Loh Huai Heng, Taipin Haslinda, Said Asri
Faculty of Medicine and Health Sciences Universiti Malaysia Sarawak Malaysia.
Malaysia Ministry of Health Training Institute Kota Kinabalu Sabah Malaysia.
Obes Sci Pract. 2021 Apr 9;7(4):425-431. doi: 10.1002/osp4.512. eCollection 2021 Aug.
Most studies showing association between mothers with obesity in pregnancy or excessive gestational weight gain (GWG) and adverse neonatal outcome were cross-sectional or retrospective. Many included patients are with gestational diabetes mellitus (GDM), which is a strong risk factor for this adverse outcome. There are no prospective studies on this topic in Malaysia. This study aimed to examine prospectively the effects of obesity in pregnancy and GWG, independent of GDM, on neonatal outcome.
Pregnant mothers in the first trimester, who presented to health clinics in Kuching, were screened. Mothers with existing diabetes mellitus or GDM were excluded using 75-g oral glucose tolerance test during the first and second trimesters. Participants with the first trimester BMI ≥ 23 kg/m were recruited as overweight/obese group, whereas those with BMI 18.5-22.9 kg/m were taken as the comparison group. At every trimester visit, mothers' weights were recorded. Babies' birth weight and occurrence of adverse neonatal outcome were documented.
There were 123 mothers recruited as overweight/obese group (mean BMI 29.0 kg/m± 4.45) and 102 mothers as comparison group (mean BMI 20.4 kg/m± 1.48). The number of low birth weight was similar between groups: 9.8% in overweight/obese group, 6.9% in the comparison group ( = 0.416). More than half of these babies were born to mothers with inadequate GWG (58.3% in obese group vs. 57.1% in control group, = 0.077). There was no significant difference in the mean birth weight (3000 g ± 454.5 vs. 3038 g ± 340.8, = 0.471), preterm delivery (8.13% vs. 3.92%, = 0.193), and admission rate to neonatal intensive care unit (8.13% vs. 7.85%, = 0.937) between groups. There was a positive correlation between the total GWG in overweight/obese group on baby's weight ( = 0.222, = 0.013). Inadequate GWG was not correlated with lower birth weight ( = 0.052).
Obesity in pregnancy was not associated with poor neonatal outcome in this small sample of women in Malaysia. Total GWG showed a weak correlation with baby's birth weight in overweight/obese group.
大多数显示孕期肥胖或孕期体重过度增加（GWG）的母亲与不良新生儿结局之间存在关联的研究都是横断面研究或回顾性研究。许多纳入的患者患有妊娠期糖尿病（GDM），这是导致这种不良结局的一个重要危险因素。马来西亚尚未有关于该主题的前瞻性研究。本研究旨在前瞻性地研究孕期肥胖和GWG（独立于GDM）对新生儿结局的影响。
对在古晋健康诊所就诊的孕早期母亲进行筛查。在孕早期和孕中期通过75克口服葡萄糖耐量试验排除患有糖尿病或GDM的母亲。孕早期BMI≥23kg/m²的参与者被招募为超重/肥胖组，而BMI为18.5 - 22.9kg/m²的参与者作为对照组。每次孕期检查时记录母亲的体重。记录婴儿的出生体重和不良新生儿结局的发生情况。
招募了123名母亲作为超重/肥胖组（平均BMI 29.0kg/m²±4.45）和102名母亲作为对照组（平均BMI 2
