Analysis Of The Influence Of Pregnancy Obesity On Maternal And Infant Outcomes And Telated Factors

BackgroundAmong women of child-bearing age,obesity or overweight have an adverse impact on pregnancy outcomes,which significantly increases the incidence of complications such as gestational diabetes mellitus,gestational hypertension,preeclampsia,macrosomia,preterm birth,and premature rupture of membranes.As a developing country,China has a relatively late understanding of the impact of obesity and overweight on pregnancy outcomes and few in-depth studies;In the research,obesity has more influence on maternal and infant outcomes,but there are still some objections to the research results,so it is necessary to carry out further research on it.Excessive weight gain during pregnancy and obesity before pregnancy are mainly caused by excessive accumulation of adipose tissue in the body,Adipokine plays a key role in the occurrence of various obesity-related complications,and it is of great significance to explore its related factors for the clinical formulation and implementation of appropriate intervention measures.Therefore,according to body weight and body mass index,the selected cases were divided into pre-pregnancy superreorganization,pre-pregnancy obesity group,excessive weight gain during pregnancy group,pre-pregnancy obesity add excessive weight gain during pregnancy group and healthy control group,and the influence of each group on maternal and infant outcomes was analyzed.The adipokines in each group were detected to investigate their factors.Objective1.To explore the effects of overweight and obesity on maternal and infant outcomes;2.To explore the related factors of pregnancy complications caused by obesity.MethodsBy retrospective analysis,152 cases of pregnant women admitted to the department ofobstetrics and gynecology of puyang maternal and child health care hospital for prenatal examination from January 2016 to December 2017 were selected as the study objects.According to pre-pregnancy and gestational weight and BMI,there were 42 cases in the pre-pregnancy overweight and obese group(pre-pregnancy group),62 cases in the gestational overweight group(mid-pregnancy group),and 48 cases in the pre-pregnancy obese or overweight + gestational overweight group(mixed group).In addition,50 cases of pregnant women with normal weight before and during pregnancy were randomly selected as the control group.Pregnancy outcomes(gestational hypertension,GDM,postpartum hemorrhage,postpartum infection,cesarean section rate,macropartum,preterm delivery,Apgar 1min score)in each group were compared and analyzed,blood lipid,blood glucose,adipokine(tnf-alpha,APN,rbp-4)and insulin resistance index(homa-ir)were compared and analyzed in each group.Results1.The incidence of cesarean section,postpartum infection and macrocephaly in the pre-pregnancy group,the mid-pregnancy group and the mixed group was significantly higher than that in the control group(P<0.05).2.The incidence of hypertensive diseases and GDM in pregnancy in the middle and mixed groups was significantly higher than that in the control group(P<0.05).The incidence of cesarean section and pregnancy hypertension in the mixed group was significantly higher than that in the pre-pregnancy group(P<0.05).The incidence of postpartum hemorrhage in the mixed group was significantly higher than that in the control group(P <0.05).3.Compared with the control group,HOMA-IR,TNF-α and RBP-4 levels were significantly increased in the pre-pregnancy group,the mid-pregnancy group and the mixed group,and APN levels were significantly decreased(P<0.05).The levels of homa-ir,tnf-a and rbp-4 in the mixed group were significantly higher than those in the pre-pregnancy group,and the levels of APN were lower than those in the pre-pregnancygroup,P<0.05.The levels of HOMA-IR,TNF-α and RBP-4 in the mixed group were significantly higher than those in the pre-pregnancy group,and the levels of APN were lower than those in the pre-pregnancy group,P<0.05.Conclusion1.Obesity or overweight during pregnancy can increase the incidence of cesarean section,postpartum hemorrhage,postpartum infection,gestational hypertension,GDM,macrosomia and other adverse pregnancy outcomes.Pregnant women who are overweight or obese before pregnancy + excessive weight gain during pregnancy have the greatest impact on adverse pregnancy outcome.2.The possible factors of adverse pregnancy outcome caused by obesity during pregnancy is related to increased insulin resistance,increased levels of adipokine tnf-alpha and RBP4,and decreased levels of APN.These indicators affect each other and eventually lead to complications such as GDM and pregnancy hypertension.