| Objective:To compare and analyze the effects of overweight,obesity,and weight gain during pregnancy on pregnancy outcomes.Method:A total of 2224 pregnant women who underwent regular obstetric examinations and delivered at the Maternal and Child Health Hospital of Inner Mongolia Autonomous Region from January 1,2022 to June 1,2022 were selected as the study subjects.They were divided into two groups based on different body mass index(BMI)before pregnancy,namely,normal weight before pregnancy and overweight and obesity before pregnancy.The incidence of pregnancy complications and complications,adverse pregnancy outcomes,induced labor failure,delivery methods,and neonatal conditions in the two groups were compared and analyzed;In addition,2224 pregnant women were divided into excessive weight gain group,insufficient weight gain group,and moderate weight gain group according to the degree of weight gain during pregnancy.The incidence of pregnancy complications,adverse pregnancy outcomes,induced labor failure,delivery methods,and neonatal conditions were compared among the three groups;Multivariate linear regression was used to analyze the risk factors for weight gain during pregnancy.Result:1.Overall situation of 224 pregnant womenThe age range is 21-45 years old,with an average age of 31.52±4.27 years.The average BMI is 24.51±1.99kg/m2,and the average gestational age is 39.22±1.89 weeks.The incidence rate of pregnancy induced hypertension was 7.4%(165/2224);The incidence of hyperlipidemia in pregnancy was 19.2%(426/2224);Incidence rate of gestational diabetes was 9.2%(205/2224);The incidence rate of intrahepatic cholestasis of pregnancy was 1.4%(32/2224);The incidence of hypothyroidism during pregnancy was 18%(400/2224);The incidence of premature rupture of membranes was 5.3%(118/2224);The incidence of placental abruption was 3.7%(83/2224);The incidence of postpartum hemorrhage was 4.3%(96/2224);The failure rate of induced labor was 4.1%(91/2224);The incidence of cervical incompetence was 1.4%(32/2224),and the cesarean section rate was 36.5%(811/2224);The forceps delivery rate was 0.5%(12/2224).The average Apgar 5-minute score of 2224newborns was(8.96±0.38),and the average weight was(3379.13±559.38)g.The incidence of neonatal asphyxia was 1.6%(36/2224);The incidence of premature delivery was 9.8%(218/2224);The incidence of macrosomia was 10.8%(240/2224);Low birth weight infants were 6.1%(136/2224).2.Comparison between the overweight and obesity group before pregnancy and the normal weight group before pregnancyOf the 2224 pregnant women,1490(67%)had a normal weight before pregnancy and734(33%)were overweight and obese.The incidence of hypertension during pregnancy in the overweight and obese group was significantly higher than that in the normal weight group before pregnancy(X~2=27.621,p<0.001);The incidence of hyperlipidemia during pregnancy in the overweight and obese group was significantly higher than that in the normal weight group before pregnancyX~2=9.862,p=0.002);The incidence of gestational diabetes in the overweight and obesity group was higher than that in the normal weight group before pregnancy,with a statistically significant difference(X~2=20.923,p<0.001);The incidence of intrahepatic cholestasis in the overweight and obese group was higher than that in the normal weight group before pregnancy,with a statistically significant difference(X~2=15.626,p<0.001);The incidence of premature rupture of membranes in pregnant women with normal pre pregnancy weight was higher than that in overweight and obese women,with no statistically significant difference(X~2=0.630,p=0.427);The incidence of placental abruption in the normal weight group before pregnancy was higher than that in the overweight and obese group,with no statistically significant difference(X~2=3.598,p=0.058);The incidence of postpartum hemorrhage in the group with normal weight before pregnancy was higher than that in the overweight and obese group,with no statistically significant difference(X~2=2.199,p=0.138);The incidence of hypothyroidism during pregnancy in the overweight and obese group was higher than that in the normal weight group before pregnancy,with no statistically significant difference(X~2=0.054,p=0.816);The incidence of cervical dysfunction in the overweight and obese group was higher than that in the normal weight group before pregnancy,with no statistically significant difference(X~2=1.696,p=0.193);The probability of neonatal asphyxia in the overweight and obese group was higher than that in the normal weight group before pregnancy,with a statistically significant difference(X~2=7.540,p=0.006);The premature delivery rate in the overweight and obese group was higher than that in the normal weight group before pregnancy,with no statistically significant difference(X~2=2.324,p=0.127);The probability of spontaneous delivery in the overweight and obese group was lower than that in the normal weight group before pregnancy,while the probability of cesarean section in the overweight and obese group was higher than that in the normal weight group before pregnancy,with a statistically significant difference(X~2=29.875,p<0.001);The probability of forceps assisted delivery in the overweight and obese group was higher than that in the normal weight group before pregnancy,with no statistically significant difference(X~2=1.576,p=0.209);The failure rate of induced labor in the overweight and obese group was higher than that in the normal weight group before pregnancy,with a statistically significant difference(X~2=5.147,p=0.023);In terms of newborn condition,the average weight of newborns in the overweight and obese group was higher than that in the normal weight group before pregnancy,with a statistically significant difference(X~2=2.213,p=0.027);The Apgar 5-minute score of newborns delivered by overweight and obese pregnant women was lower than that of pregnant women with normal weight before pregnancy,with no statistically significant difference(X~2=1.695,p=0.090);The incidence of macrosomia in the overweight and obese group was higher than that in the normal weight group before pregnancy,with a statistically significant difference(X~2=22.714,p<0.001);The incidence of low birth weight infants delivered by overweight and obese pregnant women was lower than that of pregnant women with normal pre pregnancy weight,with no statistically significant difference(X~2=0.295,p=0.587).3.Excessive weight gain during pregnancy,insufficient weight gain during pregnancy,and moderate weight gain during pregnancyAccording to the amount of weight gain during pregnancy,the subjects were divided into three groups:insufficient weight gain during pregnancy,moderate weight gain during pregnancy,and excessive weight gain during pregnancy.Of 2224 pregnant women,628(28%)had insufficient weight gain during pregnancy,564(25%)had moderate weight gain during pregnancy,and 1032(47%)had excessive weight gain during pregnancy.The incidence of hypertension during pregnancy in the overweight group was significantly higher than that in the underweight group and the moderate weight gain group(P<0.05);The incidence of hyperlipidemia during pregnancy in the excess weight gain group was significantly higher than that in the insufficient weight gain group and the moderate weight gain group(P<0.05);The incidence of diabetes during pregnancy in the overweight group was significantly higher than that in the underweight group and the moderate weight gain group(P<0.05);The incidence of premature rupture of membranes in the overweight group during pregnancy was higher than that in the underweight group and the moderate weight gain group during pregnancy,with a statistically significant difference(P<0.05);The incidence of placental abruption in the excess weight gain group during pregnancy was higher than that in the insufficient weight gain group and the moderate weight gain group during pregnancy,with a statistically significant difference(P<0.05).The incidence of postpartum hemorrhage in the excess weight gain group during pregnancy was higher than that in the insufficient weight gain group and the moderate weight gain group during pregnancy,with a statistically significant difference(P<0.05);There was no significant difference in the incidence of hypothyroidism during pregnancy among the over weight gain group,the under weight gain group,and the moderate weight gain group(P>0.05);There was no significant difference in the incidence of cervical dysfunction among the over weight gain group,the under weight gain group,and the moderate weight gain group(P>0.05);There was no significant difference in the incidence of premature infants among the over weight gain group,the under weight gain group,and the moderate weight gain group(P>0.05);The incidence of neonatal asphyxia in the over weight gain group during pregnancy was higher than that in the under weight gain group and moderate weight gain group during pregnancy,with a statistically significant difference(P<0.05);In terms of delivery methods,the rate of spontaneous delivery in the moderate weight gain group during pregnancy was higher than that in the insufficient and excessive weight gain groups during pregnancy,while the cesarean section rate in the moderate weight gain group during pregnancy was lower than that in the insufficient and excessive weight gain groups during pregnancy,with a statistically significant difference(P<0.05);The incidence of induced abortion failure in the over weight gain group during pregnancy was higher than that in the under weight gain group and moderate weight gain group during pregnancy,with a statistically significant difference(P<0.05);There was no significant difference in the incidence of forceps midwifery among the over weight gain group,the under weight gain group,and the moderate weight gain group(P>0.05);The average weight of newborns in the over weight gain group during pregnancy was greater than that in the under weight gain group and moderate weight gain group during pregnancy,with a statistically significant difference(P<0.05);The incidence of macrosomia in the over weight gain group during pregnancy was significantly higher than that in the under weight gain group and moderate weight gain group during pregnancy(P<0.05);The incidence of low birth weight infants in the insufficient weight gain group during pregnancy was significantly higher than that in the excessive weight gain group and the moderate weight gain group during pregnancy(P<0.05);There was no significant difference in the Apgar 5-minute average score among the over weight gain group,the under weight gain group,and the moderate weight gain group during pregnancy(P>0.05).4.Factors affecting weight gain during pregnancyThis study used weight gain during pregnancy as the dependent variable,and age,pre pregnancy weight,gestational week,and parity as independent variables to conduct a multifactor linear regression.The results showed that the amount of weight gain during pregnancy varies with age(β=0.32,95%CI:0.26 to 0.38)and gestational weeks(β=0.31,95%CI:0.18～0.43),while increasing with pre pregnancy BMI(β=-0.38,95%CI:-0.20～-0.26)and production times(β=-1.16,95%CI:-1.57～-0.76).Conclusion:1.Comparison between pre pregnancy overweight and obesity group and pre pregnancy normal weight groupThe risk of pregnancy hypertension,pregnancy diabetes,pregnancy with hyperlipidemia,intrahepatic cholestasis of pregnancy in the overweight and obesity group before pregnancy is higher than that in the normal weight group before pregnancy;The incidence of abortion failure in the pre pregnancy overweight obese group was higher than that in the pre pregnancy normal weight group.The incidence of neonatal asphyxia in the pre pregnancy overweight and obesity group was higher than that in the pre pregnancy normal weight group;The average weight of newborns in the pre pregnancy overweight and obesity group was larger,and the incidence of macrosomia was higher than that in the pre pregnancy normal weight group.The rate of spontaneous labor and cesarean section in the normal weight group during pregnancy is higher than that in the overweight and obese group before pregnancy.2.Comparison of excessive,insufficient,and moderate weight gain during pregnancyThe risk of pregnancy hypertension,pregnancy diabetes,pregnancy with hyperlipidemia,postpartum hemorrhage and neonatal asphyxia increased in the overweight group during pregnancy;The average weight gain of newborns,the incidence of macrosomia,and the failure rate of induced labor are high.The moderate weight gain group during pregnancy had a low incidence of cesarean section,premature rupture of membranes,and placental abruption,while a high rate of spontaneous labor.The incidence of low birth weight among newborns in the group with insufficient weight gain during pregnancy is high.3.Weight gain during pregnancy increases with age,but decreases with increased pre pregnancy BMI and parity. |
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