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Would Gestational Weight Gain Effect the Durations of Labor Stages?
Abstract Number: F3D-538
Abstract Type: Original Research
Body mass index (BMI) and Gestational Weight Gain (GWG) of pregnant women are increasing globally. The Institute of Medicine (IOM) provided specific recommendations regarding the ideal GWG. GWG greater than or less than guideline recommendations were associated with higher risk of adverse maternal and perinatal outcomes. However, the association between GWG and duration of labor stage is unclear. We performed a retrospective study to elaborate the effect.
Of 1,994 parturients who delivered vaginally successfully from 1/1/2017 to 12/31/2017 at the Brigham and Women’s Hospital (BWH), demographical data, labor stage durations, prepregnancy BMI (PPBMI), and GWG were collected. According to IOM recommendations, parturients were divided into below, within and above guideline groups. We analyzed the GWG and its correlation to age, height, weight, PPBMI, gestational age, birth weight and baby sex. The influence of GWG on the subgroup of 1,005 nulliparous women’s labor stage durations were also analyzed.
The average GWG was 13.8±13.2 kg. GWG was positively correlated with height, weight, gestational age, birth weight and baby sex (male vs female), but negatively correlated with the PPBMI (P < 0.01). Distribution of below, within and above groups of GWG in all of factors was different significantly. (Table 1) In nulliparous women with normal PPBMI (18.5 – 24.9 km/m2), above recommended GWG was significantly associated with longer duration of the first stage labor (P=0.017). There was no effect of GWG on the durations of second and third stages.
GWG is an important indicator in the antenatal management of pregnancy. Our data indicated that 31.8% of the parturients with appropriate GWG per IOM recommendation. Our data implied that the following factors of parturients and neonates could be associated with higher possibility of above normal range GWG, which included mother’s weight ≥ 90 kg, age < 25 years, height ≥ 170cm, PPBMI ≥ 25 km/m2, gestational age ≥ 40 weeks, baby birth weight ≥ 4000g, or male gender of baby. While GWG had little effect on labor duration, extra care should always be directed towards parturients with high risk factors according to the Development Origins of Health and Disease (DoHaD) hypothesis.
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