ความสัมพันธ์และค่าจุดตัดที่เหมาะสมของดัชนีมวลกายก่อนตั้งครรภ์และการเพิ่มน้ำหนักกับภาวะแทรกซ้อนในหญิงตั้งครรภ์และทารกในโรงพยาบาลพระนารายณ์มหาราช

Phornphan  Phukiatkong

Authors

Phornphan Phukiatkong โรงพยาบาลพระนารายณ์มหาราช

Keywords:

Maternal complications, Neonatal complications, Gestational weight gain

Abstract

Objective: This study aimed to investigate the associations, and optimal cut-off values of pre-pregnancy body mass index (BMI) and gestational weight gain (GWG) with maternal and neonatal complications.

Method: A retrospective cohort study design was applied, using medical records of pregnant women who delivered at King Narai Hospital between January and December 2024.

Results: A total of 469 women were included. The prevalence of gestational diabetes mellitus (GDM) and emergency cesarean section was 9.2% and 14.3%, respectively. The most common neonatal complications were transient tachypnea of the newborn (13.4%), neonatal intensive care unit (NICU) admission (13.0%), and neonatal jaundice (11.9%). Based on ROC curve analysis, pre-pregnancy BMI ≥24.4 kilograms per square meter was significantly associated with increased risks of GDM, emergency cesarean section, and overall maternal complications (p-value <0.01). Furthermore, BMI ≥26.9 kilograms per square meter was predictive of preeclampsia (AUC=0.79, p-value <0.01), and BMI ≥26.0 kilograms per square meter was predictive of gestational hypertension (AUC=0.84, p-value =0.04). In neonates, a pre-pregnancy BMI ≥26.9 kilograms per square meter was significantly associated with oligohydramnios (p-value =0.01), meconium-stained amniotic fluid (p-value =0.01), neonatal hypoglycemia (p-value =0.01), neonatal jaundice (p-value <0.01), NICU admission (p-value =0.01), respiratory distress syndrome (p-value <0.01), and macrosomia (BMI cut-off ≥28.6 kilograms per square meter, AUC=0.74, p-value <0.01). Moreover, GWG ≥12.9 kilograms was significantly associated with overall neonatal complications (p-value =0.03).

Conclusions: The current cut-off values for pre-pregnancy BMI and GWG should be reconsidered and adjusted for the Thai population. Developing population-specific guidelines would improve risk screening accuracy, reduce pregnancy-related complications, enhance maternal and neonatal safety, and strengthen maternal and child health services in Thailand.

Keywords: Maternal complications, Neonatal complications, Gestational weight gain

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