Gestational weight gain among pregnant women in Ibadan, Nigeria: Pattern, predictors and pregnancy outcomes

Abstract

Background: 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).

Methodology: 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.

Results: 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.

Conclusions: 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.

Fig 1. Flowchart of study participants.

Fig 2. GWG according to BMI in Ibadan, Nigeria.

Fig 3. 1_2_3_4: Forest plots showing the association of specific pregnancy outcomes with GWG by maternal BMI (caesarean section, spontaneous vaginal delivery, macrosomia and postpartum haemorrhage).

Footnote for the forest plots ^1. Underweight weight was absent from the forest plots because they made up a very low proportion of the final analysis 36 (2.9%) and was mostly omitted from the output of the stratified analysis for the forest plots.