Body Mass Index Changes during Pregnancy and Perinatal Outcomes - A Cross-Sectional StudyMudanças do índice de massa corporal na gravidez e resultados perinatais - um estudo transversal
11 August 2017
17 October 2017
18 December 2017 (eFirst)
Objective To evaluate the relation between changes the body mass index (BMI) percentile, reflected in the Atalah curve, and perinatal outcomes.
Methods A cross-sectional study with 1,279 women was performed. Data regarding gestational weight, sociodemographic characteristics and perinatal outcomes were collected through medical charts, prenatal card and interviews in the postpartum period. Women could be classified according to the Atalah curve in the following categories: low weight, adequate weight, overweight, and obese. The BMI was calculated at the first and at the last prenatal care visits, and these values were compared.
Results An increase in the BMI category according to the Atalah classification occurred in 19.9% of pregnant women, and an increase of 3.4, 5.8 and 6.4 points of BMI were found for women respectively classified in the adequate weight, overweight and obese categories at the first prenatal visit. Women with high school education presented a lower chance of increasing their BMI (odds ratio [OR] 0:47 [0.24- 0.95]). Women who evolved with an increase in the the Atalah classification were associated with cesarean section (OR 1.97–2.28), fetal macrosomia (OR 4.13–12.54) and large for gestational age newborn (OR 2.88–9.83).
Conclusion Pregnant women who gained enough weight to move up in their BMI classification according to the Atalah curve had a higher chance of cesarean section and macrosomia. Women classified as obese, according to the Atalah curve, at the first prenatal visit had a high chance of cesarean section and delivering a large for gestational age newborn.
Objetivo Avaliar a relação entre mudanças no percentual do índice de massa corporal (IMC), refletidas na curva de Atalah, e resultados perinatais.
Métodos Foi realizado um estudo transversal com 1.279 mulheres. Os dados sobre o peso na gestação, características sociodemográficas e resultados perinatais foram coletados através de prontuários, cartão pré-natal e entrevistas no pós-parto. As mulheres foram classificadas de acordo com a curva de Atalah nas seguintes categorias: baixo peso, peso adequado, sobrepeso e obesidade. O IMC foi calculado na primeira e na última visita ao pré-natal e esses valores foram comparados.
Resultados Houve aumento na categoria do IMC segundo a classificação de Atalah em 19,9% das mulheres grávidas e um aumento de 3,4; 5,8 e 6,4 pontos do IMC foram encontrados para mulheres respectivamente classificadas nas categorias peso adequado, sobrepeso e obesidade na primeira consulta pré-natal. As mulheres com educação secundária apresentaram menor chance de aumentar sua classificação de IMC (odds ratio [OR] 0:47 [0,24- 0,95]). As mulheres que evoluíram com o aumento na classificação de Atalah foram associadas a cesariana (OR 1,97–2,28), macrossomia fetal (OR 4,13–12,54) e recém-nascido grande para a idade gestacional (OR 2,88–9,83).
Conclusão Gestantes com ganho de peso excessivo, o suficiente para aumentar sua classificação do IMC segundo a curva de Atalah, tiveram maiores chances de cesariana e macrossomia. As mulheres classificadas como obesas na primeira visita pré-natal, de acordo com a curva de Atalah, tiveram uma grande chance de cesariana e recém-nascido grande para a idade gestacional.
The idea for the study and this specific analytical approach arose in a group discussion among Morais S. S., Surita F. G. and Nascimento S. L. Analyses were planned and performed by Morais S. S. and Surita F. G. The first version of the manuscript was drafted by Morais S. S. and then complemented with suggestions from all the others. Nascimento SL, Godoy-Miranda AC and Kasawara K. T. contributed to the development of the study protocol and data collection. All authors read and approved the final version of the manuscript.
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