Pregnancy Outcome in Undernutrition Mothers: A Multicenter Retrospective Cohort Study
Keywords:
pregnancy, under body mass index, complication, retrospective cohort studyAbstract
Objective: To study the percentage of pregnancy with undernutrition (body mass index, BMI < 18.5 kg/m2), compare the complications between undernutrition and normal groups and define the optimum cut-point of undernutrition that affect the pregnancy complications in Thai women.
Materials and Methods: A multicenter retrospective cohort study in the pregnant women in UdonThani, AngThong, Ban Phue, Ban Dung and Phen Hospitals. The percentage of under BMI group was studied. The maternal and neonatal complications were compared between undernutrition and normal groups using multiple logistic regression analysis. Then each kg/m2 of BMI that less than 21.5 kg/m2 were compared with 21.5-23 kg/m2 group to define the low BMI that increased the pregnancy complications.
Results: From a total 24,068 deliveries, 4,056 cases (16.85 % (95% confidence interval (CI) 16.38 – 17.33)) of undernutrition pregnant women were found. In the undernutrition group, 45.17% had at least one pregnancy complication (adjusted odds ratio (AOR) 1.34 , 95% CI 1.24-1.45). The risk of anemia, small for gestational age, preterm birth and low birthweight under 2,500 g infant were increased significantly in the undernutrition group. The AOR and 95%CI were 1.48 (1.33-1.64), 1.98 (1.78-2.21), 1.12 (1.01-1.26), and 1.54 (1.39-1.71) respectively. The complication risk was increased in case of BMI < 19.5 kg/m2 ( AOR 1.17, 95% CI 1.05-1.32).
Conclusion: From this study’s data, the maternal undernutrition rate was 16.85%. The recommended cut-off BMI for undernutrition diagnosis was 19.5 kg/m2. This group has the risk for anemia, small for gestational age, low birthweight under 2,500 g and preterm birth, therefore the nutritional advice, surveillance and early treatment of complications were important in this maternal group.
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