Excessive gestational weight gain during the week prior to delivery as a predictor of maternal life-threatening complications in preeclamptic women.

Abstract

To investigate the relationship between excessive gestational weight gain during the week prior to delivery (GWG) and severe morbidity and pregnancy termination among pregnant women with preeclampsia (hypertension with proteinuria). We compared GWG, laboratory data, and complication(s) between 94 preeclamptic women (preeclampsia group) with singleton pregnancies who delivered at ≥22 gestational weeks and 188 healthy women (control group) with singleton pregnancies undergoing elective cesarean deliveries. The gestational weeks at delivery were matched in the preeclampsia and control groups. Among 282 total participants, median of GWG was significantly higher in the preeclampsia group than in the control group (1.6kg vs. 0.5 kg, p < 0.0001). Furthermore, the GWG cutoff value for the preeclampsia group was 1.6kg. The odds ratio for morbidity of preeclampsia among the women with GWG ≥1.6kg at delivery was 12.5 (95% confidence interval, 6.31-24.5). In the preeclampsia group, 47 women with GWG ≥1.6kg had significantly higher risks of hypoproteinemia, proteinuria, and renal dysfunction than those of 47 women with GWG < 1.6kg. While, multivariate analysis showed 1.5kg was a GWG cutoff value for predicting maternal morbidity (p < 0.0001); preeclamptic women with GWG ≥1.5kg had a significantly higher risk of pulmonary edema than preeclamptic women with GWG < 1.5kg (odds ratio, 7.77; 95% confidence interval, 1.64-36.7). Excessive GWG in women with preeclampsia might be a predictor for severe maternal life-threatening complications requiring pregnancy termination.