Initial Body Weight Gain as a Screening Tool to Adverse Pregnancy Outcome [23P]. (May 2018) - Lozovyy, Violetta
Abstract : INTRODUCTION: Pregnancy weight gain is known to increase the risk of gestational diabetes and preeclampsia which can lead to preterm delivery. Inter-pregnancy weight retention worsens this risk. We have identified percent of initial body weight (IBW) gain that has relationship to maternal hyperglycemia and is lower than diagnostic of GDM criteria leading to adverse neonatal outcome. METHODS: 227 mothers who had a delivery from June 2014 to July 2015 requiring entry into the neonatal hypoglycemia (NH) protocol for 24 hour monitoring after birth. Patients were excluded if collection of initial maternal weight was after 16 weeks GA as waiting any longer would be unreliable to approximate pre-gestational weight. Chi-square and t-tests were used to compare outcomes. RESULTS: Mothers with an initial BMI ≥25 who gained at least 15.3% ± 0.8% p=0.05 of their initial body weight throughout the pregnancy had normal GCT on initial screening. Additionally, there was a significant inverse correlation between weight gained during pregnancy and abnormal GCT. CONCLUSION: Early screening and intervention using 16±0.8% weight gain from initial maternal body weight could serve as a risk stratification tool along with glucose challenge (GCT) parameters. These women can be stratified early in the pregnancy course as having an increased risk for developing glucose intolerance and possibly neonatal hypoglycemia. Our findings suggest that overweight women are able to accommodate for greater changes in weight without affecting the GCT screening parameters, however not enough to prevent clinically significant neonatal hypoglycemia, therefore should be additionally subjected to glucose tolerance testing (GTT).