The Influencing Factors Of Gestational Weight Gain And Its Effects On Pregnancy Outcomes In Shanghai Songjiang Area

Objective:1.To understand the status of gestational weight gain in Songjiang District,Shanghai and to provide the survey data for setting the standard of domestic gestational weight gain.2.To explore the factors that affect the gestational weight gain.3.To explore the relationship between the gestational weight gain and the pregnancy outcome(birth outcome and delivery method)in Songjiang District,Shanghai.Content:1.Collected the maternal information,the childbirth information and the neonatal information of the pregnant who gave birth in Songjiang District MCH from July to December 2016 to identify the gestational weight gain.2.To explore the relationship between pregnant age,household registration,number of inspections,delivery times,pre-pregnancy BMI and gestational weight gain.3.To explore the relationship between the gestational weight gain and the birth outcome of the newborn,mainly including the neonatal weight,the birth gestational week,the neonatal score,the weight of newborns(premature delivery,small for gestational age,large for gestational age,macrosomia),and the delivery method.Methods:4884 cases were collected in Songjiang District MCH from July to December 2016,with the complete data of Shanghai local residents or non-residents living in Songjiang District more than 1 year,who has single child and no crisis of gynecology.The collected information includes the pregnant age,the household registration,the number of inspections,the delivery times,the height,the pre-pregnancy weight,the weight before delivery,the birth gestational week,the delivery methods,the neonatal gender and the neonatal score.Results:1.The study included 4884 pregnant women.1873(38.4%)of them were Shanghai local residents.The mean age of the pregnant women was 28.8±4.1 years old.2635(54.0%)of them were primiparas,and 2249(46.1%)of them were multiparas.The mean of the pre-pregnancy BMI was 21.1±2.7kg,and the mean of the gestational weight gain was 14.1±4.6kg.The mean of the birth gestational week was 39.3±1.1.The mean of the neonatal weight was 3351.8±404.8kg.The baby girl was 2378(48.7%),and the baby boy was 2506(51.3%).2.The baseline gestational weight gain of the 4884 pregnant women: The insufficient of the gestational weight gain was 1257(25.74%)and the mean was 9.03±2.16 kg.The normal of the gestational weight gain was 2000(40.95%)and the mean was 13.58±1.90 kg.The excessive of the gestational weight gain was 1627(33.31%)and the mean was 18.72±3.79 kg.3.The factors affecting the gestational weight gain : the pregnant age,the household registration,the number of inspections,whether the first delivery and the pre-pregnancy BMI were all having an impact on gestational weight gain.The pre-pregnancy BMI and the pregnant age were having the negative correlation with the gestational weight gain.And according to the analysis of the range of the gestational weight gain(the insufficient of the gestational weight gain,the normal of the gestational weight gain,the excessive of the gestational weight gain)formulated by the Institute of Medicine(IOM)in 2009,the effects of the number of inspections and the pre-pregnancy BMI on the gestational weight gain always exist.4.The effects of gestational weight gain on the pregnancy outcomes: discovered by the linear regression analysis,The GWG was positively correlated with birth weight(β = 24.17;95% CI: 21.90,26.45).GWG was a protective factor for Small-for-gestational age(OR=0.89;95%CI:0.87,0.91).GWG was a risk factor for Large-for-gestational age(OR=1.12;95%CI:1.09,1.14)and macrosomia(OR=1.14;95%CI:1.11,1.16).The GWG was positively associated with gestational age(β = 0.03;95% CI: 0.03,0.04).The incidence of the premature delivery decreased with the increasing of the gestational weight gains(OR = 0.91;95% CI: 0.88,0.95).Women with inadequate GWG exhibited increased risks of SGA infants(OR=1.54;95% CI: 1.22,1.94)and premature delivery(OR=1.53;95% CI: 1.03,2.26),whereas women with excessive GWG exhibited increased risk of Large-for-gestational age(OR=2.2;95% CI: 1.71,2.84)and macrosomia(OR=2.41;95% CI: 1.86,3.11),when compared with women who had adequate GWG..To control the confounding factors by establishing a binary logistic regression model,we find that the incidence of cesarean increases with the gestational weight gain(OR=1.03;95%CI,1.01,1.04;p < 0.01).But there is no correlation between gestational weight gain and neonatal score.Conclusion : In this study,the proportion of pregnant women with abnormal gestational weight gain reached 59%.The pregnant age,the household registration,the number of inspections,whether the first delivery and the pre-pregnancy BMI all will have an impact on the gestational weight gain.The insufficient of the gestational weight gain may increase the risk of the premature delivery and the small for gestational age.The excessive of the gestational weight gain may increase the risk of development of the large for gestational age and the macrosomia,and it also may increase the risk of the cesarean section directly or indirectly.It is a great significance to do a good job in maternal health management and safeguard the safety and health of pregnant woman and neonatal if we pay attention to the gestational weight gain and control the gestational weight gain reasonably.