Maternal and social determinants of excessive weight gain during pregnancy: a cohort study

Abstract

INTRODUCTION: Excessive gestational weight gain might be an emerging health problem in developing countries. AIM: To determine the effect of maternal and social factors for excessive gestational weight gain. METHODS: A prospective cohort study was carried out at two Medical Officer of Health areas in Sri Lanka. Pregnant women were recruited on or before 16 weeks of gestation and followed up until delivery. The sample size for the first, second and third trimester analysis were 710, 626 and 578 respectively. The variables included socio-demographic characteristics, information on present and past obstetric history and trimester specific data related to physical activity and psychosocial stress which were gathered on average at 12th, 28th, and 36th weeks of gestation. Maternal weight was measured at the first antenatal clinic visit and at delivery. Multiple logistic regression was applied using SPSS and the results were expressed as odds ratios (OR) with the respective 95% confidence intervals (95%CI). RESULTS: The determinants of excessive weight gain were: being overweight at the booking visit (OR 9.0, 95%CI 4.6, 17.7), maternal complications during pregnancy (OR 3.0, 95%CI 1.1, 8.1), passive cigarette smoking during third trimester (OR 0.1, 95%CI 0.01, 0.9), low educational level (OR 4.2, 95%CI 1.2, 14.4) and high per capita income (OR 2.7, 95%CI 1.1, 6.7), controlling for the effect of gestational age. CONCLUSION: Being overweight, maternal complications, passive smoking, low educational level and high income were the determinants of excessive weight gain during pregnancy.