The study of the relationship of the initial body weight with gestational increase in puerperas and its effect on the course of pregnancy, childbirth outcomes and risks to the fetus

• Tatyana Yu. Demidova
• Kuznetsova Alesya A.

Abstract

The study analyzed the effect of the initial body weight of a woman and her excessive gestational increase (GIBW) on the incidence of complications of pregnancy and childbirth, fetal health. The study is retrospective. 157 birth histories of women in the postpartum department of the City Clinical Hospital named after V.P. Demikhov for the second half of 2018 were analyzed. The average age of women in childbirth was 31.2 years. When analyzing medical records, the incidence of complications such as preeclampsia, gestational diabetes mellitus (GDM), thyroid pathology, caesarean section, birth injuries, anomalies of labor, fetal macrosomia, fetal growth retardation syndrome, placental insufficiency depending on the initial body weight were estimated. puerperal and gumt. Before pregnancy, 38.2% of women had normal body mass index (BMI) (18.5-24.9 kg/m²), 35% of women had overweight (BMI 25-29.9 kg/m²) and 26.7% of women were obese (BMI ≥30 kg/m²).

In women with pregravid obesity, the incidence of placental insufficiency (28.5 vs 6.6%), preeclampsia (52.4 vs 23.2%), and GDM (26.2 vs 5%) were significantly higher compared to puerperal women with initially normal BMI (p<0.05); the incidence of GDM (26.2 vs 5.4%) and anomalies of labor activity (11.9 vs 0%) were significantly higher compared to puerperas with initially overweight (p<0.05). In puerperas with initial obesity and normal or excessive compared with the group of puerperas with initially overweight and normal or excessive GIBW, the incidence of preeclampsia, GDM and the performed cesarean section was significantly higher (p<0.05). In puerperas with initial obesity and normal or excessive GIBW, compared with the group of puerperas with initially normal BMI and normal or excessive GIBW, the frequency of development of GDM and preeclampsia is also significantly higher (p<0.05). Thus, in puerperal women who suffered from obesity before pregnancy, preeclampsia, GDM, placental insufficiency, anomalies of labor activity, and also the frequency of the performed cesarean section are significantly more likely to develop. In women with pathological GIBW, children with macrosomia are significantly more likely to be born.

Keywords:gestational weight gain, gestational diabetes, preeclampsia

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