Dynamics of Gestational Weight Gain in Women with Different Pre-pregnancy Body Weight

Abstract

International and national guidelines regulate the gestational weight gain (GWG), depending on the pre-pregnancy body mass index (BMI). Insufficient weight gain increases rate of delivery of small weight babies, and excessive GWG is associated with macrosomia, postpartum weight retention and obesity. Objective: Our objective was to assess the dynamics of GWG in women of different pre-pregnancy body weight.Material and methods: 219 pregnant women with different pre-pregnancy BMI were examined. In 45 ((20.5±2.7) %) patients were diagnosed insufficient, in 100 ((45.7±3.4) %) – normal and in 74 ((33.8±3.2) %) – excessive weight gain during pregnancy period. BMI was calculated by using the standard formula of person’s weight in kilograms divided by the square of her height in meters (kg/m2). Total weight gain was calculated by subtracting the pre-pregnancy weight from the last measured weight before delivery. Statistical analyses were carried out using Statistical program “Statistica 5.5”.Results: It has been established that the women with higher pre-pregnancy BMI have the lower weight gain during the gestation period r = -0.25 (p<0.001). Normal weight women have the highest level of GWG, while pregnant women with obesity have minimal level. However, underweight patients are in the higher risk of pathologically low GWG while overweight and obese women have greater risk of excessive GWG. The dynamics of weight gain during pregnancy shows that deficiency or absent weight gain in the first trimester is associated with an insufficient weight gain to the end of pregnancy r=0.58 (p<0.001). Conversely, rapid onset of excessive weight gain up to 12 weeks of gestation leads to further excessive GWG r = 0.77 (p<0.001).Conclusions: Body weight before pregnancy is an independent determinant of GWG. Adequate weight gain during pregnancy does not lead to obesity in women of all groups, while pathologically low and high GWG leads to inadequate accumulation of adipose tissue, which has negatively affects on the metabolism of maternal and fetal organisms.