Perception of Weight Status and its Impact on Gestational Weight Gain in an Urban Population

Matern Child Health J (2013) 17:19311939 DOI 10.1007/s10995-013-1219-8

Perception of Weight Status and its Impact on Gestational Weight Gain in an Urban Population

Shilpi S. Mehta-Lee Jennifer L. Lischewski Goel

Linzhi Xu Mindy R. Brittner Peter S. Bernstein

Karen A. Bonuck

Published online: 18 January 2013 Springer Science+Business Media New York 2013

Abstract To examine the association between actual and perceived overweight/obese status and excess gestational weight gain (GWG). As part of an infant feeding trial, multi-ethnic lower and moderate income women-completed a checklist of current health conditions, including overweight/obesity, asthma, and hypertension while pregnant. Odds of excessive GWG per the Institute of Medicine guidelines in accurate versus inaccurate reporters, by overweight status were analyzed with multivariate logistic regression for women with pre-or early pregnancy BMIs of C18.5. 775 women met study criteria. Just 21 % (n = 107) of overweight/obese women

accurately identied their weight status, compared to [90 % accurate report of documented hypertension or asthma. Compared to normal-weight accurate reporters, the adjusted odds of excessive GWG in overweight/obese women was 2.3 (95 % CI 1.4, 3.7) in accurate reporters, and 2.5 (95 % CI 1.7, 3.4) in inaccurate reporters. Over-weight/obesity is associated with excessive GWG, but this risk is not modied by inaccurate reporting/perception of weight-status.

Keywords Gestational weight gain Obesity Weight

perception Body-mass index

Introduction

Adverse neonatal and obstetric effects of pre-pregnancy obesity include pregnancy-induced hypertension, preeclampsia, gestational diabetes, cesarean section, and neonatal death [16]. More recently, gestational weight gain (GWG) has been linked to adverse neonatal and obstetric outcomes including large-for-gestational-age infants, shoulder dystocia and wound infections [7, 8]. Signicantly greater pregnancy co-morbidities are seen in obese pregnant women who gain in excess of 15 lbs. [9].

In 1990 the Institute of Medicine (IOM) issued guidelines [10] for appropriate GWG. Since that time the proportion of reproductive age women who are overweight or obese (BMI C25.0 kg/m2) increased from 37 % [11] to59.5 % in 20072008 [12]. In 2009, based upon growing evidence of adverse maternal and child outcomes associated with excess gestational weight gain, the IOM revised their earlier guidelines [13]. Notably, the revised guidelines incorporate baseline pregnancy weight based upon WHO dened BMI categories; specically the previous

Portions of these ndings presented at: The Pregnancy Meeting, The 31st...