Determinants of excessive gestational weight gain in Mexican American women in Los Angeles

Excessive gestational weight gain (EGWG) is associated with pregnancy complications, postpartum obesity and associated chronic illnesses. In the United States, Mexican American women are the largest subgroup of Hispanics but have been studied least often. The purpose of the study was to determine the prevalence of gestational weight gain and characteristics of Mexican American women in Los Angeles with adequate gestational weight gain (AGWG) and EGWG. Orem's Self-Care Deficit Theory provided the theoretical framework using concepts of Basic Conditioning Factors (age, pre-pregnancy BMI, parity, hypertension, exercise, maternal food intake, acculturation, and paternal education), Self-Care Requisite (AGWG), and Self-Care Deficit (EGWG). A retrospective, descriptive, correlational design used data from charts in a federally qualified health center in Los Angeles. Of the screened charts (n=1257), 681 met the study inclusion criteria of Mexican heritage, entry into prenatal care by 28 weeks gestation, term gestation, and completion of the Comprehensive Perinatal Services Program Prenatal Combined Assessment Reassessment Tool. The Institute of Medicine (IOM) (1990) gestational weight gain criteria were used. All eligible charts (n=681) were used for the prevalence analysis, and charts with AGWG or EGWG (n=469) were coded for the descriptive analysis. Results were that the prevalence of inadequate gestational weight gain (IGWG) was 31%, AGWG was 33%, and EGWG was 36%. Compared to Mexican American women with AGWG, Mexican American women with EGWG had higher pre-pregnancy BMI (p <.01), more hypertension (p <.01), were more acculturated (p <.01) and were more often born in the United States (p <.01). Alternately, Mexican American women with AGWG ate more servings of grains (p <.05), had more snacks per day (p <.05) and had less educated partners ( p <.05) than Mexican American women with EGWG. Risk factors for EGWG in Mexican American women with normal pre-pregnancy BMI were primiparity, hypertension, and increased acculturation. These findings may serve to identify Mexican American women who may be at risk for EGWG and may suggest areas for intervention development. Further study is warranted in Mexican American women to design strategies that will promote AGWG and reduce the risk of lifelong obesity and the associated chronic illnesses.