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Pre-pregnancy body mass index and gestational weight gain and their effects on pregnancy and birth outcomes: a cohort study in West Sumatra, Indonesia.
BMC Womens Health 2017; 17(1):102BW

Abstract

BACKGROUND

Indonesia has a considerably high incidence of maternal and infant mortality. The country has however been experiencing a social and economic transition, influencing its general population demographics and nutritional status including the state of health and nutrition of pregnant women. This study aimed to explore body mass index (BMI) and gestational weight gain (GWG), and their relationship with pregnancy outcomes in a sample of Indonesian pregnant women.

METHODS

This observational cohort study included a total of 607 pregnant women who were recruited in 2010 from maternity clinics in Western Sumatra, Indonesia. Multiple logistic and regression analyses were undertaken to compare pregnancy and birth outcomes for different BMI and GWG, using normal weight women and women with a recommended weight gain as the referent groups.

RESULTS

The prevalence of underweight (BMI < 18.5 kg/m2) in pregnancy was high at 20.1%; while 21.7% of women were overweight (BMI: 23.0-27.4 kg/m2) and 5.3% obese (BMI ≥ 27.5 kg/m2) using the Asian BMI classifications. The incidence of overweight (BMI: 25.0-29.9 kg/m2) and obese (BMI ≥ 30.0 kg/m2) according to the international BMI classifications were 13.5% and 1.1% respectively. The majority of women gained inadequate weight in pregnancy compared to the Institute of Medicine (IOM) recommendations, especially those who had a normal BMI. Birthweight adjusted mean difference aMD (95% confidence interval) 205 (46,365) and the odds of macrosomia adjusted odds ratio aOR 13.46 (2.32-77.99) significantly increased in obese women compared to those with a normal BMI. Birthweight aMD -139 (-215, -64) significantly decreased in women with inadequate GWG compared to those with recommended GWG, while SGA aOR 5.44 (1.36, 21.77) and prematurity aOR 3.55 (1.23, 10.21) increased.

CONCLUSIONS

Low nutritional status and inadequate GWG remain a cause for concern in these women. The higher odds of macrosomia with increasing maternal BMI and higher odds of prematurity and small for gestational age infants with inadequate weight gain also require attention. Research and practice recommendations: Urgent attention is required by researchers, policy makers and decision-makers to facilitate development of culturally sensitive interventions to enhance nutritional status and health of mothers and babies, in an area known for its high incidence of maternal and neonatal mortality.

Authors+Show Affiliations

Centre for Health and Social Care Research, Sheffield Hallam University, Mundella House, 34 Collegiate Crescent, Collegiate Campus, Sheffield, S10 2BP, England. h.soltani@shu.ac.uk.Faculty of Medicine, Andalas University, Padang, West Sumatra, Indonesia.Centre for Health and Social Care Research, Sheffield Hallam University, Mundella House, 34 Collegiate Crescent, Collegiate Campus, Sheffield, S10 2BP, England.Centre for Health and Social Care Research, Sheffield Hallam University, Mundella House, 34 Collegiate Crescent, Collegiate Campus, Sheffield, S10 2BP, England.Department of Obstetrics and Gynaecology, Faculty of Medicine, Andalas University, Padang, West Sumatra, Indonesia.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

29121896

Citation

Soltani, Hora, et al. "Pre-pregnancy Body Mass Index and Gestational Weight Gain and Their Effects On Pregnancy and Birth Outcomes: a Cohort Study in West Sumatra, Indonesia." BMC Women's Health, vol. 17, no. 1, 2017, p. 102.
Soltani H, Lipoeto NI, Fair FJ, et al. Pre-pregnancy body mass index and gestational weight gain and their effects on pregnancy and birth outcomes: a cohort study in West Sumatra, Indonesia. BMC Womens Health. 2017;17(1):102.
Soltani, H., Lipoeto, N. I., Fair, F. J., Kilner, K., & Yusrawati, Y. (2017). Pre-pregnancy body mass index and gestational weight gain and their effects on pregnancy and birth outcomes: a cohort study in West Sumatra, Indonesia. BMC Women's Health, 17(1), p. 102. doi:10.1186/s12905-017-0455-2.
Soltani H, et al. Pre-pregnancy Body Mass Index and Gestational Weight Gain and Their Effects On Pregnancy and Birth Outcomes: a Cohort Study in West Sumatra, Indonesia. BMC Womens Health. 2017 Nov 9;17(1):102. PubMed PMID: 29121896.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Pre-pregnancy body mass index and gestational weight gain and their effects on pregnancy and birth outcomes: a cohort study in West Sumatra, Indonesia. AU - Soltani,Hora, AU - Lipoeto,Nur I, AU - Fair,Frankie J, AU - Kilner,Karen, AU - Yusrawati,Y, Y1 - 2017/11/09/ PY - 2016/09/06/received PY - 2017/10/30/accepted PY - 2017/11/11/entrez PY - 2017/11/11/pubmed PY - 2018/3/24/medline KW - Birthweight KW - Cohort study KW - Gestational weight gain KW - Indonesia KW - Maternal BMI KW - Pregnancy outcomes SP - 102 EP - 102 JF - BMC women's health JO - BMC Womens Health VL - 17 IS - 1 N2 - BACKGROUND: Indonesia has a considerably high incidence of maternal and infant mortality. The country has however been experiencing a social and economic transition, influencing its general population demographics and nutritional status including the state of health and nutrition of pregnant women. This study aimed to explore body mass index (BMI) and gestational weight gain (GWG), and their relationship with pregnancy outcomes in a sample of Indonesian pregnant women. METHODS: This observational cohort study included a total of 607 pregnant women who were recruited in 2010 from maternity clinics in Western Sumatra, Indonesia. Multiple logistic and regression analyses were undertaken to compare pregnancy and birth outcomes for different BMI and GWG, using normal weight women and women with a recommended weight gain as the referent groups. RESULTS: The prevalence of underweight (BMI < 18.5 kg/m2) in pregnancy was high at 20.1%; while 21.7% of women were overweight (BMI: 23.0-27.4 kg/m2) and 5.3% obese (BMI ≥ 27.5 kg/m2) using the Asian BMI classifications. The incidence of overweight (BMI: 25.0-29.9 kg/m2) and obese (BMI ≥ 30.0 kg/m2) according to the international BMI classifications were 13.5% and 1.1% respectively. The majority of women gained inadequate weight in pregnancy compared to the Institute of Medicine (IOM) recommendations, especially those who had a normal BMI. Birthweight adjusted mean difference aMD (95% confidence interval) 205 (46,365) and the odds of macrosomia adjusted odds ratio aOR 13.46 (2.32-77.99) significantly increased in obese women compared to those with a normal BMI. Birthweight aMD -139 (-215, -64) significantly decreased in women with inadequate GWG compared to those with recommended GWG, while SGA aOR 5.44 (1.36, 21.77) and prematurity aOR 3.55 (1.23, 10.21) increased. CONCLUSIONS: Low nutritional status and inadequate GWG remain a cause for concern in these women. The higher odds of macrosomia with increasing maternal BMI and higher odds of prematurity and small for gestational age infants with inadequate weight gain also require attention. Research and practice recommendations: Urgent attention is required by researchers, policy makers and decision-makers to facilitate development of culturally sensitive interventions to enhance nutritional status and health of mothers and babies, in an area known for its high incidence of maternal and neonatal mortality. SN - 1472-6874 UR - https://www.unboundmedicine.com/medline/citation/29121896/Pre_pregnancy_body_mass_index_and_gestational_weight_gain_and_their_effects_on_pregnancy_and_birth_outcomes:_a_cohort_study_in_West_Sumatra_Indonesia_ L2 - https://bmcwomenshealth.biomedcentral.com/articles/10.1186/s12905-017-0455-2 DB - PRIME DP - Unbound Medicine ER -