268: The impact of gestational change in body mass index (BMI) on adverse pregnancy outcomes among women with gestational diabetes

AbstractThe relevance of pregestational body mass index (BMI) on adverse pregnancy outcomes remained unclear in Southwest China. This study aimed to investigate the overall and age-category specific association between pre-gestational BMI and gestational diabetes mellitus (GDM), preeclampsia, cesarean delivery, preterm delivery, stillbirth, macrosomia, and small-for-gestational age (SGA) or large-for-gestational age (LGA) neonates in Southwest China. Furthermore, it explores the relative importance of influence of pregravid BMI and maternal age on pregnancy outcomes. 51,125 Chinese singleton pregnant women were recruited as study subjects. Multiple logistic regression models were used to examine the influence of pre-pregnancy BMI on adverse pregnancy outcomes. Gradient boosting machine was used to evaluate the relative importance of influence of pregravid BMI and maternal age on pregnancy outcomes. It is found that women who were overweight or obese before pregnancy are at higher risk of adverse pregnancy outcomes except for SGA neonates, while pre-pregnancy underweight is a protective factor for GDM, preeclampsia, cesarean delivery, macrosomia and LGA, but not SGA. Younger mothers are more susceptible to GDM and macrosomia neonates, while older mothers are more prone to preeclampsia. Pre-pregnancy BMI has more influence on various pregnancy outcomes than maternal age. To improve pregnancy outcomes, normal BMI weight as well as relatively young maternal ages are recommended for women in child-bearing age.

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Interpregnancy Body Mass Index Changes: Distribution and Impact on Adverse Pregnancy Outcomes in the Subsequent Pregnancy

American Journal of Perinatology ◽

10.1055/s-0038-1670634 ◽

2018 ◽

Vol 36 (05) ◽

pp. 517-521 ◽

Cited By ~ 3

Author(s):

Whitney Bender ◽

Adi Hirshberg ◽

Lisa Levine

Keyword(s):

Body Mass Index ◽

Preterm Birth ◽

Body Mass ◽

Pregnancy Outcomes ◽

Subsequent Pregnancy ◽

Adverse Pregnancy Outcomes ◽

Increased Risk ◽

History Of ◽

Index Changes ◽

Adverse Pregnancy

Objective To examine the change in body mass index (BMI) categories between pregnancies and its effect on adverse pregnancy outcomes. Study Design We performed a retrospective cohort study of women with two consecutive deliveries from 2005 to 2010. Analysis was limited to women with BMI recorded at <24 weeks for both pregnancies. Standard BMI categories were used. Adverse pregnancy outcomes included preterm birth at <37 weeks, intrauterine growth restriction (IUGR), pregnancy-related hypertension, and gestational diabetes mellitus (GDM). Women with increased BMI category between pregnancies were compared with those who remained in the same BMI category. Results In total, 537 women were included, of whom 125 (23%) increased BMI category. There was no association between increase in BMI category and risk of preterm birth, IUGR, or pregnancy-related hypertension. Women who increased BMI category had an increased odds of GDM compared with women who remained in the same BMI category (6.4 vs. 2.2%; p = 0.018). The increased risk remained after controlling for age, history of GDM, and starting BMI (adjusted odds ratio: 8.2; 95% confidence interval: 2.1–32.7; p = 0.003). Conclusion Almost one-quarter of women increased BMI categories between pregnancies. This modifiable risk factor has a significant impact on the risk of GDM.

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Maternal super-obesity (body mass index ≥ 50) and adverse pregnancy outcomes

Acta Obstetricia Et Gynecologica Scandinavica ◽

10.3109/00016341003657884 ◽

2010 ◽

Vol 89 (7) ◽

pp. 924-930 ◽

Cited By ~ 58

Author(s):

Mark Christopher Alanis ◽

William H. Goodnight ◽

Elizabeth G. Hill ◽

Christopher J. Robinson ◽

Margaret S. Villers ◽

...

Keyword(s):

Body Mass Index ◽

Body Mass ◽

Pregnancy Outcomes ◽

Adverse Pregnancy Outcomes ◽

Super Obesity ◽

Adverse Pregnancy

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Nutritional status of pregnant women: prevalence and associated pregnancy outcomes

Revista de Saúde Pública ◽

10.1590/s0034-89102001000600002 ◽

2001 ◽

Vol 35 (6) ◽

pp. 502-507 ◽

Cited By ~ 74

Author(s):

Luciana Bertoldi Nucci ◽

Maria Inês Schmidt ◽

Bruce Bartholow Duncan ◽

Sandra Costa Fuchs ◽

Eni Teresinha Fleck ◽

...

Keyword(s):

Gestational Diabetes ◽

Nutritional Status ◽

Pregnant Women ◽

Pregnancy Outcomes ◽

Educational Level ◽

Adverse Pregnancy Outcomes ◽

World Health ◽

Prepregnancy Weight ◽

Adverse Pregnancy ◽

The Impact

INTRODUCTION: Although obesity is well recognized as a current public health problem, its prevalence and impact among pregnant women have been less investigated in Brazil. The objective of the study was to evaluate the impact of pre-obesity and obesity among pregnant women, describing its prevalence and risk factors, and their association with adverse pregnancy outcomes. METHODS: A cohort of 5,564 pregnant women, aged 20 years or more, enrolled at aproximately 20 to 28 weeks of pregnancy, seen in prenatal public clinics of six state capitals in Brazil were followed up, between 1991 and 1995. Prepregnancy weight, age, educational level and parity were obtained from a standard questionnaire. Height was measured in duplicate and the interviewer assigned the skin color. Nutritional status was defined using body mass index (BMI), according to World Health Organization (WHO) criteria. Odds ratios and 95% confidence interval were calculated using logistic regression. RESULTS: Age-adjusted prevalences (and 95% CI) based on prepregnancy weight were: underweight 5.7% (5.1%-6.3%), overweight 19.2% (18.1%-20.3%), and obesity 5.5% (4.9%-6.2%). Obesity was more frequently observed in older black women, with a lower educational level and multiparous. Obese women had higher frequencies of gestational diabetes, macrosomia, hypertensive disorders, and lower risk of microsomia. CONCLUSIONS: Overweight nutritional status (obesity and pre-obesity) was seen in 25% of adult pregnant women and it was associated with increased risk for several adverse pregnancy outcomes, such as gestational diabetes and pre-eclampsia.

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Association of maternal pre-pregnancy body mass index with adverse pregnancy outcomes according to maternal age: a population-based cohort study

Authorea ◽

10.22541/au.158687237.73417925 ◽

2020 ◽

Author(s):

Jie Tang ◽

Xinhong Zhu ◽

Mingzhen Li ◽

Dongming Huang ◽

Tiemeier Henning ◽

...

Keyword(s):

Body Mass Index ◽

Cohort Study ◽

Body Mass ◽

Pregnancy Outcomes ◽

Maternal Age ◽

Population Based ◽

Adverse Pregnancy Outcomes ◽

Adverse Pregnancy

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The Impact of Gestational Weight Gain on the Risks of Adverse Maternal and Infant Outcomes among Normal BMI Women with High Triglyceride Levels during Early Pregnancy

Nutrients ◽

10.3390/nu13103454 ◽

2021 ◽

Vol 13 (10) ◽

pp. 3454

Author(s):

Xia-Fei Jiang ◽

Hui Wang ◽

Dan-Dan Wu ◽

Jian-Lin Zhang ◽

Ling Gao ◽

...

Keyword(s):

Weight Gain ◽

Preterm Birth ◽

Gestational Diabetes ◽

Early Pregnancy ◽

Pregnancy Outcomes ◽

Gestational Hypertension ◽

Adverse Pregnancy Outcomes ◽

Gestational Weight ◽

Adverse Pregnancy ◽

The Impact

A high maternal triglyceride (mTG) level during early pregnancy is linked to adverse pregnancy outcomes, but the use of specific interventions has been met with limited success. A retrospective cohort study was designed to investigate the impact of gestational weight gain (GWG) on the relationship between high levels of mTG and adverse pregnancy outcomes in normal early pregnancy body mass index (BMI) women. The patients included 39,665 women with normal BMI who had a singleton pregnancy and underwent serum lipids screening during early pregnancy. The main outcomes were adverse pregnancy outcomes, including gestational hypertension, preeclampsia, gestational diabetes, cesarean delivery, preterm birth, and large or small size for gestational age (LGA or SGA) at birth. As a result, the high mTG (≥2.05mM) group had increased risks for gestational hypertension ((Adjusted odds ratio (AOR), 1.80; 95% CI, 1.46 to 2.24)), preeclampsia (1.70; 1.38 to 2.11), gestational diabetes (2.50; 2.26 to 2.76), cesarean delivery (1.22; 1.13 to 1.32), preterm birth (1.42, 1.21 to 1.66), and LGA (1.49, 1.33 to 1.68) compared to the low mTG group, after adjustment for potential confounding factors. Additionally, the risks of any adverse outcome were higher in each GWG subgroup among women with high mTG than those in the low mTG group. High mTG augmented risks of gestational hypertension, preeclampsia, preterm birth, and LGA among women with 50th or greater percentile of GWG. Interestingly, among women who gained less than the 50th percentile of GWG subgroups, there was no relationship between high mTG level and risks for those pregnancy outcomes when compared to low mTG women. Therefore, weight control and staying below 50th centile of the suggested GWG according to gestational age can diminish the increased risks of adverse pregnancy outcomes caused by high mTG during early pregnancy.

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The impact of high maternal body mass index on obstetric and perinatal outcomes

International Journal of Reproduction Contraception Obstetrics and Gynecology ◽

10.18203/2320-1770.ijrcog20210729 ◽

2021 ◽

Vol 10 (3) ◽

pp. 1031

Author(s):

Natasha Sharma ◽

Manasi Patnaik

Keyword(s):

Body Mass Index ◽

Body Mass ◽

Pregnancy Outcomes ◽

Maternal Obesity ◽

Gestational Hypertension ◽

First Trimester ◽

Maternal Body Mass Index ◽

Obese Women ◽

Adverse Pregnancy ◽

The Impact

Background: The incidence of obesity has increased to pandemic proportions over the last 20 years. Maternal obesity is associated with a wide array of adverse maternal pregnancy outcomes and increased risks in the offspring. The aim of the study was to find the effect of obesity on maternal and perinatal outcome in obese women in comparison to those of normal weight women.Methods: The study was designed as a case-control study. Antenatal women with first trimester body mass index (BMI) of more than 30 kg/m2 constituted the cases and those with BMI between 18 and 24.9 kg/m2 formed the controls.Results: There was increased incidence of antepartum complications in obese women. Obese women had a significant history of prior treatment for infertility (p<0.00001). The incidence of gestational diabetes (OR 4.76, 95%CI 1.267-17.72 p=0.014), gestational hypertension (OR 3.05, 95%CI 1.01-9.20 p=0.04), induction of labor (OR 2.5, 95%CI 1.0-6.28 p=0.04), preeclampsia (OR 2.38, 95%CI 1.0-5.64 p=0.04, Caesarean section (OR 1.98, 95%CI 1.24-3.14 p=0.003), postpartum haemorrhage (OR 8.57, 95%CI 1.07-76.15 p=0.04) and wound infection (OR 8.57, 95%CI 1.07-76.15 p=0.04) and adverse neonatal outcomes such as higher mean birth weight (p<0.0001) and requirement of NICU (OR 2.79, 95%CI 1.33 -5.84 p=0.006) was higher in obese women.Conclusions: Obesity is an independent risk factor for adverse pregnancy outcomes and hence, interventions directed towards weight loss and prevention of excessive weight gain must begin in the preconception period.

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