Adequação do ganho de peso gestacional de mulheres atendidas em maternidade do Rio de Janeiro: comparação entre as curvas brasileiras e a recomendação do instituto de medicina (IOM, 2009)

Abstract

Introduction: Gestational weight gain (GWG) is physiological and necessary for fetal growth and development. Its monitoring regards an important part of prenatal care, since when inadequate, it is related to adverse perinatal outcomes. In 2021, the Brazilian Weight Gain Curves were developed based on this population. However, studies evaluating their performance are scarce. Objective: To analyze the adequacy of GWG of pregnant women, according to the Brazilian Weight Gain Curves. Methods: The study was designed as observational and cross-sectional, conducted in a public maternity hospital in the city of Rio de Janeiro. A total of 725 adult pregnant women (≥18 years old) with low- and high-risk pregnancies, with a single fetus, who received prenatal care and had anthropometric data available were evaluated. Sociodemographic data, current and previous clinical and obstetric history were analyzed from interviews conducted postpartum and data collection from medical records. The sample was divided into three groups: insufficient GWG, adequate GWG and excessive GWG, according to the Brazilian weight gain recommendation. The 9 Chi-square and Kruskal-Wallis tests were used to compare frequencies and medians, respectively, and Dunn's test to verify differences between groups, assuming statistical significance of p<0.05. Results: The prevalence of insufficient GWG was 25.8%, 21.1% for adequate GWG and 53.1% for excessive GWG. When compared with the adequacy assessed by the IOM (2009) method, there were lower prevalences of insufficient and adequate GWG and higher prevalences of excessive GWG (p<0.001). The modifiable factors related to GWG were pre-gestational BMI (p=0.001) and number of consultations with a nutritionist (p=0.008). The sensitivity of the Brazilian curves in relation to the IOM (2009) recommendation for excessive GWG was 100%, with specificity of 76.6%. For insufficient GWG, the sensitivity and specificity were 72.3% and 20%, respectively. Conclusion: The Brazilian curves have better sensitivity and specificity values for excessive GWG compared to insufficient GWG, using the IOM (2009) recommendation as the standard test. Research on gestational and neonatal outcomes in Brazilian pregnant women in relation to the recommendations of the Brazilian Weight Gain Curves is necessary to consolidate their use in this population.