Institute of Medicine Recommendations on the Rate of Gestational Weight Gain and Perinatal Outcomes in Rural Bangladesh

Abstract

Although validated in other parts of the world, the suitability of the U.S. Institute of Medicine (IOM) 2009 recommendations on gestational weight gain (GWG) for Bangladeshi women remains to be examined. We evaluated the association between the weekly rate of weight gain during the second and third trimester of pregnancy, categorized according to IOM recommendations, and adverse perinatal outcomes among 1569 pregnant women with singleton live births in rural Matlab, Bangladesh. Gaining weight at rates below the IOM recommendations was associated with higher odds of preterm birth (adjusted odds ratio (AOR) = 2.0, 95% CI: 1.1–3.6), low birth weight (AOR = 1.4, 95% CI: 1.03–2.0), small-for-gestational-age newborns (AOR = 1.3, 95% CI: 1.04–1.7), and poor neonatal outcome (severe neonatal morbidity or death, AOR = 2.4, 95% CI: 1.03–5.6). A GWG rate above the recommendations was associated with higher odds of cesarean delivery (AOR = 1.7, 95% CI: 1.1–2.6), preterm birth (AOR = 2.2, 95% CI: 1.1–4.4), large-for-gestational-age newborns (AOR = 5.9, 95% CI: 1.5–23.1), and poor neonatal outcome (AOR = 2.7, 95% CI: 1.04–7.0). Our results suggest that the IOM 2009 recommendations on GWG rate during the second and third trimester may be suitable for guiding rural Bangladeshi women in the prenatal period, although the women should aim for rates near the lower bound of the range.

Association Between Diet Quality & Gestational Weight Gain Rate Among Pregnant Women in Dhulikhel, Nepal

“…Only a few studies have looked at rate of GWG in lower-middle income countries (LMICs). The prevalence of excessive GWG rate in our study did exceed that of a study in Bangladesh where only 19.9% (n=312) of women had excessive GWG rate (41) . The higher prevalence of women with overweight and obesity in our sample (40.6%) could partially explain these ndings.…”

Association of Household Food Insecurity with Nutritional Status and Mental Health of Pregnant Women in Rural Bangladesh

“…Short maternal height has serious public health implications. Maternal short stature increases the risk of poor GWG [40], obstructed labor [65], caesarean delivery [66], preterm birth, and low birth weight (LBW) [67]. Moreover, short stature is associated with reduced work capacity and economic productivity, limiting women's ability to provide income, food, care, and other resources for households.…”

“…However, future prospective cohort studies are needed to confirm the direction and strength of the dose-dependent relationship between HFI and the nutritional status of women. Women with low weight or MUAC in the first trimester are more likely to experience low GWG in the second and third trimesters [38,40], and subsequently are more likely to have preterm births and deliver LBW and small for gestational age (SGA) infants [38][39][40]. Furthermore, infants born to mothers with low GWG have a higher risk of neonatal morbidities and death [38,40].…”

“…Apart from a few mental health studies [28,29,32,34], investigating the effect of HFI in pregnant women, one of the most vulnerable population groups, are also limited, whereas millions of women are exposed to food insecurity in pregnancy [2,37]. Furthermore, few contemporary food-security studies investigated pregnant women in early pregnancy, whereas women's nutritional status (BMI and MUAC) in the first trimester determines the required gestational weight gain (GWG) and subsequently affects perinatal outcomes [38][39][40][41]. This study investigated the association of HFI with nutritional status and mental health of early-gestation pregnant women in rural Bangladesh.…”

Association of human milk oligosaccharides and nutritional status of young infants among Bangladeshi mother–infant dyads

“…We also fitted infant age- and infant sex-adjusted models separately for secretor and non-secretor mothers. To examine the discriminative performance of the logit models for the detection of SAM, the area under the receiver operating characteristic (AUROC) curves was estimated 38 .…”