Adverse Outcomes of Pregnancy with Abnormal Weight Gain at Phramongkutklao Hospital

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.

Keywords

• adverse outcomes of pregnancy
• gestational weight gain
• pre-pregnancy BMI