Abstract
The objective of the study is to analyze the association between early pregnancy body mass index (BMI), gestational weight gain (GWG), and maternal and neonatal outcomes. The retrospective cohort study was conducted at Quanzhou First Hospital Affiliated to Fujian Medical University from January 2018 to May 2021, with 552 women enrolled. Women were divided into the underweight group, normal weight group, overweight group, and obese group according to early pregnancy BMI. Univariate and multivariate logistic regression analyses were performed. The absolute risk of adverse maternal and neonatal outcomes in the early pregnancy BMI group was calculated to further analyze the association between GWG and adverse maternal and neonatal outcomes. Of the 552 women, 390 (70.65%) women had adverse maternal and neonatal outcomes. The result revealed that overweight was associated with increased risk of adverse maternal and neonatal outcomes (odds ratio (OR): 1.643, 95% confidence interval (CI): 1.006-2.684), maternal complications (OR: 1.937, 95% CI: 1.188-3.159), and large for gestational age (LGA) (OR: 1.905, 95% CI: 1.061-3.422). In the obese group, the risk of adverse maternal and neonatal outcomes (OR: 5.760, 95% CI: 1.997-16.786), maternal complications (OR: 3.112, 95% CI: 1.645-5.887), gestational diabetes mellitus (GDM) (OR: 2.943, 95% CI: 1.509-5.741), cesarean section (OR: 1.899, 95% CI: 1.002-3.599), and preterm delivery (OR: 4.752, 95% CI: 1.395-16.185) increased. Besides, there was an association between insufficient GWG and decreased risk of LGA (OR: 0.392, 95% CI: 0.187-0.826) and higher risk of preterm delivery (OR: 2.818, 95% CI: 1.171-6.784). This study demonstrates that BMI and GWG are related to maternal and neonatal outcomes. It is necessary to regularly monitor the weight of pregnant women during pregnancy. And regional guidelines for GWG also need to be explored.
Highlights
In recent years, the prevalence of overweight and obesity among women at reproductive age is increasing [1, 2]
Compared with women in the normal weight group, overweight women had an increased risk of adverse maternal and neonatal outcomes (OR: 1.926, 95% confidence interval (CI): 1.198-3.094), maternal complications (OR: 2.140, 95% confidence interval (95% CI): 1.329-3.446), cesarean section (OR: 1.618, 95% CI: 1.070-2.448), and large for gestational age (LGA) (OR: 2.230, 95% CI: 1.271-3.912)
The risk of adverse maternal and neonatal outcomes (OR: 5.760, 95% CI: 1.997-16.786), maternal complications (OR: 3.112, 95% CI: 1.645-5.887), gestational diabetes mellitus (GDM) (OR: 2.943, 95% CI: 1.509-5.741), cesarean section (OR: 1.899, 95% CI: 1.002-3.599), and preterm delivery (OR: 4.752, 95% CI: 1.395-16.185) increased (Table 3)
Summary
The prevalence of overweight and obesity among women at reproductive age is increasing [1, 2]. The 2011 Pregnancy Nutrition Surveillance on maternal health indicators showed a prevalence of 4.5% and 53.7% of women having a prepregnancy body mass index (BMI) in the underweight and overweight category, respectively [3]. Being overweight or obese increases the risk of diabetes, high blood pressure, and disorders of fetal growth and is even linked to the development of many cancers, which is a serious global public health challenge [5]. The repercussion of this rising increase in weight on maternal and neonatal outcomes is imperative to be studied. It is of particular relevance to study the effects of BMI and GWG on pregnancy and the newborn and to develop a reasonable pregnancy weight control plan
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