Abstract
Background/ObjectiveHealthy weight maintenance before and during pregnancy has a significant effect on pregnancy outcomes; however, there are no specific guidelines for gestational weight gain in pregnant Korean women. Therefore, we investigated the impact of pre-pregnancy body mass index (BMI) and gestational weight gain on the risk of maternal and infant pregnancy complications in pregnant Korean women.MethodsStudy participants comprised 3454 singleton pregnant women from the Korean Pregnancy Outcome Study who had baseline examination and pregnancy outcome data. Maternal pre-pregnancy BMI and gestational weight gain were categorized according to the Asia-pacific regional guidelines and the Institute of Medicine recommendations, respectively. The primary outcome was any adverse outcomes, defined as the presence of one or more of the following: hypertensive disorders of pregnancy, gestational diabetes mellitus, peripartum depressive symptom, cesarean delivery, delivery complications, preterm birth, small or large weight infant, neonatal intensive care unit admission, or a congenital anomaly. Multiple logistic regression models were applied to examine the independent and combined impact of pre-pregnancy BMI and gestational weight gain on the risk of maternal and infant outcomes.ResultsObesity before pregnancy significantly increased the risk of perinatal adverse outcomes by more than 2.5 times [odds ratio (OR): 2.512, 95% confidence interval (CI): 1.817–3.473]. Compared to that in women with appropriate gestational weight gain, women with excessive weight gain had a 36.4% incremental increase in the risk of any adverse outcomes [OR: 1.364, 95% CI: 1.115–1.670]. Moreover, women who were overweight or obese before pregnancy and had excessive gestational weight gain had a three-fold increase in the risk of adverse outcomes [OR: 3.460, 95% CI: 2.210–5.417].ConclusionThis study highlights the need for appropriate weight recommendations before and during pregnancy to prevent perinatal complications in Korean women of childbearing age.
Highlights
The increasing prevalence of obesity has become one of the most important public health concerns worldwide [1,2,3,4]
Gestational weight gain is necessary to ensure a healthy fetus, inappropriate weight gain is associated with adverse outcomes, including gestational diabetes mellitus (GDM), preeclampsia, peripartum depressive symptom, cesarean delivery, preterm birth, low birth weight, and macrosomia [10, 11, 15, 18,19,20]
Women who were obese before pregnancy were slightly older and had higher systolic and diastolic blood pressures, lower gestational weight gain, and higher frequencies of former and passive smoker status, excessive, based on the pre-pregnancy body mass index (BMI) and gestational weight gain, in accordance with the IOM guidelines [21]
Summary
The increasing prevalence of obesity has become one of the most important public health concerns worldwide [1,2,3,4]. The prevalence of obesity in reproductive women is increasing globally, and one in four Korean women is obese [3, 4]. Overweight or obese status before pregnancy strongly influences metabolic complications and adverse perinatal consequences. Directly influences placental and fetal cardiometabolic development [5,6,7,8]. The offsprings of mothers with a high prepregnancy BMI are at increased long-term risk for obesity and cardiometabolic dysfunction [9]. Gestational weight gain is necessary to ensure a healthy fetus, inappropriate weight gain is associated with adverse outcomes, including gestational diabetes mellitus (GDM), preeclampsia, peripartum depressive symptom, cesarean delivery, preterm birth, low birth weight, and macrosomia [10, 11, 15, 18,19,20]
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