Clinical Sciences Department, College of Medicine, Princess Nourah Bint Abdulrahman University, Riyadh, Saudi Arabia.
Research Chair of Evidence-Based Healthcare and Knowledge Translation, King Saud University, Riyadh, Saudi Arabia.
PLoS One. 2022 Jan 11;17(1):e0262437. doi: 10.1371/journal.pone.0262437. eCollection 2022.
Gestational weight gain (GWG) and prepregnancy obesity are garnering more attention as determining factors of pregnancy outcomes when it comes to the wellbeing of both the mother and her baby. This study was conducted to describe the pattern of GWG among participants of Riyadh Mother and Baby Multicenter Cohort Study (RAHMA) and to investigate the detrimental effects of excessive GWG and prepregnancy obesity on pregnancy outcomes.
RAHMA is a multicentre cohort study conducted in three hospitals in Riyadh, Saudi Arabia. Participants were categorized according to the Institute of Medicine into inadequate, adequate, and excessive GWG, and stratified by body mass index (BMI) into under/normal weight, overweight, and obese. To examine the independent effect of maternal prepregnancy obesity and GWG, a multivariate regression model was used and adjusted odds ratio (AOR) and 95% Confidence Interval (CI) for each outcome were calculated.
A total of 7029 participants were included in this study; 31.8% had adequate GWG, 25.9% had excessive GWG and 42.3% had inadequate GWG, while 29.7% had normal BMI, 33.3% were overweight, 34.8% were obese, and 2.2% were underweight. Excessive GWG was independently associated with increased risk of hypertensive events, (AOR = 1.77, 95% CI 1.20-2.63). Obesity was associated with higher risk of gestational diabetes (AOR 2.11, 95% CI 1.76-2.53), hypertensive events (AOR 2.06, 95% CI 1.48-3.01), and delivery by emergency caesarean section (AOR = 1.63, 95% CI 1.35-1.97). Infants of obese women had increased odds of macrosomia (AOR 3.11, 95% CI 1.94-4.99) and lower odds of low birth weight (AOR = 0.68, 95% CI 0.53-0.88).
In comparison to excessive GWG, which increases the risk of hypertensive events during pregnancy, prepregnancy obesity is associated with more adverse outcomes including GDM, hypertensive events in pregnancy and emergency CS.
在涉及母婴健康的妊娠结局方面，孕期体重增加（GWG）和孕前肥胖作为决定因素正受到越来越多的关注。本研究旨在描述利雅得母婴多中心队列研究（RAHMA）参与者的 GWG 模式，并探讨 GWG 过多和孕前肥胖对妊娠结局的不良影响。
RAHMA 是在沙特阿拉伯利雅得的 3 家医院进行的一项多中心队列研究。根据美国医学研究所（IOM）的标准，参与者被分为 GWG 不足、适当和过多，同时根据体重指数（BMI）分为体重不足/正常、超重和肥胖。为了检验母体孕前肥胖和 GWG 的独立影响，使用了多元回归模型，并计算了每个结局的调整比值比（AOR）和 95%置信区间（CI）。
共有 7029 名参与者纳入本研究；31.8%的参与者 GWG 适当，25.9%的参与者 GWG 过多，42.3%的参与者 GWG 不足；29.7%的参与者 BMI 正常，33.3%的参与者超重，34.8%的参与者肥胖，2.2%的参与者体重不足。GWG 过多与高血压事件风险增加独立相关（AOR=1.77，95%CI 1.20-2.63）。肥胖与妊娠期糖尿病（AOR 2.11，95%CI 1.76-2.53）、高血压事件（AOR 2.06，95%CI 1.48-3.01）和急诊剖宫产（AOR=1.63，95%CI 1.35-1.97）风险增加相关。肥胖女性的婴儿发生巨大儿的几率增加（AOR 3.11，95%CI 1.94-4.99），而低出生体重的几率降低（AOR=0.68，95%CI 0.53-0.88）。
与 GWG 过多增加妊娠期间高血压事件风险相比，孕前肥胖与更多不良结局相关，包括 GDM、妊娠期间高血压事件和急诊 CS。
