Obstetric complications among Chinese parturients with extreme prepregnancy ponderal indices

A multicentre study to investigate the prevalence of abnormal carbohydrate metabolism in Chinese pregnant women

OBJECTIVES

To determine the prevalence of abnormal carbohydrate metabolism in Chinese pregnant women. To study the inter-relationship between maternal body habitus, maternal serum glucose and birth weight of the baby.

METHODS

Multicentre observational study involving 713 pregnant Chinese women, attending antenatal clinics in Beijing, Shanghai, Guangzhou and Hong Kong.

RESULTS AND CONCLUSION

The overall prevalence of abnormal glucose tolerance was 6.9%. The prevalence was 6.8%, 5.5%, 7.2% and 8.1% in Beijing, Shanghai, Guangzhou and Hong Kong, respectively. The differences among the centres did not reach statistical significance (p = 0.9). The mean ponderal index of women with abnormal glucose tolerance was significantly higher than that of women with normal glucose tolerance (15.2 vs 14.3, p < 0.01). The birth weight ratio of the babies was positively correlated with the maternal height (correlation coefficient 0.23, 95% C.I. 0.15-0.30), weight (0.32, 95% C.I. 0.25-0.39) and to a lesser extent, the fasting level of serum glucose (0.10, 95% C.I. 0.02-0.28) but not with the 2 hour level of serum glucose.

Pregnancy hazards associated with low maternal body mass indices

Analysis of the obstetric records of 41,955 public patients with singleton pregnancies at the Mater Misericordiae Mothers' Hospital, South Brisbane, showed a significant association (increased odds ratio) between Low Maximum Pregnancy Maternal Body Mass Index (Quetelets Index 20-24.6 and maternal anaemia, the use of intravenous tocolysis, low birth-weight (< 1,500 g and < 2,500 g), low Apgar score (< 7 at 5 minutes) and perinatal mortality. Parturients with a Very Low Body Mass Index (Quetelets Index < 20) had even greater odds ratios in respect of the above obstetric hazards. Both the Low and Very Low Body Mass Index cohorts had significantly reduced risks of having hypertension (both essential and preeclamptic) or having their labours induced or augmented. The results are presented as odds ratios with confidence limits after controlling for the potentially confounding covariables of maternal age, parity, smoking habits and gestational age.