Association of pre-pregnancy obesity versus excessive gestational weight gain with adverse neonatal outcomes in the United States.

IF 1.5 4区医学 Q3 OBSTETRICS & GYNECOLOGY

American journal of perinatology Pub Date : 2025-03-25 DOI:10.1055/a-2565-1687

Rodney McLaren, Deepa Rastogi, Shantanu Rastogi

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引用次数: 0

Abstract

Objective: Pre-pregnancy obesity (PPO) and excessive gestational weight gain (eGWG) during pregnancy, both are associated with adverse neonatal outcomes. The objective of this study was to compare the independent associations of PPO and eGWG with adverse neonatal outcomes.

Methods: This was a retrospective cohort study of singleton, live births in the United States in 2018 using National Vital Statistics System data. These were divided into four groups: 1) normal pre-pregnancy BMI and normal GWG, 2) normal pre-pregnancy BMI and eGWG, 3) pre-pregnancy BMI >30 kg/m2 (PPO) and normal GWG and 4) PPO and eGWG. The adverse neonatal outcomes, including preterm delivery, large for gestational age (LGA) infants, assisted neonatal ventilation, low 5-minute Apgar scores, neonatal intensive care unit (NICU) admissions, and surfactant use were studied. These outcomes were compared among groups using ANOVA and multivariable analyses.

Results: Of the 1,477,062 births included, 21.8%, 41.6%, 10.4% and 26.3% were in Groups 1-4 respectively. With Group 1 as the reference group after correcting for significant factors, groups 2-4 had higher risk (aOR with 95% CI), for preterm delivery of <37 weeks 1.17 (1.14-1.20), 1.05 (1.02-1.09) and 1.14 (1.11-1.18) and for LGA infants 2.38 (2.31-2.44), 2.37 (2.29-2.45), 3.91 (3.80-4.02) in groups 2-4 respectively. Further, patients with PPO with and without eGWG also had increased risk of immediate assisted neonatal ventilation 1.07 (1.02-1.12) and 1.16 (1.12-1.218), for 5-minute Apgar score <3 1.40 (1.19-1.65), 1.38 (1.20-1.58), and for NICU admission in 1.04, (1.01-1.08), 1.12 (1.09-1.15) for Groups 3 and 4 respectively.

Conclusion: Both PPO and eGWG were independently associated with preterm delivery and LGA infants. PPO with or without excessive GWG was also associated with low Apgar scores, more NICU admission and higher need for immediate ventilatory support. This data supports the importance of pre-pregnancy weight loss to prevent or decrease adverse neonatal outcomes.

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目的：孕前肥胖（PPO）和孕期体重增加过多（eGWG）都与新生儿不良结局有关。本研究旨在比较 PPO 和 eGWG 与新生儿不良结局的独立关联：这是一项回顾性队列研究，使用了美国国家生命统计系统数据，研究对象为 2018 年在美国出生的单胎活产婴儿。这些婴儿被分为四组：1）孕前 BMI 正常且 GWG 正常；2）孕前 BMI 正常且 eGWG 正常；3）孕前 BMI >30 kg/m2 (PPO) 且 GWG 正常；4）PPO 且 eGWG 正常。对新生儿不良结局进行了研究，包括早产、胎龄偏大（LGA）婴儿、新生儿辅助通气、5 分钟 Apgar 评分偏低、新生儿重症监护室（NICU）入院和表面活性物质的使用。通过方差分析和多变量分析对各组间的结果进行了比较：在纳入的 1,477,062 例新生儿中，1-4 组分别占 21.8%、41.6%、10.4% 和 26.3%。在对重要因素进行校正后，以第 1 组为参照组，第 2-4 组的早产风险更高（aOR，95% CI）：PPO和eGWG都与早产和LGA婴儿有关。伴有或不伴有过高 GWG 的 PPO 还与低 Apgar 评分、更多新生儿重症监护室入院和更需要立即呼吸支持有关。这些数据支持了孕前减重对预防或减少新生儿不良结局的重要性。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

American journal of perinatology 医学-妇产科学

CiteScore

5.90

自引率

0.00%

发文量

302

审稿时长

4-8 weeks

期刊介绍： The American Journal of Perinatology is an international, peer-reviewed, and indexed journal publishing 14 issues a year dealing with original research and topical reviews. It is the definitive forum for specialists in obstetrics, neonatology, perinatology, and maternal/fetal medicine, with emphasis on bridging the different fields. The focus is primarily on clinical and translational research, clinical and technical advances in diagnosis, monitoring, and treatment as well as evidence-based reviews. Topics of interest include epidemiology, diagnosis, prevention, and management of maternal, fetal, and neonatal diseases. Manuscripts on new technology, NICU set-ups, and nursing topics are published to provide a broad survey of important issues in this field. All articles undergo rigorous peer review, with web-based submission, expedited turn-around, and availability of electronic publication. The American Journal of Perinatology is accompanied by AJP Reports - an Open Access journal for case reports in neonatology and maternal/fetal medicine.