Effect of Pregestational Body Mass Index, Trimester-specific Weight Gain, and Total Gestational Weight Gain on Pregnancy Outcomes: A Retrospective Observational Study
Esther Issac, Anuradha M, Shanmugapriya C, Gowthaman Sankar
Keywords :
Fetomaternal outcomes, Gestational weight gain, Pregnancy, Trimester-specific weight gain
Citation Information :
Issac E, M A, C S, Sankar G. Effect of Pregestational Body Mass Index, Trimester-specific Weight Gain, and Total Gestational Weight Gain on Pregnancy Outcomes: A Retrospective Observational Study. J South Asian Feder Obs Gynae 2024; 16 (5):509-514.
Background: Overweight women with higher BMI present with an increased risk of complications in gestation, especially the hypertensive disorders of pregnancy (HDP) and gestational diabetes mellitus (GDM). In addition to the increased risk of antenatal complications, there is an increased risk of cesarean delivery and associated morbidities in pregestational overweight or obese women. For the neonate, there is an increased risk of macrosomia, neonatal hypoglycemia or hyperbilirubinemia, in addition to a higher risk of childhood obesity.
Materials and methods: This retrospective observational study aimed to investigate the effect of pre-gestational and trimester-specific weight gain on maternal and neonatal outcomes among pregnant women. Using the universe sampling method, we collected obstetric and postnatal details from previous records in the Department of Obstetrics and Gynecology at a tertiary care hospital in Tamil Nadu.
Results: The receiver operating characteristics probability curve showed that the model had moderate discrimination capacity for GDM [area under the curve (AUC) = 0.591], gestational hypertension (GHTN) (AUC = 0.531), and pre-labor rupture of membranes (PROM) (AUC = 0.553), but no discriminating ability for large for gestational age (LGA) (AUC = 0.509). Additionally, the model demonstrated moderate discriminating capacity of pre-gestational BMI (AUC = 0.522) and trimester-specific weight gain (AUC for first trimester = 0.533; AUC for second and third trimester = 0.525) in predicting GHTN.
Conclusion: First-trimester weight gain and total gestational weight gain (GWG) are positively associated with GDM. Second-trimester weight gain had a positive association with PROM. Third-trimester weight gain was associated with a higher risk for large for gestation babies.
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