Maternal overweight, obesity and weight gain during pregnancy have become important obstetric concerns as they represent the most common risk factor for adverse perinatal outcomes in developed countries. The aim of this study was to determine trends in pre-pregnancy body mass index (BMI) and gestational weight gain (GWG) in Croatia. Pre-pregnancy BMI and GWG trends from 2003 to 2019 were analyzed using national delivery data. Joinpoint regression analysis was performed. Age adjusted obesity rate among pregnant women significantly increased from 59.4 to 77.7 per 1000, with a mean of 1.7% per year (95% CI 0.6 to 2.8, p=0.004), while age adjusted rate of women achieving GWG above recommendations significantly decreased from 352.1 to 301.1 per 1000 women (annual percent change-1.0%, 95% CI -1.4 to -0.6, p<0.001). The rate of women with normal BMI and those achieving recommended GWG increased, but these trends were not statistically significant. In conclusion, the rate of obesity in pregnant women in Croatia is high and has an increasing trend that has not been halted or reversed. Public health strategies addressing weight management require reevaluation with emphasis on preconception care. A decreasing trend of pregnant women achieving GWG above recommendations is welcoming and reflects increasing awareness of appropriate weight management during pregnancy.
Vince et al. (Wed,) studied this question.