A multifactorial perspective of risks associated with inadequate and excessive pregnancy weight gain
Description
Objectives. To identify maternal characteristics associated with the risk of pregnancy weight gain below the range recommended by the Institute of Medicine (IOM), particularly focusing upon whether risk factors differ by race. To identify the maternal factors associated with excessive maternal weight gain. And, to identify maternal characteristics associated with recurrent adverse birth weight outcomes in a representative sample of Louisiana multiparous women, 1997--1999 Methods. For each of these three studies I analyzed deterministically-linked birth certificates and PRAMS questionnaires for 4,078 live births, delivered in 1997--1999. Nineteen variables reflecting socioeconomic, demographic, substance exposure, pregnancy history, psychosocial, and anthropometric indicators were included in multiple logistic regression models Results. Maternal race was not statistically associated with the risk of gaining below the IOM guidelines after adjusting for other covariates, despite a higher frequency of Black women being classified within this low weight gain group. Instead, risk was significantly associated with low pregravid BMI, maternal youth, gestational duration, and smoking cessation Women who gained more weight than recommended were more likely to have high pregravid BMI, longer gestations, quit smoking, smoking cessation counseling, household incomes >$40,000, and reported stress from moving residences. Multiparity and low pregravid BMI were related to a lower risk of excessive pregnancy gain. White mothers over-gained more frequently, but again, race was not associated with HiMWG risk after controlling for other factors The last of the three studies found that consecutive negative birth weight outcomes were not associated with inappropriate maternal weight gain. Instead these adverse outcomes were positively related to drinking alcohol late in pregnancy, shortened gestation, maternal youth, and Black race. Traditional risk factors, such as smoking and prenatal care, were not associated with repeated negative birth outcomes in this representative sample Conclusion. Race alone was not significantly related to the risk of gaining outside the recommended levels for pregnant mothers in this sample. Instead, these results suggest that underlying risk factors (many being pre-conceptional) could provide more accurate targeting information when designing pregnancy weight gain compliance efforts