Compliance with gestational weight gain recommendations in a cross-sectional study of term pregnancies — how far reality falls from the standard?

Abstract

Objectives: During pregnancy, two aspects are critical in the context of adverse perinatal outcomes (APO): preconception obesity and gestational weight gain. This study aimed to assess compliance with the 2009 IOM guidelines, compare GWG with and without correcting for gestation duration, and observe the relationship between pre-pregnancy BMI and GWG and neonatal birth weight.
Material and methods: This is a cross-sectional study conducted from 2015–2018 at the St. Sophia’s Specialist Hospital in Warsaw, Poland. Self-reported pre-pregnancy and predelivery weight were collected.
Results: The presented data set amounts to 7820 records. Analysis of weight gain compliance with IOM recommendations showed that only 41–44% (depending on the calculation method) of women had weight gain in accordance with IOM guidelines (22–23% — below; 33–37% — above). Overweight and obese women with diabetes are more likely to comply with IOM than women without diabetes. In contrast, women with normal-weight and underweight with diabetes are less likely to achieve IOM weight gain in pregnancy than women without diabetes. Women who have GWG below recommendations significantly more often gave birth to SGA neonates, and women who exceeded GWG standards significantly more often gave birth to LGA neonates.
Conclusions: Less than half of women had GWG within the recommended norms. Statistically significant differences were found in methods of calculation of GWG, but it was not found clinically significant. Correction for pregnancy duration when calculating GWG reclassifies two percent of patients. We underestimate the risk of crossing the line between overweight and obesity during pregnancy.