The Relationship Between Overweight Or Obese Pregnant Women And Several Adverse Pregnancy Outcomes

Obesity is one of the most important factor affecting human health,there are nearly 1.7 billion adult overweight and obesity in the world at present. As the prevalence of obesity is rising, there are many women in the period of child-bearing age are overweight or obese. The average body mass index( BMI )of pregnant women in all age groups persistently increased, seriously affected the health of pregnant women and fetuses, and resulted in increase of the incidence of adverse pregnancy outcomes. Pregnancy obesity is an important risk factor of pregnancy-induced hypertension, gestational diabetes, postpartum infection, fetal congenital malformations, shoulder dystocia,etc. In addition, for pregnant women, obesity is also the potential risk factor of adverse pregnancy outcomes. Maternal obesity has become an important factor affecting maother and baby health.At present, there are many studies reported that maternal obesity was related with macrosomia, stillbirth, cesarean section, but some reports indicated that there was no significant statistical difference between obese pregnant women and normal weight pregnant women. Because these reports are either difficult to exclude the interference of other factors, or restricted by the sample size, as well as the inconsistency in the study population, time, location, etc,so the results are different. After all, the effects of obesity on adverse pregnancy outcomes are complex, for obese pregnant women, whether obesity is a independent risk factor for macrosomia, stillbirth, and cesarean section, it is still controversial, there is no consensus.Based on the above analysis, to explore the relationship between pregnancy overweight or obesity and adverse pregnancy outcomes,this study is divided into two parts:the first one is the survey of the status of adverse pregnancy outcomes including macrosomia, stillbirth, cesarean section in overweight or obese pregnant women,the second one is a Meta analysis of association between overweight or obese pregnant women and adverse pregnancy outcomes.The major findings and conclusions are as follows:1. The physical status of 396 pregnant women in a third-level grade-A hospital in Kunming city showed that pre-pregnancy overweight and obesity accounted for 32.3%(128/396 cases), and as a result of obesity, excessive gestational weight gain accounted for 48.2% (189/392 cases). It suggests that pregnancy obesity is more common than pre-pregnancy obesity. Weight control for obese pregnant women, should pay more attention to pregnancy obesity.2. The birth rate of macrosomia in pre-pregnancy overweight and obesity groups was significantly higher than that in normal weight group (P <0.05 and P <0.01 respectively), the cesarean section rate of pre-pregnancy overweight and obesity groups was also significantly higher than that of normal weight group (P <0.05), the stillbirth rate of pre-pregnancy obesity group was significantly higher than that of normal weight group(P <0.05),but there was no significant difference between pre-pregnancy overweight group and normal weight group.3. The birth rate of macrosomia and cesarean section rate in pregnancy obesity group were significantly higher than that in normal weight group( P<0.01 and P<0.05 respectively), while the stillbirth rate had no significant difference between obese group and normal weight group. 4. Meta analysis showed that pregnancy overweight or obesity can increase the risk of macrosomia, stillbirth and cesarean section. The OR value of overweight and obesity for macrosomia was 1.51 (95% CI :1.48-1 .55) and 1.99 (95% CI :1.77-2 .24) respectively, the OR value of overweight and obesity for stillbirth rate was 1.21 (95% CI :1.05-1 .40) and 1.69 (95% CI :1.51-1 .90) respectively, the OR value of overweight and obesity for cesarean section was 1.51 (95% CI :1.46-1 .57) and 2.18 (95% CI :2.01-2 .37) respectively.Pregnant women are overweight or obese can increase the risk of macrosomia, stillbirth and cesarean section. Control of pre-pregnancy weight and gestational weight gain can prevent the incidence of macrosomia, stillbirths and cesarean section.