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Yamaguchi T, Kyozuka H, Ito M, Hiraiwa T, Murata T, Sugeno M, Ito F, Suzuki D, Fukuda T, Yasuda S, Keiya F, Nomura Y. Predicting postpartum hemorrhage in women undergoing planned cesarean section: A multicenter retrospective cohort study in Japan. PLoS One 2024; 19:e0306488. [PMID: 38980883 PMCID: PMC11233003 DOI: 10.1371/journal.pone.0306488] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Accepted: 06/18/2024] [Indexed: 07/11/2024] Open
Abstract
Given Japan's unique social background, it is critical to understand the current risk factors for postpartum hemorrhage (PPH) to effectively manage the condition, especially among specific groups. Therefore, this study aimed to identify the current risk factors for PPH during planned cesarean section (CS) in Japan. This multicenter retrospective cohort study was conducted in two tertiary maternal-fetal medicine units in Fukushima, Japan and included 1,069 women who underwent planned CS between January 1, 2013, and December 31, 2022. Risk factors for PPH (of > 1000 g and > 1500 g) were assessed using multivariate logistic regression analysis, considering variables such as maternal age, parity, assisted reproductive technology (ART) pregnancy, pre-pregnancy body mass index (BMI), uterine myoma, placenta previa, gestational age at delivery, birth weight categories, and hypertensive disorders of pregnancy (HDP). Multivariate linear regression analyses were conducted to predict estimated blood loss during planned CS. ART pregnancy, a pre-pregnancy BMI of 25.0-29.9 kg/m2, and uterine myoma increased PPH risk at various levels. Maternal smoking increased the risk of >1500 g PPH (adjusted odds ratio: 3.09, 95% confidence interval [CI]: 1.16-8.20). Multivariate linear analysis showed that advanced maternal age (B: 83 g; 95% CI: 27-139 g), ART pregnancy (B: 239 g; 95% CI: 121-357 g), pre-pregnancy BMI of 25.0-29.9 kg/m2 (B: 74 g; 95% CI: 22-167 g), uterine myoma (B: 151 g; 95% CI: 47-256 g), smoking (B: 107 g; 95% CI: 13-200 g), and birth weight > 3,500 g (B: 203 g; 95% CI: 67-338 g) were associated with blood loss during planned CS. Considering a patient's clinical characteristic may help predict bleeding in planned CSs and help improve patient safety.
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Affiliation(s)
- Tomoko Yamaguchi
- Department of Obstetrics and Gynecology, Ohta Nishinouchi Hospital, Koriyama city, Fukushima, Japan
| | - Hyo Kyozuka
- Department of Obstetrics and Gynecology, Ohta Nishinouchi Hospital, Koriyama city, Fukushima, Japan
| | - Momoka Ito
- Department of Obstetrics and Gynecology, Ohta Nishinouchi Hospital, Koriyama city, Fukushima, Japan
| | - Tsuyoshi Hiraiwa
- Department of Obstetrics and Gynecology, Iwase General Hospital, Sukagawa city, Fukushima, Japan
| | - Tsuyoshi Murata
- Department of Obstetrics and Gynecology, Shirakawa Kosei General Hospital, Shirakawa, Fukushima, Japan
| | - Misa Sugeno
- Department of Obstetrics and Gynecology, Iwase General Hospital, Sukagawa city, Fukushima, Japan
| | - Fumihiro Ito
- Department of Obstetrics and Gynecology, Ohta Nishinouchi Hospital, Koriyama city, Fukushima, Japan
| | - Daisuke Suzuki
- Department of Obstetrics and Gynecology, Ohta Nishinouchi Hospital, Koriyama city, Fukushima, Japan
| | - Toma Fukuda
- Department of Obstetrics and Gynecology, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Shun Yasuda
- Department of Obstetrics and Gynecology, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Fujimori Keiya
- Department of Obstetrics and Gynecology, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Yasuhisa Nomura
- Department of Obstetrics and Gynecology, Ohta Nishinouchi Hospital, Koriyama city, Fukushima, Japan
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Ramón-Arbués E, Granada-López JM, Martínez-Abadía B, Echániz-Serrano E, Sagarra-Romero L, Antón-Solanas I. Physical activity during pregnancy and its relationship with gestational weight gain. Rev Lat Am Enfermagem 2023. [DOI: 10.1590/1518-8345.6488.3876] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/29/2023] Open
Abstract
Objective: to describe the physical activity patterns of a cohort comprised by pregnant women from our environment and to explore its association with weight gain in each of the trimesters of pregnancy. Methods: a descriptive and longitudinal study conducted with a sample of 151 women. The International Physical Activity Questionnaire was used to assess physical activity during pregnancy based on volume, intensity and setting where it is performed. Different multiple linear regression models were performed to analyze the association between physical activity and gestational weight gain Results: physical activity decreased during pregnancy, both in terms of time and intensity. Pre-gestational Body Mass Index was the main factor associated with lower weight gain throughout pregnancy. The influence of physical activity on gestational weight gain was limited to the third trimester of pregnancy, where an inverse association was observed between both variables. Conclusion: the results of this study show an important reduction in physical activity during pregnancy and suggest that it exerts a limited influence on gestational weight gain
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Ramón-Arbués E, Granada-López JM, Martínez-Abadía B, Echániz-Serrano E, Sagarra-Romero L, Antón-Solanas I. Atividade física durante a gestação e sua relação com o ganho de peso gestacional. Rev Lat Am Enfermagem 2023. [DOI: 10.1590/1518-8345.6488.3877] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/29/2023] Open
Abstract
Objetivo: descrever os padrões de atividade física de uma coorte de gestantes em nosso meio e explorar sua associação com o ganho de peso em cada um dos trimestres de gestação. Método: estudo descritivo longitudinal com uma amostra de 151 mulheres. O Questionário Internacional de Atividade Física foi utilizado para avaliar a atividade física durante a gestação de acordo com o volume, intensidade e escopo do desempenho. Diferentes modelos de regressão linear múltipla foram utilizados para analisar a associação entre atividade física e ganho de peso gestacional. Resultados: a atividade física diminuiu durante a gestação, tanto em tempo quanto em intensidade. O índice de massa corporal pré-gestacional foi o principal fator associado ao menor ganho de peso ao longo da gestação. A influência da atividade física no ganho de peso gestacional limitou-se ao terceiro trimestre de gestação, no qual foi observada associação inversa entre ambas as variáveis. Conclusão: os resultados deste estudo mostram uma diminuição significativa da atividade física no momento da gravidez e sugerem uma influência limitada desta no ganho de peso gestacional.
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Gong X, Wu T, Zhang L, You Y, Wei H, Zuo X, Zhou Y, Xing X, Meng Z, Lv Q, Liu Z, Zhang J, Hu L, Li J, Li L, Chen C, Liu C, Sun G, Liu A, Lv Y, Zhao Y, Chen J, Wei Y. Comparison of the 2009 Institute of Medicine and 2021 Chinese guidelines for gestational weight gain: A retrospective population-based cohort study. Int J Gynaecol Obstet 2023; 162:1033-1041. [PMID: 37128813 DOI: 10.1002/ijgo.14788] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2022] [Revised: 03/09/2023] [Accepted: 03/29/2023] [Indexed: 05/03/2023]
Abstract
OBJECTIVE To analyze the associations between gestational weight gain (GWG) and perinatal outcomes based on the GWG guidelines of the Chinese Nutrition Society (CNS) and the Institute of Medicine (IOM). METHODS This was a retrospective study with 9075 low-risk singleton pregnant women. Logistic regression model was used to analyze associations between GWG categories and perinatal outcomes. Sensitivity analyses were performed based on pre-pregnancy body mass index (calculated as weight in kilograms divided by the square of height in meters). RESULTS Excessive GWG as defined by the two guidelines was associated with a higher risk of adverse perinatal outcomes. Inadequate GWG was associated with higher risks of small for gestational age (adjusted odds ratio [aOR] 1.34, 95% confidence interval [CI] 1.10-1.64) and preterm birth (aOR 1.70, 95% CI 1.22-2.36), but a lower risk of large for gestational age (LGA) (aOR 0.77, 95% CI 0.63-0.95) according to the IOM guidelines. When using the CNS guidelines, inadequate GWG was associated with only a lower risk of preterm birth (aOR 1.80, 95% CI 1.19-2.70). Sensitivity analyses suggested that excessive GWG was associated with a higher risk of LGA in underweight women. CONCLUSIONS Both guidelines could demonstrate the relationship between GWG and adverse perinatal outcomes. The CNS guidelines were more suitable for the Chinese population with underweight or normal weight before pregnancy, whereas IOM was more suitable for pregnant women with inadequate GWG.
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Affiliation(s)
- Xiaoli Gong
- Department of Obstetrics and Gynecology, Peking University Third Hospital, Beijing, China
- National Clinical Research Center for Obstetrics and Gynecology, Beijing, China
- National Center for Healthcare Quality Management in Obstetrics, Beijing, China
| | - Tianchen Wu
- Department of Obstetrics and Gynecology, Peking University Third Hospital, Beijing, China
- National Clinical Research Center for Obstetrics and Gynecology, Beijing, China
- National Center for Healthcare Quality Management in Obstetrics, Beijing, China
| | - Lizhen Zhang
- Department of Obstetrics and Gynecology, Maternal and Child Health Hospital of Qinhuangdao, Qinhuangdao, China
| | - Yiping You
- Department of Obstetrics, Maternal and Child Health Hospital of Hunan, Changsha, China
| | - Hongwei Wei
- Department of Obstetrics, Maternal and Child Health Hospital of Guangxi Zhuang Autonomous Region, Nanning, China
| | - Xifang Zuo
- Department of Obstetrics, Tongzhou Maternal and Child Health Hospital of Beijing, Beijing, China
| | - Ying Zhou
- Department of Obstetrics and Gynecology, The First Affiliated Hospital of Xiamen University, Xiamen, China
| | - Xinli Xing
- Maternal and Child Health Hospital of Dongchangfu District, Liaocheng, China
| | - Zhaoyan Meng
- Department of Obstetrics, Gansu Maternal and Child Health Hospital, Lan Zhou, China
| | - Qi Lv
- Department of Obstetrics and Gynecology, Changchun Obstetrics-Gynecology Hospital, Changchun, China
| | - Zhaodong Liu
- Fujian Maternity and Child Health Hospital, Affiliated Hospital of Fujian Medical University, Fu Zhou, China
| | - Jian Zhang
- Department of Function, Maternal and Child Health Hospital of Shijiazhuang, Shijiazhuang, China
| | - Liyan Hu
- Department of Obstetrics, Shanxi Maternal and Child Health Hospital, Taiyuan, China
| | - Junnan Li
- Department of Obstetrics, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Li Li
- Department of Obstetrics, Zhengzhou Central Hospital, Zhengzhou, China
| | - Chulin Chen
- Department of Obstetrics, Maternal and Child Health Hospital of Changzhi, Changzhi, China
| | - Chunyan Liu
- Department of Obstetrics, Maternity and Infant Hospital of Shenyang, Shenyang, China
| | - Guoqiang Sun
- Department of Obstetrics, Hubei Maternal and Child Health Hospital, Wu Han, China
| | - Aiju Liu
- Department of Obstetrics, Inner Mongolia Maternal and Child Health Hospital, Hohhot, China
| | - Yuan Lv
- Shengjing Hospital Affiliated to China Medical University, Shenyang, China
| | - Yangyu Zhao
- Department of Obstetrics and Gynecology, Peking University Third Hospital, Beijing, China
- National Clinical Research Center for Obstetrics and Gynecology, Beijing, China
- National Center for Healthcare Quality Management in Obstetrics, Beijing, China
| | - Jingsi Chen
- Department of Prenatal Diagnosis, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Yuan Wei
- Department of Obstetrics and Gynecology, Peking University Third Hospital, Beijing, China
- National Clinical Research Center for Obstetrics and Gynecology, Beijing, China
- National Center for Healthcare Quality Management in Obstetrics, Beijing, China
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Ito M, Kyozuka H, Yamaguchi T, Sugeno M, Murata T, Hiraiwa T, Ito F, Suzuki D, Fukuda T, Yasuda S, Fujimori K, Nomura Y. Association between Gestational Weight Gain and Risk of Hypertensive Disorders of Pregnancy among Women with Obesity: A Multicenter Retrospective Cohort Study in Japan. Nutrients 2023; 15:nu15112428. [PMID: 37299392 DOI: 10.3390/nu15112428] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2023] [Revised: 05/16/2023] [Accepted: 05/19/2023] [Indexed: 06/12/2023] Open
Abstract
The relationship between weight gain during pregnancy and the onset of hypertensive disorders of pregnancy in women with pre-pregnancy obesity remains unclear. We examined the effects of weight gain during pregnancy on hypertensive disorders of pregnancy among women with pre-pregnancy body mass index (BMI) ≥ 25.0 kg/m2. This multicenter retrospective cohort study included nullipara women who delivered at two units in Japan between 1 January 2013, and 31 December 2020. Singleton primipara (n = 3040) were categorized into two pre-pregnancy BMI groups: 25.0-<30.0, and ≥30.0 kg/m2. Using multiple logistic regression analyses (reported as adjusted odds ratio and 95% confidence interval), gestational weight gain effects on overall hypertensive disorders of pregnancy, gestational hypertension, and pre-eclampsia were determined. Gestational weight gain increased hypertensive disorders of pregnancy (1.09, 1.03-1.16, p < 0.05) and pre-eclampsia risk (1.10, 1.01-1.20, p < 0.05) among the BMI 25.0-<30.0 kg/m2 group and hypertensive disorders of pregnancy risk among the ≥30.0 kg/m2 group (1.07, 1.00-1.05, p < 0.05). Using receiver operating characteristic curve analyses, among the BMI 25.0-<30.0 kg/m2 group, for hypertensive disorders of pregnancy (area under the curve [AUC], 0.63, p < 0.05) and pre-eclampsia (AUC, 0.62; p < 0.05), the weight gain cut-off was 10.5 and 10.6 kg, with sensitivity/specificity of 0.47/0.73 and 0.50/0.73, respectively. For the BMI ≥30.0 kg/m2 group (AUC, 0.63, p < 0.05), the cut-off was 3.5 kg (sensitivity/specificity, 0.75/0.49). The optimal gestational weight gain for reducing hypertensive disorders of pregnancy among women with a pre-pregnancy BMI > 25 kg/m2 may facilitate personalized pre-conception counseling among women with obesity.
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Affiliation(s)
- Momoka Ito
- Department of Obstetrics and Gynecology, Ohta Nisinouchi Hospital, 2-5-20, Nishinouchi, Koriyama City 963-8558, Fukushima, Japan
| | - Hyo Kyozuka
- Department of Obstetrics and Gynecology, Ohta Nisinouchi Hospital, 2-5-20, Nishinouchi, Koriyama City 963-8558, Fukushima, Japan
| | - Tomoko Yamaguchi
- Department of Obstetrics and Gynecology, Ohta Nisinouchi Hospital, 2-5-20, Nishinouchi, Koriyama City 963-8558, Fukushima, Japan
| | - Misa Sugeno
- Department of Obstetrics and Gynecology, Ohta Nisinouchi Hospital, 2-5-20, Nishinouchi, Koriyama City 963-8558, Fukushima, Japan
| | - Tsuyoshi Murata
- Department of Obstetrics and Gynecology, Fukushima Medical University, 1, Hikarigaoka, Fukushima City 961-8141, Fukushima, Japan
| | - Tsuyoshi Hiraiwa
- Department of Obstetrics and Gynecology, Iwase General Hospital, 20, Kitamachi, Sukagawa City 962-8503, Fukushima, Japan
| | - Fumihiro Ito
- Department of Obstetrics and Gynecology, Ohta Nisinouchi Hospital, 2-5-20, Nishinouchi, Koriyama City 963-8558, Fukushima, Japan
| | - Daisuke Suzuki
- Department of Obstetrics and Gynecology, Ohta Nisinouchi Hospital, 2-5-20, Nishinouchi, Koriyama City 963-8558, Fukushima, Japan
| | - Toma Fukuda
- Department of Obstetrics and Gynecology, Fukushima Medical University, 1, Hikarigaoka, Fukushima City 961-8141, Fukushima, Japan
| | - Shun Yasuda
- Department of Obstetrics and Gynecology, Fukushima Medical University, 1, Hikarigaoka, Fukushima City 961-8141, Fukushima, Japan
| | - Keiya Fujimori
- Department of Obstetrics and Gynecology, Fukushima Medical University, 1, Hikarigaoka, Fukushima City 961-8141, Fukushima, Japan
| | - Yasuhisa Nomura
- Department of Obstetrics and Gynecology, Ohta Nisinouchi Hospital, 2-5-20, Nishinouchi, Koriyama City 963-8558, Fukushima, Japan
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Ramón-Arbués E, Granada-López JM, Martínez-Abadía B, Echániz-Serrano E, Sagarra-Romero L, Antón-Solanas I. Physical activity during pregnancy and its relationship with gestational weight gain. Rev Lat Am Enfermagem 2023; 31:e3875. [PMID: 36995855 PMCID: PMC10077864 DOI: 10.1590/1518-8345.6488.3875] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Accepted: 11/02/2022] [Indexed: 03/29/2023] Open
Abstract
OBJECTIVE to describe the physical activity patterns of a cohort comprised by pregnant women from our environment and to explore its association with weight gain in each of the trimesters of pregnancy. METHODS a descriptive and longitudinal study conducted with a sample of 151 women. The International Physical Activity Questionnaire was used to assess physical activity during pregnancy based on volume, intensity and setting where it is performed. Different multiple linear regression models were performed to analyze the association between physical activity and gestational weight gain. RESULTS physical activity decreased during pregnancy, both in terms of time and intensity. Pre-gestational Body Mass Index was the main factor associated with lower weight gain throughout pregnancy. The influence of physical activity on gestational weight gain was limited to the third trimester of pregnancy, where an inverse association was observed between both variables. CONCLUSION the results of this study show an important reduction in physical activity during pregnancy and suggest that it exerts a limited influence on gestational weight gain.
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Affiliation(s)
- Enrique Ramón-Arbués
- Universidad San Jorge, Facultad de Ciencias de la Salud, Villanueva de Gállego, Aragón, Espanha
- Grupo de investigación TRANSFERCULT (H27_20D), Zaragoza, Aragón, Espanha
| | - José Manuel Granada-López
- Universidad San Jorge, Facultad de Ciencias de la Salud, Villanueva de Gállego, Aragón, Espanha
- Universidad de Zaragoza, Facultad de Ciencias de la Salud, Zaragoza, Aragón, Espanha
- Grupo de investigación Seguridad y Cuidados (GIISA021), Zaragoza, Aragón, Espanha
| | - Blanca Martínez-Abadía
- Ayuntamiento de Zaragoza, Servicio de Prevención y Salud Laboral, Zaragoza, Aragón, Espanha
| | - Emmanuel Echániz-Serrano
- Grupo de investigación TRANSFERCULT (H27_20D), Zaragoza, Aragón, Espanha
- Universidad de Zaragoza, Facultad de Ciencias de la Salud, Zaragoza, Aragón, Espanha
| | - Lucía Sagarra-Romero
- Universidad San Jorge, Facultad de Ciencias de la Salud, Villanueva de Gállego, Aragón, Espanha
- Grupo de investigación GAIAS (S59_20D), Zaragoza, Aragón, Espanha
| | - Isabel Antón-Solanas
- Universidad de Zaragoza, Facultad de Ciencias de la Salud, Zaragoza, Aragón, Espanha
- Grupo de investigación GENIAPA (GIIS094), Zaragoza, Aragón, Espanha
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Kyozuka H, Hiraiwa T, Murata T, Sugeno M, Jin T, Ito F, Suzuki D, Nomura Y, Fukuda T, Yasuda S, Fujimori K. Gestational weight gain as a risk factor for dystocia during first delivery: a multicenter retrospective cohort study in Japan. BMC Pregnancy Childbirth 2022; 22:728. [PMID: 36151536 PMCID: PMC9503209 DOI: 10.1186/s12884-022-05055-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2022] [Accepted: 09/13/2022] [Indexed: 11/18/2022] Open
Abstract
Background Dystocia is a common obstetric complication among nulliparous women, which requires medical intervention and carries the risk of negative maternal and neonatal outcomes. Our aim was to examine the association between body mass index (BMI) and the occurrence of dystocia. We also identified cutoffs of gestational weight gain, based on pre-pregnancy BMI, associated with the risk of dystocia. Methods This was a multicenter, retrospective, cohort study conducted in two tertiary Maternal–Fetal medicine units in Fukushima, Japan. The study population included nullipara women who delivered at either of the two units between January 1, 2013, and December 31, 2020. Women (n = 2597) were categorized into six groups (G) based on their pre-pregnancy BMI: G1 (< 18.5 kg/m2), G2 (18.5 to < 20.0 kg/m2), G3 (20.0 to < 23.0 kg/m2), G4 (23.0 to < 25.0 kg/m2), G5 (25.0 to < 30.0 kg/m2), and G6 (≥ 30.0 kg/m2). Using G3 as a reference, multiple logistic regression analyses were performed to estimate the risk of dystocia for each BMI category. Receiver operating characteristic curve analyses were performed to determine the cutoff value of gestational weight gain for the risk of dystocia. Results The highest BMI category (G6) was an independent risk factor for dystocia (adjusted odds ratio, 3.0; 95% confidence interval, 1.5–5.8). The receiver operating characteristic curve analysis revealed no association between gestational weight gain and the occurrence of dystocia in G5 and G6 (P = 0.446 and P = 0.291, respectively). For G1 to G4, AUC and predictive cutoffs of gestational weight gain for dystocia were as follows: G1, AUC 0.64 and cutoff 11.5 kg (P < 0.05); G2, AUC 0.63 and cutoff 12.3 kg (P < 0.05); G3, AUC 0.67 and cutoff 14.3 kg (P < 0.01); and G4, AUC 0.63 and cutoff 11.5 kg (P < 0.05). Conclusion A pre-pregnancy BMI > 30.0 kg/m2 was an independent risk factor for dystocia. For women with a pre-pregnancy BMI < 25.0 kg/m2, the risk of dystocia increases as a function of gestational weight gain. These findings could inform personalized preconception care for women to optimize maternal and neonatal health.
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Affiliation(s)
- Hyo Kyozuka
- Department of Obstetrics and Gynecology, Ohta Nishinouchi Hospital, 2-5-20, Nishinouchi, Koriyama city, Fukushima, 963-8558, Japan. .,Department of Obstetrics and Gynecology, Fukushima Medical University School of Medicine, 1 Hikarigaoka, Fukushima, 960-1295, Japan.
| | - Tsuyoshi Hiraiwa
- Department of Obstetrics and Gynecology, Iwase General Hospital, 20, Kitamachi, Sukagawa city, Fukushima, 962-8503, Japan
| | - Tsuyoshi Murata
- Department of Obstetrics and Gynecology, Shirakawa Kosei General Hospital, Fukushima, 961-0005, Japan
| | - Misa Sugeno
- Department of Obstetrics and Gynecology, Ohta Nishinouchi Hospital, 2-5-20, Nishinouchi, Koriyama city, Fukushima, 963-8558, Japan
| | - Toki Jin
- Department of Obstetrics and Gynecology, Ohta Nishinouchi Hospital, 2-5-20, Nishinouchi, Koriyama city, Fukushima, 963-8558, Japan
| | - Fumihito Ito
- Department of Obstetrics and Gynecology, Ohta Nishinouchi Hospital, 2-5-20, Nishinouchi, Koriyama city, Fukushima, 963-8558, Japan
| | - Daisuke Suzuki
- Department of Obstetrics and Gynecology, Ohta Nishinouchi Hospital, 2-5-20, Nishinouchi, Koriyama city, Fukushima, 963-8558, Japan
| | - Yasuhisa Nomura
- Department of Obstetrics and Gynecology, Ohta Nishinouchi Hospital, 2-5-20, Nishinouchi, Koriyama city, Fukushima, 963-8558, Japan
| | - Toma Fukuda
- Department of Obstetrics and Gynecology, Fukushima Medical University School of Medicine, 1 Hikarigaoka, Fukushima, 960-1295, Japan
| | - Shun Yasuda
- Department of Obstetrics and Gynecology, Fukushima Medical University School of Medicine, 1 Hikarigaoka, Fukushima, 960-1295, Japan
| | - Keiya Fujimori
- Department of Obstetrics and Gynecology, Fukushima Medical University School of Medicine, 1 Hikarigaoka, Fukushima, 960-1295, Japan
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Gong X, Li J, Jiang Y, Yuan P, Chen L, Yang Y, Li Y, Sun M, Zhao Y, Shi H, Wei Y. Risk of preeclampsia by gestational weight gain in women with varied prepregnancy BMI: A retrospective cohort study. Front Endocrinol (Lausanne) 2022; 13:967102. [PMID: 36313754 PMCID: PMC9616116 DOI: 10.3389/fendo.2022.967102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/12/2022] [Accepted: 09/26/2022] [Indexed: 11/13/2022] Open
Abstract
INTRODUCTION Despite the important clinical significance, limited data on the joint contribution of prepregnancy body mass index (BMI) and gestational weight gain (GWG) to preeclampsia, the second leading cause of maternal mortality worldwide. This study aimed to estimate the risk of preeclampsia by GWG among women with varied prepregnancy BMI. METHODS We conducted a retrospective cohort study using data of 117 738 singleton pregnant women aged 18-49 years from 150 maternity hospitals in China between 2015 and 2018. GWG was calculated as the measured weight at the time of preeclampsia assessment minus prepregnancy weight; GWG velocity was calculated as the GWG divided by the gestational age at weighing. The non-linear associations of GWG with preeclampsia were examined by restricted cubic spline regression analysis according to prepregnancy BMI. The association of the GWG categories with preeclampsia was further examined by performing robust Poisson regression stratified by the prepregnancy BMI categories. RESULTS Among participants, 2426 (2.06%) were diagnosed with preeclampsia. Compared to women with normal BMI, those who were overweight and obese had 1.92- fold (95%CI, 1.73-2.14) and 5.06- fold (95%CI, 4.43-5.78) increased risks for preeclampsia, respectively. The association of GWG velocity with preeclampsia was presented as a J-shaped curve with the varied inflexion point (where the rate of preeclampsia was 2%), which was 0.54, 0.38, and 0.25 kg/week in women with normal BMI, overweight, and obesity, respectively; a steep risk rise was observed along with GWG velocity beyond the inflexion points. The overall adjusted relative risk for preeclampsia was calculated among women with the different GWG categories of GWG. CONCLUSIONS The findings highlight that high prepregnancy BMI and exceed GWG contributed to increased risk of preeclampsia with a superimposed effect and underscore the need to optimize the recommendations for GWG for women with different prepregnancy BMI.
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Affiliation(s)
- Xiaoli Gong
- Department of Obstetrics and Gynecology, Peking University Third Hospital, Beijing, China
- National Clinical Research Centre for Obstetrics and Gynecology, Beijing, China
| | - Jiaxin Li
- Department of Obstetrics and Gynecology, Peking University Third Hospital, Beijing, China
- National Clinical Research Centre for Obstetrics and Gynecology, Beijing, China
| | - Yuanhui Jiang
- Department of Obstetrics and Gynecology, Peking University Third Hospital, Beijing, China
- National Clinical Research Centre for Obstetrics and Gynecology, Beijing, China
| | - Pengbo Yuan
- Department of Obstetrics and Gynecology, Peking University Third Hospital, Beijing, China
- National Clinical Research Centre for Obstetrics and Gynecology, Beijing, China
| | - Lian Chen
- Department of Obstetrics and Gynecology, Peking University Third Hospital, Beijing, China
- National Clinical Research Centre for Obstetrics and Gynecology, Beijing, China
- National Centre for Healthcare Quality Management in Obstetrics, Beijing, China
| | - Yike Yang
- Department of Obstetrics and Gynecology, Peking University Third Hospital, Beijing, China
- National Clinical Research Centre for Obstetrics and Gynecology, Beijing, China
| | - You Li
- Department of Obstetrics and Gynecology, Peking University Third Hospital, Beijing, China
- National Clinical Research Centre for Obstetrics and Gynecology, Beijing, China
| | - Mengxing Sun
- Department of Obstetrics and Gynecology, Peking University Third Hospital, Beijing, China
- National Clinical Research Centre for Obstetrics and Gynecology, Beijing, China
| | - Yangyu Zhao
- Department of Obstetrics and Gynecology, Peking University Third Hospital, Beijing, China
- National Clinical Research Centre for Obstetrics and Gynecology, Beijing, China
- National Centre for Healthcare Quality Management in Obstetrics, Beijing, China
- *Correspondence: Yuan Wei, ; Huifeng Shi, ; Yangyu Zhao,
| | - Huifeng Shi
- Department of Obstetrics and Gynecology, Peking University Third Hospital, Beijing, China
- National Clinical Research Centre for Obstetrics and Gynecology, Beijing, China
- National Centre for Healthcare Quality Management in Obstetrics, Beijing, China
- *Correspondence: Yuan Wei, ; Huifeng Shi, ; Yangyu Zhao,
| | - Yuan Wei
- Department of Obstetrics and Gynecology, Peking University Third Hospital, Beijing, China
- National Clinical Research Centre for Obstetrics and Gynecology, Beijing, China
- National Centre for Healthcare Quality Management in Obstetrics, Beijing, China
- *Correspondence: Yuan Wei, ; Huifeng Shi, ; Yangyu Zhao,
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