Maternal and perinatal outcomes in obese versus non-obese pregnant women at a tertiary care hospital in western India: a prospective comparative study
DOI:
https://doi.org/10.18203/2320-1770.ijrcog20262111Keywords:
Body mass index, Caesarean section, Gestational diabetes mellitus, Hypertensive disorders of pregnancy, Maternal obesity, Perinatal outcomesAbstract
Background: Maternal obesity is increasing worldwide and in India and is associated with adverse pregnancy outcomes. This study compared maternal and perinatal outcomes in obese (body mass index ≥25 kg/m²) and non-obese (body mass index 18.5–24.9 kg/m²) pregnant women in a tertiary care hospital using Indian BMI cut-offs.
Methods: A prospective comparative analytical study was conducted in the Department of Obstetrics and Gynaecology, Krishna Institute of Medical Sciences, Karad, Maharashtra. A total of 204 women were enrolled and equally allocated to an obese group (n=102) and a non-obese group (n=102). Maternal outcomes included hypertensive disorders of pregnancy (HDP), gestational diabetes mellitus (GDM), mode of delivery, postpartum haemorrhage (PPH) and wound infection. Perinatal outcomes included preterm birth, birth weight, Apgar scores and neonatal intensive care unit (NICU) admission. Data were analysed using Chi-square test, Fisher’s exact test and Student’s t-test, with p<0.05 considered statistically significant.
Results: Obese women had higher rates of pregnancy-induced hypertension (25.5% vs 7.8%), eclampsia (3.9% vs 0%), GDM (29.4% vs 0%), lower-segment caesarean section (51.0% vs 37.3%), PPH (15.7% vs 3.9%) and preterm delivery (23.5% vs 11.8%). Neonates of obese mothers more often had macrosomia (17.6% vs 0%), low Apgar score at 1 minute (25.5% vs 13.7%) and 5 minutes (11.8% vs 3.9%), and NICU admission (41.2% vs 13.7%).
Conclusions: Maternal obesity defined by Indian BMI cut-offs is associated with markedly increased risks of GDM, HDP, operative delivery, PPH, macrosomia and NICU admission, supporting targeted preconception counselling and intensified antenatal surveillance in obese women.
Metrics
References
World Health Organization. Obesity and overweight, 2025. Available at: https://www.who.int/news-room/fact-sheets/detail/obesity-and-overweight. Accessed 12 Feb 2026.
Kent L, McGirr M, Eastwood KA. Global trends in prevalence of maternal overweight and obesity: a systematic review and meta-analysis of routinely collected data retrospective cohorts. Int J Popul Data Sci. 2024;9(2):2401. DOI: https://doi.org/10.23889/ijpds.v9i2.2401
Chakrabarty M, Let S. Spatial clustering of overweight/obesity among women in India: insights from the latest National Family Health Survey. PLoS One. 2024;19(7):e0305205. DOI: https://doi.org/10.1371/journal.pone.0305205
Singh A, Karun S, Chakrabarty M, Verma M, Esht V, Alshehri MM, et al. Trends and determinants of obesity among ever-married women aged 15-49 in India: insights from National Family Health Surveys (NFHS 1998-2021). BMC Publ Heal. 2025;25:480. DOI: https://doi.org/10.1186/s12889-025-21635-5
Ahmed B, Konje JC. The epidemiology of obesity in reproduction. Best Pract Res Clin Obstet Gynaecol. 2023;89:102342. DOI: https://doi.org/10.1016/j.bpobgyn.2023.102342
Gerede A, Danavasi M, Stavros S, Papadopoulos A, Nikolaou E, Petrou P, et al. Obesity and pregnancy: impact on childbirth timing, delivery mode, and maternal recovery: an update. Med Sci. 2025;13(3):182. DOI: https://doi.org/10.3390/medsci13030182
Kalantari E, Tajvar M, Naderimagham S, Yamrali M, Hekmat N, Ghasemian A, et al. Maternal obesity management: a narrative literature review of health policies. BMC Womens Health. 2024;24(1):520. DOI: https://doi.org/10.1186/s12905-024-03342-2
Mackeen AD, Boyd VE, Schuster M, Badell ML, McNeeley SG, Hughes BL. The impact of pre-pregnancy body mass index on pregnancy and neonatal outcomes. J Osteopath Med. 2024;124(10):447-53. DOI: https://doi.org/10.1515/jom-2024-0025
Almutairi FS, Alsaykhan AM, Almatrood AA, Almudaiheem FA, Almuqbil BY, Alshammari MA, et al. Obesity prevalence and its impact on maternal and neonatal outcomes in pregnant women: a systematic review. Cureus. 2024;16(12):e75262. DOI: https://doi.org/10.7759/cureus.75262
Froń A, Tomecka P, Orczyk-Pawiłowicz M. Impact of maternal overweight and obesity on adipokines during pregnancy and lactation. Int J Mol Sci. 2025;26(19):9757. DOI: https://doi.org/10.3390/ijms26199757
Valencia-Ortega J, González-Reynoso R, Ramos-Martínez EG, Minegishi S, Higa R, Martínez-Hernández MG, et al. New insights into adipokines in gestational diabetes mellitus. Int J Mol Sci. 2022;23(11):6279. DOI: https://doi.org/10.3390/ijms23116279
Sharma AK, Singh S, Singh H, Kumar A, Verma A, Yadav P, et al. Deep insight of the pathophysiology of gestational diabetes mellitus. Cells. 2022;11(17):2672. DOI: https://doi.org/10.3390/cells11172672
Chen J, Zhu Y, Liu J, Wang R, Li X, Zhang Y, et al. Interaction between maternal obesity and metabolic dysfunction in gestational hypertension and preeclampsia: a prospective birth cohort study. J Clin Hypertens. 2026;28(1):e70205. DOI: https://doi.org/10.1111/jch.70205
Zhang Y, Lu M, Yi Y, Li H, Wang Q, Sun J, et al. Influence of maternal body mass index on pregnancy complications and outcomes: a systematic review and meta-analysis. Front Endocrinol (Lausanne). 2024;15:1280692. DOI: https://doi.org/10.3389/fendo.2024.1280692
Pandit K, Goswami S, Ghosh S, Mukhopadhyay P, Chowdhury S. Metabolic syndrome in South Asians. Indian J Endocrinol Metab. 2012;16(1):44-55. DOI: https://doi.org/10.4103/2230-8210.91187
Kalra S, Kapoor N, Verma M, Das AK, Baruah MP, Sahay R, et al. Defining and diagnosing obesity in India: a call for advocacy and action. J Obes. 2023;2023:4178121. DOI: https://doi.org/10.1155/2023/4178121
Dash KK, Burman J, Bala B, Panda SK, Chakraborty R, Sahoo B, et al. A prospective observational study on maternal and foetal outcomes among primigravid women with high body mass index in a tertiary care hospital in West Bengal. Cureus. 2026;18(1):e102141. DOI: https://doi.org/10.7759/cureus.102141
Kutchi I, Chellammal P, Akila A. Maternal obesity and pregnancy outcome: in perspective of new Asian Indian guidelines. J Obstet Gynaecol India. 2020;70(2):138-44. DOI: https://doi.org/10.1007/s13224-019-01301-8
Verma M, Esht V, Alshehri MM, Borah P, Kumari R, Meena N, et al. Factors contributing to the change in overweight/obesity prevalence among Indian adults: a multivariate decomposition analysis of data from the National Family Health Surveys. Adv Ther. 2023;40(12):5222-42. DOI: https://doi.org/10.1007/s12325-023-02670-3
Massalha M, Iskander R, Hassan H, Abusbaih A, Abu Fanne R, Badran S, et al. Gestational diabetes mellitus -more than the eye can see-a warning sign for future maternal health with transgenerational impact. Front Clin Diabetes Healthc. 2025;6:1527076. DOI: https://doi.org/10.3389/fcdhc.2025.1527076
Lourenço J, Guedes-Martins L. Pathophysiology of maternal obesity and hypertension in pregnancy. J Cardiovasc Dev Dis. 2025;12(3):91. DOI: https://doi.org/10.3390/jcdd12030091
Nikolova Z, Sandeva M, Uchikova E, Popova M, Ivanova A, Dimitrova M, et al. Impact of maternal overweight and obesity on pregnancy outcomes following cesarean delivery: a retrospective cohort study. Healthcare (Basel). 2025;13(15):1893. DOI: https://doi.org/10.3390/healthcare13151893
Ismail N, Ismail MF. Maternal obesity and obstetric anesthesia: a comprehensive review of challenges and clinical strategies. Asian J Med Health. 2025;23(3):105-11. DOI: https://doi.org/10.9734/ajmah/2025/v23i31193
Gudipally M, Farooq F, Basany K, Dhanalakshmi D, Kancherla S, Jalajakshi P, et al. Impact of pre-pregnancy body mass index on adverse pregnancy outcomes: analysis from the Longitudinal Indian Family hEalth cohort study. AJOG Glob Rep. 2022;3(1):100134. DOI: https://doi.org/10.1016/j.xagr.2022.100134
Whitley J, Dazelle W, Kripalani S, May R, Johnson T, Brown A, et al. The association between body mass index and postpartum hemorrhage after cesarean delivery. Sci Rep. 2023;13(1):11998. DOI: https://doi.org/10.1038/s41598-023-38526-7
Chandrasekaran S, N U, Barathi A, Raghuraman S, Kumari S, Nair R, et al. Impact of pre-pregnancy BMI and gestational weight gain on fetomaternal outcomes: a cross-sectional analytical study. Cureus. 2026;18(3):e104941. DOI: https://doi.org/10.7759/cureus.104941
Fyfe EM, Thompson JM, Anderson NH, Groom KM, McCowan LM, Stone PR. Maternal obesity and postpartum haemorrhage after vaginal and caesarean delivery among nulliparous women at term: a retrospective cohort study. BMC Pregnancy Childbirth. 2012;12:112. DOI: https://doi.org/10.1186/1471-2393-12-112
Ramonienė G, Malakauskienė L, Savukynė E, Lesauskaitė V, Beržanskytė A, Ramašauskaitė D, et al. Pregnancy complications and outcomes in obese women with gestational diabetes. Medicina (Kaunas). 2025;61(1):51. DOI: https://doi.org/10.3390/medicina61010051
Neal K, Ullah S, Glastras SJ. Obesity class impacts adverse maternal and neonatal outcomes independent of diabetes. Front Endocrinol (Lausanne). 2022;13:832678. DOI: https://doi.org/10.3389/fendo.2022.832678
Downloads
Published
How to Cite
Issue
Section
