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 wornen living in Jarnes 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) >18.5 kg/m(2) 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/m(2)), 27.9% were overweight (BMI 25-29.9 kg/m(2)), and 49.1 % were obese (BMI >= 30 kg/m(2)). 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.