The maternal mortality rate is an important indicator to determine the degree of public health in a country. One of the biggest factors causing maternal mortality is preeclampsia. Worldwide, the incidence of preeclampsia ranges between 2% and 10% of pregnancies. World Health Organization estimates the incidence of preeclampsia to be seven times higher in developing countries (2.8% of live birth) than in developed countries (0.4%). The cause of preeclampsia is uncertain, but recent evidence suggests that excessive gestational weight gain and elevated pre-pregnancy body mass index (BMI) may be the important factors. Many studies have shown a variety of results about this topic, but a meta-analysis is needed to get a clearer understanding of it.
The systematic review-meta-analysis showed that there is a relationship between pre-pregnancy BMI, gestational weight gain, and the risk of preeclampsia. Underweight body mass index (BMI) is a protective factor against the incidence of preeclampsia because it reduces the risk of developing preeclampsia compared to the normal body mass index (BMI). On the other hand, the overweight and obese body mass index (BMI) category increases the risk many times greater. In people with obesity, not only the amount of fat, but the distribution of fat is also very important. Central obesity as a marker of visceral obesity has a higher risk of preeclampsia as compared with peripheral obesity. Visceral fat produces more C-reactive protein and inflammatory cytokines, resulting in more oxidative stress. Antioxidant levels in people with obesity are relatively low which is likely due to the low consumption of foods that contain antioxidants and high consumption of carbohydrates and fats.
From the results of the meta-analysis, it can be concluded that pregnant women who experience weight gain above the recommendations have almost a 2-fold risk of developing preeclampsia. Excessive gestational weight gain’s causes are often multifactorial and complex, such as low incomes, the unbalanced composition of diet, less physical activity, psychosocial factors such as stress, depression, and lack of social support are also associated with excessive weight gain in pregnancy. Weight gain in pregnancy is normal, but gaining more or less than the standard recommendation can lead to maternal-fetal and neonatal complications.
Author: Muhammad Ilham Aldika Akbar
Details of the article can be viewed:
https://www.apjr.net/temp/AsianPacJReprod1011-1326586_034105.pdf
Renata Alya Ulhaq, Wahyul Anis, Widati Fatmaningrum, Muhammad Ilham Aldika Akbar. 2021, Association between pre-pregnancy body mass index and gestational weight gain and the risk of preeclampsia: A systematic review and meta-analysis.
