Archivos Latinoamericanos de Nutrición (Sep 2009)
Cambios en el índice de masa corporal en adolescentes y adultas entre el embarazo y el posparto BMI changes in adolescents and adults women between pregnancy and pospartum
Abstract
Los objetivos fueron evaluar las consecuencias del embarazo en el IMC de las adolescentes en comparación con adultas e identificar los factores que aumentan el riesgo de un IMC bajo en el posparto. Se estudiaron 742 adolescentes (13 a 19 años) y 779 adultas (25 a 34 años) de Guatemala, República Dominicana y Uruguay. Se midieron variables demográficas, sociales, obstétricas, ganancia de peso e IMC antes de las 14 semanas de gestación y a los 4 ± 1 mes posparto. El IMC en adultas se clasificó según la OMS y en adolescentes según NCHS/OMS. Por análisis logístico uni y multivariado se estimó el riesgo de un IMC bajo en el posparto. Al inicio se observó mayor prevalencia de bajo peso en adolescentes y de sobrepeso y obesidad en adultas (p Te aim of the study was to evaluate pregnancy nutritional consequences in adolescent pregnant women and to identify factors which increase risk of an adverse postpartum nutritional result. We conducted a prospective cohort study in 742 adolescent and 779 adult pregnant women in Guatemala, Dominican Republic and Uruguay, assessing demographic, social, obstetric, weight gain and BMI at first prenatal control, and 4 + 1 month post partum. BMI in adults was classified according to WHO recommendations and NCHS/WHO in adolescents. We assessed changes of BMI between the beginning and postpartum time and a logistic model analysis was applied about the risk of having low BMI at postpartum time. At the beginning of pregnancy the prevalence of low weight was higher in adolescent group and the overweight and obesity higher in adults (p< 0.001). Weight gain was significantly higher in adolescents at same nutritional BMI, except for low weighted. Adolescents had a significant change in their BMI at postpartum time, showing a tendency to increase weight and a higher prevalence of overweight and obesity (p< 0.001). Higher risk of low BMI in postpartum was associated with low prenatal BMI (OR 25,6, CI 12,6 - 52), adolescence (OR 3,3 CI 1,6 - 6,6) and gestational weight gain < 300 g. per week (OR 1,4 CI 1,1 - 3,9). In conclusion adolescent nutritional status was not damaged after pregnancy. The strongest variable associated with postpartum low BMI was BMI which mothers begin pregnancy as equal of adult mothers.
