Adverse Outcomes of Pregnancy with Abnormal Weight Gain at Phramongkutklao Hospital
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Published:
Dec 28, 2018
Keywords:
gestational weight gain pre-pregnancy BMI adverse outcomes of pregnancy
Main Article Content
Abstract
Objectives: To determine adverse maternal and neonatal outcomes of pregnant women who did not reach optimal gestational weight gain (GWG).
Materials and Methods: Medical records of 2,103 term singleton delivery at Phramongkutklao Hospital during 1 January 2013 – 31 December 2015 were retrospectively reviewed. According to Institute of Medicine (IOM) 2009 guideline, the pregnant women were categorized into 3 groups (701 subjects in each group); less than optimal GWG, optimal GWG and excessive GWG corresponding to their pre-pregnancy body mass index (BMI) classified by World Health Organization (WHO) for Asian population. Adverse pregnancy outcomes were compared between groups.
Results: Excessive GWG was significantly associated with gestational hypertension (p < 0.001), preeclampsia (p = 0.003), cesarean section (p < 0.001), large for gestational age (p < 0.001), macrosomia (p = 0.005) and hyperbilirubinemia (p < 0.001). Less GWG was significantly related to intrauterine growth restriction (p < 0.001), small for gestational age (p < 0.001) and low birth weight (p < 0.001) but was associated with significant good pregnancy outcomes in terms of successful vaginal delivery (p < 0.001), first degree perineal injury (p < 0.001). Multiple logistic regression analysis adjusted for maternal age, gestational age, and pre-pregnancy BMI further confirmed the aforementioned associations.
Conclusion: Women with abnormal gestational weight gain are at risk for adverse maternal and neonatal outcomes.
Article Details
How to Cite
(1)
Chaipongpun, N.; Punpuckdeekoon, P. Adverse Outcomes of Pregnancy With Abnormal Weight Gain at Phramongkutklao Hospital. Thai J Obstet Gynaecol 2018, 26, 217-227.
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Original Article
References
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27. Koh H, Ee TX, Malhotra R, Allen JC, Tan TC, Ostbye T. Predictors and adverse outcomes of inadequate or excessive gestational weight gain in an Asian population. J Obstet Gynecol Res 2013;39:905-13.
28. Melby MK, Yamada G, Surkan PJ. Inadequate gestational weight gain increase risk of small-for-gestional-age term birth in girls in japan: A population-base cohort study. Am J Hum Biol 2016;28:714-20.
29. Chibber R. Unexplained antepartum fetal deaths: what are the determinants?. Arch Gynecol Obstet 2005;271: 286-91.
30. Drehmer M, Duncan BB, Kac G, Schmidt MI. Association of second and third trimester weight gain in pregnancy with maternal and fetal outcomes. PLoS One 2013;8 :e54704.
31. Li C, Liu Y, Zhang W. Joint and independent associations of gestational weight gain and pre-pregnancy body mass index with outcomes of pregnancy in Chinese women: a retrospective cohort study. PLoS One 2015:10: e0136850.
32. Catalano PM. Management of obesity in pregnancy. Obstet Gynecol 2007;109:419-33.
2. WHO expert consultation. Appropriate body-mass index for Asia populations and its implications for policy and intervention strategies. Lancet 2004;363:157-63.
3. Institute of Medicine (US) and National Research Council (US) Committee to Reexamine IOM Pregnancy Weight Guidelines. Weight gain during pregnancy: Reexamining the guidelines. Washington, DC: Institute of Medicine, 2009.
4. Chu SY, Callaghan WM, Kim SY, Schmid CH, Lau J, England LJ, et al. Maternal obesity and risk of gestational diabetes mellitus. Diabetes Care 2007;30: 2070-6.
5. Baeten JM, Bukusi EA, Lambe M. Pregnancy complications and outcomes among overweight and obese nulliparous women. Am J Public Health 2001; 91:436-40.
6. Catalano PM. Management of obesity in pregnancy. Obstet Gynecol 2007;109:419-33.
7. Ehrenberg HM, Durnwald CP, Catalano P, Mercer BM. The influence of obesity and diabetes on the risk of cesarean delivery. Am J Obstet Gynecol 2004;191: 969-74.
8. Salihu HM, Dunlop AL, Hedayatzadeh M, Alio AP, Kirby RS, Alexander GR. Extreme obesity and risk of stillbirth among black and white gravidas. Obstet Gynecol 2007; 110:552-7.
9. Aune D, Saugstad OD, Henriksen T, Tonstad S. Maternal body mass index and the risk of fetal death, stillbirth, and infant death: a systematic review and meta-analysis. JAMA 2014;311:1536-46.
10. Girsen AI, Mayo JA, Carmicheal SL, Phibbs CS, Shachar BZ, Stevenson DK, et al. Women’s prepregnancy underweight as a risk factor for preterm birth: a retrospective study. BJOG 2016;123:2001-7
11. Macones G. Weight gain and loss in pregnancy. Uptodate [Internet].2016[cited 2016 Aug 20]. Available from: https://www.uptodate.com/contents/weight-gain-and-loss-in-pregnancy.
12. Harita N, Kariya M, Hayashi T, Sato KK, Aoki T, Nakamura K, et al. Gestational bodyweight gain among underweight Japanese women related to small-for-gestational-age birth. J Obstet Gynaecol Res 2012;38: 1137-44.
13. English FA, Kenny LC, McCarthy FP. Risk factor and effective management of preeclampsia. Integr Blood Press Control 2015;8:7-12.
14. Moroni G, Ponticelli C. Pregnancy in women with systemic lupus erythematous (SLE). Eur J Intern Med 2016;32:7-12.
15. Cunningham FG, Leveno KJ, Bloom SL, Spong CY, Dashe JS, Hoffman BL, Casey BM, Sheffield JS, editors. Williams Obstetrics. 24th ed. New York: Mc-Graw Hill, 2014.
16. Practice Bulletin No. 180: Gestational Diabetes Mellitus. Obstet Gynecol 2017;130:e17-e37.
17. Carpenter MW, Coustan DR. Criteria for screening tests for gestational diabetes. Am J Obstet Gynecol 1982; 144:768-73.
18. O’Sullivan JB, Mahan CM. Criteria for the oral glucose tolerance test in pregnancy. Diabetes 1964;13: 278-85.
19. Maternal-fetal medicine. CPG for intrauterine growth restriction [Internet]. Department of Obstetrics and Gynecology, Faculty of Medicine, Chiangmai University. 2010 [cited 2015 Aug 11]. Available from: http://www.med.cmu.ac.th/dept/obgyn/2011/index.php?option=com_content&view=article&id=188:cpg-intrauterine-growth-restriction&catid=41&Itemid=127.
20. Jirapaet K, Ngerncham S, Srisuparp P. CPG for neonatal jaundice in newborns with GA > 35 week [Internet]. Department of pediatrics, Faculty of medicine, Siriraj hospital, Mahidol University. 2007 [cited 2015 Aug 11]. Available from: http://www.ped.si.mahidol.ac.th/HA/CPG/5Neonataljaundiceinnewborn.pdf.
21. Enomoto K, Aoki S, Toma R, Fujiwara K, Sakamaki K, Hirahara F. Pregnancy outcomes based on pre-pregnancy body mass index in japanese women. PLoS One 2016;11:e0157081.
22. Radhakrishnan U, Kolar G, Nirmalan PK. Cross-sectional study of gestational weight gain and perinatal outcomes in pregnant women at a tertiary care center in southern India. J Obstet Gynaecol Res 2014;40: 25-31.
23. Crane JM, White J, Murphy P, Burrage L, Hutchenes D. The effective of gestational weight gain by body mass index on maternal and neonatal outcomes. J Obstet Gynaecol Can 2009;31:28-35.
24. Hung TH, Hsieh TT. Pregestational body mass index, gestational weight gain, and risks for adverse pregnancy outcomes among Taiwanese women: A retrospective cohort study. Taiwan J Obstet Gynecol 2016; 55: 575-81.
25. Zilberlicht A, Feferkorn I, Younes G, Damti A, Auslender R , Riskin-Mashiah A. The mutual effect of pregestational body mass index, maternal hyperglycemia and gestational weight gain on adverse pregnancy outcomes. Gynecol Endocrinol 2016;32:416-20.
26. Hedderson MM, Weiss NS, Sacks DA, Pettitt DJ, Selby JV, Quesenberry CP, et al. Pregnancy weight gain and risk of neonatal complications: macrosomia, hypoglycemia, and hyperbilirubinemia. Obstet Gynecol 2006;108:1153-61.
27. Koh H, Ee TX, Malhotra R, Allen JC, Tan TC, Ostbye T. Predictors and adverse outcomes of inadequate or excessive gestational weight gain in an Asian population. J Obstet Gynecol Res 2013;39:905-13.
28. Melby MK, Yamada G, Surkan PJ. Inadequate gestational weight gain increase risk of small-for-gestional-age term birth in girls in japan: A population-base cohort study. Am J Hum Biol 2016;28:714-20.
29. Chibber R. Unexplained antepartum fetal deaths: what are the determinants?. Arch Gynecol Obstet 2005;271: 286-91.
30. Drehmer M, Duncan BB, Kac G, Schmidt MI. Association of second and third trimester weight gain in pregnancy with maternal and fetal outcomes. PLoS One 2013;8 :e54704.
31. Li C, Liu Y, Zhang W. Joint and independent associations of gestational weight gain and pre-pregnancy body mass index with outcomes of pregnancy in Chinese women: a retrospective cohort study. PLoS One 2015:10: e0136850.
32. Catalano PM. Management of obesity in pregnancy. Obstet Gynecol 2007;109:419-33.