Correlation Analysis Of Pre-pregnancy Body Mass Index And Gestational Weight Gain With Adverse Pregnancy Outcomes

Objective: To explore the effects of different body mass index(BMI)and gestational weight gain(GWG)on adverse pregnancy outcomes.Methods: A total of 14,532 pregnant women who were hospitalized and delivered in our hospital from June 2016 to December 2018 were selected.Statistics and demographic information: such as name,age,height,weight before pregnancy,weight during hospital delivery and birth history.Clinical data: gestational week,delivery method,neonatal weight;Gestational diabetes mellitus(GDM),Gestational hypertension(GH),Pre-eclampsia(PE),Premature rupture of membranes(PROM),Large for gestational age(LGA),Small for gestational age(SGA),Preterm birth(PTB),Fetal distress,Neonatal asphyxia,Fetal growth restriction(FGR)and other incidence.Divided into four groups according to pre-pregnancy body mass index(BMI): pre-pregnancy obesity group(including grade I,II and III groups),pre-pregnancy overweight group,pre-pregnancy normal weight group and pre-pregnancy low body weight group.According to Gestational Weight Gain(GWG),it was divided into three groups: too little GWG group,suitable GWG group and too much GWG group.SPSS25.0 software was used for statistical analysis.Measurement data were expressed as mean ± standard error or median(quartile),and Kruskal-Wallis rank sum test was used.Counting data was expressed as the number of cases(percentage),using Cochran-Mantel-Haenszel chi-square test.The incidence of adverse pregnancy outcomes was expressed in cases(percentage).A logistic regression model was used to assess the relationship between weight gain during pregnancy and adverse pregnancy outcomes,and the odds ratio(OR)of any adverse pregnancy outcomes was calculated.P <0.05 was considered statistically significant.Analyze and compare the differences in pregnancy outcomes of pregnant women with different pre-pregnancy BMI and different GWG.Results: 1.There was a statistically significant difference in age,number of pregnancy,gestational week,number of deliveries,number of miscarriages,cesarean delivery,neonatal weight,incidence of gestational diabetes mellitus,incidence of gestational hypertension, incidence of pre-eclampsia,preterm birth and LGA/SGA incidence among different pre-pregnancy BMI groups(P <0.05);there was no statistical difference in incidence of premature rupture of membranes,incidence of fetal distress,incidence of fetal growth restriction and incidence of neonatal asphyxia(P> 0.05).2.There were statistically significant differences in the degrees of pre-pregnancy obesity among the number of miscarriages,pre-eclampsia and LGA incidence(P <0.05);There were no statistical difference in the age,number of pregnancy,gestational week,number of deliveries,cesarean delivery,neonatal weight,SGA incidence,incidence of premature rupture of membranes,incidence of gestational diabetes mellitus,incidence of gestational hypertension,incidence of asphyxia in newborns,incidence of preterm birth,incidence of fetal distress and the incidence of fetal growth restriction(P> 0.05).With the increase of the pre-pregnancy obesity level,the number of miscarriages,the incidence of pre-eclampsia and the incidence of LGA were raising.3.The incidence of weight gain in pregnant women with different BMI before pregnancy was different,and the incidence of gestational weight gain in the group with low BMI before pregnancy was the lowest,accounting for 35.54%.In different pre-pregnancy BMI groups,women with insufficient GWG had higher rates of gestational diabetes mellitus,premature rupture of membranes,premature delivery and SGR than women with excessive GWG.The risk of gestational hypertension and LGA were lower than people who had excessive GWG.Among people with a low BMI before pregnancy,women with underweight gain were more likely to have preeclampsia than women with overweight,and in the remaining three groups,excessive GWG women were more likely to have pre-eclampsia.Among different pre-pregnancy BMI groups,the incidence of SGA was highest among women with too little GWG during pregnancy.4.In the group of pre-pregnancy low BMI,normal BMI and overweight,the risk of gestational diabetes mellitus was significantly higher in patients with insufficient GWG than in the appropriate group.In the pre-pregnancy normal BMI group,excessive GWG was 77% higher than the risk of developing preeclampsia in appropriate GWG women.If pre-pregnant obese pregnant women had excessive GWG,their risk of developing gestational hypertension was 3.05 times that of women who were suitable for weight gain.In different pre-pregnancy BMI groups,too little GWG caused a significantly higher risk of preterm birth than the appropriate one.Among them,the risk of low pre-pregnancy BMI was 7.43 times that of women who are suitable for weight gain.In different pre-pregnancy BMI,women with excessive GWG were at higher risk of developing LGA than the appropriate group.In the low pre-pregnancy BMI group,the risk of developing SGA with too little GWG was 2.89 times that of women who were suitable for weight gain.Among pre-pregnant obese pregnant women,women with too little GWG had a 10.0% risk of developing fetal distress.Conclusions: 1.Within a certain range,different pre-pregnancy BMI,GDM,LGA,SGA,PE and PTB had different risk of onset.Different levels of pre-pregnancy obesity,the frequency of miscarriage,the incidence of PE and LGA were different.Women with excessive weight gain during pregnancy had a higher risk of PE and LGA,while the risk of GDM and SGA was lower than women with too little weight gain and appropriate weight gain.2.For women of childbearing age who were overweight or obese before pregnancy,they should actively manage before and during pregnancy,focusing on reducing BMI before pregnancy to reduce the adverse outcomes of women during pregnancy.