A comparative study on gestational weight gain and adverse pregnancy outcomes in obese women in different degrees
Objective To compare the occurrence of adverse pregnancy outcomes in obese women in different degrees with different gestational weight gain(GWG).Methods Obese singleton pregnant women who were delivered by regular antenatal examination in Beijing Obstetrics and Gynecology Hospital,Capital Medical University and participated in the Beijing birth cohort study(registration number ChiCTR220058395)from January 2018 to October 2022 were selected.The clinical data of the subjects were collected,and were divided into mild obesity group(28～<30 kg/m2),moderate obesity group(30～<32 kg/m2)and severe obesity group(≥32 kg/m2)according to the pre-pregnancy BMI,and the three obesity groups with different degrees were subdivided into low GWG group(GWG<5 kg),suitable GWG group(GWG 5～9 kg)and high GWG group(GWG>9kg),and the incidence of adverse pregnancy outcomes in each gourp were compared.Results A total of 2 925 subjects were included,including 1 431 cases in mild obesity group,824 cases in moderate obesity group,and 670 in severe obesity group.The 2 925 subjects aged from 22 to 50 years,with an average age of(34.2±4.2)years,and the pregnancy BMI ranged from 28.0 to 58.7 kg/m2,with an average(30.7±2.6)kg/m2.With the increase of obesity before pregnancy,the proportion of family history of diabetes(21.4%,25.4%,28.8%),abnormalities of glucose metabolism before pregnancy(4.3%,6.6%,10.6%),chronic hypertension(5.0%,6.7%,13.4%)and polycystic ovary syndrome(PCOS)(12.8%,15.4%,18.7%)in the three obesity groups increased gradually,the differences were statistically significant(P<0.05).With the increase of obesity before pregnancy,the GWG of the three groups decreased gradually(median GWG was 10 kg,8 kg,7 kg).Compared with mild obesity group and moderate obesity group,the proportion of large for gestational age(LGA)(33.4%vs.27.7%and 30.3%),fetal macrosomia(15.8%vs.11.5%and 10.7%),pregnancy induced hypertension(PIH)(34.8%vs.25.6%and 28.3%),preeclampsia(17.6%vs.13.0%and 13.0%)and cesarean section(66.0%vs.57.2%and 58.0%)were all higher in the severe obesity group,and the differences were statistically significant(P<0.05).In obesity groups of different degrees,the proportion of premature delivery in low GWG group were higher than those in suitable GWG group and high GWG group(14.5%vs.10.4%and 5.9%in mild obesity group,14.9%vs.10.0%and 6.3%in moderate obesity group,15.0%vs.9.2%and 5.8%in severe obesity group),and the proportion of small for gestational age(SGA)in low GWG group were higher than those in suitable GWG group and high GWG group(7.7%vs.3.0%and 3.2%in mild obesity group,4.6%vs.3.2%and 1.7%in moderate obesity group,6.0%vs.2.6%and 2.1%in severe obesity group),and the differences were statistically significant(P<0.05).In obesity groups of different degrees,the proportion of PIH,pregnancy-induced hypertension,neonatal weight and LGA in high GWG group were higher than those in low GWG group and suitable GWG group,and the differences were statistically significant(P<0.05).There were no significant differences in the proportion of premature rupture of membranes,neonatal asphyxia and postpartum hemorrhage(PPH)in the three different GWG groups among different obesity groups(P<0.05).Conclusions There are differences in adverse pregnancy outcomes among pregnant women with different degrees of obesity,and the proportion of PIH,pre-eclampsia,macrosomia and cesarean section delivery in severe obese pregnant women are higher.Different GWG affects the adverse pregnancy outcomes of pregnant women with different degrees of obesity,and the risks of PIH,premature delivery,cesarean section and other adverse pregnancy outcomes of pregnant women with GWG 5～9 kg are relatively low.
万方数据
维普
