Impact of excessive pregnancy weight gain on pregnancy outcomes and neonatal conditions in pre-pregnancy overweight and obese women

Abstract

ObjectiveTo explore the influence of excessive weight gain during pregnancy in pre-pregnancy overweight and obese women on pregnancy outcomes and neonatal conditions， and to provide scientific evidence for formulating weight management strategies before and during pregnancy and prevent adverse pregnancy outcomes.MethodsClinical data of 2 172 parturients collected from a community in Huangpu District from 2017 to 2021 were retrospectively analyzed， and they were divided into pre-pregnancy overweight and obesity group （n=530）， normal pre-pregnancy weight group（n=937）， and underweight pre-pregnancy group（n=705） according to maternal precursor body mass index （BMI）. Based on their weight gain during pregnancy，the parturient were divided into moderate gestational weight gain （MGWG） group and excessive gestational weight gain （EGWG） group. Meanwhile， the pregnancy and neonatal outcomes such as postpartum hemorrhage， puerperal infection， placental abruption， premature rupture of membranes， mode of delivery， premature birth， stillbirth， fetal distress， admission to the intensive care unit （ICU）， macrosomia， and Apgar score， were recorded. Then the differences in pregnancy and neonatal outcomes between groups were compared. The effects of pre-pregnancy BMI and gestational weight gain on pregnancy outcomes and neonatal conditions was retrospectively analyzed.ResultsThe pre-pregnancy overweight and obese group had higher proportions of placental abruption， premature rupture of membranes， cesarean section， premature birth， fetal distress， and macrosomia compared to the normal pre-pregnancy weight group and the underweight pre-pregnancy group， with Apgar scores lower than the normal pre-pregnancy weight group and the underweight pre-pregnancy group （all P<0.05）. The EGWG group had higher proportions of postpartum hemorrhage， placental abruption， premature rupture of membranes， cesarean section， premature birth， fetal distress， admission to the ICU， and macrosomia than the MGWG group （all P<0.05）. In the pre-pregnancy overweight and obese group， the EGWG group had higher proportions of placental abruption， premature rupture of membranes， premature birth， fetal distress， admission to the ICU， and macrosomia than the MGWG group， with lower Apgar scores than the MGWG group （all P<0.05）. In the normal pre-pregnancy weight group， the EGWG group had higher proportions of placental abruption， premature rupture of membranes， premature birth， fetal distress， admission to the ICU， and macrosomia than the MGWG group （all P<0.05）. In the pre-pregnancy overweight and obese group， the EGWG group had higher proportions of premature rupture of membranes， cesarean section， premature birth， fetal distress， and macrosomia than the EGWG group in the normal pre-pregnancy weight group（all P<0.05）. Logistic regression analysis showed that EGWG in pre-pregnancy overweight and obese women was a risk factor for placental abruption （OR=2.971， 95%CI： 1.098‒8.042）， premature rupture of membranes （OR=4.662， 95%CI： 2.798‒7.770）， cesarean delivery （OR=1.375，95%CI： 1.260‒2.541）， premature birth （OR=4.249， 95%CI： 2.384‒7.573）， fetal distress （OR=3.238， 95%CI： 1.589‒6.598）， admission to the ICU （OR=3.010， 95%CI： 1.265‒7.164）， and macrosomia （OR=5.437， 95%CI： 3.392‒8.716） （all P<0.05）.ConclusionExcessive gestational weight gain in pre-pregnancy overweight and obese women is a risk factors for placental abruption， premature rupture of membranes， cesarean section， premature birth， fetal distress， admission to the ICU， and macrosomia.

Keywords

• overweight and obesity
• gestational weight gain
• outcome of pregnancy
• newborn
• influence