CC BY 4.0 · Rev Bras Ginecol Obstet 2019; 41(04): 220-229
DOI: 10.1055/s-0039-1683373
Original Article
Thieme Revinter Publicações Ltda Rio de Janeiro, Brazil

Maternal Weight Variation in Different Intrauterine Environments: An Important Role of Hypertension

Variação de peso materno em diferentes ambientes intrauterinos: um papel importante da hipertensão
1   Postgraduate Program in Child and Adolescent Health, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
,
Charles Francisco Ferreira
1   Postgraduate Program in Child and Adolescent Health, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
,
Amanda Pereira Ferreira
1   Postgraduate Program in Child and Adolescent Health, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
,
Luciano Santos Pinto Guimarães
1   Postgraduate Program in Child and Adolescent Health, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
,
Vera Lúcia Bosa
1   Postgraduate Program in Child and Adolescent Health, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
,
Juliana Rombaldi Bernardi
1   Postgraduate Program in Child and Adolescent Health, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
,
Marcelo Zubaran Goldani
1   Postgraduate Program in Child and Adolescent Health, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
,
Clécio Homrich da Silva
1   Postgraduate Program in Child and Adolescent Health, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
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Weitere Informationen

Publikationsverlauf

04. September 2018

28. Januar 2019

Publikationsdatum:
02. April 2019 (online)

Abstract

Objective Different intrauterine environments may influence the maternal prepregnancy body weight (BW) variation up to 6 months postpartum. The objective of the present study was to verify the association of sociodemographic, obstetric, nutritional, and behavioral factors with weight variation in women divided into four groups: hypertensive (HM), diabetic (DM), smokers (SM), and control mothers (CM).

Methods It was a convenience sample of 124 postpartum women recruited from 3 public hospitals in the city of Porto Alegre, state of Rio Grande do Sul, Brazil, between 2011 and 2016. Multiple linear regressions and generalized estimating equations (GEE) were conducted to identify the factors associated with maternal weight variation. For all GEE, the maternal weight measurements were adjusted for maternal height, parity, educational level, and the type of delivery, and 3 weight measurements (prepregnancy, preceding delivery, and 15 days postpartum) were fixed.

Results A hierarchical model closely associated the maternal diagnosis of hypertension and a prepregnancy body mass index (BMI) classified as overweight with maternal weight gain measured up to the 6th month postpartum (the difference between the maternal weight at 6 months postpartum and the prepregnancy weight). These results showed that the BW of the HM group and of overweight women increased ∼ 5.2 kg 6 months postpartum, compared with the other groups. Additionally, women classified as overweight had a greater BW variation of 3.150 kg.

Conclusion This evidence supports the need for specific nutritional guidelines for gestational hypertensive disorders, as well as great public attention for overweight women in the fertile age.

Resumo

Objetivo Diferentes ambientes intrauterinos podem influenciar a variação de peso corporal pré-gestacional materno até 6 meses pós-parto. O objetivo do presente estudo foi verificar a associação de fatores sociodemográficos, obstétricos, nutricionais e comportamentais com a variação de peso em mulheres divididas em quatro grupos: hipertensas (HM), diabéticas (DM), tabagistas (SM) e controles (CM).

Métodos Amostra de conveniência de 124 puérperas recrutadas em 3 hospitais públicos da cidade de Porto Alegre, Rio Grande do Sul, Brasil, entre 2011 e 2016. Regressões lineares múltiplas e modelos de equações de estimativas generalizadas (GEE) foram realizados para identificar os fatores associados à variação do peso materno. Para todas as GEE, as medidas de peso materno foram ajustadas para a estatura materna, paridade, escolaridade e tipo de parto, e três medidas de peso (pré-gravidez, anterior ao parto e 15 dias pós-parto) foram fixadas.

Resultados Um modelo hierárquico associou o diagnóstico materno de hipertensão e o índice de massa corporal (IMC) pré-gestacional de sobrepeso com ganho de peso materno medido até o 6° mês pós-parto (diferença entre o peso materno aos 6 meses pós-parto e o peso pré-gestacional). Estes resultados mostraram que o grupo HM e mulheres com sobrepeso aumentaram o peso corporal em ∼ 5,2 kg 6 meses pós-parto, em comparação com os demais grupos. Além disso, as mulheres classificadas com sobrepeso tiveram uma variação maior de peso corporal, de 3,150 kg.

Conclusão Evidenciou-se a necessidade de diretrizes nutricionais específicas para distúrbios hipertensivos gestacionais, bem como de maior atenção dos serviços de saúde públicos para mulheres com excesso de peso em idade fértil.

Contributors

All of the authors listed above participated in the study to a significant extent. Cazarotto B. R., Ferreira C. F., Ferreira A. P., Guimarães L. S. P., Bernardi J. R., Goldani M. Z., and da Silva C. H. worked on the analysis and interpretation of data, critically reviewed and revised the manuscript. Cazarotto B. R., Ferreira C. F., Ferreira A. P., Bosa V. R., Bernardi J. R., Goldani M. R., and da Silva C. H. worked on the conception, on the design and on the data collection.


 
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