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Obstetrics
Trends in gestational weight gain: the Pregnancy Risk Assessment Monitoring System, 2000–2009

https://doi.org/10.1016/j.ajog.2015.01.030Get rights and content

Objective

Achieving adequate gestational weight gain (GWG) is important for optimal health of the infant and mother. We estimate current population-based trends of GWG.

Study design

We analyzed data from the Pregnancy Risk Assessment Monitoring System for 124,348 women who delivered live infants in 14 states during 2000 through 2009. We examined prevalence and trends in GWG in pounds as a continuous variable, and within 1990 Institute of Medicine (IOM) recommendations (yes/no) as a dichotomous variable. We examined adjusted trends in mean GWG using multivariable linear regression and GWG within recommendations using multivariable multinomial logistic regression.

Results

During 2000 through 2009, 35.8% of women gained within IOM GWG recommendations, 44.4% gained above, and 19.8% gained below. From 2000 through 2009, there was a biennial 1.0 percentage point decrease in women gaining within IOM GWG recommendations (P trend < .01) and a biennial 0.8 percentage point increase in women gaining above IOM recommendations (P trend < .01). The percentage of women gaining weight below IOM recommendations remained relatively constant from 2000 through 2009 (P trend = .14). The adjusted odds of gaining within IOM recommendations were lower in 2006 through 2007 (adjusted odds ratio, 0.90; 95% confidence interval, 0.85–0.96) and 2008 through 2009 (adjusted odds ratio, 0.90; 95% confidence interval, 0.85–0.96) relative to 2000 through 2001.

Conclusion

Overall, from 2000 through 2009 the percentage of women gaining within IOM recommendations slightly decreased while mean GWG slightly increased. Efforts are needed to develop and implement strategies to ensure that women achieve GWG within recommendations.

Section snippets

Materials and Methods

We used data from the PRAMS, an ongoing, state-representative, population-based surveillance system of the Centers for Disease Control and Prevention (CDC) and state health departments. PRAMS collects information in participating states about maternal behaviors and experiences before, during, and after pregnancies resulting in live infants. In each participating site, PRAMS uses birth certificates to draw a stratified sample of live births, and oversamples certain high-risk populations.

Results

Women in the sample had an overall mean GWG of 31.3 lb. Approximately 35.8% of women had GWG within IOM recommendations, 44.4% gained above recommendations, and 19.8% gained below recommendations (Table 1). Of the 124,348 women in the final sample, the majority had a normal prepregnancy BMI (53.4%), were <30 years of age (61.3%), were non-Hispanic white (74.3%), had a post-high school education (57.7%), were multiparous (60.8%), were not enrolled in Medicaid at delivery (64.5%), were nonsmokers

Comment

We examined trends in GWG from 2000 through 2009 in a US state-representative, population-based sample and found that among women with singleton, full-term live birth, there has been a significant decrease in the proportion gaining within IOM recommendations, falling from 37.5% in 2000 through 2001 to 34.2% in 2008 through 2009, while the proportion gaining above IOM recommendations increased from 42.5-45.5% during the same time period. However, these trends differed by prepregnancy BMI.

Acknowledgments

The authors thank the members of the Pregnancy Risk Assessment Monitoring System Working Group for their work in data collection.

Alabama–Izza Afgan, MPH

Alaska–Kathy Perham-Hester, MS, MPH

Arkansas–Mary McGehee, PhD

Colorado–Alyson Shupe, PhD

Connecticut–Jennifer Morin, MPH

Delaware–George Yocher, MS

Florida–Avalon Adams-Thames, MPH, CHES

Georgia–Chinelo Ogbuanu, MD, MPH, PhD

Hawaii–Emily Roberson, MPH

Illinois–Theresa Sandidge, MA

Iowa–Sarah Mauch, MPH

Louisiana–Amy Zapata, MPH

Maine–Tom Patenaude, MPH

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    Members of the Pregnancy Risk Assessment Monitoring System Working Group who prepared data collection for this research are listed in the Acknowledgments.

    Funding was provided by the Centers for Disease Control and Prevention (CDC).

    The authors report no conflict of interest.

    The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the CDC.

    Cite this article as: Johnson JL, Farr SL, Dietz PM, et al. Trends in gestational weight gain: the Pregnancy Risk Assessment Monitoring System, 2000–2009. Am J Obstet Gynecol 2015;212:806.e1-8.

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