Fetal Growth Disorders and Influence of Maternal Adiposity

Abstract

Introduction: Infant birth weight is recognized as the leading indicator of health among infants and affects a wide range of subsequent outcomes later in life. The incidence of neonates with high birth weight has increased in recent years. Many studies in the past have revealed that high birth weight is associated with neonatal morbidity and mortality and associated with complications in later life. These complications include shoulder dystocia, birth trauma, asphyxia, and neonatal deaths. In the later life these neonates have high risk for obesity, hypertension, diabetes mellitus and cancer. High pre-pregnancy body mass index (BMI) has been reported as a well-established risk factors for adverse pregnancy outcomes. Despite the high prevalence of maternal obesity in the gulf region, only a few studies in this regard have been published. Methods: A retrospective service evaluation was conducted at a secondary hospital to evaluate the effect of pre-pregnancy BMI on neonatal birth weight. 950 women were randomly selected from women delivered at or more than 37 weeks gestation and grouped on the basis of pregnancy BMI as group A-BMI 18.5–24.9 kg/m2, group-B- BMI 25–29.9 kg/m2 and group C-BMI >30 kg/m2. Infants were grouped according to birth weight as low birth weight(<2500 g), normal birth weight (2500–3999 g), and high birth weight >4000g and correlation was studied with maternal body mass index. Chi square test was used for statistical evaluation using Medcal online software. Results: In the study group, 34.43% women had normal body mass index, 37.21 % women were overweight and 28.36 % were obese. In group A, 6.50% and 4.64 % infants were with low and high birth weight, respectively. In group B, 4.3% and 5.73 % were with low and high birth weight, respectively. In group C, 4.51% and 20.33 % infants were with low and high birth weight, respectively. In comparison to women with normal BMI, low birth weight infants in group B (OR-0.922, 95% CI- 0.327–1.275) and group C (OR- 0.679, 95% CI-0.682–1.572) were not statistically significant. High birth weight infants in group B (OR- 1.2482, 95% CI- 0.3270 to 1.2756, p = 0.2080) and group C (OR-5.230, 95% CI-2.875–9.512, p= < 0.0001) were positively correlated with pre-pregnancy BMI. Pre-pregnancy overweight and obesity increased the risk of high birth weight (OR- 1.248 and 5.230 respectively). The results were statistically significant in obese women (p=< 0.0001). Conclusion: Women with pre-pregnancy overweight and obesity have higher likelihood of high birth weight in infants. Pre-pregnancy weight loss is the key to reduce maternal and fetal complications. Early pregnancy booking and antenatal fetal surveillance is recommended for all women with high body mass index.