Effect of pre-pregnancy body mass index and gestational weight gain on perinatal outcomes
- XING Meng-meng, WEI Guo, WANG Zhi-long, REN Lu-zhong
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Objective To investigate the effects of pre-pregnancy body mass index (BMI) and gestational weight gain on pregnancy outcomes,in order to provide evidence for pregnancy health care and prenatal weight management. Method A historical cohort study of 95 849 single full-term pregnant women from 26 midwifery hospitals in Longgang District of Shenzhen City from 2014 to 2017 was conducted on the influence of pre-pregnancy BMI and gestational weight gain on perinatal outcomes. Results The average pre-pregnancy BMI was (20.49±2.83) kg/m2 in 95 849 pregnant women,the average gestational weight gain was (14.49 ±5.89) kg.Compared with pregnant women with normal BMI and suitable weight gain during pregnancy,the emaciation (BMI<18.5 kg/m2) (OR=1.80,95%CI: 1.61-2.00) and insufficient gestational weight gain (OR=1.83,95%CI: 1.63-2.05) were risk factors for low birth weight infants.Pre-pregnancy overweight (BMI≥24 kg/m2) was a risk factor for gestational diabetes mellitus (GDM) (OR=1.84,95%CI: 1.68-2.02),gestational hypertension(OR=2.40,95%CI: 1.90-3.04),preeclampsia/eclampsia(OR=3.07,95%CI: 2.39-3.96),macrosomia(OR=2.70,95%CI: 2.49-2.92),cesarean section(OR=1.89,95%CI: 1.81-1.97),birth asphyxia(OR=1.33,95%CI: 1.05-1.67).Excessive weight gain during pregnancy was a risk factor for macrosomia (OR=2.59,95%CI: 2.40-2.79),cesarean section(OR=1.45,95%CI: 1.40-1.50),pregnancy hypertension (OR=2.83,95%CI: 2.21-3.62),preeclampsia/eclampsia(OR=2.18,95%CI: 1.69-2.81),premature rupture of membranes(OR=1.26,95%CI: 1.13-1.40) and postpartum hemorrhage(OR=1.26,95%CI: 1.07-1.48). Conclusionss Pre-pregnancy BMI and pregnancy weight gain are the influencing factors of cesarean section,gestational hypertension,preeclampsia/eclampsia,low birth weight and macrosomia.Therefore,it will be conducive to a good pregnancy outcome by controlling pre-pregnancy BMI and gestational weight gain.