This study aims to explore the importance of optimizing gestational weight for obese women in order to reduce fatal morbidities. We conducted a retrospective observational study in a large tertiary maternity unit located in Reunion Island, a French department in the Indian Ocean. Our study population consisted of consecutive singleton births delivered at the Centre Hospitalier Universitaire Hospitalier Sud Reunion’s maternity. We used a standardized epidemiological perinatal database to analyze the data.
Using a mathematical simulation on a 19-year historical cohort (2001-2019), we applied the optimal gestational weight gain (optGWG) equation we proposed in 2018 to the population and observed its effects on maternal/fetal morbidities in singleton term pregnancies (≥37 weeks). We presented the data as numbers and proportions for categorical variables and mean and Standard Deviation (SD) for continuous ones.
The study measured five maternal/fetal morbidities. Starting with overweight women and extending to other grades of obesity (class I to III), we considered maternal pre-pregnancy BMI (ppBMI) and individually counseled women on their GWG (optimal gestational weight gain, optGWG). The results showed that optGWG significantly lowers maternal/fetal morbidities in a logistic regression model among overweight/obese women. Several morbidities, including cesarean-section, birthweight ≥ 4000 g, term preeclampsia, and the effect of rising maternal ppBMI per increment of 5 kg/m² (coefficient -0.13), had a negative coefficient as independent factors. Dietary and lifestyle interventional studies have reduced GWG by 0.7kg or 3.7kg and had no effect on other pregnancy and birth outcomes, including GDM, PE, PIH, LGA, and macrosomic infants.
Our prediction, which needs to be verified in future prospective studies, is that follow-up and counseling since the first prenatal visit should lower gestational diabetes mellitus rates. In conclusion, we can benefit significantly by reducing c-section rates, term preeclampsia, macrosomic and LGA babies in overweight/obese women and low-birthweight babies in lean women. Reducing weight gain during pregnancy in overweight/obese women is crucial to achieving these benefits. It is essential to verify and establish the specific linear curve of optGWG for each geographic/ethnic area on all continents.
Author(s) Details:
Pierre-Yves Robillard,
Service de Néonatologie, Centre Hospitalier Universitaire Sud Réunion, Saint-Pierre Cedex, La Réunion, France and Centre d’Etudes Périnatales Océan Indien (CEPOI), Centre Hospitalier Universitaire Sud Réunion, Saint-Pierre Cedex, La Réunion, France.
Gustaaf Dekker,
Department of Obstetrics & Gynaecology, University of Adelaide, Robinson Institute, Lyell McEwin Hospital, Australia.
Malik Boukerrou,
Centre d’Etudes Périnatales Océan Indien (CEPOI), Centre Hospitalier Universitaire Sud Réunion, Saint-Pierre Cedex, La Réunion, France and Service de Gynécologie et Obstétrique, Centre Hospitalier Universitaire Sud Réunion, BP 350, 97448 Saint-Pierre Cedex, La Réunion, France.
Brahim Boumahni,
Service de Neonatologie, Centre Hospitalier Universitaire Sud Reunion, Saint-Pierre Cedex, La Reunion, France.
Thomas C Hulsey,
Department of Epidemiology, School of Public Health, West Virginia University, Morgantown WV, USA.
Marco Scioscia,
Department of Obstetrics and Gynaecology, Policlinico of Abano Terme, Abano Terme (PD), Italy.
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