Abstract
Objective
To investigate the association between gestational weight gain (GWG) and perinatal outcomes in pregnant Amazonian women.
Methods
Data from 1305 mother–child pairs from the MINA-Brazil population-based birth cohort study were used. GWG was classified according to two methods, the Institute of Medicine (IOM) guidelines and INTERGROWTH-21st standards. Poisson and linear regression analyses were conducted to evaluate associations with perinatal outcomes.
Results
Following IOM guidelines (n = 1305), the rates of insufficient and excessive GWG were found to be similar (32%). Excessive GWG was associated with higher new-born birthweight (BW) z-scores; increased risks of macrosomia, large for gestational age (LGA), and caesarean delivery; and lower risks of low birthweight (LBW) and being small for gestational age (SGA). Insufficient GWG was associated with lower new-born BW z-scores. Among women with normal pre-pregnancy body mass indices (BMIs, n = 658), inappropriate GWG was high following both methods (IOM: 41.2% insufficient, 24.8% excessive; INTERGROWTH-21st: 25.2% below − 1 z-score, 16.9% above 1 z-score). Both methods also indicated that new-borns of women with excessive GWG had higher BW z-scores and increased risk of macrosomia and LGA. Women with GWG below the INTERGROWTH-21st standards were more likely to deliver an infant SGA and with lower BW z-scores.
Conclusions
Inappropriate GWG remains a health concern irrespective of the method used to classify weight gain. GWG above the recommendations of both methods and below the INTERGROWTH-21st standard was associated with adverse perinatal outcomes. Therefore, INTERGROWTH-21st standards seem to be a better fit for healthy women in this population.
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Change history
23 August 2022
The error in the supplementary file has been corrected.
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Acknowledgements
The authors are thankful to the mothers and children who continue to take part of this ongoing study. We acknowledge the research team members for their contributions to the MINA-Brazil Study data collection. The present study was funded by the Brazilian National Council of Technological and Scientific Development, CNPq (Grant No. 407255/2013-3); the São Paulo Research Foundation, FAPESP (Grant No. 2016/00270-6). P.S.M. received Doctoral of Public Health scholarships from the Coordination for the Improvement of Higher Education Personnel, CAPES (Grant No. 372666/2019-00). AM and MAC are recipients of CNPq senior research scholarships. The views expressed in the present article are those of the authors and not necessarily those of any funding agencies. The funders had no role in the design and analysis of the study or in the writing of this article.
Funding
Conselho Nacional de Desenvolvimento Científico e Tecnológico, 407255/2013-3, Marly Augusto Cardoso, 307808/2017-3,Alicia Matijasevich, 303794/2021-6, Marly Augusto Cardoso, Fundação de Amparo à Pesquisa do Estado de São Paulo, 2016/00270-6, Marly Augusto Cardoso, Coordenação de Aperfeiçoamento de Pessoal de Nível Superior, 372666/2019-00, Paola Soledad Mosquera
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The authors’ contributions are as follows: PSM conducted data analysis, participated in data interpretation, and wrote the initial draft of the article; MBM participated in data collection, analysis and interpretation, and were involved in the review of the article; AAAD and PARN contributed to the data collection and interpretation; AM participated in data analysis and interpretation; MAC was responsible for project management, participated in data analysis and interpretation, and was involved in the writing of the article. All authors have critically reviewed the manuscript and have approved the final version submitted for publication.
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Appendix
Members of MINA-Brazil Study Group: Marly Augusto Cardoso (PI), Alicia Matijasevich, Bárbara Hatzlhoffer Lourenço, Jenny Abanto, Maíra Barreto Malta, Marcelo Urbano Ferreira, Paulo Augusto Ribeiro Neves (University of São Paulo, São Paulo, Brazil); Ana Alice Damasceno, Bruno Pereira da Silva, Rodrigo Medeiros de Souza (Federal University of Acre, Cruzeiro do Sul, Brazil); Simone Ladeia-Andrade (Oswaldo Cruz Institute, Fiocruz, Rio de Janeiro, Brazil), Márcia Caldas de Castro (Harvard T.H. Chan School of Public Health, Boston, USA).
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Mosquera, P.S., Malta, M.B., de Araújo Damasceno, A.A. et al. Associations of Gestational Weight Gain with Perinatal Outcomes in Western Brazilian Amazon. Matern Child Health J 26, 2030–2039 (2022). https://doi.org/10.1007/s10995-022-03480-9
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DOI: https://doi.org/10.1007/s10995-022-03480-9