Jin Long,* Zhou Chu,* Yanfang Xiao, Chanjuan Chen, Juan Zhang, Xiuying Yi, Fei Liu, Guohong Hu

Department of Pediatrics, Zhuzhou Hospital Affiliated to Xiangya School of Medicine, Central South University, Zhuzhou, Hunan, 412007, People’s Republic of China

*These authors contributed equally to this work

Correspondence: Guohong Hu, Department of Pediatrics, Zhuzhou Hospital Affiliated to Xiangya School of Medicine, Central South University, Zhuzhou, Hunan, 412007, People’s Republic of China, Email 290171219@qq.com

Objective: To assess impacts of pre-pregnancy BMI and gestational weight gain (GWG) on pregnancy complications and outcomes.
Methods: This retrospective study analyzed 2488 pregnant women from Zhuzhou Central Hospital (2022). Participants were categorized by pre-pregnancy BMI (underweight, normal, overweight, obese) and GWG (insufficient, appropriate, excessive). Multivariate logistic regression evaluated associations with outcomes, adjusting for confounders.
Results: Significant differences existed across BMI groups for age, parity, gestational diabetes (GDM), gestational hypertension (GHT), preterm birth, birth weight, cord entanglement, and delivery mode (all p< 0.05). GWG significantly associated with age, parity, GDM, GHT, preterm birth, birth weight, and delivery mode (all p< 0.05). After adjustment: Pre-pregnancy BMI: Underweight women had higher risks of preterm birth (OR=3.14, 95% CI:1.37– 7.23) and GDM (OR=2.94, 95% CI:1.60– 5.39). Overweight women had higher risks of GDM (OR=5.62, 95% CI:2.86– 11.06) and GHT (OR=9.49, 95% CI:4.17– 21.60). GWG: Insufficient gain increased risks of cesarean delivery (OR=1.48), low birth weight (LBW; OR=2.30), and macrosomia (OR=2.82). Excessive gain increased risks of preterm birth (OR=2.36), GDM (OR=1.52), GHT (OR=1.61), cesarean delivery (OR=1.57), LBW (OR=3.70), and macrosomia (OR=5.39) (all p< 0.05 unless specified). Notably, obesity showed no significant associations. Maternal age ≥ 35 years independently increased preterm birth risk (OR=1.58), while high parity (≥ 3) was protective (OR=0.75).
Conclusion: Pre-pregnancy BMI and GWG significantly influence pregnancy complications and neonatal outcomes. Proper weight management may improve outcomes.

Keywords: pre-pregnancy body mass index, gestational weight gain, pregnancy complications, pregnancy outcomes