Haemodynamic and impedenzometric profile in low-risk pregnant women at term with excessive gestational weight gain: a pilot study

Objective. We showed that excessive GWG (eGWG) as­sociates with adverse outcomes among low-risk pregnan­cies, similarly to women with excessive pregestational BMI (epBMI). Yet, the underlying mechanisms are still unclarified. We hypothesized that abnormalities in hae­modynamics and body composition could play a poten­tial role.
Materials and Methods. A prospective cohort study in­cluding women with a singleton, low-risk gestation at term (11/2021-3/2023). Maternal haemodynamics and body composition were evaluated by USCOM-1A and im­pedance balance Inbody 270. GWG was defined according to 2009 NAM guideline. Women with normal pBMI (npB­MI 18.5-24.9 Kg/m2) and adequate (aGWG) or excessive GWG (eGWG) were considered. Also, we included women with epBMI (≥ 25 Kg/m2) and eGWG (epBMI/GWG).
Results. We enrolled 147 npBMI women: 88 aGWG and 59 eGWG. Twenty-four patients showed epBMI/GWG. Gestation­al age at enrollment was 38-41 weeks. As compared to aGWG, women with eGWG showed higher SV and CO MoM (0.67 ver­sus 0.60, p = 0.004; 0.72 versus 0.63, p = 0.001), with values sim­ilar to epBMI/GWG patients (0.72, p = 0.354 for SV; 0.74, p = 0.319 for CO). Body composition assessment showed similarly higher TBW levels in eGWG and epBMI/GWG versus aGWG (38.5 and 37.8 versus 35.3 L, p < 0.001). Also, abdominal fat mass % and visceral fat levels were increased in eGWG versus aGWG (253 versus 215%, p < 0.001; 12 versus 10, p < 0.001).
Conclusions. Low-risk, term pregnant women with npBMI and eGWG display haemodynamic and impedenzometric features that resemble those observed in women with epBMI/ GWG. This could represent a mechanism underlying the risk of adverse outcomes, thus deserving further exploration.