Pre-pregnancy body mass index and gestational weight gain and their effects on pregnancy and birth outcomes: a cohort study in West Sumatra, Indonesia. Soltani, H., Lipoeto, N. I, Fair, F. J, Kilner, K., & Yusrawati, Y BMC Womens. Health, 17(1):102, November, 2017.
Pre-pregnancy body mass index and gestational weight gain and their effects on pregnancy and birth outcomes: a cohort study in West Sumatra, Indonesia [link]Paper  doi  abstract   bibtex   
BACKGROUND: Indonesia has a considerably high incidence of maternal and infant mortality. The country has however been experiencing a social and economic transition, influencing its general population demographics and nutritional status including the state of health and nutrition of pregnant women. This study aimed to explore body mass index (BMI) and gestational weight gain (GWG), and their relationship with pregnancy outcomes in a sample of Indonesian pregnant women. METHODS: This observational cohort study included a total of 607 pregnant women who were recruited in 2010 from maternity clinics in Western Sumatra, Indonesia. Multiple logistic and regression analyses were undertaken to compare pregnancy and birth outcomes for different BMI and GWG, using normal weight women and women with a recommended weight gain as the referent groups. RESULTS: The prevalence of underweight (BMI \textless 18.5 kg/m(2)) in pregnancy was high at 20.1%; while 21.7% of women were overweight (BMI: 23.0-27.4 kg/m(2)) and 5.3% obese (BMI ≥ 27.5 kg/m(2)) using the Asian BMI classifications. The incidence of overweight (BMI: 25.0-29.9 kg/m(2)) and obese (BMI ≥ 30.0 kg/m(2)) according to the international BMI classifications were 13.5% and 1.1% respectively. The majority of women gained inadequate weight in pregnancy compared to the Institute of Medicine (IOM) recommendations, especially those who had a normal BMI. Birthweight adjusted mean difference aMD (95% confidence interval) 205 (46,365) and the odds of macrosomia adjusted odds ratio aOR 13.46 (2.32-77.99) significantly increased in obese women compared to those with a normal BMI. Birthweight aMD -139 (-215, -64) significantly decreased in women with inadequate GWG compared to those with recommended GWG, while SGA aOR 5.44 (1.36, 21.77) and prematurity aOR 3.55 (1.23, 10.21) increased. CONCLUSIONS: Low nutritional status and inadequate GWG remain a cause for concern in these women. The higher odds of macrosomia with increasing maternal BMI and higher odds of prematurity and small for gestational age infants with inadequate weight gain also require attention. Research and practice recommendations: Urgent attention is required by researchers, policy makers and decision-makers to facilitate development of culturally sensitive interventions to enhance nutritional status and health of mothers and babies, in an area known for its high incidence of maternal and neonatal mortality.
@article{soltani_pre-pregnancy_2017,
	title = {Pre-pregnancy body mass index and gestational weight gain and their effects on pregnancy and birth outcomes: a cohort study in {West} {Sumatra}, {Indonesia}},
	volume = {17},
	issn = {1472-6874},
	url = {http://dx.doi.org/10.1186/s12905-017-0455-2},
	doi = {10.1186/s12905-017-0455-2},
	abstract = {BACKGROUND: Indonesia has a considerably high incidence of maternal and
infant mortality. The country has however been experiencing a social and
economic transition, influencing its general population demographics and
nutritional status including the state of health and nutrition of pregnant
women. This study aimed to explore body mass index (BMI) and gestational
weight gain (GWG), and their relationship with pregnancy outcomes in a
sample of Indonesian pregnant women. METHODS: This observational cohort
study included a total of 607 pregnant women who were recruited in 2010
from maternity clinics in Western Sumatra, Indonesia. Multiple logistic
and regression analyses were undertaken to compare pregnancy and birth
outcomes for different BMI and GWG, using normal weight women and women
with a recommended weight gain as the referent groups. RESULTS: The
prevalence of underweight (BMI {\textless} 18.5 kg/m(2)) in pregnancy was high at
20.1\%; while 21.7\% of women were overweight (BMI: 23.0-27.4 kg/m(2)) and
5.3\% obese (BMI ≥ 27.5 kg/m(2)) using the Asian BMI classifications. The
incidence of overweight (BMI: 25.0-29.9 kg/m(2)) and obese (BMI ≥ 30.0
kg/m(2)) according to the international BMI classifications were 13.5\% and
1.1\% respectively. The majority of women gained inadequate weight in
pregnancy compared to the Institute of Medicine (IOM) recommendations,
especially those who had a normal BMI. Birthweight adjusted mean
difference aMD (95\% confidence interval) 205 (46,365) and the odds of
macrosomia adjusted odds ratio aOR 13.46 (2.32-77.99) significantly
increased in obese women compared to those with a normal BMI. Birthweight
aMD -139 (-215, -64) significantly decreased in women with inadequate GWG
compared to those with recommended GWG, while SGA aOR 5.44 (1.36, 21.77)
and prematurity aOR 3.55 (1.23, 10.21) increased. CONCLUSIONS: Low
nutritional status and inadequate GWG remain a cause for concern in these
women. The higher odds of macrosomia with increasing maternal BMI and
higher odds of prematurity and small for gestational age infants with
inadequate weight gain also require attention. Research and practice
recommendations: Urgent attention is required by researchers, policy
makers and decision-makers to facilitate development of culturally
sensitive interventions to enhance nutritional status and health of
mothers and babies, in an area known for its high incidence of maternal
and neonatal mortality.},
	number = {1},
	journal = {BMC Womens. Health},
	author = {Soltani, Hora and Lipoeto, Nur I and Fair, Frankie J and Kilner, Karen and Yusrawati, Y},
	month = nov,
	year = {2017},
	keywords = {Archive, Birthweight, Cohort study, Gestational weight gain, Indonesia, Maternal BMI, Pregnancy outcomes},
	pages = {102}
}
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