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Topical Area: Maternal, Perinatal and Pediatric Nutrition

Maternal, Perinatal and Pediatric Nutrition (II) (Poster Session)

(P18-046-23) The Association Between Gestational Weight Gain Rate and Birth Outcomes Among Nepalese Women

Sunday, July 23, 2023
12:45 PM – 1:45 PM ET
Location: Poster Board 520

    Presenting Author(s)

  • Shristi Rawal, PhD (she/her/hers)

    Assistant Professor
    Rutgers University
    Philadelphia, Pennsylvania, United States

    • Co-Author(s)

  • JN

    Jyoti Nepal, Masters in Public Health

    Department of Research and Development, Dhulikhel Hospital-Kathmandu University Hospital, Nepal

  • KC

    Kalpana Chaudhary, Master's in public health

    Department of Public Health, Kathmandu University School of Medical Sciences, Institute for Implementation Science and Health, Nepal

  • KS

    Kusum Shrestha

    Department of Nursing, Dhulikhel Hospital-Kathmandu University Hospital, Nepal

  • MK

    Manita Karmacharya

    Department of Nursing, Dhulikhel Hospital-Kathmandu University Hospital, Nepal

  • BA

    Bikram Adhikari

    Department of Research, HERD international, Nepal

  • AS

    Abha Shrestha, MD

    Department of Obstetrics and Gynecology, Dhulikhel Hospital-Kathmandu University Hospital, Nepal

  • SS

    Shanti Subedi, MD

    Department of Obstetrics and Gynecology, Nobel Medical College Teaching Hospital, Nepal

  • SK

    Sangita P. Kapri

    School of Nursing-Camden, Rutgers University

  • AS

    Archana Shrestha, PhD

    Associate Professor
    Department of Public Health, Kathmandu University School of Medical Sciences, Nepal, Institute for Implementation Science and Health, Nepal, Department of Chronic Disease Epidemiology, Yale School of Public Health
    Dhulikhel, Bagmati, Nepal

Disclosure(s):
Shristi Rawal, PhD: No relevant financial relationship(s) with ineligible companies to disclose.


Objectives: Gestational weight gain (GWG) has been associated with pregnancy outcomes including birth weight but only few studies have been conducted in low-income countries including Nepal. We prospectively examined the association of GWG rate with neonatal birth weight and cesarean delivery in a pregnancy cohort in Nepal.

Methods: This prospective cohort study was conducted from January 2019 to August 2021 at a tertiary peri urban hospital in Dhulikhel, Nepal. In total, 191 pregnant women who had a singleton, liveborn and term delivery were included in the analysis. Data was obtained through semi-structured interviews and medical records. GWG rate was calculated as the measured weight gain from the 2nd trimester to late pregnancy, divided by the number of weeks in between. GWG rate was categorized as inadequate, adequate, or excessive based on the pre-pregnancy body mass index (BMI) specific GWG recommendations from the 2009 Institute of Medicine (IOM) report. Descriptive and regression analyses were performed in SPSS.

Results: The mean GWG rate from 2nd to 3rd trimester was 0.5 ± 0.2kg/week. Half of the mothers (52.4%) had a GWG rate exceeding the recommended GWG rate based on IOM guidelines. The mean birth weight of the neonates was 2964.9 ± 407.0 grams. Around 45% of the mothers had cesarean delivery. For every 1 kg per week increase in mother’s gestational weight from 2nd to 3rd trimester, the mean birth weight of the neonate increased by 264 grams (β=264.3, 95%CI=22.5-506.0, p=0.03). Significant positive association was observed between maternal pre-pregnancy BMI and neonatal birth weight (β=17.0, 95%CI=1.6-32.6, p=0.03). The pregnant women with inadequate GWG rate had 60% lower odds of having cesarean delivery compared to women with adequate GWG rate (OR=0.4, 95%CI=0.1-0.9, p=0.02). All associations were attenuated after adjusting for potential confounders including age, pre-pregnancy BMI, education, ethnicity, occupation and parity.

Conclusions: Maternal GWG rate was positively and significantly associated with infant birth weight and cesarean delivery. A larger study is warranted to investigate the influence of GWG rate on other adverse neonatal and maternal outcomes in this population.

Funding Sources: Rutgers Global Health Institute; NIH/FIC