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Description
Background
Preeclampsia, a hypertensive disorder of pregnancy is well recognized for its mortality and morbidity rate in both mother and foetus. Globally, it affects about 5% of all pregnancies. This rate is slightly higher in developing countries (1.8-16.7%) such as Ghana. In clinical settings, it is classified as early onset preeclampsia (developed after 20 weeks but less than 34 weeks of gestation) and late onset preeclampsia (developed after 34 weeks of gestation). Although late onset preeclampsia is more prevalent, it is associated with less severe symptoms and outcomes. Available data provide information on the impact of preeclampsia on pregnancies but there is limited data on the association between pregestational BMI and gestational weight gain and their associations with adverse pregnancy outcomes in late onset preeclampsia women in Ghana. This study aimed to determine the association between pregestational body mass index and gestational weight gain and adverse pregnancy outcomes among late onset preeclampsia women.
Methodology
A retrospective case-control study conducted using maternal records of 161 pregnant women who attended Komfo Anokye Teaching Hospital from September 2023 to May 2024. We included participants with singleton pregnancies, nulliparous/multiparous and ≥34 weeks of gestation. All controls were normotensive. Adverse pregnancy outcomes included in the study are: stillbirth, preterm, foetal distress, asphyxia, maternal death, prolonged labour, placental previa, placental abruptio, HELLP syndrome, IUFD, PPROM, PPH. Descriptive statistics, Chi-square tests and binary logistic regression were performed using SPSS v27.0.
Results
57.7%, 28.8% and 13.5% of the control group gained inadequate, excess and adequate gestational weight respectively. Despite these findings, there was no significant association between pregestational BMI and gestational weight gain among the controls. Also, no adverse pregnancy outcome was recorded among our controls, thus no significant association between pregestational BMI and adverse pregnancy outcomes.
In the late onset preeclampsia group/cases, 52.3%, 26.6% and 20.2% gained excess, adequate and inadequate gestational weight respectively. Pregestational BMI was significantly associated (p<0.001) with gestational weight gain. Among the adverse outcomes studied, only placenta abruptio was associated with pregestational BMI (p=0.036). Binary logistic regression analysis to determine the predictors of gestational weight gain and placenta abruptio showed no significant results.
Conclusion
Pregestational BMI was significantly associated with the amount of gestational weight gain in the late onset preeclampsia group but plays minimal role in the development of adverse pregnancy outcomes.
Keywords: Preeclampsia, Pregestational BMI, Gestational weight gain