Assessment of maternal nutritional status in early pregnancy and gestational weight gain in selected areas in the Philippines: A pilot study.

BACKGROUND: Information on pre-pregnancy body mass index (BMI), gestational weight gain (GWG), and adverse outcomes in the Philippines is limited particularly in primary care settings. OBJECTIVES: This study aims to assess the nutritional status of Filipino women in early pregnancy, their GWG, and associated outcomes. DESIGN: This prospective study included 176 Filipino pregnant women aged 15-49 years, recruited from 35 locations between October 2021 and December 2022. METHODS: Measured weight was recorded in the mother-infant booklet by midwives as reported by pregnant women through phone interviews. Weight during the first prenatal visit (<15 completed weeks) was considered the pre-pregnancy weight (PPW). Pre-pregnancy BMI was calculated using the World Health Organization and Centers for Disease Control and Prevention classifications. Total GWG (tGWG) was determined by subtracting PPW from the weight measured at the last prenatal visit, assessed according to the 2009 Institute of Medicine (IOM) recommendations, and analyzed using logistic regression. Dietary intake was assessed using the standardized 24-h food recall method. RESULTS: Of the study participants, 15.3% were underweight, 56.8% normal, and 27.8% overweight/obese. The mean tGWG was 9.0 ± 4.9 kg, with most women having a tGWG below the 2009 IOM recommendations. Overweight and obese women had nearly three times the odds of having a cesarean section (odds ratio [OR] 2.85 (95% confidence interval [CI] 1.14-7.13), p = 0.025), while those whose gestational weight gain was below the IOM recommendations had significantly lower odds of having such a procedure (OR 0.24 (95% CI 0.09-0.67), p = 0.007). CONCLUSION: Total GWG varies by pre-pregnancy BMI, with many Filipino women not meeting the 2009 IOM recommendations for GWG, yet without negative outcomes. These findings indicate that lower GWG may be typical among Filipino women. From the outcomes studied, only the rate of cesarean sections and having a GWG below the 2009 IOM recommendations reached statistical significance. This highlights the need for further evaluation of the 2009 IOM recommendations for Filipino women through well-designed prospective studies.