1
|
Beyene GA, Yunus MA, Deribew AB, Kasahun AW. Gestational weight gain and its determinants among pregnant women in Gurage zone, Central Ethiopia: a cohort study. BMC Womens Health 2024; 24:376. [PMID: 38937766 PMCID: PMC11212422 DOI: 10.1186/s12905-024-03223-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2023] [Accepted: 06/24/2024] [Indexed: 06/29/2024] Open
Abstract
BACKGROUND The nutritional status of the mothers before pregnancy and the weights gained during pregnancy are very crucial factors affecting the pregnancy outcomes and health of the infants. This study aimed to assess early pregnancy weight, determine the magnitude of gestational weight gain, and investigate the factors affecting gestational weight gain among pregnant women in the Gurage zone, 2022. METHODS A prospective cohort study was conducted among pregnant women who started antenatal care follow-up before the 16th week of gestation in the selected hospitals and health centers of the Gurage zone, Ethiopia. The gestational weight gain was obtained by subtracting the early pregnancy weight from the last pregnancy weight and categorizing based on the Institute of Medicine (IOM) recommendation. RESULTS The early pregnancy weight status of the women at enrollment indicates that 10% of them were underweight and 83% of them had normal weight. On average, the study participants gained 13.3 kgs of weight with [95% CI: 13.0, 13.6]. More than half (56%) of them gained adequate weight, a quarter (26%) of them gained inadequate weight, and 18% of them gained excess weight during pregnancy compared to the IOM recommendation. Maternal age, occupational status, and early pregnancy weight status were found to have a statistically significant association with the gestational weight gained. CONCLUSION Almost half (44%) of the pregnant women gained either inadequate or excess weight during pregnancy. Promoting gestational weight gain within recommended guidelines should be emphasized for younger, employed women and those who are either underweight or overweight.
Collapse
Affiliation(s)
- Girma Alemayehu Beyene
- Department of Public Health, College of Medicine and Health Sciences, Wolkite University, Wolkite, Ethiopia.
| | - Mukrem Abdulwehab Yunus
- Department of Internal Medicine, College of Medicine and Health Sciences, Wolkite University, Wolkite, Ethiopia
| | - Aberash Beyene Deribew
- Department of Midwifery, College of Medicine and Health Sciences, Wolkite University, Wolkite, Ethiopia
| | - Abebaw Wasie Kasahun
- Department of Public Health, College of Medicine and Health Sciences, Wolkite University, Wolkite, Ethiopia
| |
Collapse
|
2
|
Yang M, Feng Q, Chen C, Chen S, Guo Y, Su D, Chen H, Sun H, Dong H, Zeng G. Healthier diet associated with reduced risk of excessive gestational weight gain: A Chinese prospective cohort study. MATERNAL & CHILD NUTRITION 2022:e13397. [PMID: 35821659 DOI: 10.1111/mcn.13397] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Revised: 06/07/2022] [Accepted: 06/12/2022] [Indexed: 11/29/2022]
Abstract
Limited studies have examined the associations between diet quality and gestational weight gain (GWG) among Chinese pregnant women, adopting Chinese GWG guidelines. We prospectively investigate the associations of diet quality, using the Chinese Healthy Diet Index for Pregnancy (CHDI-P), which assessed diet quality from 'Diversity', 'Adequacy' and 'Limitation' dimensions with overall 100 points, with GWG among participants enroled in Southwest China. Food consumption was collected by 24 h dietary recalls for three consecutive days and CHDI-P scores were divided into tertiles. GWG was calculated according to the weight measured before delivery and classified into adequate weight gain (AWG), insufficient weight gain (IWG) and excessive weight gain(EWG) following Chinese GWG guidelines. Multinomial regression analyses and stratified analyses by pre-pregnancy body mass index were performed to estimate the association between CHDI-P and GWG. A total of 1416 participants were recruited in early pregnancy, and 971 and 997 participants were respectively followed up in middle and late pregnancy. The mean CHDI-P score was 56.44 ± 6.74, 57.07 ± 7.44 and 57.38 ± 7.94 points in early, middle and late pregnancy, respectively. Women in the lowest CHDI-P scores group had an increased risk of EWG in middle (OR = 1.53, 95% confidence interval [CI] = 1.08-2.17) and late pregnancy (OR = 1.71, 95% CI = 1.21-2.41) than women in the highest group, while overweight/obese women had a greater risk of EWG in late pregnancy (OR = 4.25, 95% CI = 1.30-13.90). No association was found between the CHDI-P scores and IWG. Poor diet quality in middle and late pregnancy was associated with a higher risk of EWG.
Collapse
Affiliation(s)
- Mengtong Yang
- Department of Nutrition and Food Safety, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Qiuyu Feng
- Department of Nutrition and Food Safety, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Cong Chen
- Department of Nutrition and Food Safety, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Sijia Chen
- Department of Nutrition and Food Safety, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Yishan Guo
- Department of Nutrition and Food Safety, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Danping Su
- Department of Nutrition and Food Safety, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Hong Chen
- Department of Nutrition and Food Safety, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Hong Sun
- Department of Nutrition and Food Safety, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Hongli Dong
- Department of Nutrition and Food Safety, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Guo Zeng
- Department of Nutrition and Food Safety, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan, China
| |
Collapse
|
3
|
Arzhang P, Ramezan M, Borazjani M, Jamshidi S, Bavani NG, Rahmanabadi A, Bagheri A. The association between food insecurity and gestational weight gain: A systematic review and meta-analysis. Appetite 2022; 176:106124. [PMID: 35714821 DOI: 10.1016/j.appet.2022.106124] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2021] [Revised: 05/13/2022] [Accepted: 06/02/2022] [Indexed: 11/27/2022]
Abstract
Gestational weight gain has been one of the most important risk factors for adverse maternal, perinatal, and long-term outcomes. Our systematic review and meta-analysis aimed to incorporate the evidence regarding the association between gestational weight gain and food insecurity (FI). We performed a systematic review and meta-analysis on the possible association between FI and insufficient or excessive gestational weight gain by conducting a systematic search in PubMed, Scopus, ISI, and Google Scholar from January 1, 1990 until February 1, 2022. Odds Ratio (OR) was pooled using a random-effects model. Standard methods were used for the assessment of heterogeneity and publication bias. Data included fifteen studies with 7651 individual participants from different countries pooled for the meta-analysis. Of the fifteen studies included in the final meta-analysis, seven had a cross-sectional and eight had a longitudinal design. In the pooled analysis, FI had significant relationship with both inadequate (OR = 1.49; 95% CI = 1.26 to 1.76) and excessive weight gain in pregnancy (OR = 1.27; 95% CI = 1.05 to 1.54). In conclusion, FI during pregnancy was directly associated with both inadequate and excessive gestational weight gain. Therefore, changes at a policy level should be considered to increase food security in pregnant women.
Collapse
Affiliation(s)
- Pishva Arzhang
- Qods Hospital, Kermanshah University of Medical Sciences, Kermanshah, Iran.
| | - Marjan Ramezan
- Department of Nutritional Sciences, College of Human Sciences, Texas Tech University, Lubbock, TX, 79409, USA.
| | - Mohadeseh Borazjani
- School of Nutrition and Food Sciences, Shiraz University of Medical Sciences, Shiraz, Iran.
| | - Sanaz Jamshidi
- Department of Nutrition, School of Public Health, Iran University of Medical Sciences, Tehran, Iran.
| | - Narges Ghorbani Bavani
- Department of Community Nutrition, School of Nutrition and Food Science, Isfahan University of Medical Sciences, Isfahan, Iran.
| | - Alireza Rahmanabadi
- Student Research Committee, Faculty of Nutrition and Food Sciences, Tabriz University of Medical Sciences, Tabriz, Iran.
| | - Amir Bagheri
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran.
| |
Collapse
|
4
|
van Lonkhuijzen RMR, Cremers SS, de Vries JHMJ, Feskens EJME, Wagemakers MAEA. Evaluating ‘Power 4 a Healthy Pregnancy’ (P4HP) – protocol for a cluster randomized controlled trial and process evaluation to empower pregnant women towards improved diet quality. BMC Public Health 2022; 22:148. [PMID: 35062921 PMCID: PMC8780817 DOI: 10.1186/s12889-022-12543-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2021] [Accepted: 01/07/2022] [Indexed: 12/19/2022] Open
Abstract
Background In general during pregnancy, women are aware of the importance of good diet quality, interested in nutrition, and receptive to changing dietary intake. However, adherence to dietary guidelines is sub-optimal. A pregnant woman’s first information source regarding nutrition information is her midwife. Healthy nutrition promotion by midwives may therefore be very promising, but midwives face multiple barriers in providing nutritional support. Empowering pregnant women to improve their diet quality is expected to improve their health. Therefore an empowerment intervention has been developed to improve diet quality among pregnant women. The objective of this study is to evaluate the effectiveness and feasibility of Power 4 a Healthy Pregnancy (P4HP). P4HP aims to empower pregnant women to have a healthier diet quality. Methods/design This study applies a mixed methodology consisting of a non-blinded cluster randomized trial with an intervention (P4HP) group and a control group and a process evaluation. Midwifery practices, the clusters, will be randomly allocated to the intervention arm (n = 7) and control arm (n = 7). Participating women are placed in intervention or control conditions based on their midwifery practice. Each midwifery practice includes 25 pregnant women, making 350 participants in total. Health related outcomes, diet quality, empowerment, Sense of Coherence, Quality of Life, and Self-Rated Health of participants will be assessed before (T0) and after (T1) the intervention. The process evaluation focuses on multidisciplinary collaboration, facilitators, and barriers, and consists of in-depth interviews with midwives, dieticians and pregnant women. Discussion This study is the first to evaluate an empowerment intervention to improve diet quality in this target population. This mixed method evaluation will contribute to knowledge about the effectiveness and feasibility regarding diet quality, empowerment, health-related outcomes, multidisciplinary collaboration, facilitators and barriers of the empowerment intervention P4HP. Results will help inform how to empower pregnant women to achieve improved diet quality by midwives and dieticians. If proven effective, P4HP has the potential to be implemented nationally and scaled up to a long-term trajectory from preconception to the postnatal phase. Trial registration The trial is prospectively registered at the Netherlands Trial Register (NL9551). Date registered: 19/05/2021. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-022-12543-z.
Collapse
|
5
|
Misgina KH, Groen H, Bezabih AM, Boezen HM, van der Beek EM. Postpartum Weight Change in Relation to Pre-Pregnancy Weight and Gestational Weight Gain in Women in Low-Income Setting: Data from the KITE Cohort in the Northern Part of Ethiopia. Nutrients 2021; 14:131. [PMID: 35011006 PMCID: PMC8746538 DOI: 10.3390/nu14010131] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2021] [Revised: 12/22/2021] [Accepted: 12/24/2021] [Indexed: 11/16/2022] Open
Abstract
(1) Background: Postpartum weight may increase compared to pre-pregnancy due to weight retention or decrease due to weight loss. Both changes could pose deleterious effects on maternal health and subsequent pregnancy outcomes. Therefore, this study aimed to assess postpartum weight change and its associated factors. (2) Methods: A total of 585 women from the KIlte-Awlaelo Tigray Ethiopia (KITE) cohort were included in the analysis. (3) Results: The mean pre-pregnancy body mass index and weight gain during pregnancy were 19.7 kg/m2 and 10.8 kg, respectively. At 18 to 24 months postpartum, the weight change ranged from -3.2 to 5.5 kg (mean = 0.42 kg [SD = 1.5]). In addition, 17.8% of women shifted to normal weight and 5.1% to underweight compared to the pre-pregnancy period. A unit increase in weight during pregnancy was associated with higher weight change (β = 0.56 kg, 95% CI [0.52, 0.60]) and increased probability to achieve normal weight (AOR = 1.65, 95% CI [1.37, 2.00]). Food insecurity (AOR = 5.26, 95% CI [1.68, 16.50]), however, was associated with a shift to underweight postpartum. Interestingly, high symptoms of distress (AOR = 0.13, 95% CI [0.03, 0.48]) also negatively impacted a change in weight category. (4) Conclusions: In low-income settings such as northern Ethiopia, higher weight gain and better mental health during pregnancy may help women achieve a better nutritional status after pregnancy and before a possible subsequent pregnancy.
Collapse
Affiliation(s)
- Kebede Haile Misgina
- Department of Public Health, College of Health Sciences, University of Aksum, Axum P.O. Box 1010, Ethiopia
- Department of Epidemiology, University Medical Center Groningen, University of Groningen, 9700 RB Groningen, The Netherlands; (H.G.); (H.M.B.)
| | - Henk Groen
- Department of Epidemiology, University Medical Center Groningen, University of Groningen, 9700 RB Groningen, The Netherlands; (H.G.); (H.M.B.)
| | - Afework Mulugeta Bezabih
- School of Public Health, College of Health Sciences, University of Mekelle, Mekelle P.O. Box 231, Ethiopia;
| | - Hendrika Marike Boezen
- Department of Epidemiology, University Medical Center Groningen, University of Groningen, 9700 RB Groningen, The Netherlands; (H.G.); (H.M.B.)
| | - Eline M. van der Beek
- Department of Paediatrics, University Medical Center Groningen, University of Groningen, 9700 RB Groningen, The Netherlands;
| |
Collapse
|