The Associations Of Pregestational BMI And Gestational Weight Gain With Blood Pressure Levels During Early Pregnancy

Objective:To investigate the effects of pre-pregnancy body mass index(BMI)and weight gain in early pregnancy on blood pressure during pregnancy,and to provide scientific basis for optimizing health interventions and promoting maternal and off spring health.Methods:Study time:December 31,2018-December 31,2019.Subjects:The pregnant women who went to Anshan Women's and Children's Hospital in liaoning province to make an appointment for routine antenatal examination in the obstetrics clinic and agreed to participate in the maternal and fetal cohort in northeast China after gestation?17weeks were finally included in the effective number of 330 cases.Before the pregnancy body mass index(body mass index,BMI)is based on the first visit of self-reported calculation and field measurement of height and weight before becoming pregnant,according to our country the Chinese adult overweight and obesity prevention and control guide definition standard,pregnancy BMI can be divided into low pregnancy weight(BMI<18.5 kg/m~2),normal weight(BMI 18.5?23.9 kg/m~2),overweight(BMI24.0?27.9 kg/m2)and obesity(BMI)of 28.0 kg/m2 or four groups.Weight gain during the first trimester of pregnancy is calculated by subtracting pregestational weight from the weight measured during the first trimester of pregnancy.Systolic blood pressure(SBP)and diastolic blood pressure(DBP)were measured at multiple follow-ups during pregnancy,each of which was measured for 3 consecutive times.In this study,a cohort study was conducted,with pre-pregnancy BMI and early gestational weight gain as exposure indicators,systolic blood pressure(SBP),diastolic blood pressure(DBP)and mean arterial pressure(MAP)as outcome indicators,and multiple linear regression model was used for statistical analysis.Results:After multi-factor analysis,compared with the normal weight group,the SBP of the low weight group decreased by 4.99mmHg(95%CI:-8.98?1.00),the SBP of the overweight group and the obese group increased by 3.41 mmHg(95%CI:1.24?5.58)and8.25mmHg(95%CI:5.66?10.84).DBP in the low-weight group decreased by 3.08mmhg(95%CI:-7.12?0.97),and increased by 1.36mmHg(95%CI:-0.84?3.55),while DBP in the obese group increased by 5.16mmHg(95%CI:2.54?7.78).MAP in the low body weight group decreased by 3.73mmhg(95%CI:-7.00?-0.50),overweight group and obese group increased by 2.03mm Hg(95%CI:0.28?3.79)and 6.18mmHg(95%CI:4.10?8.27).Compared with normal increase,the weight less than 0.5 kg group average SBP,DBP,MAP reduce respectively 2.79mmHg(95%CI:5.62?0.04),0.81mmHg(95%CI:2.07?3.68),the decrease of 0.39mmHg(95%CI:2.68?1.91),the average weight more than 2 kg group SBP,DBP,MAP reduce respectively 1.46mmHg(95%CI:4.47?1.55),the decrease of 1.01mmHg(95%CI:4.06?2.05),1.15mmHg(95%CI:-3.59?-1.29).However,there was no significant statistical difference between SDP,DBP,MAP and normal group.Conclusion:There was a linear trend between pre-pregnancy BMI and SBP and DBP levels during pregnancy.With the increase of pre-pregnancy BMI,SBP,DBP and MAP in early pregnancy increased.Weight gain in early pregnancy was associated with SBP in early pregnancy,but no significant association was found with DBP and MAP.