Publication details

Thinking ahead: Brazilian healthcare providers also need culturally relevant tools to communicate gestational weight gain recommendations


SOUZA Sara C S DA Silva Danilo F PICCININI-VALLIS Helena NAGPAL Taniya S PALUDO Ana Carolina MATTES Veronica V SALAS Ximena R ADAMO Kristi B

Year of publication 2022
Type Article in Periodical
Magazine / Source American Journal of Clinical Nutrition
MU Faculty or unit

Faculty of Sports Studies

Keywords healthcare; gestational weight
Attached files
Description Dear Editor: We read with interest the article by Kac et al. (1), in which the authors constructed gestational weight gain (GWG) charts according to prepregnancy BMI for Brazilian women. This is a remarkable step towards the development of specific GWG recommendations for the diverse Brazilian population. As brought up by the authors, the current charts and recommendations adopted by the Brazilian Ministry of Health in the public health system have been developed for other countries. Although the International Fetal and Newborn Growth Consortium for the 21st century published GWG standards with data from 8 countries, including Brazil, Kac et al. (1) pointed out relevant limitations for incorporating this tool in the Brazilian public health system (e.g. participants limited to the normal weight classification and charts started at 14 weeks of gestation). With that in mind, the authors addressed these limitations and assessed a cohort of 7086 Brazilian women with 29,323 weight measurements to construct GWG charts based on prepregnancy BMI classification (i.e. WHO cut-offs) and evaluated 4711 women with 31,052 measurements to externally validate the selected percentiles. Following the authors’ conclusions, the study findings suggest that this new tool can be used to monitor GWG in the Brazilian public healthcare system. GWG is a critical marker of maternal and fetal health, and guideline-discordant GWG has been associated with several negative health outcomes for women and their children (2). Although it is a national accomplishment to progress towards evidence-based population-specific GWG recommendations, recommendations alone may not result in adherence to new GWG cut-offs. Considering the maternal-fetal risks of gaining outside GWG guidelines, weight management throughout pregnancy is a public health priority. Importantly, GWG counseling from healthcare providers (HCP) is essential to support women to meet GWG cut-offs; given that we are moving towards population-specific GWG recommendations, we also require a population-specific GWG counseling tool (3).

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