PATTERN OF MATERNAL WEIGHT GAIN AND PREGNANCY OUTCOME AMONG WOMEN ATTENDING ANTENATAL CLINIC AT FEDERAL MEDICAL CENTRE BIDA, NIGER STATE, NIGERIA

Abstract

Malnutrition in pregnant women is of public health concern because of its associated risk both to the women and their infants. Inadequate weight gain in pregnancy is a known risk factor for poor pregnancy outcome. Limited studies have been carried out on the pattern of weight gain and pregnancy outcome in Niger State of Nigeria. This study was therefore designed to assess the pattern of weight gain and pregnancy outcome among women of childbearing age at Federal Medical Centre, Bida, Niger State of Nigeria. A retrospective review of case notes of 1037women who obtained antenatal care and delivered at Federal Medical Centre Bida, Niger State, Nigeria from January 2005 to December 2009 was conducted. Socio-demographic and obstetric characteristics, weight at booking, second and third trimesters, and delivery were obtained. Infant birth weights were also obtained. Data were analyzed using SPSS version 15 for descriptive statistics, Chi-square test, and logistics regression at 5% level of significance. There were 63 adolescents and 974 adult women. The age of adolescent and adult mothers ranged between 15-19 years and 20-50 years with the mean age of 17.6±1.3 years and 26.2±4.8 years respectively. Almost all (99.6%) the women were married. Majorities (80.1%) of the women were Muslims and 72.0% were urban residents. About half (49.2%) and 11.1% of adolescent women were either students or unemployed as compared with 9.6% and 37.6% of adult mothers respectively. Fewer (44.4%) adolescent compared with 46.1% of adult mothers booked at the second trimester for antenatal care. The mean weight gain at delivery of 6.4±3.1kg and 6.7±4.1kg, for the adolescent and adult mothers respectively, was significantly different (p<0.05). The proportion of adolescent mothers (36.5%) with packed cell volume (<30%) was higher than adult mothers (30.9%), (p>0.05). Adolescents were about eight times less likely to have (normal) spontaneous vaginal delivery (OR=0.120, 95%CI=0.03-0.39) and about eleven times less likely to have caesarean section (OR=0.09, 95%CI=0.02-0.34) when compared to adult mothers. Mean infant birth weight (3.0±0.4kg) among adolescent was significantly lower to that of adult mothers (3.2±0.5kg), p<0.05. The proportion (9.5%) of low birth weight (LBW) infants was significantly higher among adolescents compared to (7.1%) among adult mothers. Adolescent also had significantly lower mean Body Mass Index [(BMI), 20.0±3.0kg/m2] in pregnancy compared to adult mothers (22.3±4.0kg/m2), p<0.05. The proportion of the primiparous, multiparous, and grandmultiparous women were 34.7%, 41.2%, and 24.1% respectively. Underweight (BMI<18.5kg/m2) mothers were about 27 times more likely to have LBW infants than normal weight (18.5-24.9kg/m2) and overweight/obese (≥25kg/m2/≥30kg/m2) mothers (OR= 27.1, 95%CI=3.52-208.40), (p<0.05). Primiparous mothers were about 0.5 times less likely to have macrosomic infants than multiparous and grandmultiparous mothers (OR=0.5, 95%CI=0.36-0.79), (p<0.05). Women who had antenatal care visits ≤3 times were about 4times more likely to have LBW infants than those with ≥3 times antenatal care visits (OR=3.7, 95%CI=2.00-6.91), (p<0.05). Low packed cell volume, early age at conception, low BMI, parity, late and inconsistent antenatal care visits were observed to be associated with low birth weight. Strategies to reduce incidence of adolescent pregnancies, encourage early booking and regular antenatal care visits are recommended to enhance good pregnancy outcome.