Prevalence and predictors of early gestational weight gain associated with obesity risk in a diverse Australian antenatal population: a cross-sectional study

Abstract

BackgroundExcess gestational weight gain (GWG) leads to adverse short- and long-term consequences for women and their offspring. Evidence suggests that excess GWG in early pregnancy may be particularly detrimental, contributing to the intergenerational cycle of obesity. The primary outcome was to investigate the prevalence and predictors of excess GWG in early pregnancy, and if women understand the risks to themselves and their offspring stratified by maternal body mass index (BMI).MethodsThis was a secondary analysis (n = 2131) of a cross-sectional study (n = 2338) conducted over 6 months in 2015 of pregnant women attending antenatal clinics at four maternity hospitals across Sydney, Australia before 22 completed weeks gestation An self-completed questionnaire was used to investigate knowledge of expected weight gain in pregnancy, understanding of risks associated with excess GWG, self-reported anthropometric measures and socio-demographic data.ResultsOne third (34.2%) of women gained weight in excess of the recommendations by 22 completed weeks gestation. Women who were overweight (OR: 1.69, 95% CI: 1.33–2.14) or obese (OR: 1.64, 95% CI: 1.20–2.24) pre-pregnancy were more likely to gain excess weight in early pregnancy compared to normal weight women; as were women from lower socio-economic areas (OR: 1.89, 95% CI: 1.49–2.41). Half (51%) the women were unsure about the effect of excess GWG on their baby; 11% did not believe that excess GWG would affect the weight of the baby and 14% did not believe that excess GWG would affect longer term outcomes for their baby. Women who gained weight above the recommendations were significantly more likely to believe that excessive GWG in pregnancy would not have any adverse future effect on health outcomes or weight of their baby.ConclusionsThe women at particular risk of excess early GWG are those who are overweight and obese and/or residing in lower socio-economic areas. These women need to be targeted for appropriate counselling preconception or in early pregnancy. Given the significant adverse outcomes associated with excess GWG in early pregnancy, preconception or early pregnancy counselling with respect to GWG and intervention research regarding best approach remains a public health priority.Electronic supplementary materialThe online version of this article (10.1186/s12884-017-1482-6) contains supplementary material, which is available to authorized users.

Gestational Weight Gain and Pregnancy Outcomes among Nulliparous Women

“…Many reports elucidated risk factors for inappropriate (excessive or inadequate) gestational weight gain, including prepregnancy BMI, 30 race or ethnicity, 31 and socioeconomic status. 32 Several studies have also considered interventions in an effort to optimize gestational weight gain, including dietary counseling, 33 exercise, 34 or both of these, 35 although there has not been clear demonstration that such interventions are easy to implement in typical settings or can lead to better pregnancy outcomes. Provider advice regarding gestational weight gain may have a positive effect on helping women to achieve appropriate gestational weight gain, but this advice is often not forthcoming, inconsistently provided, or inaccurate.…”

Text messaging to help women with overweight or obesity lose weight after childbirth: the intervention adaptation and SMS feasibility RCT

“…14 This trend is particularly evident in women who start their pregnancy overweight or obese, 15 as well as among those of a lower socioeconomic status. 16 Excessive gestational weight gain and a high pre-pregnancy body mass index (BMI) are both predictors of postpartum weight retention [17][18][19][20][21] and are influenced by many other maternal factors, including diet and physical activity behaviours, breastfeeding, sleep, ethnicity, maternity leave, income and mental health. 13,21 Failure to lose pregnancy-related weight by 6 months post partum is considered an important predictor of obesity and associated conditions in mid-life; 22,23 many women with obesity attribute the onset of the condition to weight gained in pregnancy.…”

An Awareness and Experiences of Pregnant Women towards Antenatal Weight Management at a Maternity Hospital in Najran City, KSA

“…One of them was largest Australian survey (n=2338) conducted over in 2015 of pregnant women attending antenatal clinics at four maternity hospitals, examining knowledge of expected weight gain in pregnancy, understanding of risks associated with excess GWG. It revealed only half the cohort (51.0%) understood the potential impact of excess GWG [10].…”