Rate of gestational weight gain trajectory is associated with adverse pregnancy outcomes

Objective: To examine the gestational weight gain (GWG) trajectory and its possible association with pregnancy outcomes. Design: GWG trajectories were identified using the latent class growth model. Binary logistic regression was performed to examine the associations between adverse pregnancy outcomes and these trajectories. Setting: Negeri Sembilan, Malaysia. Participants: Two thousand one hundred ninety-three pregnant women. Results: Three GWG trajectories were identified: 'Group 1 - slow initial GWG but followed by drastic GWG', 'Group 2 - maintaining rate of GWG at 0 center dot 58 kg/week' and 'Group 3 - maintaining rate of GWG at 0 center dot 38 kg/week'. Group 1 had higher risk of postpartum weight retention (PWR) (adjusted OR (AOR) 1 center dot 02, 95 % CI 1 center dot 01, 1 center dot 04), caesarean delivery (AOR 1 center dot 03, 95 % CI 1 center dot 01, 1 center dot 04) and having low birth weight (AOR 1 center dot 04, 95 % CI 1 center dot 02, 1 center dot 05) compared with group 3. Group 2 was at higher risk of PWR (AOR 1 center dot 18, 95 % CI 1 center dot 16, 1 center dot 21), preterm delivery (AOR 1 center dot 03, 95 % CI 1 center dot 01, 1 center dot 05) and caesarean delivery (AOR 1 center dot 02, 95 % CI 1 center dot 01, 1 center dot 03), but at lower risk of having small-for-gestational-age infants (AOR 0 center dot 97, 95 % CI 0 center dot 96, 0 center dot 99) compared with group 3. The significant associations between group 1 and PWR were observed among non-overweight/obese women; between group 1 and caesarean delivery among overweight/obese women; group 2 with preterm delivery and caesarean delivery were only found among overweight/obese women. Conclusions: Higher GWG as well as increasing GWG trajectories was associated with higher risk of adverse pregnancy outcomes. Promoting GWG within the recommended range should be emphasised in antenatal care to prevent the risk of adverse pregnancy outcomes.