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Objective To explore the effect of body mass index before pregnancy on various gestational diseases and adverse pregnancy outcomes. Methods Related cohort studies at home and abroad from 2014 to 2019 in China, the United States, Canada, Vietnam and Indonesia were reviewed to evaluate the effects of pre-pregnancy BMI on the risk of gestational disease and pregnancy outcomes.The number of 773 articles was collected and 8 cohort studies were selected in accordance with the inclusion criteria for this study. Results Low pre-pregnancy BMI could significantly increase the risk of postpartum hemorrhage (OR=7.1, 95%CI:2.7-13.6), acute renal failure (OR=1.6, 95%CI:0.1-5.3), low birth weight (OR=3.1, 95%CI:1.5-6.2), less than gestational age (OR=2.9, 95%CI: 1.9-4.5) and so on.High pre-pregnancy BMI could significantly increase the risk of preeclampsia (OR=1.09, 95%CI:1.04- 1.14), gestational hypertension (OR=5.49-11.42), cesarean section (OR=1.94, 95%CI:1.80-2.08), obstetric complications (OR=4.4-8.2), fetal macrosomia (OR=2.36, 95%CI:2.15-2.59) and other diseases.Spontaneous abortion, ectopic pregnancy were significantly associated with abnormal pre-pregnancy BMI (too high or too low). Conclusion Pre-pregnancy BMI is significantly associated with severe maternal diseases such as gestational hypertension, preeclampsia, gestational diabetes and adverse pregnancy outcomes like premature birth, abnormal birth weight, cesarean section.It suggests that more population-based prospective cohort studies are needed in this field to provide stronger evidence for pre-pregnancy weight management.
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@#Introduction: This cross-sectional study determines factors associated with the rates of gestational weight gain (GWG) among women in the second and third trimester of pregnancy. Methods: A total of 180 pregnant women (29.2 ± 4.3 years old) attending the maternal and child health clinics in Batu Pahat district were enrolled in the present study between January and February, 2015. Information regarding demographic characteristics, obstetrical history, physical activity, and calorie intake was assessed through direct interview. Anthropometric data were collected from medical records. GWG rates were determined based on 2009 IOM recommendations. Results: Of the 180 pregnant women, 37.2% were at their second trimester and 62.8% were at the third trimester of pregnancy. While 53.3% of them had excessive GWG rate, 28.9% have inadequate GWG rate. More than half of the women (56.7%) were normal weight, 21.1% overweight, 14.4% underweight, and 7.8% obese before pregnant. The total mean activity and energy intake of the pregnant women were 195.9±94.2 MET-hour/week and 2365±709 kcal/day, respectively. The multinomial logistic model indicates that women who were overweight or obese at pre-pregnancy were seven times more likely to have excessive GWG rate (OR = 7.44, 95% CI = 2.07-26.66) as compared to women who were pre-pregnancy normal weight. Conclusions: About four in every five of the pregnant women had their GWG rates outside the IOM recommendations. Women who were overweight/obese at pre-pregnancy were at-risk of having excessive GWG rate, which underlines the importance of targeting these women for pre-conception counselling on GWG.
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ObesityABSTRACT
Introducción: el embarazo adolescente supone un 15% del total de los nacimientos. A pesar de esta gran prevalencia, el conocimiento y las recomendaciones específicas para este grupo poblacional son escasos. Las embarazadas adolescentes suelen tener ganancias de peso superior a las recomendaciones, aumentando el riesgo de complicaciones obstétricas y neonatales. Objetivo: evaluar la ganancia de peso gestacional en embarazadas adolescentes según las recomendaciones del Institute of Medicine 2009. Materiales y método: estudio observacional descriptivo transversal llevado a cabo en adolescentes con embarazo único en puerperio inmediato evaluadas entre los meses de Agosto del 2017 y Enero del 2018. El IMC pre-gestacional y la ganancia de peso en el embarazo fueron estudiados y comparados con la edad, historia de enfermedades y complicaciones obstétricas. Resultados: el tamaño total de la muestra fue de 89 adolescentes con una media de edad de 17±1,54 años; solo el 4,49% correspondió a menores de 15 años. El diagnóstico nutricional pre-gestacional fue de: bajo peso 6,74%, normopeso 71,91%, sobrepeso 13,48% y obesidad 7,87%. El 22,47%, el 31,46% y 46,07% tuvieron una ganancia de peso inferior, adecuada y superior respectivamente. El 66,67% de las adolescentes con bajo peso evidenciaron una ganancia de peso inferior, mientras que las embarazadas con exceso de peso superaron las recomendaciones en el 57,89% de los casos. Del total de las obesas, el 71,42% presentaron complicaciones en el embarazo. Conclusiones: Casi el 70% de las embarazadas adolescentes presentaron una ganancia de peso inadecuada. Aquellas que comenzaron la gestación con bajo peso ganaron menos de lo recomendado, siendo las embarazadas con exceso de peso las que aumentaron más de lo establecido por las guías. Por último, resulta interesante destacar el desarrollo de complicaciones en el embarazo de las adolescentes obesas(AU).
Introduction: in Argentina, adolescent pregnancy represents 15% of total births. Despite this high prevalence, knowledge and specific recommendations for this population group are low. Adolescent mothers usually have more weight gain than recommended, increasing the risk of obstetric and neonatal complications. Objective: to evaluate the gestational weight gain in adolescent pregnancy following recommendations by the Institute of Medicine 2009. Methods: a cross-sectional observational study was carried out in adolescents with single pregnancies in immediate puerperal period, between August 2017 and January 2018. The pre-pregnancy BMI and the gestational weight gain were studied and compared to age, medical history and obstetric complications. Results: a total of 89 adolescents averaged age 17 ± 1.54 were evaluated; only 4.49% of the sample corresponded to mothers aged under 15. The pre-pregnancy BMI was: underweight 6.74%, normal weight 71.91%, overweight 13.48% and obesity 7.87%. 22.47%, 31.46% and 46.07% had a lower, appropriate and excessive weight gain respectively. 66.67% of underweight adolescents showed a lower weight gain, while the overweight ones exceeded the recommendations in 57.89% of cases. Within total obese, 71,42% presented obstetric complications. Conclusions: nearly 70% of adolescent mothers had an inappropriate weight gain. The adolescents who started the gestation with underweight gained less weight than recommended, and the ones with overweight gained more weight than the one recommended by the guidelines. Lastly, it is worth highlighting the development of obstetric complications in obese adolescents(AU).
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Humans , Female , Adolescent , Pregnancy in Adolescence , Weight Gain , Gestational Weight Gain , Adolescent Mothers , Hospitals, State , ObstetricsABSTRACT
Objective To investigate the association between maternal pre-pregnant body mass index and gestational weight gain,as well as their interaction on neonatal birthweight.Methods We built a cohort in Anqing Municipal Hospital from January 2014 to March 2015,enrolling pregnant women who decided to give birth in this hospital.All women were asked to fill a questionnaire for basic information collection.Medical information of both pregnant women and their newborns were obtained through electronic medical record.Chi-square analysis,multinomial logistic regression,multiplicative and additive interaction methods were used to analyze the association between prepregnant body mass index and gestational weight gain as well as their interactions on birth weight of the neonates.Results A total of 2 881 pregnant women were included in this study.Of the 2 881 newborns,359 (12.46％) were small for gestational age (SGA) and 273 (9.48％) were large for gestational age (LGA).After adjusting the possible confounding factors,results from the multinomial logistic regression showed that pre-pregnancy underweight women were more possible to deliver SGA (aRR=1.33,95％CI:1.02-1.73).If the gestational weight gain was below the recommended criteria,the risk of SGA (aRR=1.64,95％ CI:1.23-2.19) might increase.Pre-pregnancy overweight/obese could increase the risk of being LGA (aRR=1.86,95％ CI:1.33-2.60).Maternal gestational weight gain above the recommendation level was associated with higher rates of LGA (aRR=2.03,95％CI:1.49-2.78).Results from the interaction analysis showed that there appeared no significant interaction between pre-pregnancy BMI and gestational weight on birthweight.Conclusion Pre-pregnancy body mass index and gestational weight gain were independently associated with neonatal birthweight while pre-pregnancy BMI and gestational weight gain did not present interaction on birthweight.
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Objective To investigate the association between maternal pre-pregnant body mass index and gestational weight gain,as well as their interaction on neonatal birthweight.Methods We built a cohort in Anqing Municipal Hospital from January 2014 to March 2015,enrolling pregnant women who decided to give birth in this hospital.All women were asked to fill a questionnaire for basic information collection.Medical information of both pregnant women and their newborns were obtained through electronic medical record.Chi-square analysis,multinomial logistic regression,multiplicative and additive interaction methods were used to analyze the association between prepregnant body mass index and gestational weight gain as well as their interactions on birth weight of the neonates.Results A total of 2 881 pregnant women were included in this study.Of the 2 881 newborns,359 (12.46％) were small for gestational age (SGA) and 273 (9.48％) were large for gestational age (LGA).After adjusting the possible confounding factors,results from the multinomial logistic regression showed that pre-pregnancy underweight women were more possible to deliver SGA (aRR=1.33,95％CI:1.02-1.73).If the gestational weight gain was below the recommended criteria,the risk of SGA (aRR=1.64,95％ CI:1.23-2.19) might increase.Pre-pregnancy overweight/obese could increase the risk of being LGA (aRR=1.86,95％ CI:1.33-2.60).Maternal gestational weight gain above the recommendation level was associated with higher rates of LGA (aRR=2.03,95％CI:1.49-2.78).Results from the interaction analysis showed that there appeared no significant interaction between pre-pregnancy BMI and gestational weight on birthweight.Conclusion Pre-pregnancy body mass index and gestational weight gain were independently associated with neonatal birthweight while pre-pregnancy BMI and gestational weight gain did not present interaction on birthweight.
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The necessity of adequate pregnancy weight gain for optimal pregnancy outcome has been recognized. However, the specific components of pregnancy weight gain that might be critical for fetal growth and development have not been elucidated clearly. The purpose of this study was to investigate the correlation of pregnancy weight gain and birth weight with serum leptin levels in women delivered newborns. The subjects were recruited from K university hospital. The subject's characteristic data (age 32.1+/-4.3 y, gestational age 39.5+/-1.1wk, pre-pregnancy weight 58.0+/-8.6 kg, pregnancy weight gain 12.7+/-5.5 kg, newborn's birth weight 3.5+/-0.5 kg) were gathered. Maternal dietary assessment was carried out at the end of pregnancy. After delivery, blood samples were collected from 20 mother-newborn pairs. Serum levels of various lipids and leptin were analyzed. Maternal daily consumption of iron, zinc, folate were lower than the RDA of each nutrient and index of nutritional quality was less than 1 showing that the quality of maternal diet was low. The levels of serum leptin of mothers and infants were 10.2+/-6.7 ng/ ml and 1.7+/-0.6 ng/ml, respectively. The serum leptin concentrations of male infants (1.9+/-0.7 ng /ml) were not different from that of females (1.7+/-0.5 ng/ml). A negative correlation was found between the maternal pre-pregnant BMI and weight gain during pregnancy (r=-0.54, p<0.05). There was a positive correlation between the pregnancy weight gain and the newborn's birth weight (r = 0.59, p<0.01). There were also positive correlation between newborn's birth weight and newborn's serum leptin levels (r =0.57, p<0.01). No correlations were found between maternal serum leptin levels and that of newborn's. Efforts should be made to attain adequate diet and weight gain during the pregnancy to reduce the likelihood of low or over birth weight of newborns.