Revista Brasileira de Epidemiologia
Print version ISSN 1415-790X
STULBACH, Tamara E.; BENICIO, Maria Helena D'Aquino; ANDREAZZA, Rosemarie and KONO, Silvia. Determinants of excessive weight gain during pregnancy in a public low risk antenatal care service. Rev. bras. epidemiol. [online]. 2007, vol.10, n.1, pp.99-108. ISSN 1415-790X. http://dx.doi.org/10.1590/S1415-790X2007000100011.
INTRODUCTION: Excessive weight gain during pregnancy tends to result in postpartum weight retention and contributes to obesity in women. METHODS: This study evaluated the influence of socio-economic factors, obstetric history, smoking, having a job, and initial nutritional status on excessive weight gain (EWG). EWG was estimated according to IOM recommendations (weekly gain > 0.58g, >0.53g and >0.39g which correspond to an initial nutritional status of underweight, eutrophic, overweight/obesity, respectively). We studied a cohort of 141 healthy pregnant women enrolled in public health services, between March 1997 and March 1998. The influence of each study variable on EWG was checked separately for the 2nd and 3rd trimesters using the Poisson model for hierarchy multiple regression analysis. RESULTS: Amongst the 237 eligible pregnant women, there were 37.8% of patient losses, but no statistical significance was detected for the main study variables. The incidence of EWG during the 2nd trimester was 38.6% (CI95% 30.5 - 47.2) and during 3rd trimester it was 36.4% (CI95% 28.5 - 45.0). During the 2nd trimester only schooling was associated with EWG. When comparing women who studied less than 5 years, with the ones who studied 5 to 8 years and those with more than 8 years of schooling, relative risks were 2.09 (CI95% 1.03 - 4.25) and 2.62 (CI95% 1.32 - 5.22), respectively. In the 3rd trimester the variables that resulted in statistical significance were: less than 8 years of schooling (RR= 1.91 [CI95% 1.22 - 2.97], living without a partner (RR=1.66 [(CI95% 1.06 - 2.59], primiparas (RR= 2.13 [CI95% 1.20 - 3.85]; adequate initial nutritional status and overweight/obesity (RR= 1.53 [CI95% 0.82 - 2.84] and RR=2.02 [IC95% 1.04 - 3.92], respectively) in comparison to those who were underweight. CONCLUSION: Based on the high incidence of EWG, more attention should be given during antenatal care, particularly in women with more schooling, those living without partner, primiparas and those who have an initial adequate nutritional status or overweight/obesity during pregnancy, in order to prevent and control the problem.
Keywords : Pregnancy; Excessive weight gain; BMI.