COVID-19 pandemic associated with changes in gestational weight gain

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According to a recent study published in JAMA Network Open, rates of gestational weight gain (GWG) increased during the COVID-19 pandemic but leveled out in the later years of the pandemic.

Maternal and child health is significantly impacted by maternal weight, but only about 1/3 of pregnant women are able to have appropriate weight gain during pregnancy. GWG occurs in most pregnancies, often leading to adverse outcomes and increased cardiovascular disease risk.

Social distancing policies during the COVID-19 pandemic led to many individuals having a more sedentary lifestyle, changes in eating habits, and increased anxiety and depression. Data has also indicated increased rates of adverse pregnancy outcomes during the pandemic.

While higher GWG was observed in the first year of the pandemic, there is little data on how GWG rates shifted with the introduction of COVID-19 vaccines and reduces social distancing policies. To evaluate GWG through the second year of the pandemic, investigators conducted a retrospective cohort study.

Electronic health records of patients aged 12 to 50 years with a delivery at a women’s specialty hospital in Baton Rouge, Louisianafrom January 1, 2017, and July 31, 2022, were consulted. Pregnancies after March 13, 2020, were considered pandemic affected.

Delivery data and conception date were used to measure GWG, with 3 delivery groups created. These groups included prepandemic from March 13, 2019, to March 12, 2020, peak pandemic from March 13, 2020, to March 12, 2021, and late pandemic from March 13, 2021, to March 12, 2022.

Total GWG was measured using self-reported weight at delivery, with body mass index calculations including underweight, at under 18.5, normal weight at 18.5 to 24.9, overweight at 25 to 29.9, and obesity at 30 and above. GWG per week was measured as total GWG divided by gestation length.

Covariates included participant age, education level, self-reported race and ethnicity, insurance type, marital status, smoking, alcohol use, employment status, and parity.

There were 25,237 patients with a pregnancy or delivery during the study period. Of the 23,012 deliveries, the mean maternal age was 28.9 years and the mean prepregnancy weight was 75.1 kg. Passing the recommended weight gain was seen in 42% of prepandemic patients, 45.4% of peak pandemic patients, and 44% of late pandemic patients.

Overweight was reported in 25.5% of patients, obesity in 33.4%, and normal weight in 38.2%. Total GWG and weight gain per week were slightly higher in the peak and late pandemic periods than the prepandemic period. More GWG and weight gain per week were also observed in overweight and obese patients during these periods compared to their prepandemic counterparts.

These results indicated increased rates of GWG in the first 2 years of the COVID-19 pandemic compared to the prepandemic period, but a decrease toward prepandemic levels in later pandemic deliveries. Investigators concluded the COVID-19 pandemic was associated with clinically meaningful changes in prepregnancy weight and GWG.

Reference

Harville EW, Kracht CL, Cohen NL, Sutton EF, Kebbe M, Redman LM. Trends in gestational weight gain in Louisiana, March 2019 to March 2022. JAMA Netw Open. 2023;6(8):e2331277. doi:10.1001/jamanetworkopen.2023.31277