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Federación Mexicana de Ginecología y Obstetricia, A.C.

2016, Number 11

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Ginecol Obstet Mex 2016; 84 (11)

Gestational weight gain and perinatal outcomes: Study of a Spanish population and the effect of Assisted Reproduction Techniques

Carmona-Ruiz IO, Saucedo-de la Llata E, Moraga-Sánchez MR, Cantero-Miñano MD, Romeu-Sarrió A

Language: Spanish
References: 44
Page: 684-695
PDF size: 332.37 Kb.


ABSTRACT

Objetive: To compare perinatal outcomes according to gestational weight gain (GWG) and differentiate the rate of spontaneous and assisted reproduction patients.
Material and Method: Observational descriptive retrospective study. This is a review of perinatal outcomes of spontaneous and assisted reproduction pregnancies in a private institution. Those women who had a pre-existent condition that could represent an adverse outcome were excluded. The same was established with twin or multiple pregnancies. 860 cases were included. Patients were classified into three groups: Group 1, GWG below the Institute of Medicine (IOM) recommendations (Group 1); Group 2, GWG within IOM recommendations (=rIOM); and Group 3, GWG above IOM recommendations (›rIOM). Statistical difference is defined as a value of ‹0.05 after applying Anova or the chi square test, accordingly.
Results: We observed a statistically significant difference between the rate of patients who presented gestational hypertension (26.28% vs. 3.55 and 4.21%, ›rIOM, ‹rIOM and =rIOM respectively), preeclampsia (23.07% vs. 0.79 and 0.88%, ›rIOM, ‹rIOM and =rIOM respectively), gestational diabetes (55.76% vs. 7.50 and 16.62%, ›rIOM, ‹rIOM and =rIOM respectively) and obstetric bleeding (23.71% vs. 7.50 y 7.98%, ›rIOM, ‹rIOM and =rIOM respectively) favouring the ›rIOM Group (p‹0.001). C-section rate was higher in groups ›rIOM (66.66%) and ‹rIOM (34.38%) than in those patients within ideal range (6.20%) (p‹0.001). Out of range groups had higher rates of new-borns who needed intensive care unit care than those patients who were within ideal weight gain range (24.90% for ‹rIOM and 19.23 for ›rIOM vs 0.44% Group =rIOM)(p‹0.001). GWG ›rIOM has an adjusted odds ratio (aOR) of 2.1 (95%CI 1.5-2.6) with having a poor perinatal outcome (PPO). Age, smoking and assisted reproduction techniques do not present an association with PPO in a multivariable logistic regression model (aOR 1.1 95%CI 0.69-1.8; aOR 0.9 95%CI 0.5-1.4; aOR 0.6 95%CI 0.3-1.1, respectively).
Conclusions: Excessive weight gain or an inadequate weight gain in pregnancy, result in poor perinatal outcomes to both, the mother and the fetus. Assisted reproduction technique patients may have a better preconceptional care that offers advantages in terms of nutritional and weight status.


REFERENCES

  1. Stotland NE, Hopkins LM, Caughey AB. Gestational weight gain, macrosomia, and risk of cesarean birth in nondiabetic nulliparas. Obstetrics and gynecology. 2004;104(4):671-7.

  2. Nohr EA, Vaeth M, Baker JL, Sorensen T, Olsen J, Rasmussen KM. Combined associations of prepregnancy body mass index and gestational weight gain with the outcome of pregnancy. The American journal of clinical nutrition. 2008;87(6):1750-9.

  3. Oken E, Kleinman KP, Belfort MB, Hammitt JK, Gillman MW. Associations of gestational weight gain with short- and longer-term maternal and child health outcomes. American journal of epidemiology. 2009;170(2):173-80.

  4. Ferraro ZM, Barrowman N, Prud'homme D, Walker M, Wen SW, Rodger M, et al. Excessive gestational weight gain predicts large for gestational age neonates independent of maternal body mass index. The journal of maternal-fetal & neonatal medicine : the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstet. 2012;25(5):538-42.

  5. McDonald SD, Han Z, Mulla S, Lutsiv O, Lee T, Beyene J, et al. High gestational weight gain and the risk of preterm birth and low birth weight: a systematic review and metaanalysis. Journal of obstetrics and gynaecology Canada : JOGC = Journal d'obstetrique et gynecologie du Canada : JOGC. 2011;33(12):1223-33.

  6. Fraser A, Tilling K, Macdonald-Wallis C, Hughes R, Sattar N, Nelson SM, et al. Associations of gestational weight gain with maternal body mass index, waist circumference, and blood pressure measured 16 y after pregnancy: the Avon Longitudinal Study of Parents and Children (ALSPAC). The American journal of clinical nutrition. 2011;93(6):1285-92.

  7. Fraser A, Tilling K, Macdonald-Wallis C, Sattar N, Brion MJ, Benfield L, et al. Association of maternal weight gain in pregnancy with offspring obesity and metabolic and vascular traits in childhood. Circulation. 2010;121(23):2557-64.

  8. Chasan-Taber L, Schmidt MD, Pekow P, Sternfeld B, Solomon CG, Markenson G. Predictors of excessive and inadequate gestational weight gain in Hispanic women. Obesity. 2008;16(7):1657-66.

  9. Nielsen JN, O'Brien KO, Witter FR, Chang SC, Mancini J, Nathanson MS, et al. High gestational weight gain does not improve birth weight in a cohort of African American adolescents. The American journal of clinical nutrition. 2006;84(1):183-9.

  10. Kinnunen TI, Luoto R, Gissler M, Hemminki E. Pregnancy weight gain from 1960s to 2000 in Finland. International journal of obesity and related metabolic disorders : journal of the International Association for the Study of Obesity. 2003;27(12):1572-7.

  11. Ota E, Haruna M, Suzuki M, Anh DD, Tho le H, Tam NT, et al. Maternal body mass index and gestational weight gain and their association with perinatal outcomes in Viet Nam. Bulletin of the World Health Organization. 2011;89(2):127-36.

  12. Yekta Z, Ayatollahi H, Porali R, Farzin A. The effect of prepregnancy body mass index and gestational weight gain on pregnancy outcomes in urban care settings in Urmia-Iran. BMC pregnancy and childbirth. 2006;6:15.

  13. Maddah M, Karandish M, Mohammadpour-Ahranjani B, Neyestani TR, Vafa R, Rashidi A. Social factors and pregnancy weight gain in relation to infant birth weight: a study in public health centers in Rasht, Iran. European journal of clinical nutrition. 2005;59(10):1208-12.

  14. Ebrahimi F, Shariff ZM, Tabatabaei SZ, Fathollahi MS, Mun CY, Nazari M. Relationship between Sociodemographics, Dietary Intake, and Physical Activity with Gestational Weight Gain among Pregnant Women in Rafsanjan City, Iran. Journal of health, population, and nutrition. 2015;33(1):168-76.

  15. Rasmussen KM, Yaktine AL, Institute of Medicine (U.S.). Committee to Reexamine IOM Pregnancy Weight Guidelines. Weight gain during pregnancy : reexamining the guidelines. Washington, DC: National Academies Press; 2009. xiv, 854 p. p.

  16. Obesidad y Embarazo, (2011).

  17. Ashrafi M, Gosili R, Hosseini R, Arabipoor A, Ahmadi J, Chehrazi M. Risk of gestational diabetes mellitus in patients undergoing assisted reproductive techniques. Eur J Obstet Gynecol Reprod Biol. 2014;176:149-52.

  18. Henningsen AK, Pinborg A, Lidegaard O, Vestergaard C, Forman JL, Andersen AN. Perinatal outcome of singleton siblings born after assisted reproductive technology and spontaneous conception: Danish national sibling-cohort study. Fertil Steril. 2011;95(3):959-63.

  19. Reefhuis J, Honein MA, Schieve LA, Correa A, Hobbs CA, Rasmussen SA, et al. Assisted reproductive technology and major structural birth defects in the United States. Hum Reprod. 2009;24(2):360-6.

  20. Talaulikar VS, Arulkumaran S. Maternal, perinatal and long-term outcomes after assisted reproductive techniques (ART): implications for clinical practice. Eur J Obstet Gynecol Reprod Biol. 2013;170(1):13-9.

  21. Saucedo E, Carmona I, Moraga M, López J, Riquelme I, Romeu A. Assisted Reproduction: Should be transferred only one embryo? Rev Iberoam Fert Rep Hum. 2015;32(1):16-21.

  22. Luke B, Brown MB. Contemporary risks of maternal morbidity and adverse outcomes with increasing maternal age and plurality. Fertility and sterility. 2007;88(2):283-93.

  23. Sibai BM, Hauth J, Caritis S, Lindheimer MD, MacPherson C, Klebanoff M, et al. Hypertensive disorders in twin versus singleton gestations. National Institute of Child Health and Human Development Network of Maternal-Fetal Medicine Units. American journal of obstetrics and gynecology. 2000;182(4):938-42.

  24. Sivan E, Maman E, Homko CJ, Lipitz S, Cohen S, Schiff E. Impact of fetal reduction on the incidence of gestational diabetes. Obstetrics and gynecology. 2002;99(1):91-4.

  25. Moini A, Shiva M, Arabipoor A, Hosseini R, Chehrazi M, Sadeghi M. Obstetric and neonatal outcomes of twin pregnancies conceived by assisted reproductive technology compared with twin pregnancies conceived spontaneously: a prospective follow-up study. European journal of obstetrics, gynecology, and reproductive biology. 2012;165(1):29-32.

  26. Estados hipertensivos del embarazo, (2007).

  27. Asistencia a la gestante con diabetes, (2014).

  28. Definiciones perinatológicas, (2010).

  29. Cardenas-Castro M, Arancibia-Martini H. Statistical power and effect size calculating in g*power: complementary analysis of statistical significance testing and its application in psychology. Salud & Sociedad. 2014;5(2):210-24.

  30. National Research Council (U.S.). Committee on Maternal Nutrition. Maternal nutrition and the course of pregnancy. Washington,: National Academy of Sciences; 1970. ix, 241 p. p.

  31. Institute of Medicine (U.S.). Subcommittee on Nutritional Status and Weight Gain during Pregnancy., Institute of Medicine (U.S.). Subcommittee on Dietary Intake and Nutrient Supplements during Pregnancy. Nutrition during pregnancy : part I, weight gain : part II, nutrient supplements. Washington, D.C.: National Academy Press; 1990. xii, 468 p. p.

  32. Fouelifack FY, Fouedjio JH, Fouogue JT, Sando Z, Fouelifa LD, Mbu RE. Associations of body mass index and gestational weight gain with term pregnancy outcomes in urban Cameroon: a retrospective cohort study in a tertiary hospital. BMC Res Notes. 2015;8:806.

  33. Dzakpasu S, Fahey J, Kirby RS, Tough SC, Chalmers B, Heaman MI, et al. Contribution of prepregnancy body mass index and gestational weight gain to adverse neonatal outcomes: population attributable fractions for Canada. BMC Pregnancy Childbirth. 2015;15:21.

  34. Wen T, Lv Y. Inadequate gestational weight gain and adverse pregnancy outcomes among normal weight women in China. Int J Clin Exp Med. 2015;8(2):2881-6.

  35. Godoy AC, Nascimento SL, Surita FG. A systematic review and meta-analysis of gestational weight gain recommendations and related outcomes in Brazil. Clinics (Sao Paulo). 2015;70(11):758-64.

  36. De Amorim MM, Leite DF, Gadelha TG, Muniz AG, Melo AS, Rocha Ada M. [Risk factors for macrosomia in newborns at a school-maternity in northeast of Brazil]. Rev Bras Ginecol Obstet. 2009;31(5):241-8.

  37. Santos EM, Amorim LP, Costa OL, Oliveira N, Guimaraes AC. [Profile of gestational and metabolic risk in the prenatal care service of a public maternity in the Brazilian Northeast]. Rev Bras Ginecol Obstet. 2012;34(3):102-6.

  38. Control prenatal del embarazo normal, (2010).

  39. Abrams B, Altman SL, Pickett KE. Pregnancy weight gain: still controversial. The American journal of clinical nutrition. 2000;71(5 Suppl):1233S-41S.

  40. Groth S. Adolescent gestational weight gain: does it contribute to obesity? MCN The American journal of maternal child nursing. 2006;31(2):101-5.

  41. Taffel SM, Keppel KG, Jones GK. Medical advice on maternal weight gain and actual weight gain. Results from the 1988 National Maternal and Infant Health Survey. Annals of the New York Academy of Sciences. 1993;678:293-305.

  42. Kim SY, Dietz PM, England L, Morrow B, Callaghan WM. Trends in pre-pregnancy obesity in nine states, 1993-2003. Obesity. 2007;15(4):986-93.

  43. Yeh J, Shelton JA. Increasing prepregnancy body mass index: analysis of trends and contributing variables. American journal of obstetrics and gynecology. 2005;193(6):1994-8.

  44. Kupka MS, Ferraretti AP, de Mouzon J, Erb K, D'Hooghe T, Castilla JA, et al. Assisted reproductive technology in Europe, 2010: results generated from European registers by ESHREdagger. Human reproduction. 2014.




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