Evaluation of Preeclampsia Risk in Gestational Weight Gain
Keywords:
Maternal obesity, perinatal outcome, complication
Abstract
Background: The incidence of obesity worldwide has increased over the last 20 years. The increase in obesity in maternal pregnancy is causing a major challenge to obstetrics practices. The aimed study was to evaluate gestational weight gain as a risk for preeclampsia in pregnant women. Methods: This cross-sectional study was conducted on 2756 pregnant women with gestational age≥37 weeks. The selection of women was categorized into two groups, 1528 normal-weight women with BMI less than 25kg/m2 and 1228 pregnant women with BMI over 25kg/m2. SPSS software version 26.0 was used to analyze data. Multivariate logistic regression described the relation of weight change to pregnancy course and outcomes. Results: A comparison between study groups appears an increase in antepartum complications in obese weight women. Besides that, arterial hypertension, pre-eclampsia, and gestational diabetes were more frequent in obese weight women compared to normal-weight women obese women. The incidence of cesarean was highest in obese women statistically significant difference from normal women with a p-value <0.005. In addition, maternal obese pregnancies were at twice the risk for delivery of infants who were macrosomia with higher odds (OR = 3.1, 95%CI = [1.09-5.8]). In perinatal outcomes, the difference in mean birth weight of the babies among normal and obese women was statistically significant (p<0.05). Conclusion: As we saw from the results of this study obesity during pregnancy was associated with pregnancy complications. To optimize all complications to maternal and fetus, weight gains during the pregnancy must be controlled and appropriate. Furthermore, studies are recommended to explore the maternal obesity complication and risk factors that influence obesity to minimize the adverse negative effect of this risk.
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References
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24. Badran, EF., Abu-Libdeh, AM., Kasaleh, F., Saleh, Sh., Basha, A., Khader, Y., et al. (2014). Impact of Maternal Overweight and Obesity on Perinatal Outcomes. J Med J 2014; Vol. 48 (2):121- 131.
25. Khashan, A., Kenny, L. (2009). The effects of maternal body mass index on pregnancy outcome. European Journal of Epidemiology. 24 (11): 697-705.
26. Doherty, DA., Magann, EF., Francis, J., Morrison, JC., Newnham, JP. (2006). Pre-pregnancy body mass index and pregnancy outcomes. International Journal of Gynecology and Obstetrics. 95(3):242-7.DOI: 10.1016/j.ijgo.2006.06.021.
27. Sun, H., Liu, Y., Huang, S., Liu, X., Li, G., Du, Q. (2022). Association Between Pre-Pregnancy Body Mass Index and Maternal and Neonatal Outcomes of Singleton Pregnancies After Assisted Reproductive Technology. Front. Endocrinol. 12:825336. doi: 10.3389/fendo.2021.825336
28. Marozio, L., Picardo, E., Filippini, C., Mainolfi, E., Berchialla, P., Cavallo, F., et al. (2019). Maternal Age Over 40 Years and Pregnancy Outcome: A Hospital-Based Survey. J Matern Fetal Neonatal Med. 32:1602–8. DOI: 10.1080/14767058.2017.1410793
29. Wei, YM., Yang, HX., Zhu, WW., Liu, XY., Meng, WY., Wang, YQ., et al. (2015). Risk of adverse pregnancy outcomes stratified for pre-pregnancy body mass index. J Matern Fetal Neonatal Med. 1–5.
30. Vinturache, A., Moledina, N., McDonald, S., Slater, D., Tough, S. (2014). Pre-pregnancy body mass index (BMI) and delivery outcomes in a Canadian population. BMC Pregnancy Childbirth. 14:422.
31. Claramonte, Nieto, M., Meler, Barrabes, E., Garcia, Martınez, S., Gutierrez, Prat, M., Serra, Zantop, B. (2019). Impact of Aging on Obstetric Outcomes: Defining Advanced Maternal Age in Barcelona. BMC Pregnancy Childbirth. 19:342. DOI: 10.1186/s12884-019-2415-3.
32. Shrestha, A., Prowak, M., Berlandi-Short, VM., Garay, J., Ramalingam, L. (2021). Maternal Obesity: A Focus on Maternal Interventions to Improve Health of Offspring. Front Cardiovasc Med. 8:696812. doi:10.3389/fcvm.2021.696812.
33. Syngelaki, A., Sequeira Campos, M., Roberge, S., et al. (2019). Diet and exercise for preeclampsia prevention in overweight and obese pregnant women: systematic review and meta-analysis. J Matern Fetal Neonatal Med. 32: 3495–3501.
34. Bracken, O., Langhe, R (2021). Evaluation of maternal and perinatal outcomes in pregnancy with high BMI. Ir J Med Sci. 190(4):1439-1444. doi: 10.1007/s11845-020-02456-4. Epub 2021 Jan 11. PMID: 33428089.
35. Marchi, J., Berg, M., Dencker, A., Olander, EK., Begley, C. (2015). Risks associated with obesity in pregnancy, for the mother and baby: a systematic review of reviews. Obes Rev. 16:621–638. https://doi.org/10.1111/obr.12288
36. Heslehurst, N., Simpson, H., Ells, LJ., Rankin, J., Wilkinson, J., Lang, R., Brown, TJ., Summerbell, CD. (2008). The impact of maternal BMI status on pregnancy outcomes with immediate short-term obstetric resource implications: a meta-analysis. Obes Rev. 9:635–683. https://doi.org/10.1111/j.1467-789X.2008.00511.x
37. Melchor, I., Burgos, J., Campo, A., Aiartzaguena, A., Gutiérrez, J., Melchor, JC. (2019). Effect of maternal obesity on pregnancy outcomes in women delivering singleton babies: a historical cohort study. J Perinat Med. 47:625–630. https://doi.org/10.1515/jpm-2019-0103
2. World Health Organization. (2020). Facts on Obesity. Available online: https://www.who.int/news-room/facts-in-pictures/detail/6-facts-on-obesity (accessed on 30 October 2020).
3. Abraham, T., Romani, AMP. (2022). The Relationship between Obesity and Pre-Eclampsia: Incidental Risks and Identification of Potential Biomarkers for Pre-Eclampsia. Cells. 11: 1548. https://doi.org/10.3390/ cells11091548.
4. Ramonienė, G., Maleckienė, L., Nadišauskienė, RJ., Bartusevičienė, E., et al. (2017). Maternal obesity and obstetric outcomes in a tertiary referral center. Medicina. 53(2): 109-113. https://doi.org/10.1016/j.medici.2017.03.003.
5. Misra, A., Khurana, L. (2008). Obesity and the metabolic syndrome in developing countries. Journal of Clinical Endocrinology & Metabolism. 93 (11_Supplement_1):s9.
6. Tenenbaum-Gavish, K., Hod M. (2013). Impact of maternal obesity on fetal health. Fetal Diagn Ther.34(1):1-7. doi: 10.1159/000350170.
7. Hutcheon, JA., Lisonkova, S., Joseph, KS. (2011). Epidemiology of pre-eclampsia and the other hypertensive disorders of pregnancy. Best prac res Clin Obstet Gynaecol. 25(4):391–403.
8. Shao, Y., Qiu, J., Huang, H. et al. (2017). Pre-pregnancy BMI, gestational weight gain and risk of preeclampsia: a birth cohort study in Lanzhou, China. BMC Pregnancy Childbirth 17, 400.
9. Bodnar, L.M.; Ness, R.B.; Markovic, N.; Roberts, J.M. (2005). The risk of pre-eclampsia rises with increasing prepregnancy body mass index. Ann. Epidemiol. 15, 475–482.
10. Mbah, A.; Kornosky, J.; Kristensen, S.; August, E.; Alio, A.; Marty, P.; Belogolovkin, V.; Bruder, K.; Salihu, H. Super-obesity, and risk for early and late pre-eclampsia. BJOG Int. J. Obstet. Gynaecol. 2010, 117, 997–1004.
11. Bodnar, L.M.; Catov, J.M.; Klebanoff, M.A.; Ness, R.B.; Roberts, J.M. (2007). Prepregnancy Body Mass Index and the Occurrence of Severe Hypertensive Disorders of Pregnancy. Epidemiology. 18, 234–239.
12. Say, L. et al. (2014). Global causes of maternal death: A WHO systematic analysis. Lancet Glob. Health. 2(6): e323-333.
13. Roberts, JM., Pearson, G., Cutler, J., Lindheimer, M. (2003). Pregnancy NWGoRoHD: summary of the NHLBI working group on research on hypertension during pregnancy. Hypertension. 41(3):437–45.
14. Shao, Y., Qiu, J., Huang, H., Mao, B., Dai, W., et al. (2017). Pre-pregnancy BMI, gestational weight gain and risk of preeclampsia: a birth cohort study in Lanzhou, China. BMC Pregnancy and Childbirth. 17:400 DOI 10.1186/s12884-017-1567-2.
15. Kuciene, R., & Dulskiene, V. (2022). Associations of maternal gestational hypertension with high blood pressure and overweight/ obesity in their adolescent offspring: a retrospective cohort study. 12:3800 | https://doi.org/10.1038/s41598-022-07903-z
16. Williams, B. et al. (2018). ESC/ESH guidelines for the management of arterial hypertension. Eur. Heart J. 39(33): 3021–3104.
17. Redman, CW., & Sargent, IL. (2005). Latest advances in understanding preeclampsia. Science. (308(5728)):1592–1594.
18. Park, Y., Cho, GJ., Kim, LY., Le, TS., Oh, MJ., Kim, YH. *2018). Preeclampsia Increases the Incidence of Postpartum Cerebrovascular Disease in Korean Population. J Korean Med Sci. 33(6): e35. https://doi.org/10.3346/jkms.2018.33.e35
19. Porreco, RP., Barkey, R. (2010). Peripartum intensive care. The journal of maternal fetal & neonatal medicine: the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal societies. Int Perinatal Obstet. 23(10):1136–8.
20. Irgens, HU., Reisaeter, L., Irgens, LM., Lie, RT. (2001). Long-term mortality of mothers and fathers after preeclampsia population-based cohort study. BMJ. 323(7323):1213–7.
21. Haugen, M., Brantsaeter, AL., Winkvist, A., Lissner, L., Alexander, J., Oftedal, B., Magnus, P., Meltzer, HM. (2014). Associations of pre-pregnancy body mass index and gestational weight gain with pregnancy outcome and postpartum weight retention: a prospective observational cohort study. Bmc Pregnancy and Childbirth. 14.
22. Jagan, A., Pandi, K., Coumary, S. (2020). Effect of body mass index on maternal and perinatal outcomes in nulliparous women: A prospective comparative study. International Journal of Clinical Obstetrics and Gynaecology 4(6): 36-39. DOI:https://doi.org/10.33545/gynae.2020.v4.i6a.731
23. Durst, JK., Tuuli, MG., Stout, MJ., Macones, GA., Cahill, AG. (2016). Degree of obesity at delivery and risk of preeclampsia with severe features. Am J Obstet Gynecol. May;214(5): 651.e1-5. doi: 10.1016/j.ajog.2015.11.024.
24. Badran, EF., Abu-Libdeh, AM., Kasaleh, F., Saleh, Sh., Basha, A., Khader, Y., et al. (2014). Impact of Maternal Overweight and Obesity on Perinatal Outcomes. J Med J 2014; Vol. 48 (2):121- 131.
25. Khashan, A., Kenny, L. (2009). The effects of maternal body mass index on pregnancy outcome. European Journal of Epidemiology. 24 (11): 697-705.
26. Doherty, DA., Magann, EF., Francis, J., Morrison, JC., Newnham, JP. (2006). Pre-pregnancy body mass index and pregnancy outcomes. International Journal of Gynecology and Obstetrics. 95(3):242-7.DOI: 10.1016/j.ijgo.2006.06.021.
27. Sun, H., Liu, Y., Huang, S., Liu, X., Li, G., Du, Q. (2022). Association Between Pre-Pregnancy Body Mass Index and Maternal and Neonatal Outcomes of Singleton Pregnancies After Assisted Reproductive Technology. Front. Endocrinol. 12:825336. doi: 10.3389/fendo.2021.825336
28. Marozio, L., Picardo, E., Filippini, C., Mainolfi, E., Berchialla, P., Cavallo, F., et al. (2019). Maternal Age Over 40 Years and Pregnancy Outcome: A Hospital-Based Survey. J Matern Fetal Neonatal Med. 32:1602–8. DOI: 10.1080/14767058.2017.1410793
29. Wei, YM., Yang, HX., Zhu, WW., Liu, XY., Meng, WY., Wang, YQ., et al. (2015). Risk of adverse pregnancy outcomes stratified for pre-pregnancy body mass index. J Matern Fetal Neonatal Med. 1–5.
30. Vinturache, A., Moledina, N., McDonald, S., Slater, D., Tough, S. (2014). Pre-pregnancy body mass index (BMI) and delivery outcomes in a Canadian population. BMC Pregnancy Childbirth. 14:422.
31. Claramonte, Nieto, M., Meler, Barrabes, E., Garcia, Martınez, S., Gutierrez, Prat, M., Serra, Zantop, B. (2019). Impact of Aging on Obstetric Outcomes: Defining Advanced Maternal Age in Barcelona. BMC Pregnancy Childbirth. 19:342. DOI: 10.1186/s12884-019-2415-3.
32. Shrestha, A., Prowak, M., Berlandi-Short, VM., Garay, J., Ramalingam, L. (2021). Maternal Obesity: A Focus on Maternal Interventions to Improve Health of Offspring. Front Cardiovasc Med. 8:696812. doi:10.3389/fcvm.2021.696812.
33. Syngelaki, A., Sequeira Campos, M., Roberge, S., et al. (2019). Diet and exercise for preeclampsia prevention in overweight and obese pregnant women: systematic review and meta-analysis. J Matern Fetal Neonatal Med. 32: 3495–3501.
34. Bracken, O., Langhe, R (2021). Evaluation of maternal and perinatal outcomes in pregnancy with high BMI. Ir J Med Sci. 190(4):1439-1444. doi: 10.1007/s11845-020-02456-4. Epub 2021 Jan 11. PMID: 33428089.
35. Marchi, J., Berg, M., Dencker, A., Olander, EK., Begley, C. (2015). Risks associated with obesity in pregnancy, for the mother and baby: a systematic review of reviews. Obes Rev. 16:621–638. https://doi.org/10.1111/obr.12288
36. Heslehurst, N., Simpson, H., Ells, LJ., Rankin, J., Wilkinson, J., Lang, R., Brown, TJ., Summerbell, CD. (2008). The impact of maternal BMI status on pregnancy outcomes with immediate short-term obstetric resource implications: a meta-analysis. Obes Rev. 9:635–683. https://doi.org/10.1111/j.1467-789X.2008.00511.x
37. Melchor, I., Burgos, J., Campo, A., Aiartzaguena, A., Gutiérrez, J., Melchor, JC. (2019). Effect of maternal obesity on pregnancy outcomes in women delivering singleton babies: a historical cohort study. J Perinat Med. 47:625–630. https://doi.org/10.1515/jpm-2019-0103
Published
2022-12-14
How to Cite
Baftiu, D., Abazaj, E., Ali, E., & Nikolla, L. (2022). Evaluation of Preeclampsia Risk in Gestational Weight Gain. European Scientific Journal, ESJ, 12, 263. Retrieved from https://eujournal.org/index.php/esj/article/view/16215
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ESI Preprints
Copyright (c) 2022 Dardan Baftiu, Erjona Abazaj, Ela Ali, Ledina Nikolla
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