Advertisement

Maternal and Child Health Journal

, Volume 12, Issue 6, pp 783–786 | Cite as

Urban and Rural Differences in Pregnancy Weight Gain in Guilan, Northern Iran

  • Mohsen MaddahEmail author
  • Bahareh Nikooyeh
Article

Abstract

Objectives This study aimed to compare pregnancy weight gain and weight gain patterns in a group of Iranian women who attended urban and rural public health centers for prenatal care in Guilan, Iran. Design A secondary data analysis using routinely collected health centers data. Setting 12 randomly selected health centers in urban and rural areas in Guilan. Participants A total of 2,047 pregnant women (1,097 in urban areas and 950 in rural areas) who regularly attended health centers for prenatal care and delivered between June 2003 and August 2006. Measurements Data on prepregnancy weight, height, pregnancy weight gain, mother’s age, parity, education and infant birth weight were extracted from the health records. The women were categorized based on their prepregnancy body mass index as underweight, normal weight and overweight. Findings These results showed that among normal weight women, 41.1% of urban and 56.6% of rural women had weight gains below the Institute of Medicine (IOM) recommendation (P < 0.0001). Among underweight women, 48.1% of urban and 65.8% of rural women had weight gains below the IOM recommendation (P < 0.0001). Rural women with normal prepregnancy weight gained less weight than the urban women in the second trimester of their pregnancy (5.7 ± 2.9 kg vs. 4.6 ± 2.5 kg, P < 0.0001). The underweight rural women gained less weight in both the second and the third trimesters of their pregnancy than the urban women. While the overall prevalence of having low birth weight (LBW) infants for underweight women were 5.2% only 1.9 % of those who gained adequate pregnancy weight gain had LBW infants. Conclusion This study indicated that a considerable proportion of the women both in urban and rural areas in Guilan, Iran had inadequate pregnancy weight gain. These results showed that prenatal care in terms of pregnancy weight gain in the present health system is not satisfactory.

Keywords

Health system Iran Pregnancy weight gain Rural Urban 

Notes

Acknowledgments

We would like to thank the mothers who participated in this study. We also wish to thank the health care personnel for collecting the data.

References

  1. 1.
    Efteghari, H., & Azordegan, F. (1991). Relationship between birth weight and infant mortality. Medical Journal of I. R. Iran, 5, 131–134.Google Scholar
  2. 2.
    Mora, J. O., & Nestel, P. S. (2000). Improving prenatal nutrition in developing countries: Strategies, prospects and challenges. The American Journal of Clinical Nutrition, 71, S1353–S1363.Google Scholar
  3. 3.
    Godfrey, K. M., & Barker, D. J. P. (2000). Fetal nutrition and adult disease. The American Journal of Clinical Nutrition, 71, S1344–S1352.Google Scholar
  4. 4.
    Carmichael, S., Abrams, B., & Selvin, S. (1997). The pattern of maternal weight gain in women with good pregnancy outcome. American Journal of Public Health, 87, 1984–1988.PubMedCrossRefGoogle Scholar
  5. 5.
    Lederman, S. A., Paxton, A., Heymsfield, S. B., Wang, J., Thoronton, J., & Pierson, R. N. (1997). Body fat and water changes during pregnancy in women with different body weight and weight gain. Obstetrics Gynecology 90, 483–488.PubMedCrossRefGoogle Scholar
  6. 6.
    Parker, J. D., & Abrams, B. (1992). Prenatal weight gain advice: An examination of the recent prenatal weight gain recommendations of the Institute of Medicine. Obstetrics Gynecology 79, 664–669.PubMedGoogle Scholar
  7. 7.
    Maddah, M. (2005). Pregnancy weight gain in Iranian women attending in across-sectional study of public health centers in Rasht. Midwifery 21, 365–370.PubMedCrossRefGoogle Scholar
  8. 8.
    Iranian Ministry of Health and Medical Education. (2000). The health situation of mothers and children in the Islamic Republic of Iran. Report, Tehran.Google Scholar
  9. 9.
    The Iranian Ministry of Health and Medical Education. (2003). Anthropometry and nutrition indicator survey (ANIS). Report, Tehran.Google Scholar
  10. 10.
    Institute of Medicine. (1990). Nutrition during pregnancy, weight gain and nutrient supplements. Report of the subcommittee on nutritional status and weight gain during pregnancy, subcommittee on dietary intake and nutrient supplementation during pregnancy, committee on nutritional status during pregnancy and lactation, food and nutrition board (pp. 1–233). Washington, DC: National Academy Press.Google Scholar
  11. 11.
    Abrams, B., Altman S. L., & Pickett, K. E. (2000). Pregnancy weight gain: Still controversial. The American Journal of Clinical Nutrition, 71, 1233–1241.Google Scholar
  12. 12.
    Scotland, N. E., Hass, J. S., Brawarsky, P., Jackson, R. A., Fuentes-Afflick, E., & Escobar, G. J. (2005). Body mass index, provider advice and target gestational weight gain. Obstetrics Gynecology, 105, 633–638.Google Scholar
  13. 13.
    Ogunyemi, D., Hullett, S., Leeper, J., & Risk, A. (1998). Prepregnancy body mass index, weight gain during pregnancy and perinatal outcome in rural black population. Journal of Maternal-Fetal Medicine, 7, 190–193.PubMedCrossRefGoogle Scholar
  14. 14.
    Alexy, B., Nichols, B., Hevely, M. A., & Garzonl, L. (1997). Prenatal factors and birth outcomes in the public health services: A rural/urban comparison. Research in Nursing and Health, 20, 61–70.PubMedCrossRefGoogle Scholar
  15. 15.
    Mejia-Rodriguez, O., Alvarez-Aguilar, C., & Velazco Orellana, R. (2000). Changes in the weight of women from rural and urban areas in normal pregnancy. Ginecología y obstetricia de México, 68, 339–334.PubMedGoogle Scholar
  16. 16.
    Winkuist, A., Stenlund, H., Hakimi, M., Nurdiati, D. S., & Dibley, M. J. (2000). Weight gain pattern from prepregnancy until delivery among women in central Java, Indonesia. The American Journal of Clinical Nutrition, 75, 1072–1077.Google Scholar
  17. 17.
    Alam, D. S., Van Raaij, J. M., Haut vast, J. G., Yunus, M., & Fuchs, G. S. (2003). Energy stress during pregnancy and lactation: Consequences for maternal nutrition in rural Bangladesh. European Journal of Clinical Nutrition, 57, 151–156.PubMedCrossRefGoogle Scholar
  18. 18.
    King, J. C., Butte, N. F., Bronstein, M. N., Kopp, L. E., & Linquist, S. A. (1994). Energy metabolism during pregnancy: Influence of maternal energy status. American Journal of Clinical Nutrition, 59, 439–454.Google Scholar
  19. 19.
    Hickey, C., Cliver, S., McNeal, S., Hoffmann, H., & Goldenberg, R. (1996). Prenatal weight gain pattern and birth weight among non-obese black and white women. Obstetrics Gynecology, 88, 490–496.PubMedCrossRefGoogle Scholar
  20. 20.
    Hickey, C., Cliver, S., McNeal, S., Hoffmann, H., Goldenberg RL. (1992). Prenatal weight gain pattern and spontaneous preterm birth among non-obese black and white women. Obstetrics Gynecology, 79, 664–669.Google Scholar
  21. 21.
    Strauss, R. S., & Dietz, W. S. (1999). Low maternal weight gain in the second or third trimester increases the risk of intrauterine growth retardation. Journal of Nutrition, 129, 988–993.PubMedGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC 2007

Authors and Affiliations

  1. 1.Department of Human Nutrition, School of Public HealthGuilan University of Medical Sciences and Health ServicesRashtIran

Personalised recommendations