Topical Area: Maternal, Perinatal and Pediatric Nutrition

Objectives : To compare gestational weight gain (GWG) trajectories of Brazilian women with three international charts used to monitor GWG, and to test whether there are differences in the classification of total GWG centiles between these charts.

Methods : This is a multiple combined cohort dataset with data from 10 Brazilian studies with repeated measures (mean of 6.9 measures) of GWG. Total GWG was obtained by the difference between the weight measured up to 14 days before delivery and the weight measured in the 1st trimester [Intergrowth-21st, I-chart] or the pre-pregnancy self-reported weight [Life-cycle project, L-charts; and Hutcheon, H-charts]. A total of 3,423 (23,340 observations) adult women with singleton pregnancies and free of hypertension and diabetes were included. We compared graphically the mean linear prediction (linear mixed-effect models) of Brazilian women GWG with the 50th centile of three international charts. The agreement of total GWG classification in < 10th, 10th–90th and >90th centiles was tested using Cohen's kappa coefficient according to Landis & Koch classification.

Results : Women had a mean total GWG of 12.2 kg (SD: 5.8) and were, on average, 27.4 (SD: 5.8) years old. Pre-pregnancy normal weight women had a different pattern of GWG compared to I-chart, and the mean GWG of this group was slightly higher than the 50^th centile of the L-chart. Underweight and obese women presented a different slope of GWG compared with the 50^th centiles of H and L-charts. Pre-pregnancy overweight women presented a linear prediction that overlaps the 50^th centile of the L-chart in the second half of pregnancy (Figure). It was observed a moderate agreement (kappa=0.56) comparing the 10^th, 10^th–90^th and 90^th centiles classification between L and I-charts for normal weight women. L and H-charts presented a substantial agreement for underweight (kappa=0.71), and moderate for overweight (kappa=0.52) and obese women (kappa=0.59).

Conclusions : L-charts are the ones that most closely resemble the Brazilian GWG distribution, especially for overweight women. We observed moderate agreement in the GWG classification of women in the 10^th and 90^th centiles between charts, which may lead to different diagnosis of GWG depending on which chart is used. This is a first step to create new Brazilian GWG recommendations.

Funding Sources : The Brazilian National Council for Scientific and Technological Development and Bill and Melinda Gates Foundation (Grand Challenges Exploration).

Presenting Author(s)

• 

  Dayana Farias

  Federal University of Rio de Janeiro

Co-Author(s)

• TC

  Thais Carrilho

  Nutrition Institute, Rio de Janeiro Federal University

• RA

  Ronaldo Alves

  Nutritional Epidemiology Observatory, Rio De Janeiro Federal University

• NC

  Nathalia Costa

  Nutritional Epidemiology Observatory, Rio De Janeiro Federal University

• MB

  Monica Batalha

  Nutritional Epidemiology Observatory, Rio De Janeiro Federal University

• EA

  Emanuelli Aguiar

  Student
  Federal University of Rio de Janeiro

• MG

  Mylena Gonzalez

  Student
  Federal University of Rio de Janeiro

• GK

  Gilberto Kac

  Professor
  Federal University of Rio de Janeiro

• BC

  Brazilian Gestational Weight Gain Consortium

  Nutritional Epidemiology Observatory, Rio De Janeiro Federal University

• MD

  Marlos Domingues

  Nutrition Epidemiology Observatory

• MD

  Michele Drehmer

  Nutritional Epidemiology Observatory, Rio De Janeiro Federal University

• SG

  Silvana Granado

  Nutritional Epidemiology Observatory, Rio De Janeiro Federal University

• ML

  Maria do Carmo Leal

  Nutritional Epidemiology Observatory, Rio De Janeiro Federal University

• AP

  Ana Paula Pereira

  Nutritional Epidemiology Observatory, Rio De Janeiro Federal University

• MC

  Maria Antonieta Carvalhaes

  Nutritional Epidemiology Observatory, Rio De Janeiro Federal University

• CP

  Cristina Parada

  Nutritional Epidemiology Observatory, Rio De Janeiro Federal University

• CG

  Caroline Gomes

  Nutritional Epidemiology Observatory, Rio De Janeiro Federal University

• EF

  Elizabeth Fujimori

  Nutritional Epidemiology Observatory, Rio De Janeiro Federal University

• AS

  Ana Paula Sato

  Nutritional Epidemiology Observatory, Rio De Janeiro Federal University

• SS

  Silvia Saldiva

  Nutritional Epidemiology Observatory, Rio De Janeiro Federal University

• JC

  José Cecatti

  Nutritional Epidemiology Observatory, Rio De Janeiro Federal University

• DR

  Daniela Rocha

  Nutritional Epidemiology Observatory, Rio De Janeiro Federal University

• RS

  Renato Souza

  Nutritional Epidemiology Observatory, Rio De Janeiro Federal University