293: Impact of BMI and gestational weight gain on term pregnancy outcome in Rwanda

Abstract Purpose To describe the clinical characteristics, management and pregnancy outcome of women with prepregnancy hypopituitarism (HYPO) that received care at our center. Methods Retrospective study describing 12 pregnancies in women with prepregnancy HYPO (two or more pituitary hormonal deficiencies under replacement treatment) that received care during pregnancy at Hospital Santa Creu i Sant Pau. Clinical characteristics, management and pregnancy outcome were systematically collected. Results Average patients’ age was 35 years and HYPO duration at the beginning of pregnancy was 19 years. The most frequent cause of HYPO was surgical treatment of a sellar mass (8 pregnancies). Eight pregnancies were in primigravid women and 10 required assisted reproductive techniques. The hormonal deficits before pregnancy were as follows: GH in 12 women, TSH in 10, gonadotropin in 9, ACTH in 5 and ADH in 2. All deficits were under hormonal substitution except for GH deficit in 4 pregnancies. During pregnancy, 4 new deficits were diagnosed. The dosage of replacement treatment for TSH, ACTH and ADH deficits was increased and GH was stopped. Average gestational age at birth was 40 weeks, gestational weight gain was excessive in 9 women, 8 patients required induction/elective delivery and cesarean section was performed in 6. Average birthweight was 3227 g. No major complications were observed. Five women were breastfeeding at discharge. Conclusions In this group of women with long-standing HYPO, with careful clinical management (including treatment of new-onset hormonal deficits) pregnancy outcome was satisfactory but with a high rate of excessive gestational weight gain and cesarean section.

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A Study to Assess the Effect of Maternal Obesity on Pregnancy Outcome in a Tertiary Medical Centre of South Bihar

Journal of Evidence Based Medicine and Healthcare ◽

10.18410/jebmh/2021/511 ◽

2021 ◽

Vol 8 (30) ◽

pp. 2784-2789

Author(s):

Aishwarya Aishwarya ◽

Arshi Praveen ◽

Vineeta Singh

Keyword(s):

Weight Gain ◽

Pregnancy Outcome ◽

Vaginal Delivery ◽

Gestational Weight Gain ◽

Maternal Obesity ◽

World Health ◽

Normal Vaginal Delivery ◽

Childbearing Age ◽

Gestational Weight ◽

Excessive Gestational Weight Gain

BACKGROUND World health organization (WHO) declares obesity as a pandemic issue, having high prevalence in females, especially in the childbearing age than in males. Pregnancies complicated by obesity has been identified as early as 1945. Prepregnancy obesity endangers both maternal and fetal well-being. Increasing body mass index (BMI) is associated with increased adverse obstetric and fetal outcomes. Pre-pregnancy obesity and excessive gestational weight gain are parts of maternal obesity during pregnancy. Prenatal maternal obesity and excessive gestational weight gain also improve placental nutrition transfer to the developing foetus and foetal development. The purpose of this study was to evaluate the association between early pregnancy BMI and maternal complications as well as labour outcome. METHODS A prospective observational study comprising 250 antenatal women with singleton uncomplicated pregnancies, booked at Narayan Hospital, Rohtas, South Bihar within the first 12 weeks of gestation were selected for the study. The following inclusion and exclusion criteria were considered. With the help of a predesigned questionnaire, basic information including weight and height was collected in the first check up and BMI was calculated accordingly. BMI was calculated using the formula weight (kg)/height 2 (m2). RESULTS The mean age of mothers was 25.98 ± 3.92 years. Mothers who underwent caesarean section had BMI of 27.36 ± 5.768 and for normal vaginal delivery mothers it was 27.94 ± 6.076, whereas for mother who had undergone forceps delivery, BMI was 30.60 ± 3.864 whereas for other assisted vaginal delivery it was 29.75 ± 7.246. There is mild correlation of BMI of mother to the birth weight of baby. On applying regression analysis, we found mild correlation with R square 0.134. There was no correlation of BMI of mother to the hospital stay of their children. CONCLUSIONS We concluded that however statistically there is no significant association between obesity and numerous maternal and perinatal risks in obese pregnant women but it poses a considerable challenge to the obese patient in successful completion of pregnancy. KEYWORDS Obesity, BMI, Pregnancy Outcome, NICU, Mode of Delivery

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