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Table 4 Pregnancy and birth outcomes in relation to gestational weight gain according to IOM recommendations based on international and Asian BMI classifications

From: Pre-pregnancy body mass index and gestational weight gain and their effects on pregnancy and birth outcomes: a cohort study in West Sumatra, Indonesia

 

IOM weight gain recommendations applied to international BMI classification

IOM weight gain recommendations applied to Asian BMI classification

Inadequate

Excessive

Inadequate

Excessive

Number in each category (%)

297 (56.1%)

62 (11.7%)

268 (50.7%)

80 (15.1%)

Mean birthweight (g)

MD (95% CI)

−98 (−173, −22)*

131 (14, 248)*

−139 (−215, −64)***

83 (−23, 188)

aMD (95% CI)‡

−104 (−180, −29)**

128 (12, 245)*

−139 (−215, −64)***

63 (−43, 169)

Number of antenatal visits

MD (95% CI)

−0.27 (−0.97, 0.44)

0.62 (−0.46, 1.71)

−0.48 (−1.18, 0.23)

0.62 (−0.37, 1.60)

aMD (95% CI)‡

−0.20 (−0.89, 0.50)

0.45 (−0.63, 1.52)

−0.43 (−1.13, 0.27)

0.43 (−0.64, 1.41)

Gestation at delivery

MD (95% CI)

−1.22 (−2.03, −0.42)**

−0.45 (−1.77, 0.88)

−1.13 (−1.95, −0.31)**

−0.38 (−1.56, 0.80)

aMD (95% CI)‡

−1.28 (−2.10, −0.45)**

−0.42 (−1.78, 0.94)

−1.18 (−2.02, −0.35)**

−0.37 (−1.63, 0.89)

Haemoglobin <11.0 g/dl in trimester 2

OR (95% CI)

1.26 (0.82, 1.94)

1.09 (0.56, 2.10)

1.23 (0.80, 1.90)

0.98 (0.54, 1.80)

aOR (95% CI) ‡

1.28 (0.81, 2.01)

1.39 (0.69, 2.79)

1.22 (0.77, 1.93)

1.23 (0.65, 2.35)

Haemoglobin <11.0 g/dl in trimester 3

OR (95% CI)

1.42 (0.90, 2.25)

1.19 (0.59, 2.42)

1.46 (0.92, 2.32)

1.17 (0.61, 2.23)

aOR (95% CI) ‡

1.41 (0.88, 2.26)

1.32 (0.64, 2.74)

1.45 (0.91, 2.32)

1.31 (0.67, 2.56)

Induction

OR (95% CI)

0.69 (0.35, 1.40)

1.34 (0.52, 3.48)

0.81 (0.39, 1.66)

1.75 (0.74, 4.12)

aOR (95% CI) ‡

0.73 (0.35, 1.50)

1.13 (0.42, 3.06)

0.85 (0.40, 1.79)

1.60 (0.65,3.92)

Spontaneous vaginal delivery

OR (95% CI)

1.20 (0.73, 1.97)

0.98 (0.47, 2.04)

1.23 (0.74, 2.02)

0.92 (0.47, 1.78)

aOR (95% CI)‡

1.13 (0.67, 1.91)

1.15 (0.52, 2.51)

1.10 (0.65, 1.85)

1.06 (0.52, 2.17)

Caesarean section

OR (95% CI)

0.67 (0.39, 1.13)

0.72 (0.31, 1.67)

0.66 (0.38, 1.14)

0.90 (0.44, 1.87)

aOR (95% CI)‡

0.69 (0.39, 1.20)

0.59 (0.24, 1.43)

0.72 (0.41, 1.27)

0.75 (0.34, 1.67)

LBW <2.5 kg

OR (95% CI)

0.89 (0.31, 2.53)

–

1.24 (0.41, 3.76)

0.45 (0.05, 3.89)

aOR (95% CI)‡

0.87 (0.30, 2.51)

–

1.25 (0.41, 3.86)

0.47 (0.05, 4.21)

Macrosomia >4.0 kg

OR (95% CI)

0.19 (0.04, 0.96)*

0.94 (0.18, 4.77)

0.11 (0.01, 0.93)*

1.14 (0.28, 4.68)

aOR (95% CI)‡

0.19 (0.04, 1.02)

1.04 (0.18, 5.95)

0.10 (0.01, 0.87)*

0.85 (0.19, 3.86)

SGA

OR (95% CI)

2.79 (0.89, 8.69)

0.77 (0.08, 7.32)

3.87 (1.09, 13.82)*

1.48 (0.23, 9.46)

 

aOR (95% CI)‡

4.52 (1.26, 16.24)*

0.72 (0.07, 7.78)

5.44 (1.36, 21.77)*

1.22 (0.14, 10.31)

LGA

OR (95% CI)

0.35 (0.06, 2.18)

2.21 (0.34, 14.39)

1.12 (0.10, 12.60)

10.10 (1.07, 95.70)*

aOR (95% CI)‡

0.29 (0.04, 2.27)

2.25 (0.29, 17.50)

0.68 (0.05, 8.97)

5.66 (0.48, 66.64)

Born <37 weeks

OR (95% CI)

3.17 (1.14, 8.80)*

2.03 (0.44, 9.41)

3.18 (1.14, 8.88)*

1.94 (0.48, 7.95)

aOR (95% CI)‡

3.38 (1.17, 9.73)*

2.76 (0.55, 13.69)

3.55 (1.23, 10.21)*

3.14 (0.70, 14.19)

Born ≥42 weeks

OR (95% CI)

0.30 (0.12, 0.79)*

0.47 (0.09, 2.33)

0.35 (0.13, 0.94)*

0.56 (0.14, 2.21)

aOR (95% CI)‡

0.27 (0.10, 0.73)*

0.58 (0.11, 3.02)

0.34 (0.13, 0.93)*

0.82 (0.19, 3.55)

Postpartum Haemorrhage

OR (95% CI)

1.00 (0.43, 2.33)

2.26 (0.80, 6.37)

1.03 (0.43, 2.47)

2.45 (0.93, 6.44)

aOR (95% CI)‡

0.98 (0.41, 2.34)

2.11 (0.72, 6.17)

1.13 (0.47, 2.77)

2.40 (0.88, 6.51)

Perineal sutures

OR (95% CI)

0.60 (0.39, 0.91)*

0.85 (0.44, 1.64)

0.60 (0.39, 0.91)*

0.63 (0.34, 1.14)

aOR (95% CI)‡

0.56 (0.34, 0.91)*

0.72 (0.34, 1.50)

0.51 (0.31, 0.83)**

0.57 (0.29, 1.14)

Initial feed at breast

OR (95% CI)

1.89 (0.91, 3.93)

0.97 (0.36, 2.59)

1.59 (0.75, 3.38)

0.82 (0.33, 2.01)

aOR (95% CI)‡

1.68 (0.78, 3.62)

1.16 (0.41, 3.32)

1.33 (0.61, 2.92)

1.05 (0.40, 2.78)

Breastfeeding at discharge

OR (95% CI)

0.86 (0.54, 1.38)

0.95 (0.46,1.94)

0.83 (0.52, 1.32)

1.02 (0.53, 1.96)

aOR (95% CI)‡

0.86 (0.54, 1.39)

1.02 (0.49, 2.13)

0.83 (0.51, 1.33)

1.20 (0.61, 2.36)

Back pain

OR (95% CI)

0.05 (0.01, 0.37)**

1.43 (0.51, 4.01)

0.07 (0.01, 0.54)*

1.96 (0.74, 5.16)

aOR (95% CI)‡

0.06 (0.01, 0.43)**

1.29 (0.42, 3.96)

0.07 (0.10, 0.60)*

2.10 (0.70, 6.25)

Neonatal intensive care admission

OR (95% CI)

0.41 (0.07, 2.49)

1.94 (0.32, 11.91)

0.74 (0.10, 5.28)

3.64 (0.60, 22.27)

aOR (95% CI)‡

0.50 (0.08, 3.19)

1.44 (0.22, 9.65)

0.89 (0.12, 6.68)

2.40 (0.35, 16.33)

  1. Reference group: recommended weight gain
  2. ‡Adjusted for woman’s education, district type (urban/ rural), maternal age, parity and maternal body mass index
  3. IOM institute of medicine, BMI Body mass index, MD mean difference, aMD adjusted mean difference, OR odds ratio, aOR adjusted odds ratio, LBW low birth weight, SGA small for gestational age, LGA large for gestational age
  4. * = p < 0.05, ** = p < 0.01, *** = p < 0.001