Maternal pre-pregnancy body mass index and foetal acidosis in vaginal and caesarean deliveries: The Japan Environment and Children\u2019s Study

Tsuyoshi Murata,Koichi Hashimoto,Akiko Sato,Akiko Yamaguchi,Kosei Shinoki,Mitsuaki Hosoya,Hyo Kyozuka,Seiji Yasumura,Toma Fukuda,Hidekazu Nishigori,Yuka Ogata,Keiya Fujimori,Shun Yasuda

doi:10.1038/s41598-020-79178-1

Tsuyoshi Murata, Koichi Hashimoto + Show 11 more

Open Access

https://doi.org/10.1038/s41598-020-79178-1

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Abstract

A high maternal body mass index (BMI) is associated with increased risks of asphyxia-related neonatal morbidity. We evaluated the association between maternal pre-pregnancy BMI and foetal acidosis while accounting for the mode of delivery. Participants from the Japan Environment and Children’s Study with singleton pregnancies after 22 weeks of gestation who gave birth during 2011–2014 were included. The participants (n = 71,799) were categorised into five groups according to the pre-pregnancy BMI: G1 (BMI < 18.5 kg/m2), G2 (18.5 to < 20.0 kg/m2), G3 (20.0 to < 23.0 kg/m2), G4 (23.0 to < 25.0 kg/m2), and G5 (≥ 25.0 kg/m2). Foetal acidosis was defined as umbilical artery pH (UmA-pH) < 7.20 or < 7.10. Multiple logistic regression analyses were used to evaluate the effect of pre-pregnancy BMI on foetal acidosis risk, accounting for the mode of delivery. In Japanese women, pre-pregnancy BMI ≥ 25.0 kg/m2 significantly increased the likelihood of foetal acidosis in newborns delivered vaginally. We found no association between pre-pregnancy BMI and foetal acidosis in newborns delivered via caesarean section. Counselling for body weight control before pregnancy and adequate management and selection of the mode of delivery in pregnant women with a high BMI who are in labour may be essential to avoid foetal acidosis.

Highlights

Foetal acidosis is a factor associated with birth asphyxia resulting from an interruption of the placental blood flow and subsequent foetal hypoxia and h ypercarbia[15,16,17]
Using data from the Japan Environment and Children’s Study (JECS), we have reported that excessive gestational weight gain is significantly associated with increased foetal acidosis in women with a pre-pregnancy body mass index (BMI) of 23.0–25.0 kg/m2 and not in women with a pre-pregnancy BMI ≥ 25.0 kg/m220
This study evaluated the association between maternal pre-pregnancy BMI and foetal acidosis while accounting for the mode of delivery

Summary

Introduction

Foetal acidosis is a factor associated with birth asphyxia resulting from an interruption of the placental blood flow and subsequent foetal hypoxia and h ypercarbia[15,16,17]. Using data from the Japan Environment and Children’s Study (JECS), we have reported that excessive gestational weight gain is significantly associated with increased foetal acidosis in women with a pre-pregnancy BMI of 23.0–25.0 kg/m2 and not in women with a pre-pregnancy BMI ≥ 25.0 kg/m220. Previous studies reporting that maternal obesity increases the risk of foetal acidosis were limited to hospital-based or retrospective cohort study designs and included only v aginal[21,22] or caesarean[23] deliveries, not both. As the mode of delivery can affect the neonatal c ondition[24], the association between maternal obesity and foetal acidosis should be evaluated while accounting for the mode of delivery. This study aimed to evaluate the association between maternal pre-pregnancy BMI and foetal acidosis while accounting for the mode of delivery in a large Japanese cohort

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