the study from [52,57,58]. One study reported that 27.5% of pregnant women gained gestational weight less than the third centile which is considered insufficient; 82.7% gained gestational weight less than the 50 th centile; and 2.0% gained gestational weight above the 97 th centile which is considered excess [58].…”