Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.
ADVANCED SEARCH
Log in
Top
BMC Women's Health
Published in: BMC Women's Health 1/2017

Open Access 01-12-2017 | Research article

Pre-pregnancy body mass index and gestational weight gain and their effects on pregnancy and birth outcomes: a cohort study in West Sumatra, Indonesia

Authors: Hora Soltani, Nur I. Lipoeto, Frankie J. Fair, Karen Kilner, Y. Yusrawati

Published in: BMC Women's Health | Issue 1/2017

Login to get access

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.
Appendix
Available only for authorised users
Literature
1.
Han Z, Mulla S, Beyene J, et al. Maternal underweight and the risk of preterm birth and low birth weight: a systematic review and metaanalyses. Int J Epidemiol. 2011;40(issue 1):65–101.CrossRefPubMed
2.
3.
Marchi J, Berg M, Dencker A, et al. Risks associated with obesity in pregnancy, for the mother and baby: a systematic review of reviews. Obes Rev. 2015;16(8):621–38.CrossRefPubMed
4.
Tsukamoto H, Fukuoka H, Inoue K, et al. Restricting weight gain during pregnancy in Japan: a controversial factor in reducing perinatal complications. Eur J Obstet Gynecol Reprod Biol. 2007;133:53–9.CrossRefPubMed
5.
Centre for Maternal and Child Enquiries (CMACE). Saving mothers’ lives: reviewing maternal deaths to make motherhood safer: 2006–08. The eighth report on confidential enquiries into maternal deaths in the United Kingdom. Int J Obstet Gynaecol (BJOG). 2011;118(Suppl. 1):1–203.
6.
7.
Denison FC, Norwood P, Bhattacharya S, et al. Association between maternal body mass index during pregnancy, short-term morbidity, and increased health service costs: a population-based study. Int J Obstet Gynaecol (BJOG). 2014;121:72–82.CrossRef
8.
Nijland MJ, Ford SP, Nathanielsz PW. Prenatal origins of adult disease. Curr Opin Obstet Gynecol. 2008;20:132–8.CrossRefPubMed
9.
Bruno RM, Faconti L, Taddei S, et al. Birth weight and arterial hypertension. Curr Opin Cardiol. 2015;30(4):398–402.PubMed
10.
Fraser A, Tilling K, Macdonald-Wallis C, et al. Association of Maternal Weight Gain in pregnancy with offspring obesity and metabolic and vascular traits in childhood. Circulation. 2010;121:2557–64.CrossRefPubMedPubMedCentral
11.
Viswanathan M, Siega-Riz AM, Moos MK, Deierlein A, Mumford S, Knaack J, et al. Outcomes of maternal weight gain. Evidence Report/Technology Assessment No. 168. AHRQ Publication No. 08-E-09. Rockville: Agency for Healthcare Research and Quality; 2008.
12.
Wrotniak BH, Shults J, Butts S, et al. Gestational weight gain and risk of overweight in the offspring at age 7 y in a multicenter, multiethnic cohort study. Am J Clin Nutr. 2008;87:1818–24.PubMed
13.
Institute of Medicine (US). Weight gain during pregnancy: re-examining the guidelines. Washington DC: The National Academies Press; 2009.
14.
15.
Lipoeto NI, Wattanapenpaiboon N, Malik A, et al. The nutrition transition in West Sumatra, Indonesia. Asia Pac J Clin Nutr. 2004;13:312–6.PubMed
16.
Achadi EL, Hansell MJ, Sloan NL, et al. Women's nutritional status, iron consumption and weight gain during pregnancy in relation to neonatal weight and length in west java, Indonesia. Int J Gynecol Obstet. 1995;48(Suppl):S103–19.CrossRef
17.
Winkvist A, Stenlund H, Hakimi M, et al. Weight-gain patterns from prepregnancy until delivery among women in central java, Indonesia. Am J Clin Nutr. 2002;75:1072–7.PubMed
18.
Ministry of Health, Republic of Indonesia. Indonesia Health Profile 2010. Jakata: Ministry of Health, Republic of Indonesia; 2011
19.
20.
WHO technical report series 894. Obesity: preventing and managing the global epidemic Report of a WHO consultation. Geneva: The World Health Organization; 2000.
21.
WHO expert consultation. Appropriate body-mass index for Asian populations and its implications for policy and intervention strategies. Lancet. 2004;363:157–63.CrossRef
22.
23.
Ota E, Haruna M, Suzuki M, et al. Maternal body mass index and gestational weight gain and their association with perinatal outcomes in Viet Nam. Bull World Health Organ. 2011;89:127–36.CrossRefPubMed
24.
Alexander GR, Himes JH, Kaufman RB, et al. A United States national reference for fetal growth. Obstet Gynecol. 1996;87:163–8.CrossRefPubMed
25.
Lee ACC, Katz J, Blencowe H, et al. National and regional estimates of term and preterm babies born small for gestational age in 138 low-income and middle-income countries in 2010. Lancet Glob Health. 2013;1:e26–36.CrossRefPubMedPubMedCentral
26.
Teune MJ, Bakhuizen S, Bannerman CG, et al. A systematic review of severe morbidity in infants born late preterm. Am J Obstet Gynecol. 2011;205(4):374. e1-374.e9CrossRefPubMed
27.
28.
Munim S, Maheen H. Association of gestational weight gain and pre-pregnancy body mass index with adverse pregnancy outcome. J Coll Physicians Surg Pak. 2012;22:694–8.PubMed
29.
Yekta Z, Ayatollahi H, Porali R, et al. The effect of pre-pregnancy body mass index and gestational weight gain on pregnancy outcomes in urban care settings in Urmia-Iran. BMC Pregnancy Childbirth. 2006;6 10.​1186/​1471-2393-6-15.
30.
Holowko N, Mishra G, Koupil I. Social inequality in excessive gestational weight gain. Int J Obes. 2014;38:91–6.CrossRef
31.
Park S, Sappenfield WM, Bish C, et al. Assessment of the Institute of Medicine Recommendations for weight gain during pregnancy: Florida, 2004–2007. Matern Child Health J. 2011;15:289–301.CrossRefPubMed
32.
Kowal C, Kuk J, Tamim H. Characteristics of weight gain in pregnancy among Canadian women. Matern Child Health J. 2012;16:668–76.CrossRefPubMed
33.
Johnson J, Clifton RG, Roberts JM, et al. Pregnancy outcomes with weight gain above or below the 2009 Institute of Medicine Guidelines. Obstet Gynecol. 2013;121:969–75.CrossRefPubMedPubMedCentral
34.
Frederick IO, Williams MA, Sales AE, et al. Pre-pregnancy body mass index, gestational weight gain, and other maternal characteristics in relation to infant birth weight. Matern Child Health J. 2008;12:557–67.CrossRefPubMed
35.
Nohr EA, Vaeth M, Baker JL, et al. Combined associations of prepregnancy body mass index and gestational weight gain with the outcome of pregnancy. Am J Clin Nutr. 2008;87:1750–9.PubMed
36.
Margerison Zilko CE, Rehkopf D, Abrams B. Association of maternal gestational weight gain with short and long-term maternal and child health outcomes. Am J Obstet Gynecol. 2010;202:574. e1-574.e8CrossRefPubMed
37.
Ferraro ZM, Barrowman N, Prud’homme D, et al. Excessive gestational weight gain predicts large for gestational age neonates independent of maternal body mass index. J Maternal-Fetal Neonatal Med. 2012;25:538–42.CrossRef
38.
Choi S-K, Park I-Y, Shin J-C. The effects of pre-pregnancy body mass index and gestational weight gain on perinatal outcomes in Korean women: a retrospective cohort study. Reprod Biol Endocrinol. 2011;9:6.CrossRefPubMedPubMedCentral
39.
Tanaka T, Ashihara K, Nakamura M, et al. Associations between the pre-pregnancy body mass index and gestational weight gain with pregnancy outcomes in Japanese women. J Obstet Gynaecol Res. 2014;40:1296–303.CrossRefPubMed
40.
Chen Z, Du J, Shao L, et al. Pre-pregnancy body mass index, gestational weight gain, and pregnancy outcomes in China. Int J Gynecol Obstet. 2010;109:41–4.CrossRef
41.
Siega-Riz AM, Viswanathan M, Moos M-K, et al. A systematic review of outcomes of maternal weight gain according to the Institute of Medicine recommendations: birthweight, fetal growth, and postpartum weight retention. Am J Obstet Gynecol. 2009;201:339. e1-339.e14CrossRefPubMed
42.
Zhang X, Decker A, Platt RW, et al. How big is too big? The perinatal consequences of fetal macrosomia how big is too big? The perinatal consequences of fetal macrosomia. Am J Obstet Gynecol. 2008;198:517. e1-517.e6CrossRefPubMed
43.
Roseboom T, de Rooij S, Painter R (2006) The Dutch famine and its long-term consequences for adult health. Early Hum Dev 82, 485-491.
44.
Levy A, Fraser D, Katz M, et al. Maternal anemia during pregnancy is an independent risk factor for low birthweight and preterm delivery. Eur J Obstet Gynecol Reprod Biol. 2005;122:182–6.CrossRefPubMed
45.
46.
Mok E, Multon C, Piguel L, et al. Decreased full breastfeeding, altered practices, perceptions, and infant weight change of Prepregnant obese women: a need for extra support. Pediatrics. 2008;121:e1319–24.CrossRefPubMed
47.
Badan Penelitian dan Pengembangan Kesehatan. Riset Kesehatan Dasar (RISKESDAS, 2007). Laporan Nasional 2007. Jakarta: Ministry of Health, Republic of Indonesia; 2008.
Metadata
Title
Pre-pregnancy body mass index and gestational weight gain and their effects on pregnancy and birth outcomes: a cohort study in West Sumatra, Indonesia
Authors
Hora Soltani
Nur I. Lipoeto
Frankie J. Fair
Karen Kilner
Y. Yusrawati
Publication date
01-12-2017
Publisher
BioMed Central
Published in
BMC Women's Health / Issue 1/2017
Electronic ISSN: 1472-6874
DOI
https://doi.org/10.1186/s12905-017-0455-2

Other articles of this Issue 1/2017

BMC Women's Health 1/2017 Go to the issue

Research article

Why women choose compounded bioidentical hormone therapy: lessons from a qualitative study of menopausal decision-making

Research article

‘I stayed with my illness’: a grounded theory study of health seeking behaviour and treatment pathways of patients with obstetric fistula in Kenya

Research article

Factors associated with sexual dysfunction in Taiwanese females with rheumatoid arthritis

Study protocol

Cardiovascular RiskprofilE - IMaging and gender-specific disOrders (CREw-IMAGO): rationale and design of a multicenter cohort study

Research article

Binge eating is associated with trait anxiety in Korean adolescent girls: a cross sectional study

Research article

Anxiety and depression among infertile women: a cross-sectional survey from Hungary