The Relation Between Maternal Gestational Weight Gain And Pregnancy Outcomes

Objective:The purpose of this study was to investigate the relation between gestational weight gain(GWG) and pregnancy outcomes in pregnant women with different pre-pregnancy body mass indexs(BMI) who delivered in our hospital.Methods:A retrospective study was carried out by reviewing 2013 medical records of pregnant women who delivered at the Shanxi Academy of Medical Sciences, Shanxi Da Yi Hospital during 1 January 2014–1 February 2016. The collection of singleton pregnancy pre-pregnancy weight and height.1.Pregnant women were categorized according to their pre-pregnant BMI and GWG to evaluate the impacts of pre-pregnant BMI and maternal weight gain on the risk of pregnancy complications.2.Pre-pregnancy BMI were categorized according to the Chinese body mass index(BMI) criteria. Comparison of the influence of the recommended range of GWG on pregnancy outcome between 2009 IOM and ours. The evaluation index of pregnancy outcome was appropriate for gestational age(AGA) newborns. The applicable gestational weight gain was aimed to attain a high proportion of appropriate-for-gestational age newborns.Results:1.Patients were divided into four groups according to their pre-pregnancy BMI:underweight(16.7%), normal weight(64.4%), overweight(15.2%), and obese(3.7%).Compared to a normal BMI, a higher pre-pregnancy BMI(≥28kg/m2) increased the risk of giant infant(OR :2.39,P =0.016), a Cesarean delivery(OR :3.78,P <0.001),preeclampsia(OR :6.69,P <0.001), and GDM(OR :2.58,P <0.001). Women with a lower pre-pregnant BMI(<18.5kg/m2) is a protective factor for macrosomia( OR :0.50,P =0.001)、Cesarean delivery(OR :0.58,P <0.001) and gestational diabetes( OR :0.43, P <0.001). Less gestational weight gain increases the risk of low birth weight infants(OR :3.36,P =0.006). Excessive gestational weight gain increases the risk of macrosomia(OR :3.58,P <0.001), a Cesarean delivery(OR :1.43,P =0.013),preeclampsia(OR :1.43, P =0.013).2.Optimal gestational weight gain ranges for each group were 14-20kg、13-19.5kg、11-18 kg and 8-16 kg, respectively. Our proposed criteria seem to be realistic, with 56.2%of pregnant women able to adhere to the recommendation, compared to 37.4% adherence to the 2009 Institute of Medicine recommendation. There were no significant differences in obstetric complications between the two groups. Adverse pregnancy outcomes(large for gestational age(LGA), gestational diabetes mellitus(GDM) and cesarean section),were obvious decreased in women who adhereed to our recommendation.