Dr Hillary Hu1,2, Dr Monica Zen1,2, Associate Professor Vincent Lee3
1Obstetrics and Gynaecology Westmead Hospital, Westmead, Australia, 2Medicine, University of Sydney, Sydney, Australia, 3Department of Renal Medicine, Westmead & Blacktown Hospitals, Westmead, Australia
Biography:
Dr Hillary Hu is an Obstetrician Gynaecologist at Westmead Hospital. She studied Medicine at Western Sydney University graduating in 2013 and has completed a Masters of Medicine: Clinical Epidemiology from University of Sydney in 2015. She is a current PhD student with University of Sydney looking into eHealth and preeclampsia.
Abstract:
Aims: Preeclampsia has a significant negative impact on maternal and foetal health and occurs in 2-3% obstetric patients in Australia. Excessive gestational weight gain (eGWG) is defined as weight gain in excess of recommendations as per the Institute of Medicine guidelines based on the pre-pregnancy body mass index. Studies have found that eGWG increases the risk of preeclampsia.
Methods: We conducted a retrospective cohort study to investigate the patterns of gestational weight gain and relationship with the incidence of preeclampsia as well as trends in blood pressure at a tertiary hospital in Sydney, Australia.
Results: 20,081 women were included in the study. The incidence of preeclampsia was 2.26%. 43.57% of patients were overweight or obese prior to pregnancy. 58% of patients had eGWG. eGWG correlated with increased incidence of preeclampsia (2.82% n=313, p<0.01). eGWG was associated with increased incidence of caesarean section (34.42% vs 31.11% and 29.62%), instrumental deliveries (12.15% vs 11.79% and 9.84%) and postpartum haemorrhage (8.71% vs 6.98% and 5.96%) compared to adequate and insufficient GWG. eGWG was also associated with higher blood pressure. Pre-pregnancy overweight and obesity increased risk of excessive gestational weight gain as well as blood pressure and incidence of preeclampsia. The average starting and finishing weight was higher in the preeclampsia patients compared to background population (72.58kg vs 69.99kg and 85.69kg vs. 81.51kg).
Discussion: eGWG in pregnancy increases the risk of developing preeclampsia. Gestational weight gain is amenable to interventions and patients should be advised on the importance of healthy weight gain in pregnancy.
Keywords
gestational weight gain, preeclampsia, pregnancy