Prepregnancy obesity status and risks on pregnancy outcomes in Shanghai

Abstract

Obesity in women of reproductive age is not only associated with numerous adverse maternal and fetal effects prenatally but also exerts a negative influence on female fertility. The aim of this study was to investigate the situation of prepregnant obesity in Shanghai and explore the impact of prepregnant obesity on gestational weight gain as well as other pregnancy outcomes. A prospective hospital-based pregnant women cohort was established in Shanghai since January 2015. All pregnant women who were registered and expected to deliver in this hospital were included in the cohort. Nearly one fourth of pregnant women in Shanghai were overweight/obese and the prevalence of overweight/obesity was more common among women with advancing age (P < .001). Women prepregnancy overweight/obesity was associated with 3.5-fold higher risk of excessive gestational weight gain (odds ratio, OR 3.58; 95% confidence interval, CI, 2.82–4.55; P < .001). Women prepregnancy BMI was statistically related to pregnancy outcomes as macrosomia (OR 2.24; 95% CI, 1.55–3.23; P < .001), cesarean delivery (OR 2.04; 95% CI, 1.60–2.62; P < .001), maternal complications (OR 1.53; 95% CI, 1.18–1.98; P < .001). Prepregnancy obesity is associated with a much higher risk of excessive gestational weight gain and pregnancy outcomes in Shanghai. Further interventions targeting maternal obesity, especially prepregnancy obesity are required.

Potentially modifiable predictors of adverse neonatal and maternal outcomes in pregnancies with gestational diabetes mellitus: can they help for future risk stratification and risk-adapted patient care?

“…Prepregnancy BMI was significantly correlated with the need for cesarean section, which is also consistent with previous studies [40, 41]. It showed an inverse association with SGA in univariate and multiple regression analyses, in good agreement with a metanalysis by Goto et al and a study by Li et al [42, 43].…”

A Lancet Commission on 70 years of women's reproductive, maternal, newborn, child, and adolescent health in China

“…Pregnant women should have access to lifestyle and nutritional advice to manage weight gain during pregnancy. 173 The weight monitoring and guidance in pregnancy also need to be strengthened, and to establish the weight growth standard suitable for Chinese pregnant women is critical for scientific guidance of maternal nutrition.…”

Impact of body weight on the outcome of pregnancy

“…Studies described how obesity might predispose for maternal and fetal illnesses either before or during pregnancy. 21,22 On contrary, a previous study suggested that prepregnancy obesity has a protective effect associated with longer gestation duration and lower risk of preterm or low birth weight. 23 Insulin resistance increases during pregnancy especially during the last half of pregnancy.…”