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Relationship Between Gestational Weight Gain and Birthweight Among Clients Enrolled in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC), Hawaii, 2003–2005

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Abstract

To investigate the relationship between gestational weight gain (GWG) and birthweight outcomes among a low-income population in Hawaii using GWG recommendations from the 2009 Institute of Medicine (IOM) guidelines. Data were analyzed for 19,130 mother-infant pairs who participated in Hawaii’s Special Supplemental Nutrition Program for Women, Infants, and Children from 2003 through 2005. GWG was categorized as inadequate, adequate, or excessive on the basis of GWG charts in the guidelines. Generalized logit models assessed the relationship between mothers’ GWG and their child’s birthweight category (low birthweight [LBW: <2,500 g], normal birthweight [2,500 g ≤ BW < 4,000 g], or high birthweight [HBW: ≥4,000 g]). Final models were stratified by prepregnancy body mass index (underweight, normal weight, overweight, or obese) and adjusted for maternal age, education, race/ethnicity, smoking status, parity, and marital status. Overall, 62 % of the sample had excessive weight gain and 15 % had inadequate weight gain. Women with excessive weight gain were more likely to deliver a HBW infant; this relationship was observed for women in all prepregnancy weight categories. Among women with underweight or normal weight prior to pregnancy, those with inadequate weight gain during pregnancy were more likely to deliver a LBW infant. Among the low-income population of Hawaii, women with GWG within the range recommended in the 2009 IOM guidelines had better birthweight outcomes than those with GWG outside the recommended range. Further study is needed to identify optimal GWG goals for women with an obese BMI prior to pregnancy.

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Acknowledgments

The authors would like to thank Ms. Melanie Murakami, Mr. Gordon Chinen, Mr. Lloyd Miyashiro, and other staff of the Hawaii State Department of Health, Family Health Services Division for their help in extracting and interpreting the WIC data. The authors also appreciate the assistance from Dr. Cheryl Prince, Dr. Dave Goodman, and Dr. Charlan Kroelinger from the Maternal and Child Health Epidemiology Program, Applied Sciences Branch, Division of Reproductive Health, National Center for Chronic Disease Prevention and Public Health Promotion, Centers for Disease Control and Prevention, for scientific guidance on this analysis and manuscript.

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Authors and Affiliations

  1. Community Health Sciences Division, School of Public Health, University of Illinois at Chicago, 1603 W. Taylor St., Chicago, IL, 60612-4394, USA

    Izumi Chihara & Arden S. Handler

  2. Hawaii Department of Health, Honolulu, HI, USA

    Donald K. Hayes, Linda R. Chock & Loretta J. Fuddy

  3. Division of Reproductive Health, Centers for Disease Control and Prevention, Druid Hills, GA, USA

    Donald K. Hayes

  4. Epidemiology and Biostatistics Division, School of Public Health, University of Illinois at Chicago, Chicago, IL, USA

    Deborah L. Rosenberg

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  1. Izumi Chihara
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  2. Donald K. Hayes
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  3. Linda R. Chock
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  4. Loretta J. Fuddy
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  5. Deborah L. Rosenberg
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Correspondence to Izumi Chihara.

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Disclaimer: The findings and conclusions in this article are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention.

Appendices

Appendix 1

See Table 4

Table 4 2009 Institute of Medicine recommendation for total and rate of gestational weight gain by prepregnancy body mass index (BMI) categories
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Appendix 2

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Fig. 1
figure 1

Gestational weight gain chart for normal weight women based on 2009 Institute of Medicine Recommendations. Source Institute of Medicine, 2009. Weight Gain During Pregnancy: Reexamining the Guidelines. Washington, DC. National Academies Press; Committee to Reexamine IOM Pregnancy Guidelines

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Chihara, I., Hayes, D.K., Chock, L.R. et al. Relationship Between Gestational Weight Gain and Birthweight Among Clients Enrolled in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC), Hawaii, 2003–2005. Matern Child Health J 18, 1123–1131 (2014). https://doi.org/10.1007/s10995-013-1342-6

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