scholarly journals A180 RISK FACTORS FOR INADEQUATE GESTATIONAL WEIGHT GAIN IN PREGNANT PATIENTS WITH INFLAMMATORY BOWEL DISEASES

2021 ◽  
Vol 4 (Supplement_1) ◽  
pp. 194-195
Author(s):  
P Tandon ◽  
Y Hanna ◽  
J Cepo ◽  
C Maxwell ◽  
V W Huang
Keyword(s):  
Weight Gain ◽  
Gestational Weight Gain ◽  
Pregnancy Outcomes ◽  
First Trimester ◽  
Gestational Weight ◽  
Emergency Cesarean ◽  
Inflammatory Bowel ◽  
The Mean ◽  
Adverse Pregnancy ◽  
Active Disease

Abstract Background Patients with inflammatory bowel disease (IBD) are at a risk of inadequate gestational weight-gain (GWG) which in turn may increase the risk of adverse pregnancy outcomes. Aims To determine the risk factors for inadequate GWG in these patients and to determine the impact on adverse pregnancy outcomes. Methods Pregnant patients with IBD, both ulcerative colitis (UC) and Crohn’s disease (CD), were identified retrospectively at the Mount Sinai Hospital from 2016 to 2020. Total gestational weight-gain (GWG) was calculated as the difference of the weight recorded at time of labor and pre-pregnancy weight. GWG was further stratified into less than adequate, adequate, and more than adequate based on the pre-pregnancy body-mass index and standards set by the U.S. Institute of Medicine. Pregnancy-related outcomes were also recorded for each patient. Disease activity was recorded at each trimester visit and defined by a fecal calprotectin (FCP) > 250 ug/g. Differences in the mean GWG were compared using independent T-test with standard deviations (SD) whereas categorical variables were compared using the Chi-square (x2) test. Results 71 pregnancies in 71 patients were included (33 UC and 38 CD). Thirteen patients (18.3%) had less than adequate, 23 (32.4%) adequate, and 35 (49.3%) more than adequate GWG. Of the 33 patients with UC, 4 (12.2%) had less than adequate, 15 (45.5%) had adequate, and 14 (42.4%) had more than adequate GWG. Of the 38 patients with CD, 9 (23.7%) had less than adequate, 8 (21.1%) had adequate, and 21 (55.3%) had more than adequate GWG (p=0.07) for CD vs. UC). In those with CD, both fistulizing and stricturing CD phenotypes appeared to be numerically associated with inadequate GWG. Specifically, none of the 13 patients with fistulizing CD had adequate GWG compared to 32.0% (8/25) in those without fistulizing disease (p=0.07). Similarly, only 2/22 (9.1%) of those with stricturing CD had adequate GWG compared to 6/16 (37.5%) in those without stricturing disease (p=0.07). Furthermore, of seven patients with active disease in the first trimester, only one had adequate GWG (14.3%) compared to 37.5% (3/8) of those in clinical remission (p=0.044). Active disease in trimesters two and three was not associated with inadequate GWG. Finally, the mean GWG was higher in those undergoing Cesarean (37.8 kg (SD 14.1) vs. 30.4 kg (SD 10.5), p=0.014)) and emergency Cesarean delivery (43.5 kg (SD 17.6) vs. 31.9 kg (SD 10.7) (p=0.004) compared to vaginal delivery respectively. Conclusions Patients with CD, but not UC, and those with active disease in the first trimester, are at risk of inadequate GWG during pregnancy. In those with larger GWG, a higher rate of emergency Cesarean birth was noted. Optimal intervention to achieve recommended gestational weight-gains in patients with IBD remains to be determined. Funding Agencies None

scholarly journals Association of Pre-Pregnancy Body Mass Index and Gestational Weight Gain with Preterm Delivery in Pregnant Women

2021 ◽  
Author(s):  
Bhavya Baxi ◽  
Jigna Shah
Keyword(s):  
Weight Gain ◽  
Birth Weight ◽  
Pregnant Women ◽  
Gestational Weight Gain ◽  
Pregnancy Outcomes ◽  
Caesarean Delivery ◽  
Junk Food ◽  
Economic Class ◽  
Gestational Weight ◽  
Adverse Pregnancy

The perinatal mortality rate, which is one of the important adverse pregnancy outcome and includes stillbirths and infant death within first week of life is estimated to be nearly 40 deaths per 1,000 pregnancies in Gujarat. Also the infant mortality rates have been estimated to be 50 deaths before age of one year per 1,000 pregnancies. It is stated that children whose mothers are illiterate or belong to low socio-economic class have two and half times more chances to die within 1 year of their birth compared to those whose mothers have completed atleast 10 years of education or belong to high socio-economic class. There are nearly 13% of women who does not receive proper antenatal care and facility during pregnancy. In India, there are nearly half of the women (52%) who possess normal BMI range: rest are either underweight or overweight. Approximately 55% of the women of total population in India are anaemic. These maternal parameters directly affect the children causing 48% of the children to be malnourished and 43% to be underweight. Therefore, it is imperative to examine the association of pre-pregnancy Body Mass Index (BMI) as well as Gestational Weight Gain (GWG) with diverse pregnancy outcomes such as gestational diabetes, gestational hypertension and also with preterm delivery, caesarean delivery, etc. The present study was designed to investigate the prevalence, GWG, various pregnancy outcomes of underweight, overweight or obese pregnant women, and to explore the relationship between pre-pregnancy BMI as well as gestational weight gain during pregnancy and adverse pregnancy outcomes. This is a prospective, multi-centric study involving pregnant women with gestation week ≤20 weeks in Ahmedabad in Gujarat region. Our study observed that out of 226 women enrolled, 44 women (19.47%) were underweight, 137 women (60.62%) were normal, 30 women (13.27%) were overweight and 15 women (6.64%) were obese. The incidence of caesarean delivery (56.92%) was found more in nuclear family as compared to joint family (46.92%). It was found that in women taking no junk food at all, the chances of LBW were 16.39%, which was less as compared to mothers who had junk food. It was also observed that amongst women taking 1 glass milk daily (42.92%), about 55.67% of had normal type of delivery. Amongst women taking 1 fruit daily (57.52%), 53% women had normal delivery. Present study spotted decrease in risk of caesarean delivery with increase in maternal haemoglobin level from 9.0 gm/dl till 12.0 gm/dl. Average weight gain observed in underweight was 12.93 ± 1.90, in normal 12.32 ± 1.71, in overweight 10.23 ± 1.28 and in obese 9.6 ± 1.50. A negative correlation was found between GWG and pre-pregnancy BMI, i.e. as pre-pregnancy BMI increase, the GWG decrease. The incidence of pre-term delivery (9.49%) was much less in normal BMI range. The average infant birth weight observed in underweight women was 2.63 ± 0.47, in normal was 2.9 ± 0.49, in overweight was 2.92 ± 0.56 and in obese was 2.95 ± 0.86. It is observed that highest birth weight is obtained in obese women, which decreases as the maternal BMI range decreases. The incidence of LBW in normal and overweight women was 15.33 and 16.67%, which was low as compared to obese and underweight women. Our study reveals that parameters such as GWG, type of family, intake of milk, fruits and junk food, haemoglobin concentration directly affects the pregnancy outcomes such as term of delivery, type of delivery and infant birth weight.

scholarly journals EFFECT OF EXCESSIVE GESTATIONAL WEIGHT GAIN ON PREGNANCY OUTCOME: A CASE STUDY OF TERTIARY HOSPITALS IN BENUE STATE, NIGERIA

2020 ◽  
Vol 8 (3) ◽  
pp. 180-189
Author(s):  
Amarachi Nwaogwugwu ◽  
Nwabueze Achunam Simeon ◽  
Celestine E Ekwuluo
Keyword(s):  
Weight Gain ◽  
Pregnancy Outcome ◽  
Gestational Weight Gain ◽  
Pregnancy Outcomes ◽  
Strong Association ◽  
Adverse Pregnancy Outcomes ◽  
Value Analysis ◽  
Gestational Weight ◽  
Tertiary Hospitals ◽  
Adverse Pregnancy

Motivation/Background: Little is known of adverse pregnancy outcomes resulting from Excess Gestational Weight Gain (EGWG) in Benue state, Nigeria. In this study, we aimed to assess the effects and association of EGWG on pregnancy outcome in tertiary hospitals in Benue State. Method: We used retrospective cohort study to examine the data obtained from the general Antenatal Care (ANC) Register of 350 pregnant women who attended ANC clinic between January 1, 2016 and December 31, 2016. Pre-pregnancy Body Mass Index (BMI) was calculated by dividing weight in kilograms within first 14 weeks of gestation by square of height in meters while total gestational weight was calculated as difference between weight before, or at 14 weeks and weight at 37 weeks of gestation prior to delivery. Results: Data analysis was done using SPSS version 21. Out of the sampled folders, 103 (29.4%) women gained excess weight during pregnancy, 130 (37.1%) women gained the recommended weight while 117 (33.4%) women gained weight less than the recommended value. Analysis showed strong association between EGWG and pregnancy induced hypertension/pre-eclampsia, caesarean section and macrosomia. Conclusions: The study concluded that EGWG should be avoided by educating women on the need to gain appropriate weight during pregnancy to prevent adverse pregnancy outcomes which affect both mothers and their offspring.

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