Impact of pre-pregnancy body mass index and gestational weight gain on the risk of maternal and infant pregnancy complications in Korean women

Abstract

Background/Objective Healthy weight maintenance before and during pregnancy has a significant effect on pregnancy outcomes; however, there are no specific guidelines for gestational weight gain in pregnant Korean women. Therefore, we investigated the impact of pre-pregnancy body mass index (BMI) and gestational weight gain on the risk of maternal and infant pregnancy complications in pregnant Korean women. Methods Study participants comprised 3454 singleton pregnant women from the Korean Pregnancy Outcome Study who had baseline examination and pregnancy outcome data. Maternal pre-pregnancy BMI and gestational weight gain were categorized according to the Asia-pacific regional guidelines and the Institute of Medicine recommendations, respectively. The primary outcome was any adverse outcomes, defined as the presence of one or more of the following: hypertensive disorders of pregnancy, gestational diabetes mellitus, peripartum depressive symptom, cesarean delivery, delivery complications, preterm birth, small or large weight infant, neonatal intensive care unit admission, or a congenital anomaly. Multiple logistic regression models were applied to examine the independent and combined impact of pre-pregnancy BMI and gestational weight gain on the risk of maternal and infant outcomes. Results Obesity before pregnancy significantly increased the risk of perinatal adverse outcomes by more than 2.5 times [odds ratio (OR): 2.512, 95% confidence interval (CI): 1.817–3.473]. Compared to that in women with appropriate gestational weight gain, women with excessive weight gain had a 36.4% incremental increase in the risk of any adverse outcomes [OR: 1.364, 95% CI: 1.115–1.670]. Moreover, women who were overweight or obese before pregnancy and had excessive gestational weight gain had a three-fold increase in the risk of adverse outcomes [OR: 3.460, 95% CI: 2.210–5.417]. Conclusion This study highlights the need for appropriate weight recommendations before and during pregnancy to prevent perinatal complications in Korean women of childbearing age.

Relationship of anthropometric measurements with glycated hemoglobin and 1‐h blood glucose after 50 g glucose challenge test in pregnant women: A longitudinal cohort study in Southern Thailand

“…The variation of cut-off values for obese group were differently used. [29][30][31][32][33] In addition, pre-pregnancy BMI was shown to be higher in women with multigravida, as two-thirds of women included in our study, comparing to primigravida or nulliparity 34 as other studies. [29][30][31] Weak correlation of HbA1c and 1-h blood sugar levels after the 50 g GCT in the first trimester and moderate correlations of those in late trimester with anthropometric measurements in our study could be explained that the early pregnancy is a time of relative insulin sensitivity, which then decreases sharply in the second and early third trimesters.…”

“…[29][30][31][32][33] In addition, pre-pregnancy BMI was shown to be higher in women with multigravida, as two-thirds of women included in our study, comparing to primigravida or nulliparity 34 as other studies. [29][30][31] Weak correlation of HbA1c and 1-h blood sugar levels after the 50 g GCT in the first trimester and moderate correlations of those in late trimester with anthropometric measurements in our study could be explained that the early pregnancy is a time of relative insulin sensitivity, which then decreases sharply in the second and early third trimesters. 35 Higher correlation of anthropometric measurements with HbA1c than 1-h blood sugar levels after the 50 g GCT because HbA1c readings reflect the long half-life of red blood cells and represent an estimate of average glucose over the prior 3 months, which is different from the physiological responses of the glucose challenge for glucose homeostasis.…”

“…This may be explained by different designs, study settings, and women's characteristics. The variation of cut‐off values for obese group were differently used 29–33 . In addition, pre‐pregnancy BMI was shown to be higher in women with multigravida, as two‐thirds of women included in our study, comparing to primigravida or nulliparity 34 as other studies 29–31 …”

Effectiveness of a nurse‐led mHealth app to prevent excessive gestational weight gain among overweight and obese women: A randomized controlled trial

“…Approximately half of pregnant women in the general population of European‐Americans exceeded the GWG recommended by the Institute of Medicine (IOM) in 2009 (Groth et al, 2021), and similar data have been obtained in Taiwan (Wen et al, 2019). Women who are already overweight or obese before pregnancy are prone to more excessive GWG than those with normal weight (Choi et al, 2021; Vinturache et al, 2019). Excessive body weight before pregnancy and GWG increase pregnancy complications, such as gestational diabetes mellitus (GDM), postpartum depressive symptoms, and cesarean section, as well as adverse consequences for the infant, such as being large for gestational age (LGA), preterm birth, congenital abnormalities, macrosomia, and a high risk of metabolic disease later in life (Choi et al, 2021; Li et al, 2021; Renault et al, 2014).…”

“…Women who are already overweight or obese before pregnancy are prone to more excessive GWG than those with normal weight (Choi et al, 2021; Vinturache et al, 2019). Excessive body weight before pregnancy and GWG increase pregnancy complications, such as gestational diabetes mellitus (GDM), postpartum depressive symptoms, and cesarean section, as well as adverse consequences for the infant, such as being large for gestational age (LGA), preterm birth, congenital abnormalities, macrosomia, and a high risk of metabolic disease later in life (Choi et al, 2021; Li et al, 2021; Renault et al, 2014). Therefore, overweight and obese women with high BMI tend to have excessive GWG, and weight management has become an increasingly important issue.…”