Maternal weight gain during pregnancy and outcomes for the newborn child and mother in Tulkarem and in camps: a retrospective cohort study

Abstract Background Excessive gestational weight gain appears to be a risk factor for low and high birthweight, preterm delivery, gestational diabetes, pre-eclampsia, caesarean section, and post-partum haemorrhage). The objective of this study was to determine the association between gestational weight gain and pregnancy outcomes. Methods This retrospective cohort study was done at a primary health-care centre supported by the Palestinian Ministry of Health in Tulkarem (one of the main cities in northern occupied Palestinian territory) and in two United Nations Relief and Works Agency (UNRWA) primary health-care centres (in the Tulkarem and Nourshams Camps) in 2016. Patient files of women who had given birth were reviewed, and sociodemographic data, medical history, body-mass index (BMI), and gestational weight gain were recorded. We used SPSS version 20 for statistical analysis. Significance was set at a p value of less than 0·05. This study was approved by the Institutional Review Board committee at An-Najah National University, and permission was obtained from the Ministry of Health and the UNRWA. Findings 771 patient files were reviewed (326 from Tulkarem City, 274 from Tulkarem Camp, and 171 from Nourshams Camp). The mean age of mothers at first visit was 26·5 years (SD 5·81), and 328 (43%) women had attended tertiary education. 341 (44%) women had a normal BMI at first visit, 254 (33%) women were overweight, and 147 (19%) women were obese. 283 (37%) women gained weight within recommended levels, and 213 (28%) women gained more than the recommended weight. 210 (27%) women had a caesarean section. The incidences of preterm delivery, gestational diabetes, pre-eclampsia, and post-partum haemorrhage were 9%, 6%, 2%, and 10%, respectively. 405 (53%) newborn babies were boys and 366 (48%) were girls, with an overall mean birthweight of 3313 g (SD 511·83). 37 (5%) neonates had low birthweight, and 60 (8%) neonates had high birthweight. Bivariate analysis showed a significant association between gestational weight gain and BMI at first visit, high birthweight, and post-partum haemorrhage (p Interpretation Gaining more than the recommended weight during pregnancy is consistently associated with negative maternal and infant outcomes. These effects could be avoided if improved individualised care were systematically implemented in both ministry of health and UNRWA clinics to support women preconceptionally, prenatally, and post partum. Funding None.