Urban and rural differences in pregnancy weight gain in Guilan, northern Iran.

OBJECTIVES

This study aimed to compare pregnancy weight gain and weight gain patterns in a group of Iranian women who attended urban and rural public health centers for prenatal care in Guilan, Iran.

DESIGN

A secondary data analysis using routinely collected health centers data.

SETTING

12 randomly selected health centers in urban and rural areas in Guilan.

PARTICIPANTS

A total of 2,047 pregnant women (1,097 in urban areas and 950 in rural areas) who regularly attended health centers for prenatal care and delivered between June 2003 and August 2006.

MEASUREMENTS

Data on prepregnancy weight, height, pregnancy weight gain, mother's age, parity, education and infant birth weight were extracted from the health records. The women were categorized based on their prepregnancy body mass index as underweight, normal weight and overweight.

FINDINGS

These results showed that among normal weight women, 41.1% of urban and 56.6% of rural women had weight gains below the Institute of Medicine (IOM) recommendation (P<0.0001). Among underweight women, 48.1% of urban and 65.8% of rural women had weight gains below the IOM recommendation (P<0.0001). Rural women with normal prepregnancy weight gained less weight than the urban women in the second trimester of their pregnancy (5.7+/-2.9 kg vs. 4.6+/-2.5 kg, P<0.0001). The underweight rural women gained less weight in both the second and the third trimesters of their pregnancy than the urban women. While the overall prevalence of having low birth weight (LBW) infants for underweight women were 5.2% only 1.9 % of those who gained adequate pregnancy weight gain had LBW infants.

CONCLUSION

This study indicated that a considerable proportion of the women both in urban and rural areas in Guilan, Iran had inadequate pregnancy weight gain. These results showed that prenatal care in terms of pregnancy weight gain in the present health system is not satisfactory.