Phyllis Brawarsky, MPH¹, Elena Fuentes-Afflick, MD², Anita L. Stewart, PhD³, Rebecca Jackson, MD⁴, Mitzi Dean, MHA², Gabriel J. Escobar, MD⁵, Nick Rubashkin, MS⁶, and Jennifer Haas, MD, MSPH⁷. (1) Division of General Medicine, Brigham and Women's Hospital, 1620 Tremont Street, Boston, MA 02120, 617-732-5500, ext 32951, pbrawarsky@partners.org, (2) University of California, San Francisco, Box 0936, San Francisco, CA 94143, (3) Institute for Health & Aging, University of California San Francisco, 3333 California Street, Suite 340, San Francisco, CA 94118, (4) Women's Health Clinic, San Francisco General Hospital, San Francisco Public Health Deparment, San Francisco General Hospital, 1001 Potrero Avenue, 5M, San Francisco, CA 94110, (5) Division of Research, Kaiser Permanente, 2000 Broadway, Oakland, CA 94612, (6) Stanford University Medical School, 270 Liberty Street, San Francisco, CA 94114, (7) General Medicine, Brigham and Women's Hospital/ Harvard Medical School, 1620 Tremont St, Boston, MA 02458

Objective: The Institute of Medicine (IOM)-recommended gestational weight gain, based on pre-pregnancy weight/height, is associated with better maternal and infant outcomes. Our objective was to identify risk factors, including pregnancy diet, associated with inadequate and excessive weight gain and to determine if risk factors differed by race/ethnicity.

Study design:

The study sample was 1152 women from a longitudinal cohort of pregnant women who answered questions about frequency of consumption of specific foods (ie, weekly servings of chicken/turkey) and weight gain during pregnancy and delivered a singleton, full-term infant. Additional information included socio-demographics, risk-related behaviors, and pre-pregnancy and pregnancy health conditions including diabetes, hypertension and depression.

Results:

One-third of women gained within IOM recommendations. Weight gain was inadequate for 16% of women, excessive for 50%. Multivariate analysis showed Blacks (OR = 2.2) and Hispanics (OR = 1.8) were more likely than Whites to have inadequate weight gain, which was also positively associated with insufficient money for food during pregnancy, and diabetes prior to or during pregnancy. Excessive weight gain was positively associated with being overweight prior to pregnancy and smoking but not exercise. Although diet differed by race, there was little association between any specific food and inadequate/excessive weight gain.

Conclusion:

Inadequate weight gain has been associated with pre-term birth and small-for- gestational-age infants while excessive weight gain has been associated with large-for gestational-age-infants and maternal weight retention. These findings can help identify women at risk for inappropriate weight gain and develop interventions to assist women achieve recommended gain.

Learning Objectives:

(
• Identify the risk factors for inadequate and excessive weight gain during pregnancy; (
• Understand racial differences in inadequate and excessive weight gain; (
• Examine the role of diet in inadequate and excessive gestational weight gain.

Keywords: Maternal Health, Infant Health

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.