Factors affecting gestational weight gain: a cross-sectional study from Semnan city

authors:

avatar Sayed Saeed Kassaeian ORCID , avatar navid danai , avatar Sana Jafaei , avatar Mohammad Hossein Taherian ORCID , avatar Masoumeh Ebrahimi Tavani , avatar Farid Gharibi , *

Koomesh: Vol.25, issue 3; 347-356
published online: August 02, 2023
article type: Research Article
received: January 04, 2023
accepted: June 02, 2023

how to cite: Kassaeian S S, danai N, Jafaei S, Taherian M H, Ebrahimi Tavani M, et al. Factors affecting gestational weight gain: a cross-sectional study from Semnan city. koomesh. 2023;25(3):e152833. 

Abstract

Introduction: Maternal care is one of the fundamental healthcare domains that undeniably affect community health. Given the importance of gestational weight gain (GWG) as a vital care indicator, this study aims to assess the GWG and identify its determinants. Materials and Methods: This cross-sectional study was conducted in the autumn of 2022 and included 400 postpartum women. The study tool was a researcher-made questionnaire whose content validity was approved by experts, and its Content Validity Ratio (CVR) and Content Validity Index (CVI) were found to be 0.94 and 0.92, respectively. The descriptive results were reported as frequency (percentages) for qualitative variables and mean (standard deviation) for quantitative variables. Moreover, the chi-square test was used to assess the statistical relationship between demographic and background variables with GWG status. Results: The results indicated that the average GWG was 11.59 kg. Additionally, it was observed that 65% of mothers had a normal weight gain during their last pregnancy, while 17% had a low weight gain and 18% had a high weight gain. The analysis of demographic and background variables revealed that basic health insurance, the type of basic health insurance, borrowing money to pay for health expenses, pre-pregnancy weight status, pre-existing cardiac and renal conditions, gestational diabetes, and experiencing leaking amniotic fluid and hemorrhage during pregnancy is significantly associated with gestational weight gain status (P<0.05).      Conclusion: The unfavorable state of the GWG index can be attributed to several factors, such as income and employment disparities. Therefore, it is crucial to devise and finance policies to enhance women's health after delivery.

References

  • 1.

    WHO. Trends in maternal mortality: 1990-2010. Geneva: The World Health Organization Publisher; 2012.

  • 2.

    Lawn JE, Cousens S, Zupan J. 4 million neonatal deaths: when? Where? Why? Lancet 2005; 365: 891-900.

  • 3.

    Sandall J, Devane D, Soltani H, Hatem M, Gates S. Improving quality and safety in maternity care: the contribution of midwife-led care. J Midwifery Womens Health 2010; 55: 255-261.

  • 4.

    Warren C, Njuki R, Abuya T, Ndwiga C, Maingi G, Serwanga J. Study protocol for promoting respectful maternity care initiative to assess, measure and design interventions to reduce disrespect and abuse during childbirth in Kenya. BMC Pregnan Childbirth 2013; 13: 1-9.

  • 5.

    de Bernis L, Kinney MV, Stones W, Hoope-Bender PT, Vivio D, Leisher S. Stillbirths: ending preventable deaths by 2030. Lancet 2016; 387: 703-716.

  • 6.

    Heazell AE, Siassakos D, Blencowe H, Burden C, Bhutta ZA, Cacciatore J. Stillbirths: economic and psychosocial consequences. Lancet 2016; 387: 604-616.

  • 7.

    Debiec KE, Paul KJ, Mitchell CM, Hitti JE. Inadequate prenatal care and risk of preterm delivery among adolescents: a retrospective study over 10 years. Am J Obstet Gynecol 2010; 203: 1-6.

  • 8.

    WHO. Low birth weight - a tabulation of available information. Maternal and safe motherhood program. Geneva: The World Health Organization Publisher; 2003.

  • 9.

    Vintzileos AM, Ananth CV, Smulian JC, Scorza WE, Knuppel RA. Prenatal care and black-white fetal death disparity in the United States: heterogeneity by high-risk conditions. Obstet Gynecol 2002; 99: 483-489.

  • 10.

    Stephansson O, Dickman PW, Johansson AL, Cnattingius S. The influence of socioeconomic status on stillbirth risk in Sweden. Int J Epidemiol 2001; 30: 1296-1301.

  • 11.

    Lowery C, Bronstein J, McGhee J, Ott R, Reece EA, Mays GP. ANGELS and university of arkansas for medical sciences paradigm for distant obstetrical care delivery. Am J Obstet Gynecol 2007; 196: 1-9.

  • 12.

    Reece EA, Leguizamon G, Silva J, Whiteman V, Smith D. Intensive interventional maternity care reduces infant morbidity and hospital costs. J Matern Fetal Neonatal Med 2002; 11: 204-210.

  • 13.

    Bahri N, Arabnejad BA, Bahri N, Eshaghi F, Fathi Najafi T, Larki M. Objective structured clinical evaluation for assessment of the quality of practice of health practitioners during preconception, prenatal and postnatal cares. Koomesh 2015; 17: 45-53. (Persian).

  • 14.

    Li N, Liu E, Guo J, Pan L, Li B, Wang P, et al. Maternal prepregnancy body mass index and gestational weight gain on pregnancy outcomes. PloS One 2013; 8: e82310.

  • 15.

    Kominiarek MA, Peaceman AM. Gestational weight gain. Am J Obstet Gynecol 2017; 217: 642-651.

  • 16.

    Yang S, Peng A, Wei S, Wu J, Zhao J, Zhang Y, et al. Pre-pregnancy body mass index, gestational weight gain, and birth weight: a cohort study in China. PloS One 2015; 10: e0130101.

  • 17.

    Goldstein RF, Abell SK, Ranasinha S, Misso M, Boyle JA, Black MH, et al. Association of gestational weight gain with maternal and infant outcomes: a systematic review and meta-analysis. JAMA 2017; 317: 2207-2225.

  • 18.

    Almasi-Hashiani A, Sepidarkish M, Omani-Samani R. Relationship of gestational weight gain with cesarean delivery risk, low birth weight and preterm labor in underweight women. Koomesh 2017; 20: 7-14. (Persian).

  • 19.

    Waring ME, Moore Simas TA, Liao X. Gestational weight gain within recommended ranges in consecutive pregnancies: a retrospective cohort study. Midwifery 2013; 29: 550-556.

  • 20.

    Chin JR, Krause KM, Ostbye T, Chowdhury N, Lovelady CA, Swamy GK. Gestational weight gain in consecutive pregnancies. Am J Obstet Gynecol 2010; 203: e1-6.

  • 21.

    Mannan M, Doi SA, Mamun AA. Association between weight gain during pregnancy and postpartum weight retention and obesity: a bias-adjusted meta-analysis. Nutr Rev 2013; 71: 343-352.

  • 22.

    Voerman E, Santos S, Inskip H, Amiano P, Barros H, Charles MA, et al. Association of gestational weight gain with adverse maternal and infant outcomes. JAMA 2019; 321: 1702-1715.

  • 23.

    Durst JK, Sutton AL, Cliver SP, Tita AT, Biggio JR. Impact of gestational weight gain on perinatal outcomes in obese women. Am J Perinatol 2016; 33: 849-555.

  • 24.

    Faucher MA, Barger MK. Gestational weight gain in obese women by class of obesity and select maternal/newborn outcomes: a systematic review. Women Birth 2015; 28: e70-79.

  • 25.

    Crane JM, White J, Murphy P. The effect of gestational weight gain by body mass index on maternal and neonatal outcomes. J Obstet Gynaecol Can 2009; 31: 28-35.

  • 26.

    Herring SJ, Rose MZ, Skouteris H, Oken E. Optimizing weight gain in pregnancy to prevent obesity in women and children. Diabet Obes Metabol 2012; 14: 195-203.

  • 27.

    Vanstone M, Kandasamy S, Giacomini M, DeJean D, McDonald SD. Pregnant women's perceptions of gestational weight gain: A systematic review and metasynthesis of qualitative research. Matern Child Nutr 2017; 13: e12374.

  • 28.

    Yang W, Carmichael SL, Tinker SC, Shaw GM. Association between weight gain during pregnancy and neural tube defects and gastroschisis in offspring. Birth Defec Res 2012; 94: 1019-1025.

  • 29.

    Hinkle SN, Sharma AJ, Swan DW, Schieve LA, Ramakrishnan U, Stein AD. Excess gestational weight gain is associated with child adiposity among mothers with normal and overweight prepregnancy weight status. J Nutr 2012; 142: 1851-1858.

  • 30.

    Asefa F, Cummins A, Dessie Y, Hayen A, Foureur M. Gestational weight gain and its effect on birth outcomes in sub-Saharan Africa: systematic review and meta-analysis. PLoS One 2020; 15: e0231889.

  • 31.

    Benham JL, Booth JB, Donovan LE, Leung AA, Ronald JS, Rabi DM. Prevalence of and risk factors for excess weight gain in pregnancy: a cross-sectional study using survey data. CMAJ Open 2021; 9: E1168-E74.

  • 32.

    Esteghamati A, Etemad K, Koohpayehzadeh J, Abbasi M, Meysamie A, Noshad S. Trends in the prevalence of diabetes and impaired fasting glucose in association with obesity in Iran: 2005-2011. Diabetes Res Clin Pract 2014; 103: 319-327.

  • 33.

    Mutyambizi C, Pavlova M, Hongoro C, Booysen F, Groot W. Incidence, socio-economic inequalities and determinants of catastrophic health expenditure and impoverishment for diabetes care in South Africa: a study at two public hospitals in Tshwane. Int J Equity Health 2019; 18: 1-15.

  • 34.

    Cunningham F, Leveno K, Bloom S, Spong CY, Dashe J. Williams obstetrics. 24 ed. Mcgraw-hill2014.

  • 35.

    Deputy NP, Sharma AJ, Kim SY, Hinkle SN. Prevalence and characteristics associated with gestational weight gain adequacy. Obst Gyneco 2015; 125: 773-778.

  • 36.

    Chung JG, Taylor RS, Thompson JM, Anderson NH, Dekker GA, Kenny LC, et al. Gestational weight gain and adverse pregnancy outcomes in a nulliparous cohort. Eur J Obst Gynec Reproduct Biol 2013; 167: 149-153.

  • 37.

    Flegal KM, Kruszon-Moran D, Carroll MD. Trends in obesity among adults in the United States, 2005 to 2014. JAMA 2016; 315: 2284-2291.

  • 38.

    Davis EM, Stange KC, Horwitz RI. Childbearing, stress and obesity disparities in women: A public health perspective. Mater Child Health J 2012; 16: 109-118.

  • 39.

    Wells CS, Schwalberg R, Noonan G, Gabor V. Factors influencing inadequate and excessive weight gain in pregnancy: Colorado, 2000-2002. Mater Child Health J 2006; 10: 55-62.

  • 40.

    Amorim AR, Rossner S, Neovius M. Does excess pregnancy weight gain constitute a major risk for increasing long-term BMI? Obesity 2007; 15: 1278-1286.

  • 41.

    Rooney BL, Schauberger CW. Excess pregnancy weight gain and long-term obesity: one decade later. Obstet Gynecol 2002; 100: 245-252.

  • 42.

    Dolatian M, Sharifi N, Mahmoodi Z, Fathnezhad-kazemi A, Bahrami-vazir E, Rashidian T. Weight gain during pregnancy and its associated factors: a path analysis. Nurs Open 2020; 7: 1568-1577.