Maternal Prepregnancy Body Mass Index, Gestational Weight Gain, and Risk of Adverse Perinatal Outcomes in Taiwan: A Population-Based Birth Cohort Study.

Chi-Nien Chen,Heng-Cheng Hsu,Ho-Sheng Chen

doi:10.3390/ijerph17041221

Abstract

Epidemiological studies have shown that maternal prepregnancy body mass index (BMI) and gestational weight gain (GWG) are associated with increased risk of perinatal outcomes. However, the evidence of such associations in Asian populations is limited. We conducted a secondary data analysis to investigate the relationships of prepregnancy BMI and GWG with the risks of adverse perinatal outcomes, including gestational diabetes (GDM), gestational hypertension (GHTN), preeclampsia, cesarean delivery, preterm birth, low birth weight (LBW), and macrosomia. We categorized prepregnancy BMI by the WHO classification and GWG by the Institute of Medicine guidelines. We performed adjusted logistic regression models to estimate the odds ratios of adverse perinatal outcomes. A total of 19,052 women were included; prepregnancy overweight and obesity were associated with a greater risk of GDM, GHTN, preeclampsia, cesarean delivery, preterm birth, and macrosomia. Women with excessive GWG had a greater risk of GHTN, preeclampsia, cesarean delivery, and macrosomia. In conclusion, regardless of the range of GWG during pregnancy, maternal prepregnancy BMI is significantly associated with the risk of adverse perinatal outcomes in Taiwan. Public health attention regarding obesity reduction before conception and prenatal counseling for optimal GWG is needed to mitigate the risk of poor perinatal outcomes.

Highlights

Maternal mortality and morbidity remain significant public health concerns
Maternal overweight and obesity are associated with an increased risk of many adverse perinatal outcomes, such as preterm birth, gestational diabetes, gestational hypertension (GHTN), preeclampsia, cesarean delivery and macrosomia [4,5,6,7,8,9,10,11,12]
After controlling for confounding factors, the adjusted risks of GHTN, preeclampsia, cesarean delivery, and macrosomia were significantly higher in the excessive gestational weight gain (GWG) group than in the adequate GWG group

Summary

Introduction

Maternal mortality and morbidity remain significant public health concerns. Despite modern perinatal care, the rates of maternal pregnancy complications have continued to increase in recent decades [1]. The main risk factors for these poor pregnancy outcomes might contribute to chronic health conditions, including diabetes, hypertension, and cardiac disease [2]. The prevalence of overweight and obesity among women at reproductive age is increasing [3]. Obesity is another clinical concern and is linked to the development of the abovementioned chronic health conditions related to maternal morbidities. Maternal overweight and obesity are associated with an increased risk of many adverse perinatal outcomes, such as preterm birth, gestational diabetes, gestational hypertension (GHTN), preeclampsia, cesarean delivery and macrosomia [4,5,6,7,8,9,10,11,12].

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