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

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.

2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Yin Sun ◽  
Zhongzhou Shen ◽  
Yongle Zhan ◽  
Yawen Wang ◽  
Shuai Ma ◽  
...  

Abstract Objective To investigate recommendations for appropriate gestational weight gain (GWG) of Chinese females. Methods In total of 3,172 eligible women in the first trimester were recruited into the Chinese Pregnant Women Cohort Study (CPWCS) project. Pregnancy complications and outcomes were collated using the hospital medical records system. The method of occurrence of participants with adverse pregnancy outcomes (Occurrence Method) was conducted to calculate the recommended total GWG for each participant’s pre-pregnancy BMI. Occurrence Method data were judged against the Institute of Medicine (IOM) and Japanese recommended criteria in terms of the total occurrence of adverse pregnancy outcomes of pregnant women with appropriate weight gain. Results The most frequent GWG was ≥ 14 kg and < 16 kg (19.4%), followed by ≥ 10 kg and < 12 kg (15.5%) and ≥ 12 kg and < 14 kg (15.2%). The most frequently occurring adverse pregnancy outcomes were cesarean sections for underweight (30.0%), normal weight (40.4%), overweight (53.6%) and obese (53.7%) women. A large for gestational age (LGA) accounted for 18.0% of the overweight and 20.9% of the obesity group. Gestational diabetes mellitus (GDM) occurred in 16.9% of overweight and 23.1% of obese women. The recommended total GWG in a Chinese women population is ≥ 8 and < 12 kg if underweight, ≥ 12 and < 14 kg for normal weight, ≥ 8.0 and < 10.0 kg if overweight, and < 8 kg for women with obesity. Conclusions Current Chinese recommendations provide the optimal ranges of GWG to minimize the occurrence of undesirable pregnancy outcomes for each group of pre-pregnancy BMIs in a Chinese population. Trial registration Registered with ClinicalTrials (NCT03403543).


2021 ◽  
Author(s):  
Jiaxi Yang ◽  
Molin Wang ◽  
Deirdre K. Tobias ◽  
Janet W. Rich-Edwards ◽  
Anne Marie Darling ◽  
...  

Abstract Background Appropriate gestational weight gain (GWG) is important for optimal pregnancy outcomes. This study prospectively evaluated the associations between GWG during the second and third trimesters of pregnancy and adverse pregnancy outcomes in an urban Tanzanian pregnancy cohort. Methods We used data from a randomized clinical trial conducted among pregnant women recruited by 27 weeks of gestation in Dar es Salaam, Tanzania (N = 1,230). Women’s gestational weight was measured at baseline and at monthly antenatal visits. Weekly GWG rate during the second and third trimesters was calculated and characterized as inadequate, adequate, or excessive, in conjunction with measured or imputed early-pregnancy BMI status according to the 2009 Institute of Medicine (IOM) GWG guidelines. We used multivariable Poisson regression with a sandwich variance estimator to calculate risk ratios (RR) for associations of GWG with low birth weight, preterm birth, small for gestational age (SGA), and large for gestational age (LGA). Degree of appropriate GWG defined using additional metrics (i.e., percentage of adequacy, z-score) and potential effect modification by maternal BMI were additionally evaluated. Results According to the IOM guidelines, 517 (42.0%), 270 (22.0%), and 443 (36.0%) women were characterized as having inadequate, adequate, and excessive GWG, respectively. Overall, compared to women with adequate GWG, women with inadequate GWG had a lower risk of LGA births (RR=0.54, 95% CI: 0.36 - 0.80) and a higher risk of SGA births (RR=1.32, 95% CI: 0.95 - 1.81). ­­Women with inadequate GWG as defined by percentage of GWG adequacy had a higher risk of LBW (OR=1.93, 95% CI: 1.03 - 3.63). In stratified analyses by early-pregnancy BMI, excessive GWG among women with normal BMI was associated with a higher risk of preterm birth (RR=1.59, 95% CI: 1.03 - 2.44). Conclusions A comparatively high percentage of excessive GWG was observed among healthy pregnant women in Tanzania. Both inadequate and excessive GWGs were associated with elevated risks of poor pregnancy outcomes. Future studies among diverse SSA populations are warranted to confirm our findings, and clinical recommendations on optimal GWG should be developed to promote healthy GWG in SSA settings. Trial registration This trial was registered as “Prenatal Iron Supplements: Safety and Efficacy in Tanzania” (NCT01119612; http://clinicaltrials.gov/show/NCT01119612).


Author(s):  
Annie M. Dude ◽  
William Grobman ◽  
David Haas ◽  
Brian M. Mercer ◽  
Samuel Parry ◽  
...  

Abstract Objective To determine the association between total gestational weight gain and perinatal outcomes. Study Design Data from the Nulliparous Pregnancy Outcomes Study: Monitoring Mothers-To-Be (NuMoM2b) study were used. Total gestational weight gain was categorized as inadequate, adequate, or excessive based on the 2009 Institute of Medicine guidelines. Outcomes examined included hypertensive disorders of pregnancy, mode of delivery, shoulder dystocia, large for gestational age or small for-gestational age birth weight, and neonatal intensive care unit admission. Results Among 8,628 women, 1,666 (19.3%) had inadequate, 2,945 (34.1%) had adequate, and 4,017 (46.6%) had excessive gestational weight gain. Excessive gestational weight gain was associated with higher odds of hypertensive disorders (adjusted odds ratio [aOR] = 2.05, 95% confidence interval [CI]: 1.78–2.36) Cesarean delivery (aOR = 1.24, 95% CI: 1.09–1.41), and large for gestational age birth weight (aOR = 1.49, 95% CI: 1.23–1.80), but lower odds of small for gestational age birth weight (aOR = 0.59, 95% CI: 0.50–0.71). Conversely, inadequate gestational weight gain was associated with lower odds of hypertensive disorders (aOR = 0.75, 95% CI: 0.62–0.92), Cesarean delivery (aOR = 0.77, 95% CI: 0.65–0.92), and a large for gestational age birth weight (aOR = 0.72, 95% CI: 0.55–0.94), but higher odds of having a small for gestational age birth weight (aOR = 1.64, 95% CI: 1.37–1.96). Conclusion Both excessive and inadequate gestational weight gain are associated with adverse maternal and neonatal outcomes.


2020 ◽  
Vol 9 (1) ◽  
Author(s):  
Farideh Kazemi ◽  
Seyedeh Zahra Masoumi ◽  
Arezoo Shayan ◽  
Seyedeh Zahra Shahidi Yasaghi

Abstract Background The results of some studies have indicated the association between food insecurity and certain adverse pregnancy outcomes. The present study aimed to investigate the prevalence of food insecurity in pregnant women and its association with pregnancy outcomes and complications. Methods The present cross-sectional study was conducted on 772 mothers who visited comprehensive health service centers during the first 10 days after delivery in 2018. The tools included the demographic and midwifery information questionnaire and an 18-item questionnaire devised by the U.S. Department of Agriculture. The significance level was considered to be 0.05. Results 67.5% of pregnant women had food insecurity. The multivariate analysis showed that birth weight decreased with the increase in the severity of food insecurity, but the reduction was not statistically significant. Based on the results, food insecurity had no statistically significant impact on the mothers’ weight gain pattern (p = 0.13). The risk of hypertension/preeclampsia and anemia was not related to food insecurity. Compared with the food-secure group, the probability of gestational diabetes was 56% lower in the food-insecure group without hunger and 61% lower in the food-insecure group with moderate hunger; however, in the food-insecure group with severe hunger, this probability was 1.5 times more than the food-secure group, which is not statistically significant. Conclusions The prevalence of food insecurity was high in pregnant women. Maternal weight gains during pregnancy and birth weight (despite being statistically insignificant) were affected by this condition; therefore, it is necessary to identify women with food insecurity on their first pregnancy visit; it is also crucial to take steps towards improving their health through allocating a family food basket and nutritional support for these women at least during pregnancy. Due to the limited sample size and inability to control the potential confounders, the association between food insecurity during pregnancy and the incidence of pregnancy complications could not be reached, hence the need for more studies.


2020 ◽  
Author(s):  
Márcia Dornelles Machado Mariot ◽  
Daniela Cortés Kretzer ◽  
Isadora Musse Nunes ◽  
Marcelo Zubaran Goldani ◽  
Juliana Rombaldi Bernardi ◽  
...  

Abstract BACKGROUND: This study evaluate the influence of weight gain of pregnant women under different clinical conditions (Tobacco, Diabetes mellitus (DM), Hypertension, Intrauterine growth restriction (IUGR) and Control) on the birth weight of newborns. METHODS: This is an observational, longitudinal study nested in a prospective controlled cohort and conducted from 2011 to 2016 in three hospitals in the city of Porto Alegre (Brazil). Sociodemographic, prenatal (maternal gestational weight gain, among others) and perinatal (birth weight) data from 372 mother-child pairs were analyzed. Pearson's correlation was used to verify the relationship between gestational weight gain and birth weight. Multivariate regression was performed to determine the association between maternal weight gain in the presence of various health conditions and birth weight. RESULTS: There were no statistical differences in gestational weight gain in different health condition groups (p=0.092). However, women in the Hypertension group had a tendency to gain more weight (p = 0.097). Mothers in the intrauterine growth restriction group gained less weight. A positive correlation was observed between gestational weight gain and birth weight in the Tobacco (p = 0.003) and Control (p =0.001) groups, which remained positive only in the Control group after adjustment (p<0.004). CONCLUSIONS: Only weight gain in pregnant women without clinical changes during pregnancy seemed to influence the weight of the newborn. It is assumed that other factors, such as metabolic or nutritional, present among smoking, diabetes mellitus, hypertensive or with intrauterine growth restriction pregnant women have different modulations on the intrauterine environment and, therefore, exert a different influence on fetal growth.


2021 ◽  
Vol 5 (Supplement_2) ◽  
pp. 770-770
Author(s):  
Dyah Ayu Larasati Kisworo Putri ◽  
Nur Indrawaty Lipoeto ◽  
Arif Sabta Aji

Abstract Objectives The aim of this study was to analyze the interaction between pre-pregnancy body mass index (PP BMI), gestational weight gain (GWG), and newborn outcomes among pregnant mothers in West Sumatera, Indonesia. Methods This VDPM cohort study was conducted from September 2017 to March 2018 in West Sumatra, Indonesia. We obtained 195 healthy mother-infant pairs. GWG status created by comparing PP BMI and GWG guidelines based on the World Health Organization (WHO). Newborn birth weight, birth length, and head circumference were taken immediately after delivery as pregnancy outcomes. SPSS version 20.0 was used to analyze bivariate and multivariate analysis to assess the interaction between PP BMI and gestational weight gain in pregnancy outcomes with adjusting potential confounders. A P-value less than 0.05 was considered as a significant association. Results Of the 195 mother-infant pairs (Mean 29.66 years) included in the main sample, Most of the mothers had 46.7% normal PP BMI with most of them had an inadequate GWG status during pregnancy with 53.3%. Adequate and excessive GWG statuses were 34.4% and 12.3%, respectively. There was a significant association between PP BMI and GWG (p &lt; 0.01). This study had no interaction between PP BMI and GWG to the newborn outcomes (p &gt; 0.05). Adverse newborn outcomes were not statistically significant among groups. However, mothers who had inadequate GWG status may have significant lower birth weight and head circumference compared to normal and excessive GWG status (p &lt; 0.05). Conclusions This study had no interaction between PP BMI and GWG status to newborn outcomes. However, the GWG status associated with newborn outcomes in birth weight and head circumference level. Further prospective studies with a larger number are required to confirm this finding. Funding Sources Indonesian Danone Institute Foundation.


2019 ◽  
Vol 2019 ◽  
pp. 1-10 ◽  
Author(s):  
Priyanka Arora ◽  
Bani Tamber Aeri

In 1990, Institute of Medicine (IOM) recommended gestational weight gain (GWG) ranges for women in the United States primarily to improve infant birth weight. Changes in key aspects of reproductive health of women of child bearing age, a rising prevalence of obesity, and noncommunicable diseases prompted the revision of IOM guidelines in 2009. However, there is no such recommendation available for Asian women. This systematic review assesses the utility of IOM-2009 guidelines among Indian and other Asian pregnant women in terms of maternal and fetal outcomes. 624 citations were identified using PubMed and Google Scholar, out of which 13 were included. Prospective/retrospective studies of healthy Asian women with a singleton pregnancy which specifically examined fetal-maternal outcomes relative to IOM-2009 guidelines were included. Results. Majority of pregnant Indian women achieved less GWG than the recommendations whereas a mixed trend was noticed among the other Asian pregnant women. The most common fetal-maternal complications among the excessive GWG women were found to be macrosomia, large for gestational age and caesarean section followed by gestational diabetes and hypertension, whereas low birth weight, small for gestational age and preterm birth, was found to be associated with low GWG women. The findings highlight the need for appropriate GWG limits across the different body mass index levels specifically for Indians and other Asian population. However, there are not enough publications regarding the utility of IOM-2009 guidelines among the Indian and other Asian women. Thus, higher-quality researches are warranted in future to further validate the findings of the present review.


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