Gestational weight gain among American Samoan women and its impact on delivery and infant outcomes

BMC Pregnancy and Childbirth

Stephen T McGarvey⁵  Bethel Muasau-Howard⁶  John Ah Ching⁶  Elizabeth W Triche⁴  Chantelle N Hart¹  William Johnson²  Nicola L Hawley³ 

[1] Center for Obesity Research and Education & the Department of Public Health, Temple University, Philadelphia, USA;MRC Human Nutrition Research Unit, Cambridge, UK;Department of Chronic Disease Epidemiology, School of Public Health, Yale University, New Haven 06520-8034, CT, USA;Department of Epidemiology, School of Public Health, Brown University, Providence, USA;International Health Institute, School of Public Health, Brown University, Providence, USA;LBJ Tropical Medical Center, Pago Pago, American Samoa, USA

关键词: Obesity;    Gestational weight gain;    Cesarean delivery;    Birth size;    American Samoa;   

Others  :  1125417
DOI  :  10.1186/s12884-015-0451-1

 received in 2014-10-05, accepted in 2015-01-22,  发布年份 2015

【 摘 要 】

Background

As obesity has increased worldwide, so have levels of obesity during pregnancy and excess gestational weight gain (GWG). The aim of this paper was to describe GWG among American Samoan women and examine the association between GWG and four adverse pregnancy and infant outcomes: cesarean delivery, small- and large-for-gestational age (SGA/LGA), and infant overweight/obesity.

Methods

Data were extracted from prenatal care records of 632 Samoan women. Mixed-effects growth models were used to produce individual weight-for-gestational week curves from which second and third trimester weight gain was estimated. Binary logistic regression was used to examine associations between GWG and the outcomes of interest.

Results

Most women were overweight/obese in early pregnancy (86%) and 78% exceeded the Institute of Medicine GWG guidelines. Greater GWG in the second trimester and early pregnancy weight were independently associated with increased odds of a c-section (OR 1.40 [95% CI: 1.08, 1.83]) and OR 1.51 [95% CI: 1.17, 1.95], respectively). Risk of delivering a LGA infant increased with greater third trimester weight gain and higher early pregnancy weight, while second trimester weight gain was negatively associated with SGA. Risk of infant overweight/obesity at 12 months increased with early pregnancy weight (OR: 1.23 [95% CI: 1.01, 1.51]) and infant birthweight.

Conclusions

The high levels of pregnancy obesity and excessive GWG in American Samoa suggest that it is important for physicians to encourage women into prenatal care early and begin education about appropriate GWG and the potential risks of excess weight gain for both the mother and baby.

【 授权许可】

   
2015 Hawley et al.; licensee BioMed Central.

【 图 表 】

Figure 1.

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