The effects of pre-pregnancy body mass index and gestational weight gain on perinatal outcomes in Korean women: a retros
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RESEARCH
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The effects of pre-pregnancy body mass index and gestational weight gain on perinatal outcomes in Korean women: a retrospective cohort study Sae-Kyung Choi, In-Yang Park, Jong-chul Shin*
Abstract Background: The purpose of the study was to evaluate the effects of maternal pre-pregnancy body mass index (BMI) and gestational weight gain on perinatal outcomes in a population of Korean women. Methods: We retrospectively reviewed the medical records of 2,454 women who had received antenatal care at Seoul St. Mary’s Hospital from January 2007 to December 2009. We used World Health Organization definitions for Asian populations of underweight (BMI < 18.5), normal (BMI equal or higher 18.5 and < 23), overweight (BMI equal or higher 23 and < 25), and obese (BMI equal or higher 25). We analyzed perinatal outcomes according to the prepregnancy BMI and weight gain during pregnancy, and calculated the adjusted odds ratios (ORs) and 95% confidence intervals (CIs) from multiple logistic regression models by considering maternal age, parity, number of fetuses, length of gestation, and medical history. Results: Among obese women, the adjusted ORs for gestational diabetes, hypertensive disorder, and incompetent internal os of cervix were 4.46, 2.53, and 3.70 (95% CI = 2.63-7.59, 1.26-5.07, and 1.50-9.12), respectively, and the adjusted ORs for neonatal complications such as macrosomia and low Apgar score were 2.08 and 1.98 (95% CI = 1.34-3.22 and 1.19-3.29), respectively, compared with normal weight women. However, there was no positive linear association between gestational weight gain and obstetric outcomes. In normal weight women, maternal and neonatal complications were significantly increased with inadequate weight gain during pregnancy (p < 0.0001 and = 0.0180, respectively), and we observed similar results in underweight women (p = 0.0136 and 0.0004, respectively). Conclusions: This study shows that pre-pregnancy overweight and obesity are more closely related to the adverse obstetric outcomes than excess weight gain during pregnancy. In addition, inadequate weight gain during pregnancy can result in significant complications.
Background Obesity has been frequently cited as a health problem in women of childbearing age. A recent report found that 25% of the adult population was obese. The obesity rate has rapidly increased in the general population and in women of childbearing age [1,2]. According to a study conducted from 2002 to 2004 in Scotland, 20% of women who received antenatal care were obese, * Correspondence: [email protected] Department of Obstetrics and Gynecology, College of Medicine, The Catholic University of Korea, 505 Banpo-dong, Seocho-gu, Seoul, Korea
representing a twofold increase over the past 10 years [3]. A similar study in the United States reported that the percentage of obese women who received antenatal care increased from 16% in 1980 to 36% in 1999 [4]. Gestational weight gain is also higher than ever before, with approximately 40% of pregnant women gaining more weight
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