Perception of Weight Status and its Impact on Gestational Weight Gain in an Urban Population
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Perception of Weight Status and its Impact on Gestational Weight Gain in an Urban Population Shilpi S. Mehta-Lee • Jennifer L. Lischewski Goel • Linzhi Xu • Mindy R. Brittner • Peter S. Bernstein • Karen A. Bonuck
Ó Springer Science+Business Media New York 2013
Abstract To examine the association between actual and perceived overweight/obese status and excess gestational weight gain (GWG). As part of an infant feeding trial, multi-ethnic lower and moderate income women-completed a checklist of current health conditions, including ‘‘overweight/obesity,’’ ‘‘asthma,’’ and ‘‘hypertension’’ while pregnant. Odds of excessive GWG per the Institute of Medicine guidelines in ‘accurate’ versus ‘inaccurate’ reporters, by overweight status were analyzed with multivariate logistic regression for women with pre-or early pregnancy BMIs of C18.5. 775 women met study criteria. Just 21 % (n = 107) of overweight/obese women
accurately identified their weight status, compared to [90 % accurate report of documented hypertension or asthma. Compared to normal-weight accurate reporters, the adjusted odds of excessive GWG in overweight/obese women was 2.3 (95 % CI 1.4, 3.7) in accurate reporters, and 2.5 (95 % CI 1.7, 3.4) in inaccurate reporters. Overweight/obesity is associated with excessive GWG, but this risk is not modified by inaccurate reporting/perception of weight-status.
Portions of these findings presented at: The Pregnancy Meeting, ‘‘The 31st Annual Meeting of the Society for Maternal-Fetal Medicine’’ San Francisco, CA, February 11, 2011.
Introduction
S. S. Mehta-Lee (&) Department of Obstetrics and Gynecology, Maternal-Fetal Care Center, NYU Langone Medical Center, 150 East 32nd St., Suite 101, New York, NY 10016, USA e-mail: [email protected] J. L. Lischewski Goel K. A. Bonuck Department of Family and Social Medicine, Albert Einstein College of Medicine, Bronx, NY, USA L. Xu Department of Pediatrics, Baylor College of Medicine, Waco, TX, USA M. R. Brittner Robert Wood Johnson Medical School, UMDNJ, New Brunswick, NJ, USA P. S. Bernstein Obstetrics and Gynecology and Women’s Health, Albert Einstein College of Medicine/Montefiore Medical Center, Bronx, NY, USA
Keywords Gestational weight gain Obesity Weight perception Body-mass index
Adverse neonatal and obstetric effects of pre-pregnancy obesity include pregnancy-induced hypertension, preeclampsia, gestational diabetes, cesarean section, and neonatal death [1–6]. More recently, gestational weight gain (GWG) has been linked to adverse neonatal and obstetric outcomes including large-for-gestational-age infants, shoulder dystocia and wound infections [7, 8]. Significantly greater pregnancy co-morbidities are seen in obese pregnant women who gain in excess of 15 lbs. [9]. In 1990 the Institute of Medicine (IOM) issued guidelines [10] for appropriate GWG. Since that time the proportion of reproductive age women who are overweight or obese (BMI C25.0 kg/m2) increased from 37 % [11] to 59.5 % in 2007–2008 [12]. In 2009, based upon growing evidence of adverse
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