Evaluation of Preeclampsia Risk in Gestational Weight Gain
Keywords:
Maternal obesity, perinatal outcome, complications
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 a BMI of 25kg/m2 or more. 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 shows an increase in antepartum complications in obese women. Besides that, arterial hypertension, pre-eclampsia, and gestational diabetes were more frequent in overweight women compared to normal-weight women. The incidence of cesarean was highest in overweight and obese women with a statistically significant difference from normal weight women (p-value <0.005). In addition, maternal overweight and obese were at twice the risk for delivering infants with macrosomia (OR = 3.1, 95%CI = [1.09-5.8]). The difference in mean birth weight of the babies between normal and overweight women was statistically significant (p<0.05). Conclusion: The results of this study show that obesity during pregnancy is associated with pregnancy complications. To optimize all complications for the mother and fetus, weight gain during the pregnancy must be controlled and appropriate. Furthermore, studies are recommended to explore maternal obesity complications and risk factors for obesity to minimize the adverse effect of this risk.
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References
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21. Misra A, Khurana L. Obesity and the metabolic syndrome in developing countries. Journal of Clinical Endocrinology & Metabolism. 2008; 93 (11_Supplement_1):s9.
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25. Redman CW, Sargent IL: Latest advances in understanding preeclampsia. Science 2005, (308(5728)):1592–1594. 5. Xiao R, Sorensen TK, Williams MA, Luthy DA. Influence of pre-eclampsia on fetal growth. 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. 2003;13(3):157–62. 6.
26. Roberts JM, Pearson G, Cutler J, Lindheimer M. Pregnancy NWGoRoHD: summary of the NHLBI working group on research on hypertension during pregnancy. Hypertension. 2003;41(3):437–45.
27. Say, L. et al. Global causes of maternal death: A WHO systematic analysis. Lancet Glob. Health. 2014;2(6): e323-333.
28. Shao Y, Qiu J, Huang H, Mao B, Dai W, et al. Pre-pregnancy BMI, gestational weight gain and risk of preeclampsia: a birth cohort study in Lanzhou, China. BMC Pregnancy and Childbirth (2017) 17:400 DOI 10.1186/s12884-017-1567-2.
29. Shrestha A, Prowak M, Berlandi-Short VM, Garay J, Ramalingam L. Maternal Obesity: A Focus on Maternal Interventions to Improve Health of Offspring. Front Cardiovasc Med. 2021;8:696812. Published 2021 Jul 21. doi:10.3389/fcvm.2021.696812.
30. Sun H, Liu Y, Huang S, Liu X, Li G and Du Q Association Between Pre-Pregnancy Body Mass Index and Maternal and Neonatal Outcomes of Singleton Pregnancies After Assisted Reproductive Technology. Front. Endocrinol. 2022; 12:825336. doi: 10.3389/fendo.2021.825336
31. Syngelaki A, Sequeira Campos M, Roberge S, et al. Diet and exercise for preeclampsia prevention in overweight and obese pregnant women: systematic review and meta-analysis. J Matern Fetal Neonatal Med 2019; 32: 3495–3501.
32. Tenenbaum-Gavish K, Hod M. Impact of maternal obesity on fetal health. Fetal Diagn Ther. 2013;34(1):1-7. doi: 10.1159/000350170.
33. Vinturache A, Moledina N, McDonald S, Slater D, Tough S. Pre-pregnancy body mass index (BMI) and delivery outcomes in a Canadian population. BMC Pregnancy Childbirth. 2014; 14:422.
34. Wei YM, Yang HX, Zhu WW, Liu XY, Meng WY, Wang YQ, Shang LX, Cai ZY, Ji LP, Wang YF, et al. Risk of adverse pregnancy outcomes stratified for pre-pregnancy body mass index. J Matern Fetal Neonatal Med. 2015:1–5.
35. Williams, B. et al. 2018 ESC/ESH guidelines for the management of arterial hypertension. Eur. Heart J. 2018;39(33): 3021–3104.
36. World Health Organization. Facts on Obesity. Available online: https://www.who.int/news-room/facts-in-pictures/detail/6-facts-on-obesity (accessed on 30 October 2020).
37. World Health Organization. Global Database on BMI [http://apps.who.int/bmi]
2. Badran, E.F., Abu, Libdeh, A.M., Kasaleh, F., Saleh, Sh., Basha, A., Khader, Y., et al. (2014). Impact of Maternal Overweight and Obesity on Perinatal Outcomes. J Med J Vol. 48 (2):121- 131.
3. 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.
4. 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.
5. 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.
6. 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.
7. Das, R., & Biswas, S. (2015). Eclapmsia: The Major Cause of Maternal Mortality in Eastern India. Ethiopian journal of health sciences, 25(2), 111–116. https://doi.org/10.4314/ejhs.v25i2.2
8. Doherty, D.A, Magann, E.F., Francis, J., Morrison, J.C., Newnham, J.P. (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.
9. Durst, J.K., Tuuli, M.G., Stout, M.J., Macones, G.A., Cahill, A.G. (2016). Degree of obesity at delivery and risk of preeclampsia with severe features. Am J Obstet Gynecol. 214(5): 651.e1-5. doi: 10.1016/j.ajog.2015.11.024.
10. Haugen, M., Brantsaeter, A.L., Winkvist, A., Lissner, L., Alexander, J., Oftedal, B., Magnus, P., Meltzer, H.M. (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.
11. 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
12. Hutcheon JA, Lisonkova S, Joseph KS. Epidemiology of pre-eclampsia and the other hypertensive disorders of pregnancy. Best prac res Clin Obstet Gynaecol. 2011;25(4):391–403.
13. Irgens HU, Reisaeter L, Irgens LM, Lie RT. Long-term mortality of mothers and fathers after preeclampsia population-based cohort study. BMJ. 2001; 323(7323):1213–7.
14. Jagan A, Pandi K, Coumary S. Effect of body mass index on maternal and perinatal outcomes in nulliparous women: A prospective comparative study. International Journal of Clinical Obstetrics and Gynaecology 2020; 4(6): 36-39. DOI:https://doi.org/10.33545/gynae.2020.v4.i6a.731
15. Khashan A, Kenny L. The effects of maternal body mass index on pregnancy outcome. European Journal of Epidemiology. 2009; 24 (11): 697-705.
16. Kuciene R & Dulskiene V. Associations of maternal gestational hypertension with high blood pressure and overweight/ obesity in their adolescent offspring: a retrospective cohort study 2022; 12:3800 | https://doi.org/10.1038/s41598-022-07903-z
17. 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
18. Marozio L, Picardo E, Filippini C, Mainolfi E, Berchialla P, Cavallo F, et al. Maternal Age Over 40 Years and Pregnancy Outcome: A Hospital-Based Survey. J Matern Fetal Neonatal Med (2019) 32:1602–8. DOI: 10.1080/14767058.2017.1410793
19. 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.
20. 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.
21. Misra A, Khurana L. Obesity and the metabolic syndrome in developing countries. Journal of Clinical Endocrinology & Metabolism. 2008; 93 (11_Supplement_1):s9.
22. Park Y, Cho GJ, Kim LY, Lee TS, Oh MJ, Kim YH. Preeclampsia Increases the Incidence of Postpartum Cerebrovascular Disease in Korean Population. J Korean Med Sci. J Korean Med Sci. 2018 Feb 5;33(6):e35. doi: 10.3346/jkms.2018.33.e35.
23. Porreco RP, Barkey R. 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. 2010;23(10):1136–8.
24. Ramonienė G, Maleckienė L, Nadišauskienė RJ, Bartusevičienė E, et al. Maternal obesity and obstetric outcomes in a tertiary referral center. Medicina. 2017; 53(2): 109-113. https://doi.org/10.1016/j.medici.2017.03.003.
25. Redman CW, Sargent IL: Latest advances in understanding preeclampsia. Science 2005, (308(5728)):1592–1594. 5. Xiao R, Sorensen TK, Williams MA, Luthy DA. Influence of pre-eclampsia on fetal growth. 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. 2003;13(3):157–62. 6.
26. Roberts JM, Pearson G, Cutler J, Lindheimer M. Pregnancy NWGoRoHD: summary of the NHLBI working group on research on hypertension during pregnancy. Hypertension. 2003;41(3):437–45.
27. Say, L. et al. Global causes of maternal death: A WHO systematic analysis. Lancet Glob. Health. 2014;2(6): e323-333.
28. Shao Y, Qiu J, Huang H, Mao B, Dai W, et al. Pre-pregnancy BMI, gestational weight gain and risk of preeclampsia: a birth cohort study in Lanzhou, China. BMC Pregnancy and Childbirth (2017) 17:400 DOI 10.1186/s12884-017-1567-2.
29. Shrestha A, Prowak M, Berlandi-Short VM, Garay J, Ramalingam L. Maternal Obesity: A Focus on Maternal Interventions to Improve Health of Offspring. Front Cardiovasc Med. 2021;8:696812. Published 2021 Jul 21. doi:10.3389/fcvm.2021.696812.
30. Sun H, Liu Y, Huang S, Liu X, Li G and Du Q Association Between Pre-Pregnancy Body Mass Index and Maternal and Neonatal Outcomes of Singleton Pregnancies After Assisted Reproductive Technology. Front. Endocrinol. 2022; 12:825336. doi: 10.3389/fendo.2021.825336
31. Syngelaki A, Sequeira Campos M, Roberge S, et al. Diet and exercise for preeclampsia prevention in overweight and obese pregnant women: systematic review and meta-analysis. J Matern Fetal Neonatal Med 2019; 32: 3495–3501.
32. Tenenbaum-Gavish K, Hod M. Impact of maternal obesity on fetal health. Fetal Diagn Ther. 2013;34(1):1-7. doi: 10.1159/000350170.
33. Vinturache A, Moledina N, McDonald S, Slater D, Tough S. Pre-pregnancy body mass index (BMI) and delivery outcomes in a Canadian population. BMC Pregnancy Childbirth. 2014; 14:422.
34. Wei YM, Yang HX, Zhu WW, Liu XY, Meng WY, Wang YQ, Shang LX, Cai ZY, Ji LP, Wang YF, et al. Risk of adverse pregnancy outcomes stratified for pre-pregnancy body mass index. J Matern Fetal Neonatal Med. 2015:1–5.
35. Williams, B. et al. 2018 ESC/ESH guidelines for the management of arterial hypertension. Eur. Heart J. 2018;39(33): 3021–3104.
36. World Health Organization. Facts on Obesity. Available online: https://www.who.int/news-room/facts-in-pictures/detail/6-facts-on-obesity (accessed on 30 October 2020).
37. World Health Organization. Global Database on BMI [http://apps.who.int/bmi]
Published
2022-12-31
How to Cite
Baftiu, D., Abazaj, E., Ali, E., & Nikolla, L. (2022). Evaluation of Preeclampsia Risk in Gestational Weight Gain. European Scientific Journal, ESJ, 18(40), 389. https://doi.org/10.19044/esj.2022.v18n40p389
Section
ESJ Natural/Life/Medical Sciences
Copyright (c) 2022 Dardan Baftiu, Erjona Abazaj, Ela Ali, Ledina Nikolla
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
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