ความสัมพันธ์ระหว่างดัชนีมวลกายก่อนการตั้งครรภ์และน้ำหนักที่เพิ่มขึ้นระหว่างการตั้งครรภ์ ต่อภาวะแทรกซ้อนของมารดาและทารกในระยะคลอด

Kasorn Tosaeng; Panuttita  Khoonboonyung

Authors

Kasorn Tosaeng Rajavithi Hospital
Panuttita Khoonboonyung Boromarajonani College of Nursing Bangkok, Faculty of Nursing, Praboromarajchanok Institute

Keywords:

Perinatal complication , body mass index, Gestational weight gain

Abstract

Introduction: Pregnant women, with a body mass index before pregnancy (pre-pregnancy body mass index; pre-BMI)and weight gain during pregnancy outside the Institute of Medicine (IOM) ecommendation, have an increased risk of perinatal complications.

Research objectives: This study aimed to investigate the associations between pre-pregnancy body mass index (pre-BMI), gestational weight gain (GWG), and maternal and neonatal complications.

Research methodology: This retrospective analytic study collected data from the medical records of the singleton pregnant women with no complications 3,614 women.Data were analyzed using descriptive statistics, chi-squared test, Spearman’s rank correlation test, and multivariate analysis. Statistical significance was set at p-value < .05.

Results: Pre-BMI was positively related to gestational age and birth weight, and an abnormal pre-BMI was associated with cesarean section delivery. Pre-BMI exceeding the threshold, and obesity were related to the GDMA1 status. Obesity was associated with GDMA2, gestational hypertension, Postpartum hemorrhage (PPH), and newborn death. Also, GWG was positively correlated to birth weight and gestational age, except for GWG in a group of pre-BMI exceeding the threshold. GWG not achieving the IOM recommendations was associated with cesarean section delivery.GWG exceeding the threshold was associated with severe preeclampsia and cephalopelvic disproportion (CPD). GWG lower than the threshold was associated with fetal hypoxia.

Conclusions: Among pregnant women, two out of four had an abnormal pre-BMI and two-thirds had a GWG that did not achieve the IOM recommendations; and were associated with maternal and perinatal complications.

Implications: Nurses, midwives and multidisciplinary professionals should set a cooperative planning to prepare women before pregnancy to reach an appropriate pre-BMI and determine GWG appropriately for individual.

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