Evaluation of the influence of maternal weight on the course of pregnancy and birth outcomes of fetuses with macrosomia
AbstractThe purpose of the study. To characterize the clinical portrait of women who have given birth to large children, as well as to assess the influence of maternal weight on the peculiarities of pregnancy and birth outcomes of fetuses with macrosomia.
Material and methods. The analysis of 107 case histories of patients of Maternity Hospital No. 8, Moscow, who gave birth to children weighing ≥4000 g in 2021 was carried out. The subjects were divided into 2 groups: 64 (59.81%) had a body mass index (BMI) <25 kg/m2 (group 1), 43 (40.19%) had a BMI ≥25 kg/m2 (group 2). A comparative analysis was carried out by age, anthropometry before pregnancy and before delivery, pelviometry, the presence of concomitant diseases, fetometry before childbirth, the weight of the newborn, as well as the frequency of complications in childbirth. Statistical analysis was carried out using Microsoft Office Excel 2019, Statistica 10 programs (StatSoft.Inc), EasyGV, version 9.
Results. The homogeneity of the groups by age, by gestation period at the time of delivery, total weight gain, fetometry of the fetus, as well as the weight of the newborn was revealed: 4200.0 [4075.0; 4325.0] g versus 4170.0 [4090.0; 4330.0] g (p>0.05). Independent childbirth in group 1 was in 78.13%, and in group 2 in 65.12%, gestational diabetes mellitus was almost 2 times more often registered in women in group 2 in 30.23%, and in group 1 in 17.19%. The rate of complications in childbirth is 1.5 times higher in patients with a BMI ≥25 kg/m2 of 60.47%, and with a BMI <25 kg/m2 – in 39.06% (p<0.05). A strong correlation was revealed: in both groups between the weight of the mother before pregnancy and before delivery. In group 2, a significant correlation was observed between BMI before pregnancy and before delivery (r>0.75, p<0.05); in group 1, a significant relationship was found between pre-pregnancy weight and women’s age, abdominal circumference, BMI before pregnancy and after delivery, as well as with overall weight gain (r>0.25, p<0.05).
Conclusion. Thus, despite the homogeneity of the groups of women with different initial BMI, higher risks of complicated delivery of a large fetus and the occurrence of gestational diabetes mellitus were observed in the group with a higher BMI. At the same time, no other significant predictors of macrosomia and its risks have been identified, which requires additional research in this direction. More thorough pre-gravidar preparation is necessary in the group of overweight and obese patients, which can change the metabolic programming of the fetus during pregnancy.
Keywords:obesity; pregnancy; macrosomy; gestational diabetes mellitus
Funding. The study had no sponsor support.
Conflict of interest. The authors declare no conflict of interest.
For citation: Kazankina A.S., Ushanova F.O. Evaluation of the influence of maternal weight on the course of pregnancy and birth outcomes of fetuses with macrosomia. Endokrinologiya: novosti, mneniya, obuchenie [Endocrinology: News, Opinions, Training]. 2023; 12 (3): 20–5. DOI: https://doi.org/10.33029/2304-9529-2023-12-3-20-25 (in Russian)
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