Difference Analysis Of BMI And Gestational Weight Gain Before Pregnancy On Maternal And Child Outcomes And Delivery Patterns

Objective:To investigate the effects of pre-pregnancy body mass index(BMI),gestational weight gain(GWG)and increase of BMI during pregnancy on maternal and child outcomes and delivery methods,and to explore the management of reasonable weight gain during pregnancy to ensure the safety of maternal and child-rearing.Methods:We made a retrospective analysis of hospitalized delivery data of single live birth in th e Second Affiliated Hospital of Soochow University from August 2017 to December 2018.Data collection was based on patient’s antenatal care data and inpatient medical reco rd,including patient’s baseline data(age,height,pre-pregnancy weight,maternal parity,ge stational weeks),abnormal pregnancy outcome(gestational diabetes mellitus(GDM),gesta tional hypertension,premature delivery,macrosomia,postpartum hemorrhage)and deliver y methods.According to the patient’s pre-pregnancy BMI,pregnant women were divided into weight loss group(BMI<18.5kg/m2),normal weight group(18.5kg/m2≤BMI<24kg/m2),overweight and obesity group(24kg/m2≤BMI),the age,height,pre-pregnancy weight,maternal birth,gestational age and other factors of the three groups of data were analyzed.The database was established by SPSS 25.0 and the corresponding statistical analysis was carried out.The effect of weight on maternal and fetal outcomes,and analysis of the effects of pre-pregnancy BMI,increased BMI during pregnancy,and GWG on maternal and fetal outcomes and delivery patterns.Results:1.The mean age of the total sample was(29.09±3.98)years old,the average age of the lean group was(27.37±4.12)years old,the average age of normal body reorganization was(29.22±3.92)years old,and the average age of the overweight/obesity group was(29.73).±3.81)years old;2.In patients with GDM,the pre-pregnancy BMI was higher than normal The incidence of GDM in overweight/obesity group was significantly higher than that in lean and normal weight pregnancy group,suggesting that GDM is closely related to pre-pregnancy BMI.However,the mean weight gain during pregnancy(12.39±3.81kg)was lower in the GDM group than in the normal group(14.01±3.83kg),p<0.001,and there was a statistically significant difference.3.A total of 35 cases of gestational hypertension occurred,which was related to pre-pregnancy BMI.Pre-pregnancy BMI was higher in the pregnancy-induced hypertension group than in the normal group,and the occurrence of gestational hypertension was not associated with increased BMI and GWG during pregnancy;4.5.4%of the subjects had premature birth,and the occurrence of preterm birth was not related to pre-pregnancy BMI;increased weight during pregnancy was associated with preterm birth;5.There were84 cases of giant children,accounting for 6.5%of the total samples;in the large group,the pre-pregnancy BMI and the increase in body weight during pregnancy were higher;6.4.3%of the subjects had postpartum hemorrhage,which was not associated with pre-pregnancy BMI,increased BMI during pregnancy,and GWG;7.After excluding elective cesarean section,the remaining 1094 cases,835 cases of vaginal delivery,accounting for 76.3%;the pre-pregnancy BMI in the vaginal delivery group was lower than the cesarean section.Conclusion:1.Most pregnant women’s pre-pregnancy BMI is at normal weight(18.5 ≤ BMI<24kg/m2);combined with pre-pregnancy BMI group,the group with larger BMI,pregnant women’s age,pregnancy,birth,and card formation,hemoglobin and blood lipid levels are also biased high;2.The prevalence of GDM was 15.0%.In patients with GDM,the mean BMI before pregnancy was larger than that in the normal group,and the BMI during pregnancy and the weight gain during pregnancy were lower than those in the normal group.The hypertensive disorder group in pregnancy was compared with the normal group.Pre-pregnancy BMI was high,but there was no statistically significant difference in the increase of BMI and GWG during pregnancy;3.There was no significant difference in pre-pregnancy BMI between the preterm group and the full-term delivery group.The mean BMI in the preterm group was less than that in the full-term delivery group,and the premature delivery group was less than the full-term delivery group.The pre-pregnancy BMI was higher than the normal group,the large group had greater BMI and GWG than normal body reconstitution during pregnancy;the post-production bleeding accounted for 4.3%of the total sample;postpartum hemorrhage group and normal group In contrast,there was no significant difference in BMI before pregnancy,BMI and GWG during pregnancy;4.The mean BMI before pregnancy in the vaginal delivery group was lower than that in the cesarean section,but the difference was not statistically significant.In summary,pre-pregnancy overweight or obesity,excessive weight gain during pregnancy,will increase the incidence of maternal and child adverse outcomes and cesarean section,therefore,must strengthen the weight management before pregnancy and pregnancy,reduce the incidence of pregnancy complications.