Association of pre-pregnancy body mass index and gestational weight gain with pregnancy outcomes
DOI:
https://doi.org/10.12809/hkjgom.22.2.03Keywords:
Body mass index, Gestational weight gain, National Academies of Science, Engineering, and Medicine, U.S., Health and Medicine Division, Pregnancy outcomeAbstract
Background: Gestational weight gain (GWG) is a modifiable risk factor for pregnancy outcomes. This study aimed to evaluate the associations of pre-pregnancy body mass index (BMI) and GWG with perinatal and maternal outcomes in Hong Kong women and to identify risk factors for poor perinatal/maternal outcomes.
Methods: Medical records of low-risk women with singleton pregnancy who delivered babies between 1 January 2019 and 28 February 2019 at our hospital were reviewed. Based on pre-pregnancy BMI, women were categorised as underweight (<18.5 kg/m2), normal weight (18.5-24.9 kg/m2), pre-obesity (25-29.9 kg/m2), and obesity (>30 kg/m2). Based on the recommended total GWG by the Institute of Medicine, women were categorised as inadequate, normal, and excessive GWG. The normal group was compared with each of the other groups.
Results: 465 women were included for analysis. Of them, 439 (94.4%) delivered after 37 weeks of gestation and 26 (5.6%) delivered before 37 weeks of gestation. After adjusting for confounders, the risk factors for gestational diabetes were women with pre-obesity (odds ratio [OR]=3.879, p=0.001) and women with obesity (OR=15.118, p<0.001), whereas the risk factor for neonatal ventilator use was women with pre-obesity (OR=5.719, p=0.035) and the risk factor for caesarean section was women with excessive GWG (OR=1.591, p=0.047).
Conclusion: High pre-pregnancy BMI is associated with gestational diabetes and neonatal ventilator use, whereas excessive GWG is associated with caesarean section.
References
Institute of Medicine, Food and Nutrition Board. Committee on Nutritional Status During Pregnancy, part I: Nutritional Status and Weight Gain. Washington: National Academy Press; 2000.
Silvestris E, de Pergola G, Rosania R, Loverro G. Obesity as disruptor of the female fertility. Reprod Biol Endocrinol 2018;16:22.
Simko M, Totka A, Vondrova D, et al. Maternal body mass index and gestational weight gain and their association with pregnancy complications and perinatal conditions. Int J Environ Res Public Health 2019;16:1751.
Parker HW, Tovar A, McCurdy K, Vadiveloo M. Associations between pre-pregnancy BMI, gestational weight gain, and prenatal diet quality in a national sample. PLoS One 2019;14:e0224034.
Shin D, Lee KW, Song WO. Pre-pregnancy weight status is associated with diet quality and nutritional biomarkers during pregnancy. Nutrients 2016;8:162.
de Jersey SJ, Mallan K, Callaway L, Daniels, LA, Nicholson JM. A cross sectional comparison of predisposing, reinforcing and enabling factors for lifestyle health behaviours and weight gain in healthy and overweight pregnant women. Matern Child Health J 2017;21:626-35.
Cedergren M. Effects of gestational weight gain and body mass index on obstetric outcome in Sweden. Int J Gynaecol Obstet 2006;93:269-74.
Chung JG, Taylor RS, Thompson JM, et al. Gestational weight gain and adverse pregnancy outcomes in a nulliparous cohort. Eur J Obstet Gynecol Reprod Biol 2013;167:149-53.
Margerison Zilko CE, Rehkopf D, Abrams B. Association of maternal gestational weight gain with short- and long-term maternal and child health outcomes. Am J Obstet Gynecol 2010;202:574.e1-8.
Durie DE, Thornburg LL, Glantz JC. Effect of second-trimester and third-trimester rate of gestational weight gain on maternal and neonatal outcomes. Obstet Gynecol 2011;118:569-75.
Thorsdottir I, Torfadottir JE, Birgisdottir BE, Geirsson RT. Weight gain in women of normal weight before pregnancy: complications in pregnancy or delivery and birth outcome. Obstet Gynecol 2002;99:799-806.
Sun Y, Shen Z, Zhan Y, et al. Effects of pre-pregnancy body mass index and gestational weight gain on maternal and infant complications. BMC Pregnancy Childbirth 2020;20:390.
Vrachnis N, Belitsos P, Sifakis S, et al. Role of adipokines and other inflammatory mediators in gestational diabetes mellitus and previous gestational diabetes mellitus. Int J Endocrinol 2012;2012:549748.
Najafi F, Hasani J, Izadi N, et al. The effect of prepregnancy body mass index on the risk of gestational diabetes mellitus: a systematic review and dose-response meta-analysis. Obes Rev 2019;20:472-86.
Kim SY, Sharma AJ, Sappenfield W, Wilson HG, Salihu HM. Association of maternal body mass index, excessive weight gain, and gestational diabetes mellitus with large-for-gestational-age births. Obstet Gynecol 2014;123:737-44.
Hedderson MM, Gunderson EP, Ferrara A. Gestational weight gain and risk of gestational diabetes mellitus. Obstet Gynecol 2010;115:597-604.
Wu Y, Wan S, Gu S, et al. Gestational weight gain and adverse pregnancy outcomes: a prospective cohort study. BMJ Open 2020;10:e038187.
Catalano PM, McIntyre HD, Cruickshank JK, et al. The hyperglycemia and adverse pregnancy outcome study: associations of GDM and obesity with pregnancy outcomes. Diabetes Care 2012;35:780-6.
Ukah UV, Bayrampour H, Sabr Y, et al. Association between gestational weight gain and severe adverse birth outcomes in Washington State, US: a population-based retrospective cohort study, 2004-2013. PLoS Med 2019;16:e1003009.
Eraslan Sahin M, Col Madendag I. Effect of gestational weight gain on perinatal outcomes in low risk pregnancies with normal prepregnancy body mass index. Biomed Res Int 2019;2019:3768601.
Mei-Dan E, Walfisch A, Weisz B, Hallak, M, Brown R, Shrim A. The unborn smoker: association between smoking during pregnancy and adverse perinatal outcomes. J Perinat Med 2015;43:553-8.
Hsieh TT, Liou JD, Hsu JJ, Lo LM, Chen SF, Hung TH. Advanced maternal age and adverse perinatal outcomes in an Asian population. Eur J Obstet Gynecol Reprod Biol 2010;148:21-6.
Li N, Liu E, Guo J, et al. Maternal prepregnancy body mass index and gestational weight gain on pregnancy outcomes. PLoS One 2013;8:e82310.
Chen CN, Chen HS, Hsu HC. Maternal prepregnancy body mass index, gestational weight gain, and risk of adverse perinatal outcomes in Taiwan: a population-based birth cohort study. Int J Environ Res Public Health 2020;17:1221.
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