Maternal Weight Gain and Correlation with Birth Weight Infants

  Procedia - Social and Behavioral Sciences Latest issue Special issues All issues About the journal Follow journal 13th International Educational Technology Conference Edited by Aytekin ISMAN, Saedah SIRAJ, Mubin KIYICI Volume 103, Pages 1-1356 (26 November 2013)

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Copyright © 2018 Elsevier B.V. or its licensors or contributors. ScienceDirect ® is a registered trademark of Elsevier B.V. Available online at www.sciencedirect.com _{Procedia - Social and Behavioral Sciences 103 ( 2013 ) 647 – 656} ScienceDirect th

  13 International Educational Technology Conference

  Maternal weight gain and correlation with birth weight infants _{a a a,* Abstract Department of Obstetrics and Gynecology, Universitas Sumatera Utara, Medan, Indonesia} S. Lumbanraja , D. Lutan , I. Usman _{all trimester of pregnancy and its correlation with the birth weight.} Objective: Maternal weight gain affect the infant birth weight. Aim of this study was to describe maternal weight gain during _{Results: Maternal weight gain increased its peak point at the second and third trimester with overall total weight gain ranged Methods: Pregnant women who got antenatal care in Adam Malik General Hospital and Sundari Hospital, underwent body Baby birth weight also measured after delivery. weight measurement during routine examination at first, second and third trimester and also at delivery time at those hospital.}

_{Conclusion: Maternal weight gain in the second and third trimester showed statistically significance difference with baby}

_{between maternal weight gain with baby birth weight with p = 0,03 ( p<0,05, CI 95%), even the correlation was weak.}

_{gain was more higher in the primi gravida group compared with multi and grandemulti gravida groups. There is correlation} at 5 – 20 kg during pregnancy. Baby birth on normal weight ranged at 2500 – 4000 grams ( SD + 399,86 ). Maternal weight _{and better birthweight of the babies. birth weight. Adequate total maternal weight gain based on IOM recommendation considered for resulting a better outcome Universitesi, Turkey. Keywords: Maternal weight, infant birth weight, body mass index Selection and peer-review under responsibility of The Association of Science, Education and Technology-TASET, Sakarya © 2013 The Authors. Published by Elsevier Ltd. Universitesi, Turkey. Selection and peer-review under responsibility of The Association of Science, Education and Technology-TASET, Sakarya} © 2013 The Authors. Published by Elsevier Ltd. Open access under CC BY-NC-ND license.

  Introduction

  The gestational period determine the quality of human resources and depend on the intra uterine condition. Healthy pregnant women with a good nutritional status certainly improves the outcome of baby. Low birth weight rate in developing countries were higher four _{E-mail address: apokrifmail@gmail.com Corresponding author.}

• _{doi: 10.1016/j.sbspro.2013.10.383 Universitesi, Turkey. Selection and peer-review under responsibility of The Association of Science, Education and Technology-TASET, Sakarya 1877-0428 © 2013 The Authors. Published by Elsevier Ltd.}

  Open access under CC BY-NC-ND license.

  648 S. Lumbanraja et al. / Procedia - Social and Behavioral Sciences 103 ( 2013 ) 647 – 656

  times than developed countries. More than 9 million babies die each year, 98% occur in developing countries and most of them caused by low birth weight. Therefore, optimal maternal weight gain is essential for better outcome.

  In 1987, The Global Safe Motherhood Initiative was launched for improving the coverage of Antenatal Care and counseling around the world. This Program concentrated on Nutritional status and Maternal weight gain during pregnancy. Institute of Medicine ( IOM ) in 2009, issued a new revision of maternal weight gain recommendation from the earlier version of 1990 according to Body Mass Index ( BMI ) pre-pregnancy.

  Aims of the present study were 1). To compare maternal weight gain in all trimester and total weight gain during pregnancy, 2). To evaluate the relationship between total _{Patients and Methods} maternal weight gain and infant birth weight.

  Patients

  Pregnant women who were getting ante natal care in Adam Malik General Hospital and Sundari Hospital between August 2012 and January 2013 were eligible for this study. All eligible patients were on delivery time got body weight measurement before and 24 hours after baby birth. And then, maternal weight gain during first, second, and third trimester were collected from the Antenatal record from outpatient care.

  Statistical Analysis

  All data were analyzed with the Statistical Package for the Social Sciences. Correlation between maternal weight gain and infant birth weight were computerized by using Pearson _Results test. P values < 0,05 were considered significant.

  Patients Characteristics

  104 eligible pregnant women were get ante natal care and delivered at Adam Malik General Hospital and Sundari Hospital in Medan. Table 1 showed distribution of subject based on age, parity, pre-pregnancy body weight, height, body mass index and gestational age. As results, most of subjects were on 20-

  35 years with normoweight in body mass index. Most of them were on 38 weeks of gestational _{Table 1} age. Patients Characteristics

  Total ( n=104)

  Age ( years)

  <20 7 (6,7%) 20-35 84 (80,8%) >35 13 (12,5%)

   S. Lumbanraja et al. / Procedia - Social and Behavioral Sciences 103 ( 2013 ) 647 – 656 649 Parity

  Primi 44 (42,3%) Multi 59 (56,7%) Grandemulti 1 (1,0%)

  Pre-pregnancy body weight ( kg )

  Mean 53,06 ( + 7,09)

  Height ( cm )

  Mean 155,85 ( + 5,8)

  Body Mass Index

  Mean 21,78 ( +2,06)

  Gestational Age

  37 weeks 5 ( 4,8%) 38 weeks 54 (51,9%) 39 weeks 31 (29,8%) 40 weeks 14 (13,5%)

  Table 2 showed relations of age and maternal weight gain each trimester. As results, maternal weight gain in third trimester have statistically significance difference between pregnant women from 20-35 years group, with p-value 0,01 ; 5,45 ( p-value < 0,05, CI 95%). On the other hand, no statistically significance difference between maternal weight gain in the first and second trimester between age group with p-value 0,150, and 0,415 respectively ( p- _{Table 2} value < 0,05, CI 95%). Relationship between maternal weight gain each trimester

  Age <20 20-35 (SD) >35 p-value

  (SD) (SD)

  Trimester

  First 0,43(1,13) 0,93(0,91) 0,92(0,93) 0,150 Second 5,00(2,84) 5,33(1,93) 4,50(2,96) 0,415 Third 4,64(2,17) 5,75(2,19) 5,45(2,05) 0,014

  650 S. Lumbanraja et al. / Procedia - Social and Behavioral Sciences 103 ( 2013 ) 647 – 656 _{Table 3}

  Maternal weight gain each trimester Body weight (Kg) Minimal Maximal Mean SD

  Trimester I 3,50 0,90 0,92 Trimester II 10,00 5,21 2,14 Trimester III 0,5 10,50 5,45 2,24 Total increase in 5 20,00 11,56 3,50 Weight

  Kruskall-Wallis test p=0,0001

  Table 3 showed maternal weight gain in each trimesters. As results, there is statistically significance difference between maternal weight gain in each trimester with Kruskall-Wallis test obtained p<0,0001. In overall pregnancy, total maternal weight gain _{Table 4} ranged at 5-20 kg ( 11,56 + 3,5 ) Average of total maternal weight gain and baby birth weight according to gestational age Gestational Maternal Anova Birth weight (gr) Anova Ages weight Test Test gain (Kg) P value P value 37 week Mean 13 3430.0 Std.

  2.72 426.61458 Deviation Minimum 9.5 2850.00

  0.351 0.113 Maximum 17.0 3800.00 38 week Mean

  11.23 3068.52 Std. 3.43 316.57011

  Deviation

  651 S. Lumbanraja et al. / Procedia - Social and Behavioral Sciences 103 ( 2013 ) 647 – 656

  Minimum 5 2500.00 Maximum 20 3800.00 39 week Mean

  12.26 3127.74 Std. Deviation

  3.32 327.35006 Minimum 6 2650.00 Maximum 19 4000.00 40 week Mean

  10.75 3185.71 Std. Deviation

  4.27 388.00702 Minimum 5 2500.00 Maximum 18 3800.00

  Table 4 showed average total maternal weight gain and baby birth with gestational age when delivery. As results, no statistically significance difference with ANOVA test between both of gestational age and total maternal weight gain with p-value 0,351 ( p>0,05), and gestational age and baby birth weight with p-value 0,113 ( p>0,05). On the other hands, we found statistically significance difference between baby birth weight and gestational age at 37 and 38 weeks with p-value 0,023 (p<0,05). _{Table 5} Relationship between maternal weight gain with parity in each trimesters.

  Parity Primi (SD)

  Multi (SD)

  Grande multi (SD)

  p-value Trimester

  First Second Third

  0,86(0,92) 5,51(2,13) 6,08(2,18)

  0,91(0,93) 5,01(2,15) 5,03(2,18)

  2,0 3,5 2,0

  0,444 0,365 0,018

  652 S. Lumbanraja et al. / Procedia - Social and Behavioral Sciences 103 ( 2013 ) 647 – 656

  Table 5 showed relationship between maternal weight gain with parity in each trimesters. As results, there is no statistically significance difference with maternal weight gain with parity in each trimester with p-value 0,44; 0,36; and 0,018 respectively (p>0,05, CI _{Table 6} 95%).

  Maternal weight before and 24 hours after delivery Body weight(Kg)

  Minimum Maximum Mean SD Before 48,0 83,0 64,75 8,85 delivery 24 hours 42,0 78,5 59,92 8,81 after

  paired t-test, p = 0,0001

  Table 6 showed significance difference between maternal body weight before and 24 hours after delivery with average differences of 4,83 Kg from paired t-test with p-value < _{Table 7} 0,05.

  Infant birth weight Body weight (gr)

  Minimum Maximum Mean SD Infant 2500.0 4000.0 3119 399.86

  Table 8

  Correlation between total maternal weight gain and infant birth weight

   S. Lumbanraja et al. / Procedia - Social and Behavioral Sciences 103 ( 2013 ) 647 – 656 653

  Body weight(Kg) r p Total maternal weight 0,213 0,03 gain with infant birth weight

  From this study, babies were born at normal weight ranged at 2500-4000 grams as seen in Table 7. Table 8 showed that there is significant correlation between total maternal weight _Discussion gain with baby birth weight with p-value 0,03 ( p<0,05) but shows a weak correlation (r=0,2).

  Women with normal body mass index before pregnancy promised a better outcome for pregnancy itself, also for the outcome of baby birth. Pregnant women with inadequate maternal weight gain were often result on low baby birth weight and increase perinatal morbidity and mortality. On the other hands, over increase of maternal weight gain also resulted on poor fetal outcome and affect the methods of delivery later.

  Our study shows that patient with normal body mass index before pregnancy resulted in adequate baby birth weight, as far poor prognosis can be alleviated. Our study showed that maternal weight gain increase significantly during second and third trimester, with total maternal weight gain ranged at 5-20 kg.

  This maternal weight gain was proper with the IOM recommendation about maternal weight gain during pregnancy. Ota, et al (2011), and Yang, et al (2005) found the same result with our study. Maybe, it is because of decreasing emesis symptoms in second trimester and also increasing of uterine size and volume, so does the other maternal organic tissues. Maternal weight gain also affected by Leptin, a protein-like produced by adipose tissue that regulate appetite and body weight.

  There is significance difference of maternal weight gain before and 24 hours after delivery. Based on parity, it seems that maternal weight gain showed significance changes in primigravida in the third trimester. Higher parity showed higher maternal weight gain compared with other groups.

  Finally, our study showed there is correlation among total maternal weight gain with baby birth weight with p-value = 0,03 ( p<0,05, CI 95%), but poor correlation (r=0,2). Total maternal weight gain seems predict birth weight of baby. Unfortunately, baby birth weight not only influenced by maternal weight gain, but also amniotic fluid increases, placental tissue, maternal oedema, and maternal tissue enlargement.

  654 S. Lumbanraja et al. / Procedia - Social and Behavioral Sciences 103 ( 2013 ) 647 – 656

  In conclusion, our study shows that maternal weight gain should be based on IOM recommendation and also consider optimal maternal age in order to get sufficient baby birth weight. Adequate maternal weight gain resulted on low morbidity and mortality in fetal and _References also maternal.

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