Maternal determinants of pregnancy complications, birth outcomes, and postpartum depression (369.8)

Abstract

Various socio‐demographic and lifestyle factors have independently been reported to be associated with pregnancy complications, birth outcomes. We aimed to identify if prepregnancy BMI, gestational weight gain (GWG) and Adequacy of Prenatal Care Utilization (APNCU) are collective determinants of pregnancy complications, birth outcomes and postpartum depression. Multiple logistic regression analyses were conducted using the data of 7,911 Michigan’s 2007‐2010 Pregnancy Risk Assessment Monitoring System (PRAMS). After age, race/ethnicity, education, incomes, smoking status, and gestational weeks were controlled, prepregnancy BMI>30 was associated with high risk for large‐for gestational age (LGA) (aOR:1.97, 95% CI:1.61‐2.42), gestational hypertension (GH) (2.68, 2.23‐3.22), and gestational diabetes mellitus (GDM) (4.33, 2.79‐6.71) and low risk for small‐for‐gestational age (SGA) (0.70, 0.55‐0.87); excessive GWG increased the risk for LGA (1.73, 1.40‐2.12), macrosomia (3.23, 1.70‐6.13), and GH (1.36, 1.12‐1.64) and decreased the risk for SGA (0.56, 0.45‐0.68) and preterm labor (0.75, 0.64‐0.88). Compared to the women who started prenatal care in the first trimester, those who received no prenatal care had a higher risk for LGA (3.06, 1.05‐8.91). Prenatal care received during the 2nd or 3rd trimesters decreased the risk of having postpartum depression (0.73, 0.56‐0.95). However, APNCU was not associated with pregnancy complications, birth outcomes and postpartum depression. Maintaining healthy prepregnancy BMI and adequate GWG are important determinants for optimal health outcomes of pregnant women.