Prevalência e fatores associados ao ganho de peso gestacional inadequado em Manaus: uma análise transversal

Abstract

The objective is to identify the prevalence and predictors associated with inadequate gestational weight gain in pregnant women assisted by Primary Health Care in the urban area of the municipality of Manaus, Amazonas. This is a cross-sectional study using primary data from adult pregnant women (≥20 years) participating in a randomized clinical trial carried out between 2014 and 2018, with 785 pregnant women attended at 10 UBS in Manaus. Pregnant women with complete clinical data were included and those aged <20 years, <16 weeks gestation or incomplete medical records were excluded. Data was collected from medical records and interviews and processed in SPSS®. The dependent variable was inadequate gestational weight gain, classified according to the Institute of Medicine (IOM) criteria, and the independent variables included clinical and socioeconomic factors. The statistical analysis used Chi-square tests and logistic regression. Among pregnant women, 57% had inadequate pre- gestational nutritional status, with a higher prevalence of overweight and obesity. Parity was high, with 66% of the participants being nulliparous. Variables such as parity and number of previous vaginal deliveries were significantly associated with inadequate gestational weight gain (p = 0.003 and p = 0.000, respectively). Maternal age was the only socioeconomic variable with a significant association (p = 0.00), with pregnant women ≥30 years having a lower prevalence of inadequate weight gain. In the logistic regression, overweight pre-gestational nutritional status (OR = 1.66; 95% CI: 1.03-2.68) and maternal age >30 years (OR = 0.53; 95% CI: 0.34-0.81) maintained a significant association with the outcome. There was a high prevalence of inadequate gestational weight gain among pregnant women attending primary healthcare centers in Manaus. Inadequate gestational weight gain showed a significant association with clinical and obstetric factors, with pre-gestational overweight standing out as a predictor of increased chances of inadequate outcomes. In addition, socioeconomic and demographic factors, particularly maternal age equal to or greater than 30 years, were associated with a lower probability of inadequate gestational weight gain, suggesting a possible protective effect.