Association of pre-pregnancy body mass index and gestational weight gain with pregnancy outcomes Abstract

Department of Obstetrics and Gynaecology, Queen Elizabeth Hospital, Hong Kong

Background: Gestational weight gain (GWG) is a modifiable risk factor for pregnancy outcomes. This study aimed to evaluate the associations of pre-pregnancy body mass index (BMI) and GWG with perinatal and maternal outcomes in Hong Kong women and to identify risk factors for poor perinatal/maternal outcomes.
Methods: Medical records of low-risk women with singleton pregnancy who delivered babies between 1 January 2019 and 28 February 2019 at our hospital were reviewed. Based on pre-pregnancy BMI, women were categorised as underweight (<18.5 kg/m2), normal weight (18.5-24.9 kg/m2), pre-obesity (25-29.9 kg/m2), and obesity (>30 kg/m2). Based on the recommended total GWG by the Institute of Medicine, women were categorised as inadequate, normal, and excessive GWG. The normal group was compared with each of the other groups.
Results: 465 women were included for analysis. Of them, 439 (94.4%) delivered after 37 weeks of gestation and 26 (5.6%) delivered before 37 weeks of gestation. After adjusting for confounders, the risk factors for gestational diabetes were women with pre-obesity (odds ratio [OR]=3.879, p=0.001) and women with obesity (OR=15.118, p<0.001), whereas the risk factor for neonatal ventilator use was women with pre-obesity (OR=5.719, p=0.035) and the risk factor for caesarean section was women with excessive GWG (OR=1.591, p=0.047).
Conclusion: High pre-pregnancy BMI is associated with gestational diabetes and neonatal ventilator use, whereas excessive GWG is associated with caesarean section.
Hong Kong J Gynaecol Obstet Midwifery 2022; 22(2):66-72
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