Faculty of Public Health, Department of Epidemiology and Medical Statistics, College of Medicine, University of Ibadan, Ibadan, Nigeria.
Consortium of Advanced Research for Africa (CARTA), Nairobi, Kenya.
PLoS One. 2023 Aug 18;18(8):e0290102. doi: 10.1371/journal.pone.0290102. eCollection 2023.
Gestational weight gain (GWG) is a risk factor for adverse pregnancy outcomes, future obesity and chronic diseases among women. However, has not received much attention in many low and middle-income countries such as Nigeria. We investigated the pattern, associated factors and pregnancy outcomes of GWG in Ibadan, Nigeria, using the Ibadan Pregnancy Cohort Study (IbPCS).
The IbPCS is a multicentre prospective cohort study conducted among 1745 pregnant women recruited from four health facilities in Ibadan, Nigeria. GWG, the primary outcome, was categorised according to the Institute of Medicine's classification into insufficient, adequate and excessive weight gain. Pregnancy outcomes were the secondary outcome variables. Logistic regression analysis (Adjusted odds ratios and 95% confidence interval CI) was used to examine associations, and Poisson regression analyses were used to investigate associations with outcomes.
Only 16.9% of women had optimal GWG, 56.8% had excessive GWG, and 26.9% had insufficient GWG. Excessive GWG was associated with high income '> #20,000-' (AOR: 1.64, 95% CI: 1.25-2.17), being overweight (AOR: 2.12, 95% CI: 1.52-2.95) and obese (AOR: 1.47, 95% CI: 1.02-2.13) after adjusting for confounders. In contrast, increased odds of insufficient GWG have associated women with depression (AOR: 1.70, 95% CI 1.17-2.47). There was no significant association between inappropriate GWG and pregnancy outcomes However, there was an increased odds for postpartum haemorrhage (AOR: 2.44, 95% CI 1.14-5.22) among women with obesity and excessive GWG.
Excessive GWG was the most typical form of GWG among our study participants and was associated with high maternal income, and being overweight or obese. GWG needs to be monitored during antenatal care, and interventions that promote appropriate GWG should be implemented among pregnant women in Nigeria.
妊娠体重增加(GWG)是导致不良妊娠结局、女性未来肥胖和慢性病的一个风险因素。然而,在许多中低收入国家,如尼日利亚,GWG 并没有受到太多关注。我们利用伊巴丹妊娠队列研究(IbPCS)调查了尼日利亚伊巴丹 GWG 的模式、相关因素和妊娠结局。
IbPCS 是一项多中心前瞻性队列研究,在尼日利亚伊巴丹的 4 家医疗机构招募了 1745 名孕妇。GWG 是主要结局,根据医学研究所的分类分为不足、适当和过多体重增加。妊娠结局是次要结局变量。逻辑回归分析(调整后的优势比和 95%置信区间 CI)用于检查关联,泊松回归分析用于调查与结局的关联。
只有 16.9%的女性有最佳 GWG,56.8%的女性有过多 GWG,26.9%的女性有不足 GWG。过多的 GWG 与高收入“> #20,000-”(OR:1.64,95%CI:1.25-2.17)、超重(OR:2.12,95%CI:1.52-2.95)和肥胖(OR:1.47,95%CI:1.02-2.13)有关,调整混杂因素后。相比之下,GWG 不足的可能性与抑郁有关(OR:1.70,95%CI 1.17-2.47)。GWG 不当与妊娠结局之间没有显著关联。然而,肥胖和过多 GWG 的女性产后出血的几率增加(OR:2.44,95%CI 1.14-5.22)。
在我们的研究参与者中,过多的 GWG 是最常见的 GWG 形式,与高产妇收入和超重或肥胖有关。在产前保健期间需要监测 GWG,并应在尼日利亚孕妇中实施促进适当 GWG 的干预措施。