MATERNAL OBESITY AND ASSOCIATED RISK OF ADVERSE PREGNANCY OUTCOMES IN WOMEN WITH HYPERGLYCEMIA
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Objective We designed this study to explore the pregnancy outcomes in women with hyperglycemia according to their prepregnancy body mass index (BMI) and to identify risk factors of poor pregnancy outcomes. Methods A total of 1,056 pregnant women, who took a standard 100 g oral glucose tolerance test, were recruited between July 1, 2007and December 31, 2009. The participants were stratifi ed into 3 groups (group 1 [BMI < 18.5 kg/m2], group 2 [BMI 18.5-24.9 kg/m2],and group 3 [obese] [BMI ≥ 25 kg/m2]) based on their prepregnancy BMI following the World Health Organization Asia-Pacifi c guidelines. Results Older age and multi-parity, and family history of diabetes were significantly higher in the obese group. Development of hypertension and gestational diabetes mellitus were also significantly increased with obesity. Maternal weight gain, however,was inversely correlated pattern with prepregnancy BMI. Poor pregnancy outcomes are increased with older age, multi parity,gestational ages at delivery, increased prepregnancy BMI, maternal high glucose status and weight gain rate. Particularly,prepregnancy BMI had higher risk than maternal hyperglycemia on macrosomia (odd ratio [OR] 5.0, 95% confi dence intervals [CI]2.28-11.02 vs. OR 3.0, 95% CI 1.63-5.85), and on primary cesarean section rate (OR 2.5, 95% CI 1.46-4.46 vs. OR 1.6, 95% CI 1.14-2.43). Conclusion Pregnant women with obesity are more likely to have poor pregnancy outcomes than pregnant women without obesity. Therefore,with prepregnancy BMI considered, effective management during pregnancy should be designed and intervention trials are needed to identify individuals at risk before developing hyperglycemia.
Abstract
Objective We designed this study to explore the pregnancy outcomes in women with hyperglycemia according to their prepregnancy body mass index (BMI) and to identify risk factors of poor pregnancy outcomes. Methods A total of 1,056 pregnant women, who took a standard 100 g oral glucose tolerance test, were recruited between July 1, 2007and December 31, 2009. The participants were stratifi ed into 3 groups (group 1 [BMI < 18.5 kg/m2], group 2 [BMI 18.5-24.9 kg/m2],and group 3 [obese] [BMI ≥ 25 kg/m2]) based on their prepregnancy BMI following the World Health Organization Asia-Pacifi c guidelines. Results Older age and multi-parity, and family history of diabetes were significantly higher in the obese group. Development of hypertension and gestational diabetes mellitus were also significantly increased with obesity. Maternal weight gain, however,was inversely correlated pattern with prepregnancy BMI. Poor pregnancy outcomes are increased with older age, multi parity,gestational ages at delivery, increased prepregnancy BMI, maternal high glucose status and weight gain rate. Particularly,prepregnancy BMI had higher risk than maternal hyperglycemia on macrosomia (odd ratio [OR] 5.0, 95% confi dence intervals [CI]2.28-11.02 vs. OR 3.0, 95% CI 1.63-5.85), and on primary cesarean section rate (OR 2.5, 95% CI 1.46-4.46 vs. OR 1.6, 95% CI 1.14-2.43). Conclusion Pregnant women with obesity are more likely to have poor pregnancy outcomes than pregnant women without obesity. Therefore,with prepregnancy BMI considered, effective management during pregnancy should be designed and intervention trials are needed to identify individuals at risk before developing hyperglycemia.
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