Journal List > J Korean Acad Nurs > v.42(4) > 1002832

Kim, Shin, Park, Yang, Lee, and Ryu: Impact of Prepregnancy Body Mass Index on Pregnancy Outcome in Women with a Singleton Conceived by Assisted Reproductive Technology and Spontaneously Conceived Pregnancy: A Case-Control Study

Abstract

Purpose

To compare and confirm the impact of prepregnancy body mass index on pregnancy outcome in women with a singleton conceived by assisted reproductive technology and spontaneously conceived pregnancy.

Methods

A sample of 165 and 247 pregnant women with and without assisted reproductive technology were retrospectively recruited from electronic medical charts of C hospital.

Results

There were significant differences between the two groups for maternal age, paternal age, length of marriage, prepregnancy body mass index, parity, spontaneous abortion experience, and preterm delivery. A prepregnancy body mass index of ≥25 was associated with higher risk for maternal and neonatal complication in the assisted reproductive technology group.

Conclusion

The results indicate that a higher prepregnancy body mass index is associated with increased risks for adverse pregnancy outcomes for women using assisted reproductive technology. So these women need appropriate care to compensate for the risk.

References

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Table 1.
Characteristics and Pregnancy Outcomes of Pregnant Women with and without ART (N =412)
Variables Characteristics Categories ART group (n=165)
Natural group (n=247)
χ2 p
n (%) n (%)
General and obstetric characteristics Age (yr) < 35 67 (40.6) 141 (57.1) 10.75 .001
≥35 98 (59.4) 106 (42.9)
Husbands' age (yr) < 35 40 (24.2) 92 (37.2) 7.68 .007
≥35 125 (75.8) 155 (62.8)
Employment Yes 66 (40.7) 110 (44.7) 0.63 .475
No 96 (59.3) 136 (55.3)
Length of marriage (yr) < 3 32 (19.4) 95 (38.5) 16.87 < .001
≥3 133 (80.6) 152 (61.5)
PBMI < 25 132 (80.0) 223 (90.3) 8.78 .004
≥25 33 (20.0) 24 (9.7)
GWG (kg) Normal range 95 (57.6) 129 (52.2) 1.14 .167
Abnormal range 70 (42.4) 118 (47.8)
Parity Primipara 85 (51.5) 66 (26.7) 26.19 < .001
Multipara 80 (48.5) 181 (73.3)
Spontaneous abortion Yes 44 (26.7) 124 (50.2) 22.69 < .001
 experience No 121 (73.3) 123 (49.8)
Artificial abortion Yes 34 (20.4) 49 (19.8) 0.04 .900
  experience No 131 (79.4) 198 (80.2)
Maternal outcomes Maternal complication Yes 24 (14.5) 28 (11.3) 0.92 .365
No 141 (85.5) 219 (88.7)
Preterm delivery Yes 24 (14.5) 13 (5.3) 10.43 .001
No 141 (85.5) 234 (94.7)
Delivery method NSVD 78 (47.3) 140 (56.7) 3.51 .070
C/S 87 (52.7) 107 (43.3)
Neonatal outcomes Neonatal birth weight (g) Abnormal 19 (11.5) 23 (9.3) 0.53 .508
Normal 146 (88.5) 224 (90.7)
Neonatal complication Yes 9 (5.5) 5 (2.0) 3.55 .093
No 156 (94.5) 242 (98.0)

ART=Artificial reproduction technology; PBMI=Prepregnancy body mass index; GWG=Gestational weight gain; NSVD=Nomal spontaneous vaginal delivery.

Table 2.
Characteristics and Pregnancy Outcomes of Pregnant Women with and without ART according to PBMI
Variables Characteristics Categories PBMI in ART group
χ2 p PBMI in natural group
χ2 p
< 25 (n=132)
≥25 (n=33)
< 25 (n=223)
≥25 (n=24)
n (%) n (%) n (%) n (%)
General and obstetric characteristics Age (yr) < 35 53 (40.2) 14 (42.4) 0.06 .845 132 (59.2) 9 (37.5) 4.16 .035
≥35 79 (59.8) 19 (57.6) 91 (40.8) 15 (62.5)
Employment Yes 77 (58.3) 22 (66.7) 0.76 .431 122 (55.0) 14 (58.3) 0.10 .831
No 55 (41.7) 11 (33.3) 100 (45.0) 10 (41.7)
GWG (kg) Normal 81 (61.4) 14 (42.4) 3.88 .039 115 (51.6) 14 (58.3) 0.40 .668
Abnormal 51 (38.6) 19 (57.6) 108 (48.4) 10 (41.7)
Parity Primipara* 69 (52.3) 16 (48.5) 0.15 .703 65 (29.1) 1 (1.5) 6.91 .007
Multipara 63 (47.7) 17 (51.5) 158 (70.9) 23 (95.8)
Spontaneous abortion Yes 33 (25.0) 11 (33.3) 0.94 .380 108 (48.4) 16 (66.7) 2.88 .131
 experience No 99 (75.0) 22 (66.7) 115 (51.6) 8 (33.3)
Artificial abortion Yes 25 (18.9) 9 (27.3) 1.12 .336 41 (18.4) 8 (33.3) 3.04 .104
experience No 107 (81.1) 24 (72.7) 182 (81.6) 16 (66.7)
Maternal outcomes Maternal complication Yes* 14 (10.6) 10 (30.3) 8.24 .010 25 (11.2) 3 (12.5) 0.04 .742
No 118 (89.4) 23 (69.7) 198 (88.8) 21 (87.5)
Preterm delivery Yes* 20 (15.2) 4 (12.1) 0.20 .788 10 (4.5) 3 (12.5) 2.79 .120
No 112 (84.8) 29 (87.9) 213 (95.5) 21 (87.5)
Delivery method NSVD 64 (48.5) 14 (42.4) 0.39 .564 127 (57.0) 13 (54.2) 0.07 .832
C/S 68 (51.5) 19 (57.6) 96 (43.0) 11 (45.8)
Neonatal outcomes Neonatal complication Yes* 5 (3.8) 4 (12.1) 3.56 .080 4 (1.8) 1 (4.2) 0.62 .403
No 127 (96.2) 29 (87.9) 219 (98.2) 23 (95.8)
Neonatal birth weight Abnormal* 16 (12.1) 3 (9.1) 0.24 .768 19 (8.5) 4 (16.7) 1.70 .255
Normal 116 (87.9) 30 (90.9) 204 (91.5) 20 (83.3)

ART=Artificial reproduction technology; PBMI=Prepregnancy body mass index; GWG=Gestational weight gain; NSVD=Nomal spontaneous vaginal delivery.

* Fisher's exact test.

Table 3.
Odds Ratio for Associations between PBMI and Pregnancy Outcomes
Variable PBMI in ART group
PBMI in natural group
Crude OR 95% CI p Adjusted OR 95% CI p Crude OR 95% CI p Adjusted OR 95% CI p
Maternal complication 4.72 1.65-13.50 .004 4.29 1.47-12.57 .008 1.05 0.28-3.94 .945 0.95 0.24-3.80 .942
Preterm delivery 0.31 0.06-1.45 .137 0.34 0.07-1.69 .188 2.53 0.54-11.82 .238 3.53 0.64-19.45 .147
Cesarean section 1.39 0.62-3.13 .426 0.75 0.32-1.74 .499 1.01 0.43-2.42 .977 1.13 0.46-2.78 .786
Neonatal complication 4.60 0.94-22.50 .059 5.40 1.04-28.17 .045 2.46 0.25-24.28 .441 2.02 0.19-21.70 .561
Abnormal birth weight 1.70 0.37-7.89 .499 2.19 0.41-11.79 .360 0.65 0.17-2.51 .534 0.65 0.15-2.84 .568

OR=Odds ratio; CI=Confidence interval; PBMI=Prepregnancy body mass index; Pregnancy BMI< 25 served as the reference group. Adjusted for age, GWG, parity, and spontaneous abortion experience.

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