2016, Number 11
Gestational weight gain and perinatal outcomes: Study of a Spanish population and the effect of Assisted Reproduction Techniques
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ABSTRACTObjetive: To compare perinatal outcomes according to gestational weight gain (GWG) and differentiate the rate of spontaneous and assisted reproduction patients.
Material and Method: Observational descriptive retrospective study. This is a review of perinatal outcomes of spontaneous and assisted reproduction pregnancies in a private institution. Those women who had a pre-existent condition that could represent an adverse outcome were excluded. The same was established with twin or multiple pregnancies. 860 cases were included. Patients were classified into three groups: Group 1, GWG below the Institute of Medicine (IOM) recommendations (Group 1); Group 2, GWG within IOM recommendations (=rIOM); and Group 3, GWG above IOM recommendations (›rIOM). Statistical difference is defined as a value of ‹0.05 after applying Anova or the chi square test, accordingly.
Results: We observed a statistically significant difference between the rate of patients who presented gestational hypertension (26.28% vs. 3.55 and 4.21%, ›rIOM, ‹rIOM and =rIOM respectively), preeclampsia (23.07% vs. 0.79 and 0.88%, ›rIOM, ‹rIOM and =rIOM respectively), gestational diabetes (55.76% vs. 7.50 and 16.62%, ›rIOM, ‹rIOM and =rIOM respectively) and obstetric bleeding (23.71% vs. 7.50 y 7.98%, ›rIOM, ‹rIOM and =rIOM respectively) favouring the ›rIOM Group (p‹0.001). C-section rate was higher in groups ›rIOM (66.66%) and ‹rIOM (34.38%) than in those patients within ideal range (6.20%) (p‹0.001). Out of range groups had higher rates of new-borns who needed intensive care unit care than those patients who were within ideal weight gain range (24.90% for ‹rIOM and 19.23 for ›rIOM vs 0.44% Group =rIOM)(p‹0.001). GWG ›rIOM has an adjusted odds ratio (aOR) of 2.1 (95%CI 1.5-2.6) with having a poor perinatal outcome (PPO). Age, smoking and assisted reproduction techniques do not present an association with PPO in a multivariable logistic regression model (aOR 1.1 95%CI 0.69-1.8; aOR 0.9 95%CI 0.5-1.4; aOR 0.6 95%CI 0.3-1.1, respectively).
Conclusions: Excessive weight gain or an inadequate weight gain in pregnancy, result in poor perinatal outcomes to both, the mother and the fetus. Assisted reproduction technique patients may have a better preconceptional care that offers advantages in terms of nutritional and weight status.
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