Association Between Pre-Pregnancy Body Mass Index and Maternal and Neonatal Outcomes of Singleton Pregnancies After Assisted Reproductive Technology.

Hanxiang Sun,Guohua Li,Shijia Huang,Yang Liu,Xiaosong Liu,Qiaoling Du

doi:10.3389/fendo.2021.825336

Hanxiang Sun, Guohua Li + Show 4 more

Open Access

https://doi.org/10.3389/fendo.2021.825336

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Abstract

ObjectiveTo study the association between pre-pregnancy body mass index (BMI) and adverse maternal and neonatal outcomes of singleton pregnancies after assisted reproductive technology (ART).MethodsThis hospital-based retrospective cohort study of women with live singleton births through ART in China from January 2015 to August 2020 included 3043 Chinese women. According to the latest BMI classification standard of Asian women, the women included in this study were classified as underweight (BMI <18.5 kg/m2), normal (BMI 18.5 to <23 kg/m2), overweight (BMI 23 to <27.5 kg/m2), and obese (BMI ≥27.5 kg/m2). We compared the risk of adverse outcomes of different pre-pregnancy BMI values of women with singleton pregnancies conceived through ART. We used Logistic regression analysis to estimate the associations between pre-pregnancy BMI and adverse perinatal and neonatal outcomes.ResultsOur findings showed that women who were overweight or obese before pregnancy through ART are more likely to have a cesarean section, gestational diabetes mellitus, gestational hypertension, and preeclampsia, regardless of whether confounding factors are adjusted. Moreover, pre-pregnancy obesity was more associated with a higher risk of these adverse outcomes than pre-pregnancy overweight. In addition, neonates from women who had obesity before pregnancy through ART were more likely to have macrosomia; adjusted odds ratios and 95% confidence intervals were 3.004 (1.693-5.330).ConclusionsOur research showed that women who had pre-pregnancy overweight or obesity with singleton pregnancies through ART were more likely to have a cesarean section, gestational diabetes mellitus, gestational hypertension, and preeclampsia. Moreover, neonates from women who had obesity before pregnancy were more likely to have macrosomia.

Highlights

Studies have shown that being underweight or overweight before pregnancy has adverse effects on pregnant women and their newborns [1,2,3]
Some studies reported that newborns conceived through assisted reproductive technology (ART) are at a greater risk of premature delivery and low birth weight (LBW) [10]
There was no statistically significant difference in the history of premature delivery, primiparity, or multiparity among women across different BMI categories; the cesarean section rates in women with pre-pregnancy overweight and obesity were higher at 60.70% and 63.84%, respectively

Summary

Introduction

Studies have shown that being underweight or overweight before pregnancy has adverse effects on pregnant women and their newborns [1,2,3]. Many studies have reported that pregnant women who conceived through ART experience more perinatal complications, and their newborns may have a greater risk of adverse outcomes. A study in Japan showed that pregnancies conceived through ART are prone to a variety of adverse complications, such as premature delivery, placenta previa, placental adhesion, placental abruption, gestational hypertension, etc. Other studies showed that, even without complications during pregnancy, there was an increased risk of placental adhesion and postpartum hemorrhage during delivery at term [9]. Some studies reported that newborns conceived through ART are at a greater risk of premature delivery and LBW [10]. A prospective study in the United States showed that growth and development in offspring conceived through ART and those conceived naturally were similar, without significant difference [11]

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