Effects Of Different Progestational BMI And Different BMI Increase In Pregnancy On Pregnancy Outcome

Objective:This study explores the relationship between progestational body mass index(BMI),BMI increase during pregnancy,and pregnancy outcome.This study studied the population with different progestational BMI and different BMI increases during pregnancy.By analyzing the differences in the incidence of adverse pregnancy outcomes such as gestational diabetes mellitus(GDM),hypertensive disorders of pregnancy(HDP),preterm birth,and macrosomia among people with different pre-pregnancy BMI and different increase of BMI during pregnancy,to explore the effects of the different pre-pregnancy BMI and the rise of BMI during pregnancy on adverse pregnancy outcomes,to provide a basis for preventing pregnancy complications and reducing adverse pregnancy outcomes.Methods:Using retrospective research methods,455 pregnant women who established maternity check-up health cards in Shinan District and had a regular antenatal examination in the obstetrics clinic of our hospital from November 2018 to November2019 were investigated,including age,progestational BMI,pre-delivery BMI,pregnancy increased BMI(△BMI),neonatal sex,various adverse pregnancy outcomes and so on.According to the difference of BMI of pregnant women before pregnancy,they were divided into low weight group(BMI<18.5kg/m~2),standard weight group(18.5 kg/m~2≤BMI<24kg/m~2),overweight group(24≤BMI<28kg/m~2)and obesity group(BMI≥28kg/m~2).According to the difference of BMI,they were divided into three groups:group△BMI<4 with less weight increase during pregnancy,the group with normal weight growth during pregnancy with 4≤△BMI<6,and group with excessive weight increase during pregnancy with△BMI≥6.Then SPSS24.0 data statistical software was used for statistical analysis to evaluate the effects of progestational BMI and△BMI on pregnancy complications and adverse pregnancy outcomes and analyze neonatal sex,region,elderly pregnant women,and delivery times on the incidence of various adverse pregnancy outcomes.Results:(1)A total of 455 pregnant women were investigated,and those who did not meet the inclusion requirements were excluded.A total of 427 effective pregnant women were obtained,with an effective rate of 93.8%.(2)The incidence of adverse pregnancy outcomes in pregnant women is about 25.7%.(3)Among women with low-BMI before pregnancy,the incidences of adverse pregnancy outcomes were GDM(11.9%),HDP(1.7%),macrosomia(5.1%),neonatal asphyxia(1.7%),postpartum hemorrhage(3.4%),forceps delivery(1.7%),preterm delivery(3.4%),low birth weight infants(3.4%),lateral episiotomy(16.9%),and puerperal infection(0).The incidence of normal-BMI before pregnancy was GDM(16.3%),HDP(3.1%),macrosomia(7.1%),neonatal asphyxia(1.7%),postpartum hemorrhage(2.0%),forceps delivery(1.0%),preterm delivery(5.1%),low birth weight infants(0.3%),lateral episiotomy(12.9%),and puerperal infection(0.7%).The incidence of overweight before pregnancy was GDM(32.8%),HDP(5.2%),macrosomia(8.6%),neonatal asphyxia(3.4%),postpartum hemorrhage(3.4%),forceps delivery(1.7%),preterm delivery(8.6%),low birth weight infants(1.7%),lateral episiotomy(22.4%),and puerperal infection(0).In the progestational obesity group,the incidence rates were GDM(20.0%),HDP(13.3%),macrosomia(20.0%),neonatal asphyxia(0),postpartum hemorrhage(0),forceps delivery(0),preterm delivery(13.3%),low birth weight infants(0),lateral episiotomy(13.3%),and puerperal infection(0).There are significant differences in different progestational BMI groups about the incidence of GDM,HDP,macrosomia,and preterm delivery,and they all increased with progestational BMI.The incidence of lateral episiotomy was significantly different(P<0.05),and the overweight group was the highest.There was no significant difference in neonatal asphyxia,low birth weight,forceps delivery,postpartum hemorrhage,and puerperal infection(P>0.05).(4)In the△BMI<4 group,the incidences of GDM,HDP,the incidences of adverse pregnancy outcomes were GDM(30.1%),HDP(0),macrosomia(7.5%),neonatal asphyxia(7.5%),postpartum hemorrhage(0),forceps delivery(1.9%),preterm delivery(17.0%),low birth weight infants(1.9%),lateral episiotomy(15.1%),and puerperal infection(0).In 4≤△BMI<6 group,the incidence was GDM(19.2%),HDP(0.6%),macrosomia(2.3%),neonatal asphyxia(2.3%),postpartum hemorrhage(2.9%),forceps delivery(1.2%),preterm delivery(5.2%),low birth weight infants(0.6%),lateral episiotomy(15.1%),and puerperal infection(0).In the△BMI≥6 group,the incidence was GDM(13.9%),HDP(6.9%),macrosomia(11.9%),neonatal asphyxia(0),postpartum hemorrhage(24.8%),forceps delivery(1.0%),preterm delivery(0),low birth weight infants(1.0%),lateral episiotomy(14.4%),and puerperal infection(1.0%).There are significant differences in different△BMI groups about the incidence of GDM and macrosomia.The incidence of HDP increased with the increase of△BMI.The incidence of macrosomia was the highest in the group with△BMI≥6and the lowest in the group with 4≤△BMI<6.The incidence of postpartum hemorrhage increased with△BMI,but the difference was not statistically significant.There was no significant difference in the incidence of GDM,preterm delivery,neonatal asphyxia,low birth weight infants,forceps delivery,lateral episiotomy,and puerperal infection(P>0.05).Conclusion:(1)The incidence of adverse pregnancy outcomes in the progestational overweight and obesity group is higher than in the standard progestational weight group and low progestational weight group,suggesting that controlling progestational weight and avoiding overweight or obesity will reduce the incidence of adverse pregnancy outcomes.(2)There were significant differences in the incidence of five kinds of adverse pregnancy outcomes among different BMI groups before pregnancy.Only HDP and macrosomia were significantly different△BMI groups,and the incidences of HDP and macrosomia were the highest in the△BMI≥6 group.Therefore,controlling the BMI during pregnancy within a reasonable range can reduce the incidence of adverse pregnancy outcomes.The correlation between progestational BMI and adverse pregnancy outcomes is more robust than that of△BMI during pregnancy.(3)Controlling the progestational BMI and△BMI during pregnancy can reduce the incidence of various adverse pregnancy outcomes to a certain extent.Medical workers should actively educate and guide pregnant preparations to control BMI in an appropriate range before pregnancy and continue to pay attention to the reasonable growth of BMI during subsequent pregnancy to reduce the occurrence of adverse pregnancy outcomes,reduce the consumption of medical resources,and may bring long-term benefits to mothers and infants.