Obesity in Early Pregnancy Has a Stronger Association to Pre-eclampsia and Diabetes Than Weight Gain [28D]

Abstract

INTRODUCTION: To evaluate the association of obesity in early gestation and weight gain during pregnancy to pre-eclampsia, pre-gestational and gestational diabetes rates. METHODS: We conducted a retrospective cohort study at our center from January 2013 to December 2015. Women with singleton pregnancies, who started prenatal care at less than 20 weeks, and who completed delivery at our center were included. The primary outcome was pre-eclampsia. Secondary outcomes were pre-gestational (PGDM) and gestational diabetes (GDM). Body mass index (BMI) was taken from the initial OB visit and stratified into five different categories: 18–24.9, 25–29.9, 30.0–34.9, 35.0–39.9, and ≥40 kg/m2. Obesity was defined as BMI ≥30 kg/m2. Weight gain was stratified into four different categories: <5, 5–10, 11–15, >15 kg. Statistical analysis was performed using Chi-square test for group comparisons. A P-value of <0.05 was considered significant. RESULTS: 687 women met inclusion criteria and were included in this study. There was a direct relationship between pre-eclampsia and increasing BMI (9.25%, 10.61%, 15.58%, 15.79%, 20.0%, P=.0795). When BMI was divided into non-obese (<30) versus obese (≥30), there was a significant association with pre-eclampsia (P=.0127). There was a significant association with PGDM as BMI increased (P<.0001); as well as a trend to higher rates of GDM. There was no association between pre-eclampsia and weight gained during pregnancy (P=.912). CONCLUSION: Obesity appears to be more important than weight gained during pregnancy in the development of pre-eclampsia and gestational diabetes. This highlights the importance of pre-conception weight reduction and optimization for the prevention of morbidity in pregnancy.

An Audit of Pre-Pregnancy Maternal Obesity and Diabetes Screening in Rural Regional Tasmania and Its Impact on Pregnancy and Neonatal Outcomes

“…Assessment and care options will depend on the clinical circumstances, the presence of comorbidities, and the resources and services available at each healthcare facility. Roman et al [17] concluded that obesity is more important than GWG in the development of pre-eclampsia and GDM and refer to the importance of pre-conception weight reduction and counselling, in reducing morbidity in pregnancy. However, a meta-analysis of the association between GWG and adverse maternal and neonatal outcomes, was related to the risk of complications in pregnancy, weight retention and obesity in the offspring [23].…”