| Summary: | 碩士 === 輔英科技大學 === 保健營養系碩士班 === 103 === Objective: Obesity has emerged as a major public health problem around the globe. Pre-pregnancy obesity and excessive gestational weight gain will increase the risk of adverse pregnancy outcomes and increase the subsequent risk of metabolic disorders and complications. The main purpose of this study is to determine the relationship between pre-pregnancy body mass index (BMI), gestational weight gain to the gestational diabetes (GDM) and birth outcome. Moreover to determine the relationship of pre-pregnancy BMI, gestational weight gain to the postpartum weights retention. Methods: In this purposive sampling maternal cohort study, we recruit pregnant women, who are over, at the obstetrical and gynecological prenatal care clinic in the southern Taiwan. After 29 weeks of pregnancy, eligible pregnant women data were collected during their prenatal visit which included maternal socio-economic data, reproductive history, pre-pregnancy posture, pregnancy eating behavior, and lifestyle data. Moreover, a month after child birth we will review the result of their pregnancy glucose tolerance test, the production and post-natal special complications, neonatal birth outcomes, giving birth and postpartum weight record. Result: A total of 191 agreed to participate, the average maternal age was 31.3±4.7 years, mean prepregnancy BMI was 22.7±3.8 kg/m2、total gestational weight gain11.7±4.4kg,1 month postpartum weight retention3.3±4.2kg. Our study found that pregnant women with GDM had higher BMI compared with women with normal blood sugar. Weight gain in early pregnancy, total gestational weight gain and postpartum weight retention showed a positive correlation (p <0.01). One way ANOVA of variance showed pre-pregnancy overweight women had a lower total pregnancy weight gain (10.5 vs. 13.7 kg, 10.5 vs. 11.8 kg respectively, p <0.05) and postpartum weight retention (1.8 vs. 5.7 kg, 1.8 vs. 3.4 kg respectively, p <0.05) than pre-pregnancy underweight and normal women. A positive relationship showed that higher than the recommended amount of weight gain during pregnancy lead to higher postpartum weight retention either based on IOM’s recommendation or Taiwan’s recommendation. Multiple regression analysis of weight retention to factors of pregnancy weight status showed that total gestational weight gain is the most important contributor to postpartum weight retention. (R2=0.68, p<0.01), pre-pregnancy BMI had a significant but negative correlation to postpartum weight retention. High frequency eating out of pregnancy had significant higher total gestational weight gain (p <0.01) and postpartum weight retention (p <0.05) than women who eating at home. Up to 70.3% of women had sugary drinks habit during pregnancy might also contributed to a higher pregnancy weight gain in this study. Conclusion: The results indicate pre-pregnancy BMI and appropriate weight gain during pregnancy is significant control point to prevent GDM and postpartum weight retention. Pre and pregnancy Lifestyle and dietary habits, as well as promoting nutrition education intervention is necessary to maternal and child’s long-term health.
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