DOI: http://dx.doi.org/10.18203/2320-1770.ijrcog20210729

The impact of high maternal body mass index on obstetric and perinatal outcomes

Natasha Sharma, Manasi Patnaik

Abstract


Background: The incidence of obesity has increased to pandemic proportions over the last 20 years. Maternal obesity is associated with a wide array of adverse maternal pregnancy outcomes and increased risks in the offspring. The aim of the study was to find the effect of obesity on maternal and perinatal outcome in obese women in comparison to those of normal weight women.

Methods: The study was designed as a case-control study. Antenatal women with first trimester body mass index (BMI) of more than 30 kg/m2 constituted the cases and those with BMI between 18 and 24.9 kg/m2 formed the controls.

Results: There was increased incidence of antepartum complications in obese women. Obese women had a significant history of prior treatment for infertility (p<0.00001). The incidence of gestational diabetes (OR 4.76, 95%CI 1.267-17.72 p=0.014), gestational hypertension (OR 3.05, 95%CI 1.01-9.20 p=0.04), induction of labor (OR 2.5, 95%CI 1.0-6.28 p=0.04), preeclampsia (OR 2.38, 95%CI 1.0-5.64 p=0.04, Caesarean section (OR 1.98, 95%CI 1.24-3.14 p=0.003), postpartum haemorrhage (OR 8.57, 95%CI 1.07-76.15 p=0.04) and wound infection (OR 8.57, 95%CI 1.07-76.15 p=0.04) and adverse neonatal outcomes such as higher mean birth weight (p<0.0001) and requirement of NICU (OR 2.79, 95%CI 1.33 -5.84 p=0.006) was higher in obese women.

Conclusions: Obesity is an independent risk factor for adverse pregnancy outcomes and hence, interventions directed towards weight loss and prevention of excessive weight gain must begin in the preconception period.

 


Keywords


Body mass index, Maternal outcome, Obesity, Perinatal outcome

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References


Flier JS, Maratos-Flier E. Biology of Obesity. In: Fauci, Braunwald, Kasper, Hauser, Longo, Jameson, Loscalzo. Harrison’s Principles of Internal Medicine. 17th ed. New York: McGraw-Hill;2008:463.

WHO. Obesity and overweight, 2020. Available from: https://www.who.int/news-room/fact-sheets/detail/obesity-and-overweight. Accessed at 28 December 2020.

National Family Health Survey-4: 2015-16. Ministry of Health and Family Welfare, Government of India. Available at: http://rchiips.org/nfhs/NFHS-4Reports/India.pdf. Accessed at 28 December 2020.

Cunningham FG, Leveno KJ, Bloom SL, Hauth JC, Rouse DJ, Spong CY. Williams Obstetrics. 23rd ed. McGraw-Hill;2010:946.

Rowlands I, Graves N, de Jersey S, McIntyre HD, Callaway L. Obesity in pregnancy: outcomes and economics. Semin Fetal Neonatal Med. 2010;15(2):94-9.

Dennedy MC, Dune F. The maternal and fetal impacts of obesity and gestational diabetes on pregnancy outcome. Best Pract Res Clin Endocrinol Metabol. 2010;24:573-89.

Alves P, Malheiro MF, Gomes JC, Ferraz T, Montenegro N. Risks of Maternal Obesity in Pregnancy: A Case-control Study in a Portuguese Obstetrical Population. Rev Bras Ginecol Obstet. 2019;41(12 ):682-7.

Vellanki VS, Kocherlakota VL, Kaul R. High body mass index in pregnancy, its effects on maternal and fetal outcome. J Clin Gynecol Obst. 2012;1(1):15-8.

Green BB, Weiss NS, Daling JR. Risk of ovulatory infertility in relation to body weight. Fertil Steril. 1988;50:721-6.

Rich-Edwards JW, Goldman MB, Willett WC, Hunter DJ, Stampfer MJ, Colditz GA, Manson JE. Adolescent body mass index and infertility caused by ovulatory disorder. Am J Obstet Gynecol. 1994;171:171-7.

Grodstein F, Goldman M, Camer DE. Body mass index and ovulatory infertility. Epidemiol. 1994:5:247-50.

Ovesen P, Rasmussen S, Kesmodel U. Effect of Prepregnancy Maternal Overweight and Obesity on Pregnancy Outcome. Obstet Gynecol. 2011;118:305-12.

Chu SY, Callaghan WM, Kim SY, Schmid CH, Lau J, England LJ, et al. Maternal Obesity and Risk of Gestational Diabetes Mellitus. Diabet Care. 2007;30(8):2070-6.

Yogev Y, Visser GHA. Obesity, gestational diabetes and pregnancy outcome. Semin Fetal Neonatal Med. 2009;14(2):77-84.

Leddy MA, Power ML, Schulkin J. The impact of maternal obesity on maternal and fetal health. Rev Obstet Gynecol. 2008;1(4):170-8.

Dave A, Maru L, Daksha S, Natu N. Weight does Matter! A Study of Effect of Obesity on Pregnancy and its Outcome. J SAFOG. 2013;5:107-10.

Kumari P, Gupta M, Kahlon P, Malviya S. Association between high maternal body mass index and feto-maternal outcome. J Obes Metab Res. 2014;3:143–4.

Scott-Pillai R, Spence D, Cardwell C, Hunter A, Holmes V. The impact of body mass index on maternal and neonatal outcomes: a retrospective study in a UK obstetric population, 2004-2011. BJOG Int J Obstet Gynaecol. 2013;120(8):932-9.

Ramonienė G, Maleckienė L, Nadišauskienė RJ, Bartusevičienė E, Railaitė DR, Mačiulevičienė R, et al. Maternal obesity and obstetric outcomes in a tertiary referral center. Medicina. 2017;53(2):109-13.

Wahabi HA, Fayed AA, Alzeidan RA, Mandil AA. The independent effects of maternal obesity and gestational diabetes on the pregnancy outcomes. BMC Endocrine Disorders. 2014;14(1):47.

Sebire NJ, Jolly M, Harris JP, Wadsworth J, Joffe M, Beard RW, et al. Maternal obesity and pregnancy outcome: a study of 287 213 pregnancies in London. Int J Obesity. 2001;25(8):1175.

Usha Kiran TS, Hemmadi S, Bethel J, Evans J. Outcome of pregnancy in a woman with an increased body mass index. BJOG. 2005;112(6):768-72.

Vasudevan C, Renfrew M, McGuire W. Fetal and perinatal consequences of maternal obesity. Arch Dis Child Fetal Neonatal Ed. 2011;96(5):F378-82.