RESUMO
BACKGROUND: Gestational weight gain (GWG) is an important indicator for monitoring maternal and fetal health. OBJECTIVE: To evaluate the effect of GWG outside the recommendations of the Institute of Medicine (IOM) on fetal and neonatal outcomes. STUDY DESIGN: A prospective cohort study with 1642 pregnant women selected from 2017 to 2023, with gestational age ≤ 18 weeks and followed until delivery in the city of Araraquara, Southeast Brazil. The relationship between IOM-recommended GWG and fetal outcomes (abdominal subcutaneous tissue thickness, arm and thigh subcutaneous tissue area and intrauterine growth restriction) and neonatal outcomes (percentage of fat mass, fat-free mass, birth weight and length, ponderal index, weight adequateness for gestational age by the Intergrowth curve, prematurity, and Apgar score) were investigated. Generalized Estimating Equations were used. RESULTS: GWG below the IOM recommendations was associated with increased risks of intrauterine growth restriction (IUGR) (aOR 1.61; 95% CI: 1.14-2.27), low birth weight (aOR 2.44; 95% CI: 1.85-3.21), and prematurity (aOR 2.35; 95% CI: 1.81-3.05), and lower chance of being Large for Gestational Age (LGA) (aOR 0.38; 95% CI: 0.28-0.54), with smaller arm subcutaneous tissue area (AST) (-7.99 g; 95% CI: -8.97 to -7.02), birth length (-0.76 cm; 95% CI: -1.03 to -0.49), and neonatal fat mass percentage (-0.85%; 95% CI: -1.12 to -0.58). Conversely, exceeding GWG guidelines increased the likelihood of LGA (aOR 1.53; 95% CI: 1.20-1.96), with lower 5th-minute Apgar score (aOR 0.42; 95% CI: 0.20-0.87), and increased birth weight (90.14 g; 95% CI: 53.30 to 126.99). CONCLUSION: Adherence to GWG recommendations is crucial, with deviations negatively impacting fetal health. Effective weight control strategies are imperative.
Assuntos
Retardo do Crescimento Fetal , Ganho de Peso na Gestação , Humanos , Feminino , Gravidez , Adulto , Recém-Nascido , Estudos Prospectivos , Brasil/epidemiologia , Retardo do Crescimento Fetal/epidemiologia , Resultado da Gravidez/epidemiologia , Peso ao Nascer , Recém-Nascido de Baixo Peso , Nascimento Prematuro/epidemiologia , Adulto Jovem , Estudos de Coortes , Idade GestacionalRESUMO
Objetivo: descrever o perfil sociodemográfico e antropométrico de gestantes internadas com diagnóstico de pré-eclâmpsia grave em maternidade de referência. Métodos: estudo descritivo e transversal, realizado em Teresina Piauí, com 114 prontuários de gestantes internadas com diagnóstico de pré-eclâmpsia grave. Resultados: as gestantes com baixo peso possuem idade entre 19 a 25 anos, são solteiras e escolaridade até o ensino fundamental. Mulheres com índice de massa corporal adequado têm entre 12 a 19 anos de idade, são majoritariamente casadas e com renda familiar de um a três salários mínimos. E as obesas estão na faixa etária de 33 a 39 anos, sendo predominantemente casadas, com grau de instrução até o ensino fundamental e renda de um salário mínimo. Conclusão: a descrição do perfil antropométrico é relevante para que os profissionais de saúde realizem o planejamento da assistência integral, a fim de reduzir os agravos decorrentes de síndromes hipertensivas.(AU)
Objective: describe the sociodemographic and anthropometric profile of pregnant women hospitalized with diagnosis of severe preeclampsia in a referral maternity hospital. Methods: a descriptive and cross-sectional study conducted in Teresina - Piaui, with 114 medical records of pregnant women hospitalized with diagnosis of severe preeclampsia. Results: underweight pregnant women are between 19 and 25 years old, single and have education until elementary school. Women with adequate body mass index are between 12 and 19 years old, are mostly married and have a family income of one to three minimum wages. And the obese are in the age group of 33 to 39 years, being predominantly married, with education until elementary school and income of a minimum wage. Conclusion: the description of the anthropometric profile is relevant for health professionals to perform comprehensive care planning, in order to reduce the problems resulting from hypertensive syndromes.(AU)