Factors Influencing Excessive Gestational Weight Gain Among Pregnant Women in Urban Malaysia Introduction Excessive gestational weight gain (GWG) is a growing public health concern due to its association with higher risk of adverse maternal and perinatal outcomes. Recognising the key factors of underlying GWG incidence is thus crucial for developing targeted interventions. This study aims to determine the prevalence of excessive GWG and its associated factors among pregnant women in an urban district of Klang Valley, Malaysia. Methods A retrospective cross-sectional study was conducted (betweenNovember 2017 and October 2018) among 472 pregnant women who gave birth between January 2015 and December 2016. Data on sociodemographic characteristics, medical illnesses, and pre-pregnancy body mass index (BMI) were retrieved from the birth registry and maternal health records. The classification of GWG is based on the Institute of Medicine's recommendation Results The classification of GWG is based on the Institute of Medicine's recommendation. A total of 113 (23.9%) pregnant women had excessive GWG. Multiple logistic regression showed the odds of getting excessive GWG were higher among those with lower education levels (Adj. OR = 1.85; 95% CI = 1.084, 3.147), being employed (Adj. OR = 2.30; 95% CI = 1.342, 3.928), nulliparous (Adj. OR = 2.46; 95% CI = 1.450, 4.164), and having pre-pregnancy BMI of ≥25kg/m2(Adj. OR = 6.47; 95% CI = 3.909, 10.721). Conclusions Lifestyle interventions, such as weight reduction programs and health education, should focus on women with high pre-pregnancy BMI, nulliparous women, working women and women with low education levels. Pre-pregnancy clinics and workplaces can serve as platforms to promote healthy dietary choices and encourage regular physical exercise.

Introduction In 2015, almost half of low birth weight babies in the world were born in Southern Asia. It is contributed by multiple factors including maternal exposure to the elements in the environment during the antenatal period. Particulate matter (PM10) pollution in Southeast Asian region have been extensively studied with known attributions and sources. It is also known that PM10 is able to restrict foetal growth at molecular level. This review intends to investigate if the unborn in Asia are affected by air pollutants indirectly through their mothers. Methods Publications from Scopus and Science Direct digital databases in Asian region from 2015 onwards were reviewed. Details collected were the year of publication and study location, the study design, investigated air pollutants, exposure estimation methods used, the timing of exposure in relation to pregnancy, pregnancy outcome measured and the relative risk or odds of effect. Results A total of eight full text articles were included. Most of the studies were of cohort and quasi experimental designs, involving local air monitoring measurements to assign exposure. Conclusions There were more studies considered multiple air pollutants as contributing risk rather than a single pollutant. The exposure was measured according to stages of pregnancy and the trimester stratification is the most often method used. Modalities used in representing birth outcomes were not confined to birth weight alone but also included the length of gestation. Exposure to PM10 have been found to be associated with reduction in birth weight and increased risk for preterm birth in Asia.