Korean J Obstet Gynecol.  2011 Oct;54(10):591-598. 10.5468/KJOG.2011.54.10.591.

Maternal obesity and associated risk of adverse pregnancy outcomes in women with hyperglycemia

• Kim MK
• Hur J
• Lee SY
• Kim YL
• Park KS
• Park SW
• Lee KJ

• KMID: 1836744
• DOI: http://doi.org/10.5468/KJOG.2011.54.10.591

Abstract

OBJECTIVE
We designed this study to explore the pregnancy outcomes in women with hyperglycemia according to their prepregnancy body mass index (BMI) and to identify risk factors of poor pregnancy outcomes.
METHODS
A total of 1,056 pregnant women, who took a standard 100 g oral glucose tolerance test, were recruited between July 1, 2007 and December 31, 2009. The participants were stratified into 3 groups (group 1 [BMI < 18.5 kg/m2], group 2 [BMI 18.5-24.9 kg/m2], and group 3 [obese] [BMI > or = 25 kg/m2]) based on their prepregnancy BMI following the World Health Organization Asia-Pacific guidelines.
RESULTS
Older age and multi-parity, and family history of diabetes were significantly higher in the obese group. Development of hypertension and gestational diabetes mellitus were also significantly increased with obesity. Maternal weight gain, however, was inversely correlated pattern with prepregnancy BMI. Poor pregnancy outcomes are increased with older age, multi parity, gestational ages at delivery, increased prepregnancy BMI, maternal high glucose status and weight gain rate. Particularly, prepregnancy BMI had higher risk than maternal hyperglycemia on macrosomia (odd ratio [OR] 5.0, 95% confidence intervals [CI] 2.28-11.02 vs. OR 3.0, 95% CI 1.63-5.85), and on primary cesarean section rate (OR 2.5, 95% CI 1.46-4.46 vs. OR 1.6, 95% CI 1.14-2.43).
CONCLUSION
Pregnant women with obesity are more likely to have poor pregnancy outcomes than pregnant women without obesity. Therefore, with prepregnancy BMI considered, effective management during pregnancy should be designed and intervention trials are needed to identify individuals at risk before developing hyperglycemia.

Keyword

Prepregnancy body mass index; Pregnancy outcomes; Hyperglycemia

MeSH Terms

Body Mass Index
Cesarean Section
Diabetes, Gestational
Female
Gestational Age
Glucose
Glucose Tolerance Test
Humans
Hyperglycemia
Hypertension
Obesity
Parity
Pregnancy
Pregnancy Outcome
Pregnant Women
Risk Factors
Weight Gain
World Health Organization
Glucose

Figure

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  Fig. 1 Pattern between maternal prepregnancy body mass index (BMI) and total weight gain.

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  Fig. 2 Maternal weight gain rate before and after oral glucose challenge test. Among these groups there were significant different weight gain (P <0.001). OGCT, oral glucose challenge test; BMI, body mass index.

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