The Impact of Dehydration in the Third Trimesters on Pregnancy Outcome-Infant Birth Weight and Length

Abstract

This cohort study aimed to analyze the effect of dehydration on pregnancy outcome. A total of 66 pregnant women aged (18-35 years) at second trimester (>12 weeks) of pregnancy was recruited from seven health centers (Puskesmas) Kebon Jeruk, West Jakarta from December 2016 to January 2018. Five biomarkers (urine color, urine osmolality, urine specific gravity, serum osmolality, serum sodium) were utilized to determine hydration status. Based on the result, subjects were then assigned to dehydration group (DG) and normal group (NG), 51.5% was in the DG and 48.5%, in the NG respectively. Independent t-tests and Chi-square were employed to answer research questions. There were differences in weight of the mothers in the second and third trimester between the two groups (p<0.05), but no differences in weight gain during pregnancy (p≥0.05). More than fifty percent of subjects suffered nausea and vomiting during pregnancy in the two groups. Water intake level in DG (72.53±14.41%) were lower than NG (118.68±14.37%). The accounted difference in Infant birth weight, length, chest circumference and head circumference; were 491.84 g, 0.98 cm, 0.98 cm, and 1.11 cm, respectively where infant from the NG had higher measurements than DG. After adjustment for water intake level, the infant birth weight and length in DG (2,798.53±97.85 g; 47.32±0.32 cm) was lower than NG (3,371.77±102.60 g; 49.09±0.33 cm). The aacounted difference in infant birth weight and length between the two groups were 596.1 g and 1.8 cm, respectively. Thus in addition to nutrient intake and weight gain during pregnancy, pregnant mothers should also concern for their fluid intake in order to maintain their health condition and feotal growth-development.

Biobehavioral variation in human water needs: How adaptations, early life environments, and the life course affect body water homeostasis

“…Among humans, it is less clear how water scarcity or reduced water intake during development is related to birth outcomes. One observational study in Indonesia examined this potential developmental effect of maternal hydration status on birth outcomes finding that dehydration in the third trimester was associated with lower birth weight of 596 g and 1.8 cm reduced length (Mulyani, Hardinsyah, Briawan, & Santoso, ). However, this study did not specify which cut‐points it used to define dehydration nor did it restrict water intake among women (as that would be unethical) and therefore the results should be viewed with caution and only as associations.…”

Prevalence and Associated Risk Factors of Dehydration among Pregnant Women in Southern Nigeria

“…For instance, a similar study in Greece carried out by Malisova et al [13] found that 34% of the pregnant women were dehydrated. Likewise a study carried out by Mulyani et al [4] in seven areas of Kebon Jeruk public Health Center reported that 51.5% of pregnant women were dehydrated. In an earlier study, Pieters et al [12] reported a lower prevalence rate of dehydration (11.8%) among young pregnant women in Hawally, Kuwait.…”

“…In a cross-sectional study to assess the fluid intake of pregnant women in Indonesia, Bardosono et al [11] found that water intake in 42% of the pregnant women was below the adequate intake limit as recommended by the European Food Safety Authority (EFSA) and Institute of Medicine (IOM). In a parallel animal study, Mulyani et al [4] reported lower water intake among dehydrated pregnant animals compared with the non-dehydrated group. Water is especially important in pregnancy and contributes to maternal wellbeing and fetal growth and development.…”

“…A three-section, semi-structured selfadministered questionnaire was used to obtain information from the participants. The questionnaire was adapted from previous studies that assessed the hydration status of pregnant women and associated risk factors [12,3,4,11]. However, few modifications were made to suite the hypothesis of the present study.…”

“…Interestingly, this extensive water retention occurs in the face of increased water loss due to several physiological and metabolic activities associated with pregnancy. For instance, ventilation increased by 40%/min, tidal volume increased by 39%/min, water loss through expiration and sweating increased by 500 ml/day greater than the pre-pregnant level due to increase activities of thyroid and adrenal glands [3], while vomiting and salivation may be excessive during the first and second trimesters [4]. It is reported that the total body water increased by 6-8 liters and plasma osmolality decreased by 10 mosm/kg below the non-pregnant level.…”