Characterizing gestational weight gain in a cohort of Indigenous Australian women

Objective: to determine the adequacy of gestational weight gain for a cohort of Indigenous Australian women and investigate whether it is associated with pre-pregnancy body mass index.Design: analysis of observational data collected from a longitudinal cohort study that follows Indigenous Australian women through pregnancy.Setting: women recruited through antenatal clinics in regional and remote towns in NSW, Australia to the Gomeroi gaaynggal program.Participants: 110 pregnant women who either identified as being an Indigenous Australian or as carrying an Indigenous child.Measurements and findings: measurements included weight and height, self-reported prepregnancy weight and smoking status, parity and health conditions that may contribute to gestational weight gain, such as hypertensive or diabetic disorders. Compared to the 2009 Institute of Medicine recommendations for gestational weight gain and based on pre-pregnancy body mass index, the rate of adequate gestational weight gain in this cohort was very low (15%). 32% of women had inadequate weight gain and 54% had excessive weight gain. The highest rate of excessive gestational weight gain was found in overweight women (74%), with rates of 48% and 50% found in healthy and obese (all classes) categories, respectively. Parity (coefficient 4.5, p < 0.01) and hypertension (coefficient 4.8, p = 0.04) were found to be significantly associated with gestational weight gain in mixed model linear regression.Conclusions: few women gained adequate gestational weight gain in this study. Culturally acceptable ways of addressing this issue are needed for this group of women, as inadequate and excessive rates of gestational weight gain have health implications for women and their offspring. Implications for practice: a systematic approach to addressing gestational weight gain within antenatal care is required, including asking about diet and exercise, for all women identifying as Indigenous Australian