Abstract
Background Pre-pregnancy body mass index and gestational weight gain were related to perinatal outcomes. It was not know the changes of pre-pregnancy body mass index, weight gain during pregnancy and its effect on perinatal outcomes in two-child women.Methods This was a retrospective study. Data of single term women delivered in the First Affiliated Hospital of Sun Yat-sen University were collected from July 2017 to June 2018. Gestational weight gain criteria of the American Institute of Medical Research and pre-pregnancy body mass index classes were used to evaluate the effects on pregnancy outcomes.Results A total of 3049 cases were enrolled in the study. Overweight cases was 9.0% and obesity was 2.4%. The weight gain of the two-child women was less than that of primipara(12.4±3.9vs13.3±4.0kg, P<0.001). The proportion of primipara with excessive weight gain was higher compared to two-child women(20.1%versus17.3%, P<0.001). There were 40.0% overweight primipara and 55.2% of two-child women had excessive weight gain. And 40.5% primipara and 54.5% two-child women of obesity had excessive weight gain during pregnancy. Obese primipara increased the risk of pre-eclampsia (aOR2.38, 95%CI 0.76-7.46). And the odds of diabetes mellitus and large for gestational age also increased in this group (aOR3.49, 95%CI 1.46-8.35 and aOR7.65, 95%CI 1.83-31.97, respectively). Two-child women had similar results. Underweight primipara with excessive weight gain increased the pre-eclampsia risk (aOR2.26, 95%CI 0.29-17.46). Normal weight and overweight/obese primipara also had similar results. But in two-child women, only overweight/obesity increased the risk of pre-eclampsia (aOR2.01, 95%CI 0.41-9.98). Underweight two-child women with less weight gain increased the risk of diabetes(aOR2.06, 95%CI 0.43-9.8). Two-child women with overweight/obese increased the odds of LGA even if they had less weight gain(aOR2.58, 95%CI 0.11-63.22). Normal weight primipara and two-child women with overweight and obese with excessive weight gain had similar results. On the other way, underweight primipara with less weight gain increased the risk of SGA(aOR1.74, 95%CI 0.81-3.76).Conclusions Gestational weight gain of two-child women was less than primipara. Overweight/obese women with excessive weight gain of two-child women increased the risk of adverse outcomes.
682 Everything in moderation: impact of extremes of BMI & gestational weight gain on perinatal outcomes
