Influence of Excessive Weight Gain on Maternal and Perinatal Morbidity and Mortality in a University Hospital Environment in Cotono

Abstract

Introduction: The pathologies associated with excessive weight gain during pregnancy are numerous and frequent. They are the cause of significant maternal and perinatal morbidity and mortality and thus pose a real public health problem. Patients and method: The main objective of our work was to study the influence of excessive weight gain on maternal and perinatal morbidity and mortality in a university hospital in Cotonou. Study method: The study took place at the CUGO. This was a descriptive and analytical study with retrospective data collection over a period of 10 years from January 1, 2012 to December 31, 2021. The analysis focused on the description of pregnant women and the search for factors associated with an excessive weight gain during pregnancy and which influence maternal and perinatal prognosis. The different odds ratios and their confidence intervals were calculated. The significance level was 5%. Results: A total of 690 pregnant women were included and divided into four sub-populations according to their pre-gestational or first trimester BMI: 05.94% underweight pregnant women, 41.74% normal BMI pregnant women, 28.55% of overweight pregnant women and 23.77% obese pregnant women. The average age of pregnant women was 30.41 years ± 5.40 years. They were civil servants (35.80%) and resided in Cotonou in 93.91% of cases. Pregnant women had a history of hypertension in nearly 3% of cases. Pregnancy hypertension (07.97%) was the main pathology associated with pregnancy in our study. Weight gain was excessive in overweight pregnant women and obese pregnant women in the same proportion 41.12%. The average weight gain was 9.42 kg for underweight pregnant women, 8.35 kg for pregnant women with a normal BMI, 8.46 kg for overweight pregnant women and 7.45 kg for obese pregnant women. Pregnant women who had gained excessive weight during pregnancy had a 9 times higher risk of having pregnancy-induced hypertension (OR = 9.5 and p ≤ 0.0001). They also presented a 6 times higher risk of having pre-eclampsia (OR = 6.6; p ≤ 0.0001). The risk of gestational diabetes is also high (OR = 3.82; p ≤ 0.0001). There is also a risk of macrosomia (OR = 3.33 and p = 0.007) and the risk of cesarean delivery 2 times higher: OR = 2.15 and p = 0.0004. There was no statistically significant link between excessive weight gain and term at delivery, the condition of the newborn at birth, and neonatal mortality. Conclusion: Excessive weight gain during pregnancy in our study was assessed in several pregnant women with a high prevalence. It is the source of several maternal and fetal complications.