Adverse Pregnancy Outcomes in Overweight and Obese Pregnant Women in a Tertiary Care Center of Western Nepal: A Prospective Cohort Study

Keywords: Body mass index, Obesity, Overweight, Pregnancy outcomes

Abstract

Introduction: Maternal obesity is an established risk factor for various adverse pregnancy outcomes. Increased chances of labour induction, prolonged labour, instrumental and cesarean deliveries, medical disorders of pregnancy, post partum haemorrhage, preterm deliveries, macrosomia, low Apgar score etc. are well recognised risks of maternal obesity. This study aimed to evaluate these maternal and fetal outcomes in relation to the body mass index (BMI) of parturients.  Methods: A prospective cohort study involving 115 overweight and obese women was conducted. Various maternal and fetal outcomes were studied and compared with those of 115 postpartum women with normal BMI. Statistical analysis was done using student's t-test and Chi square test. Binomial logistic regression analysis was carried out to examine the magnitude and significance of the independent effect of BMI. Results: The three groups were comparable in terms of maternal age and gestational age at delivery. The total blood loss was significantly higher in the obese group as compared to the normal BMI (p=0.001) or overweight groups (p=0.005). Vaginal delivery was 69% less common in obese group in comparison to normal BMI group. The prevalence of meconium stained liquor, labour induction, preterm labour, and admission to neonatal intensive care unit were not significantly different across the three groups. Conclusion: This study highlighted the increased risk of total blood loss and birth weight >3500 grams with increasing BMI of pregnant women. A multicentric prospective study with larger sample size would shed further light on the strength of association between maternal BMI and various outcomes.

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Author Biographies

Deepak Shrestha, Lumbini Medical College and Teaching Hospital

Assistant Professor,

Department of Obstetrics and Gynecology.

Kritina Singh, Lumbini Medical College and Teaching Hospital

Lecturer,

Department of Obstetrics and Gynaecology.

Shreyashi Aryal, Lumbini Medical College and Teaching Hospital

Associate Professor,

Department of Obstetrics and Gynaecology.

References

World Health Organization. Obesity and Overweight [Internet]. Geneva, Switzerland: WHO, 2021. [Accessed on 15 Oct 2021] Available from: https://www.who.int/news-room/fact-sheets/detail/obesity-and-overweight

Swinburn BA, Sacks G, Hall KD, McPherson K, Finegood DT, Moodie ML, et al. The global obesity pandemic: Shaped by global drivers and local environments. Lancet. 2011;378(9793):804-14. PMID: 21872749 DOI: https://doi.org/10.1016/S0140-6736(11)60813-1

Ministry of Health Nepal, New ERA, ICF. Nepal Demographic and Health Survey 2016 [Internet]. Kathmandu, Nepal: Ministry of Health, 2017. [Accessed on 14 Oct 2021] Available from: https://www.dhsprogram.com/pubs/pdf/fr336/fr336.pdf

Usha Kira 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. PMID: 15924535 DOI: https://doi.org/10.1111/j.1471-0528.2004.00546.x

Schrauwers C, Dekkra G. Maternal and perinatal outcome in obese pregnant patients. J Matern Fetal Neonatal Med. 2009;22(3):218-26. PMID: 19330705 DOI: https://pubmed.ncbi.nlm.nih.gov/19330705/

Manzanares SG, Santallaa HA, Vicoa ZI, Criadoa MSL, Pineda LA, Galloa VJL. Abnormal maternal body mass index and obstetric and neonatal outcome. J Matern Fetal Neonatal Med. 2012;25(3):308-12. PMID: 21615231 DOI: https://doi.org/10.3109/14767058.2011.575905

Nohr EA, Vaeth M, Baker JL, Sørensen TIa, Olsen J, Rasmussen KM. Combined association of prepregnancy body mass index and gestational weight gain with the outcome of pregnancy. Am J Clin Nutr. 2008;87(6):1750-9. PMID: 18541565 DOI: https://doi.org/10.1093/ajcn/87.6.1750

Tenant PWG, Rankin J, Bell R. Maternal body mass index and the risk of fetal and infant death: a cohort study from the North of England. Hum Reprod. 2011;26(6):1501-11. PMID: 21467206 DOI: https://doi.org/10.1093/humrep/der052

Persson M, Johansson S, Villamor E, Cnattingius S. Maternal overweight and obesity and risks of severe birth-asphyxia-related complications in term infants: a population-based cohort Study in Sweden. PLoS Med. 2014;11(5):e1001648. PMID: 24845218 DOI: https://doi.org/10.1371/journal.pmed.1001648

Ojha N. Pregnancy outcome in overweight and obese mothers at a tertiary care hospital. Journal of Institute of Medicine. 2016;38(2/3):56-62. Available from:

World Health Organization. Obesity: Preventing and managing the global epidemic. Geneva, Switzerland: World Health Organization. Report number: WHO Technical Report Series 894, 2000. Available from: https://apps.who.int/iris/handle/10665/42330

O’Dwyer V, O’Kelly S, Monaghan B, Rowan A, Farah N, Turner MJ, et al. Maternal obesity and induction of labor. Acta Obstet Gynecol Scand. 2013;92(12):1414-8. PMID: 24116732 DOI: https://doi.org/10.1111/aogs.12263

Vinturache AE, McDonald S, Slater D, Tough S. Perinatal outcomes of maternal overweight and obesity in term infants: a population-based cohort study in Canada. 2015;5(0):9334. PMID: 25791339 DOI: https://doi.org/10.1038/srep09334

Published
2022-01-12
How to Cite
1.
Shrestha D, Singh K, Aryal S. Adverse Pregnancy Outcomes in Overweight and Obese Pregnant Women in a Tertiary Care Center of Western Nepal: A Prospective Cohort Study. J Lumbini Med Coll [Internet]. 12Jan.2022 [cited 22May2022];9(2):5 pages. Available from: https://jlmc.edu.np/index.php/JLMC/article/view/459
Section
Original Research Article