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Restrepo-Mesa SL, Benjumea Rincón MV, Estrada Restrepo A, Bousquet Carrilho TR, Kac G, Cano Pulgarín JS, Cano-Pulgarín K, Severi C, Sinisterra O, Zimmer Sarmiento MDC, López Ocampos MI, Araya Bannout M, Chico-Barba G, Pinto Arteaga N, Grandi C, Atalah Samur E, Santa Escobar CD. Gestational weight gain charts for Latin American adolescents. PLoS One 2023; 18:e0292070. [PMID: 37910544 PMCID: PMC10619863 DOI: 10.1371/journal.pone.0292070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2023] [Accepted: 09/12/2023] [Indexed: 11/03/2023] Open
Abstract
Monitoring gestational weight gain (GWG) throughout pregnancy among adolescents is important for detecting individuals at risk and timely intervention. However, there are no specific tools or guidelines for GWG monitoring of this group. We aimed to construct GWG charts for pregnant adolescents (10-19 years old) according to pre-pregnancy body mass index (BMI) using a pooled dataset from nine Latin American countries. Datasets from Argentina, Brazil, Chile, Colombia, Mexico, Panama, Paraguay, Peru, and Uruguay collected between 2003 and 2021 were combined after data cleaning and harmonization. Adolescents free of diseases that could affect GWG and who gave birth to newborns weighing between 2,500-4,000 g and free of congenital malformations were included. Multiple imputation techniques were applied to increase the sample size available for underweight and obesity categories. Generalized Additive Models for Location, Scale, and Shape were used to construct the charts of GWG according to gestational age. Internal and external validation procedures were performed to ensure that models were not over-adjusted to the data. The cohort included 6,414 individuals and 29,414 measurements to construct the charts and 1,684 individuals and 8,879 measurements for external validation. The medians (and interquartile ranges) for GWG at 40 weeks according to pre-pregnancy BMI were: underweight, 14.9 (11.9-18.6); normal weight, 14.0 (10.6-17.7); overweight, 11.6 (7.7-15.6); obesity, 10.6 kg (6.7-14.3). Internal and external validation showed that the percentages above/below selected percentiles were close to those expected, except for underweight adolescents. These charts describe the GWG throughout pregnancy among Latin American adolescents and represent a significant contribution to the prenatal care of this group. GWG cut-offs based on values associated with lower risks of unfavorable outcomes for the mother-child binomial should be determined before implementing the charts in clinical practice.
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Affiliation(s)
- Sandra Lucía Restrepo-Mesa
- Research Group on Food and Human Nutrition, School of Nutrition and Dietetics, University of Antioquia, Medellín, Colombia
| | | | - Alejandro Estrada Restrepo
- Research Group on Demographics and Health, School of Nutrition and Dietetics, University of Antioquia, Medellín, Colombia
| | - Thais Rangel Bousquet Carrilho
- Nutritional Epidemiology Observatory, Josué de Castro Nutrition Institute, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Gilberto Kac
- Nutritional Epidemiology Observatory, Josué de Castro Nutrition Institute, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | | | - Keren Cano-Pulgarín
- Research Group on Food and Human Nutrition, School of Nutrition and Dietetics, University of Antioquia, Medellín, Colombia
| | - Cecilia Severi
- Faculty of Medicine, Preventive Medicine Department, University of Republic, Montevideo, Uruguay
| | | | | | - Maria Isabel López Ocampos
- Health Promotion Section, Loma Pyta Maternal and Child Hospital, Public Health and Social Welfare Ministry, Asunción, Paraguay
| | - Marcela Araya Bannout
- Faculty of Medicine, Women and Newborn Health Promotion Department, Chile University, Santiago, Chile
| | - Gabriela Chico-Barba
- Nutrition and Bioprogramming Coordination, National Institute of Perinatology, Ciudad de México, México
| | | | - Carlos Grandi
- Pediatric Research Department, Argentine Society of Pediatrics, Buenos Aires, Argentina
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