Pregnancy outcomes of First Nations women in relation to pregravid weight and pregnancy weight gain.

OBJECTIVE

To determine the effect of pregravid weight and pregnancy weight gain on pregnancy outcomes in Cree women.

METHODS

We reviewed maternal and infant outcomes of the first pregnancy in Cree women living in James Bay, Quebec, from 1994 to 2000. We examined data from women who had a full-term singleton birth and a maternal pregravid body mass index (BMI) > or = 18.5 kg/m2 and whose weight had been recorded in the first trimester and within one month prior to delivery. Weight in the first trimester was used to estimate pregravid BMI.

RESULTS

Data were available for 603 women. At the beginning of pregnancy, 23.1% of the women had normal weight (BMI 18.5-24.9 kg/m2), 27.9% were overweight (BMI 25-29.9 kg/m2), and 49.1% were obese (BMI > or = 30 kg/m2). Nearly one-half of the women gained excessive weight in pregnancy. Adverse outcomes were less common in women with a normal pregravid BMI than in women with a pregravid BMI in the overweight or obese range. Obese women with excessive weight gain had a higher prevalence of preeclampsia (14.9%) than obese women with low (3.7%) or acceptable (6.3%) weight gain; however, obese women with excessive weight gain had a lower prevalence of gestational diabetes mellitus.

CONCLUSION

Interventions must be developed to prevent pregravid obesity and excessive weight gain in pregnancy in Cree women to improve maternal and fetal outcomes.