Adequacy of weight gain in pregnant women from two municipalities of Rio de Janeiro state (RJ), Brazil, 2008

PURPOSE: To evaluate sociodemographic, behavioral and reproductive factors and morbidities associated with inadequate weight gain during pregnancy. METHODS: Cohort study conducted from December 2007 to August 2008 with women in the first trimester of pregnancy looking for prenatal care in the Public Health System who lived in the cities of Petropolis or Queimados, Rio de Janeiro state (Brazil). Women with multiple pregnancy, who had a miscarriage in the index pregnancy or who lacked information for the assessment of pregravid nutritional status or weight gain were excluded. Pregravid nutritional status and weight gain during pregnancy were determined according to the criterion established by the Institute of Medicine (IOM). Statistical analysis was performed using a multinomial logistic regression model. RESULTS: A total of 1,287 women were included in the study; 26.6% of them were overweight or obese while 11% were underweight. Inadequate weight gain during pregnancy was observed in 71.4% of pregnant women; 35.6% of them did not gain enough weight while 35.8% gained more weight than recommended by the IOM. In the multivariate analysis, women with hypertension (OR=2.1; 95% CI 1.4-3.1), pregravid overweight (OR=2.5; 95% CI 1.4-4.5) or obesity (OR=2.7; 95% CI 1.8-3.9) and who had a higher educational level were more likely to gain more weight than recommended, while pregravid underweight (OR=0.6; 95% CI 0.4-0.9) represented a protection against excessive gain. CONCLUSION: Pregravid nutritional diagnosis and weight gain monitoring should be actions effectively instituted in the routine of health professionals.