Article

Associations of maternal pre-pregnancy obesity and excess pregnancy weight gains with adverse pregnancy outcomes and length of hospital stay.

School of Population Health, The University of Queensland, Brisbane, Australia.
BMC Pregnancy and Childbirth (Impact Factor: 2.52). 09/2011; 11:62. DOI: 10.1186/1471-2393-11-62
Source: PubMed

ABSTRACT It is relatively less known whether pre-pregnancy obesity and excess gestational weight gain (GWG) are associated with caesarean delivery, pregnancy complications, preterm birth, birth and placenta weights and increased length of postnatal hospital stay.
We used a population-based cohort of 6632 women who gave birth in Brisbane, Australia, between 1981 and 1983. The independent associations of pre-pregnancy obesity, GWG and institute of medicine (IOM) categories of combined pre-pregnancy BMI and GWG with outcomes were examined using multivariable regression (for continuous outcomes) and multivariable multinomial regression (for categorical outcomes) models.
We found women who were obese prior to pregnancy and women who gained excess weight during pregnancy were at greater risk for a pregnancy complications (OR: 2.10; 1.74, 2.54; age adjusted model), caesarean section (OR 1.29; 1.09, 1.54), higher birth weight difference (206.45 gm; 178.82, 234.08) and greater placental weight difference (41.16 gm; 33.83, 48.49) and longer length of hospital stay. We also found that mothers who gained inadequate weight or were underweight before pregnancy were at greater risk of preterm birth (2.27; 1.71, 3.00), lower risk of pregnancy complications (0.58; 0.44, 0.77) and had lower birth (-190.63;-221.05,-160.20) and placental (-37.16; -45.23,-29.09) weights. Results indicate that all associations remain consistent after adjustment for a range of potential confounding factors with the exception of the association between pre-pregnancy obesity and hospital stay.
Pre-pregnancy obesity or excessive GWG are associated with greater risk of pregnancy complications, caesarean delivery and greater birth and placenta weight. Excess GWG is associated with a longer stay in hospital after delivery, independent of pre-pregnancy BMI, pregnancy complications and caesarean delivery. In addition to pre-pregnancy obesity, it is vital that clinical practice considers excess GWG as another indicator of adverse pregnancy outcomes.

1 Bookmark
 · 
373 Views
  • [Show abstract] [Hide abstract]
    ABSTRACT: Obesity contributes to various pregnancy complications and therefore, may compromise maternal quality of life. The study aim was to investigate the relationship between body mass index (BMI) and health-related quality of life (HRQoL) during pregnancy. Study involved every 6th woman who gave birth in the Clinic for Obstetrics and Gynecology Clinical Center of Serbia during the year 2010. Initial and end pregnancy BMIs were calculated for every woman. The parturients (604) completed the SF36 questionnaire (physical-PHC; mental-MHC; total quality of life-TQL), Beck’s Depression Inventory, Fatigue Severity Scale, Pregnancy Symptom Scale, Multidimensional Personal Support Scale, and Acceptance of Illness Scale. Before pregnancy most women had normal or decreased weight, while at the end of pregnancy the majority were overweight or obese (p = 0.000). Initial and end pregnancy weights (p < 0.05) and BMIs (p < 0.05) were positively correlated with depression. Depression was significantly lower in overweight compared to mildly or morbidly obese women during pregnancy (p < 0.05). Pregnancy weight change correlated negatively with PHC (p = 0.029), and positively with fatigue (p = 0.030), and symptoms (p = 0.011). Of all BMI categories, morbidly obese women had the worst feeling of social support (p < 0.05). Pregnancy symptoms were significantly less problematic in women with normal weight compared to overweight and obese women during pregnancy (p < 0.05). Assessing the impact of all investigated parameters together, we established significant models for PHC (p = 0.036), depression (p = 0.030), and fatigue (p = 0.038). Pregnant women should be advised to keep their gestational weight gain within the normal recommended range to have a good pregnancy outcome and HRQoL.
    Applied Research in Quality of Life 06/2014; · 0.74 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Growing evidence suggests that maternal prepregnancy weight and gestational weight gain are risk factors for perinatal complications and subsequent maternal and child health. Postpartum weight retention is also associated with adverse birth outcomes and maternal obesity. Clinical guidelines addressing healthy weight before, during, and after pregnancy have been introduced in some countries, but at present a systematic accounting for these policies has not been conducted. The objective of the present study was to conduct a cross-national comparison of maternal weight guidelines.
    BMC Pregnancy and Childbirth 05/2014; 14(1):167. · 2.52 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Preeclampsia (PE) and gestational diabetes mellitus (GDM) adversely affect pregnancy outcomes and the subsequent health of both mother and infant. It is known that elevated pre-pregnancy body mass index (BMI) is associated with increased risk of these obstetrical complications. However, little is known about the role of adult weight patterns prior to pregnancy.
    Paediatric and Perinatal Epidemiology 05/2014; · 2.16 Impact Factor

Full-text (4 Sources)

View
31 Downloads
Available from
May 23, 2014