CLINICAL FEATURES OF PREGNANCY COURSE AND OUTCOMES IN WOMEN WITH OBESITY AND EXCESSIVE WEIGHT GAIN DURING PREGNANCY


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Abstract

Objective. To show the impact of excessive weight gain (WG) on the course of pregnancy, labor, and postpartum period in normal-weight, overweight, and obese patients. Subject and methods. The investigation enrolled 170 patients: Group 1 included 46 women with normal weight and overweight (body mass index (BMI) 18.5-29.9 kg/m 2) and normal WG (11.5-16 kgfor normal weight; 7.0-11.5 kg for overweight) during pregnancy; Group 2 consisted of 52 women with a BMI of 18.5-29.9 kg/m 2 and excessive WG (>16 kg for normal weight and >11.5 kg for overweight) during pregnancy; Group 3 comprised 30 patients with pre-pregnancy obesity (BMI > 30 kg/m 2) and normal WG (from 5 to 9 kg) during pregnancy; Group 4 included 42 pregnant women with obesity (BMI >30 kg/m 2) and excessive WG (>9 kg). Results. Pregnancy in the women who are obese is much more often complicated by gestational diabetes mellitus than in those with normal-weight and overweight and the concurrence of obesity and excessive WG substantially increases the risk of moderate preeclampsia and the birth of a big baby. The postpartum period in the obese patients is more frequently accompanied by complications; among which endometritis and disseminated intravascular coagulation are most common. Lactation disorders most commonly accompany the postpartum period in the group of obese and overweight pregnant women. Conclusion. Obese pregnant women belong to a group at high risk for pregnancy, labor, and postpartum complications. The incidence and magnitude of the complications depends not only on the baseline obesity, but also on excessive pregnancy WG. In pregnant women with baseline normal weight or overweight and excessive WG, the complications of pregnancy, labor, and postpartum occur significantly more rarely than in those with baseline obesity and excessive WG.

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About the authors

Irina V. Timoshina

Research Center of Obstetrics, Gynecology, and Perinatology, Ministry of Health of Russia

Email: i_timoshina@oparina4.ru
researcher of the 1st obstetric department of pathology of pregnancy 117997, Russia, Moscow, Ac. Oparina str. 4

Larisa M. Komissarova

"Generation Next" Russian-German Center for Reproduction and Clinical Immunology

Email: komissarov.maks@ro.ru
Professor, MD, obstetrician-gynecologist 109544, Russia, Moscow, Shkolnaya str. 40-42

Leila A. Timofeyeva

Research Center of Obstetrics, Gynecology, and Perinatology, Ministry of Health of Russia

head of the Department of newborn 117997, Russia, Moscow, Ac. Oparina str. 4

Natalia A. Ilyasova

Research Center of Obstetrics, Gynecology, and Perinatology, Ministry of Health of Russia

Email: n_ilyasova@oparina4.ru
researcher at the Department of scientific planning and audit 117997, Russia, Moscow, Ac. Oparina str. 4

Vladimir A. Burlev

Research Center of Obstetrics, Gynecology, and Perinatology, Ministry of Health of Russia

Email: v_burlev@oparina4.ru
MD, Professor, Chief Researcher 117997, Russia, Moscow, Ac. Oparina str. 4

Zulfiya S. Khodjaeva

Research Center of Obstetrics, Gynecology, and Perinatology, Ministry of Health of Russia

Email: z_khodzhaeva@oparina4.ru
MD, professor, main researcher of the 1st obstetric department of pathology of pregnancy 117997, Russia, Moscow, Ac. Oparina str. 4

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