Maternal Weight Gain and its Relationship with Birth Weight of Baby at Term

Abstract

Background: Perinatal health is influenced by maternal weight gain. Increase in obesity in population and excess weight during pregnancy may be different complications including large for gestational age fetus. As a result cesarean delivery has increased in prevalence. Maternal weight gain during the 2nd and 3rd trimesters is an important determinant of fetal growth Objective: To determine the relationship between maternal weight gain and birth weight of baby at term. Methodology : A cross sectional study was carried among 50 pregnant women at term in the Department of Obstetrics and Gynaecology, Shaheed Suhrawardy Medical College and Hospital and Anwer Khan Modern Medical College Hospital during the period of January 2013 to July 2013. Data were collected in pre-designed data collection sheet. Results: This study found maximum (36%) were age group 21-25 years followed by 28% were ≤20 years, 24% were between 26-30 years, 8% were between 31-35 years and only 4% were of 36-40 years. The average age was 25 years. Among these 50 pregnant women, 2 cases (4%) had BMI < 18.5, 15 cases (30%) had a BMI 18.5-24.9, 19 cases (38%) had a BMI 25-29.9 and 14 cases (28%) had a BMI ≥30. The mean birth weight was 2.77±0.33. kg. Mean weight gain was 10.72±3.72 Kg. Conclusion: This study showed that reasonable maternal weight gain significantly increased birth weight of the baby at term. Key word: Maternal weight gain in pregnancy, Birth weight of baby 1. Registrar Dept. of Obstetrics and Gynecology, Anwer Khan Modern Medical College Hospital 2. Assistant Professor, Dept. of Obstetrics and Gynecology, Anwer Khan Modern Medical College hospital 3. Head, Dept. of Obstetrics and Gynecology, Shaheed Suhrawardy Medical College and Hospital 4. Head Dept. of Obstetrics and Gynecology, Anwer Khan Modern Medical College Hospital 5. Registrar, Dept. of Obstetrics and Gynecology Delta Medical College Hospital Address of Correspondence: Dr. Shiffin Rijvi, Registrar Dept of obstetrics and gynecology Anwer Khan Modern Medical College Hospital Bangladesh J Obstet Gynaecol, 2017; Vol. 32(2): 79-83 Maternal Weight Gain and its Relationship with Birth Weight of Baby at Term Shiffin Rijvi et al. 80 underweight (BMI less than 19.8 kg/m2), normal weight (19.8 –26.0 kg/m2), overweight (26.1–29.0 kg/m2), and obese women (BMI more than 29.0 kg/ m2).2 Weight gain during pregnancy has been associated with high birth weight and measures of adiposity early in life. Because high birth weight predicts BMI later in life, these findings suggest that excessive weight gain during pregnancy could raise the long-term risk of obesity-related disease in offspring. High birth weight might also increase risk of other diseases later in life, including asthma, atopy, and cancer.3 Low weight gain in pregnancy is associated with increased risk of preterm delivery, particularly if women are underweight or of average weight before pregnancy. But still there is increasing evidence that higher weight gains during pregnancy do not improve infant outcomes and instead may elevate the mothers’ long-term risk of chronic disease.4 Nahar et al. found that mean birth weight of infant increased by 20.2g per kilogram of weight gain during pregnancy.5 Birth weight was correlated both with maternal weight in early pregnancy and with weight gain during pregnancy, but only 10% of the variation in birth weight was explained by these maternal factors. Mean maternal weight 24 h postpartum was equal to the weight at 14 weeks of pregnancy, implying, on the average, no net weight gain. Women with a positive net weight gain had heavier babies than women with a negative net weight gain. Maternal anthropometric characteristics are important underlying determinants of intrauterine growth and birth weight, but they explain only a minor part of the variation and are of little value for screening purposes in individual women.6 Maternal weight gain is one of the most important independent predictors of infant birth weight. Birth weight (BW) is an important determinant of infant’s well being. Several factors such as mothers’ genetic characteristics, socio-cultural, demographic, behavioural factors, prepregnancy body mass index (BMI), gestational weight gain (GWG) etc contribute to birth weight. BW is important as low birth weight is known to increase the risk of adult onset diseases like type -2 diabetes and ischemic heart disease.7 Nevertheless, maternal weight gain is associated with large infants i.e., macrosomia (>4000 g) or large for gestational age infants who have higher risk of birth injuries and other problems like shoulder dystocia, fractures of the clavicles or limbs, and perinatal asphyxia. The total amount of weight gained in normalterm pregnancies varies considerably among women and the variance appears to be due to many maternal characteristics and pregnancy outcomes.8 Weight gain during pregnancy has always been a matter of great concern for most women and obstetricians. This concern exists because gestational weight gain is related to many complications, both maternal and fetal. Macrosomia is a major fetal complication, consisting of cases of infants born weighing more than 4,000 g, regardless of the gestational age.9 This higher weight is associated with complications for both the mother and the child. The most common complications in macrosomic fetuses include: increased risk of intrauterine death, hypertrophic cardiomyopathy, need for intensive care, shoulder dystocia, humeral and clavicle fractures, meconium aspiration, hypoglycemia, neonatal hyperbilirubinemia, paralysis of the facial and brachial plexus and obesity in childhood and adulthood.10,11 For mothers, the most common complications include: increased risk of cesarean section, cephalopelvic disproportion, prolonged labor, soft-tissue lacerations and postpartum hemorrhage.1 The present study was designed to determine the relationship between maternal weight gain and birth weight of new born at term. Materials And Methods: A cross sectional study was undertaken in department of Obstetrics and Gynaecology, Shaheed Suhrawardy Medical College and Hospital and Anwer Khan Modern Medical College Hospital during the period of January 2013 to July 2013. Fifty pregnant women were included in study. Healthy pregnant women at term who were in regular antenatal checkup (37 completed weeks of gestational age) were included in this study. Pregnant women suffering from hypertension, pre-eclampsia, eclampsia, diabetes mellitus, thyroid dysfunction, nephritis were excluded from study. Data were collected in pre-designed data collection sheet. A structured questionnaire was developed and pre-teste before administration by the author. Data was collected from the pregnant mother admitted in the in-patient department for a period of 6 months. The data were collected by face to face interview for Bangladesh J Obstet Gynaecol Vol. 32, No. 2 81 relevant information and measured the weight and height of the women before delivery and weight of the neonate were measured following delivery. Mothers weight was measured by a valid & reliable weighing machine. Mother’s height was measured with a height measuring scale. A valid and reliable neonatal weighing machine determined the neonatal weight. Written informed consent was taken from each patient. Prior to consent they were explained the aim and purpose of the research. Confidentiality and anonymity was maintained..