Determinants of excessive gestational weight gain: a systematic review and meta-analysis

Abstract

Background The prevalence of excessive gestational weight gain (EGWG) during pregnancy is increasing, and it is extremely harmful to pregnant women and newborns. Previous studies have suggested that EGWG is associated with various factors. We conducted a systematic review and meta-analysis to identify, quantify and analyze determinants of EGWG and evaluate the effect of these determinants on EGWG. Methods We searched for articles, from January 2009 to November 2020, related to the determinants of EGWG during pregnancy using four Chinese and four English databases. The Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) statement was utilized to guide the systematic review and meta-analysis process. Results Seventy studies, which identified EGWG factors in pregnant women (58 factors, 3 themes: individual [7 aspects, 37 factors]; family [4 aspects, 8 factors]; and social [4 aspects, 13 factors]), were included and analyzed in the systematic review. A meta-analysis was conducted for 13 factors (including 10 individual factors, 2 family factors, and 1 social factor) and revealed that pre-pregnancy overweight (including obesity), younger age (≤ 30 years old), unemployed, primiparity, smoking, and being unmarried (including divorced) were risk factors for EGWG, while prepregnancy underweight and inadequate antenatal care were protective factors for EGWG. There was no significant correlation between EGWG and education level, alcohol consumption, planning pregnancy, food security, and whether access to nutrition guidance during pregnancy. Conclusions EGWG was prevalent in pregnant women, and its prevalence seemed to be high and similar in many countries. Based on observational studies with medium-level and high-level evidence, some individual, family, and social factors were found to be associated with EGWG using qualitative and quantitative methods. In the future, exposure of pregnant women to risk factors for EGWG should be avoided, and interventions should be developed around the identified factors.

Ethnic Disparities and Obesity Risk Factors in Pregnant Women: A Retrospective Observational Cohort Study

“…In accordance with our results, pregnant women aged above 30 years, and especially above 35 years, showed higher relations with obese conditions. Although, age < 30 years is thought to present more weight gain during pregnancy [ 8 ] other authors describe that women with pregnancy BMI >25 had a higher baseline weight and were more likely to experience excessive gestational weight gain, especially those aged over 30 years [ 17 ]. Additionally, the excess weight of pregnant women led to delivery complications such as abortion, preeclampsia and cesarean births.…”

“…Previous studies have suggested that weight gain in pregnant women is associated with various factors beyond individual ones. For example, family and social factors are ascribed a potential influence on weight gain [ 8 ]. In this context, ethnicity may have an impact on the lifestyle and dietary habits that lead to increases in the BMI in pre-conceptional women.…”

Intimate partner physical violence and inadequate weight gain in pregnancy

“…4,5 Athar et al 6 conducted a scoping review assessing nine articles published between 2015 and 2020 and demonstrated that IPV affects gestational weight gain. Another review conducted by Zhou et al 7 about determinants of excessive gestational weight gain-including 70 studies published between 2009 and 2020, originated in countries from America, Asia, Europe, Oceania and Africademonstrated IPPV as an important risk factor for excessive gestational weight gain. 7 It is worth mentioning that IPPV is also an important national and international public health problem, is defined as "any behavior that inflicts or has the possibility of inflicting physical, psychological or sexual harm to those that are in an intimate relationship".…”

“…Another review conducted by Zhou et al 7 about determinants of excessive gestational weight gain-including 70 studies published between 2009 and 2020, originated in countries from America, Asia, Europe, Oceania and Africademonstrated IPPV as an important risk factor for excessive gestational weight gain. 7 It is worth mentioning that IPPV is also an important national and international public health problem, is defined as "any behavior that inflicts or has the possibility of inflicting physical, psychological or sexual harm to those that are in an intimate relationship". 8 Distinct manifestations of violence (psychological, physical or sexual) may coexist within a relationship, in various moments of a couple's life, including pregnancy.…”

Weight gain trajectories patterns from pregnancy to early postpartum: identifying women at risk and timing to prevent weight regain

“…Body weight before, during, and after pregnancy results from a complex interaction between biological, behavioral, and social factors. Maternal factors related to a higher increase in weight during pregnancy and postpartum are pre-pregnancy body mass index, education, socioeconomic status, age, parity, breastfeeding, food intake, physical activity, sedentarism, sleep hygiene, and psychological stress [12][13][14].…”