Associations of maternal pre-pregnancy obesity and excess pregnancy weight gains with adverse pregnancy outcomes and length of hospital stay

Mamun, Abdullah A., Callaway, Leonie K., O'Callaghan, Michael J., Williams, Gail M., Najman, Jake M., Alati, Rosa, Clavarino, Alexandra and Lawlor, Debbie A. (2011) Associations of maternal pre-pregnancy obesity and excess pregnancy weight gains with adverse pregnancy outcomes and length of hospital stay. BMC Pregnancy and Childbirth, 11 Article #62: .


Author Mamun, Abdullah A.
Callaway, Leonie K.
O'Callaghan, Michael J.
Williams, Gail M.
Najman, Jake M.
Alati, Rosa
Clavarino, Alexandra
Lawlor, Debbie A.
Title Associations of maternal pre-pregnancy obesity and excess pregnancy weight gains with adverse pregnancy outcomes and length of hospital stay
Journal name BMC Pregnancy and Childbirth  (ERA 2012 Listed)    (ERA 2010 Rank C)   Check publisher's open access policy
Publication date 2011-09-06
Sub-type Article
DOI 10.1186/1471-2393-11-62
Volume number 11
Issue number Article #62
ISSN 1471-2393
Total pages 9
Place of publication London, England, United Kingdom
Publisher BioMed Central
Collection year 2012
Language eng
Formatted abstract Background
It is relatively less known whether pre-pregnancy obesity and excess gestational weight gain (GWG) are associated with caesarean delivery, pregnancy complications, preterm birth, birth and placenta weights and increased length of postnatal hospital stay.

Methods
We used a population-based cohort of 6632 women who gave birth in Brisbane, Australia, between 1981 and 1983. The independent associations of pre-pregnancy obesity, GWG and institute of medicine (IOM) categories of combined pre-pregnancy BMI and GWG with outcomes were examined using multivariable regression (for continuous outcomes) and multivariable multinomial regression (for categorical outcomes) models.

Results
We found women who were obese prior to pregnancy and women who gained excess weight during pregnancy were at greater risk for a pregnancy complications (OR: 2.10; 1.74, 2.54; age adjusted model), caesarean section (OR 1.29; 1.09, 1.54), higher birth weight difference (206.45 gm; 178.82, 234.08) and greater placental weight difference (41.16 gm; 33.83, 48.49) and longer length of hospital stay. We also found that mothers who gained inadequate weight or were underweight before pregnancy were at greater risk of preterm birth (2.27; 1.71, 3.00), lower risk of pregnancy complications (0.58; 0.44, 0.77) and had lower birth (-190.63;-221.05,-160.20) and placental (-37.16; -45.23,-29.09) weights. Results indicate that all associations remain consistent after adjustment for a range of potential confounding factors with the exception of the association between pre-pregnancy obesity and hospital stay.

Conclusions
Pre-pregnancy obesity or excessive GWG are associated with greater risk of pregnancy complications, caesarean delivery and greater birth and placenta weight. Excess GWG is associated with a longer stay in hospital after delivery, independent of pre-pregnancy BMI, pregnancy complications and caesarean delivery. In addition to pre-pregnancy obesity, it is vital that clinical practice considers excess GWG as another indicator of adverse pregnancy outcomes.
Keyword Pregnancy Outcomes
Gestational weight gain
Pre-pregnancy obesity
Health care
Body-Mass Index
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ

 
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