Gestational Weight Gain Inadequacy and Nutritional Status During Pregnancy in Ethiopia: Analysis From BUNMAP Cohort in Ethiopia

Objectives: This study aimed to investigate the effect of maternal nutritional status during pregnancy on adequacy of gestational weight gain in Ethiopia.Methods: We conducted a prospective community-based cohort study from March 2018 to December 2019, enrolling pregnant women residing in the Butajira Health and Demographic Surveillance System who were at or below 24 weeks of gestation.Total gestational weight gain (GWG) was determined as the difference between the weight measured at the first antenatal visit and the last visit prior to delivery.Participants were categorized based on the United States Institute of Medicine (IOM) criteria for GWG.We fitted a modified Poisson regression model and estimated the effect of maternal nutrition status during pregnancy and gestational weight gain (GWG).Results: This analysis is based on data from 593 pregnant women with singleton pregnancies.At enrollment, 17.7% of the participants were undernourished, with a MUAC of less than 23 cm.The mean (AESD) gestational weight gain (GWG) was 5.24 (5.1) kg.Our findings revealed that 6.1% of women achieved adequate GWG, 91.9% had inadequate GWG, and 2.02% experienced excessive GWG.Notably, there was a significant association between MUAC and inadequate GWG.Undernutrition, indicated by low MUAC, was resulted in an increased risk of inadequate GWG between the late first and early third trimesters (adjusted relative risk [aRR]: 1.05; 95% CI: 1.01-1.10),reflecting a 5% higher risk of inadequate GWG.Conclusions: In conclusion, our findings underscore that maternal undernutrition is a critical factor significantly increasing the risk of inadequate gestational weight gain.These results emphasize the need for early nutritional interventions to address maternal undernutrition and ensure optimal gestational weight gain during pregnancy.