Journal of South Asian Federation of Obstetrics and Gynaecology

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VOLUME 16 , ISSUE 5 ( September-October, 2024 ) > List of Articles

RESEARCH ARTICLE

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.

DOI: 10.5005/jp-journals-10006-2493

License: CC BY-NC 4.0

Published Online: 23-10-2024

Copyright Statement:  Copyright © 2024; The Author(s).


Abstract

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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  1. Huda SS, Brodie LE, Sattar N. Obesity in pregnancy: Prevalence and metabolic consequences. Semin Fetal Neonatal Med 2010;15:70–76. DOI: 10.1016/j.siny.2009.09.006.
  2. Fox A, Feng W, Asal V. What is driving global obesity trends? Globalization or “modernization”? Glob Health 2019;15:32. DOI: 10.1186/s12992-019-0457-y.
  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): National Academies Press (US). Available from: http://www.ncbi.nlm.nih.gov/books/NBK32813/. (2009, accessed 15 March 2024).
  4. Gaillard R, Felix JF, Duijts L, et al. Childhood consequences of maternal obesity and excessive weight gain during pregnancy. Acta Obstet Gynecol Scand 2014;93:1085–1089. DOI: 10.1111/aogs.12506.
  5. Rasmussen KM, Abrams B, Bodnar LM, et al. Recommendations for weight gain during pregnancy in the context of the obesity epidemic. Obstet Gynecol 2010;116:1191–1195. DOI: 10.1097/AOG.0b013e3181f60da7.
  6. Davies GAL, Maxwell C, McLeod L, et al. SOGC Clinical Practice Guidelines: Obesity in pregnancy. No. 239, February 2010. Int J Gynaecol Obstet Off Organ Int Fed Gynaecol Obstet 2010;110:167–173. DOI: 10.1016/j.ijgo.2010.03.008.
  7. Hung T-H, Hsieh T-T. 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;55:575–581. DOI: 10.1016/j.tjog.2016.06.016.
  8. 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. DOI: 10.1371/journal.pone.013 6850.
  9. Oken E, Taveras EM, Kleinman KP, et al. Gestational weight gain and child adiposity at age 3 years. Am J Obstet Gynecol 2007;196:322.e1–322.e8. DOI: 10.1016/j.ajog.2006.11.027.
  10. Hedderson MM, Weiss NS, Sacks DA, et al. Pregnancy weight gain and risk of neonatal complications: Macrosomia, hypoglycemia, and hyperbilirubinemia. Obstet Gynecol 2006;108:1153–1161. DOI: 10.1097/01.AOG.0000242568.75785.68.
  11. Haugen M, Brantsæter AL, Winkvist A, et al. Associations of pre-pregnancy body mass index and gestational weight gain with pregnancy outcome and postpartum weight retention: A prospective observational cohort study. BMC Pregnancy Childbirth 2014;14:201. DOI: 10.1186/1471-2393-14-201.
  12. Gonzalez-Ballano I, Saviron-Cornudella R, Esteban LM, et al. Pregestational body mass index, trimester-specific weight gain and total gestational weight gain: How do they influence perinatal outcomes? J Matern Fetal Neonatal Med 2021;34:1207–1214. DOI: 10.1080/14767058.2019.1628942.
  13. Sekiya N, Anai T, Matsubara M, et al. Maternal weight gain rate in the second trimester are associated with birth weight and length of gestation. Gynecol Obstet Invest 2007;63:45–48. DOI: 10.1159/000095286.
  14. Hung T-H, Hsieh T-T. The effects of implementing the International Association of Diabetes and Pregnancy Study Groups criteria for diagnosing gestational diabetes on maternal and neonatal outcomes. PloS ONE 2015;10:e0122261. DOI: 10.1371/journal.pone.0122261.
  15. Saldana TM, Siega-Riz AM, Adair LS, et al. The relationship between pregnancy weight gain and glucose tolerance status among black and white women in central North Carolina. Am J Obstet Gynecol 2006;195:1629–1635. DOI: 10.1016/j.ajog.2006.05.017.
  16. Scott-Pillai R, Spence D, Cardwell CR, et al. The impact of body mass index on maternal and neonatal outcomes: A retrospective study in a UK obstetric population, 2004-2011. BJOG Int J Obstet Gynaecol 2013;120:932–939. DOI: 10.1111/1471-0528.12193.
  17. Young MF, Hong Nguyen P, Addo OY, et al. Timing of gestational weight gain on fetal growth and infant size at birth in Vietnam. PLoS ONE 2017;12:e0170192. DOI: 10.1371/journal.pone.0170192.
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