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Maternal and Child Health Journal

, Volume 20, Issue 7, pp 1485–1496 | Cite as

Ethnic Differences in Gestational Weight Gain: A Population-Based Cohort Study in Norway

  • Tarja I. KinnunenEmail author
  • Christin W. Waage
  • Christine Sommer
  • Line Sletner
  • Jani Raitanen
  • Anne Karen Jenum
Article

Abstract

Objectives To explore ethnic differences in gestational weight gain (GWG). Methods This was a population-based cohort study conducted in primary care child health clinics in Groruddalen, Oslo, Norway. Participants were healthy pregnant women (n = 632) categorised to six ethnic groups (43 % were Western European women, the reference group). Body weight was measured at 15 and 28 weeks’ gestation on average. Data on pre-pregnancy weight and total GWG until delivery were self-reported. The main method of analysis was linear regression adjusting for age, weeks’ gestation, pre-pregnancy body mass index, education and severe nausea. Results No ethnic differences were observed in GWG by 15 weeks’ gestation. By 28 weeks’ gestation, Eastern European women had gained 2.71 kg (95 % confidence interval, CI 1.10–4.33) and Middle Eastern women 1.32 kg (95 % CI 0.14–2.50) more weight on average than the Western European women in the fully adjusted model. Among Eastern European women, the total adjusted GWG was 3.47 kg (95 % CI 1.33–5.61) above the reference group. Other ethnic groups (South Asian, East Asian and African) did not differ from the reference group. When including non-smokers (n = 522) only, observed between-group differences increased and Middle Eastern women gained more weight than the reference group by all time points. Conclusions Eastern European and Middle Eastern women had higher GWG on average than Western European women, especially among the non-smokers. Although prevention of excessive GWG is important for all pregnant women, these ethnic groups might need special attention during pregnancy.

Keywords

Ethnicity Pregnancy Gestational weight gain Fat gain Smoking 

Notes

Acknowledgments

This research was by funded by The Research Council of Norway and the South-Eastern Norway Regional Health Authority, Norwegian Directorate of Health and collaborative partners in The City of Oslo, Stovner, Grorud and Bjerke administrative districts. The pregnant women who participated in this study are gratefully acknowledged. We also thank the study staff at the child health clinics in Stovner, Grorud and Bjerke districts in Oslo and Haavard Skaaland, Oslo University Hospital, for help with the data collection.

Compliance with Ethical Standards

Conflict of interest

The authors declare that they have no conflict of interest.

References

  1. 1.
    Bollini, P., Pampallona, S., Wanner, P., & Kupelnick, B. (2009). Pregnancy outcome of migrant women and integration policy: A systematic review of the international literature. Social Science and Medicine, 68, 452–461.CrossRefPubMedGoogle Scholar
  2. 2.
    Bowers, K., Laughon, S., Kiely, M., Brite, J., Chen, Z., & Zhang, C. (2013). Gestational diabetes, pre-pregnancy obesity and pregnancy weight gain in relation to excess fetal growth: Variations by race/ethnicity. Diabetologia, 56, 1263–1271.CrossRefPubMedGoogle Scholar
  3. 3.
    Brekke, I., Berg, J. E., Sletner, L., & Jenum, A. K. (2013). Doctor-certified sickness absence in first and second trimesters of pregnancy among native and immigrant women in Norway. Scandinavian Journal of Public Health, 41, 166–173.CrossRefPubMedGoogle Scholar
  4. 4.
    Carreno, C. A., Clifton, R. G., Hauth, J. C., Myatt, L., Roberts, J. M., Spong, C. Y., et al. (2012). Excessive early gestational weight gain and risk of gestational diabetes mellitus in nulliparous women. Obstetrics and Gynecology, 119, 1227.CrossRefPubMedPubMedCentralGoogle Scholar
  5. 5.
    Chasan-Taber, L., Schmidt, M. D., Pekow, P., Sternfeld, B., Solomon, C. G., & Markenson, G. (2008). Predictors of excessive and inadequate gestational weight gain in Hispanic women. Obesity, 16, 1657–1666.CrossRefPubMedGoogle Scholar
  6. 6.
    Fontaine, P. L., Hellerstedt, W. L., Dayman, C. E., Wall, M. M., & Sherwood, N. E. (2012). Evaluating body mass index-specific trimester weight gain recommendations: Differences between black and white women. Journal of Midwifery and Women’s Health, 57, 327–335.CrossRefPubMedPubMedCentralGoogle Scholar
  7. 7.
    Fraser, A., Tilling, K., Macdonald-Wallis, C., Sattar, N., Brion, M.-J., Benfield, L., et al. (2010). Association of maternal weight gain in pregnancy with offspring obesity and metabolic and vascular traits in childhood. Circulation, 121, 2557–2564.CrossRefPubMedPubMedCentralGoogle Scholar
  8. 8.
    Gagnon, A. J., McDermott, S., Rigol-Chachamovich, J., Bandyopadhyay, M., Stray-Pedersen, B., Stewart, D., et al. (2011). International migration and gestational diabetes mellitus: A systematic review of the literature and meta-analysis. Paediatric and Perinatal Epidemiology, 25, 575–592.CrossRefPubMedGoogle Scholar
  9. 9.
    Gray, L. J., Yates, T., Davies, M. J., Brady, E., Webb, D. R., Sattar, N., et al. (2011). Defining obesity cut-off points for migrant South Asians. PLoS ONE, 6, e26464.CrossRefPubMedPubMedCentralGoogle Scholar
  10. 10.
    Harris, B., Huckle, P., Thomas, R., Johns, S., & Fung, H. (1989). The use of rating scales to identify post-natal depression. British Journal of Psychiatry, 154, 813–817.CrossRefPubMedGoogle Scholar
  11. 11.
    Haugen, M., Brantsaeter, A. L., Winkvist, A., Lissner, L., Alexander, J., Oftedal, B., et al. (2014). Associations of pre-pregnancy body mass index and gestational weight gain with pregnancy outcome and postpartum weight retention: A prospective observational cohort study. BMC Pregnancy and Childbirth, 14, 201.CrossRefPubMedPubMedCentralGoogle Scholar
  12. 12.
    Headen, I. E., Davis, E. M., Mujahid, M. S., & Abrams, B. (2012). Racial-ethnic differences in pregnancy-related weight. Advances in Nutrition, 3, 83–94.CrossRefPubMedPubMedCentralGoogle Scholar
  13. 13.
    Institute of Medicine (IOM). (2009). Weight gain during pregnancy: Reexamining the guidelines. Washington, DC: National Academy of Sciences.Google Scholar
  14. 14.
    Jenum, A. K., Diep, L. M., Holmboe-Ottesen, G., Holme, I. M., Kumar, B. N., & Birkeland, K. I. (2012). Diabetes susceptibility in ethnic minority groups from Turkey, Vietnam, Sri Lanka and Pakistan compared with Norwegians—The association with adiposity is strongest for ethnic minority women. BMC Public Health, 12, 150.CrossRefPubMedPubMedCentralGoogle Scholar
  15. 15.
    Jenum, A. K., Sletner, L., Voldner, N., Vangen, S., Mørkrid, K., Andersen, L. F., et al. (2010). The STORK Groruddalen research programme: A population-based cohort study of gestational diabetes, physical activity, and obesity in pregnancy in a multiethnic population. Rationale, methods, study population, and participation rates. Scandinavian Journal of Public Health, 38(5 Suppl.), 60–70.CrossRefPubMedGoogle Scholar
  16. 16.
    Jenum, A. K., Sommer, C., Sletner, L., Mørkrid, K., Bærug, A., Mosdøl, A. (2013). Adiposity and hyperglycaemia in pregnancy and related health outcomes in European ethnic minorities of Asian and African origin: A review. Food & Nutrition Research, 57, 1–22.CrossRefGoogle Scholar
  17. 17.
    Kowal, C., Kuk, J., & Tamim, H. (2012). Characteristics of weight gain in pregnancy among Canadian women. Maternal and Child Health Journal, 16, 668–676.CrossRefPubMedGoogle Scholar
  18. 18.
    Larouche, M., Ponette, V., Correa, J. A., & Krishnamurthy, S. (2010). The effect of recent immigration to Canada on gestational weight gain. Journal of Obstetrics and Gynaecology Canada, 32, 829–836.CrossRefPubMedGoogle Scholar
  19. 19.
    Lawlor, D. A., Lichtenstein, P., Fraser, A., & Långström, N. (2011). Does maternal weight gain in pregnancy have long-term effects on offspring adiposity? A sibling study in a prospective cohort of 146,894 men from 136,050 families. American Journal of Clinical Nutrition, 94, 142–148.CrossRefPubMedPubMedCentralGoogle Scholar
  20. 20.
    Liu, J., Gallagher, A. E., Carta, C. M., Torres, M. E., Moran, R., & Wilcox, S. (2014). Racial differences in gestational weight gain and pregnancy-related hypertension. Annals of Epidemiology, 24, 441–447.CrossRefPubMedPubMedCentralGoogle Scholar
  21. 21.
    Misra, A., & Khurana, L. (2010). Obesity-related non-communicable diseases: South Asians vs White Caucasians. International Journal of Obesity, 35, 167–187.CrossRefPubMedGoogle Scholar
  22. 22.
    Murray, L., & Carothers, A. D. (1990). The validation of the Edinburgh Post-natal Depression Scale on a community sample. British Journal of Psychiatry, 157, 288–290.CrossRefPubMedGoogle Scholar
  23. 23.
    Nehring, I., Schmoll, S., Beyerlein, A., Hauner, H., & von Kries, R. (2011). Gestational weight gain and long-term postpartum weight retention: A meta-analysis. American Journal of Clinical Nutrition, 94, 1225–1231.CrossRefPubMedGoogle Scholar
  24. 24.
    Nohr, E. A., Vaeth, M., Baker, J. L., Sørensen, T. I., Olsen, J., & Rasmussen, K. M. (2008). Combined associations of prepregnancy body mass index and gestational weight gain with the outcome of pregnancy. American Journal of Clinical Nutrition, 87, 1750–1759.PubMedGoogle Scholar
  25. 25.
    Onyango, A. W., Nommsen-Rivers, L., Siyam, A., Borghi, E., de Onis, M., Garza, C., et al. (2011). Post-partum weight change patterns in the WHO multicentre growth reference study. Maternal & Child Nutrition, 7, 228–240.CrossRefGoogle Scholar
  26. 26.
    Pawlak, M. T., Alvarez, B. T., Jones, D. M., & Lezotte, D. C. (2015). The effect of race/ethnicity on gestational weight gain. Journal of Immigrant and Minority Health, 17, 325–332.CrossRefPubMedGoogle Scholar
  27. 27.
    Restall, A., Taylor, R. S., Thompson, J. M., Flower, D., Dekker, G. A., Kenny, L. C., et al. (2014). Risk factors for excessive gestational weight gain in a healthy, nulliparous cohort. Journal of Obesity, 2014, 148391.CrossRefPubMedPubMedCentralGoogle Scholar
  28. 28.
    Rode, L., Kjærgaard, H., Damm, P., Ottesen, B., & Hegaard, H. (2013). Effect of smoking cessation on gestational and postpartum weight gain and neonatal birth weight. Obstetrics and Gynecolology, 122, 618–625.CrossRefGoogle Scholar
  29. 29.
    Siega-Riz, A. M., Viswanathan, M., Moos, M.-K., Deierlein, A., Mumford, S., Knaack, J., et al. (2009). A systematic review of outcomes of maternal weight gain according to the Institute of Medicine recommendations: Birthweight, fetal growth, and postpartum weight retention. American Journal of Obstetrics and Gynaecology, 201, 339.e1–339.e14.CrossRefGoogle Scholar
  30. 30.
    Sommer, C., Mørkrid, K., Jenum, A. K., Sletner, L., Mosdol, A., & Birkeland, K. I. (2014). Weight gain, total fat gain and regional fat gain during pregnancy and the association with gestational diabetes: A population-based cohort study. International Journal of Obesity, 38, 76–81.CrossRefPubMedGoogle Scholar
  31. 31.
    Tran, A. T., Straand, J., Diep, L. M., Meyer, H. E., Birkeland, K. I., & Jenum, A. K. (2011). Cardiovascular disease by diabetes status in five ethnic minority groups compared to ethnic Norwegians. BMC Public Health, 11, 554.CrossRefPubMedPubMedCentralGoogle Scholar
  32. 32.
    Ueda, Y., Maruo, M., Nakano, H., Honda, Y., Miyama, T., Nishizawa, M., et al. (2006). Estimation of body fat mass in pregnant women by a new method using bioelectrical impedance analysis with compensation for intrauterine component weight. International Journal of Body Composition Research, 4, 145.Google Scholar
  33. 33.
    Uitewaal, P. J., Manna, D. R., Bruijnzeels, M. A., Hoes, A. W., & Thomas, S. (2004). Prevalence of type 2 diabetes mellitus, other cardiovascular risk factors, and cardiovascular disease in Turkish and Moroccan immigrants in North West Europe: A systematic review. Preventive Medicine, 39, 1068–1076.CrossRefPubMedGoogle Scholar
  34. 34.
    Waage, C. W., Falk, R. S., Sommer, C., Mørkrid, K., Richardsen, K., Bærug, A., et al. (2015). Ethnic differences in postpartum weight retention: A Norwegian cohort study. British Journal of Obstetrics and Gynaecology,. doi: 10.1111/1471-0528.13321.PubMedGoogle Scholar
  35. 35.
    Wright, C. S., Weiner, M., Localio, R., Song, L., Chen, P., & Rubin, D. (2012). Misreport of gestational weight gain (GWG) in birth certificate data. Maternal and Child Health Journal, 16, 197–202.CrossRefPubMedGoogle Scholar

Copyright information

© Springer Science+Business Media New York 2016

Authors and Affiliations

  • Tarja I. Kinnunen
    • 1
    Email author
  • Christin W. Waage
    • 2
    • 3
  • Christine Sommer
    • 2
    • 3
  • Line Sletner
    • 4
  • Jani Raitanen
    • 1
    • 5
  • Anne Karen Jenum
    • 3
    • 6
  1. 1.School of Health SciencesUniversity of TampereTampereFinland
  2. 2.Department of Endocrinology, Morbid Obesity and Preventive MedicineOslo University HospitalOsloNorway
  3. 3.Department of General Practice, Institute of Health and Society, Faculty of MedicineUniversity of OsloOsloNorway
  4. 4.Department of Child and Adolescents MedicineAkerhus University HospitalLørenskog, OsloNorway
  5. 5.The UKK Institute for Health Promotion ResearchTampereFinland
  6. 6.Faculty of Health SciencesOslo and Akershus University College of Applied SciencesOsloNorway

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