ความสัมพันธ์ระหว่างดัชนีมวลกายก่อนการตั้งครรภ์และน้ำหนักที่เพิ่มขึ้นระหว่างการตั้งครรภ์ ต่อภาวะพร่องออกซิเจนแรกเกิด

Sririwan  Somjaijing; Panuttita  Khoonboonyung

Authors

Sririwan Somjaijing Nakhonpathom hospital
Panuttita Khoonboonyung Boromarajonani College of Nursing Bangkok, Faculty of Nursing, Praboromarajchanok Institute

Keywords:

birth asphyxia, body mass index, body weight gain, antepartum

Abstract

Introduction: According to recent statistics, an incidence of birth asphyxia has significantly increased, and this is a leading cause of perinatal mortality. Additionally, the prevalence of maternal overweight and obese while entering pregnancy has been increased.

Research objectives: The study aimed to investigate association between pre-pregnancy maternal body mass index (BMI) and gestational weight gain (GWG) and birth-asphyxia-related outcomes in singleton term pregnant women.

Research methodology: This retrospective analytic study collected data from medical records of the singleton pregnant women, 37-42 weeks gestation, having labour pain and deliver at labor room, Nakhon Pathom hospital. Data were collected between January 1 - December 31, 2020. Information from the records were assigned into two groups as following: 215 mothers who delivered the infant with Apgar score > 7; and 85 mothers who delivered the infant with Apgar score < 7. Instruments included personal information, obstetric history, pre-pregnancy body mass index, and gestational weight gain. Data were analyzed using Spearman and binary logistic regression analysis.

Results: Pre-pregnancy maternal BMI was negatively related to Apgar score at a low level (r_s= -0.246). The study also found significantly negatively moderate association between maternal overweight (BMI >25-29.9 kg/m²) and Apgar score. (r_s = -0.489). The results of binary logistic regression show that pre-pregnancy maternal BMI 25-29.9 kg/m² ( $gif.latex?\beta$ = 7.63, p < 0.01) and weigh gain more than 11.5 kg ( $gif.latex?\beta$ = 9.6, p < 0.01) during pregnancy was significant predictor of birth asphyxia. Pre-pregnancy maternal BMI 25-29.9 kg/m² and weigh gain more than 11.5 kg together explained 23.6% of the variance in birth asphyxia (Cox and Snell R square = .236, Negalkerke R square = .318)

Conclusions: Pregnant women with pre-pregnancy overweight were 7.6 times more likely to have a neonatal birth asphyxia. Pre-pregnancy overweight with weight gain more than 11.5 kg during pregnancy was 9.6 times more likely to cause neonatal birth asphyxia.

Implications for practice: Midwives and stakeholders could support women of reproductive age planning for a pregnancy to optimize weight management. They are responsible for advice and support overweight or obese women to maintain a healthy weight during pregnancy.

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