Comparison and Characterization of Prenatal Nutrition Counseling among Large-for-Gestational Age Deliveries by Pre-Pregnancy BMI

It is recommended that prenatal care include nutrition counseling; however, 4000 g. Of the 2380 deliveries, 165 met the inclusion criteria. Demographics, PNC receipt, and pregnancy outcomes were compared among normal-weight (NW; BMI: 18.5-24.9 kg/m , 19%, = 31), overweight (OW; BMI: 25-29.9 kg/m , 29%, = 48), and obese (OB; BMI > 30 kg/m , 52%, = 86) women. The majority (78%, = 129) of women were Hispanic White with a mean age of 30.4 ± 5.7 yrs and gestational weight gain of 12.1 ± 5.8 kgs. A total of 62% ( = 103) of women received PNC. A total of 57% gained above the Institute of Medicine (IOM) recommendations ( = 94). OB women were 2.6 and 2.1 times more likely to receive PNC than OW (95% CI: 1.1-2.0) and NW (95% CI: 0.9-1.9) women, respectively. Women who gained within the IOM recommendations for their pre-pregnancy body mass index (BMI) were 50% less likely to receive PNC than women who gained above the IOM recommendations for their pre-pregnancy weight (χ = 4.45, = 0.035; OR = 0.48, CI: 0.24 to 0.95). Infant birthweight was significantly higher among women who received PNC (4314 ± 285 4197 ± 175 g, = 0.004). These data suggest that PNC was directed toward women who enter pregnancy in the obese weight category and/or gain excessively across gestation. Future studies should provide PNC to all women to evaluate whether it reduces the risk of delivering large-for-gestational age deliveries across all maternal weight categories. Additionally, more work is needed to identify the types of PNC that are most effective for this high-risk population.