open access

Vol 92, No 12 (2021)
Research paper
Published online: 2021-04-23
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Compliance with gestational weight gain recommendations in a cross-sectional study of term pregnancies — how far reality falls from the standard?

Anna Kajdy1, Justyna Sztajerowska2, Katarzyna Muzyka-Placzynska1, Jan Modzelewski1, Dorota Sys1, Malgorzata Starzec-Proserpio3, Barbara Baranowska3, Dagmara Filipecka-Tyczka1, Michal Rabijewski1
·
Pubmed: 33914305
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Ginekol Pol 2021;92(12):884-891.
Affiliations
  1. Department of Reproductive Health, Center of Postgraduate Medical Education, Warsaw, Poland
  2. St. Sophia’s Specialist Hospital, Warsaw, Poland
  3. Department of Midwifery, Center of Postgraduate Medical Education, Warsaw, Poland

open access

Vol 92, No 12 (2021)
ORIGINAL PAPERS Obstetrics
Published online: 2021-04-23

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.

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.

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Keywords

pregnancy; gestational weight gain; diabetes, gestational, body mass index, cross-sectional studies; Poland

About this article
Title

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

Journal

Ginekologia Polska

Issue

Vol 92, No 12 (2021)

Article type

Research paper

Pages

884-891

Published online

2021-04-23

Page views

6928

Article views/downloads

909

DOI

10.5603/GP.a2021.0076

Pubmed

33914305

Bibliographic record

Ginekol Pol 2021;92(12):884-891.

Keywords

pregnancy
gestational weight gain
diabetes
gestational
body mass index
cross-sectional studies
Poland

Authors

Anna Kajdy
Justyna Sztajerowska
Katarzyna Muzyka-Placzynska
Jan Modzelewski
Dorota Sys
Malgorzata Starzec-Proserpio
Barbara Baranowska
Dagmara Filipecka-Tyczka
Michal Rabijewski

References (25)
  1. Gilmore LA, Redman LM. Weight gain in pregnancy and application of the 2009 IOM guidelines: toward a uniform approach. Obesity (Silver Spring). 2015; 23(3): 507–511.
  2. Most Obese Countries 2019. http://worldpopulationreview.com/countries/most-obese-countries/ (2019-11-16).
  3. Blüher M. The distinction of metabolically ‘healthy’ from ‘unhealthy’ obese individuals. Current Opinion in Lipidology. 2010; 21(1): 38–43.
  4. O'Reilly J, Reynolds R. The risk of maternal obesity to the long-term health of the offspring. Clinical Endocrinology. 2012; 78(1): 9–16.
  5. Kominiarek M, Peaceman A. Gestational weight gain. American Journal of Obstetrics and Gynecology. 2017; 217(6): 642–651.
  6. Nutrition During Pregnancy. 1990.
  7. Weight Gain During Pregnancy. 2009.
  8. Fenton T, Kim J. A systematic review and meta-analysis to revise the Fenton growth chart for preterm infants. BMC Pediatrics. 2013; 13(1).
  9. Fattest Country in The World: What is the Most Obese Country? https://www.who.com (2019-11-16).
  10. GUS. Zdrowie i zachowanie zdrowotne mieszkańców Polski w świetle Europejskiego Ankietowego Badania Zdrowia (EHIS) 2014 r. 2015.
  11. Departament analiz i strategii, Narodowy Fundusz Zdrowia. Cukier, otyłość — konsekwencje. Przegląd literatury, szacunki dla Polski. ; 2018.
  12. Marques A, Peralta M, Naia A, et al. Prevalence of adult overweight and obesity in 20 European countries, 2014. European Journal of Public Health. 2017; 28(2): 295–300.
  13. Ruager-Martin R, Hyde MJ, Modi N. Maternal obesity and infant outcomes. Early Hum Dev. 2010; 86(11): 715–722.
  14. Santos S, Voerman E, Amiano P, et al. Impact of maternal body mass index and gestational weight gain on pregnancy complications: an individual participant data meta‐analysis of European, North American, and Australian cohorts. BJOG: An International Journal of Obstetrics & Gynaecology. 2019.
  15. Zhao R, Xu L, Wu ML, et al. Maternal pre-pregnancy body mass index, gestational weight gain influence birth weight. Women and Birth. 2018; 31(1): e20–e25.
  16. Thapa M, Paneru R. Gestational Weight Gain and its Relation with Birth Weight of the Newborn. JNMA J Nepal Med Assoc. 2017; 56(207): 309–313.
  17. Diemert A, Lezius S, Pagenkemper M, et al. Maternal nutrition, inadequate gestational weight gain and birth weight: results from a prospective birth cohort. BMC Pregnancy Childbirth. 2016; 16: 224.
  18. Aiken C, Hone L, Murphy HR, et al. Improving outcomes in gestational diabetes: does gestational weight gain matter? Diabetic Medicine. 2018; 36(2): 167–176.
  19. Tian C, Hu C, He X, et al. Excessive weight gain during pregnancy and risk of macrosomia: a meta-analysis. Archives of Gynecology and Obstetrics. 2015; 293(1): 29–35.
  20. Yang W, Han F, Gao X, et al. Relationship Between Gestational Weight Gain and Pregnancy Complications or Delivery Outcome. Scientific Reports. 2017; 7(1).
  21. Vieira C, Sarabando R, Teixeira N, et al. Impact of gestational weight gain on obstetric outcomes. European Journal of Obstetrics & Gynecology and Reproductive Biology. 2019; 234: e71.
  22. Du Mk, Ge Ly, Zhou Ml, et al. Effects of pre-pregnancy body mass index and gestational weight gain on neonatal birth weight. Journal of Zhejiang University-SCIENCE B. 2017; 18(3): 263–271.
  23. Lin C, DeRoo L, Jacobs S, et al. Accuracy and reliability of self-reported weight and height in the Sister Study. Public Health Nutrition. 2011; 15(6): 989–999.
  24. Phelan S, Phipps M, Abrams B, et al. Randomized trial of a behavioral intervention to prevent excessive gestational weight gain: the Fit for Delivery Study. The American Journal of Clinical Nutrition. 2011; 93(4): 772–779.
  25. Headen I, Cohen AK, Mujahid M, et al. The accuracy of self-reported pregnancy-related weight: a systematic review. Obesity Reviews. 2017; 18(3): 350–369.

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