Fetomaternal outcome in overweight and obese pregnant women in tertiary care hospital in Northeast India
DOI:
https://doi.org/10.18203/2320-1770.ijrcog20251572Keywords:
Fetal outcome, Maternal outcome, Obese womenAbstract
Background: The global prevalence of overweight and obesity in 2014 was 39% and 13% respectively. Underweight is defined as BMI less than 18.5, normal weight as BMI from 18.5 to 24.9, overweight from 25 to 29.5 and obese as BMI of 30 or greater. Obesity is critically important to maternal and fetal health during the perinatal period. Obesity increases the risks of gestational diabetes mellitus, overt diabetes, pregnancy induced hypertension including gestational hypertension, pre-eclampsia, eclampsia, thrombo-embolic phenomena, infections, miscarriage.
Methods: A prospective cohort study was carried out in the Department of Obstetrics and Gynaecology, RIMS, Imphal, Manipur for duration of two years beginning from July, 2019 to August, 2021. Consecutive sampling method was followed to include 38 cases and 38 controls and analysis was done.
Results: Comparison of pre-eclampsia among the study groups showed 8 (21.1%) of exposed group and 1 (2.6%) of the non-exposed group developed preeclampsia. The association between overweight and obesity with GDM. 9 (23.7%) of overweight and obese women while 1 (2.6%) of non-obese women developed GDM. The distribution of neonates requiring neonatal resuscitation among the two study groups showed that 14 (36.84%) of neonates born by overweight and obese women required resuscitation as against 5 (13.16%) of neonates born by non-obese women.
Conclusions: It was evident from the study that maternal obesity has adverse maternal and fetal outcomes. Maternal obesity was strongly associated with antenatal complications like gestational diabetes mellitus, preeclampsia and increase in need for newborn resuscitation.
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References
Lim J, Han K, Ki SY, Chod YH, Yoone YS, Park HS, et al. Effects of central obesity on maternal complications in Korean women of reproductive age. Obes Res Clin Pract. 2019;13(2):156-63. DOI: https://doi.org/10.1016/j.orcp.2019.03.004
Flegal KM, Kit BK, Graubard BI. Overweight, obesity and all-cause mortality. J Am Med Assoc. 2013;309(16):1681-2. DOI: https://doi.org/10.1001/jama.2013.3101
Awan S, Bibi S, Makhdoom A, Farooq S, Sm T, Qazi RA. Adverse fetomaternal outcome among pregnant overweight women. Pak J of Med Sci. 2015;31(2):383. DOI: https://doi.org/10.12669/pjms.312.6530
Lu GC, Rouse DJ, Dubard M, Cliver S, Kimberlin D, Hauth JC. The effect of the increasing prevalence of maternal obesity on perinatal morbidity. Am J Obstet Gynecol. 2001;185(4):845-9. DOI: https://doi.org/10.1067/mob.2001.117351
Ali BS, Janghorbani M. Epidemiology of preeclampsia in pregnant women referred to Shahid Bahonar Hospital of Kerman in 1994. J Kerman Univ Med Sci. 1996;4(1):20-5.
Yogev Y, Visser GH. Obesity, gestational diabetes and pregnancy outcome. Semin Fetal Neonatal Med. 2009;14:77-84. DOI: https://doi.org/10.1016/j.siny.2008.09.002
O’Brien TE, Ray JG, Chan WS. Maternal body mass index and the risk of preeclampsia: a systematic overview. Epidemiology. 2003;14:368-74. DOI: https://doi.org/10.1097/01.EDE.0000059921.71494.D1
Torloni MR, Betran AP, Horta BL, Nakamura MU, Atallah AN, Moron AF, et al. Pre pregnancy BMI and the risk of gestational diabetes: a systematic review of the literature with meta-analysis. Obes Rev. 2009;10(2):194-203. DOI: https://doi.org/10.1111/j.1467-789X.2008.00541.x
Iyoke CA, Ugwu GO, Ezugwu FO, Lawani OL, Onyebuchi AK. Retrospective cohort study of the effects of obesity in early pregnancy on maternal weight gain and obstetric outcomes in an obstetric population in Africa. Int J Women’s Health. 2013;5:501. DOI: https://doi.org/10.2147/IJWH.S49909
Lashen H, Fear K, Sturdee DW. Obesity is associated with increased risk of first trimester and recurrent miscarriage: matched case-control study. Hum Reprod. 2004;19(7):1644-6. DOI: https://doi.org/10.1093/humrep/deh277
Lewandowska M, Wieckowska B, Sajdak S. Pre-pregnancy obesity, excessive gestational weight gain and the risk of pregnancy-induced hypertension and gestational diabetes mellitus. J Clin Med. 2020;9(6):1980. DOI: https://doi.org/10.3390/jcm9061980
Kutchi I, Chellammal P, Akila A. Maternal Obesity and Pregnancy Outcome: in perspective of New Asian Indian Guidelines. J Obstet Gynecol India. 2020;13:1-7. DOI: https://doi.org/10.1007/s13224-019-01301-8
Khuhro BN, Hussain R. Effects of high body mass index on fetomaternal outcome. Pak J Med Dent 2013;1(1):12-20.
Tosson MM, Alhussaini TK. The impact of maternal obesity on pregnancy outcome at Assiut University Hospital. Ass Univ Bull Environ Res. 2005;8(2):1-1. DOI: https://doi.org/10.21608/auber.2005.150554
Mandal D, Manda S, Rakshi A, Dey RP, Biswas SC, Banerjee A. Maternal obesity and pregnancy outcome: a prospective analysis. J Assoc of Physicians India. 2011;59:486-9.
Gutierrez GR, Ortiz FJ, de Leon AL, Amador N. Maternal and fetal morbidity in obese pregnant women. Ginecol Obstet Mex. 2006;74(9):483-7.
Avci ME, Sanlikan F, Celik M, Avci A, Kocaer M, Gocmen A. Effects of Maternal Obesity on antenatal, perinatal and neonatal Outcomes. J Matern-Fetal Neonatal Med. 2015;28(17):2080-3. DOI: https://doi.org/10.3109/14767058.2014.978279
Michlin R, Oettinger M, Odeh M, Khoury S, Ophir E, Barak M et al. Maternal obesity and pregnancy outcome. Isr Med Assoc J. 2000;2(1):10-3.
Sheiner E, Levy A, Menes TS, Silverberg D, Katz M, Mazor M. Maternal obesity as an independent risk factor for caesarean delivery. Paediatr Perinat Epidemiol. 2004;18(3):196-201. DOI: https://doi.org/10.1111/j.1365-3016.2004.00557.x
Burstein E, Levy A, Mazor M, Wiznitzer A, Sheiner E. Pregnancy outcome among obese women: a prospective study. Am J Perinatol. 2008;25(9):561- 6. DOI: https://doi.org/10.1055/s-0028-1085623