Gestational weight gain in sub-Saharan Africa: Estimation based on pseudo-cohort design.
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ABSTRACT: Background
Inadequate or excess gestational weight gain (GWG) leads to multiple undesirable birth outcomes. Yet, in sub-Saharan Africa (SSA) little is known about the weight gain pattern in pregnancy. The purpose of the study is to estimate the average gestational weight gain (GWG) in sub-Saharan Africa (SSA) and to examined whether there had been recent improvements or not.Methods
Based on cross-sectional anthropometric data extracted from multiple Demographic and Health Surveys conducted in SSA, we estimated the average GWG in the region. Pseudo-cohort design was used to reconstruct GWG trajectories based on aggregated data of 110,482 women extracted from 30 recent surveys. Trend in GWG between 2000 and 2015 was determined using the data of 11 SSA countries. Pre-pregnancy weight was estimated based on the weight of non-pregnant women at risk of conception.Results
On average, women in SSA gain inadequate weight (6.6 kg, 95% confidence interval, 6.0-7.2) over pregnancy. No meaningful gain was observed in the first trimester; whereas, women in the second and third trimesters put on 2.2 and 3.2 kg, respectively. The highest weight gain (10.5, 8.2-12.9 kg) was observed in Southern African sub-region and the lowest in Western Africa (5.8, 5.0-6.6 kg). The GWG among women who had secondary or above education (9.5, 8.2-10.9 kg) was higher than women with lower education (5.0, 4.3-5.8 kg). Likewise, GWG in women from richest households (9.0, 7.2-10.7 kg) was superior to those from poorest households (6.1, 5.3-7.0 kg). The estimated recent (2015-20) mean GWG (6.6, 5.8-7.4 kg) was not significantly different from what had been at beginning of the new millennium (6.7, 5.9-7.5 kg).Conclusion
In SSA GWG is extremely low and is not showing improvements.
SUBMITTER: Gebremedhin S
PROVIDER: S-EPMC8153429 | biostudies-literature |
REPOSITORIES: biostudies-literature
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Project description:ObjectiveTo assess the associations of gestational weight gain (GWG) in early and late pregnancy with subsequent risks of adverse pregnancy outcomes in Chinese women.DesignProspective cohort study.SettingShanghai, China.ParticipantsWe studied 2630 nulliparous singleton pregnant women with complete data on weight gain in early (≤17 weeks of gestation) and late (>17 weeks) pregnancy in the Shanghai Birth Cohort.MethodsGWG was standardised into z-scores by gestational age and categorised as low (z-score <-1), normal (-1 to +1) and high (>1). The adjusted relative risks (aRRs) and 95%CIs were estimated through log-binomial regression models. Interaction effects between GWG and some other adjustment factors were tested, further stratified analyses were performed separately where interaction terms were significant.Outcome measuresAdverse maternal and neonatal outcomes.ResultsIndependent from GWG in late pregnancy, higher GWG in early pregnancy was associated with higher risks of gestational diabetes mellitus (aRR: 1.66; 95% CI: 1.11 to 2.48), caesarean section (aRR: 1.21; 95% CI: 1.05 to 1.39) and prolonged hospitalisation (aRR: 1.56; 95% CI: 1.03 to 2.38). Higher GWG in late pregnancy was independently associated with higher risks of caesarean section (aRR: 1.24; 95% CI: 1.09 to 1.41), large for gestational age (aRR: 2.01; 95% CI: 1.50 to 2.7) and macrosomia (aRR: 1.90; 95% CI: 1.30 to 2.78). In addition, the risk of gestational hypertension increased significantly with increased total GWG (aRR: 1.78; 95% CI: 1.14 to 2.76). The effects of GWG in late pregnancy on maternal and neonatal outcomes were significantly different between the women bearing a female and the women bearing male fetus.ConclusionThe GWG associations with adverse pregnancy outcomes differ at early and late pregnancy, and there may be effect modification by fetal sex in the association of GWG in late pregnancy with some pregnancy outcomes.
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